Romance at heart of ethics controversy

Friday, March 31, 2000 | 11:24 a.m.

CARSON CITY -- A controversy is swirling around state Human Resources Director Charlotte Crawford and her one-time boyfriend, a medical director of a Las Vegas mental health program that has an exclusive contract to treat state patients.

Questions have been raised about ethics and a past disciplinary action against Dr. Charles Mahakian, who agreed in 1997 not to renew his license in California after being charged with sexual misconduct and gross negligence.

The state division of Mental Health and Developmental Services and the Division of Child and Family Services are paying more than $3 million a year to the Mojave Mental Health Center, where Mahakian is medical director. The two state agencies are under the jurisdiction of Crawford.

There also is a contract paying the psychiatrist $100 an hour to treat mentally retarded patients at the state's Desert Developmental Center in Las Vegas. The contract signed in July 1998 expires in June, and the maximum he can receive during the two-year period is $100,000.

Mahakian also is named in a complaint filed with the state Ethics Commission against Crawford, alleging she gave favored treatment to his clinic while they were involved in a romance. The complaint questions whether she shuttled extra patients to the Las Vegas center and if there were higher rates paid by the state.

Crawford strongly denies any improprieties. So does Mahakian.

"I doubt very much my connection with Miss Crawford has anything to do with this. I know there is no ethical violation," says the psychiatrist, who has a clean record in Nevada.

Crawford said the contracts with the Mojave center were put into effect by former Director Jerry Griepentrog in the early 1980s before she took over the agency. She said that there have been only minor changes to the contract and that she has no dealings with the center.

"I do not have direct supervision over him (Mahakian)," said Crawford. "I do not now or have I ever referred clients personally," to Mojave. "I have no responsibility over Mojave."

She does supervise the two agencies that have contracts with the mental health program.

The issue has bubbled below the surface for some time and has attracted the attention of at least one state legislator. Assemblywoman Sheila Leslie, D-Reno, says she finds it "indefensible" that the state "uses a psychiatrist given his background."

"I find it appalling," she said. "The medical board may find it all right, but I as a legislator don't."

Her comments referred to the Nevada State Board of Medical Examiners, which was informed of the California disciplinary action, but did not take any independent action in this state.

In September 1996 the California Medical Board filed a complaint against Mahakian, alleging he had sexual relations with a female patient in 1980 for a period of three years.

The patient, who was identified only as DB, was hospitalized at Walnut Creek Hospital in California after taking an overdose of medication. Mahakian treated her for depression, and she described her problems with her marriage and other personal troubles.

The complaint said Mahakian and the patient engaged in sexual relations during the entire three-year period of therapy. In 1981 she loaned Mahakian $7,000 for him to invest in stocks to make enough money to buy her a house so they could live together. He used part of the money to buy her presents.

The patient broke off the relationship when she discovered Mahakian was seeing another woman, according to the complaint. Besides the sexual misconduct, the board alleged gross negligence and unprofessional conduct.

In April 1997 Mahakian signed a stipulation agreeing not to seek renewal of his license. He agreed "that prima facia cause exists to impose discipline on his license," and agreed to surrender his rights to reinstatement of his license, which expired April 30, 1996.

Mahakian notes the incident took place 20 years ago. He has had a clean record since. The Nevada Medical Board has renewed his license twice, he said.

But Leslie says a doctor with that type of an offense shouldn't be allowed to treat state patients.

The complaint filed against Crawford with the Ethics Commission was submitted by Hamilton Moore, a Las Vegas attorney who is suing on behalf of a patient at Mojave who allegedly had sexual relations with a caseworker at the mental health center.

"I don't know if there was any impropriety between Dr. Mahakian and Crawford," Moore said. "I suspect there was."

Moore said "many, many people" have made the claim about improper behavior. But he admits he has only rumors to go on.

"There is no evidence that would be admissible in court that a relationship existed," he said.

But he said the Ethics Commission should get to the bottom to determine if special treatment was given the medical center by the state because of the Mahakian-Crawford relationship. He supplied the Ethics Commission with the names of three people who might attest to the relationship.

