The state hospital has been cited for dietary program deficiencies, says Catherine Eden, director of the Department of Health Services (DHS).

“It’s nothing big,” she said in response to a report received the week of Dec. 13 from the Centers for Medicare and Medicaid, which conducted a complete audit of the hospital this fall.

The federal agency also conducted a special inspection of psychiatric operations at the hospital in May and reported six areas of concern, which have since been corrected.

“We’ve got a clean bill of health” from the May inspection, Ms. Eden said.

She said a full hospital audit in September reported problems with patient weight gain. “On psychotropic drugs, people gain weight,” Ms. Eden said.

Psychotropic drugs, which have an altering effect on perception, emotion or behavior, are used to treat a variety of psychiatric disorders.

Ms. Eden said the hospital has called in specialty consultants to work with medical and other staff on dietary programs, and DHS will notify the Centers for Medicare and Medicaid of corrective actions.

The agency in August approved the hospital’s plan to correct the original deficiencies with comprehensive written treatment plans for civilly committed patients and avoidance of improper seclusion and improper use of physical restraints.

The agency does not oversee treatment of criminal patients.

Ms. Eden said the news media blew the earlier psychiatric inspection out of proportion, adding that the citation for improper use of restraints was a mistake.

“Every time you go into a facility, you find something,” she said. “They found two things on us. We were not making sure some people were going to their therapy.”

Ms. Eden said the Centers for Medicare and Medicaid has apologized for the citation on restraints.

“One of our criminal patients had to be brought to the civil hospital because he had a big toothache,” she said. “He was a flight risk, so we had him shackled. The Medicare observer saw it and wrote it up.

“After they left and the press got a hold of it, they called me and said, ‘We’re so sorry. That isn’t our responsibility. We’re supposed to be minding our own business,’ ” Ms. Eden said.

Health Plan Due

Meanwhile, DHS was due in court Dec. 17 to present a four-year behavioral health plan that the department says has been agreed to by plaintiffs in a 23-year old lawsuit against the state.

Maricopa County Superior Court Judge Pro Tem Bernard Dougherty, who for years has been critical of the state’s efforts to deal with the mentally ill, will have to agree to the plan, which he called for to settle Arnold v. Sarn, a class-action lawsuit filed in 1981.The case was filed by Phoenix attorney Charles Arnold, alleging the state did not fund a comprehensive mental health system in Maricopa County.

Mr. Dougherty ordered the agency in October to prepare a detailed report on how it will comply with court orders to remedy problems cited in a court-ordered audit.

The agreement, details of which were not released, commits the state to “fundamental reform of how mental health services are delivered in Maricopa County and puts mental health consumers and their families at the core of those reforms,” DHS said in a news release.

Mr. Dougherty questioned the state’s $450 million per year, three-year contract with ValueOptions, a large company that was rehired in July to manage and provide mental health services to 50,000 clients, 17,000 of them classified as seriously mentally ill.

DHS Deputy Director Leslie Schwalbe testified before the Senate and House Health Committee of Reference last month about ValueOptions.

“What we learned from our last contract throughout the system was it didn’t have enough teeth in it,” she said. “So, as of July 1, quite frankly, we were able to take a higher level of enforcement on our contractors if they fail to perform.” —