Category: Olmstead

Olmstead Talks In Terms of the State's Plan for Services for People with Disabilities in Both Institutions & the Community---Should Our Olmstead Planning Bill Consider Both As Well

10/22/2017

Generally, when we think of an "Olmstead Plan" we think of housing and community services for people with disabilities.
BUT the Supreme Court in Olmstead really talked about this "Comprehensive, Effectively Working Plan" as being thoroughly related to the State's Overall Plan for the Provision of Services for People with Disabilities, both in Institutions and in the Community.
So this is also very related to the idea of allocation of resources for disability services and that States can't necessarily be expected to change their programs overnight BUT they should have a "comprehensive, effectively working plan" to prevent the unnecessary institutionalization of people with disabilities or the great risk of institutionalization inherent in homelessness.
We are asking the question: Should we include "institutions" in our Olmstead Planning Bill because:

Institutions for people with disabilities have had a lot of problems this year in Colorado and there is currently not a lot of inclusion of people with disabilities with regard to the planning or oversight of these institutions.
Often people with disabilities in these institutions and their family members know what the barriers are to community living.
Staffing is a HUGE issue. We need people who are really motivated to solve those problems -- that includes staff and people with disabilities.
When we think about planning for institutions that is necessarily related to planning for Community Services AND we probably need to be doing that together.

Colorado Mental Health Institute @ Pueblo

El Pueblo, a mental health and substance abuse treatment center for children was shut down by state authorities late Sept. 2017 following complaints that children were abused and underfed. http://www.denverpost.com/2017/09/28/el-pueblo-boys-and-girls-ranch-closed/

The Beginning of Our Olmstead State Pages: Arizona & California In Colorado, it is NOT just a lack of Leadership But of Integrity

10/8/2017

We have the Minnesota Olmstead Case in which a Federal Judge requires specific measurable goals for an Olmstead Plan.

In addition to that, specific measurable goals and real State accountability are common themes across the Country when it comes to Olmstead Compliance or lack of Compliance.

Our pages on Arizona and California are still in the draft stage -- but they make their points.

We hope to have most of the States covered by the end of the month, and we think they do give insight into the common issues in Olmstead Compliance.

Colorado government talks about Accountability BUT when it comes to OLMSTEAD they have wanted none of it.

Further, some might say Leadership is lacking. Maybe. Insofar as integrity and telling the truth are a part of leadership then yes.

BUT it has really been an integrity problem not just in Olmstead but:

Contracting for the Crisis Center Providers

"Crisis Access protested the cancellation, eventually appealing to the court that there had been “inappropriate political pressure from disappointed bidders.”

"[Judge] Stern agreed the process was “highly suspect.” He issued a preliminary injunction in February to stop the state from awarding new contracts to another group of mental health providers."

http://www.denverpost.com/2014/05/16/judge-advises-state-do-over-of-bungled-mental-health-contract/

Well, this little controversy had to do with the inappropriate (some advocates even said criminal) awarding of the Crisis Center Contracts to other than the initially chosen recipient -- That intially chosen recipient did NOT happen to be a current Mental Health Provider in Colorado -- AND that didn't go down well with the Mental Health power brokers in this State.

At the time it wasn't our issue, but we should have paid much more attention, because the lack of integrity it hinted at or as many believed evidenced was to be seen again and again.

the Jail Wait Case,

"The suit also alleged that the Colorado Department of Human Services had fabricated monthly data to make it appear as though detainees were receiving timely services.

"The agreement orders the department to hire an independent consultant to oversee continuing operations of the state’s mental health system for the remaining duration of a 10-year agreement made in 2012. The consultant is to ensure compliance and data reporting, and is to meet with DLC [Disability Law Colorado] and the state on a quarterly basis to provide updates."

http://www.coloradoindependent.com/160513/colorado-to-hire-consultant-agrees-to-independent-oversight-for-mental-health-system-in-lawsuit

CMHIP (Colorado Mental Health Institute @ Pueblo)

Long standing care and staffing problems going back decades. But under the Hickenlooper Administration:
*CMS "Immediate Jeopardy Designation"
*Failure to Inform Colorado Legislature of magnitude of staffing problems during the 2017 Legislative Session;
*Months of abusive overtime staffing practices, before Colorado finally asked for emergency increases in salaries in the range of 18-23 percent.
*According to the Pueblo Chieftain, CMHIP staff were advised to answer questions of CMS investigators, BUT don't volunteer anything.

lack of complete compliance with the ban on AdSeg for people with mental illness in CO Prisons.

