Category: Inclusion

INTEGRATING AMERICAN CONSERVATISM WITH AMERICAN PROGRESS--IVISM: "STATECRAFT AS SOULCRAFT"

7/24/2019

So we think one of the things Americans have learned is that their leaders are IMPERFECT, and sometime later Americans realized they themselves were imperfect as well -- not as a result of being an American but as the result of being human.

When Will talks about confidence in government going down 60% since the 1970s -- Americans have been having a sometimes traumatic encounter with reality:

JFK & Camelot weren't what people thought they were (just one of many examples in US history -- there are many across the globe)
Wars have limited ability to solve complex problems (generally, the people who now understand that the best today are or have been in the military -- which isn't to say self defense isn't important)
Human beings are a lot more complex and diverse than we thought -- and that has a lot of implications for government.

P.S. We're pretty sure Will's continued admonition that Government is not meant to address "Orchids" is referring to houseplants not our incredibly ingenious symbol for people. Fortunately or unfortunately, our symbol is not unique and appears to be used to symbolize several other vulnerable groups by other non-profits.

So nobody really has a monopoly on "good ideas." Further, many Americans really do appreciate:

Separation of Powers
"Natural Rights"
The "Ameliorative" Role of Government,
Cost, and
The "scope" and "competence" of their government [& their economies]

So whether "conservatives" or "progressives," nobody generally likes to be ignored. There is good research on this.

The "deliberative bodies" have really been insufficient to address this -- because the incentives favor majorities, and things tend to swing back and forth as one group or many groups gets fed up with being ignored.

The answer to this is INCLUSION of those most impacted by the policies under discussion and who feel excluded. It is not easy and it is not perfect, but neither is democracy.

Democracy can have a healing effect. One of the places we learned that was George Will's "Statecraft as Soulcraft."

In praise of D.J. Jaffe & SB19-222 -- the unacknow-ledged Debt the State & Traditional disability advocates owe the conserva-tiveS & Moderates & Orchid

4/26/2019

SB19-222 requires the State to strengthen and expand the behavioral health safety-net system so that individuals who are the hardest to serve do not end up in jails, caught in the child welfare system or homeless.

This really marks a major shift in policy and position -- for the State, State Government & the Disability Community.

What role if any did Orchid play in that?

How does that inform what we will be doing going forward?

What we really did was MARRY the CONSERVATIVE DISABILITY ADVOCACY of D.J. Jaffe and the Mental Illness Policy Organization & Treatment Advocacy Center with the Traditional Disability Activism & Sensiibilities symbolized by Olmstead.

We think that is the MIDDLE GROUND that the Community & Many Advocacy Organizations & Institutions can EMBRACE.

SB19-222 really embraces that and we know that some within State government and advocates are familiar with our criticisms of Colorado's Mental Health System & its "Continuum of Care Hell."

We think it is that Middle Ground that can be embraced nationally by:

Mental Health America,
NAMI
the National Disability Rights Network [the Nation's federally-mandated Protection & Advocacy Offices],
SAMHSA, &
CMS

We don't agree with everything D.J. Jaffe and the Conservative Mental Health Advocacy Movement want -- BUT they FORCED a CONFRONTATION with REALITY that the Mental Health Advocacy & Activist Community was doing its very best to ignore.

That reality was largely related to the GROSS HUMAN RIGHTS VIOLATIONS against people with cognitive disabilities in the CRIMINAL JUSTICE SYSTEM & HOMELESS.

NOW the Activist Community is Embracing those concerns of people in the Criminal Justice System and Homeless and involved with the Child Welfare System.

Further, Mental Health Advocates and Disability Advocates in general had gotten so pressured into believing that the ECONOMIC CASE for SERVICES was more IMPORTANT than the MORAL CASE that the SYSTEM that was CREATED was INCAPABLE of adequately serving people with intensive needs.

AND make no mistake about it the Disability Community got co-opted by States into going along with inadequately resourced systems because there was no clear vision of a Continuum of Care just a disdain for Institutionalization.

So this brings up one of the REALLY INCONVENIENT SYSTEMS FAILURES --the Mental Health Profession itself.

Where is the LEADERSHIP in the Mental Health Profession to address this -- we don't know.

We definitely need the American Psychiatric & Psychological Associations to step up to the plate & take responsibility and remedy the DSM 5 debacle.

That could be accomplished by just acknowledging their IGNORANCE -and stop allowing themselves to be improperly used by the Criminal Justice System.

Most specifically mental health professionals need to stop handing out those DAMNING "anti-social personality disorder" diagnoses -- when they really don't have knowledge to know what's going on.

