Whitesburg KY

ARH psychiatric center says murder suspect needs freed

A hearing will be held in Letcher Circuit Court next week to determine whether a psychiatric center in Hazard must continue to treat an elderly Letcher County man who still hasn’t been tried for two murders he allegedly committed more than five years ago.

Attorneys for the psychiatric center, operated by the Appalachian Regional Healthcare chain, argue in a motion to be heard on Dec. 11 that 72-year-old R.B. Dixon is suffering from dementia and will never become trial for the shooting deaths of Harry Smith and Allen “Cat” Dixon. The attorneys argue that Dixon’s due process rights are being violated and that he continues to tie up a hospital bed for which ARH is not being paid.

Dixon is accused of killing Smith, 73, of Letcher, and Dixon, 49, of Jeremiah, on September 26, 2003 at Smith’s home on Artist Drive. R.B. Dixon shot and seriously wounded himself as police closed in.

When paramedics and police arrived at the scene shortly before 3 p.m. on that day, Allen Dixon was lying on the ground beside the tree-shaded porch of the house, where his wife had found him. He had apparently been shot seven times and was near death. He was pronounced dead on arrival at Whitesburg Appalachian Regional Hospital by Letcher County Deputy Coroner Perry Fowler.

Smith was found in the hallway of the two-room home, shot twice in the arm and once in the chest. Letcher County Deputy Coroner Robbie Campbell pronounced Smith dead at the scene.

Several persons involved with the investigation said R.B. Dixon took a large quantity of prescription pills before going out the back door of his house and shooting himself once in the upper left side of his chest.

Allen Dixon was a nephew of both Smith and R.B. Dixon. Smith’s home and R.B. Dixon’s home are within a few hundred yards of each other at the mouth of Pratt Branch.

The motion filed on behalf of ARH by the Lexington firm Wyatt, Tarrant and Combs says the treatment available to R.B. Dixon at the Hazard psychiatric center will not improve his condition. The motion says Dixon, who will turn 73 on March 2, is not improving mentally or physically as he continues to age.

“Since the first evaluation report in December 2003, Mr. Dixon’s dementia has progressed, as can be expected with aging and his form of dementia. Further, no treatment offered to Mr. Dixon by Hazard ARH has or will improve his condition,” the motion says.

The motion lays out the following history of the case against R.B. Dixon:

“Mr. Dixon was charged with committing two counts of murder and one count of first-degree burglary on September 26, 2003, over five years ago. The Letcher County Grand Jury returned an indictment of Mr. Dixon on these charges on October 15, 2003. A few days prior, on or about October 10, 2003, Hon. James T. Wood, Jr. entered an agreed order for evaluation of Mr. Dixon’s competence or incompetence to stand trial. Mr. Dixon was transported to the Kentucky Correctional Psychiatric Center (KCPC) in LaGrange, Kentucky for this purpose. On December 16, 2003, Steven J. Simon Ph.D., a licensed clinical psychologist for the Commonwealth, concluded that Mr. Dixon was competent to stand trial.

“Mr. Dixon was arraigned on March 1, 2004 and entered a ‘not guilty’ plea. A competency hearing, at which Dr. Simon’s report would be presented, was set for May 13, 2004, then continued to June 18, 2004, and finally continued to September 9, 2004. During this first competency hearing, Dr. Simon presented his December 16, 2003 report and opinion that Mr. Dixon met the minimum requirements of competency to stand trial.

“Dr. Artie Ann Bates, another licensed clinical psychologist, who had been treating Mr. Dixon during his incarceration at the Letcher County Jail in the period after Dr. Simon’s findings, offered a contrary opinion. In light of this, the Court continued the competency hearing in order to allow Dr. Simon to consider Dr. Bates’s more recent observations that Mr. Dixon’s competency had deteriorated. On or about November 10, 2004 , this Court entered another Agreed Order for Competency Examination, pursuant to which Mr. Dixon was readmitted to KCPC for further evaluation. On January 31, 2005, Dr. Simon rendered his second written opinion and, again, found that Mr. Dixon met the minimum requirements for competency to stand trial.

