Arizona Military Affairs: Veteran Home

May 24, 2007

Transcript:

Larry Lemmons:
Tonight on Horizon, the Arizona Veteran Home, after months of trouble, passes its last inspection with flying colors. We'll give you an update. Plus, it's been 15 years since the standoff that led to Indian gaming in Arizona. We'll talk about what happened then and how that's changed things. All that's coming up next, on Horizon.

Announcer:
Horizon is made possible by contributions from the friends of Eight, members of your Arizona PBS station. Thank you.

Larry Lemmons:
Good evening and welcome to Horizon. I'm Larry Lemmons. The Arizona Veteran Home burst into the headlines this spring -- shortly after problems at the Walter Reed Army Medical Center surfaced. The home was fined by state and federal officials because of deficiencies. But it recently received a clean bill of health. I'll talk to the interim director of the home. But first, here's more on the controversy and comments from Patrick Chorpenning, the former director of the home who resigned after being relieved of certain duties by the governor.

Mike Sauceda:
The Arizona State Veteran Home is a new 200-bed licensed and skilled nursing facility. It's located in central Phoenix and was built to serve the long-term needs of veterans of Arizona. In February a surprise visit by the Arizona Department of Health Services found various problems including long waits for service when patient press call lights, and in some cases patients left in soiled clothing. The results were not made public until March, creating a fire storm of publicity. The home was given a $5,250 fine by the state, then another $10,000 fine by federal officials. This month the state conducted a surprise visit on behalf of the federal government and found the home to be deficiency-free.

Patrick Chorpenning:
I think Walter Reed was a major, major factor. To really get a real good understanding of what happened, about two weeks prior to the Department of Health Services coming in for their survey, the end of January we had the V.A. They came in and did their survey. They found certain things that were wrong. I mean, it's difficult to run a facility where you have about 200 employees and 190 elderly residents in various stages of medical care and medical need, not to have some problems. I mean, it's impossible not to. And, so two weeks after that, on the early part of February, as far as February 5th is concerned, the Department of Health Services came in for their survey. In the process of doing that, from the 5th, which was Monday, through that Friday, which was the 9th, there basically were very little problems that they found. One of the major problems that they found was the lack of responding quickly and promptly to call lights. The other issue that they found was really more of a paper issue in the sense of keeping resident care plans up-to-date and so forth. And everything seemed to be going relatively well until they spotted the smokers. Once they spotted the smokers and placed us into immediate Jeopardy, the whole magnitude of that survey team and the whole emphasis of where they were changed drastically. The plan of correction was done, you know, Friday of the 23rd of March and submitted to the Department of Health Services. The governor's office basically notified me on Monday -- or on Saturday the 24th. And in came a couple of attorneys from Coppersmith and Gordon. And we spent the next two days, probably 20 some hours, at that home explaining everything that took place, the plan of correction that was put in place, what we were doing to solve that problem and so forth. And yet at the same time, it was as if it just happened. I think the governor's general counsel sort of overreacted. I think bringing in the attorneys to look at the home and so forth, I mean, initially with the understanding that they were there to help. And what they basically did on Monday, which would have been the 26th of -- I think it was 26th of March, when we met with the governor, basically outlined all of the horrors as they were reported by the press. And when I tried to make the governor aware of the fact that plan of correction was already completed, it was at that particular meeting that she very specifically told me I would not attend another meeting dealing with the home, number one. Number two, that I was out of the chain of command as far as the home was concerned. And number three, I was forbidden to go back into the home in a formal or informal capacity until she gave me permission to go back into the home. I'm willing to admit, as I did in reference to Greg Maxon, I'm willing to admit that I may have made mistakes in the process. But for some reason, it is very, very difficult for this administration to get to a point of saying, we may have overreacted on this as a result of Walter Reed and as a result of the media.

Larry Lemmons:
Here now to give us an update on the Arizona veteran home is Gregg Maxon, the interim director of the care home. Welcome, Mr. Maxon. Thanks so much for coming down here.

Brig. Gen. Richard Gregg Maxon:
Thank you.

Larry Lemmons:
A clean bill of health for the Arizona veteran home now?

Brig. Gen. Richard Gregg Maxon:
Yes. We got a resurvey by the Department of Health Services about, well, I kind of lost track of time, but the last two or three weeks. And they came in, did a complete Survey. And they came -- the outbriefing that we got was five words, you are in substantial compliance. And that was the sum total of their outbrief to us. And that is actually the highest rating you can get in that kind of a survey.

Larry Lemmons:
Congratulations.

Brig. Gen. Richard Gregg Maxon:
Thank you.

Larry Lemmons:
Patrick Chorpenning said that he had a plan of action in place by the end of March. We were just wondering, was that implemented and if so, did that fix the problem?

