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Ariz. State Hospital developing new plan

Fear of sanctions prompts revision

Susie Steckner and Jodie Snyder
The Arizona Republic
Aug. 7, 2004 12:00 AM

Seriously mentally ill patients at the Arizona State Hospital will receive more individual attention under a plan outlined Friday to avoid federal sanctions.

Hospital officials are rewriting treatment plans for about 140 civilly committed patients. State officials believe those rewrites and other policy changes will be accepted by the Centers for Medicare and Medicaid Services.

In a written statement, Gov. Janet Napolitano said, "Every step is being taken to correct these deficiencies as soon as possible."

Federal officials last month rejected the state's first plan. If the second is not approved, the hospital could lose its Medicare certification and as much as $2.7 million in federal payments. Federal officials could also pull $28 million in funding for Arizona hospitals.

A surprise review of the hospital, at 24th and Van Buren streets, found patients wandering around instead of getting treatment. Patients were also handcuffed, which is a federal violation, and put into seclusion for unnecessarily long periods of time.

The hospital now does not use handcuffs and has changed its seclusion policy.

Nursing staff will now escort patients to activities. There will be internal audits to make sure treatment plans have specific goals.

For instance, a male patient admitted in October partly because he wouldn't take medications will now get a daily prompt to take them.

Under the treatment plan first submitted to reviewers, there was no mention of daily reminders. Instead, a doctor was to talk with him monthly about medication, and a nurse was to speak with him weekly.

Sue Grace, a former lawmaker and longtime mental health advocate, sits on the hospital's advisory board. She was unaware of the results of the Medicare review.

"It's so sad," Grace said.

"It's the age-old, 'What's the role?' " she said. "Is it that the care is bad or is it that maybe state hospitals are a thing of the past? I don't think they are over in the very short run. I still believe that people who are in a very dangerous situation need that last respite."

Reach the reporters at jodie.snyder@arizonarepublic.com or susie.steckner@arizonarepublic.com.