“Mr. Dixon remained in the Letcher County Jail until or about September 1, 2005. On that date, the Deputy Jailer of Letcher County submitted a verified petition for involuntary hospitalization. The jailer’s petition was accompanied by two verified petitions of qualified mental health professionals for 72-hour involuntary hospitalization, one from Dr. Bates and the other from Jeffrey Tackett, a licensed clinical social worker. The jailer’s involuntary hospitalization request cited Mr. Dixon’s past suicide attempt, his state of being very distraught over his current situation, and that he had been treated for mental illness during the past two years. On or about September 2, 2005, the Court entered its ‘Findings of Fact and Conclusions of Law’ holding that Mr. Dixon was incompetent to stand trial with no substantial probability that he would attain competency in the foreseeable future.

“Pursuant to this order, Mr. Dixon was to be involuntarily hospitalized at Central State Hospital in Louisville for at least 360 days for treatment with a goal to restore his competency to stand trial. This order stated that neither Central State nor Mr. Dixon’s treating psychiatrist could release Mr. Dixon from his involuntary hospitalization ‘without further orders of this court.’ This Court further ordered Central State to notify the Court if it determined that Mr. Dixon had attained or been restored to competency. While there, however, Mr. Dixon, developed pneumonia and was transferred to the University of Louisville Hospital for medical treatment. After resolving his pneumonia, Central State asserted that it could not take Mr. Dixon back because he was too medically complex to care for in its psychiatric unit. The Commonwealth suggested that Mr. Dixon be transferred from the U of L hospital to Hazard ARH.

“Accordingly, on or about October 14, 2005, the court ordered Mr. Dixon to be admitted to Hazard ARH ‘as the best placement for defendant under his current health condition.’ Hazard ARH treated Dixon from October 17, 2005 until October 27, 2005, during which time a Hazard ARH case worker successfully sought his transfer to KCPC for further evaluation of his competency to stand trial. On November 29, 2005, this court ordered that Dixon be re-admitted to Hazard ARH for his treatment. On Dec. 1, 2005, Mr. Dixon re-entered Hazard ARH, where he has since remained.”

The motion argues that Dixon should be released because his “current medical condition does not meet the criteria for involuntary hospitalization. Kentucky’s involuntary hospitalization criteria are as follows: 1) Mr. Dixon must be a mentally ill person; 2) who presents a danger or threat of danger to his self, family or others as a result of his mental illness; 3) who can reasonably benefit from treatment; and 4) for whom hospitalization is the least restrictive alternative mode of treatment presently available. All four factors must be met in order for a court to involuntarily hospitalize a patient.

“Absolutely no evidence was presented at the April 25, 2008 hearing or in Dr. Timothy Allen’s report indicating that Dixon presents a danger or threat of danger to himself, family or others as a result of the mental illness. Moreover, in the past two years at Hazard ARH, Dixon has never been aggressive or violent.

“Dr. Allen did not even think that the actions in which Dixon was charged had anything to do with a mental illness. The only comment Dr. Allen made regarding Dixon being a danger to himself involved his inability to take care of himself, which would cause him to waste away. This has more to do with his frail condition than any mental illness.”

The motion also argues that the charges against Dixon should be dropped because of his current condition.

“It should go without saying that Hazard ARH appreciates the court’s concerns with releasing a criminal defendant into the community without prior notice to the court,” the motion says. “All the same, however, the Commonwealth is denying Mr. Dixon his due process rights by maintaining criminal charges indefinitely against him when he does not have a substantial probability of attaining competence in the foreseeable future.

“Despite the laudable humanitarian motives, the Commonwealth cannot continue to allow Mr. Dixon’s charges to hang over his head if it has already determined that he does not have a substantial probability of attaining competency in the foreseeable future. Not only does this violate his due process rights, it is affecting his mental state. Dr. Allen reported that Mr. Dixon is ‘anxious’ and ‘very worried about his case.’ The charges pending against Mr. Dixon must be dismissed without prejudice.”

ARH also says that keeping Dixon is tying up a bed needed to treat those with a treatable mental illness.

“Typically, psychiatric units such as Hazard ARH have short lengths of stay in order to maximize the number of patients who need to be treated,” the motion says. “Mr. Dixon’s continued inappropriate admission at Hazard ARH is tying up a vital short-term psychiatric bed that would otherwise be used to treat others. Given the limited census capacity, bed days are precious commodities and improper admissions detrimentally impact an already burdened and underfunded mental health network for residents in this community.

“Hazard ARH is incurring costs to care for Mr. Dixon for which it has not been, and will not likely be, compensated through state or federal sources. Mr. Dixon’s uncompensated care is diverting money away from improvements in the facility and is impacting Hazard ARH’s ability to expand services to the 21 counties it serves.”

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