American History After 1998 on the Forcible Administration of Psychotropic Drugs - #Michael A. Ayele (a.k.a) W Decision to File Habeas Corpus Complaint After January 10th 2016 - #Health Insurance Portability and Accountability Act (HIPAA)

National Council on Disability An independent federal agency making recommendations to the President and Congress to enhance the quality of life for all Americans with disabilities and their families. 1331 F Street, NW ■ Suite 850 ■ Washington, DC 20004 202-272-2004 Voice ■ 202-272-2022 Fax ■ www.ncd.gov January 28, 2022 W (AACL) Michael A. Ayele PO Box 20438 Addis Ababa, Ethiopia Re: FOIA Request NCD-2022-01 Dear W: This letter is in response to your Freedom of Information Act (FOIA) request, dated January 3, 2022, in which you requested: “What I am requesting for prompt disclosure are all records within your possession detailing (1) formal and informal ties that exist between your offices, the National Council on Disability (NCD), the Department of Justice (DOJ), the Equal Employment Opportunity Commission (EEOC) and the Department of Health and Human Services (HHS); (2) your communications about the NCD as an independent federal agency mandated to make recommendations to the President and Congress on disability issues; (3) your communications about the NCD as a federal agency emphasizing that people with disabilities should be the ones who make the major decisions about their lives; (4) your communications about the NCD as a federal agency that endorses and supports the principles of independent living; (5) your communications about the NCD as a federal agency, which recognizes that people with psychiatric disabilities are routinely deprived of their rights in a way no other disability group has been; (6) your communications about the NCD as a federal agency, which has previously heard testimony graphically describing how people with psychiatric disability have been beaten, shocked, isolated, incarcerated, restricted, raped, deprived of food and bathroom privileges, and physically and psychologically abused in institutions and in their communities; (7) your communications about the NCD as a federal agency, which has previously been informed about the routine use and overuse of psychiatric drugs, often against people’s will; (8) your communications about the overuse of psychiatric drugs against people’s will being inconsistent with Title IX of the Education Amendments Act of 1972; (9) your communications about the overuse of psychiatric drugs against people’s will being inconsistent with the concept of affirmative and effective consent; (10) your communications about the overuse of psychiatric drugs against people’s will being comparable to what the HHS refers to as a “drug facilitated sexual assault;” (11) your communications about the HHS identifying Rohypnol (flunitrazepam), GHB (gamma hydroxybutyric acid) and Ketamine as the three most common date rape drugs; (12) your communications about the statement provided by Marcie Kelley to the NCD attesting that “eight men jumped on top of [her] (…) wrestled

2 her to the floor (…) and shot [her] up with Thorazine;” (13) your communications about the NCD as a federal agency, which has concluded that the manner in which American society treats people with psychiatric disabilities constitutes a national emergency and a national disgrace; (14) your communications about the NCD as a federal agency, which has concluded that one of the reasons public policy concerning psychiatric disability is so different from that concerning other disabilities is the systemic exclusion of people with psychiatric disabilities from policymaking; (15) your communications about the NCD as a federal agency, which recommends for the use of involuntary treatments, such as forced drugging and inpatient and outpatient commitment laws, to be viewed as inherently suspect and as incompatible with the principles of self-determination; (16) your communications about the NCD as a federal agency, which recommends for aversive treatments that involve the infliction of pain or the restriction of movement for purposes of changing behavior to be banned; (17) your communications about the NCD as a federal agency, which recommends for people labeled with psychiatric disabilities to have a major role in the direction and control of programs and services designed for their benefits; (18) your communications about the NCD as a federal agency, which recommends for public policy to move toward the elimination of electro-convulsive therapy and psycho surgery; (19) your communications about the NCD as a federal agency, which recommends for research and demonstration resource to place a higher priority on the development of culturally appropriate alternative; (20) your communications about the NCD as a federal agency, which recommends for services in the community to not be contingent on participation in treatment programs; (21) your communications about the NCD as a federal agency, which recommends for employment and vocational rehabilitation program to account for the wide range of abilities, skills, knowledge, and experience of people labeled with psychiatric disabilities; (22) your communications about the NCD as a federal agency, which recommends for federal income support programs like Supplemental Security Income and Social Security Disability Insurance to provide flexible and work-friendly support options so that people with episodic or unpredictable disabilities are not required to participate in the current ‘all or nothing’ federal disability benefit system, often at the expense of pursuing their employment goals; (23) your communications about the NCD as a federal agency, which recommends for parity to be defined in terms of voluntary treatments and services; (24) your communications about the NCD as a federal agency, which recommends for government civil rights enforcement agencies and publicly-funded advocacy organization to work more closely together and with adequate funding to implement effectively critical existing laws like the Americans with Disabilities Act, Fair Housing Act, Civil Rights of Institutionalized Persons Act, Protection and Advocacy for Individuals with Mental Illness Act, and Individuals With Disabilities Education Act; (25) your communications about the NCD as a federal agency, which recommends for children and young adults with disabilities, particularly those labeled seriously emotionally disturbed to not be placed in correctional facilities and other segregated settings; (26) your communications about the articles published in the Hartford Courant on October 11th 1998 entitled: A Nationwide Pattern of Death; (27) your communications about the article published on the Hartford Courant entitled Why They Die: Little Training, Few Standards, Poor Staffing; (28) your communications about the decision of the Hartford Courant to quote a psychologist who stated that staff of mental

3 health institutions were really behaving like “cowboys;” (29) your communications about the article published on the Hartford Courant published on October 13th 1998 entitled Patients Suffer In A System Without Oversight; (30) your communications about the decision of the Hartford Courant to quote a doctor who said that staff members of mental health institutions should follow their conscience; (31) your communications about the Health Insurance Portability and Accountability Act (HIPAA) providing the opportunity for covered entities of mental hospitals to object to the treatment of a patient/prisoner; (32) your communications about the Government Accountability Office (GAO) September 1996 report entitled Medicaid: Oversight of Institutions for the Mentally Retarded Should Be Strengthened; (33) your communications about the Hartford Courant October 14th 1998 article entitled People Die and Nothing Is Done; (34) your communications about the May 1997 report into the Napa State Hospital’s Failure to Protect Residents from Abusive Seclusion and Restraint Practices and to Properly Investigate Related Potential Criminal Acts by Staff; (35) your communications about the May 1997 report highlighting within Napa State Hospital (NSH) a failure to speak out when wrongdoing is committed by coworkers; (36) your communications about the decision of several news outlets to report on the “blue wall of silence” that was crumbling in the Derek Chauvin trial; (37) your communications about the October 15th 1998 article published on the Hartford Courant entitled From ‘Enforcer’ to Counselor; (38) your communications about Michael A. Ayele (a.k.a) W as a Black man who applied for a Social Security card with the assistance of Westminster College (Fulton, Missouri) between January 2010 and March 2010; (39) your communications about Michael A. Aye (a.k.a) W as a Black man whose application for a social security number (SSN) was granted by the Social Security Administration (SSA) in 2010; (40) your communications about Michael A. Ayele (a.k.a) W as a Black man who worked for the Fulton State Hospital (FSH) between June and December 2013; (41) your communications about Michael A. Ayele (a.k.a) W as a Black man who has expressed concerns about the language used by the Director of the Division of Behavioral Health (DBH) pertaining to the involuntary administration of psychotropic drugs; (42) your communications about Michael A. Ayele (a.k.a) W as a Black man who has cautioned the DBH to refrain from forcibly administering psychotropic drugs unto patients/prisoners not posing harm to themselves and others; (43) your communications about Michael A. Ayele (a.k.a) W as a Black man who has advised the DBH to submit video and audio evidence of patients/prisoners posing harm to themselves and others before any hearing where employees and legal representatives of the DBH are considering the drastic measure of forcibly administering psychotropic drugs; (44) your communications about Michael A. Ayele (a.k.a) W as a Black man who has opposed preferential treatment in the service of healthcare as a former employee of the FSH; (45) your communications about Michael A. Ayele (a.k.a) W as a Black man who had expressed these objections pursuant to the Health Insurance Portability and Accountability Act (HIPAA) when he was a covered entity of the FSH; (46) your communications about Michael A. Ayele (a.k.a) W as a Black man who has lived several horrible experiences between January 07th 2016 and July 2016 similar to the testimonies provided to the NCD; (47) your communications about Michael A. Ayele (a.k.a) W as a Black man, who has had similar experiences to Marcie Kelley between January 07th 2016 and January 13th 2016; (48) documents

4 outlining the policy adopted by your mental health service provider on limiting the use of restraint and seclusion for people with disabilities; (47) documents outlining the policy adopted by your mental health service provider on the forcible administration of psychotropic drugs; (48) documents outlining the exception(s) granted by your mental health service provider to religious practitioners of Rastafarianism; (49) your communications about the decision of the Joseph R. Biden White House Administration to issue a statement on the Celebration of Enkutatash on September 10th 2021; (50) your communications about the article published by the British Broadcasting Corporation (BBC) pertaining to the Ethiopian calendar on September 11th 2021;(51) the academic background, the professional responsibilities and annual salaries of Yerker Andersson, Dave N. Brown, John D. Kemp, Audrey McCrimon, Gina McDonald, Nonnie O’Day, Lilliam Rangel-Diaz, Debra Robinson, Shirley W. Ryan, Michael B. Unhejm, Rae E. Unzicker, Ella Yazzie-King, Ethel D. Briggs, Mark S. Quigley, Kathleen A. Blank, Geraldine Drake Hawkins, Susan Madison, Allan W. Holland, Brenda Bratton, Stacey S. Brown, Rae E. Unzicker, Kate P. Wolters, Leye Chrzanowski, Mike Ervin and Judi Chamberlin.” NCD reports and most official correspondence is posted for public view on NCD’s website at NCD.gov. In regard to your request for specific NCD personnel academic background, professional responsibilities and annual salary, Stacey S. Brown is the only current NCD employee on the list of individuals you provided. Mr. Brown is a Howard University graduate, his annual salary is $80,532 and his professional responsibilities are as a staff assistant. He is a member of the Administration, Finance, and Operations (AFO) Team under the direction of the Director of Administration, Finance and Operations. In coordination with the AFO team, Mr. Brown provides critical support to the staff and members of NCD. NCD does not have any other records responsive to your request. For tracking purposes, your tracking number is NCD-2022-01. If you need further assistance, you may contact Amy Nicholas, NCD’s FOIA Public Liaison at 202-272-2008 or [email protected]. Please include your tracking number with any correspondence. If needed, it is your right to seek dispute resolution services from NCD’s Public Liaison or the Office of Government Information Services (OGIS). OGIS may be reached at: Office of Government Information Services (OGIS) National Archives and Records Administration 8601 Adelphi Road College Park, MD 20740-6001 [email protected] 202-741-5770 fax 202-741-5769 NCD’s appeal process allows you to appeal withheld information or the adequacy of NCD’s search by writing within 90 days of your receipt of this letter to:

5 Anne Sommers McIntosh Executive Director National Council on Disability 1331 F St. NW. Suite 850 Washington DC 20004 Your appeal must be in writing and should contain a brief statement of the reasons why you believe the requested information should be released. Enclose a copy of your initial request, request number and a copy of this letter. Both the appeal letter and envelope should be prominently marked “Freedom of Information Act Appeal.” After processing, actual fees must be equal to or exceed $25 for the Council to require payment of fees. See 5 CFR §10,00010k. The fulfillment of your request did not exceed $25, therefore there is no billable fee for the processing of this request. Respectfully, Joan Durocher Chief FOIA Officer

