State officials and mental health advocates approved an historic deal Wednesday to provide more services for the seriously mentally ill, bringing an end to a 33-year-old lawsuit.
The agreement sets out what the state must provide to the more than 19,000 individuals in Maricopa County who need services but are not impaired enough to be institutionalized. These range from everything from medications to housing and supportive employment services.
But while the pact legally is limited to Maricopa County, Don Hughes, the health advisor to Gov. Jan Brewer, said the same services will be made available statewide.
Brewer, who has been dealing with the issue since her first days as a legislator, called the deal “landmark.”
“They're going to have coverage that they were promised for 30 years that instituted the (legal) case, things that we knew were necessary and important that weren't being delivered,” she said.
Brewer credited the mental health advocates who brought the lawsuit — and pursued it for decades — with providing “the hammer” to ensure the state lives up to its legal obligations.
“I'm really, really proud, let me say this, that we are able to accomplish what we've been able to accomplish,” the governor said.
“And I think that today we can proudly say that Arizona is the model on behavioral health across the country,” Brewer continued. “Realizing where we have come from in the last 30-plus years, that's a big step.”
Brewer said no additional state funds will be required beyond the additional dollars lawmakers provided two years ago when the first tentative pact was reached. She said part of that is because many of those who need services will be able to get it because of Arizona's ability to expand its Medicaid program — and get federal dollars — because of her decision to take advantage of the federal Affordable Care Act.
The lawsuit actually traces its roots to the 1970s when Arizona, like many other states, decided to deinstitutionalize the mentally ill. The idea was to provide care in the community rather than have people “warehoused” in the Arizona State Hospital.
But Maricopa County Superior Court Judge Bernard Dougherty ruled in 1985 these people were simply released from the hospital, with the state never setting up and funding they need to survive.
The result, as even some state officials conceded, was that many former patients ended up living on the streets or getting arrested.
Dougherty ordered the state to provide the “continuum of care” for the chronically mentally ill as they had promised.
There were some interim agreements that did add funding, but hopes for a final deal slipped four years ago when Brewer announced the state just did not have the money for the care.
It took until 2012 for the Arizona Center for Law in the Public Interest to see evidence Arizona was finally serious about doing what was legally required. That resulted in an interim deal — including close to $40 million in new funds — and paved the way for what was finally inked on Wednesday.
Among the requirements are:
• a team of professionals available around the clock to provide both crisis services and attend to other needs by individuals allowing them to live independently;
• more permanent housing sites coupled with ongoing mental health and other support services;
• help for people to find and maintain suitable employment to be able to support themselves and their families;
• peer and family support services.
Attorney Anne Ronan, representing those who sued, said in a prepared statement that 2012 deal, coupled with Brewer's “long-standing commitment to persons with serious mental illness” provided the basis to finally settle the case.
Brewer may have been in a unique position to get final resolution to the case which dates from when she was first running for the Legislature: Her son, Ronald, has been a patient at the Arizona State Hospital for more than 20 years after being found not guilty of rape by reason of insanity, though he is allowed off the grounds with staff or his parents. She said that gave her a unique insight.
“I'd be more aware of what families are dealing with in the ups and the downs of life with these people, with their illnesses,” she said.
The governor said she has seen what most have only read or heard about — and not always accurately.
“There's been so much written about the chronically mentally ill or the seriously mentally ill that is somewhat glamorized or exaggerated in movies or in books and stuff like that, that people can't really get their hands around it unless they're faced with it,” she said. Brewer also said her own experience shows her that, normally, those with mental health problems can “function at a pretty high level.”
“And then they spin down and decompensate and you have to bring them back up,” Brewer said.