We're Encouraged by this Legislative Session ---BUT There are Some Scary Reminders About How Far We Have To Go

FEDS:  WHERE ARE YOU?

In March 2022, the US Department of Justice issued a "FINDINGS LETTER" to COLORADO re:  people with physical disabilities and nursing homes.

• There are more "FINDINGS LETTERS" that need to be issued to Colorado and most States.
• We are on the 100-YEAR PLAN to COMPLIANCE with EXISTING FEDERAL DISABILITY CIVIL RIGHTS LAWS.

 

• What we really need is COMPREHENSIVE TECHNICAL ASSISTANCE and EFFECTIVE UNIFORM ADMINISTRATIVE ENFORCEMENT.

 

• I am for INDIVIDUAL STATE INNOVATION, CREATIVITY and Tailoring.
  • There is NOT just ONE RIGHT WAY to comply with:
    • The Americans with Disabilities Act (ADA)
    • Section 504 of the Rehabilitation Act
    • Mental Health Parity & Addiction Equity
    • Medicaid Network Adequacy
    • Etc.
  • The PROBLEM is there is NOT JUST ONE WAY to NON-COMPLIANCE either.

 

• We NEED the FEDS to provide more in the way of CONTINUOUSLY IMPROVED  DEFAULT TEMPLATES.

 

• CMS and others are providing "GUIDANCE" sort of BUT Compliance is:
  • TECHNICALLY COMPLICATED, and
  • POLITICALLY COMPLICATED, and
  • ENFORCEMENT is PATCHY.

 

• We do need STATES to push to bring down COSTS, BUT Ironically 2 of the things that are going to bring down costs are:
  • BETTER TREATMENTS, and
  • BREAKING DOWN BARRIERS to realizing the INTEGRATION MANDATE in the ADA

 

• Especially for Cognitive Disability, Developmental Difference with Average or Above Average IQ --- the CURRENT PATHS TO INCLUSION  are more difficult than the MAJORITY appreciates.
  • Further, those people with Developmental Differences involving Sensory Processing and Executive Functioning are more VULNERABLE TO PSYCHIATRIC DISORDERS.
  • THEIR Strengths and Weaknesses are DIFFERENT ENOUGH that the NEURO-TYPICAL MOLD won't fit.
  • If we really put some CONSCIOUS EFFORT into MAXIMIZING the STRENGTHS and WORKING AROUND the "WEAKNESSES" ---
    • We probably can realize some COST SAVINGS.

 

• Many people are not going to get into a HOUSE without a 30-YEAR MORTGAGE ---
  • BUT EVERYONE understands that the more YEARS you add to that MORTGAGE --
    • The more you are ULTIMATELY going to pay.

 

• Well, the INTEREST RATE for SOCIAL EXCLUSION, INADEQUATE TREATMENTS, HOUSING & PLACEMENTS for Cognitive Disability/Difference is MANY TIMES that of the average 3O-year mortgage---
  • BOTH in TREASURE and HUMAN SUFFERING.
    

• Further, we don't seem poised to REACH COMPLIANCE with EXISTING DISABILITY CIVIL RIGHTS LAWS in 30 YEARS or 60 YEARS.

 

• In fact, it's not clear when we will reach COMPLIANCE.
  

 We need a Plan -- like an Olmstead Plan with:

• Measurable Goals
• Reasonable Time Frames, and
• Funding to Support the Plan
  

In the meantime, we would like to see ON-GOING ENGAGEMENT and Yearly Reports of State Protection & Advocacy Offices with States on:

• Olmstead
• Parity
• Network Adequacy
  

Further, State Lawyers Committees and Pro Bono Efforts should PARTNER with State P&A Offices  conduct "INVESTIGATIONS" in COORDINATION with the US Department of Justice.

Some of that is being done in States like Colorado and others.

If we are NOT going to FUND UNIFORM and EFFECTIVE ADMINISTRATIVE ENFORCEMENT --- we need to FUND P&A, Pro Bono & DOJ INVESTIGATIONS and Enforcement Efforts.

As encouraged as we all are by a new Colorado Behavioral Health Administration ---

• the most DIFFICULT CONVERSATIONS have yet to be had, and
• HCPF's 809.15.A.2 on Target Criteria for Colorado's MI Waiver requiring needing assistance with activities of daily living ----
  • Speaks VOLUMES about where we've been, where we still are and how far we have to go.
    

Cloudy Valley Morning --- photo.net