What a tangled web we weave
What was really going on In HCPF"s change of "Targeting criteria"?
Val's Take
I started Orchid in Aug. 2013. In the Fall of 2013, I started trying to engage the State on Olmstead Compliance discussions.
I started Orchid in Aug. 2013. In the Fall of 2013, I started trying to engage the State on Olmstead Compliance discussions.
|
"Targeting Criteria" limiting the CMHS [Community Mental Health Supports] Waiver to peoplei with mental illness who needed help with "ACTIVITIES OF DAILY" implemented by the Hickenlooper Administration during our Olmstead discussions & without our knowledge.
|
State stonewalling:
Does the State have an objection to a wait list for Assertive Community Treatment? Apparently, so
The State did provide some information but mostly what they provided was stonewalling.
In approximately the Summer of 2014, I asked the State if they had an objection to starting a "waitlist" for Assertive Community Treatment [ACT] -- State officials refused to respond. That question has been reiterated numerous times & I've never gotten a response. It is now 2019 & coming up on 5 years of STONEWALLING on just this one question.
In approximately the Summer of 2014, I asked the State if they had an objection to starting a "waitlist" for Assertive Community Treatment [ACT] -- State officials refused to respond. That question has been reiterated numerous times & I've never gotten a response. It is now 2019 & coming up on 5 years of STONEWALLING on just this one question.
People with MentaL Illness who are Homeless &/or incarcerated and are "IN NEED OF SUPERVISION"
So one of the arguments I started making was -- Hey, a lot of these people who are HOMELESS & INCARCERATED meet the level of care for the CMHS Waiver -- they need "supervision."
We filed our lawsuit regarding people with mental illness in the Criminal Justice System in February of 2016.
https://www.clearinghouse.net/chDocs/public/CJ-CO-0002-0001.pdf
We filed our lawsuit regarding people with mental illness in the Criminal Justice System in February of 2016.
https://www.clearinghouse.net/chDocs/public/CJ-CO-0002-0001.pdf
|
IT WASN'T ALL BAD UNDER THE LAST ADMINISTRATION -- BUT A LOT WAS BAD One of the GREAT things the Hickenlooper Administration did was MEDICAID EXPANSION. One of the worst examples of mental health policy making in Modern Times was HCPF's* 2015 targeting criteria & MONUMENTAL BAD IDEA CHANGE for the Community Mental Health Supports long term care waiver (CMHS). The State added a requirement for need for assistance with ACTIVITIES OF DAILY LIVING. Most people with intensive mental health needs don't need help with activities of daily living. They just need supervision-- and previously that had been enough. *Colorado Dept. of Health Care Policy & Financing |
SAY WHAT?!!!
At the time we filed the lawsuit, I was not even aware that in the FALL of 2015 HCPF had instituted new targeting criteria for the CMHS waiver -- saying "supervision" was no longer enough -- there had to be a need for assistance with "activities of daily living." SAY WHAT?!!!
Our named plaintiffs were homeless individuals with "mental illness" in the Denver Detention Center. If they got released from jail, we lost them. Now, it is not like there is any shortage -- BUT by this time I was on the verge of exhaustion and I was not only going to have to locate more named plaintiffs but also amend the complaint and fight numerous assistant attorney generals.
About 5 to 13 attorneys within the CO Attorney General's Office got assigned to this case with varying levels of responsibility. It was pretty clear the State wasn't going to work with me. The Plaintiff''s Jail Wait Legal Team [the CO's Lawyers' Committee] -- advised I should dismiss without prejudice -- which is what I did.
I don't really have a problem with attorneys defending their clients or people having an honest difference of opinion. BUT think the bad conduct of attorneys often confuses other people -- even State officials -- that compliance with the LAW is really JUST A BIG GAME & the #1 Rule is NOT TO GET CAUGHT.
|
|
sTATE BAD FAITH: bUT IT'S OKAy WHEN THE STATE DOES IT. tHAT CAN'T BE RIGHT
Later I came across this "targeting criteria" for the CMHS waiver promulgated in the FALL of 2015. Was this meant to say that applying the CMHS waiver to people just needing "supervision" was somehow "a fundamental alteration of the State's Plan" -- a defense under "Olmstead"? Of course, subsequently Medicaid Parity requirements and beefed up Medicaid Network Adequacy requirements -- have piled on to the LEGAL REQUIREMENTS the State is NOT complying with.
What was so troubling about the whole experience was there so much bad faith on both the part of the former CO Executive Branch [Governor, Executive Agencies] & former CO Attorney General's Office.
So back to how this has further unfolded: in the Summer & Fall of 2018 I was invited to be part of a GOVERNOR'S STAKEHOLDER GROUP to work on a Report Regarding Community Living -- Status & Recommendations.
In the course of one of these meetings I mentioned this "targeting criteria." Well, guess what the big people in the Disability Community who are in the know and who have to deal with this stuff everyday --- had never heard of it -- & were convinced I didn't know what I was talking about.
Is this "targeting criteria" even being applied -- or was it just done in anticipation of litigation? I don't know.
BUT I do know there were some pretty deep integrity problems in the former Administration & former Attorney General's Office -- and papering it over with politeness & cordiality without integrity didn't fix it.