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Strong & Creative Systemic Legal Advocacy For People with Mental Illness Who Are Incarcerated or Homeless & A Resource Center for the Community |
What about Orchid's Individual Advocacy?
Take A Walk Around Orchid's Resource Block
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ORCHID
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Marvin Sapp's "The Best In Me" on the CMHIP [CO Mental Health Institute @ Pueblo]:
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Eagle County voters to decide if marijuana taxes will fund mental health care
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Vail Daily via Park Record.com (Park City, Utah)
By Randy Wyrick Eagle County, Colorado, voters will decide whether to tax marijuana to pay for expanded mental health programs. The Eagle County commissioners voted unanimously Friday morning to put a question on the November ballot asking if voters are willing to add local sales and excise taxes to local marijuana retail sales and cultivation and spend as much as $1.2 million of that new tax money on mental health programs. “I call this a courageous step for filling this void, this vacuum for mental health in our community. It’s a huge step in sustainability … for people who need hope in their lives,” said Greg Daly, Avon’s police chief and board member of Speak Up, Reach Out, a local suicide-prevention organization. MENTAL HEALTH ‘EPIDEMIC’ Mental and behavioral health issues have become an “epidemic,” said Chris Lindley, Eagle County’s director of human services. Vail Health’s Sheila Sherman said the hospital’s number of mental health cases has skyrocketed in the past three years:
“If we were talking about sexually transmitted diseases or the flu, we’d be calling those numbers an epidemic,” Lindley said. Many people with mental health issues land in the Eagle County jail because there’s nowhere else for them, said James van Beek, Eagle County Sheriff. “Last year at this time, 70 percent of the jail inmates were on some kind of medication. I still have people in my facility who should not be there. That is not the place for them,” van Beek said. Jail could be avoided for 20 percent to 25 percent of the people incarcerated, if the county had a mental health facility, van Beek said. Half the people incarcerated have their first experience with a mental health professional when they land in jail, said Jill Ryan, Eagle County commissioner. The cops don’t like marijuana, but it’s here, said Daly and van Beek. “We’re the tip of the spear. We deal with those calls,” Daly said. “When we’re dealing with people under those circumstances, they should be treated as patients, not pseudo-suspects.” Mental health is a widespread need the county needs to focus on, said Kathy Chandler-Henry, county commissioner. “The need is clear, the will to do something is clear. What remained was how to do it. Now we’re asking the voters what they think,” Chandler-Henry said. PROGRAMS, NOT BUILDINGS The pot tax money will pay for programs, not buildings. While Mind Springs will run the mental and behavioral health programs, Mountain Family Health would fund a building separately, similar to a facility it’s constructing in Frisco. Two buildings are envisioned as part of all this — one in Edwards and one in Basalt, Lindley said. Mountain Family Health is a federally qualified health center that provides medical, dental and behavioral health care for low-income people, said Ross Brooks, Mountain Valley Health CEO. In their case, low income means 200 percent of the federal poverty level. That’s $24,000 for an individual and $49,000 for a family of four, Brooks said. The county owns land in Edwards’ Freedom Park that it would donate for a building, said Bryan Treu, interim county manager. An Edwards building would be between 12,000 and 15,000 square feet per floor, Brooks said. The county would likely add another story to house a mid-valley annex for the county’s health and human services department, Treu said. COLORADO’S CASH CROP Because Eagle County does not currently have its own pot tax, the county’s marijuana money comes from the state’s 10 percent sales tax and 15 percent excise tax. Last year was Colorado’s third year of regulated pot sales. Colorado’s statewide excise tax generated nearly $200 million in statewide marijuana tax revenue in 2016, stemming from $1.3 billion in marijuana sales, according to the Colorado Department of Revenue. Eagle County spent $14,000 for a poll by Boulder-based Magellan Strategies. Poll results found that as many as 78 percent of the 400 likely voters questioned said they would support a tax. Eagle County would join 10 counties and 76 municipalities across Colorado that levy their own pot taxes. http://www.parkrecord.com/news/colorado-voters-to-decide-if-marijuana-taxes-will-fund-mental-health-care/ |
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One of Orchid's Symbols: The Vietnam War
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Ken Burns & Lynn Novick's Documentary "The Vietnam War" does on a much grander scale what we try to do with mental health and criminal justice, etc. -- look at multiple perspectives -- with one big significant difference -- some historical distance.