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 1 W (AACL) Date.: January 26th 2022 Michael A. Ayele P.O.Box 20438 Addis Ababa, Ethiopia E-mail: [email protected] ; [email protected] ; [email protected] Request for Records Hello, This is Michael A. Ayele sending this message though I now go by W. You may call me W. I am writing this letter to file a request for records with your offices.i The bases for this request for records are (1) the National Council on Disability (NCD) January 20th 2000 report entitled From Privileges to Rights: People Labeled with Psychiatric Disabilities Speak for Themselves ii and (2) the Hartford Courant series of article published between October 11 and October 15, 1998. iii I) Request for Records What I am requesting for prompt disclosure are all records within your possession detailing (1) formal and informal ties that exist between your offices, the National Council on Disability (NCD), the Department of Justice (DOJ), the Equal Employment Opportunity Commission (EEOC) and the Department of Health and Human Services (HHS); (2) your communications about the NCD as an independent federal agency mandated to make recommendations to the President and Congress on disability issues; (3) your communications about the NCD as a federal agency emphasizing that people with disabilities should be the ones who make the major decisions about their lives; (4) your communications about the NCD as a federal agency that endorses and supports the principles of independent living; (5) your communications about the NCD as a federal agency, which recognizes that people with psychiatric disabilities are routinely deprived of their rights in a way no other disability group has been; (6) your communications about the NCD as a federal agency, which has previously heard testimony graphically describing how people with psychiatric disability have been beaten, shocked, isolated, incarcerated, restricted, raped, deprived of food and bathroom privileges, and physically and psychologically abused in institutions and in their communities; (7) your communications about the NCD as a federal agency, which has previously been informed about the routine use and overuse of psychiatric drugs, often against people’s will; (8) your communications about the overuse of psychiatric drugs against people’s will being inconsistent with Title IX of the Education Amendments Act of 1972; (9) your communications about the overuse of psychiatric drugs against people’s will being inconsistent with the concept of affirmative and effective consent; iv (10) your communications about the overuse of psychiatric drugs against people’s will being comparable to what the HHS refers to as a “drug facilitated sexual assault;” (11) your

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 2 communications about the HHS identifying Rohypnol (flunitrazepam), GHB (gamma hydroxybutyric acid) and Ketamine as the three most common date rape drugs; v (12) your communications about the statement provided by Marcie Kelley to the NCD attesting that “eight men jumped on top of [her] (…) wrestled her to the floor (…) and shot [her] up with Thorazine;” vi (13) your communications about the NCD as a federal agency, which has concluded that the manner in which American society treats people with psychiatric disabilities constitutes a national emergency and a national disgrace; (14) your communications about the NCD as a federal agency, which has concluded that one of the reasons public policy concerning psychiatric disability is so different from that concerning other disabilities is the systemic exclusion of people with psychiatric disabilities from policymaking; (15) your communications about the NCD as a federal agency, which recommends for the use of involuntary treatments, such as forced drugging and inpatient and outpatient commitment laws, to be viewed as inherently suspect and as incompatible with the principles of self-determination; (16) your communications about the NCD as a federal agency, which recommends for aversive treatments that involve the infliction of pain or the restriction of movement for purposes of changing behavior to be banned; (17) your communications about the NCD as a federal agency, which recommends for people labeled with psychiatric disabilities to have a major role in the direction and control of programs and services designed for their benefits; (18) your communications about the NCD as a federal agency, which recommends for public policy to move toward the elimination of electro-convulsive therapy and psycho surgery; (19) your communications about the NCD as a federal agency, which recommends for research and demonstration resource to place a higher priority on the development of culturally appropriate alternative; (20) your communications about the NCD as a federal agency, which recommends for services in the community to not be contingent on participation in treatment programs; (21) your communications about the NCD as a federal agency, which recommends for employment and vocational rehabilitation program to account for the wide range of abilities, skills, knowledge, and experience of people labeled with psychiatric disabilities; (22) your communications about the NCD as a federal agency, which recommends for federal income support programs like Supplemental Security Income and Social Security Disability Insurance to provide flexible and work-friendly support options so that people with episodic or unpredictable disabilities are not required to participate in the current ‘all or nothing’ federal disability benefit system, often at the expense of pursuing their employment goals; (23) your communications about the NCD as a federal agency, which recommends for parity to be defined in terms of voluntary treatments and services; (24) your communications about the NCD as a federal agency, which recommends for government civil rights enforcement agencies and publicly-funded advocacy organization to work more closely together and with adequate funding to implement effectively critical existing laws like the Americans with Disabilities Act, Fair Housing Act, Civil Rights of Institutionalized Persons Act, Protection and Advocacy for Individuals with Mental Illness Act, and Individuals With Disabilities Education Act; (25) your communications about the NCD as a federal agency, which recommends for children and young adults with disabilities, particularly those labeled seriously emotionally disturbed to not be placed in correctional facilities and other segregated settings; (26) your communications about the articles published in the Hartford Courant on

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 3 October 11th 1998 entitled: A Nationwide Pattern of Death; vii (27) your communications about the article published on the Hartford Courant entitled Why They Die: Little Training, Few Standards, Poor Staffing; viii (28) your communications about the decision of the Hartford Courant to quote a psychologist who stated that staff of mental health institutions were really behaving like “cowboys;” (29) your communications about the article published on the Hartford Courant published on October 13th 1998 entitled Patients Suffer In A System Without Oversight; ix (30) your communications about the decision of the Hartford Courant to quote a doctor who said that staff members of mental health institutions should follow their conscience; (31) your communications about the Health Insurance Portability and Accountability Act (HIPAA) providing the opportunity for covered entities of mental hospitals to object to the treatment of a patient/prisoner; (32) your communications about the Government Accountability Office (GAO) September 1996 report entitled Medicaid: Oversight of Institutions for the Mentally Retarded Should Be Strengthened; x (33) your communications about the Hartford Courant October 14th 1998 article entitled People Die and Nothing Is Done; xi (34) your communications about the May 1997 report into the Napa State Hospital’s Failure to Protect Residents from Abusive Seclusion and Restraint Practices and to Properly Investigate Related Potential Criminal Acts by Staff; xii (35) your communications about the May 1997 report highlighting within Napa State Hospital (NSH) a failure to speak out when wrongdoing is committed by co-workers; (36) your communications about the decision of several news outlets to report on the “blue wall of silence” that was crumbling in the Derek Chauvin trial; xiii (37) your communications about the October 15th 1998 article published on the Hartford Courant entitled From ‘Enforcer’ to Counselor; xiv (38) your communications about Michael A. Ayele (a.k.a) W as a Black man who applied for a Social Security card with the assistance of Westminster College (Fulton, Missouri) between January 2010 and March 2010; (39) your communications about Michael A. Aye (a.k.a) W as a Black man whose application for a social security number (SSN) was granted by the Social Security Administration (SSA) in 2010; (40) your communications about Michael A. Ayele (a.k.a) W as a Black man who worked for the Fulton State Hospital (FSH) between June and December 2013; (41) your communications about Michael A. Ayele (a.k.a) W as a Black man who has expressed concerns about the language used by the Director of the Division of Behavioral Health (DBH) pertaining to the involuntary administration of psychotropic drugs; xv (42) your communications about Michael A. Ayele (a.k.a) W as a Black man who has cautioned the DBH to refrain from forcibly administering psychotropic drugs unto patients/prisoners not posing harm to themselves and others; (43) your communications about Michael A. Ayele (a.k.a) W as a Black man who has advised the DBH to submit video and audio evidence of patients/prisoners posing harm to themselves and others before any hearing where employees and legal representatives of the DBH are considering the drastic measure of forcibly administering psychotropic drugs; xvi (44) your communications about Michael A. Ayele (a.k.a) W as a Black man who has opposed preferential treatment in the service of healthcare as a former employee of the FSH; (45) your communications about Michael A. Ayele (a.k.a) W as a Black man who had expressed these objections pursuant to the Health Insurance Portability and Accountability Act (HIPAA) when he was a covered entity of the FSH;xvii (46) your communications about Michael A. Ayele (a.k.a) W as a Black man who has lived several

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 4 horrible experiences between January 07th 2016 and July 2016 similar to the testimonies provided to the NCD; (47) your communications about Michael A. Ayele (a.k.a) W as a Black man, who has had similar experiences to Marcie Kelley between January 07th 2016 and January 13 th 2016; (48) documents outlining the policy adopted by your public health service provider on limiting the use of restraint and seclusion for people with disabilities; (47) documents outlining the policy adopted by your public health service provider on the forcible administration of psychotropic drugs; (48) documents outlining the exception(s) granted by your public health service provider to religious practitioners of Rastafarianism; (49) your communications about the decision of the Joseph R. Biden White House Administration to issue a statement on the Celebration of Enkutatash on September 10th 2021;xviii (50) your communications about the article published by the British Broadcasting Corporation (BBC) pertaining to the Ethiopian calendar on September 11th 2021; xix (51) the academic background, the professional responsibilities and annual salaries of Yerker Andersson, Dave N. Brown, John D. Kemp, Audrey McCrimon, Gina McDonald, Nonnie O’Day, Lilliam Rangel-Diaz, Debra Robinson, Shirley W. Ryan, Michael B. Unhejm, Rae E. Unzicker, Ella Yazzie-King, Ethel D. Briggs, Mark S. Quigley, Kathleen A. Blank, Geraldine Drake Hawkins, Susan Madison, Allan W. Holland, Brenda Bratton, Stacey S. Brown, Rae E. Unzicker, Kate P. Wolters, Leye Chrzanowski, Mike Ervin and Judi Chamberlin. II) Request for a Fee Waiver and Expedited Processing According to the NCD, “involuntary treatment is extremely rare outside the psychiatric system, allowable only in such cases as unconsciousness or the inability to communicate. People with psychiatric disabilities, on the other hand, even when they vigorously protest treatments they do not want, are routinely subjected to them anyway, on the justification that they ‘lack insight’ or are unable to recognize their need for treatment because of their ‘mental illness.’ In practice, ‘lack of insight’ becomes disagreement with the treating professional, and people who disagree are labeled ‘noncompliant’ or ‘uncooperative with treatment.’ After years of contact with a system that routinely does not recognize their preferences or desires, many people with psychiatric disabilities become resigned to their fate and cease to protest openly. Although this is described in the psychiatric literature as ‘compliance,’ it is actually learned helplessness (also known as ‘internalized oppression’) that is incompatible with hope and with the possibility of recovery. Traditionally, involuntary commitment has involved the loss of liberty and confinement in a facility. However, more recently the concept of involuntary outpatient commitment (IOC) has become more widespread. IOC laws have been passed in nearly twothirds of the states, and similar legislation has been introduced in Congress. IOC involves courtordered treatment (almost always medication) for people who do not meet the standards for inpatient commitment (physical dangerousness to self or others). With more states enacting IOC laws, more people with psychiatric disabilities are being forced to take medications and treatments that can be painful and debilitating. At the same time, the desire of many people labeled with psychiatric disabilities for voluntary services that affect their real-life needs (such as housing, job training, and social support) seldom receive adequate funding. One of the consequences of IOC laws is that they often take money from voluntary programs that promote

