A Phoenix police officer in body armor stood watch over the 43-year-old woman who had called 911 after buying a pack of razor blades at a drugstore. Karl Luther and Jack Perkins, two men who earned engineering degrees but chose social work instead, arrived in a minivan.
The toothless woman’s blue eyes showed sadness as she sat on a stained curb outside the drugstore. “Take care of yourself,” the officer said as he left, handing her over to the social workers. The woman explained her problem in a soft voice. “I’m depressed,” she said. “I’ve been thinking of ways to kill myself.”
With that statement, Perkins and Luther knew they couldn’t leave her. They told her they were required to commit her for a mental health evaluation if she refused to go voluntarily.
After three hours of cutting through red tape and babysitting her, they managed to get the woman in a mental hospital for an indefinite stay, a place she’d been to dozens of times during her 13 years in the mental health system.
Similar scenarios of police and Maricopa County’s behavioral health providers working hand-in-hand in getting treatment for mentally ill people play out several times a night throughout the Valley.
It is all in keeping with the behavioral health system’s approach of trying to integrate the mentally ill into society rather than institutionalizing them.
But a rash of lawsuits filed in Maricopa County Superior Court against ValueOptions, a private firm under contract to provide services for the county’s most severely mentally ill, suggest that approach can go horribly wrong.
The lawsuits stem from a spate of killings and assaults involving ValueOptions patients between 2003 and 2005, a period when the provider’s rolls swelled by 15 percent and its revenue increased by 9 percent.
Among the dead and maimed are police officers, innocent bystanders and family members, neighbors and friends of the patients. Their survivors allege that ValueOptions put the families and public in harm’s way by not providing adequate treatment for the killers as they visibly deteriorated.
ValueOptions CEO Ed Irby declined to discuss any specific litigation, but said he doesn’t believe there is a cause and effect between the incidents and the increased enrollment.
“It is part of the field of doing business just as surely as if you’re going to treat geriatric patients, they’re going to die,” Irby said. “I don’t want to minimize it. Each tragedy is individually, absolutely upsetting to the staff and all of us.”
ValueOptions also works with people who often refuse to take their medication or comply with their treatment plans, Irby said.
“It’s still a two-way street here,” he said.
A jury in October found the company 50 percent at fault in the death of Marie Cartmell, a 26-year-old developmentally disabled woman who was bludgeoned in an east Mesa home by her uncle, ValueOptions patient Marion Kozimor.
The verdict worked out to $101,000 against ValueOptions, whose attorney said in court that the death could not be foreseen.
Plaintiff’s attorney Ty Tabor called it “a case of broken promises.” Had ValueOptions committed Kozimor, who had a violent past and was delusional and paranoid at the time of the slaying, then “Marie would still be alive,” he argued.
ValueOptions, which has been under contract since 1998, isn’t the only one accused of broken promises.
Arizona and particularly Maricopa County are under court order from a 25-year-old class-action lawsuit to make improvements in the mental health system. The lawsuit found that the state failed to provide its mentally ill population with adequate community health services.
Irby said the court orders equate to micromanagement.
“We do a lot of programs in a lot of states, but there is nothing like Maricopa County,” Irby said. “We are dotting every I and crossing every T and trying to pay attention, not just to the consumers and clients that we serve, but also to many, many regulations.”
A specially appointed Office of the Monitor has routinely reported that the state is out of compliance.
The most recent report, which came out Jan. 3, says the state is still out of compliance in some areas and the improvements in care are precarious because ValueOptions reduced its work force in November and is experiencing funding cuts.
The report was released just two days before the Department of Health Services opened bidding for a private company to run the mental health system. That means ValueOptions will be competing to retain its contract.
Irby finds solace in an Auditor General’s report released in September that said the monitor’s method of determining compliance with the court orders is flawed and should focus more on the recovery of the patients and not on how many services are provided.
LONG LIST OF LAWSUITS
ValueOptions, the state’s mental health provider, has landed in court in each of these cases following allegations that it failed to provide proper care:
Ed Liu: Charged with two counts of first-degree murder in the Aug. 23, 2005, shooting deaths of Wal-Mart employees Patrick Graham, 36, and Anthony Spangler, 18. The Glendale men were in the parking lot collecting shopping carts when they were gunned down for no apparent reason.
Marion Kozimor: Serving a 16-year sentence in the Arizona State Hospital after being found guilty but insane in the Jan. 14, 2004, beating death of his 26-year-old, developmentally disabled niece, Marie Cartmell. A jury found ValueOptions 50 percent at fault for the murder on Oct. 24, the slain woman’s mother 39 percent at fault and Kozimor 11 percent. Judge Paul Katz has not signed a judgement yet sand the Cartmell family’s lawyer is asking him to increase the award.
Randolph Smith: Serving a 16-year sentence after pleading guilty to second-degree murder and attempted second-degree murder for the beating death of his 77-year-old father and assault of his 70-year-old mother with a shovel. A lawsuit alleges ValueOptions persuaded the Smiths to let their son stay with them even though the case managers knew he was off his medication and had violent tendencies and a history of violence.
Doug Tatar: Killed himself after shooting and killing Phoenix police officers Eric White and Jason Wolfe on Aug. 28, 2004. A lawsuit alleges ValueOptions declined to place him in treatment even though its managers knew he was deteriorating mentally.
Steven Hudgins: Serving a 22-year sentence for the Dec. 11, 2003, shooting death of his neighbor, Ryan Miller, 26, after an argument over loud music. A lawsuit alleges ValueOptions knew he was off his medication and he owned guns. Documents in the criminal case state that Hudgins would become paranoid if he didn’t take his medication, and he hadn’t taken it for a month before the shooting because he believed “through prayer and faith, his mental health issues would be healed.”
Natalie Cline: Charged with first-degree murder in the May 16, 2003, shooting death of her father, Albert Jimenez. A lawsuit alleges ValueOptions should have foreseen that she posed a risk to the family before discharging her from a mental hospital to their care four days before the shooting. Ten days before Jimenez was slain, Cline threatened him with a knife and was running around their Mesa house and neighborhood waving a knife and stabbing at people who weren’t there.
Franklin Button: Charged with attempted first-degree murder in the stabbing of Paul Eichfeld on March 5, 2003, at an east Mesa residence. A lawsuit alleges that ValueOptions has inadequately cared for Eichfeld, who is currently living in squalor. Eichfeld and Button were ValueOptions patients who were living with two other patients in a house.