State Audit Requests, A New Governor Next Year, & Olmstead Can't Serve as an International Model If We Won't Comply With It

My Take & Update: 

              I think Medicaid Community Mental Health Services are hard for States because they are paying a lot for mental health services.  So the problem isn't so much that they aren't spending any money, but that isn't really well correlated with the NEED.

                  If States are adequately addressing the NEED, by and large you're not going to have a lot of homeless and incarcerated people with mental illness.  That includes other disabilities as well such as traumatic brain injury and developmental disabilities.

                    NOW one may say:  These people are refusing "treatment."  Well, one of the things that makes it more expensive and actually more effective, is that the "treatments" need to be individualized to the person and they NEED to be strength-based and person-centered and person-directed to the extent possible.

                          That "extent possible" is generally quite a bit and it can be time-consuming.  On the other hand, it is generally more effective and ultimately cost effective.

                                  When we look @ the Finnish model "Open Dialogue" that has now been adopted in some other countries, including piloted in Massachusetts and Georgia in the US, upfront it is NOT cheap.

                                         It is over the long-term that it is cost-effective.

                                       We are talking to other mental health and housing advocates about probably looking @ seeking 2 separate audits:

• The Sufficiency of Medicaid Mental Health Community Services for Specific Populations -- that will probably also look @ what is available from CDHS.
• AND Housing for People with Disabilities generally with an eye to the State's Obligations under Olmstead.

           We are hopeful that a new Governor will be more inclined to address our concerns on Olmstead Planning.  There is NO GUARANTEE of that, and in fact things could get worse, we hope they don't.

             As an aside I was contacted yesterday by a Judge in the United Kingdom who handles mental health and child protection matters and is also a professor of Mental Capacity Law @ University College London.  He is interested in Human Rights and has done some work with African countries, wanting to know if there were "endeavors" we might partner together on.

              What I'm thinking and have been thinking for some time is that Olmstead and Olmstead Planning is such a great model for the rest of the world --- BUT WE DON'T DO IT!

                    How do we make this something that is just NOT on paper and is ridiculously hard to enforce?  How do we get Governments to participate?  Is "reasonable" too vague? Do we need to nail this down -- is all this "reasonableness" just causing confusion. 

                       That's what they finally had to do in the Family Law context with support issues -- provide specific guidelines.

                        This really is a "support issue."   The legal responsibility of the State to "support"  people with disabilities to live in the Community who are institutionalized or @ great risk of institutionalization.

  

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