Further, the mental health profession needs to wait for the National Institute of Mental Health's Research Domain Criteria Program to reform the DSM 5.

This is necessary in order to avoid the unscientific pronouncements the mental health profession is currently making that have the potential and often reality of greatly HARMING the lives of poor marginalized people with only partially understood cognitive issues.

There does seem to be INSIGHT & LEADERSHIP in the RESEARCH COMMUNITY and the Mental Health Activist Community to address what appears to be pretty inadequate mental health care in many cases.

We are interested in MARRYING the insights of the Immune-Brain-Gut Triad with approaches such as "Open Dialogue."

We're not for letting the Mental Health Profession continue to BILL for "CARE" without any commitment to address the HAVOC caused by a SCIENTIFICALLY INVALID DSM 5.

So what we really brought to the Table over the past 5 years was:

Information
Systemic Focus
Root Cause Analysis
& a willingness to Address Reality
while respecting Individual Rights & Needs

We've said this situation with THOUSANDS of Coloradans with cognitive disabilities in the Criminal Justice System & Homeless did NOT happen because 1 System FAILED.

Multiple Systems have FAILED. We will be continuing to provide information, a systemic focus and root cause analysis regarding those SYSTEMS THAT ARE IN DESPERATE NEED OF SUPPORT EVERY BIT AS MUCH AS THE INDIVIDUALS WHO DEPEND UPON THEM.

Of course, NONE OF IT WILL WORK WITHOUT INCLUSION.

SB19-222:

Individuals At Risk Of Institutionalization
Concerning the improvement of access to behavioral health services for individuals at risk of institutionalization, and, in connection therewith, making an appropriation.

BILL SUMMARY

The bill requires the department of health care policy and financing (state department) to develop measurable outcomes to monitor efforts to prevent medicaid recipients from becoming involved in the criminal or juvenile justice system.

The bill requires the state department to work collaboratively with managed care entities to create incentives for behavioral health providers to accept medicaid recipients with severe behavioral health disorders.

The bill requires the state department to determine if seeking a 1115 demonstration waiver is the necessary response to the requirements of 42 CFR 438.6 (e) to ensure inpatient services are available to individuals with a serious mental illness.

If the state department determines it is not appropriate, the state department is required to submit a report to the general assembly with the state department's reasoning and an alternative plan and proposed timeline for the implementation of the alternative plan.

The bill requires the state department to develop and implement admission criteria to the mental health institutes at Pueblo and Fort Logan.

The bill creates a community behavioral health safety net system (safety net system) and requires the department of human services (department), in collaboration with the state department, to conduct the following activities:

Define what constitutes a high-intensity behavioral health treatment program (treatment program), determine what an adequate network of high-intensity behavioral health treatment services includes, and identify existing treatment programs;

Develop an implementation plan to increase the number of treatment programs in the state;

Identify an advisory body to assist the department in creating a comprehensive proposal to strengthen and expand the safety net system;

Develop a comprehensive proposal to strengthen and expand the safety net system that provides behavioral health services for individuals with severe behavioral health disorders;

Implement the comprehensive proposal and the funding model no later than January 1, 2024; and
Provide an annual report from January 1, 2022, until July 1, 2024, on the safety net system to the public through the annual SMART Act hearing.

The bill makes an appropriation.

We Appreciate the State Reaching Out To Us --- But We Got Pretty Disgusted When We Realized It Wasn't To Address Our Specific Olmstead Concerns -- BUT JUST ANOTHER PR MOVE

3/16/2018

We will be asking the Hickenlooper Administration to forward us all information regarding Housing & Services for the Community that they think we and others should be aware of.
With respect to the telephone conference with the State on March 29, Bob Lawhead, Policy Advisor for the Colorado Developmental Disabilities Council and Dr. Lacey Berumen, former Executive Director of NAMI and on the NAMI National Board, would like to participate in the telephone conference with the State.
I know for those of us who have delved into the critical requirements of Olmstead --one of the nuggets of gold was "Measurable" or "Numeric" goals -- and going along with that "Reasonable Time Frames" and "Funding to Support the Plan."
It appears to me that the Hickenlooper Administration is signally that they are not prepared to do much else other than tell us they have done good things. Compliance with the Law, namely Olmstead, does not appear to be on the agenda.
If we weren't 4 years into trying to get the Hickenlooper Administration to comply with Olmstead, we wouldn't be so disgusted -- but we are disgusted, angry, exhausted, and sad.
There are still some things the Hickenlooper Administration could do. One of them would be bring together an INCLUSIVE group of Stakeholders & Focus Groups to go about the business of:

Answering their data questions for purposes of "Measurable Goals," "Reasonable Time Frames," and Funding Strategies,
And put that on a State website.