Brig. Gen. Richard Gregg Maxon:
Yeah. The way the process worked is that as they were leaving the building, the DHS survey back in February, we had to present to them -- the home had to present to them a plan of action on how we're going to take our corrective actions. And that plan of action was in fact in place. DHS, the Department of Health Services, actually did approve that on very short notice. Now we did make a few adjustments along the way. We would send a notes over to DHS saying we need to adjust this plan of action for various reasons, or that plan. But by and large, it was in place before the inspectors actually left the facility.

Larry Lemmons: Tell us about what it was like when you arrived on the scene. You were saying the morale was really low at that time.

Brig. Gen. Richard Gregg Maxon: Well, the morale of the people, both the residents and the people that worked there, was -- it was pretty low. Because they knew that they were a good facility. And the stuff that they perceived was being said about them in the media, they felt very badly about how their organization was being portrayed. Because they know they're a good facility. and so one of the things that we really had to focus on at first when we got there was to reassure everybody that things are going to be okay and that we will get through this and we're going to make the home the show place that it really can be.

Larry Lemmons:
One of the major problems, I understand, is that the staffing was inadequate, that you had a number of nurses that had left, and all of those had not been replaced.

Brig. Gen. Richard Gregg Maxon:
Well, staffing -- you'll find in the healthcare and in particularly in the long-term care arena, staffing is always an issue. There simply isn't enough of the skilled nursing care personnel to go around to meet all the needs. But what we were short of the staff that actually worked for us, we used an organization called the registry. In other words, temporary staff. So we did have staffing shortages in the sense that we didn't have all the full-time employees we should have had. But we did make up the differences with the temporary employees. But the temporary employees aren't the same as the full-time staff because they're not there long enough to develop the relationships with the residents and the other personnel that are there. And we worked very hard to recruit people to fill those jobs. And we worked very hard on reducing our turnover rate. And our turnover rates for this year are substantially below what they have been in past years. So I think the people see -- the people that work there see that this really is a good facility; that we have made great progress, and this is the place that they want to be affiliated with.

Larry Lemmons:
Can you talk a little bit about the funding? How is the Arizona Veteran Home funded? The reason I bring that up is because I think some people are confused about the V.A. and the Arizona Veteran Home. They get part of their funding there, but it is not affiliated with the V.A.

Brig. Gen. Richard Gregg Maxon:
Yeah. We're a completely separate organization from the V.A. we work very closely with them and we do a lot of things together. But we are a separate organization. And the funding for the home, when the home was set up, it was required to be self-sustaining. In other words, no appropriated funds from the general fund being placed into it. And it worked very well under that funding model for quite some time. But we're funded through a number of sources. We've got Medicaid patients, we've got people who are on pensions or some sort of compensation from the V.A. We get per Diem from the V.A. for certain patients. Some are private pay where they just pay for the services or they're private insurance. So it's those revenue sources that we have used traditionally to fund the home. And when you have a brand-new facility, there are a lot of things that you don't have to worry about because the facility is new. But as the facility ages, you have to take into consideration some of the large capital expenditures you're going to have to make. And so that funding model isn't quite what it needs to be today.

Larry Lemmons:
And I do understand, too, that both in the Senate and the House budget, currently being considered, there is, what, 3.5 million for the home as well?

Brig. Gen. Richard Gregg Maxon:
Just a little bit less than that but 3.5 is a good number to talk about, yes.

Larry Lemmons:
And what will that go towards?

Brig. Gen. Richard Gregg Maxon:
The plan is, about 2 million of that is going to go for capital improvements and things for the home. Equipment for the home to take care of the residents. And the other 1.5 million is for new hires and for pay increases for the currently existing employees.

Larry Lemmons:
Now given the fact that there are wars going on in Iraq and Afghanistan and they're returning veterans with severe problems, I understand that you're also planning a home in Tucson, possibly one in northern Arizona?

Brig. Gen. Richard Gregg Maxon:
Well, there is a home scheduled for Tucson already. In fact, I was down there last week and I met with the director of the V.A. hospital down in Tucson. The piece of land is already set aside; it's right there on the campus. And as we were talking to them, the Tucson V.A. Hospital is going to be a Polytrauma Center. And it's going to specialize in the treatment, to some degree, in the treatment of these traumatic brain injuries that we hear about. And as we were talking with them down there, we said, you know, this home, we may have a role to play in helping to care for these patients. And they're very enthusiastic about the idea of partnering specifically with us to take care of that population that is being treated today.

Larry Lemmons:
Greg Maxon, thanks so much for coming down here and talking to us about that.

Brig. Gen. Richard Gregg Maxon:
Thank you.

Larry Lemmons:
Well, before 1992, there was a limited gaming on several Arizona Indian reservations. The Fort McDowell Yavapai nation ran a bingo hall that also had slot machines. The tribe's gaming room was raided on May 12, 1992, by state and federal officials who said the tribe had violated the law because it was operating without a compact with the state. But the tribe fought back and won. The victory is celebrated every year with a march. I'll talk to the leader of the Fort McDowell tribe. But first Mike Sauceda tells us about Sovereignty Day.

