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We're Encouraged by this Legislative Session ---BUT There are Some Scary Reminders About How Far We Have To Go

6/20/2022

FEDS: WHERE ARE YOU?

In March 2022, the US Department of Justice issued a "FINDINGS LETTER" to COLORADO re: people with physical disabilities and nursing homes.

There are more "FINDINGS LETTERS" that need to be issued to Colorado and most States.
We are on the 100-YEAR PLAN to COMPLIANCE with EXISTING FEDERAL DISABILITY CIVIL RIGHTS LAWS.

What we really need is COMPREHENSIVE TECHNICAL ASSISTANCE and EFFECTIVE UNIFORM ADMINISTRATIVE ENFORCEMENT.

I am for INDIVIDUAL STATE INNOVATION, CREATIVITY and Tailoring.
- There is NOT just ONE RIGHT WAY to comply with:
  - The Americans with Disabilities Act (ADA)
  - Section 504 of the Rehabilitation Act
  - Mental Health Parity & Addiction Equity
  - Medicaid Network Adequacy
  - Etc.
- The PROBLEM is there is NOT JUST ONE WAY to NON-COMPLIANCE either.

We NEED the FEDS to provide more in the way of CONTINUOUSLY IMPROVED DEFAULT TEMPLATES.

CMS and others are providing "GUIDANCE" sort of BUT Compliance is:
- TECHNICALLY COMPLICATED, and
- POLITICALLY COMPLICATED, and
- ENFORCEMENT is PATCHY.

We do need STATES to push to bring down COSTS, BUT Ironically 2 of the things that are going to bring down costs are:
- BETTER TREATMENTS, and
- BREAKING DOWN BARRIERS to realizing the INTEGRATION MANDATE in the ADA

Especially for Cognitive Disability, Developmental Difference with Average or Above Average IQ --- the CURRENT PATHS TO INCLUSION are more difficult than the MAJORITY appreciates.
- Further, those people with Developmental Differences involving Sensory Processing and Executive Functioning are more VULNERABLE TO PSYCHIATRIC DISORDERS.
- THEIR Strengths and Weaknesses are DIFFERENT ENOUGH that the NEURO-TYPICAL MOLD won't fit.
- If we really put some CONSCIOUS EFFORT into MAXIMIZING the STRENGTHS and WORKING AROUND the "WEAKNESSES" ---
  - We probably can realize some COST SAVINGS.

Many people are not going to get into a HOUSE without a 30-YEAR MORTGAGE ---
- BUT EVERYONE understands that the more YEARS you add to that MORTGAGE --
  - The more you are ULTIMATELY going to pay.

Well, the INTEREST RATE for SOCIAL EXCLUSION, INADEQUATE TREATMENTS, HOUSING & PLACEMENTS for Cognitive Disability/Difference is MANY TIMES that of the average 3O-year mortgage---
- BOTH in TREASURE and HUMAN SUFFERING.

Further, we don't seem poised to REACH COMPLIANCE with EXISTING DISABILITY CIVIL RIGHTS LAWS in 30 YEARS or 60 YEARS.

In fact, it's not clear when we will reach COMPLIANCE.

We need a Plan -- like an Olmstead Plan with:

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

In the meantime, we would like to see ON-GOING ENGAGEMENT and Yearly Reports of State Protection & Advocacy Offices with States on:

Olmstead
Parity
Network Adequacy

Further, State Lawyers Committees and Pro Bono Efforts should PARTNER with State P&A Offices conduct "INVESTIGATIONS" in COORDINATION with the US Department of Justice.

Some of that is being done in States like Colorado and others.

If we are NOT going to FUND UNIFORM and EFFECTIVE ADMINISTRATIVE ENFORCEMENT --- we need to FUND P&A, Pro Bono & DOJ INVESTIGATIONS and Enforcement Efforts.

