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DISABILITY HOUSING & EMPLOYMENT ---Are the KEYS to Olmstead Compliance & Long Term Stability

1/21/2022

Both Feds & the States need to --- STEP UP

There's a real need to bring States to the Table on Olmstead Compliance.

Largely, the US Department of Justice (DOJ) has conceptualized that as a job for the Nation's Protection & Advocacy System for People with Disabilities (Disability Rights Network) which includes state offices and a national support center.

DOJ and the Disability Rights Network have done a lot in this area --- but they are stretched thin.

FEDERAL ADMINISTRATIVE ENFORCEMENT of
OLMSTEAD

We think the authority is already there to do that.
Because it can be CONTROVERSIAL --- a Federal Law specifically authorizing such Administrative Enforcement as a last resort when Technical Assistance efforts have failed may be considered necessary.

Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails

[I can relate to the guy on the receiving end of this.]

At some point in all this --- somebody is likely to say that people with cognitive differences / disabilities NEED TO GET A JOB.

WE AGREE.

That is going to WORK OUT so much better if we are CONSCIOUSLY identifying and addressing STRENGTHS and WEAKNESSES.

HINT: The WEAKNESSES may be coming in areas of EXECUTIVE FUNCTIONING.

OlmsteadRights.org

STATES & DISABILITY ORGANIZATIONS, FAMILIES and INDIVIDUALS need to have a COME TO JESUS, ABRAHAM, MOHAMMED, GOD, REASON discussion with the FEDS on DISABILITY HOUSING.

The most obvious answer is to allocate the financial responsibility for disability housing between the States and the Feds --- similar to Medicaid.

In a de facto way, that is already going on --- but with no ACCOUNTABILITY for PEOPLE with DISABILITIES.

If HUD was able to secure additional funds for those states that had an Olmstead Plan addressing housing with:

Measurable (Numeric) Goals
Reasonable Time Frames, and
Funding to Support the Plan

that could help.

COORDINATED LEGAL ACTION could help facilitate some of this.

A Comprehensive & Effectively Working Olmstead Plan is a DEFENSE to a Legal Action brought under Title II of the Americans with Disabilities Act ---
If States such as Colorado were willing to enter into a good faith STIPULATION that the State does not currently have SUFFICIENT HOUSING & SERVICES for:
- People with Disabilities who are Institutionalized, and
- People with Disabilities who are at great risk of Institutionalization such as is inherent in homelessness
The Feds would be willing to enter into THREE-WAY talks with STATES and ADVOCATES to bring HOUSING & SERVICES to SCALE.

The Rolling Heads in Colorado's Crappy Mental Health System

1/15/2022

Robert Werthwein & Sharon Raggio are gone and Carl Clark @ MHCD is still there, really?
Most know that there is a SIGNIFICANT LIMIT to what these kinds of EXITS are going to accomplish.
BUT we also know that things can't go on the way they have.

Further, the Mental Health Profession has problems that go beyond the PUBLIC MENTAL HEALTH SYSTEM.

It is going to be EASIER to DESIGN a BETTER SERVICE SYSTEM --- if we have a better idea about what we're talking about with regard to NEURO-DEVELOPMENTAL & PSYCHIATRIC DISORDERS.
AND that is undergoing some CONSIDERABLE REVISION ---
- It's not so much that our current explanations are WRONG (sometimes they are ) --- it's more that we've taken the first 1 or 2 links in the CHAIN of CAUSALITY that we've come across --- and thought we had the whole thing.
  - Further, that's a lot of what we're doing in our criticism of the PROVIDERS and the STATE.
  - It's not exactly wrong, but if we want to CHANGE this --- it is not going to be sufficient.
  - There are BIG SYSTEMIC CHALLENGES.

Historically, States and Providers and FISCALLY CONSERVATIVE State Legislatures have done a complicated Kabuki Dance in which the NEEDS of INDIVIDUALS and FAMILIES have been sold down the river to maintain the ILLUSION that laws were being complied with and needs met.

CERTAINLY a lot is being spent but we SHOCKINGLY have not prioritized those with the greatest needs.

