Interim settlement signed in Arizona mental health case

PHOENIX - State officials signed an interim settlement with advocates for the seriously mentally Thursday as they agreed on steps to improve community-based services and move toward resolving a decades-old court case that has frustrated both sides as previous efforts fell short.

The two-year agreement spells out the providing of medication, employment counseling, housing assistance, a crisis hotline, treatment teams, family coaching and other services.

The services are intended to help enable thousands of seriously mentally ill people to live in communities instead of being institutionalized.

Gov. Jan Brewer, the state health director and a lawyer for the class-action plaintiffs were among those who signed the agreement at the Capitol.

"This is landmark," Brewer remarked to aides and others after the ceremony.

The lawyer who filed the original lawsuit in 1981 said the agreement signals a commitment by Brewer and the state to resolve a situation that has caused uncertainty and stress for many.

The signing was "a moment of celebration," said Charles Arnold, who was serving as a fiduciary representing mentally ill people in Maricopa County when he filed the suit.

The interim agreement is subject to court approval.

Anne Ronan, a lawyer for the plaintiffs, said the agreement's adoption of national standards on the adequacy of provided services is an important element because the standards will provide objective data for use in considering additional changes.

The court case has been paused for two years due to the state's now-eased budget crisis.

In the decades since the suit was filed, it has been the subject of numerous legal fights and reviews as the state struggled to follow court orders and earlier compliance agreements. At times, advocates have estimated the cost of compliance in the hundreds of millions of dollars.

The recently approved new state budget for the fiscal year beginning July 1 includes $38.7 million in additional state spending for mental health services.

A court-sponsored office to monitor's the state's services for the seriously mentally ill was shut down during the pause because of the budget crisis. But the agreement calls for independent reviews to be restored.

Brewer, who has a mentally ill adult son and who has long championed services for the mentally ill, pushed for the Legislature to approve the additional state funding.

"This has been a critical issue for me for my entire political career and prior to that also," Brewer said.

Officials said the money restores a significant part of state funding for services that were slashed to help balance previous budgets.

They also said the federal health overhaul of Medicaid could produce more money for behavioral health services for individuals who newly qualify, but that depends on the U.S. Supreme Court upholding the overhaul.

Arizona is among the states challenging the overhaul's constitutionality.

With the health care overhaul's future uncertain, "we have a lot of unanswered questions," said Dr. Laura Nelson, a Department of Health Services official who worked on the agreement. "This is a solution for the next couple of years."

Arnold said the lawsuit class now covers approximately 22,000 people statewide, including some 14,000 in Maricopa County, which includes most of the Phoenix area.

The announcement follows negotiations during which Judge Rosa Mroz of Maricopa County Superior Court last December ordered participants to not reveal terms of proposed court orders to people not involved in the lawsuit. She said that was necessary for "open, honest and candid discussions."

Another judge in March 210 had agreed to pause the case for two years, through June 30 of this year.

At the time, lawyers for Brewer and the class-action plaintiffs were trying to block an attempt by legislatives to repeal the state law mandating community-based services.

That law provided the legal underpinning for the lawsuit.

When the case was paused, both sides in the lawsuit agreed that Arizona's then-dire budget crisis meant that no money was available to increase and improve services.

Republican legislative leaders had planned to include a repeal in a budget-balancing plan but did not after Brewer agreed to the pause.