As encouraged as we all are by a new Colorado Behavioral Health Administration ---

the most DIFFICULT CONVERSATIONS have yet to be had, and
HCPF's 809.15.A.2 on Target Criteria for Colorado's MI Waiver requiring needing assistance with activities of daily living ----
- Speaks VOLUMES about where we've been, where we still are and how far we have to go.

Cloudy Valley Morning --- photo.net

INFLAMMATION REDUCTION as a Civil Rights & Health Equity Issue

6/19/2022

Conjecture

Inflammation is something of a UNIVERSAL LANGUAGE in Animal Biology and it is coding for an enormous number of things.
One of the things that is OBVIOUS --- BUT is
- Not always obvious to the LAW, or
- MEDICAL PRACTITIONERS
We're NOT making ourselves out of WHOLE CLOTH.
We're BORN into this.

There have been a great number of books written recently on INFLAMMATION and seeing INFLAMMATION as a "ROOT CAUSE" of illness.
- That also prompts a lot of books to promote an ANTI-INFLAMMATORY "LIFESTYLE" which is good as far as it goes.
- IT DOESN'T GO FAR ENOUGH

Disparities in Susceptibility to Multisystem Inflammatory ...
https://jamanetwork.com › jamapediatrics › fullarticle

by EA Dennis-Heyward · 2021 · Cited by 3 — In May 2020, the CDC issued a national health advisory for MIS-C, which is now characterized by fever, multiorgan (2 or more) system

Certainly when it comes to NEURO-DEVELOPMENTAL and PSYCHIATRIC DIFFERENCES or DISORDERS --- the "ANTI-INFLAMMATORY LIFESTYLE" doesn't go far enough.
- We have to TARGET DEVELOPMENTAL INFLAMMATION and DYSREGULATION of MULTIPLE SYSTEMS of the BODY.

I don't think a MORE FOCUSED EFFORT on addressing the UNDERLYING BIOLOGY of Neuro-Developmental and Psychiatric Disorders INVALIDATES:
- Personal Observation
- Family Observation
- Social Observation
- Professional Observation

But it does give a much needed CROSS REFERENCE, especially for those at the BOTTOM of the HIERARCHY.

Accommodations, Work Arounds and Life Paths for Differences in Sensory Processing

6/8/2022

Conjecture

"Impairments in early sensory information processing have been consistently identified in patients with schizophrenia as well as in individuals at high clinical risk for developing psychosis.

"There is increasing evidence that the deficits at these early levels of information processing significantly ..."

Sensory Information Processing Abnormalities in ... - Frontiers

[Question: Is it a DEFICIT or is it an EXCESS, BOTH -- INDIVIDUAL?]

"Social and emotional responses rely heavily on the brain's ability to make sense of sensory information.

"Inaccurate information from processing deficits results in aversive emotional reactions from which maladaptive behaviors grow."

Sensory Processing Disorder: It's Not… Something You Outgrow

[Question Again: Is this just DEFICITS, is it also EXCESSES --- does it depend on how we look at it?]

So what does this have to do with ACCOMMODATIONS. WORK-AROUNDS and LIFE PATHS?

Differences in Sensory Processing are often something you are BORN with:
- By and large, the PATH OF LEAST RESISTANCE is just to try to fit in as best you can --- on some level MOST EVERYONE is doing that.
- The PROBLEM comes when YOUR NEEDS and the SOCIETY'S NEEDS or other PEOPLE'S NEEDS are coming into CONFLICT.

Further, HOW MUCH AWARENESS do YOU, EXPERTS or the SOCIETY really have with regard to MORE FUNDAMENTAL "ROOT CAUSES" of these CONFLICTS?

Because this is COMPLICATED --- one of the ways we have "RESOLVED" these CONFLICTS is with SYSTEMS of HIERARCHY.

Those "SYSTEMS of HIERARCHY" are under SCRUTINY by many people and groups of people, including many NEURO-DIVERSE people.