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 5 independence and redirect it toward ever more restrictive and punitive programs.” The NCD have also previously noted that “anyone with a psychiatric disability, in fact anyone deemed by a mental health professional or police officer with little or no training to have such a disability, can be legally deprived of their freedom simply with an order from a judge, law officer, or medical professional. The due process procedures to challenge those decisions, and the laws and agencies that are supposed to protect and defend the legal rights of people affected by such orders, are often inadequate, ineffective, underfunded, inaccessible, or disregarded. Even when people are entitled to hearings, these are usually brief, and representation by counsel is often inadequate or nonexistent. (…) Neither law enforcement agencies nor the judicial and correctional systems have programs and policies in place to address the particular needs of people labeled with psychiatric disabilities while at the same time ensuring that they receive equal justice under law. When they are the victims of crime, testimony revealed that people labeled with psychiatric disabilities cannot rely on law enforcement agencies to protect them. The judicial system also fails them. Studies have found that rates of incarceration for people labeled with psychiatric disabilities are almost double the comparable rates in the general population. While it is often assumed that people labeled with psychiatric disabilities are in prison because they are particularly violent and dangerous, in fact, large numbers of prisoners with psychiatric disabilities are in prison for crimes that would not normally result in incarceration for nondisabled people. Inmates with psychiatric disabilities serve longer sentences than other prisoners and are less likely to receive voluntary treatment for their disabilities. Treatment in penal settings almost always consists of drugs, most often without any meaningful informed consent. In fact, imprisonment may actually exacerbate the symptoms of people labeled with psychiatric disabilities. (…) The Police Executive Research Forum (PERF), a national organization composed of chief executives from municipal, county, and state law enforcement agencies, offers a training curriculum and model policy that addresses police response to people labeled with psychiatric disabilities. PERF's trainer's guide, Police Response to People with Mental Illness, also covers the ADA and community policing approaches, including the voluntary and involuntary commitment process, arresting, and interviewing people with mental illness. However, as is typical of such training procedures, these materials were developed without input from people labeled with psychiatric disabilities. The training guide notes, ‘It is not the role of the police officer to make the determination that a person should be committed.’ Testimony revealed, however, that police do not always adhere to this policy.” The requested records have demonstrated the existence of widespread incompetence throughout the U.S health care industry, which has led to people suffering emotional and physical harm. On the bases mentioned above, I believe this request for records should be expedited and all fees waived. As a former health care worker, I (personally) am pained whenever I am associated with a facility located 6655 Sykesville Rd, Sykesville, MD 21784 the other has decided to describe as a “hospital.” I (personally) have not sought this association with the other. Unfortunately, my name is very much linked on many internet search engines with this facility the other describes as a “hospital.” I very much regret this association. The disgraceful report written about me pertaining to events that have occurred between January 06th 2016 and January 13th 2021 has been submitted to the judicial branch of the Maryland government located 101 West Lombard Street, Baltimore, MD and 6500 Cherrywood Lane, Greenbelt, MD. I (personally) would strongly discourage people out there to describe the facility in Sykesville, MD as a “hospital”

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 6 because of the way it operates. The facility is not one that’s into “treating” and “healing” individuals who may suffer from a mental impairment. However, it’s very much a facility that’s into (1) distorting the things that I have said; (2) forcibly administering psychotropic drugs unto patients/prisoners with no legal basis for such a draconian measure; (3) not presenting audio and video evidence of the patient/prisoner behavior, which would give them the legal basis for the administration of psychotropic drugs; (4) not de-escalating tense situations, which arise when dealing with people who have a disability; (5) creating explosive situations that endanger the lives of people in the confined environment. I regret to inform you that several others I have had the displeasure to deal with between December 23rd 2015 until May 20th 2016 are shady and sketchy individuals with very much something to hide. The individuals I have had to deal with working in the facility located 7600 Carroll Ave., Takoma Part, Maryland are no better. As of this writing, getting the content of my own medical report for the purpose of submitting it to the courts in the State of Maryland has become a real legal challenge despite my best efforts. Have a good day. Take care. Keep yourselves at arms distance. Respectfully submitted: W (AACL) Michael A. Ayele Anti-Racist Human Rights Activist Audio-Visual Media Analyst Anti-Propaganda Journalist

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 7 Work Cited i Please be advised that I have previously disseminated a vast number of documents obtained through records request via Archive.org, Scribd.com, Medium.com and YouTube.com. These documents have been made available to the public at no financial expense to them. As a member of the media, I would like to take this opportunity to inform you that the records you disclose to me could be made available to the general public through the means I have mentioned above or other ones. On December 10th 2021, I have launched a website on Wordpress.com for the purpose of making the records previously disclosed to me by the U.S government further accessible to members of the general public interested in the activities of their elected and nonelected representatives. You can find out more about the recent publications of the Association for the Advancement of Civil Liberties (AACL) here.: https://michaelayeleaacl.wordpress.com/ ii From Privileges to Rights: People Labeled With Psychiatric Disabilities Speak for Themselves, National Council on Disability.: https://ncd.gov/publications/2000/Jan202000 iii Weiss EM, et al. Deadly restraint: a Hartford Courant investigative report. Hartford Courant 1998; October 11 – 15. https://www.charlydmiller.com/LIB05/1998hartforddata.html iv Many of the prescription drugs used in treatment programs do have devastating side effects. Particularly in programs that treat people by force, there are few, if any, opportunities for informed consent, discussion of alternatives, or the right to refuse treatment. From Privileges to Rights: People Labeled With Psychiatric Disabilities Speak for Themselves, National Council on Disability.: https://ncd.gov/publications/2000/Jan202000 v Date rape, also known as “drug-facilitated sexual assault,” is any type of sexual activity that a person does not agree to. It may come from someone you know, someone may have just met, and/or someone thought you could trust. What Are Date Rape Drugs and How Do You Avoid Them? Department of Health and Human Services (HHS) National Institute of Health (NIH).: https://archives.drugabuse.gov/blog/post/what-are-date-rape-drugs-and-how-do-you-avoidthem#:~:text=Date%20rape%2C%20also%20known%20as,someone%20thought%20you%20co uld%20trust. vi One sexual abuse survivor, who was forcibly restrained while in a mental institution, continues to relive the horror through nightmares. In her testimony about the traumatizing incident, she stated: Eight men jumped on top of me and wrestled me to the floor. They held me face-down on the floor, restrained me, and then shot me up [with] Thorazine. I then waited in restraints for hours until they thought my behavior was appropriate to be released. I remember begging with them like a dog to release me. I was totally powerless and at their mercy. (Marcie Kelley) (…)

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 8 Mental health service provider Marcie Kelley has personally experienced the adverse effects of restraints. As a survivor of sexual abuse, I personally have found the use of restraints on me more traumatizing than being sexually abused. Being put in restraints is a much longer, traumatic ordeal than being raped. (Marcie Kelley) From Privileges to Rights: People Labeled With Psychiatric Disabilities Speak for Themselves, National Council on Disability.: https://ncd.gov/publications/2000/Jan202000 vii Roshelle Clayborne pleaded for her life. Slammed face-down on the floor, Clayborne's arms were yanked across her chest, her wrists gripped from behind by a mental health aide. I can't breathe, the 16-year-old gasped. Her last words were ignored. A syringe delivered 50 milligrams of Thorazine into her body and, with eight staffers watching, Clayborne became, suddenly, still. Blood trickled from the corner of her mouth as she lost control of her bodily functions. Her limp body was rolled into a blanket and dumped in an 8-by10-foot room used to seclude dangerous patients at the Laurel Ridge Residential Treatment Center in San Antonio, Texas. The door clicked behind her. No one watched her die. But Roshelle Clayborne is not alone. Across the country, hundreds of patients have died after being restrained in psychiatric and mental retardation facilities, many of them in strikingly similar circumstances, a Courant investigation has found. Those who died were disproportionately young. They entered our health care system as troubled children. They left in coffins. All of them died at the hands of those who are supposed to protect, in places intended to give sanctuary. (…) Few seemed to care much about Roshelle Clayborne at Laurel Ridge, where she was known as a "hell raiser.'' But Clayborne had made one close friendship -- with her roommate, Lisa Allen. Allen remembers showing Clayborne how to throw a football during afternoon recess on that summer afternoon in 1997.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 9 "She just couldn't seem to get it right and she was getting more and more frustrated. But I told her it was OK, we'd try again tomorrow,'' said Allen, who has since rejoined her family in Indiana. Within three hours, Clayborne was dead. She had attacked staff members with pencils. And staffers had a routine for hell raisers. "This is the way we do it with Roshelle,'' a worker later told state regulators. "Boom, boom, boom: [medications] and restraints and seclusion.'' After she was restrained, Roshelle Clayborne lay in her own waste and vomit for five minutes before anyone noticed she hadn't moved. Three staffers tried in vain to find a pulse. Two went looking for a ventilation mask and oxygen bag, emergency equipment they never found. During all this time, no one started CPR. "It wouldn't have worked anyway,'' Vanessa Lewis, the licensed vocational nurse on duty, later declared to state regulators. By the time a registered nurse arrived and began CPR, it was too late. Clayborne never revived. In their final report on Clayborne's death, Texas state regulators cited Laurel Ridge for five serious violations and found staff failed to protect her health and safety during the restraint. They recommended Laurel Ridge be closed. Instead, the state placed Laurel Ridge on a one-year probation in February and the center remains open for business. In a prepared statement, Laurel Ridge said it has complied with the state's concerns -- and it pointed out the difficulty in treating someone with Clayborne's background. "Roshelle Clayborne, a ward of the state, had a very troubled and extensive psychiatric history, which is why Laurel Ridge was chosen to treat her,'' the statement said. "Roshelle's death was a tragic event and we empathize with the family.'' With no criminal prosecution and little regulatory action, the Clayborne family is now suing in civil court. The Austin chapter of the NAACP and the private watchdog group Citizens Human Rights Commission of Texas are asking for a federal civil rights investigation into the death of Clayborne. Medications and restraint and seclusion. Clayborne's friend, Lisa Allen, knew the routine well, too. For six years, Allen, now 18, lived in mental health facilities in Indiana and Texas, where her explosive personality would often boil over and land her in trouble.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 10 By her own estimate, Allen was restrained "thousands'' of times and she bears the scars to prove it: a mark on her knee from a rug burn when she was restrained on a carpet; the loss of part of a birthmark on her forehead when she was slammed against a concrete wall. Exactly two weeks after Roshelle Clayborne's death, Lisa Allen found herself in the same position as her friend. The same aide had pinned her arms across her chest. Thorazine was pumped into her system. She was deposited in the seclusion room. "It felt like my lungs were being squished together,'' Allen said. But Lisa Allen was one of the lucky ones. She survived. Weiss EM, et al. Deadly restraint: a Hartford Courant investigative report. Hartford Courant 1998; October 11 – 15. https://www.charlydmiller.com/LIB05/1998hartfordcourant11.html viii She was a 15-year-old patient, alone in a new and frightening place, clutching a comforting picture from home. He was a 200-pound mental health aide bent on enforcing the rules, and the rules said no pictures. She defied him; the dispute escalated. And for that, Edith Campos died. She was crushed face down on the floor in a “therapeutic hold'' applied by a man twice her size. Shy and well-behaved as a girl growing up in Southern California, Edith had problems as a teen. She ran away, took drugs, hung with the wrong crowd. Her family hoped treatment at the Desert Hills psychiatric center in Tucson, Ariz., would help. (…) But Edith Campos died -- as did Andrew McClain and Roshelle Clayborne and countless others - when a trivial transgression spiraled into violence. Too often, it's a reaction built right into our system that cares for people with psychiatric problems and mental retardation. The people who make and execute the critical decisions to use physical force or strap a patient to a bed or chair are often aides, the least-trained and lowest-paid workers in the field. They must make instantaneous decisions affecting patients' physical and psychological wellbeing against a backdrop of staffing cuts that result more in crowd control than in patient therapy. (…) ``I can't understand why patients don't die more often with all the things that happen on a daily basis,'' said Wesley B. Crenshaw, a psychologist who has conducted one of the few national surveys on restraint use.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 11 “You have people who are ‘cowboying’ it,'' Crenshaw said, “people who really want to get in there and show they're the boss.'' Yet only three states -- California, Colorado and Kansas -- actively license aides in psychiatric facilities. Licensing of aides is nearly non-existent in the mental retardation field, although a handful of states do certify aides. So while individual states and facilities may set their own standards, there is no uniform, minimum training for aides nationwide -- even in life-saving techniques such as CPR. In the Edith Campos case, aide Daniel Thomas Walsh successfully fought negligent homicide charges by arguing he had followed hospital guidelines. And the guidelines didn't say he needed to watch Edith's face for signs of distress, the judge found. Why They Die: Little Training, Few Standards, Poor Staffing, The Hartford Courant.: https://www.charlydmiller.com/LIB05/1998hartfordcourant12.html ix Had Gloria Huntley been able to move, had she not been bound to her bed with leather straps for days on end, perhaps she would have tried to draw the attention of the inspectors who were conducting a three-day tour of Central State Hospital. Had she been able to move, had she not been pinned down by the wrists and ankles, she might have held up a sign, as she had done before when a visitor came through Ward 7. Her handwritten plea was simple: "Pray for me. I'm dying.'' But the inspection team from the nation's leading accreditation agency never noticed Gloria Huntley before leaving the Petersburg, Va., psychiatric hospital. The three inspectors from the Joint Commission on the Accreditation of Healthcare Organizations issued Central State a glowing report card -- 92 out of 100 points. They also bestowed the commission's highest ranking for patients' rights and care when they concluded their review on June 28, 1996. The next day, Gloria Huntley died. She was 31. Her heart, fatally weakened by the constant use of restraints, had inflamed to 1 1/2 times its normal size. In her last two months, she'd been restrained 558 hours -- the equivalent of 23 full days. Nine months later, the Joint Commission gave Central State an even better score in a follow-up review -- even though Huntley's treatment would ultimately be labeled "inhumane'' by the state of Virginia and condemned by the U.S. Justice Department. "How could JCAHO give Central State the highest rating in human rights when they were killing people?'' asked Val Marsh, director of the Virginia Alliance for the Mentally Ill. The way the country's health care system works, how could it not?