We've really had a perfect storm of:
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Hot Off the Presses:
Formal Colorado Bar Association Ethics Opinion 131
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REPRESENTING CLIENTS WITH DIMINSHED CAPACITY WHERE THE SUBJECT OF THE REPRESENTATION IS THE CLIENT’S DIMINISHED CAPACITY Adopted September 13, 2017 http://www.cobar.org/Portals/COBAR/Repository/ethicsOpinions/FormalEthicsOpinion_131.pdf From Colorado Attorney Michael Kirtland of Kirtland & Seal, LLC in Colorado Springs: "I'm pleased to report that Colorado Bar Association Formal Ethics Opinion 131, Representing Clients with Diminished Capacity Where the Subject of the Representation is the Client's Diminished Capacity , of which I am the primary author, has now been published. It is the first state bar ethics opinion on this subject ever published." Link to all Formal CBA Ethics Opinions http://www.cobar.org/ethicsopinions |
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Mad Eye Moody from J.K. Rowling's "Harry Potter" series
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"If You Can't Keep A Simple Appointment, Probation May Not Be Right For You -- Same is True for My Fellow Judges"
---Denver District Court Judge
Sept. 22, 2017
Our Criminal Justice System Can Be A Very Nasty Disability Service Provider with an Abusive Edge [Even though most would identify with George Bailey below]
--- Because the State Isn't Providing the Beds, Housing or Services @ the Scale Needed for People with Disabilities
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So generally the Criminal Justice System doesn't really look @ Disability per se.
What it looks @ is:
Of course, Reality is a lot more complicated than that. A lot of the people in the Criminal Justice System in Colorado and nationally have:
AND they are probably not going to meet our high bar:
We really picked on the Denver Judiciary in the Headline, but the Truth is that Denver Judges and Judges around the State have indicated a problem of lack of services. The fact is Colorado may need:
BOTTOM LINE: ACT Needs to be available where reasonably medically necessary. WE HAVE TO HAVE SAFETY But the people in our criminal justice system have pretty complex, expensive needs & pretending they're just BAD, just makes it more difficult not less to do the hard planning ahead for this State-- AND IRONICALLY INCREASES THE NEED FOR HOUSING & SERVICES which is already ENORMOUS. |
Uncle Billy & George Bailey in It's A Wonderful, after George realizes Uncle Billy has lost the money
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Substance Abuse Is Crashing the Mental Health Party
AND Both Substance Abuse & Mental Health Seem Connected to Physical Systems, Certainly the Gut and Immune Systems, in Ways That Have NOT Been Previously Appreciated.
That Should Make A BIG DIFFERENCE in our Service Delivery Systems & our Justice Systems.
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We think there are a lot of factors for Colorado's:
AND it is what it is. BUT it does demand individualized integrated physical and mental healthcare. With substance use our treatments are generally more primitive than our mental health treatments, and that is saying something. Whether one is drawn to alcohol or various other drugs can be very much a matter of biology. See to the right various studies linking substance use to biology as well as our page ---- Drug Addiction Is A Mental Illness The point of this collection of pictures and links is to say ---
Social Behavior & the Immune System |
The Washington Post via The Denver Post
Colorado stands out as the only state which is a top consumer of all four substances [marijuana, cocaine, non-medical opiods, and alcohol]. The state’s heavy consumption of marijuana is predictable given that the drug is legal there. The other three legalization states are heavy consumers of pot, too (Washington, Alaska and Oregon; the latter is also a leader in non-medical use of prescription opioids). But Colorado residents are also heavy consumers of all non-marijuana intoxicants as well. http://www.denverpost.com/2016/05/23/colorado-first-in-drugs-survey/
University of California @ San Francisco, Psychiatry Dept. & VA
"Leukine stimulates immune system macrophages, which ingest and dispose of harmful microorganisms and waste products.