People lie, don't exactly tell the truth, generally because they're afraid. Maybe people won't like them, they did something they might "get in trouble for," etc.

AND we do use "lying" as a BIG excuse to go off on people.

AND even just saying "integrity" is sort of moral grand-standing. Like anyone of us is perfect.

In the words of Meditation Guru Eknath Easwaran, "A deer never lied to me, and I like people better."

AND we need some integrity in our Olmstead discussions with the State.

AND we need some discussions, response to our inquiries regarding our Olmstead Planning Bill.

AND the State needs to comply with the LAW.

Arizona: How Far To Comply With Olmstead?

California: How Far To Comply with Olmstead?

Lack of Housing, Facility Scandals & Mutuality of Interest -- Our Olmstead Planning Bill

10/2/2017

Housing Section 8 & SSI: Colorado Housing Search
Now – maybe we’re just doing it wrong – which is more than possible. But when going on Colorado Housing Search for available Section 8 at $400, [we couldn’t get anything at $300], there were only 2 available in the State without waitlists–

One in Las Animas, and
One in Burlington.

Now, the Governor did a great thing in proposing $20 million in affordable housing. Of course, it takes time for that to get in the pipeline.

Another, "of course." For people with disabilities, which many of these people are – There is Olmstead.

Now, it is not the case as a legal matter that the State just gets to choose how much in resources it is going to allot in housing and services to people with disabilities.
AND in a State as prosperous as Colorado – well, we think the evidence is there to prove that the lack of housing and services for people with disabilities in Colorado is NOT “reasonable.”

As a State we need to recognize that state imposed spending limits such as TABOR are NOT legally sufficient excuses for:

Failure to comply with Federal Civil Rights Laws such as the Americans with Disabilities Act and the US Supreme Court’s 1999 Olmstead decision
Failure to provide the housing and services that people with disabilities need to stay out of institutions as well as the great risk of institutionalization of homelessness; and
Failure to make the inclusive plans to bring housing and services to scale to meet the need.

We can work together to do this. Reconciliation is finding compatible interests.

The disability community has a lot of interest in a Colorado Olmstead Planning Bill, and Colorado could end up serving as a national model with regard to statutory Olmstead Planning building on Colorado’s demonstrated expertise in use of data in Human Services.

Not only that it cements a Progressive & Positive Legacy that the Hickenlooper Administration has been trying to build but has been often undermined by facility scandals whether:

In juvenile facilities (inappropriate restraint practices, etc.) (See Denver Post -- Colorado's Juvenile Detention Facilities Have Failed to Improve http://www.denverpost.com/2017/09/15/colorados-juvenile-detention-facilities/ ) (See also videos 3 and 4)
Developmental disability facilities (Pueblo Regional Center abuse of residents)--see 1st video "Investigators document abuse at Pueblo Regional Center" ,
Prisons (death of Christopher Lopez in Administrative Segregation --see 5th video "Lopez Prison Death) , Whistleblower case involving allegations of inflated compliance with ban on administrative segregation for people with mental illness in prisons (http://www.denverpost.com/2016/01/20/colorado-pays-prison-whistleblower-280000/ ) , CO Audit finding need for improvement in compliance with ban on adseg for people with mental illness in Colorado prisons (http://www.coloradotrust.org/content/story/amid-reform-prison-mental-health-program-audit-reveals-ongoing-challenges )
Jails (the jail wait case for competency exams, [See Orchid's page on the Jail Wait Case]
or Mental institutes (CMS “immediate jeopardy” determination. (Chieftain Uncovers A Mess at the State Hospital in Pueblo) http://www.chieftain.com/opinion/editorials/chieftain-uncovers-a-mess-at-the-state-hospital-in-pueblo/article_f3caa533-70c6-528a-9f94-d1fbd7a8e6e9.html)
Deaths of inmates in county jails some which are in part attributable to lack of housing and services in the community (see video 2 the death of Michael Marshall),
El Pueblo, a mental health and substance abuse treatment center for children was shut down by state authorities late Sept. 2017 following complaints that children were abused and underfed. http://www.denverpost.com/2017/09/28/el-pueblo-boys-and-girls-ranch-closed/