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 12 The Courant's nationwide investigation of restraint-related deaths underscores just how faulty -- how rife with conflicts of interest, how self-protective, how ultimately ineffective -- the system of industry oversight and government regulation really is. The health care industry is left to police itself, but often doesn't. Time and again, The Courant found, when it comes to the quality and safety of patient care, the interests of the industry far outweigh the public interest. "One reason you have overuse and misuse of restraints is because oversight is practically nonexistent,'' said Dr. E. Fuller Torrey, a nationally prominent psychiatrist and author of several books critical of the nation's mental health system. "And the health industry doesn't want oversight.'' The chain of agencies, boards and advocates that is supposed to provide oversight -- the kind of oversight that might have prevented Huntley's death and hundreds like it -- often breaks down in multiple places. But the heavy reliance on the Joint Commission -- an industry group that acts as the nation's de facto regulator -- lies at the core of the problem. The federal government relies on the private nonprofit agency's seal of approval for a psychiatric hospital's acceptance into Medicare and Medicaid programs. And 43 states, including Connecticut, accept it as meeting most or all of its licensing requirements. But the Joint Commission doesn't answer to Congress or the public. It answers to the health care industry. The Joint Commission was founded in 1951 by hospital and medical organizations, whose members still dominate the commission's board of directors. The commission is funded by the same hospitals it inspects. How tough are its inspections? Of the more than 5,000 general and psychiatric hospitals that the Joint Commission inspected between 1995 and 1997, none lost its accreditation as a result of the agency's regular inspections. None. When extraordinary circumstances arise -- a questionable death, for instance -- the Joint Commission may conduct additional inspections. Even then, less than 1 percent of facilities overall lost accreditation. Central State was not among them.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 13 Joint Commission officials are the first to say they are not regulators. Participation is voluntary, and 83 percent of hospitals inspected were found to have shortcomings that needed to be addressed. "Joint Commission accreditation is intended to say to the patient: This is a place that does things well and is constantly working to improve things,'' said Dr. Paul M. Schyve, a psychiatrist and senior vice president of the Joint Commission. If the industry is not adequately watching itself, neither is the government. The nation's top mental health official says he has little latitude when it comes to tougher regulation and oversight. "Most rules governing health care have been left to the states,'' said Dr. Bernard S. Arons, director of the U.S. Center for Mental Health Services. When it comes to mental retardation facilities, in fact, inspection is left largely to the states. But their record is not much better. The General Accounting Office, the investigative arm of Congress, has found that state regulators are loath to punish state-run facilities. In a study of state mental retardation centers, the GAO found "instances in which state surveyors were pressured by officials in their own and in other state agencies to overlook problems or downplay the seriousness of deficient care in large state institutions.'' When state regulators do show up, their inspections are scheduled with such predictability that facilities can beef up staff, improve services and even apply fresh coats of paint. Often, only the new paint remains after the inspectors leave. "These visits provide only a snapshot,'' said William J. Scanlon, director of health care studies for the GAO. "And it may be a doctored snapshot.'' It is only when the system utterly collapses, as in the Gloria Huntley case, that the federal government intervenes to set rules for patient care. Justice Department abuse investigators, who have authority to intercede when civil rights violations are suspected in publicly run facilities, often find these same facilities were recently given clean bills of health by licensing agencies or the Joint Commission. "The use of restraints is clearly a very big problem and a very significant issue in nearly all of the institutions we investigate,'' said Robinsue Froehboese, the top abuse investigator at the Justice Department. But with a staff of 22 attorneys, Froehboese's office can undertake only a handful of major investigations each year.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 14 "Nineteenth-century England had a better oversight system than we have now,'' said Torrey, describing an English system that used full-time government inspectors to check every psychiatric facility without prior notice. At Central State, the warning signs should have been apparent. But Joint Commission inspectors review just a sampling of patient records -- a sampling that may not include problem cases like Gloria Huntley's. Anyone who did look at Huntley's records would have known her health was failing -- and that heavy use of restraints was a primary reason. Two years before Huntley's death, a doctor warned officials at Central State that she would die if they didn't change her restraint plan. "Staff members should watch their conscience, and those in charge must always remember that following physical struggle and emotional strain, the patient may die in restraints,'' stated the ominously titled "duty to warn'' letter. Even if the Joint Commission inspectors had missed Huntley in particular, there were other cases at Central State that should have raised red flags. One patient was restrained for 1,727 hours over an eight-month period, yet another for 720 hours over a four-month period, according to a U.S. Justice Department report. So, in many respects, the investigation into Huntley's death is most remarkable in that it happened at all. When she died on June 29, 1996, the police were never called. It took a hospital employee's anonymous call to a citizens watchdog group, days after Huntley's death, to tip off the outside world that she died while being restrained -- and not in her sleep as hospital officials told family members. The Courant's investigation found at least six cases in which facilities, wary of lawsuits and negative publicity, tried to cover up or obscure the circumstances of a restraint-related death. "It's sort of a secretive thing,'' said Dr. Rod Munoz, president of the American Psychiatric Association. "Every hospital tries to protect itself.'' "The incentive is to settle with the family, fix it internally and move on,'' said Dr. Thomas Garthwaite, deputy undersecretary of health for the U.S. Department of Veterans Affairs. Many states, including Connecticut, have laws that shield discussions among doctors that explore what went wrong. The laws are designed to promote candid discussions, but the solutions often don't leave the closed hospital conference room. Garthwaite and other experts said hospitals need to share problems and solutions to prevent deadly errors from being repeated. Just a year ago, the VA began a comprehensive system to track all deaths and mistakes.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 15 But a plan by the Joint Commission to do the same all across the nation has been stymied so far by the powerful American Hospital Association. The AHA notified the Joint Commission in January that the proposal had created a ``firestorm'' among its members, who worried that they would have to turn over ``self-incriminating'' documents. "We've tried to make the program workable, so people would not be afraid to report on a voluntary basis,'' said Dr. Donald M. Nielsen, a senior vice president of the American Hospital Association. He said the two groups agreed last month on some ground rules regarding the issue. With the industry failing to monitor itself, with government regulators unwilling to challenge the industry, uncovering abuse is left to "protection and advocacy'' agencies established by Congress in each state. Despite $22 million in federal funding this year and broad authority to root out and litigate cases of abuse, even some advocates turn a blind eye to investigating deaths. Desperate for help, Gloria Huntley turned to one of these organizations in her last months of life. Not only was her complaint not investigated, but three weeks after her death Huntley was sent a letter saying the advocacy agency was dropping her case because it hadn't heard from her in 90 days. The letter ends: "It was a pleasure working with you to resolve your complaint. I wish you the best of luck in your future endeavors.'' Advocates say they have too little funding for their broad charge, and are fought every step of the way by hospitals and doctor groups. Scarce money and staffing are used just to secure basic information. "It's a David and Goliath battle,'' said Curtis L. Decker, executive director of the group representing advocacy organizations nationwide. "And Goliath is winning.'' Hospitals see no need for drastic change, let alone more government intervention. "Given the speed of government, it is often better to allow the private market to work issues out,'' said Nielsen of the AHA. ``Joint Commission standards have been revised recently and are continually being improved.'' Huntley's family might take issue with that assessment. They have filed a civil rights lawsuit in federal court seeking $2 million, and a wrongful death lawsuit in state court seeking $450,000. "We knew from the get-go things weren't right when they told us she died in her sleep,'' said Paige Griggs, Huntley's sister-in-law. "We thought she was being taken care of.''

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 16 Patients Suffer in a System Without Oversight, Hartford Courant.: https://www.charlydmiller.com/LIB05/1998hartfordcourant13.html x Pursuant to a congressional request, GAO reviewed the role of the Health Care Financing Administration (HCFA), state agencies, and the Department of Justice (DOJ) in overseeing quality of care in intermediate care facilities for the mentally retarded (ICF/MR), focusing on: (1) deficient care practices occurring in large ICF/MR; (2) whether state agencies identify all serious deficiencies in these institutions; and (3) weaknesses in HCFA and state oversight of ICF/MR care. GAO found that: (1) serious quality-of-care deficiencies continue to occur in some large public ICF/MR despite federal standards, HCFA and state oversight, and DOJ investigations; (2) 122 ICF/MR had at least one violation during the last four annual surveys; (3) these violations included inadequate staffing, the lack of active treatment to enhance independence and prevent degeneration, deficient medical and psychiatric care, patient abuse and mistreatment, and insufficient protection of residents' rights; (4) deficient care has led to residents' injury, illness, physical degeneration, and death in some instances; (5) HCFA and DOJ have identified more numerous and serious deficiencies than state agencies, probably because of the state agencies' limited approach and resources; (6) state agencies do not always sufficiently enforce care standards and some institutions have been repeatedly cited for the same serious violations; (7) HCFA has taken actions to improve its oversight and the use of limited federal and state resources, but weaknesses remain; (8) state surveys may lack independence because states are responsible for surveying their own facilities; and (9) concern over this lack of independence has increased, since federal oversight of institutional care and state agencies' performance has declined. Medicaid: Oversight of Institutions for the Mentally Retarded Should Be Strengthened, Government Accountability Office (GAO).: https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-131/html/GAOREPORTSHEHS-96-131.htm xi The Courant's investigation has found the nation's legal system falters time and again when it comes to restraint-related deaths. Just as the medical establishment fails to provide the kind of internal oversight that might prevent patients from dying, the legal system offers little hope for justice after they are dead. (…) A former prosecutor, Costen is familiar with the flaws of criminal investigations into restraint deaths. Among the common problems he cited: Scenes are not preserved because staff immediately clean up the room where the restraint occurred. Staffers develop a story emphasizing the patient's existing physical problems. And workers say they were just protecting themselves or others from harm, making it hard to prove criminal intent. Others have found staffers reluctant to blow the whistle on colleagues.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 17 "Despite the legal and ethical obligations to report and protect patients from abuse, a strong code of silence among direct care staff still exists,'' California investigators found last year after an investigation into restraint abuses at Napa State Hospital. Two people have died in restraintrelated incidents at Napa State in the past six years. The California report found a system rotting from within. It cited a survey in which two-thirds of psychiatric aides statewide believe there to be a "code of silence.'' Workers, the report said, consider themselves victims of a bad and abusive system. People Die and Nothing Is Done, Hartford Courant.: https://www.charlydmiller.com/LIB05/1998hartfordcourant14.html xii Napa State Hospital’s Failure to Protect Residents from Abusive Seclusion and Restraint Practices and to Properly Investigate Related Potential Criminal Acts by Staff, Protection & Advocacy, Incorporated Investigations Unit.: https://www.disabilityrightsca.org/system/files/fileattachments/701101.pdf xiii During his lengthy testimony Monday, Minneapolis' police chief minced no words in condemning the actions of Derek Chauvin, the former officer who is charged with murder in the death of George Floyd. "To continue to apply that level of force to a person proned out, handcuffed behind their back, that in no way, shape or form is anything that is by policy," Chief Medaria Arradondo said. "It is not part of our training, and it is certainly not part of our ethics or values." Arradondo's testimony should have come as no surprise. In his opening statement, prosecutor Jerry Blackwell told jurors that Arradondo wouldn't hold back in his assessment that Chauvin used "excessive force" when he knelt on Floyd's neck for 9 minutes, 29 seconds last May. Still, Arradondo's testimony was rare. That he was joined by a string of other law enforcement officers was remarkable. The “blue wall of silence” is crumbling in the Derek Chauvin trial. Why this case could be a tipping point NBC News.: https://www.nbcnews.com/news/us-news/how-derek-chauvin-s-trialbringing-down-blue-wall-n1263383 Shanette Hall hopes more police officers will follow the lead of Derek Chauvin's former colleagues, who testified against him in a two-week-long trial, and speak up when they witness misconduct. (…) Testimony condemning the actions of Chauvin in the murder of George Floyd have been described by some as a falling — or at least cracking — of the "blue wall of silence," an informal code that stops police from reporting their colleagues' misconduct and errors.