"Based on evidence that patients with the autoimmune disease rheumatoid arthritis do not tend to develop Alzheimer’s disease, the investigators first determined that a factor in these patients called “Granulocyte-Macrophage-CSF (GMCSF)” that stimulates production of immune system macrophages might help to protect them from developing Alzheimers. "That possibility is consistent with recent research suggesting that patients with Alzheimer’s disease may have reduced capacity to clear away amyloid from the brain. GMCSF is the active ingredient in Leukine." http://www.dana.org/Media/GrantsDetails.aspx?id=38876 
University of Colorado, Anshutz Medical Campus
A CU Boulder-led study showing that injecting beneficial bacteria into mice can make them more resilient to stress has been named among the “top 10 advancements and breakthroughs” of 2016 by the nation’s leading non-governmental funder of mental health research. Now, lead author Christopher Lowry, an associate professor in the Department of Integrative Physiology, is moving forward with clinical trials to see if altering the microbiome, or composition of resident bacteria, in military veterans with post-traumatic stress disorder can be beneficial. http://www.colorado.edu/today/2017/01/05/study-linking-beneficial-bacteria-mental-health-makes-top-10-list-brain-research |
UN High Commission on Human Rights: Ending Mental Health Stigma is more than creating a public awareness campaign or a powerful voting block, it's changing the service delivery system.
More -- A LOT MORE -- Money in Housing & Intensive Mental Health Treatment is Needed in Colorado for People with Mental Illness --
It Could Be Along The Lines of A Billion Dollars
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A lot of people in the general disability community were pretty envious of the Mental Health Community -- an investment of $40 Million in mental health this year in the Legislative Session.
But that was before the Sh** Hit the Fan on CMHIP (CO Mental Health Institute @ Pueblo) and the "immediate jeopardy" designation, persistent staffing problems, ad nauseam. BUT -- WHAT IS IT GOING TO TAKE TO HOUSE and TREAT THOUSANDS OF PEOPLE WITH MENTAL ILLNESS IN CO JAILS & PRISONS -- WHEN WE CURRENTLY DON'T HAVE THE HOUSING & ASSERTIVE COMMUNITY TREATMENT (ACT) IS OFTEN NOT AVAILABILE. ACT is NOT AVAILABLE to ALL WHERE REASONABLY MEDICALLY NECESSARY UNDER CO MEDICAID -- THAT'S DISCRIMINATION. BTW -- ADULT & YOUTH ACT are available in Minnesota where reasonably medically necessary. |
Colorado's gross domestic product is $334.7 billion.
As a lot of States, we have chosen to ignore the SCALE of the housing needs of people with disabilities regardless of Olmstead for years. The cost shifting of people with intensive mental health needs to the Criminal Justice System and to the Homeless Shelter and the Streets is being called out and recognized in a way it hasn't been in the past. The Chickens are coming home to roost -- AND WE WANT:
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CMHIP & Olmstead Planning Bill
-- Our Updates
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CMHIP
Olmstead Planning Bill
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Good News for CMHIP & A Long Way To Go
-- The State Needs to Include Diverse Members of the Mental Health Community as Stakeholders in CMHIP's Short & Long Term Planning as well as Oversight
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Pueblo Chieftain
Three categories of nurses at the short-staffed Colorado Mental Health Institute at Pueblo could get pay raises of up to 23 percent as early as November if the Legislature's Joint Budget Committee agrees to a $2.8 million emergency funding request sent its way Thursday. The Colorado Department of Human Services, which oversees CMHIP, says the money would raise pay for 187 qualified Nurse 1, 2 and 3 positions at the hospital. The raises would range from 18-23 percent. The higher pay is intended to help fill chronically vacant patient-care nursing positions at the 449-bed hospital. In addition, the hospital is asking for an additional $8.7 million in 2019 to cover those pay increases. The six-lawmaker JBC is expected to consider the request by Wednesday. If approved, the hospital staff could see higher pay in November. "This is a significant pay raise we're offering," said acting Superintendent Kim Nordstrom. "We're trying to move our nursing staff closer to the prevailing wage. This would help solve one part of our retention problem." In a message to hospital staff, Nordstrom said the pay raises would help ease staff complaints about "pay compression" in which DHS has been paying newer hires more than longtime staff in order to recruit staff. That has led to veteran employees leaving the hospital. According to the emergency budget request to the JBC, the state hospital has a chronic 24 percent vacancy rate for nursing, compared to a national average of 9 percent. It goes further and says that if unaddressed, the pay problems will continue to cause staff shortages, staff exhaustion due to mandatory overtime, reduced quality of care and a reduction in patient admissions. State Sen. Leroy Garcia, D-Pueblo, has been pushing for the