Nobody wants those things, and a lot of things are being done. NOT always inclusive of the people they’re effecting and generally NOT with an eye towards bringing housing and services to scale to meet the ENORMOUS Need.

Everyone brings something different to the Table whether:

ADAPT (the equivalent of Ph.Ds in civil disobedience and experts in Olmstead; the National Healthcare bill is dead in no small measure to National ADAPT and folks from Colorado ADAPT),
Colorado Coalition for the Homeless
Colorado Cross Disability Coalition, Mental Health Colorado, & Colorado Mental Wellness Network (Masters in Media and Organization)
Disability Law Colorado: the unique vantage point of the State's protection and advocacy agency for people with disabilities (celebrating its 40th Anniversary this year)
MindFreedom of Colorado (keeping the alternative voice of mental health advocacy alive in Colorado)
NAMI Colorado organizational outreach and support
The State of Colorado (Expert data meisters)
Youth Voice (giving a voice to youth in the mental health system)
Etc.

Sufficiency of Knowledge, the Criminal Justice System, People with Disabilities and the Human Rights Issue of Our Time

9/27/2017

So what are we trying to say with regard to the sufficiency of the body of knowledge in mental health as it relates to the criminal justice system?

We're NOT saying ----there is NO knowledge in the mental health profession. In fact, there is a lot of knowledge.
What we are saying is that whether knowledge is sufficient depends on the task @ hand. One may be a whiz @ engineering and not be able to get a rocket out of the Milky Way Galaxy.
Because of the historical nature of "mens rea" or mental element in the criminal law, mental health professionals have been pressed into service by desperate defense attorneys to provide "expert" testimony as to whether their client was "insane" and prosecutors have engaged their own "experts."
No other area of medicine [mental health] is so implicated in punishment and no other is so struggling in lack of sufficient scientific grounding.
The Criminal Justice System really can't just reform itself, or not easily. It will likely take a combination of Legislation and Court decisions to reform the fairly routine human rights violations that are committed against people with disabilities, especially invisible, largely cognitive disabilities, that occur on really a daily, hourly basis.
Of course, what we really need to do is get people with disabilities -- mental illness, brain injury, developmental disability, etc. --- out of the criminal justice system and provide the housing and services, including intensive services if necessary, that they will need to remain outside of the Criminal Justice System and other institutions.
This truly is the Human Rights and Civil Rights Issue of Our Time.
We Hope You Will Support Our Draft CO Olmstead Planning Bill

Mary Robinson was an Irish Independent politican who served as the 7th, and first female, President of Ireland from December 1990 to September 1997, and the United Nations High Commissioner for Human Rights from 1997 to 2002. -- Wikipedia

New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW

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.

One of Orchid's Symbols: The Vietnam War

9/24/2017

Orchid Themes & Symbols

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:

psych meds that weren't as great as we hoped for some people;
a disability community that was in horrible denial that a small but nonetheless significant percentage of their members could be caught up in the criminal justice system. Further, most did not want to be further "stigmatized" as criminals.
a criminal justice system and public that just didn't "buy" the "medicalization of evil"
a DSM 5 that lacks scientific validity according to Dr. Thomas Insel, former head of the US National Institute of Mental Health, and one of the driving reasons for the Institute's creation of the Research Domain Criteria Program.
Mental Health is now much more linked to gut and immune health than previously appreciated.
AND the reality is if the State does start to take some responsibility for the true Scale of the Need for BEDs, HOUSiNG, & INTENSIVE SERVICES -- that's expen$ive.