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 18 The so-called blue wall is a well-established concept in policing, according to Kate Levine, an associate professor of law at Cardozo School of Law in New York. "There's just tremendous organizational solidarity within police departments, which means they protect each other and it means they lie for each other," she said. "There's a phrase called 'testilying,' which was invented to describe police lying on the stand, police committing perjury." Although Hall, whose organization was founded with the goal of fighting racial discrimination in both policing and communities, recognizes the blue wall exists, she argues that those working in law enforcement should hold — and be held to — the highest levels of integrity in any profession. "It is expected of us to do what is right," she said. Testimony against Derek Chauvin exposed a crack in the ‘blue wall,’ but experts say it must come down, CBC.: https://www.cbc.ca/radio/day6/how-the-far-right-capitalizes-on-lockdowns-a-black-led-policeunion-wheatus-remakes-teenage-dirtbag-and-more-1.5999612/testimony-against-derek-chauvinexposed-a-crack-in-the-blue-wall-but-experts-say-it-must-come-down-1.5999620 xiv From ‘Enforcer to Counselor’ Hartford Courant.: https://www.cbc.ca/radio/day6/how-the-farright-capitalizes-on-lockdowns-a-black-led-police-union-wheatus-remakes-teenage-dirtbag-andmore-1.5999612/testimony-against-derek-chauvin-exposed-a-crack-in-the-blue-wall-but-expertssay-it-must-come-down-1.5999620 xv Excerpt of Email Sent by Michael A. Ayele (a.k.a) W on September 12th 2021 to the Missouri Department of Mental Health Please be advised that I have concerns about the records you have disclosed on August 26th 2021 because of the language used by the Director of the Division of Behavioral Health (DBH) about the involuntary administration of psychotropic drugs. As a former employee of the DMH (FSH), I have (personally) found the language used by the Director of the DBH to be broad, unclear, and extremely vague. For instance, the Director of the DBH has noted that "all patients in the Department of Mental Health (DMH) facilities may be administered psychotropic medication on an involuntary basis when a determination of emergency is made by appropriate clinical personnel at the facility. An emergency exists where there is reasonable likelihood of imminent physical harm and/or life threatening behavior to the patient or others. The treating provider who prescribes the psychotropic medication shall document the circumstances of the emergency, the facts surrounding the medication need, and why involuntary psychotropic medication is considered the least restrictive treatment. A new order shall be written for each emergency dose. (...) Patients admitted for Inpatient Pre-Trial Evaluations pursuant to Section 552.020, RSMo, and detainees pursuant to Section 632.480 et seq., RSMo., may not be

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 19 medicated, absent an emergency, without either the consent of the patient or expressed written consent from the committing court. The psychiatrist must communicate the desire to medicate such a patient to a designated assistant general counsel, who will communicate with the committing court and obtain a written order from the judge. (...) The Clinical Due Process hearing will be repeated every 6 months if the patient still needs to be involuntarily medicated or until the patient is discharged from the facility." As a former employee of the DMH (FSH), I have several concerns about the language used by the Director of the DBH because it fails to clearly inform appropriate clinical personnel about the type of behaviors that would warrant the forcible administration of psychotropic drugs. As a former employee of the DMH (FSH), I do believe the language used by the Director of the DBH could create circumstances ripe for abuse. Fathom for instance a hypothetical scenario where a clinical personnel of the DBH opines that a patient/prisoner is dangerous to her/himself and others. Fathom in the same hypothetical scenario that the clinical personnel who has issued this opinion is (1) biased, (2) looking to retaliate on the individual as a form of punishment; (3) not in a position to list specific behaviors that would justify the forcible administration of psychotropic drugs because the patient/prisoner has not exhibited any. As a former employee of the DMH (FSH), I believe this hypothetical scenario I have described could happen. For this very reason, I must caution you to admit as evidence audio and video footage depicting patients/prisoners displaying violent behavior that would in your opinion justify the forcible administration of psychotropic drugs (whenever you are considering such a serious thing). As you have correctly noted in the records you have disclosed to me, the forcible administration of psychotropic drugs has the potential to re-traumatize people who may have been victims of a violent crime (especially if the use of force is without appropriate medical and legal basis to justify). As a former employee of the DMH (FSH), I also have several concerns about the eagerness of the Director of the DBH to put non-violent people through the emotionally and financially draining process of guardianship. For example, the Director of the DBH has previously noted that if patients are "determined to lack adequate mental capacity but are not imminently dangerous, clinicians shall proceed by filing for guardianship." (…) What I am requesting for prompt disclosure are all records within your possession detailing (1) submitted evidence of audio and video footage depicting patients/prisoners of the DMH displaying violent behavior when considering to administer psychotropic drugs against their will; (2) documents detailing the time and circumstances under which the DMH discontinued the forcible administration of psychotropic drugs after a period of 6 (six) months; (3) your communications in the form of e-mails and postal correspondence about Rihanna being a fan of Bob Marley; (4) your communications in the form of e-mails and postal correspondence about the decision of Rihanna to pay tribute to Bob Marley by singing his songs on her concerts; (5) formal and informal opinions held by the DMH, the NCD and the EEOC about the songs of Bob Marley; (6) formal and informal opinions held by the DMH, the EEOC and the NCD about the life-style of Bob Marley; (7) formal and informal opinions held by the DMH, the EEOC and the NCD about Bob Marley having enjoyed marijuana/cannabis/weed when he was alive; (8) the names of patients/prisoners of the DMH who are Rastafarians by religion and who refuse to consume pharmaceutical drugs except marijuana/cannabis/weed for religious reasons; (9)

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 20 photos and videos taken by the DMH, the EEOC and the NCD to celebrate Bob Marley's 75th and 76th anniversary respectively dated February 06th 2020 and 2021; (10) your comunications in the form of e-mails and postal correspondence about the Joe Biden / Kamala Harris White House Administration press release wishing people of Ethiopian and Eritrean descent well. Have a good day. Take care. W (AACL) Michael A. Ayele Anti-Racist Human Rights Activist Audio-Visual Media Analyst Anti-Propaganda Journalist See e-mail of Michael A. Ayele (a.k.a) W sent on or around September 12th 2021. xvi Excerpt of Email Sent by Michael A. Ayele (a.k.a) W on September 20th 2021 to the Fulton State Hospital (FSH) W (AACL) Date.: September 20th 2021 Michael A. Ayele P.O.Box 20438 Addis Ababa, Ethiopia E-mail: [email protected] ; [email protected] ; [email protected] Sunshine Law: Request for Records Hello, Thank you for your e-mail. I am in receipt of it. I am writing this letter in response to your correspondences dated August 26th 2021 and September 15th 2021. As you are likely aware, you had disclosed on August 26th 2021 the use of force policy employed by the Department of Mental Health (DMH) pertaining to the administration of psychotropic drugs. Please be advised that I have several concerns about your correspondence dated August 26th and September 15h 2021. According to the Director of the Division of Behavioral Health (DBH), "any patient not under guardianship who is currently an active, practicing member of a generally recognized, organized church or religion which teaches reliance upon treatment by prayer or other spiritual means of healing may refuse the administration of medication unless an emergency exists as defined in section (1) of this DOR. Whenever a patient seeks to refuse medication due to religious belief, the COO shall convene and chair a review panel consisting of a facility chaplain, a licensed social worker, a psychologist and the medical director. The panel shall seek advice from an outside member of the patient’s religion or church whenever possible. The panel shall interview the patient, review records, and seek outside advice and confirmation that: 1. the patient’s religion is a generally recognized, organized faith which teaches reliance on spiritual means; 2. the patient has been and is currently an active participating member. If the review panel confirms sections 5(B) 1 and 2, the patient’s refusal of medication shall be honored. If either

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 21 section 5(B) 1 or 2 are not confirmed, the refusal will be handled as set forth in section (2) of this DOR. " As a former employee of the DMH (FSH), I have several concerns about the language used by the Director of the DBH for failing to clearly state that employees and legal representatives of the DMH will not use force in administering psychotropic drugs onto patients/prisoners who are not posing harm to themselves and others if they do not consent to taking drugs prescribed by a doctor for their alleged mental disorders/intellectual disabilities. As a former employee of the DMH (FSH), I would find it absurd if medical doctors would force the administration of pills such as Paracetamol upon patients suffering from a headache (who wish for their pain to go away without taking pharmaceutical drugs). In my opinion, the forcible use of psychotropic drugs onto patients/prisoners of the DMH (who are not posing an immediate danger to themselves/others) is just as bizarre as medical doctors looking to forcibly administer Paracetamol onto patients wishing for their headaches to go away without taking pharmaceutical drugs (including but not limited to Paracetamol). As a former employee of the DMH, I must caution you to refrain from forcibly administering psychotropic drugs upon patients/prisoners not posing harm to themselves and others if they do not wish to be on such drugs. I would also advise you to submit video and audio evidence of patients/prisoners posing harm to themselves and others before any hearing where employees and legal representatives of the DMH are considering the drastic measure of forcibly administering psychotropic drugs. (…) W (AACL) Michael A. Ayele Anti-Racist Human Rights Activist Audio-Visual Media Analyst Anti-Propaganda Journalist xvii The National Council on Disability (NCD) Deny Being in Possession of Records Pertaining to Britney Spears Perturbing Conservatorship, W (AACL), Michael A. Ayele, Scribd.: https://www.scribd.com/document/535930976/The-National-Council-on-Disability-NCD-DenyBeing-in-Possession-of-Records-Pertaining-to-Britney-Spears-Perturbing-Conservatorship-WAACL xviii Statement by President Joseph R. Biden, Jr. on the Celebration of Enkutatash, White House.: https://www.whitehouse.gov/briefing-room/statements-releases/2021/09/10/statement-bypresident-joseph-r-biden-jr-on-the-celebration-of-enkutatash/ xix Ethiopia: The country where a year lasts 13 months. BBC.: https://www.bbc.com/news/world-africa-57443424

REQUEST FOR RECORDS 01/26/2022 W (AACL) – MICHAEL A. AYELE 22

APPEND

DIX A.