Lack of Inclusiveness Is A HUGE Problem in Our Society and Even in Colorado & CO State Gov't and Even in Non-Profits: This Destructive Problem Is NOT Going To Get Solved By Accident

3/10/2018

The US Democracy is in a whole lot of trouble -- Trump isn't a cause of that, he is a symptom of it.
Most politicians [Republican & Democrat], for that matter most people, are not as horribly boorish, erratic, racist, and sexually assaultive as Trump.
BUT that's not saying a lot.
Most of us want to do right by everyone in our society--- BUT there is also a HUGE Feeling that things have to CHANGE.
In Colorado, like most States, we need to actually comply with Olmstead -- and to really do that requires a great amount of INCLUSION.
If we don't have the "systems" in place to really comply with the Law, to really include people on a consistent basis -- guess what -- it doesn't really get done.
We're really picking on the Hickenlooper Administration here -- although it is certainly not a problem limited to their administration.
Further, it has been a big problem in wonderful Colorado non-profits like the Equitas Foundation and Mental Health Colorado that represent either a wealthy or middle class perspective on Mental Health Advocacy with financial bars to "inclusion" -- although in the case of Equitas maybe one can apply for a "scholarship" to discuss policy affecting you and rub elbows with state officials.
In the case of Mental Health Colorado -- you can pay $50 to question gubenatorial candidates [they are doing outreach to students for the Forum].
This has got to CHANGE in a BIG WAY.
We think the Hickenlooper Administration has wanted to deal with the Equitas Foundation maybe more than the rest of us not only because the Equitas Foundation might be able to provide them some resources, but also because the Hickenlooper Administration relates better to the people in the Equitas Foundation because they are more like them.
I don't think it is so much a conscious thing as an unconscious thing.
That's what is so insidious about "Unconscious Bias." Mind Gym CEO Octavious Black even maintains that research shows limited effectiveness in trying to address "Unconscious Bias" through direct training -- you have to try to address it in other ways.
Well what does that mean for our governments, justice system, and society?
Well, it means this isn't going to get fixed by accident, we've got real problems of HUGE Inequality, Lack of Inclusion, Injustice in Our Societies -- and we have to have a SENSE OF URGENCY about addressing those.
Real people are suffering NOW.

We Want & Deserve More Than a CO State Gov't that Is "TRENDING" Towards Inclusion & Complying with Disability Civil Rights Laws

Unconscious Bias

Mind Gym CEO Octavius Black in this TedxTalk in London maintains that the issue isn't "Diversity" but "Inclusion" -- diversity without inclusion will NOT produce the desired results.

Further, Black maintains that trying to change "Unconscious Bias" has limited effectiveness.

He argues that a more effective practice is becoming interested in the differences.

Citizen-Driven Plans of Correction in Cases of Substantiated Abuse, Neglect or Rights Violations with the Power to Address "Root Causes"

2/2/2018

When I think of Plans of Correction, I usually think of Plans of Correction coming out of the State Health Department, Health Facilities Division.
Those are very important but they have often failed to address "Root Causes" of facility problems such as "Insufficient Staffing."
So we've often left the hard stuff for private personal injury attorneys. Well, in a lot ways like Sexual Abuse or Harassment Cases or in fact most cases that are subject to a Settlement Agreement, there is a NON-DISCLOSURE AGREEMENT.
So over decades we can never really get to the "Root Causes" of problems due to 2 very important and powerful de-incentives:

Systemic Problems that require greater reimbursement of providers to solve or other increased funding; and
Providers that don't want to be held accountable for expensive fixes.

Well who loses out on this -- primarily vulnerable populations. Historically, the State and Providers if not happy about this -- can live with it. Unfortunately, the vulnerable populations sometimes can't survive these political realities that are not putting the needs of the Vulnerable Populations FIRST.

As is so often the case before some horrific tragedy happens that is going to get filtered to the High-Powered Personal Injury Attorney --- there were a lot of WARNING SIGNS that essentially got ignored.

LET'S MAKE NO MISTAKE ABOUT IT --it is often cheaper to pay out a large damage settlement or award than it is to FIX THE PROBLEM(S).

So that is what the STATE Of COLORADO as well as a lot of other entities have been doing.

THAT NEEDS TO CHANGE -- and its in the interests of :

Vulnerable Populations
Providers, and
The State

that it change in a number of ways.

If we want this human rights disaster to change, we need to change the SYSTEM.