hospital to hire other health workers such as paramedics to fill chronically empty jobs. Garcia called the emergency budget request a "first step," but said he wants to see DHS move forward on broadening its hiring ability. "We were told all summer this wasn't just a money problem, but a problem of the culture at the hospital," he said Thursday. "I know the administration has held focus groups with employees about how to improve the work environment. I want to see what happens with that information." CMHIP has been struggling with staffing shortages for years, but it came to a crisis point in June when state inspectors said the vacant jobs -- 97 out of 723 patient-care positions -- were making it unsafe for both patients and staff. That failed inspection led to the federal Center for Medicare Services to warn the hospital was in "immediate jeopardy" of losing its federal funding. That threat caused administration to impose mandatory overtime and cancel requests for leave. DHS also had several hiring fairs to boost staff, but it seemed that staff left as quickly as were hired. At the end of August, the vacancy problem essentially was unchanged. "We're at a place where we've exhausted a lot of other tools," Nordstrom said Thursday. http://www.chieftain.com/news/pueblo/cmhip-asking-lawmakers-for-emergency-raises-for-nurses/article_e74e35df-17cc-5b40-ab48-be27f3eca629.html |
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We Can't Afford to Staff CMHIP & Lieutenant Gov. Donna Lynne Says We've Got Plenty of Money Under TABOR for the next 3 years
--We think somebody just wants to get elected Governor
https://alamosanews.com/article/candidate-for-governor-speaks
"Regarding TABOR (Taxpayer Bill of Rights), Lynne said Colorado is in a better position now to live within its TABOR restrictions, especially with the recent exemption of the hospital provider fee. She said she believes TABOR needs to be fixed, but Colorado will be able to operate without exceeding TABOR restrictions in the next three years."
We Can't Staff CMHIP --
So What's The Next Step -- "Considering" Turning the Old Pueblo County Jail Into A Treatment Facility -- OMG!
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We have got to have inclusive discussions about the staffing issues down at the Colorado Mental Health Institute @ Pueblo.
We read from the reporting from the Pueblo Chieftain that a study had been commissioned. Where is that Study? That should be public information and a lot of people want to see it. A lot of decisions about people's mental health in Colorado are made not on what is best for the person with the mental illness but on political, regional considerations. We really hoped that the CMS Immediate Jeopardy designation would be a wake up call to the State. BUT it really hasn't been. This is now September the Colorado Mental Health Institute @ Pueblo still has staffing problems, according to the Pueblo Chieftain. There has to be some serious inclusive planning about where these facilities are and if they can realistically be staffed and at what cost -- and is the State going to pay that cost. The reality is we could probably staff CMHIP right now if the State would pay for it -- the State won't pay for it, and it may be embarrassed to ask for emergency funds since it failed to inform the legislature of the problem during the session. |
CMHIP still struggling with staff shortage http://www.chieftain.com/news/pueblo/cmhip-still-struggling-with-staff-shortage/article_23a18489-2532-5011-a662-9ed64a112675.html Options for old Pueblo County jail include treatment center http://www.chieftain.com/news/options-for-old-pueblo-county-jail-include-treatment-center/article_c1e74eda-0261-5ec6-831b-582b3cbefafa.html We realize that CMHIP and the Old Pueblo County Jail represent different players -- BUT at least in some respects they may be drawing on the same labor pool and relying on government funding. AND it's the labor pool that is particularly problematic. Supply & Demand 
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Top 5 Orchid Resource Pages for August 2017
#1 Gravely Disabled
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#2 Science Up
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#3 ADHD Crime & Prison Issues
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#4 Insanity
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#5 DOJ-letter-and-Q&A-on-ADA's-integration-mandate-and-DOJ-enforcement
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Orchids / Mixed Bags / Interior Design????!!
Surrealist Art / Vietnam War / Music / Citizen Kane
Surrealist Art / Vietnam War / Music / Citizen Kane
"Stone Part One," Swedish photographer and artist Tommy Ingberg
let's find out
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We recognize that the State provides some assertive community treatment, but from our perspective it is not near enough.
What would be the cost/cost savings if the State of Colorado provided:
Including people:
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the Logical Consequences of our failure to provide Intensive Community MH Treatment
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Corrected 4-9-2017 @ 5:36 p.m.