National Council on Disability An independent federal agency making recommendations to the President and Congress to enhance the quality of life for all Americans with disabilities and their families. 1331 F Street, NW ■ Suite 850 ■ Washington, DC 20004 202-272-2004 Voice ■ 202-272-2022 Fax ■ www.ncd.gov September 30, 2021 W (AACL) Michael A. Ayele PO Box 20438 Addis Ababa, Ethiopia Re: FOIA Request NCD-2021- 13 Dear W: This letter is in response to your Freedom of Information Act (FOIA) request, dated September 20, 2021, in which you requested: “My request for records are as follows. 1) Are there any religious beliefs the DMH has previously granted an exception to for patients/prisoners not wishing to take psychotropic drugs? If yes, will you promptly disclose the names of the religious beliefs the DMH has had dealings with? 2) How do the DMH, the Equal Employment Opportunity Commission (EEOC), the National Archives Records Administration (NARA) and the National Council on Disability (NCD) view Rastafarianism? Have the DMH, the EEOC, the NARA and the NCD come to recognize Rastafarianism as a religious and social movement with no central authority and a lot of diversity among its practitioners? Have the DMH, the EEOC, the NARA and the NCD come to recognize the practice of growing dreadlocks and smoking marijuana as being consistent with Rastafarianism? Have the DMH, the EEOC, the NARA, the NCD come to recognize that practitioners of Rastafarianism avoid for religious reasons pharmaceutical drugs and only use marijuana, which they consider holy? 2) What communications in the form of emails and postal correspondence have you had about former U.S President Bill Clinton refusal to admit in public that he has previously smoked marijuana? What communications in the form of e-mails and postal correspondence have you had about former U.S President Barack Obama admission that he used to regularly smoke marijuana in high school and college? {ii} What communications in the form of e-mails and postal correspondence have you had about the many disappointing statements made by Barack Obama about marijuana after he became president? Specifically, what communications in the form of e-mails and postal correspondence have you had about Barack Obama dismissive comments about marijuana? {iii} What communications in the form of e-mails and postal correspondence have you had about former first lady Michelle Obama admission that she had smoked pot in the car of her boyfriend? What communications in the form of e-mails and postal correspondence have you had about the Young Turks (TYT) analysis of the unfair criticism directed at Malia Obama for allegedly smoking marijuana? {iv} 3) What communications in the form of e-mails and postal correspondence have you had about Bill Maher admission that he regularly

2 smokes pot and that he's an atheist? What communications in the form of e-mails and postal correspondence have you had about Bill Clinton and his guests regularly smoking pot with the guests of his show in his weekly program entitled Real Time with Bill Maher? {v} What communications in the form of e-mails and postal correspondence have you had about Bill Maher conversation with Jim Belushi (in September 2020) about becoming a marijuana farmer? Specifically, what communications in the form of e-mails and postal correspondence have you had about the systemic exclusion faced by Black/African American people looking to contribute to the marijuana industry? What I am requesting for prompt disclosure are all records within your possession detailing (1) the religious beliefs the DMH has previously granted an exception to for patients/prisoner not wishing to take psychotropic drugs; (2) the names, the academic backgrounds and the addresses of religious scholars/experts previously used by the DMH to determine whether a patient/prisoner thereof was an adherent of the organized religious belief who should not be on psychotropic drugs; (3) the manner in which the DMH, the EEOC, the NARA and the NCD view Rastafarianism; (4) your communications in the form of e-mails and postal correspondence about Rastafarianism as a religious and social movement with no central authority and a lot of diversity among its practitioners; (5) your communications in the form of e-mails and postal correspondence about the practices of growing dreadlocks and smoking marijuana being consistent with Rastafarianism; (6) your communications in the form of e-mails and postal correspondence about Rastafarians viewing marijuana as a sacrament that has healing properties; (7) your communications in the form of emails and postal correspondence about Rastafarians practice of avoiding pharmaceutical drugs (8) your communications in the form of e-mails and postal correspondence about the absurdity of forcibly administering psychotropic drugs onto patients/prisoners not posing harm to themselves and others; (9) your communications in the form of e-mails and postal correspondence about the absurdity of forcibly administering Paracetamol onto patients suffering with a headache who wish for it to go away without taking pharmaceutical drugs; (10) your communications in the form of e-mails and postal correspondence about the medical risks of using needles and syringes to forcibly administer psychotropic drugs; (11) your communications in the form of e-mails and postal correspondence about the possibility of sharing needles and syringes leading to HIV - AIDS infections; (12) the policy of the DMH about the use of needles and syringes; (13) your communications in the form of e-mails and postal correspondence about Bill Clinton refusal to admit in public that he previously smoked marijuana; (14) your communications in the form of e-mails and postal correspondence about Barack Obama previous admission to he regularly smoked marijuana in college; (15) your communications in the form of e-mails and postal correspondence about the many disappointing comments made by Barack Obama about marijuana after he became a president; (16) your communications in the form of e-mails and postal correspondence about Michelle Obama admission that she had smoked marijuana in the car of her boyfriend; (17) your communications in the form of e-mails and postal correspondence The Young Turks (TYT) analysis of the unfair criticism directed at Malia Obama for allegedly smoking pot; (18) your communications in the form of e-mails and postal correspondence about Bill Maher's admission that he regularly smokes pot and that he's an atheist; (19) your communications in the form of e-mails and postal correspondence

3 about Bill Maher and his guests regularly smoking pot on his weekly program entitled Real Time with Bill Maher; (20) your communications in the form of e-mails and postal correspondence about Bill Maher conversation with Jim Belushi about becoming a marijuana farmer; (21) your communications in the form of e-mails and postal correspondence about the systemic exclusion faced by Black/African American people looking to contribute to the U.S marijuana industry.” NCD does not have any records responsive to your request. For tracking purposes, your tracking number is NCD-2021- 13. If you need further assistance, you may contact Amy Nicholas, NCD’s FOIA Public Liaison at 202-272-2008 or [email protected]. Please include your tracking number with any correspondence. If needed, it is your right to seek dispute resolution services from NCD’s Public Liaison or the Office of Government Information Services (OGIS). OGIS may be reached at: Office of Government Information Services (OGIS) National Archives and Records Administration 8601 Adelphi Road College Park, MD 20740-6001 [email protected] 202-741-5770 fax 202-741-5769 NCD’s appeal process allows you to appeal withheld information or the adequacy of NCD’s search by writing within 90 days of your receipt of this letter to: Anne Sommers McIntosh Executive Director National Council on Disability 1331 F St. NW. Suite 850 Washington DC 20004 Your appeal must be in writing and should contain a brief statement of the reasons why you believe the requested information should be released. Enclose a copy of your initial request, request number and a copy of this letter. Both the appeal letter and envelope should be prominently marked “Freedom of Information Act Appeal.” After processing, actual fees must be equal to or exceed $25 for the Council to require payment of fees. See 5 CFR §10000.10(k). The fulfillment of your request did not exceed $25, therefore there is no billable fee for the processing of this request. Respectfully,

4 Joan Durocher Chief FOIA Officer

From: Michael Ayele <[email protected]> To: Janet <[email protected]>; INFO <[email protected]>; [email protected] <[email protected]>; FREEDOM OF INFORMATION ACT <[email protected]>; [email protected] <[email protected]>; [email protected] <[email protected]>; Joan Durocher <[email protected]>; Amy Nicholas <[email protected]> CC: Michael Ayele <[email protected]>; Michael Ayele <[email protected]>; Michael Ayele <[email protected]> Subject: Sunshine Law: Request for Records ---> Dispute Resolution Services Requested: Please Disregard Previous E-mail. Date: 12.09.2021 17:49:02 (+02:00) Attachments: DOR 4.140 - Use of Seclusion and Restraints in CPS.doc_ (1).pdf (12 pages), dor4-152.pdf (5 pages), PC.03.01 Restraint and Seclusion.doc (8 pages) W (AACL) Michael A. Ayele P.O.Box 20438 Addis Ababa, Ethiopia E-mail: [email protected] ; [email protected]; [email protected] Date.: September 12th 2021 Sunshine Law: Request for Records ---> Dispute Resolution Services Requested ----> Please Disregard Previous E-mail. Hello, Thank you for your e-mail. I am in receipt of it. I am writing this letter in response to the records you have disclosed on August 26th 2021, which I have read through. As a former employee of the Department of Mental Health (DMH) Fulton State Hospital (FSH), I can attest that I have never witnessed the asylum using pre-emptive force on a patient/prisoner thereof for refusing to take psychotropic drugs in circumstances where the patient/prisoner was not posing any harm to her/himself and others. As a former employee of the FSH, I do believe there were genuine efforts to de-escalate tense situations in the wards of the FSH (without using excessive force), which is in my opinion a very positive aspect of the asylum. As a former employee of the DMH (FSH), I would strongly encourage the asylum to continue (the path they have started) on the more positive aspects of their practice that have the potential to reduce and eradicate violent crime on their wards. Please be advised that I have concerns about the records you have disclosed on August 26th 2021 because of the language used by the Director of the Division of Behavioral Health (DBH) about the involuntary administration of psychotropic drugs. As a former employee of the DMH (FSH), I have (personally) found the language used by the Director of the DBH to be broad, unclear, and extremely vague. For instance, the Director of the DBH has noted that "all patients in the Department of Mental Health (DMH) facilities may be administered psychotropic medication on an involuntary basis when a determination of emergency is made by appropriate clinical personnel at the facility. An

emergency exists where there is reasonable likelihood of imminent physical harm and/or life threatening behavior to the patient or others. The treating provider who prescribes the psychotropic medication shall document the circumstances of the emergency, the facts surrounding the medication need, and why involuntary psychotropic medication is considered the least restrictive treatment. A new order shall be written for each emergency dose. (...) Patients admitted for Inpatient Pre-Trial Evaluations pursuant to Section 552.020, RSMo, and detainees pursuant to Section 632.480 et seq., RSMo., may not be medicated, absent an emergency, without either the consent of the patient or expressed written consent from the committing court. The psychiatrist must communicate the desire to medicate such a patient to a designated assistant general counsel, who will communicate with the committing court and obtain a written order from the judge. (...) The Clinical Due Process hearing will be repeated every 6 months if the patient still needs to be involuntarily medicated or until the patient is discharged from the facility." As a former employee of the DMH (FSH), I have several concerns about the language used by the Director of the DBH because it fails to clearly inform appropriate clinical personnel about the type of behaviors that would warrant the forcible administration of psychotropic drugs. As a former employee of the DMH (FSH), I do believe the language used by the Director of the DBH could create circumstances ripe for abuse. Fathom for instance a hypothetical scenario where a clinical personnel of the DBH opines that a patient/prisoner is dangerous to her/himself and others. Fathom in the same hypothetical scenario that the clinical personnel who has issued this opinion is (1) biased, (2) looking to retaliate on the individual as a form of punishment; (3) not in a position to list specific behaviors that would justify the forcible administration of psychotropic drugs because the patient/prisoner has not exhibited any. As a former employee of the DMH (FSH), I believe this hypothetical scenario I have described could happen. For this very reason, I must caution you to admit as evidence audio and video footage depicting patients/prisoners displaying violent behavior that would in your opinion justify the forcible administration of psychotropic drugs (whenever you are considering such a serious thing). As you have correctly noted in the records you have disclosed to me, the forcible administration of psychotropic drugs has the potential to re-traumatize people who may have been victims of a violent crime (especially if the use of force is without appropriate medical and legal basis to justify). As a former employee of the DMH (FSH), I also have several concerns about the eagerness of the Director of the DBH to put non-violent people through the emotionally and financially draining process of guardianship. For example, the Director of the DBH has previously noted that if patients are "determined to lack adequate mental capacity but are not imminently dangerous, clinicians shall proceed by filing for guardianship." As I have previously informed you, I was never a proponent of the system of guardianship, which I always viewed somewhat suspiciously. My feelings about the system of guardianship have only been reinforced throughout time because of cases such as that of Britney Spears. As you may remember, Britney Spears had in 2007 cut her hair and charged at a paparazzi vehicle that was harassing her with an umbrella. Does this mean that