Robert Werthwein resigns from Colorado Office of Behavioral Health. Photo Credit: Denver Post

From ColoradoPolitics.com:

Robert Werthwein to step down from state Office of Behavioral Health (Dec. 9, 2021)

Werthwein was never the issue with Colorado’s behavioral health system (Dec. 27, 2021)

Sharon Raggio --- Former CEO of Mind Springs -- serving the Western Slope

From SummitDaily:

County leaders across Colorado respond to Mind Springs Health CEO’s resignation

‘One person didn’t create this system and one person’s resignation isn’t going to fix it’ (Jan. 4, 2022)

Dr. Carl Clark --- CEO of Mental Health Center of Denver

From Axios Denver:

The CEO Carl Clark took a $819,340 salary in 2019, more than 10 times what the average clinician earns. (Dec. 6, 2021)

Mixed Bags
Orchid Themes & Symbols

CO Coalition for the Homeless 2022 Legislative Priorities & Financing Disability Housing, Intensive Services & Addressing "ASYNCHRony" in the Work Force

1/14/2022

Financing Disability Housing is a Huge Problem

Financing Intensive

Assertive Community Treatment at SCALE is
a Huge Problem.

Having ASYNCHRONOUS Strengths and Executive Functioning Challenges is a HUGE Problem for many people with NEURO-DEVELOPMENTAL and/or PSYCHIATRIC DISORDERS.

Disability Housing

Right now this is a SHARED SOCIETAL RESPONSIBILITY --- and that is not necessarily a bad thing even though Olmstead places the ultimate responsibility on STATES.
Funders of Disability Housing:
- the FEDS
- the STATES
- MUNICIPALITIES
- FOUNDATIONS & PHILANTHROPIC INTERESTS
- BUSINESS SUPPORT
We need the FEDS to hold the STATES' FEET to the FIRE
BOTTOM LINE: We can't continue to have people with serious cognitive disability who are HOMELESS

Medicaid Intensive Services such as Assertive Community Treatment must be brought to SCALE.

Intensive WRAPAROUND Services are important for people with significant EXECUTIVE FUNCTIONING CHALLENGES.
BOTTOM LINE: Housing First is not going to be enough for some to many people even if that is where you start.

Addressing ASYNCHRONY in the Work Force

People are coming with Executive Functioning Challenges --- we and they didn't expect, but they often also have STRENGTHS that we and they didn't expect either.
We need to expand our UNDERSTANDING of the NEEDS and STRENGTHS of the DIVERSE LEARNER to the DIVERSE WORKER, ENTREPRENEUR, etc.

When is the polis administration going to comply with olmstead?

1/11/2022

The Polis Administration (as with many Administrations before it) --- doesn't appear to know how to comply with Olmstead --- POLITICALLY -- even if the practical mechanics are not as hard as States are making it.

MAINLY States just need to get started on that Olmstead Plan with MEASURABLE GOALS. Polis Administration is in ANALYSIS PARALYLIS ("SIT TIGHT & ASSESS")-- and we're NOT HAPPY.

If they want to do on-going research that's great -- BUT they need to get TO WORK on that Olmstead Plan with MEAURABLE GOALS --- NOW --- because it must be CONTINUALLY IMPROVED anyway.

BOTTOM LINE: Colorado and other States need to get on with it and adopt REASONABLE PLANS with MEASURABLE GOALS to address BIG SHORTAGES.

FEDS we really need you to provide TECHNICAL ASSISTANCE to the STATES.

Some UNIFORM, EFFECTIVE ENFORCEMENT would be appreciated, too.

ORCHID'S 2022
CO COGNITIVE DISABILITY
2-PAGER

How Many Angels can dance on the Head of a Pin and the Free Will vs. Determinism Debate

1/4/2022

See also: SKIN IN THE GAME

There's a lot of "FIGHTING THE LAST WAR" in the Free Will vs. Determinism Debate.

In Modern America, it's become a lot about RELIGION vs. SCIENCE
- There is a lot to UNPACK --- but HISTORICAL GRIEVANCE is in the MIX.

