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Home / Opinion / Commentary / After 33 years, class-action suit seeking care for the seriously mental ill comes to a successful end

After 33 years, class-action suit seeking care for the seriously mental ill comes to a successful end

Charles "Chick" Arnold

Charles “Chick” Arnold

In 1980, local mental health experts came together to draft what became known as Senate Bill 1057, a proposed statute intended to create a responsive and accessible community-based system for persons with serious mental illness.

Our community, like many others around the country, was being forced to deal with a failed “de-hospitalization” process, and so, this bill sought to address the problem by fixing and specifically defining the state’s responsibility to create a full continuum of community-based care for persons with serious mental illness.

The bill was passed, led by the efforts of the then-Senate Majority Leader Robert Usdane, thus creating the foundation upon which rested the class action lawsuit known as Arnold vs. Sarn.

Over the 33-year life of the lawsuit, class members and the court have gently, and sometimes not so gently, nudged the state of Arizona and Maricopa County into providing a responsive and accessible person-centered behavioral health system, as envisioned by our statute. There were some notable successes spurred on by the lawsuit, such as enrolling in the Title 19 program to provide federal reimbursement for many of the required services, and significant enhancement of peer support and consumer-run services.

But, for the most part, the defendants were unable to live up to the commitments made to the court, to fix deficiencies and comply with regular corrective action plans. On Feb. 27, 2014, the Maricopa County Superior Court approved a settlement agreement in this case, which created an enforceable contract, expressly structured to hold the state of Arizona accountable to provide additional services called for in this agreement. This agreement affirmed the state’s underlying responsibility to follow the mandate of our statute and provided an opportunity for great optimism among those in Arizona’s mental health community.

The settlement agreement and accompanying court order approving that agreement require the state of Arizona to adopt national quality standards set forth by the Substance Abuse and Mental Health Services Administration. The agreement also provides for an annual quality service review to be conducted by an independent contractor. Most importantly, the settlement agreement recognizes the critical importance of stable and secure housing to a person’s recovery. As well, job opportunities must be made available to all class members.

Thus, the agreement adds additional supported housing services, capable of serving 1,200 class members, and adds additional supported employment services capable of serving 750 class members. The agreement also provides for an additional eight assertive community treatment teams, and provides support for consumer-operated and peer-support services capable of serving 1,500 class members.

The opportunity for the settlement agreement was synchronistic, coming as a result of the “perfect storm” created by Arizona’s enactment of the governor’s Medicaid Restoration Plan, the passage of the federal Affordable Care Act, and the increased national attention on mental health issues and the accompanying failure of public mental health systems around the country.

That this settlement agreement coincided with a new Regional Behavioral Health Authority taking over the system in Maricopa County, emphasizing integrated care, helps our system become more responsive and more accessible. And then, this last week, Judge Edward Bassett signed an order officially terminating the litigation, upon the agreement of all the parties to the case that the state of Arizona, and Maricopa County’s Regional Behavioral Health Authority, Mercy-Maricopa, have acted in good faith since the date of the stipulation. As well, the court found that the defendants have used their “best efforts” to assure that the terms of the stipulation are carried out.

Indeed, Arizona’s mental health community continues to feel optimism that the vision of our comprehensive statute, passed in 1980, will be realized. The settlement and resolution of this case is a big deal. As many members of the class have recognized, the ability of the court to enforce its orders seeking to actualize the services anticipated by the statute is limited. Such has been demonstrated over the years through regular and continuing audits conducted by the court monitor, which consistently showed failures on the part of the state to meet the commitments it regularly made to the court and to the citizens of Arizona.

The court process worked – until it didn’t. The authority of the court is limited. Now, it was time for the defendants in the case to embrace the letter and intent of the statute, as well as the court orders, by making them theirs. In so doing, the controversial issue of enforcement by the court is removed.

Thus, the big news about the end of Arnold vs. Sarn is the fact that the state of Arizona has now adopted and embraced all of the tenets of the orders of the court.

This will go a long way toward actualizing the vision of our statutes, and toward helping to assure that Arizona’s community behavioral health system properly serves its members. Chick Arnold is a mental health attorney in Phoenix and, while the Maricopa County public fiduciary, was the primary named plaintiff in the class action lawsuit known as Arnold vs. Sarn.

– Chick Arnold is a mental health attorney in Phoenix and, while the Maricopa County public fiduciary, was the primary named plaintiff in the class action lawsuit known as Arnold vs. Sarn.

One comment

  1. Does this ruling only apply to Maricopa County as the numbers stated in the article seem grossly underestimated …….””Thus, the agreement adds additional supported housing services, capable of serving 1,200 class members, and adds additional supported employment services capable of serving 750 class members. The agreement also provides for an additional eight assertive community treatment teams, and provides support for consumer-operated and peer-support services capable of serving 1,500 class members.”
    Hopefully the entire state will be included.

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