Our Criminal Justice System Can Be A Very Nasty Disability Service Provider with an Abusive Edge -Because the State Isn't Providing the Beds, Housing or Services @ the Scale Needed for People with Disabilities

9/23/2017

Mad Eye for the Sane Society

Mad Eye Moody from the "Harry Potter" series by J.K. Rowling

"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

So generally the Criminal Justice System doesn't really look @ Disability per se.
What it looks @ is:

Competency to Stand Trial

AND

Guilt by Reason of Insanity

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:

Learning Disabilities
Developmental Disabilities
Executive Functioning Deficits
Mental Illness
Substance Use Issues
Brain Injury

AND they are probably not going to meet our high bar:

incompetent to stand trial (ITP) or
not guilty by reason of insanity (NGRI)

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:

2000 more psych beds than what it has. (This is loosely based on the Mental Illness Policy Organization's recommendation for 50 psych beds for every 100,000 people)
3000--7000 more slots in Assertive Community Treatment (ACT) (That's a pretty broad range and is based on people trapped in the criminal justice system, nursing homes, homeless, and in institutions without sufficient intensive services in the community)

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 with George, after George realizes Uncle Billy lost the money in "It's A Wonderful Life"

D.J. Jaffe, CMHIP, Our Olmstead Planning Bill & TABOR: It Is Long Past Time To Have A Come To Jesus or More To The Point -- A Come To Reality

9/16/2017

Colorado Hasn't Allocated the Resources for the Inpatient Care or Community Care Colorado Citizens with the Most Intensive Mental Needs --- Need. That Has and Is Leading to in the words of Conservative Mental Health Advocate D.J. Jaffe "Insane Consequences." And that is true even in economically prosperous Colorado.

D.J. Jaffe is hardly a darling of the Left, in fact he is generally embraced by the Right, and we don't necessarily agree with all the prescriptions -- BUT he has pretty accurately described the problem in the US that people with the most intensive mental health needs have been written off as too expensive and cost shifted to the criminal justice system and the homeless shelter.

How can we have:

an evidenced based community mental health treatment such as Assertive Community Treatment that is the gold standard in intensive community mental health treatment
a major component of many MI US Dept. of Justice Olmstead Settlement Agreements, and
Yet not systematically required to be provided where reasonably medically necessary and desired --- politics? this is insane & life-destroying.

AND We Do Need More Beds & Sufficient Salaries for Staff.

We're asking the Hickenlooper Administration, Colorado Attorney General Coffman's Office, and the Colorado Legislature to look at the State's obligations under Federal Law as falling outside of TABOR restrictions based on the Supremacy Clause to the US Constitution.

Specifically, for our purposes that would mean:

State obligations to meet Federal Safety and Staffing requirements of facilities, etc.
Obligations under the federal Americans with Disabilities Act and the 1999 Olmstead decision and subsequent caselaw and federal guidance, etc.

National Review
By D.J. Jaffe
Price's War On Mental Illness
http://www.nationalreview.com/article/451039/mental-health-spending-serious-illnesses-should-get-bulk-spending

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.

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Val's Blog

Olmstead Talks In Terms of the State's Plan for Services for People with Disabilities in Both Institutions & the Community---Should Our Olmstead Planning Bill Consider Both As Well

The Beginning of Our Olmstead State Pages: Arizona & California In Colorado, it is NOT just a lack of Leadership But of Integrity

Lack of Housing, Facility Scandals & Mutuality of Interest -- Our Olmstead Planning Bill

Sufficiency of Knowledge, the Criminal Justice System, People with Disabilities and the Human Rights Issue of Our Time

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

One of Orchid's Symbols: The Vietnam War

Our Criminal Justice System Can Be A Very Nasty Disability Service Provider with an Abusive Edge -Because the State Isn't Providing the Beds, Housing or Services @ the Scale Needed for People with Disabilities

Mad Eye for the Sane Society

"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

D.J. Jaffe, CMHIP, Our Olmstead Planning Bill & TABOR: It Is Long Past Time To Have A Come To Jesus or More To The Point -- A Come To Reality

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

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​ ​Mad Eye for the Sane Society

​"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

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Mad Eye for the Sane Society

"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