Arizona State Hospital needs independent oversight, isn’t getting it

Arizona State Hospital fails patients, and oversight efforts are going nowhere

Opinion: The Arizona State Hospital cares for some of the state’s most vulnerable people. Yet a lack of independent oversight is putting their lives at stake.

Senators Catherine Miranda and T.J. Shope

The two-year effort to improve care at the Arizona State Hospital went up in a puff of smoke again this year at the state Legislature.

That’s a bad thing for patients, their families and every Arizonan.

The Arizona State Hospital is located on a 93-acre, 260-bed campus in Phoenix providing inpatient psychiatric care to people with mental illnesses who are under court order for treatment. 

Treatment at the hospital is considered “the highest and most restrictive” level of care in the state.

Patients are admitted because of an inability to be treated in a community facility.

The needs of patients at the state hospital can be complex and the patients are vulnerable, so it’s critical to make sure the hospital uses best practice treatment and follows a rigorous set of regulations.

A prerequisite to ensuring quality care is having a governance structure that’s accountable and free from conflicts of interest.

Sadly, that’s not what we have.

The Arizona State Hospital is part of the Arizona Department of Health Services — the same agency that’s responsible for regulating the Arizona State Hospital.

That’s a classic example of the fox watching the henhouse.

After suicide, it found ‘no deficiencies’

There is evidence that the lack of independent regulation has resulted in unchecked substandard care.

For example, in 2019, the state health department investigated a homicide at facility under its jurisdiction and concluded it wasn’t doing anything wrong and didn’t need to fix anything — indicating that there were “no deficiencies.” 

And in 2021, a patient was provided scissors and let into a bathroom, where he died by suicide.

The department downplayed its role, as a spokesperson told ABC 15, “There appears to be an inaccurate assumption that every event should automatically result in a citation or a noted deficiency for a health care institution.”

These are not isolated incidents, and as former state health director Will Humble has pointed out, suicides and homicides are almost always the result of a deficient practice, such as a poor treatment plan or medical psych assessment.

State health department won’t regulate itself

We’ve learned a lesson the hard way that we can’t count on the state health department to regulate itself.

We need better institutional controls free from conflicts of interest.

For the last couple legislative sessions, Sen. David Gowan has proposed a commonsense solution to the governance problem that’s been plaguing care: Simply separate running and regulating the Arizona State Hospital.

‘Scary place’: Arizona State Hospital has safety concerns, critics say

Senator Gowan’s bill would have set up a five-member State Hospital Governing Board and transferred operational responsibilities to the board.

Members of the governing board would be appointed by the governor. The Arizona State Hospital superintendent would report to the governing board rather than the state health director.

The Arizona Department of Health would then regulate the facility, just like it does every other hospital, but without a conflict of interest.

It’s time to fix this systemic flaw

There was bipartisan support for this important change — with the bill passing 27-2 in the state Senate, only to be undermined in the House at the 11th hour because the governor’s office had concerns about the “civil rights implications” of the bill.

For the life of us we don’t understand why there would be resistance to this commonsense change.

It’s time to fix this systemic flaw.

We call on Gov. Katie Hobbs to call together lawmakers of both parties and come up with a plan she can support to fix this major conflict of interest that has been jeopardizing patient care.

Fixing the governance structure may not guarantee that the state hospital will be well regulated, but it improves the chances that it will be.

The most vulnerable people in the state are counting on our elected and appointed officials to have their back.

So are their families. So does the public.

Let’s stop disappointing them, shall we?

Sen. Catherine Miranda is a Democrat representing Arizona Legislative District 11 (downtown Phoenix, Laveen, South Mountain, Guadalupe). Sen. T.J. Shope is a Republican representing Arizona Legislative District 8 in Pinal County and is chair of the Senate Health and Human Services Committee. On Twitter: @CatherineSenate and @TJShope

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