Mike Sauceda:
A parade marches down Fort McDowell Road on the Fort McDowell reservation, commemorating an event that 15-years ago changed the face of Native American reservations and the state itself.

Television anchor: Just after dawn, a caravan of federal agents armed with search and seizure warrants showed up at the huge gaming center. Some gamblers who camped overnight in the parking lot wondered what was up.

Standoff participant:
They come in early with the trucks and cars and everything, and they just went in and started moving machines out. When we got ready to live I asked them for permission to leave and they said go ahead.

Mike Sauceda:
May 12, 1992 was a day the Fort McDowell Yavapai nation, northeast of Phoenix, faced off against Governor Fife Symington, F.B.I. sharp shooters, and moving vans brought in to take away their 349 gaming machines. Ironically some of the moving vans were from the Mayflower Moving Company, the same name of the pilgrim ship that landed at Plymouth Rock.

Reporter:
What are you doing?

Standoff participant:
I'm not letting them out.

Reporter:
Why not?

Standoff participant:
They're taking money out of these people's-these Native Americans' mouths, it's not right. This is education. We're going for education. They're taking my scholarship away. They're taking the money away from the elderly.

Television anchor:
Word quickly spread, and by 9:00 a.m. a blockade of some 20 vehicles had formed. No one was moving, and tempers were rising.

Standoff participant:
I know what they want. They want the clothes off the babies' back. It's got the American flag on it. They can have it. They can have it.

Reporter:
What are you doing here?

Standoff participant:
I'm taking the flag off of his shirt.

Reporter:
Why?

Standoff participant:
This isn't justice. They can have it. Take it.

Mike Sauceda:
Tribal leaders blocked the road leading out of the reservation with vehicles such as this huge mining truck.

Fife Symington:
And I would hope that you would allow at least the motorized portion of these loads to leave so that rational discussion can take place, and so that there's no harm done to life and property. Because we don't need that.

Television anchor:
Within minutes the crowd had cleared a path, and taunting the drivers as they left, the group that had stood up to a government many here don't trust, celebrated its victory. [Cheers and applause]

Mike Sauceda:
Under the 1988 Indian gaming regulatory act, tribes were allowed to have gaming if they signed a compact with the state. Arizona didn't have one. But the situation was settled after the tribe and the state signed gaming compacts that allowed casino gaming of certain reservations. The marchers at this year's walk ended their walk at the bingo hall which has been operating since the early 1980's. Once in the bingo hall, the ceremony continued with kids singing the Fort McDowell anthem. [Music]

Bernadine Burnette:
Welcome to our annual event. This is an important day for us and an important word. How many of you know what sovereignty means? Well, we have the computers and the internet so I suggest you look it up. And this is one of the reasons why we're here because our tribe stood up strongly some years ago.

Mike Sauceda:
Tribal Vice-President Burnette told the tribe about the day of the standoff.

Bernadine Burnette:
I remember the raids that day in '92. Man, you talk about phone calls and our Indian people getting out of bed with their hair standing up, didn't brush their teeth. They were out here, weren't you? You know, because it was our livelihood, it was jobs. It was a business. It was income. It was education. It was housing to us.

Mike Sauceda:
Fort McDowell President Raphael Bear also addressed the crowd at the event.

Raphael Raphael Bear:
This day we celebrate. We call it Sovereignty Day out here. How many out here know what sovereignty means? Raise your hands. There is about a few of you. We still need to go and teach that. You know, sovereignty that is a word that's difficult to explain. Even governments can't explain it. Many people can't explain it. But, you know, it lives within each and every one of you.

Mike Sauceda:
Gaming has created prosperity for the tribe with nice homes and new public facilities on the reservation. Burnette talked about that success.

Bernadine Burnette:
And I go back to greed. I go back to prosperity. There is some good and bad to it. Let's respect to this acknowledge it. Let's be thankful for what the few little things we have in our new, brand-new homes. 150 to $180,000 homes you live in. Be thankful. Wash your dishes. Clean your toilet bowls. Wash your windows. Don't be lazy.

Larry Lemmons:
Here now to tell us more about the 1992 raid on the Fort McDowell Casino is Tribal President Raphael Bear. President Bear, thank you so much for coming down and talking to us.

Raphael Bear:
Thank you for having us here, Larry.

Larry Lemmons:
May 12, 1992, Sovereignty Day. What does that mean to the Yavapai nation?