Many psychiatrists now would say ADHD is not an ATTENTION DEFICIT --- it's an ATTENTION EXCESS.

I would say that ATTENTION EXCESS is the RESULT of a SENSORY EXCESS.

Further, we process information through our senses in part by using our EMOTIONS.

On the one hand, we don't REASON without EMOTION --- EMOTION is A PART of the REASONING PROCESS.

On the other hand --- EMOTION is NOT NECESSARILY the END PRODUCT --

UNDERSTANDING and AWARENESS can bring CALM
A FACADE of Understanding and Awareness --- has its limits
And that I think is what PUSHES Human Understanding and Awareness.

I don't think 40 years ago the DSM was a FACADE -- it was imperfect BUT it was the best we could do.
Today in 2022 the DSM is a FACADE for a profession that is not getting SUFFICIENT TRANSLATIONAL RESEARCH SUPPORT.
I think if we're not considering the role of DEVELOPMENTAL DIFFERENCES/DISORDERS involving SENSORY PROCESSING as they relate to PSYCHIATRIC DISORDERS and SUBSTANCE USE DISORDERS,
- We're not likely to be EFFECTIVE, and
- It won't be COST EFFECTIVE

Florence + The Machine
Free

Florence Welch is Neuro-Diverse --- she has Dyslexia.

I think a lot of people who are Neuro-Diverse with HYPER-CONNECTED BRAINS but not necessarily DYSLEXIC --- can RELATE to this idea of FEELINGS and EMOTIONS HITTING ALL AT ONCE.

GO WITH THE FLOW

Neuro-Diverse people are processing often MORE SENSORY INFORMATION
I think that is what makes it EASIER for NEURO-DIVERSE people to PICK UP PATTERNS in DIVERSE DISCIPLINES
- they have MORE EXAMPLES
BUT it takes them LONGER to PROCESS MORE INFORMATION ---
- Einstein didn't talk until he was 3 --- and most of us aren't Einstein
- BUT we are bringing our UNIQUENESS to the TABLE
- Further --- all that INFORMATION in the UNIVERSE is NOT SOMEHOW IRRELEVANT ---
  - - Saying you don't have the BANDWIDTH to CONSIDER something
    - Is SIGNIFICANTLY DIFFERENT than saying it is IRRELEVANT. Leonardo da Vinci was right --- IT IS ALL CONNECTED

For many people, processing ENORMOUS AMOUNTS of Information:
- The Arts
- Entrepreneurship
- Social Entrepreneurship
- Various Forms of Teaching

Can Work.

Neuro-Diverse people can seem CONTROLLING but they are trying to maintain a pretty elusive HOMEOSTASIS.

If you are at the TOP of some PYRAMID (PYRAMID SCHEME) -- then maybe you're able to keep it together (sort of)
If you are at the BOTTOM of some PYRAMID (PYRAMID SCHEME) -- it is going to be NEXT TO IMPOSSIBLE.
- Neuro-Diverse people need a lot of CONTROL over their ENVIRONMENTS because they are SO SENSITIVE to those ENVIRONMENTS.

Further, the important thing about NEURO-DIVERSITY is the DIVERSITY.

It's often Neuro-Diverse people who are in CONFLICT while those NEURO-TYPICALS are trying to figure out what all the FUSS is about.

This is about "Equality" and "Fairness" ---

But it is not EQUALITY in the sense of we're CLONES -- it's EQUALITY in the sense that we're all living beings and we need ENVIRONMENTS that work for us and there are DIFFERENCES.
We have to NEGOTIATE those DIFFERENCES on an EQUAL FOOTING.

Transitional/ Translational Justice Monday

We're Encouraged by this Legislative Session ---BUT There are Some Scary Reminders About How Far We Have To Go

INFLAMMATION REDUCTION as a Civil Rights & Health Equity Issue

Accommodations, Work Arounds and Life Paths for Differences in Sensory Processing

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