Crawford said the complaint by Moore is an attempt to bootstrap his civil suit and to get at the "deep pockets" of state government. She gave a deposition in the case. Moore's attempts to question her about her relationship with Mahakian were stopped by a discovery commissioner who ruled it was not relevant.

"He (Moore) is trying to discredit me, and the hearing master heard this and directed him that the personal relationship was irrelevant and outside of this case. He constructs his theory from rumors.

"I can't say how irritated I am he has taken this to the press," Crawford said. "It's defamatory. It is false and it is malicious."

But Moore replies, "As a human being and citizen this offends my sense of propriety to see an unanswered claim made by many, many people that such an impropriety exists." He said he would have filed the complaint, regardless of his lawsuit.

The Mojave center is run by the Nevada Family Practice Resident Program under the medical school at the University and Community College System of Nevada.

It was started in the early 1990s when Gov. Bob Miller was forced to cut services and reduce employees because of a downturn in the Nevada economy. With two locations in Las Vegas, 400 E. Charleston Blvd. and 5763 W. Oakey Blvd., the center treats patients who are qualified for Medicaid, a federal program that pays half the fee with the state matching the other half.

Crawford said the rate schedule hasn't been changed since it was started. But in 1999, she proposed a change in Nevada's Medicaid plan that cemented Mojave's position to be the exclusive provider of certain services to state clients outside of state facilities.

The change in the state plan, approved by the federal government, limited outside agencies to only those affiliated with the medical school.

The change said, "This provider (Mojave), an affiliate of the University of Nevada School of Medicine, has been paid at the same rate, which was formerly paid to state agencies providing the same comprehensive level of services. The State Plan Amendment is requested to assure only providers meeting that comprehensive level of service are reimbursed at this higher state rate."

Crawford said this was a technical change and these services are not put out to bid. State patients have a choice of being treated in state facilities or by Mojave. A spokesman for the mental health division says 75 percent of them prefer Mojave.

In the early 1990s, there was another incident involving Mahakian and Crawford. Mahakian was working in California and also on contract with the mental health system in Nevada. He was given a state cell phone, and he used it to place hundreds of long-distance telephone calls to Crawford in Las Vegas.

Records in the state attorney general's office show there were as many as six calls a day from California, some of them as early as 6 a.m. to Crawford at her home and as late as 11 p.m. Bob Pike, chief investigator for the attorney general's office, said, "It was the worse case of abuse of a state telephone I have seen in my nine years."

Pike said Mahakian, without protest, reimbursed the state several thousand dollars for the personal telephone calls. There was no wrongdoing found on the part of Crawford.

Crawford said she has been confronted with the Mahakian issue only once. When it was revealed he was in trouble in California, she told Carlos Brandenburg, director of the mental health division, to handle the issue. Brandenburg confirmed Crawford's story.

"Charlotte was very clear. She directed me if I had concerns, to either deal with the governor's legal counsel or with the deputy attorney general because of her potential conflict."

Brandenburg said he became aware of the disciplinary case in California through Medicaid. "It caused me concern," he said. And he asked Deputy Attorney General Joyce Borkenhagen to inform the state Medical Examiners Board of the case. He said he never received a reply from the examiners board, which licenses doctors.

There have been no problems in Nevada with Mahakian treating patients, said Brandenburg, whose division has contracts with the psychiatrist. "He has a valid Nevada license."

Asked if he would hire a psychiatrist who had a similar type of background, Brandenburg took a long pause. He finally said, "It depends on how he lost his license. I would look at it very carefully."

Brandenburg added, "I feel comfortable in hiring him," which he did when he renewed his $50,000-a-year contract in 1998. The Mojave mental health program is now only in Las Vegas. But it may be moving north into the Reno area. The Legislature sent a letter suggesting the mental health division look at expanding.

Crawford said the expansion also is part of a review under the direction of Gov. Kenny Guinn to determine if better and less costly services can be provided.

Asked about the performance of Mojave in Las Vegas, Crawford said its record is better than the state in providing services.

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