We do need the Religious Folks and Science Folks --- BUT we also need the MODERN DOCTORS, LAWYERS, EPIDEMIOLOGISTS, LAW ENFORCEMENT, ORGANIZATIONS, INDIVIDUALS, FAMILIES & POLICYMAKERS to CONTINUE BUILDING that PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE.

Some of those people are Religious, Some of them are really into Science, Some of them aren't into Religion or Science, and SOME "IDENTIFY" as both Religious and are into SCIENCE.
CRIMINAL JUSTICE is a PRAGMATIC APPROACH that is very much INFLUENCED by these PHILOSOPHICAL DEBATES --- but at the end of the day has to act without PERFECT KNOWLEDGE.
Further, we CAN'T WAIT for PERFECT KNOWLEDGE to IMPROVE our CRIMINAL JUSTICE SYSTEM both with respect to SAFETY and HUMANE TREATMENT.

What does become CLEAR is that when we are LINKING these "FREE WILL vs. DETERMINISM" ideas to "MORAL RESPONSIBILITY" --- there are MORAL HAZARDS --- whichever way you go-- that are DANGEROUS.

So if we're not demanding certain STANDARDS of BEHAVIOR ---- that can get DANGEROUS quickly.
BUT if we're not recognizing the COMPLEXITY of ACHIEVING THOSE STANDARDS of BEHAVIOR that involve the INDIVIDUAL and go BEYOND the INDIVIDUAL --- that is a MORAL HAZARD.
- We're often dealing with CHRONIC DANGEROUS BEHAVIOR --- that we're addressing as INDIVIDUAL BAD INTENT & INDIVIDUAL BAD ACTS --- that are more COMPLICATED than that.
  - BAD INTENT + BAD ACT = PUNISHMENT was quite SOPHISTICATED hundreds of years ago --- it's NOT in 2022.

There's a certain nonsensical aspect to the CONSTRUCTION of the "Free Will vs. Determinism Debate" that has some aspects in common with "HOW MANY ANGELS CAN DANCE ON THE HEAD of a PIN" --- LACK OF PRACTICALITY is right up there.

We're assuming things to be in EVIDENCE --- that seem in fact DIFFERENT than what we are ASSUMING --- namely:

Both sides could probably agree that things SEEM to be CHANGING --- things are NOT STATIC.
The question of CONTROL that LIVING THINGS have over their BEHAVIOR looks much more a matter of DEGREE.
- Is that "CONTROL" --- FREE WILL since it is DEPENDENT on the STRUCTURE of the LIVING ORGANISM and the ENVIRONMENT?
  - It DEPENDS on how we DEFINE "FREE WILL" --- those DEFINITIONS have changed over time.

Furthermore, it appears that we are "LEARNING" to CONTROL our BIOLOGY and ENVIRONMENTS.

Part 3 of 3: Hidden Brain --- So Many Implications

12/30/2021

 The Hidden Brain Episode that was set in Denver --- "Both Things Can Be True At the Same Time" went to

Integrative Complexity, and
Integrative Thinking

---it chose as its backdrop Addiction, Mental Health Problems, & Criminal Justice --- mainly because those are the EXTREMES --- and in some ways it is easier to SEE THE ISSUES.

This staid NPR Program isn't really that different than some DRAMA or SATIRE that is ratcheting things up to make a point.

WARNING: Offensive Language

J. Cole
Amari

"Let's work, hey . ..

"I punch the time sheet, not no more
And now my assigned seat is the throne."

At some point, most of us realize --- WE"RE PLAYING A GAME -- and if it's NOT WORKING FOR US --- We have to step outside it.

It usually has to be PRETTY BAD for us to do that --- BECAUSE there are many DIS-INCENTIVES.

NPR'S HIDDEN BRAIN

"Both Things Can Be True"

Don't Look Up
"Sit Tight and Assess"

Ironically, one of the things we are trying to do on Orchid is RATCHET things down for people with mental illness from SERIAL KILLER to ARTISTIC TEMPRAMENT.

The GOOD GUYS in "Don't Look Up" are the Nerdy, Anxious Outsiders --- ---- because that is who is making the ART.