Most people with serious mental illness who are not being served by Medicaid community mental health services are:
and we are not sure how many thousand in Colorado Jails. So what is the point of all this? Well, actually many:
2016 Point In Time (PIT) US Homeless Report (p. 77)
This is a very selected look, omitting families and youth. Colorado 1,181 veterans (Theoretically, the Feds are providing healthcare, but there has been a big push for communities & States to end Veteran homelessness by providing housing) 1,642 chronically homeless individuals https://www.hudexchange.info/resources/documents/2016-AHAR-Part-1.pdf National Coalition for the Homeless: Housing Is Important But It Is Not Always Enough
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CMS MDS (Minimum Data Set) for Nursing Homes Frequency Report: First Quarter 2017 Level II Pre-admission Screening and Resident Review - Serious Mental Illness CO has 2,219 people with serious mental illness in nursing homes. https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/Minimum-Data-Set-3-0-Public-Reports/Minimum-Data-Set-3-0-Frequency-Report.html# To our knowledge people with mental illness in nursing homes have never had access to assertive community treatment or the reasonable but intensive community services they need to live in the community. Does that violate the Americans with Disabilities Act and the Olmstead Decision -- it sure does. Colorado's Mental Health Institutes
451 In-Patient Beds (144 Civil Beds, 307 Forensic Beds) -- Pueblo
https://sites.google.com/a/state.co.us/cdhs-behavioral-health/home/mental-health-institutes/mental-health-institutes-at-pueblo/services http://www.leg.state.co.us/clics/clics2013a/commsumm.nsf/b4a3962433b52fa787256e5 f00670a71/869edea16f2eb25687257b360069cbd2/$FILE/13MICJS0322AttachE.pdf 94 Civil In-Patient Beds -- Ft. Logan https://sites.google.com/a/state.co.us/cdhs-behavioral-health/home/mental-health-institutes/mental-health-institute-at-fort-logan A Total of 238 Civil Beds thru Colorado's Mental Health Institutes Where Are We? Recently the Hickenlooper Administration has made valiant efforts to use marijuana tax money to fund affordable housing and other services and there's $2.7 million for housing and supportive housing for people with mental illness re-entering the community from jails & prisons. And we are big supporters of all that. BUT Colorado still has a long way to go to comply with the law -- for decades we've essentially just written off thousands of Coloradans with the most intensive community mental health needs because we thought they were too expensive. This didn't happen overnight and it certainly didn't happen over one administration -- that's how we all got so acclimated to just accepting gross human rights violations of people with mental illness as the norm. The US and certainly Colorado are beginning to wake up -- but it may be to quite a hangover -- because the consequences of our decades failure to provide adequate housing & intensive community mental health treatment are now all the more expensive because we have grossly neglected it for so long. |
We are NOT giving up on the people with disabilities in adseg in colorado jails
the United Nations, and Colorado * See CRS 17-1-113.8 -- Prohibition Against Putting People with Mental Illness in "Long Term Isolated Confinement" within the Colorado Dept of Corrections The horrible inhumane situations in Colorado Jails have to be addressed:
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Vera Justice Institute -- Solitary (AdSeg -- It's NOT over for People w/ MI in County Jails) -- It is a Human Rights Issue & There Are Alternatives
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Ryan Pettigrew -- "A Madman's Poetic Path" -- 8 years in Solitary in a Colorado prison -- now a mindfulness teacher -- beyond inspiring. Click Here
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Larry Quintana's Inspiring Story of Triumph Over Profound Loss, Foster Care, Prison, and 5 years in Colorado AdSeg. Now he's in Law School and passionate to change the system that got him to prison. Click Here
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Some of the Obscene Absurdities Lack of Housing Causes Everyday in this State:
(The Photos below are being circulated on Facebook by the National Health Care for the Homeless Council. Photos were taken at the Colorado Coalition for the Homeless.)
(The Photos below are being circulated on Facebook by the National Health Care for the Homeless Council. Photos were taken at the Colorado Coalition for the Homeless.)
Photo of Mark Sibayan, 46, @ Colorado Coalition for the Homeless
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"For everyone who has been mistreated"
----- Amanda Kearney-Smith |