Britney Spears should be required to take psychotropic drugs against her will? Does this mean that Britney Spears widely publicized incident should be used against her to force her to take psychotropic drugs against her consent? My answer to these questions is a categorical "NO!" I hope your answer is "NO" as well. As a former employee of the DMH (FSH), I hope you will take the concerns I have expressed to you seriously. I also hope you will take appropriate actions to address my concerns. My request for records are as follows. 1) Does the DMH submit into evidence audio and video footage depicting patients/prisoners displaying violent behavior when considering to administer psychotropic drugs against their consent? 2) Has the DMH ever discontinued the forcible administration of psychotropic drugs after a period of 6 months? 3) What communications in the form of e-mails and postal correspondence have you had about Robyn Fenty (aka) Rihanna being a fan of Bob Marley and performing his songs at her concerts? {i} Do the DMH, the National Council on Disability (NCD) and the Equal Employment Opportunity Commission (EEOC) hold any formal and informal opinions about the music songs of Bob Marley? Do the DMH, the NCD, and the EEOC hold any formal and/or informal opinions about the lifestyle of Bob Marley and his penchant for smoking marijuana (aka) cannabis/weed? Does the DMH have patients/prisoners who identify as Rastafarians and who are religiously opposed to consuming pharmaceutical drugs that is not marijuana/cannabis/weed? If yes, will you promptly disclose the names of these patients/prisoners of the DMH? Have your offices celebrated the 75th anniversary of Bob Marley's birthday to commemorate his music songs and his lifestyle? {ii} If yes, will you promptly disclose photos and videos taken by the DMH on February 06th, 2020 to remember Bob Marley? What I am requesting for prompt disclosure are all records within your possession detailing (1) submitted evidence of audio and video footage depicting patients/prisoners of the DMH displaying violent behavior when considering to administer psychotropic drugs against their will; (2) documents detailing the time and circumstances under which the DMH discontinued the forcible administration of psychotropic drugs after a period of 6 (six) months; (3) your communications in the form of e-mails and postal correspondence about Rihanna being a fan of Bob Marley; (4) your communications in the form of e-mails and postal correspondence about the decision of Rihanna to pay tribute to Bob Marley by singing his songs on her concerts; (5) formal and informal opinions held by the DMH, the NCD and the EEOC about the songs of Bob Marley; (6) formal and informal opinions held by the DMH, the EEOC and the NCD about the life-style of Bob Marley; (7) formal and informal opinions held by the DMH, the EEOC and the NCD about Bob Marley having enjoyed marijuana/cannabis/weed when he was alive; (8) the names of patients/prisoners of the DMH who are Rastafarians by religion and who refuse to consume pharmaceutical drugs except marijuana/cannabis/weed for religious reasons; (9) photos and videos taken by the DMH, the EEOC and the NCD to celebrate Bob Marley's 75th and 76th anniversary respectively dated February 06th 2020 and 2021; (10) your comunications in the for of e-mails and postal correspondence about the Joe Biden / Kamala Harris White House

Administration press release wishing people of Ethiopian and Eritrean descent well. {iii} Have a good day. Take care. W (AACL) Michael A. Ayele Anti-Racist Human Rights Activist Audio-Visual Media Analyst Anti-Propaganda Journalist Work Cited {i} Rihanna Cover - Is This Love? YouTube.: https://www.youtube.com/watch? v=zJYyZww2pjA Grammy Awards 2013; YouTube.: https://www.youtube.com/watch? v=XcUZ2jtUvCU Rihanna - Redemption Song; YouTube.: https://www.youtube.com/watch? v=cCqquMFQ9IM {ii} In Celebration of Bob Marley: Late Reggae Hero's 75th Birthday Commemorated With Special Events and Releases; Grammy.: https://www.grammy.com/grammys/news/celebration-bob-marleylate-reggae-hero%E2%80%99s-75th-birthday-commemorated-special-releases {iii} Statement by President Joseph R. Biden, Jr. on the Celebration of Enkutatash; White House.: https://www.whitehouse.gov/briefingroom/statements-releases/2021/09/10/statement-by-president-joseph-r-bidenjr-on-the-celebration-of-enkutatash/ From: Gordon, Janet <[email protected]> Date: Thu, Aug 26, 2021 at 11:50 PM Subject: RE: Sunshine Law: Request for Records To: Michael Ayele <[email protected]> W, Attached are the Department of Mental Health Department Operating Regulation 4.140 (Use of Seclusion and Restraints) and 4.152 (Administration of Psychotropic Medications) and the Fulton State Hospital Policy on Restraint and Seclusion PC.03.01, in response to your request below. Sincerely,

Janet Gordon Records Custodian Department of Mental Health From: Gordon, Janet Sent: Monday, August 9, 2021 2:14 PM To: 'Michael Ayele' <[email protected]> Subject: RE: Sunshine Law: Request for Records W, The search for records has begun. I will contact you again with the results of the search and to notify you of any applicable fees in accordance with Section 610.026, RSMo. Sincerely, Janet Gordon Records Custodian Department of Mental Health Resources: Stressed by COVID-19? Access these resources for your emotional health: https://dmh.mo.gov/disaster-services/covid-19-information DHSS COVID-19 24 hour hotline: 877-435-8411 Disaster Distress Helpline: Phone 800/985-5990. Text “TalkWithUs” to 66746 Social Justice: https://dmh.mo.gov/disaster-services/coping-with-community-unrest MO Show Me Hope Crisis Counseling Program: https://www.moshowmehope.org/ CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipients named above. The designated recipients are prohibited from redisclosing this information to any other party without authorization and are required to destroy the information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited by federal or state law. If you have received this communication in error, please notify me immediately by telephone at 573.751.8067, and destroy all copies of this communication and any attachments. From: Michael Ayele <[email protected]> Sent: Thursday, August 5, 2021 6:10 AM To: Gordon, Janet <[email protected]. Hello, What I am requesting for prompt disclosure are all records within your possession detailing (1) the use of force policy of the DMH; (2) the staff members of the DMH (FSH) who can order restraints to be placed on a patient/prisoner of the DMH (FSH); (3) the manner in which employees of the DMH (FSH) should handle a patient/prisoner thereof who refuses to take his prescribed psychotropic drugs but is otherwise not exhibiting any violent behavior. W (AACL) Michael A. Ayele

P.O.Box 20438 Addis Ababa, Ethiopia Virus-free. www.avast.com

7-1-22 Clinical Standards and Procedures DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR CHAPTER SUBJECT PERSON RESPONSIBLE AUTHORITY SUBCHAPTER EFFECTIVE DATE NUMBER OF PAGES PAGE NUMBER SUNSET DATE HISTORY MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS Section 630.050 and 630.175 12 1 of 12 Director CPS 6-5-19 See below Program Implementation and Records PURPOSE: Prescribes the policy on the use of restraint and seclusion. APPLICATION: Applies to the Division of Behavioral Health Adult and Children's Psychiatric Facilities. (1) This DOR applies to the Division of Behavioral Health Adult and Children’s Psychiatric Facilities, except in the following specific situations. (A) Procedures specific only to the Biggs Forensic Center (Maximum Security) regarding the maintenance of a security environment equivalent to that of a jail or correctional setting for an individual transferred to these settings whose legal status is that of jail detainee, correctional inmate, or pre-trial evaluation. All other applications of this DOR apply. (2) PHILOSOPHY. The leadership of Department of Mental Health recognizes that the use of restraint and seclusion poses an inherent risk to the physical safety and the psychological wellbeing of both individuals and staff. In particular, while some of the individuals we serve have high rates of violence toward themselves and others, there is recognition that many of the individuals we serve have also had a high incidence of exposure to sexual, physical and emotional abuse. Consequently, we recognize that any emergency interventions have the potential for (re)traumatizing such individuals. Further, we recognize that despite best intentions, decisions concerning the use of restraint and seclusion are necessarily made under less than ideal circumstances (i.e., emergencies), and involve the urgent weighing of significant risks versus the benefits of physical safety. Therefore, such emergency interventions as the use of restraint and seclusion are to be avoided wherever possible. As part of this commitment, leadership explicitly espouses the following principles and values in regard to restraint and seclusion: (A) Use of restraint and/or seclusion is seen as a safety intervention of last resort, rather than a treatment intervention per se, and its usage should be an uncommon event; (B) An organizational philosophy of giving the highest priority to all non-violence is to be articulated in all policies, procedures and practices; (C) Individuals are to have a voice in determining treatment options; (D) Practices that are sensitive to those with a history of trauma are to be in place; (E) Key models are to be identified that support a culture of individual empowerment and recovery that is supportive, compassionate and non-punitive; and (F) An environment of care is to be created that is welcoming, attractive and as adaptable as possible. (3) Restraint and seclusion shall be utilized only to ensure the immediate physical safety of the individual, a staff member, or others; must be discontinued at the earliest possible time; and used only when less restrictive interventions have been determined to be ineffective. Non-

PAGE NUMBER Internal Regulation Process 2 of 12 DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR SUBJECT NUMBER OF PAGES MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS 12 EFFECTIVE DATE 6-5-19 physical interventions are the first choice as an intervention unless safety issues demand immediate physical intervention. The facility’s approved early intervention crisis prevention techniques will be used to de-escalate conflict when possible. Restraint and seclusion shall not be used for the purposes of discipline, coercion, retaliation, the convenience of staff, as a substitute for a program, as a replacement for adequate levels of staff, as punishment, or as the sole basis for transfer from an inpatient psychiatric facility to a more secure psychiatric setting. The dignity, privacy and safety of individuals who are restrained or secluded should be preserved to the greatest extent possible during the use of these interventions. Restraint and seclusion should be initiated only in those individual specific situations in which an emergency safety need is identified, and these safety interventions should be implemented only by competent, trained staff. (4) The following shall apply to the use of manual or mechanical restraints or seclusion: (A) The use of restraint or seclusion shall be in accordance with the order of a physician responsible for the care of the individual and who is privileged by the facility or the physician’s designee (another physician or advanced practice nurse) who is also authorized and privileged by the facility to provide such orders. (B) When restraint or seclusion is ordered for an individual, the physician’s designee (another physician, or advanced practice nurse) ordering the restraint or seclusion shall consult as soon as possible with the physician responsible for providing ongoing care to the individual. The consultation shall be documented in the medical record per facility policy. (C) Only the application of approved restraint principles will be used when restraining an individual. (D) Only facility approved mechanical restraint devices will be applied should mechanical restraint be required. (E) Instances in which manual, mechanical restraint or seclusion is used are documented on appropriate facility forms. (F) Standing or PRN orders for the use of manual or mechanical restraints or seclusion shall not be used. (G) Restraints shall not be used as a means of coercion, as discipline or punishment, for the convenience of staff, as retaliation by staff, as a substitute for treatment or rehabilitation programming, or used in a manner that causes undue physical discomfort or pain to the individual. (H) The use of a restraint technique for purposes other than those stipulated in this regulation or any excess application of force shall be considered abuse and is cause for disciplinary action against the employee. (I) Verbal threats to use seclusion or restraints as a form of intimidation or control are not permitted. (J) Seclusion may only be used for the management of violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member or others. (K) Manual holds instituted to administer medication are restraints and do require an order by a physician or APN designee along with associated rationale and documentation; and do require face-to-face evaluation by a physician, APN or special