In "Don't Look Up," the Protagonists basically are following the CHAIN of COMMAND and making SUBSTANTIVE ARGUMENTS --- and it is not getting them very far.

Divergent --- Drowning Scene (2014)
Shailene Woodley as Tris Prior

Addressing "DIVERGENCE" is:

"STEPPING OUT OF OUR ASSIGNED SEAT" (see J. Cole above)
Engaging the "Other Side" to find a MUTUALLY AGREEABLE SOLUTION
And giving those POLITICIANS a CONSENSUS
Because if you wait for the POLITICIANS --- IT WILL BE TOO LATE.

We'd like to avoid ARMED REBELLION.

Part 2 of 3: Hidden BRAIN -- Everyone Has Their Problems --- Spoiler Alert

12/30/2021

Casablanca (1942)

--- In the Stephanie and Kim Story on NPR's Hidden Brain--- Kim was a life saver and a thief, and Stephanie was someone who had been suicidal and a addict and wanted to be a good friend.

Most of the time it is not that dramatic --- but EXTREMES help us see COMMON PATTERNS.

One of the COMMON PATTERNS for many NEURO-DIVERSE people is --- "Hey, I'm not the only one here with some challenging behaviors."

In fact, most of the US population has low grade inflammation ---- it may be showing up as cancer, or autoimmune diseases or other inflammatory "physical" diseases, and the psychiatric issues may be less severe but there.

Another EXTREME EXAMPLE: poor black, hispanic, white guy with psychiatric disorders is arrested for breaking into a garage while drunk/high and subsequently gets beat up by officers in the jail--- those officers have their own neuro-developmental / psychiatric problems.

Most of the time nothing happens to the officers unless there is a video and even then it can take a lot to get the matter addressed.

We have much more of a population-wide problem with INFLAMMATION than we realize and it's not just the USUAL SUSPECTS.

How did we get to the point that 1/5 to 1/4 of the populations of most developed countries and more and more developing countries have mental health concerns and chronic disease is rampant?

Some of those simple answers aren't all wrong --- we need to eat our fruits and vegetables and exercise. BUT that can come perilously close to "PRAY THE GAY AWAY."

Neuro-Diversity is not sufficiently recognized by the Mental Health Profession and it's the bulk of the Mental Health Population.

Where did that Neuro-Diversity start --- by and large IN UTERO.

NPR'S HIDDEN BRAIN

"Both Things Can Be True"

Tedx: Professor Graham Rook at Kings College London on the "Old Friends Hypothesis"

See 4:10: Widespread low level background inflammation in US population.

Starting to look at this from a Public Health -- Population-Based Approach (with some BIOMARKERS) could get us a much more accurate view of what's going on. --- and start to address some entrenched BIASES.

Further, we need to look at MORE THAN ONE GENERATION.

Developing mental health policy in Sweden:

a policy analysis exploring how a complex societal challenge was consigned to individual citizens to solve (April 2021)

Karolinska Institutet in Sweden --- Photo Credit: Nobelprize.org

Press Release from the Karolinska Institutet in Sweden (2014):

"The conference will focus on the development of the brain from conception, in utero to the early post natal stages.

"If something goes wrong during this time, it may have major consequences, and many known psychiatric illnesses can be traced back to this period.

"Schizophrenia, autism, ADHD, bipolar disorder and anxiety syndrome are just a few examples. "

Part 1 of 3: A Complicated Story from Denver --- SPOILER ALERT

12/30/2021

NPR's National Program "Hidden Brain" this week was "Both Things Can Be True" and looked at Integrative Complexity from the standpoint of "Stephanie" and her friendship with "Kim."
Kim had both saved Stephanie's life and stolen from Stephanie.
Stephanie had her own problems and needed the assistance of the SOCIETY to address the stealing.
It appears that Kim was prosecuted in Denver District Court, Kim was put on Probation, was not successful on PROBATION and went to prison for many months.

We don't have all the facts --- BUT it is not a big leap to say Stephanie didn't have a lot of options and neither did the Criminal Justice System.

For Stephanie, Kim and the Criminal Justice System, the State Legislature could be and has been a source of options.

