Is Colorado violating the Integration Mandate of the ADA and "Olmstead"  by Failing to Provide Adequate Services in the Community for People with Mental Illness?

          Let's Get Specific & Look at the Department of Justice Case Against the State of New Hampshire and what Colorado Currently  Provides under Medicaid and the Nature of Evidence-Based Services that Can Keep People with Serious Mental Illness in the Community.

New Hampshire

              New Hampshire was in a situation similar to Colorado., although their population is actually much less.

         According to census records, New Hampshire has a population of about 1.5 million people.

          The Department of Justice's Amanda D. Olmstead case against the state of New Hampshire resulted in one of the most important Settlement Agreements for people with mental illness enforcing the ADA's Integration Mandate. 

          The Agreement requires the State, for the first time, to create mobile crisis teams in the most populated areas of the State and to create crisis apartments to help support team efforts at avoiding hospitalization or institutionalization. 

          The Agreement also requires the State to make enhanced Assertive Community Treatment (“ACT”) team services available statewide, such that the mental health system can provide ACT to at least 1,500 people at any given time. 

         The Agreement requires the State to provide scattered-site, permanent, supported housing to hundreds of additional people throughout the state; the State will also create special residential community settings to address the needs of persons with complex health care issues who have had difficulty accessing sufficient community services in the past.  The State will also deliver additional and enhanced supported employment services, consistent with the Dartmouth evidence-based model, to hundreds of new recipients throughout the state.   

           Link to DOJ Amanda D. case against New Hampshire with Complaint and Proposed Settlement Agreement that has been approved by the parties.    

Services

          Introduction to Assertive Community Treatment -- Produced by SAMHSA -- 

           Substance Abuse & Mental Health Services Administration Under the U.S. Dept. of Health & Human Services (Below).

​Introduction to Dartmouth model of supported employment

​Scattered site, permanent supportive housing -- Robert Wood Johnson Foundation video on supportive housing (below)

          Below see an interview with the attorney and Executive Director of the New Hampshire Disability Rights Center Richard Cohen, after the filing of the lawsuit, but before the proposed settlement.

         
Our thoughts are below.

Colorado

              
  Like a lot of states, Colorado has never adequately funded mental health.  
        According to census records, Colorado has a population of 5.6 million, more than 3 times the population of New Hampshire .

Assertive Community Treatment 
(figures are based on 2014 BHO Contracts, new contracts did not appear to provide numerical requirements)

Access Behavioral Care (ABC):
          MHCD ACT Team --
          40 person capacity

 Behavioral Health Care Inc.  (BHI)
          300 person capacity  --    8 to 1 clinician to person ratio

Colorado Health Partnerships, LLC  (CHP)
           165 person capacity

Foothills Behavioral Health Partners, LLC
           41 people annually

Northeast Behavioral Health Partnerships, LLC

             45 people at any given time 

For your mathematical enjoyment, under the current Colorado Behavioral Health Organization  contract, there is a total ACT capacity of:

591 -- (Again, Colorado is more than 3x the size of 
New Hampshire by population)


Now in fairness, the new BHO contracts have not yet been posted on the CO Dept. of Health Care Policy & Financing website & the CO Office of Behavioral Health is asking more than $4 million for Community Transition Services from the Legislature as well as other things . . . and a needs study, etc.

          It needs to be said that individuals working in behavioral health are often highly educated, kind people pursuing a calling in sometimes very difficult and stressful circumstances.

Colorado Mental Health Institute at Pueblo (CMHIP)

Orchid's Cinematic Commentary:

Grateful BUT . . .

As grateful as we are for the $18 million for crisis centers , etc. proposed by the Governor and approved by the Legislature and the proposals for this legislative session -- that barely begins to restore the many millions in cuts mental health has endured to a system that was never adequately funded. 

Link to the U.S. Doj
 info Re: 
(ADA)/ Olmstead  ComplaintS

--PLEASE GUVNA -- WE WANT & NEED MORE.

BUT
Unlike Jedediah Leland in this scene from "Citizen Kane," we are stone-cold sober and relatively stable, yet we agree:

"You talk about the people as though you own them...When your precious underprivileged really get together-oh boy-that's going to add up to something bigger than your privileges..."