Raphael Bear:
It's a very momentous day, Larry. We celebrate that every year. This past Friday we celebrated. That was our 15th annual celebration. And we celebrate that because it was a momentous occasion for us. We had a raid upon our casino in 1992, May 12th. And my people stood up against that. There were four other casinos raided on that same morning at 5:30 a.m. when the F.B.I. came in and at gunpoint seized gaming records and slot machines and put them in moving vans. And my people started a blockade at the only exit to the casino with their own cars, with their own Indian cars. And also our sand and gravel operation also blocked the two main exits with their sand and gravel moving equipment. And that day we stood against momentous force against us.

Larry Lemmons:
They touched on it a little bit in the package there. But what did the gaming mean to the tribe at that time so that they were so insistent upon blocking and taking those machines?

Raphael Bear:
What we realized, it was our economic future. We realized, as you heard in the tape, our education, our welfare, our better health for all my people. And we realized that. We knew that then as we know today and the fruition of some of those things that are coming to pass today.

Larry Lemmons:
Why did they have gaming machines there before a compact with the state was made?

Raphael Bear:
I'm sorry?

Larry Lemmons:
Why did they have the gaming machines there already before a compact with the state had already been made?

Raphael Bear:
Yes. It was a very tenuous situation with the state. The state really didn't want to negotiate with the tribes. And there were some lawsuits moving through the courts at that time. And both sides vowed to appeal it if they lost. So it really didn't look too promising.

Larry Lemmons:
You know, we were talking a little bit before, I was trying to get a sense of the atmosphere at that time, why Governor Symington at that time was so resistant to that. What do you think was happening in the atmosphere about gaming at that time?

Raphael Bear:
I think it was really looked at as an evil type thing, that it would bring in mafia types, it would bring in the bad social aspects in life. But in reality, it really hasn't happened. In other words, just provided our economic future today.

Larry Lemmons:
Did Fort McDowell and other tribes want to get compacts with the state before '92? And were there any real efforts to do that?

Raphael Bear:
Yes, there was. The state was reluctant to -- was opposed to it. Arizona leaders, state leaders as well as tribal leaders didn't come to any kind of negotiated compact. Previous to that in 1988 the Indian gaming regulatory was passed where a negotiated gaming compact would have to be agreed to by both the state and the tribe, which didn't happen.

Larry Lemmons:
We were talking about how you were not there when that was happening, you were working. Some of us have to work. But what was going through your mind and through your friends' minds when this was happening? Did you feel threatened, attacked? Not necessarily in a physical way, but --

Raphael Bear:
Yeah. You know, I realized at that point what economic development really meant to the tribe because that's what we stood up for. Because the number of years that had gone by where we had no opportunities whatsoever. About 11 years previous to that, we just survived the Orem Dam situation. So not a lot of government money was coming to Fort McDowell. And we knew this was our only hope to develop economically. And when that happened -- and I heard it through the radio that morning. And I felt very disappointed. I felt something, like there was a punch in the gut to me. And I felt that I needed to go there. After work that day, I was there that evening.

Larry Lemmons:
What was the atmosphere like then?

Raphael Bear:
Oh, it was heated. A lot of debate. As soon as the vans left that day, after the cooling off period was negotiated with Symington and our former chairman, the vans stayed. And immediately that situation moved into the atmosphere of the public perception. And I think that really favored our community and what we were standing for that day.

Larry Lemmons:
You've mentioned just briefly about the Orem Dam and how the Fort McDowell reservation fought that as well and had won. They were going to build a dam, and it would have flooded that entire area. James Watt, I think interior secretary at the time, finally backed off on that. So clearly the tribe has fought a lot but has won a lot.

Raphael Bear:
Yes. And not only did the people survive that but also there were some species that survived and various archeological sites that would have been inundated by the dam. And today you would not have what Fort McDowell stands for today if that would have occurred.

Larry Lemmons:
So what has the casino meant for the reservation? What has it given you guys since '92?

Raphael Bear:
I think as simple as it sounds, I think it's education. It's done a lot of other things for us. But today we celebrate 80% high school graduation rates last year.

Larry Lemmons:
That's extraordinary.

Raphael Bear:
This year we're anticipating 90%. There's a couple of kids that are on the bubble still. But as simple as it sounds, I think that's what we celebrate. Because it's given us that opportunity to do those things that we never had in the past. It also means economic health or economic development, also health and welfare for our community. Not only that, it also extends back to the community and to the state of Arizona. We've given back to the state of Arizona when it wasn't required to do so under our gaming compacts.

Larry Lemmons:
President Bear, thanks so much for joining us. We appreciate you coming down.

Raphael Bear:
Okay. Thank you very much.

Larry Lemmons:
A lot of activity at the state legislature this week. The House wants to ban photo radar from state highways. And one state lawmaker is calling on Senator John McCain to resign or start doing his job. Those stories and more on the Journalists' Roundtable, Friday at 7:00 on Horizon. Thanks for joining us on this Thursday edition of Horizon. We'll see you later. I'm Larry Lemmons. Good night.