The Criminal Law is often STATE LAW.

More and more effort has been put into providing MEDICAID Services and Supportive Housing to "JUSTICE-INVOLVED" people.

PROBATION is NOT a good fit for people with EXECUTIVE FUNCTIONING CHALLENGES and many if not most people in Criminal Justice have EXECUTIVE FUNCTIONING CHALLENGES.

BUT People with Executive Functioning Challenges generally have other STRENGTHS -- they may even be SAVING OTHER PEOPLE'S LIVES.

NPR'S HIDDEN BRAIN

"Both Things Can Be True"

The link below is from San Mateo County Probation in California.

It is not what one would expect from a Government Probation website -- but it is extremely HELPFUL in providing CONTEXT --- about where we've been.

It briefly goes back to the Middle Ages and works its way up.

History of Probation

The Nexus Between Neuro-Science & Probation

Data & Olmstead

12/25/2021

Ultimately, we see this as a State Responsibility to COLLECT THE DATA going to the NEEDS OF PEOPLE WITH DISABILITIES under Olmstead.

Further, States have an INCENTIVE to COLLECT THIS DATA not only to do OLMSTEAD PLANNING --- BUT to BARGAIN WITH THE FEDS --- especially on HOUSING.

Municipalities and Counties also have an interest in collecting some of this data --- to BARGAIN with the STATE. The States are cost-shifting SIGNIFICANT HIGH COGNITIVE DISABILITY COSTS to the MUNCIPALITIES & COUNTIES.

Trying to Get A Process For Olmstead in Colorado and other States

12/25/2021

After my interview for the State's Disability Policy Coordinator Position, it was clear the State is walkin' a FINE LINE.

It was certainly clear to me that I wasn't the right person for the position, and I hope whoever gets the position gets the backing of the State.

We are 20 years out from the Olmstead Decision and STATE COMPLIANCE is a BIG ISSUE.

It's a big issue for many reasons including the decision itself.

Unfortunately, the Olmstead Decision makes an Olmstead Plan a "DEFENSE in a LAWSUIT," not an independent requirement.

So that has really put the BURDEN on People with Disabilities to File Lawsuits.

Many lawsuits have been filed against the State of Colorado, generally for good reason.

It is saying a lot in a LOUD VOICE if the John Hickenloopers and Jared Polises of the world don't really see a clear path to Olmstead Compliance.

I'm going to be focusing on this as much more of a National Issue.

The BRAVE WORK of Mental Health Colorado, NAMI Colorado, Colorado Cross Disability Coalition, ADAPT, Disability Law Colorado, the Colorado Lawyers Committee and many others has been amazing to watch and we hope they will continue to pursue these Olmstead Issues at the State Level.

With regard to Families, Private Insurance Companies, Medicare and Medicaid, States and Businesses, it is hard to see how we are going to FINANCE TREATMENT, SERVICES and SUPPORTED EMPLOYMENT for Cognitive Disability without:

Better DIAGNOSTICS and TREATMENTS and
BETTER STRATEGIES for ADDRESSING EXECUTIVE FUNCTIONING in Supported Employment,, Supported Entrepreneurship, and Non-Supported Employment and Entrepreneurship.

That has been and is going to continue to be a BIG FOCUS of Orchid going forward.

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DISABILITY HOUSING & EMPLOYMENT ---Are the KEYS to Olmstead Compliance & Long Term Stability

The Rolling Heads in Colorado's Crappy Mental Health System

CO Coalition for the Homeless 2022 Legislative Priorities & Financing Disability Housing, Intensive Services & Addressing "ASYNCHRony" in the Work Force

When is the polis administration going to comply with olmstead?

How Many Angels can dance on the Head of a Pin and the Free Will vs. Determinism Debate

Part 3 of 3: Hidden Brain --- So Many Implications

Part 2 of 3: Hidden BRAIN -- Everyone Has Their Problems --- Spoiler Alert

Part 1 of 3: A Complicated Story from Denver --- SPOILER ALERT

Data & Olmstead

Trying to Get A Process For Olmstead in Colorado and other States

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