Colorado Abuse & Neglect Scandals Involving People with Disabilities

Specifically:

State Agencies need User-Friendly, ADA Compliant Grievance Procedures
That include person/family members/etc. participation in Plans of Correction where the Complaints involve Abuse, Neglect or Rights Violations;
The Agencies will do a thorough root cause analysis and make an affirmative finding as to whether the problem is a result of Insufficient Staff with respect to both Quantity and Quality.
If the Insufficient Staffing or other matter amounts to an "Emergency" and cannot be appropriately addressed with existing funds, the State shall seek Emergency Funding.
Each year, State Agencies should make a report to appropriate State Legislative Committees:
- regarding Abuse, Neglect and Rights Violations
- Report of Including the person/family members/etc. in Plans of Correction
- Report as to Complaints leading to Emergency Concerns
- Request for Additional Funding if needed to address Abuse, Neglect or Rights Violations. Request should include need for Funding and analysis of alternatives.

Colorado has HUGE problems in addressing allegations of ABUSE, NEGLECT and Rights Violations of People with Disabilities.

We have picked on the Hickenlooper Administration A LOT and in a LOT of WAYS they've earned it. BUT they are NOT the only ones.

Boulder County Jail Inmate with Psychosis Gouges Out His Own Eyes: Possible Jail & County Liability for State Failures to Adequately Resource Mental Health

1/2/2018

Well, Colorado State Government is trying to address Mental Illness in Criminal Justice, BUT

The Scale of the Problem is HUGE.
The Lack of Inclusion of People with both mental illness & criminal justice involvement absolutely negatively impacts the effectiveness of policies; and
The refusal to address this through Olmstead Planning -- reasonable & measurable goals, reasonable time frames, and funds to support the plan -- make coming to terms with the Scale of the Problem almost impossible. --- AND Oh Yeah, it's the Law.
Last year, Colorado approved approximately $2.7 million for housing and supportive housing for inmates with mental illness leaving jails and prisons. That's great, but that's a drop in the bucket with respect to the need.
AND Colorado needs a lot more bed space and needs to implement Open Dialogue and the Soteria approach to mental health community treatment.

We're really seeing the tip of the Iceberg when we see these lawsuits filed against jails, prisons, or mental health facilities regarding inmates or patients with mental health issues.
With regard to private lawsuits, it really helps if you're dead or horribly maimed. Otherwise, most private attorneys are not going to take the case, and they probably can't afford to.
With regard to systemic public interest cases, they are hugely important and hugely resource intensive.
So a lot of stuff -- really bad human rights violations not amounting to death or maiming -- are allowed to fester -- leading to more horrible problems.
True compliance with Olmstead and Parity is in large measure the ANSWER.
Addressing the Scale of the Problem, rather than running from it ---- would help a lot, too.

Continuum of Care Mental Health Planning: The Olmstead Planning Bill and the Need for Inclusion in Mental Health Bed Expansion Planning

9/26/2017

The above may seem like an oxymoron but we have long recognized that a strong continuum of care is essential for older people: If someone breaks his or her hip, he or she may need to go to the nursing home for rehab, but with an anticipated return to home.

That need for a strong continuum of care is
even greater in mental health --- where people are bouncing between homelessness, incarceration, the mental institute, the nursing home, etc.

Of course, we don't really want people bouncing around -- and we think that:

complying with Federal law and Olmstead will help,;
increasing the inclusion of people with disabilities in the planning of disability services will help, including mental health bed expansion;
going to a Strength-based, person-centered recovery system will help;
Housing will help;
increasing availability of intensive mental health services in the community will help.

We are at a very exciting point in Colorado history. The State and the Hickenlooper Administration realize the challenge of mental health in the criminal justice system and are doing a lot to try to address it.

Eagle County is putting a measure to the voters for a local marijuana tax to fund mental health care.

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.

http://www.parkrecord.com/news/colorado-voters-to-decide-if-marijuana-taxes-will-fund-mental-health-care/

We think our Olmstead Planning Bill is a Big Piece of the Puzzle -- and helps Colorado comply with Federal Law-- It's Not necessarily the whole puzzle.

AND even for those other pieces -- we need inclusion.

We do need to work with people if our Olmstead Planning Bill is going to be successful. If you do have concerns, please let us know -- we want to work with people.

John Knowles was an American Novelist best known for "A Separate Peace" -- Wikipedia.

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

9/20/2017

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.

https://www.usgovernmentspending.com/colorado_state_spending_pie_chart

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:

Inclusion
A Comprehensvely, Effectively Working Olmstead Plan with Measurable Goals that Bring Housing & Services to Scale to Meet the Need, and
Facilities for People with Disabilities that are ADEQUATELY FUNDED & STAFFED and NOT RIFE with ABUSE or BREEDING GROUNDS FOR SUICIDE.

