A judge has rejected as inadequate a plan by Gov. Jan Brewer to improve mental health services in Maricopa County.
In a ruling made public Wednesday, Maricopa County Superior Court Judge Karen O’Connor said Brewer’s proposal “may be worthwhile to pursue” as one element toward finally ensuring that everyone who needs help gets what he or she needs. But the judge said it falls short.
“It fails to offer solutions or improvement of current services for the majority of the class members as directed by the court,” O’Connor wrote. And the judge said she was specifically disappointed that Brewer didn’t bother to consult with the attorneys for those class members — the people who need mental health services — before submitting the plan for improvement that the judge ordered.
The ruling disappointed Joe Kanefield, the governor’s attorney — and not just because O’Connor failed to see the merits of what Brewer has proposed. He said the entire basis of the judge’s order is wrong.
“The governor doesn’t believe that the (mental health) system is in crisis,” Kanefield said.
“She does believe that improvements can be made,” he continued. “But she doesn’t believe the system should be turned upside down, especially with the state’s budget situation.”
Kanefield also said Brewer intends to pursue the changes she proposed to the court in October, not only in Maricopa County but statewide, even if the judge concludes it does not finally put the state in compliance with the law.
The lawsuit, filed in 1981, came after the state’s decision in the 1970s to “de-institutionalize” people who are chronically mentally ill. The idea was to provide care in the community rather than warehouse people at the state hospital.
But Maricopa County Superior Court Judge Bernard Dougherty ruled in 1985 that the state failed to fund services these newly released people needed to survive, services it is legally obligated to provide. He said that resulted in many people getting lost in the system and not getting the care they need.
In a 1995 deal, the state agreed to improve care in hopes of ending the lawsuit. But judges have concluded, repeatedly, that it has not actually been living up to that obligation.
That includes the most recent report from a court-appointed monitor that the percentage of those who need services but are not getting them actually is increasing. That resulted in the court’s order to Brewer to come up with a solution.
One part would have all adults age 21 and older without serious mental illness who now receive behavioral health care through the state health department instead get it through the Arizona Health Care Cost Containment System, the state’s Medicaid program. That agency already contracts with doctors and others who provide direct care to those eligible for free state-paid health care.
Brewer also proposed a separate pilot program to allow those with illnesses to get all their care through an “integrated service model.” Kanefield told the judge that makes the most sense given “the interdependence of mental and physical health.”
For example, he said, those with mental problems also have various physical ailments, some of which may actually be made worse by the behavioral health conditions and the treatments provided like medications.
Kanefield said that, despite O’Connor’s criticism, Brewer did listen to the concerns of the attorneys for the plaintiffs as well as family members and the organizations with whom the state contracts for mental health services. He acknowledged, though, the governor never actually sat down with anyone else to go through her plan before she submitted it to the court.
“The court asked the governor to come up with the proposal, and she did,” Kanefield said.