A System Gone Mad

Two agencies were supposed to be taking care of Donald Ellison. Instead, they were missing in action--and the mentally ill Vietnam veteran was left to die on the street.

Donald's relationship with AVSC was never good, and he complained time and again to his family that he was getting ripped off.

"My brother was sick," Mary Howard says, "but he kept telling me [AVSC] was paying for services he wasn't using. I know now he was telling the truth. He lived on the streets far more often than not, and they would go for weeks not knowing where he was."

Records submitted to the Probate Court, which must approve all AVSC expenditures, confirm Donald Ellison's suspicions.

From March 1993 through March 1994, for example, the VA mailed Donald's disability checks totaling $20,892 to AVSC. With that money, AVSC paid itself $1,146 in "conservator's fees," and its attorney, Harold Merkow, another $561.

Also from Donald's account, AVSC paid the Burkeshire Retirement Hotel $620 a month from April to December 1993. It paid Burkeshire an additional $25 a month during that time to do Donald's laundry, and $50 monthly to "monitor" his intake of antipsychotic pills.

At the same time, AVSC also paid Fountain in the Green Apartments $341 monthly to cover Donald's rent. In a July 1993 "annual report" to the Probate Court--the last such report it would file--AVSC listed Donald's address as Fountain in the Green.

Exacerbating this misfeasance was the fact that, according to jail and hospital records, Donald spent much of 1993 in custody of some sort, or on the streets.

AVSC only rarely sought and received refunds from Donald's landlords, and none in 1993. One reason is that the agency automatically pays "vendors" each month before receiving itemized bills.

Months may pass before AVSC gets wind that a client's living situation has changed.

For example, AVSC in November 1995 issued rent checks on Donald's behalf totaling $2,150 to one boarding home and $950 to another home. Donald was in jail or in a mental hospital for all but six days that month.

In another instance, on February 1, 1996, AVSC paid La Fontenelle Guest Lodge $528 to cover a month's lodging for Donald. But Phoenix police jailed Donald on assault and disorderly conduct charges February 5. That day, a court commissioner ordered Donald to the county psych ward as "persistently, acutely disabled." He wouldn't be released for six months.

That didn't stop AVSC from remitting another $650 in rent to La Fontenelle on February 28. (AVSC hasn't yet submitted its final accountings to the Probate Court, and it is not clear when they stopped paying the boarding home.)

Because of large court calendars, jurists must rely on a ward's attorney to raise objections to fiscal or other matters. Records in Donald's case show no instances of his attorney objecting to the agency's accountings.

"In the past, we'd never get notice from the court that AVSC had even filed its accountings," explains Connie Leon, Donald's attorney since 1992. "There was nothing to object to. That's the way it was until Judge Franks changed things a few months ago."

Court commissioner Robert Colosi says he and the other jurists who routinely approved AVSC billings over the years should bear some responsibility.

"It would be easy for me to say we don't have enough time to pore over every bill," he says, "but that's not a good enough excuse. . . . I hope it's not the tip of the iceberg."

A Protected Class
The outlook brightened in the early 1990s for Maricopa County's 10,000-plus seriously mentally ill people--SMIs in health-care vernacular.

Until then, Arizona had ranked at or near the bottom in spending on services for its SMI population.

That changed after 1989's Arizona Supreme Court ruling in the historic lawsuit known as Arnold v. Sarn. In a bold move, the court ordered Arizona lawmakers to start funding programs for SMIs.

Since 1992, the county's SMIs have been treated through ComCare--Community Partnership for Behavioral Health Care--under a contract the agency holds with the state.

As a member of the "protected class" in Arnold v. Sarn, Donald Ellison automatically became a ComCare client, meaning he had two systems designed to look after him--the Arizona Veterans Service Commission and ComCare.

"Of all the vets I have represented, Donald was among the most special," says Connie Leon. "He could be a very enchanting person when he was well, though even on his good days he would talk delusionally. His was a true psychosis induced by his experience in Vietnam. He couldn't help himself."

In March 1989, a car struck Donald as he wandered onto East Van Buren Street one evening. He declined medical treatment for an injured leg.

Days later, he again was involuntarily committed to the Arizona State Hospital. It happened after he turned on the stove in his latest residence--a rickety motel on Van Buren--and piled a stack of wood on his bed.

Doctors at the mental hospital ordered x-rays of Donald's injured leg: It was broken.

His ever-revolving-door--jail, mental hospital, discharge--continued. In 1995, Donald again was incarcerated after he allegedly threatened a Phoenix cop with a knife. That December 6, a judge ordered him to undergo one year of mental treatment--with a maximum of 180 days in a mental ward and the rest prospectively as an outpatient.

Such court-ordered treatment is allowed in Arizona when "a patient is unwilling to accept or incapable of accepting treatment voluntarily."

They could call it the Donald Ellison Law.
A variety of records makes it possible to retrace the last months of Donald's life almost by the hour.

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