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Whose Quality & What Management?: One Consumer’s Travails, Part 2

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The day of my state appeal hearing finally arrives on February 2nd, five months after my 4th suicide attempt in six years and placement in an acute residential treatment facility in October 2004. This is the judicial administrative process developed to handle grievances with the Community Mental Health Services of the San Francisco Department of Public Health. I know these circumstances are going to exacerbate my panic, sorrow and fear. The idea is to employ crisis management and damage control.

Of course, I double dose on my prescribed medications to counteract the respective increase in my panic response. Contrary to urban myth that popping a pill rids the problem, it does help to keep this response playing in the background like elevator musak. This, at least, gives me a chance to utilize my mind to stay present, aware and reality-based. Otherwise, I would disassociate, disconnect and feel as if I were living a dream.

I have already gone through the standard operating procedure of “worse case scenario” night terrors and survived. With a night terror the body responds as if it actually happened. It is the mind’s own creation of virtual reality with no devices necessary. My first experience with hyperventilation, cold sweat, heart palpitations and electrical brainstorm releasing the flood gates of adrenaline, I would faint with overwhelm. Now, vertigo kicks in, the cold sweat emits a skunk-like stench, my stomach contents empty or it’s dry heaves and my bladder and colon void. It happens like a sucker punch with no warning whatsoever. I know full well when I venture outside of my safety zone—I risk the panic taking hold of me at any time, at any place. It has no respect for boundaries or comprehension of prejudice and social grace.

When facing an all-new experience in unchartered territory at this time in my life, I must have a safety person with me or the adrenaline rush begins. My patient’s right advocate (PRA) and I have pre-arranged a taxi cab to make it to the hearing location. One of the coping skills is positive visualization of the incumbent event: roads, streets, buildings, signs, the feel of the transportation, walking into the building. To increase my odds of success in taming the panic, I pop another tranquilizer along the way.

We walk into the waiting room and there sit the two representatives of the agency and our very first face-to-face meeting. Their physical demeanor is reasonable and respectful; completely opposite to their telephone presence. We are handed their position statement which was hurriedly prepared at the end of the business day before our morning hearing. We anticipated this. Their position is consistent with our expectations: omission of the entire experience that is meaningful and important regarding commitments and obligations on their part.

In the land of the judicial branch of government, this case would be labeled a “slam dunk.” They admitted their wrongdoing on the record because they are unfamiliar with the policies and procedures and law that regulate their department. The administrative law judge rules they failed to meet their burden of proof and concludes he will NOT rule in favor of a homeless shelter. Slam dunk. I go to a residential treatment facility.

My PRA and I go to the typical celebratory lunch next door to the building. I would later find out this was a bad decision on my part. I should have simply returned to my ex-husband’s house. He analyzes our performance and reviews the judicial proceeding with me from a legal standpoint because I am now disassociating. He hails me a cab. I believe I am home free; however my panic has another idea. I have a panic attack in the cab on the ride home. The cab driver is freaked out and furious that I have soiled his backseat. I give him an enormous tip for his inconvenience. Three times the amount of the cab fare. I have no balance. I am in the grip of vertigo. I stumble out of the cab, my clothing utterly soiled, and all my legal documents and contents of my purse spill out onto the pavement. I lay flat on my bottom amidst all of my belongings as my ex-husband exits the front door to his flat to get his customary beer for the night. He utters, “You are so pathetic, Leanne,” and walks on.

My ex-husband and son believe that justice is a magic wand and with one word, reality is instantly changed. The verbal abuse increases expeditiously as we anticipate the Order with three police incidents and three more panic attacks. The truth is that the wheels of justice move slowly.

Almost four weeks pass before the final Order arrives on a Saturday. Joy, joy, happy, happy. I am unable to teleconference on the Ruling. In the meantime, I contact the Judge to confirm he has ruled in my favor. He confirms my understanding. I telephone the Fair Housing Compliance Officer of the Public Accommodations Department and he tells me that “justice delayed is justice denied.” We have a verbal confirmation the Ruling is in my favor. Therefore, the Community Mental Health Services should proceed with my placement in a residential treatment facility. My PRA teleconferences with the agency representative who informs us that I MUST make it to my initial assessment at the facility that specializes in my disorder. We find this peculiar because the facility has never been discussed with such a sense of urgency.

In the final Order, the administrative law judge writes that although they did not meet their burden of proof, he has ruled in their favor! He acknowledges they must make considerations in my out-patient treatment plan for agoraphobia. There is the confirmation in writing about this odd teleconference that I MUST make it to my initial assessment. Reason whispers there has been some “back alley activity,” but I feel my entire endeavor was imagined as I read the Order. I demand a reality check from the Office of Patient’s Rights and they advise me to simply “let it go.” Allow the system to fail in order to get my needs met. They bow out of the case at this juncture. I make my initial assessment wherein the facility and agency simply ignore the Ruling that considerations for my agoraphobia (fear of public places) must be incorporated.

I am told I must go to a homeless shelter. I make my initial intake at the shelter. They need to hold a town meeting in order to ensure my physical safety and the fact that I have special needs outside the common interest of the majority of their clientele. They don’t want me perceived as being “favored.”

I sit with my safety person around the corner of the shelter at a local coffee shop. The Office of Patient’s Rights has graciously provided one of their employees for this on-site appointment. I am trying to embrace my reality that I am now truly homeless, acknowledging the fact that even homeless people are functioning at a higher level than I am at this time in my life. Their employee shares her journey with her special needs child and talks non-stop which lulls me into a meditative state. She conjures up in my mind the ideology of the “search for excellence” that was so prevalent in the ‘80s which has now died away like the fad of the “one minute manager.” This at-will employment policy has obliterated any concept of loyalty, commitment, dedication and quality of life for employees. Law firms run through their personnel like sand in a sieve. The contract worker is the current fad with employers. They don’t have to pay for health insurance and worker’s compensation benefits. It used to be an honor and a privilege to be a part of an instrument that chronicles the attitude, philanthropy and ills of society. Now, it’s about warming the seats.

I conclude that regardless of this dismissive quality of law, it has no bearing on the truth that its purpose is to meet the needs of the society it serves. I am granted my Request for Rehearing and a Judicial Review. My message is clear: there must be a viable and proactive conflict resolution and grievance process with respected enforceable measures. The need for a voter-initiated amendment is confirmed.

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Author: Street Sheet Editor

The STREET SHEET is the oldest continuously published street news paper in the United States. Organizationally, it is the public education and outreach tool of the Coalition on Homelessness. Every month, the STREET SHEET reaches 32,000 readers through over 200 homeless or low-income vendors. Our vendors are charged nothing for the papers they receive, and keep all money they earn through STREET SHEET distribution.

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