Democracy, Representative Government, & Inclusion -- We've Got To Change -- Our Governments Don't Work for a LOT of PEOPLE

9/13/2017

     We trace our democratic roots to ancient Greece, and yet even there democracy had a bad rap among some -- Mob Rule basically.
It is certainly not easy, and generally in modern times we agree with Churchill -- it is the worst form of government -- except for everything else.
Of course, we don't have "direct democracy" and direct democracy's manifestations in the US -- think especially California, but Colorado too, the referendum process -- has its critics.
   AND yet the US-form of democracy is in a lot of trouble folks. To the untrained eye, it looks a whole lot like an oligarchy.
   Even with all the good things the Hickenlooper Administration has going for it -- AND there are a LOT -- there have been A LOT of problems with LACK OF INCLUSION & NULLIFYING COMMUNITY DECISIONS in the case of the choice of the Crisis Center Providers, never really having the diverse input that is necessary for the mess that is CMHIP (Colorado Mental Health Institute @ Pueblo), etc.
     In fairness, some of this may be (likely be):

unconscious bias (they are not even aware of any bias)
lack of capacity and a protective reaction (it takes time and energy to include people)
etc.

It is critically important that our government officials have the "capacities" -- in time, money, and processes to substantively engage with people who are perceived as significantly different from themselves or marginalized.

Those reasons as well as many others are why we are supporting a CO Olmstead Planning Bill. We believe its potential as a model could go beyond the disability community.

We Need Real Inclusion On CMHIP & Olmstead

9/11/2017

I don't have a problem with "empathizing" with state officials who are charged with the difficult duty of addressing the CMS initial "immediate jeopardy" determination and the larger long-standing staffing problems at the Colorado Mental Health Institute @ Pueblo.

   In fact, such empathy and understanding is no doubt essential.

   Having said that, it does not appear that Colorado State Government has the processes in place to successfully address the scope of this problem.

   The State does not appear to be empowered to do what it needs to do, or does not "think" it is empowered to do what it needs to do to address this crisis -- and large scale staffing problems at a large institute of vulnerable individuals is a crisis.

   No doubt in the midst of crisis it is hard to figure out how to include people -- but that lack of inclusion is part of the reason for the current crisis @ CMHIP.

   We don't know whether to laugh or cry or both when the Hickenhooper Administration sets up what come off as pretty bogus "listening sessions" around state -- and they can't talk about Olmstead or CMHIP with the diverse Mental Health Community that wants to talk them about those issues..

   BTW Olmstead Compliance is required by federal law and NOT subject to a poll taken by the State.

Val's Blog

INTEGRATING AMERICAN CONSERVATISM WITH AMERICAN PROGRESS--IVISM: "STATECRAFT AS SOULCRAFT"

In praise of D.J. Jaffe & SB19-222 -- the unacknow-ledged Debt the State & Traditional disability advocates owe the conserva-tiveS & Moderates & Orchid

We Appreciate the State Reaching Out To Us --- But We Got Pretty Disgusted When We Realized It Wasn't To Address Our Specific Olmstead Concerns -- BUT JUST ANOTHER PR MOVE

Lack of Inclusiveness Is A HUGE Problem in Our Society and Even in Colorado & CO State Gov't and Even in Non-Profits: This Destructive Problem Is NOT Going To Get Solved By Accident

We Want & Deserve More Than a CO State Gov't that Is "TRENDING" Towards Inclusion & Complying with Disability Civil Rights Laws

Citizen-Driven Plans of Correction in Cases of Substantiated Abuse, Neglect or Rights Violations with the Power to Address "Root Causes"

Boulder County Jail Inmate with Psychosis Gouges Out His Own Eyes: Possible Jail & County Liability for State Failures to Adequately Resource Mental Health

Continuum of Care Mental Health Planning: The Olmstead Planning Bill and the Need for Inclusion in Mental Health Bed Expansion Planning

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

Democracy, Representative Government, & Inclusion -- We've Got To Change -- Our Governments Don't Work for a LOT of PEOPLE

We Need Real Inclusion On CMHIP & Olmstead

Author

Archives

Categories

Val's Blog

​We Want & Deserve More Than a CO State Gov't that Is "TRENDING" Towards Inclusion & Complying with Disability Civil Rights Laws

Author

Archives

Categories

We Want & Deserve More Than a CO State Gov't that Is "TRENDING" Towards Inclusion & Complying with Disability Civil Rights Laws