PAGE NUMBER Internal Regulation Process 3 of 12 DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR SUBJECT NUMBER OF PAGES MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS 12 EFFECTIVE DATE 6-5-19 procedures nurse, even in circumstances where the individual is released immediately following the medication administration. (5) As used in this DOR, the following terms mean: (A) Seclusion: The involuntary confinement of an individual alone in a room or area from which the individual is physically prevented from leaving. (B) Restraint: 1. Any physical method, manual hold or mechanical device, material, or equipment that immobilizes or reduces the ability of an individual to move his or her arms, legs, body, or head freely; or 2. A drug or medication when it is used as a restriction to manage the individual’s behavior or restrict the individual’s freedom of movement and is not a standard treatment or dosage for the individual’s medical or psychiatric condition (i.e. chemical restraint). Additionally, chemical restraint is considered an inappropriate method of controlling behavior and is not the practice of any facility in the Department of Mental Health. Use of a medication is considered inappropriate if: (a) it is not a recognized treatment for the individual’s mental disorder; or (b) the medication is administered excessively, such that it can be expected to produce sedation or limit the individual’s ability to participate in the treatment process rather than treat symptoms of the mental disorder. However, medication may be used appropriately to treat behavioral symptoms of mental disorder, including aggressive behavior, and in that case, the specific medication use shall be included in the treatment plan and shall not be considered chemical restraint. 3. For the purposes of this definition, restraint does not include: A. Devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of an individual for the purpose of conducting routine physical examinations or tests, or to permit the individual to participate in activities without the risk of physical harm. a. Hand mitts are not considered restraints unless the mitted hands are tied down or unless they cannot be removed intentionally by the individual in the same manner as they were applied by staff. b. Bed side rails used to protect a person from falling out of bed are not considered restraints. Conversely, bed side rails used to restrict the person’s freedom to exit the bed are considered a restraint. Clinical judgment must be used in determining this distinction. See Section (10) for policy related to restraint use in non-violent, non-self-destructive situations. B. The holding of a child’s hand for purposes of safely escorting across a street. C. Physical intervention from which an individual can easily break away. This includes physical redirection that continues to provide the individual the opportunity for independent movement in more than one direction (e.g. use of approved techniques for the management of physical aggression to block a blow or a block/momentary grasp of a hand or arm that prevents an individual from

PAGE NUMBER Internal Regulation Process 4 of 12 DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR SUBJECT NUMBER OF PAGES MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS 12 EFFECTIVE DATE 6-5-19 striking another person, provided that the individual is still able to move independently in other directions). D. Proper use of security escort devices pursuant to 630.175.4, RSMo. E. Extraordinary measures employed by the head of the facility to ensure the safety and security of patients, residents, clients, and other persons during times of natural or manmade disasters pursuant to 630.175.5, RSMo. (C) Trained staff: Such persons designated by facility policy who have been approved, tested, and recognized as competent to provide one of the following services: 1. All direct care staff and other staff involved in the use of restraint and seclusion shall receive education and training and shall demonstrate a working knowledge of the underlying causes of threatening behavior, related medical conditions that may cause aggression, events and environmental factors that may trigger the need for restraint or seclusion, impact of staff behavior, how to choose the least restrictive intervention based on individual assessment information, de-escalation techniques and other non-physical intervention skills, recognizing and responding to symptoms of physical distress, an individual’s viewpoints regarding use of restraint or seclusion, first aid procedures, and be certified in cardiopulmonary resuscitation. 2. Physicians and APN designees shall demonstrate a working knowledge of the Department’s and facility’s policies and procedures associated with the use of restraint and seclusion. 3. Those who apply the restraint and receive the training and demonstrate the safe use of restraint including physical hold applications, floor assisted restraint procedure, and the application and removal of mechanical restraints. 4. Those authorized to provide monitoring or 15-Minute assessment are competent and demonstrate competence in: taking and interpreting vitals, checking circulation and range of motion, skin integrity, signs of incorrect application of restraints, addressing nutrition, hydration, hygiene and elimination needs, recognizing changes in condition, addressing physical and psychological status, recognizing signs of potential readiness for discontinuation, assisting the individual to meet the behavioral criteria for discontinuation, and recognizing the need to contact medical personnel for further evaluation. 5. The assigned RN shall be competent and demonstrate competence in assessing physical, and psychological status, and assessing for discontinuation. 6. Persons authorizing restraint or seclusion in emergency situations and/or determining the need to secure a new order, are competent as above, are an RN, and have demonstrated competence in recognizing how age, developmental considerations, gender issues, physical and medical challenges/conditions, ethnicity, and history of sexual or physical abuse may affect the individual’s reactions, and using behavioral criteria for discontinuing restraint and seclusion and assisting individuals in meeting these criteria. (D) Physician: A person licensed as a physician pursuant to Chapter 334, RSMo, and designated by the facility to perform functions as set out in this DOR. 1. Attending physician: The physician primarily responsible for the individual’s ongoing care.

PAGE NUMBER Internal Regulation Process 5 of 12 DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR SUBJECT NUMBER OF PAGES MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS 12 EFFECTIVE DATE 6-5-19 (E) Registered Professional Nurse (RN): A person licensed pursuant to Chapter 335, RSMo, to engage in the practice of professional nursing as defined in section 335.016(15), RSMo. (F) Advanced Practice Nurse (APN): An RN who is recognized by the Missouri State Board of Nursing as an advanced practice nurse as defined in section 335.016(2), RSMo, and is certified as a psychiatric nurse practitioner and is clinically privileged by the facility to perform the functions as set out in this DOR. (G) Special Procedures Nurse (SPN): A facility designated and specially trained RN who may perform the face-to-face evaluations required for restrained or secluded individuals within one (1) hour of initiation of that procedure. 1. SPN must meet the criteria for a psychiatric nurse as defined in section 632.005(17), RSMo, and 2. SPN must have successfully completed a Department approved course of study designed to prepare the SPN to evaluate an individual’s medical and behavioral condition and the individual’s need for continuation/termination of restraint or seclusion, to prepare the SPN to evaluate the individual in the context of special population needs or considerations and vulnerability associated with the facility’s population demographics, and to reinforce the SPN’s understanding and application of Missouri statutes and Department policies and procedures related to individual abuse or neglect, related CMS Conditions of Participation, and Joint Commission standards, and 3. SPN must have successfully met the annual competency measures associated with this function, as well as those competencies expected of any registered professional nurse as applies in the use of restraint or seclusion in the facility. (H) Time out: Temporary exclusion or removal of an individual from positive reinforcement. It is a procedure in which, contingent upon the individual’s engagement in undesired behavior, the individual is removed from the situation that affords positive reinforcement. The use of any time-out procedures are detailed in the individual’s treatment plan and do not involve the use of restraint or seclusion. (6) Each facility shall include in its policies the proper use and maintenance of restraint and seclusion equipment. (7) Each facility shall collect from individuals and relevant others, at the time of admission, or as soon as is clinically appropriate or possible, to the facility; information that will assist in preventing the use of restraint or seclusion or in minimizing the extent of their use. This process shall include: (A) Administration of an instrument chosen by the facility to collect information about the individual’s history of exposure to sexually, physically or emotionally traumatic events, or other trauma – including trauma from previous use of seclusion and restraints or other prior mental health interventions;

PAGE NUMBER Internal Regulation Process 6 of 12 DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR SUBJECT NUMBER OF PAGES MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS 12 EFFECTIVE DATE 6-5-19 (B) Staff should discuss with each individual strategies to both identify and reduce the specific precursors of violent behavior (e.g., agitation, anger, hostility, impulsivity, etc.) that might ultimately lead to the use of restraint and seclusion; such discussion shall include what kind(s) of treatment or intervention would be most helpful and least traumatic for the individual; (C) Use of an instrument or form that collects systematic information about stimuli or situations that typically increase the individual’s degree of agitation, activities or interventions that are typically calming when the individual is agitated, and the individual’s history of restraint or seclusion in psychiatric settings; (D) Identification of individuals with hearing deficits or other receptive or expressive communication difficulties; and a plan developed for providing these individuals with appropriate communication access and resources; (E) Designation of a family member or other person the individual wishes to be informed if restraint or seclusion is used. This information shall be used in the development of the individual’s treatment plan. (F) A method for reviewing and updating this information for any individual whose length of stay exceeds twelve (12) months; and (G) History of violent acts committed by the individual. (8) While it may be necessary to initiate restraint or seclusion when the attending physician is not physically present, it is desirable that any application of restraint or seclusion be supervised by a physician to the greatest degree possible. A physician or APN designee shall be notified at the earliest time possible when a situation has a significant likelihood of leading to restraint or seclusion. When notified of such a situation, a physician or APN designee shall come personally to evaluate the situation if reasonably possible. Once a physician or APN designee is physically present, he or she shall assume leadership responsibility and direct the other clinical staff in managing the individual’s behavior. The attending physician must be consulted as soon as possible if the attending physician did not order the restraint. (A) Any restraint or seclusion order authorized by the APN designee shall be reviewed in person by the attending physician within twenty-four (24) hours or the next regular working day of the order being issued. Such review shall be documented in the clinical record of the individual. Earlier review by the attending physician is required if the any of the following exists: 1. If the APN designee orders restraint or seclusion that extends beyond four (4) continuous hours for an individual under eighteen (18) years of age or eight (8) continuous hours for an individual eighteen (18) years of age or older, then the attending physician shall review the order in person as soon as possible, but no later than prior to twenty-four (24) hours or the next regular working day of the order being issued; or 2. If the APN designee orders restraint or seclusion for any total length of time lasting more than four (4) hours in a twenty-four (24) hour period for an individual under eighteen (18) years of age or more than eight (8) hours in a twenty-four (24) hour period for an individual eighteen (18) years of age or older, then the attending physician shall review the order in person as soon as

PAGE NUMBER Internal Regulation Process 7 of 12 DEPARTMENT OPERATING REGULATION NUMBER DOR MARK STRINGER, DEPARTMENT DIRECTOR SUBJECT NUMBER OF PAGES MISSOURI DEPARTMENT OF MENTAL HEALTH 4.140 Use of Seclusion and Restraints in CPS 12 EFFECTIVE DATE 6-5-19 possible, but no later than prior to twenty-four (24) hours or the next regular working day of the order being issued. (9) Procedures for restraint or seclusion used for the management of violent or self destructive behavior shall be discontinued at the earliest possible time based on the determination that the individual’s behavior is no longer a threat to self, staff or others, and includes the following requirements: (A) Use of restraint or seclusion shall cease when the RN, physician or APN designee determines that the need for restraint or seclusion is no longer present or that the individual’s needs can be addressed using less restrictive methods. The physician or APN designee may specify how these criteria may be demonstrated or assessed prior to release, as documented on the physician’s or APN designee’s order. This criteria will be considered prior to release. (B) A physician, or his/her APN designee, may authorize an RN to use restraint or seclusion to control an individual’s dangerous behavior with a verbal order during times when a physician or his/her APN designee is not physically available as described in section (9)(G). 1. Face-to-face clinical assessments of the individual to evaluate the individual’s immediate situation, his/her reaction to the intervention, his/her medical/behavioral condition and the need to continue or terminate the restraint or seclusion are conducted: A. By a physician, or his/her APN designee, or SPN: a. Within one (1) hour of the initiation of restraint or seclusion. If performed by an SPN, the SPN shall consult with the ordering physician or APN designee as soon as possible after the completion of the one (1) hour face-to-face assessment. The consultation occurrence shall be recorded in the individual’s medical record to reflect no less than a review of the individual’s response to the restraint/seclusion, the individual’s physical and psychological status, and any resulting physician recommendations or verbal orders. b. Every eight (8) hours thereafter a face-to-face evaluation shall be performed by a physician, or APN designee, not an SPN, if the restraint or seclusion continues. B. By a physician, his/her APN designee, or SPN in facilities that primarily serve individuals eighteen (18) years or younger as follows: a. Within one (1) hour of the initiation of restraint or seclusion. If performed by an SPN, the SPN shall consult with the ordering physician or APN designee as soon as possible after the completion of the one (1) hour face-to-face assessment. The consultation occurrence shall be recorded in the individual’s medical record to reflect no less than a review of the individual’s response to the restraint/seclusion, the individual’s physical and psychological status, and any resulting physician recommendations or verbal orders.