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      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
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      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
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New CO Definition of "Gravely Disabled"  -- Eff. July 1, 2014

CRS 27-65-102(9)
(search for statute at http://www.lexisnexis.com/hottopics/colorado/ )

(9) "Gravely disabled" means a condition in which a person, as a result of a mental health disorder, is incapable of making informed decisions about or providing for his or her essential needs without significant supervision and assistance from other people. As a result of being incapable of making these informed decisions, a person who is gravely disabled is at risk of substantial bodily harm, dangerous worsening of any concomitant serious physical illness, significant psychiatric deterioration, or mismanagement of his or her essential needs that could result in substantial bodily harm. A person of any age may be "gravely disabled", but such term does not include a person whose decision-making capabilities are limited solely by his or her developmental disability.

Val's Take
     This is pretty broad language and in fact the previous language was pretty broad.  As a mental health advocate, I hate  to say this BUT you could drive a Mack Truck through this -- if you really wanted to.

      But the fact of the matter is that's really impossible given the current resources -- and so cases are triaged.  Many clinicians are certainly aware of this "triaging" and "course of dealing," so that's one of the reasons why they "think" word-smithing the civil commitment statutes to make it easier to commit people is the answer.

     People --- The plain language of "gravely disabled" is about as easy as it can get.

     In fact, one mental advocate has reported that a city attorney who shall remain nameless has indicated the State is ripe for a lawsuit because all of these homeless and other people who clearly meet the criteria for "gravely disabled" but the State doesn't provide the resources to serve them.

     This is just one more reason among many why Comprehensive On-going Olmstead Planning is Desperately needed in Colorado and for the matter the Country.

​
Certification &/or Incarceration is really "Treatment Failure"
Val's Take          

              It was really Jim Dean who first introduced me to the concept which is really pretty basic that "Certification is Treatment Failure."
              I'm wanting to emphasize this important concept, especially because I think my comments above on Civil Commitment and "Gravely Disabled" might be misinterpreted to mean that I think the answer is to provide the resources so we can commit as many people as possible.
              I think the reality is -- if we provide the resources -- the perceived need to commit people is going to go way down.
              "Most people"  don't want to be homeless and/or incarcerated and there are generally a lot of complicated reasons why they are, not least of which:
  • they are very, very poor;
  • they have absolutely experienced dangerous forms of racism, etc. and those have impacted their mental health;
  • they have substance abuse issues and those have impacted their mental health;
  • they are the victims of childhood trauma and abuse and those have impacted their mental health;
  • they have biologically based mental illnesses that they have never received adequate treatment for and those have effected their mental health
  • they may have developmental disabilities that are poorly recognized or understood;
  • they may have traumatic brain injuries that are poorly recognized or understood.
               As a very short person -- I'm always for safety -- Safety First -- and beyond that I think the Community is only going to buy into all of this if they do feel Safe.
               And even in certification, we have to have  "Shared Decision-Making," because we do so often poorly recognize what is really going on with others and understand what they truly need.
Picture
Retired Colorado Legal Services Mental Health Gadfly & Attorney Jim Dean -- Truly the "Dean" of Colorado Mental Health Law & the "Mental Health Medicaid Mavens"
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  • Home
    • About Orchid >
      • Why Orchid?
      • ORCHID'S SYSTEMIC FOCUS & "ROOT CAUSE" ANALYSIS APPROACH TO PROBLEM SOLVING WITH A COMMITMENT TO CREATIVITY & INNOVATION
      • Disclaimers, Limitations and An Invitation
      • Orchid Board
      • Orchid Book Club
      • Conjecture, Science & Translational Research & Medicine
      • Orchid Themes & Symbols
      • The Tipping Point
      • Orchid's Website Advertising Policy
      • Statement for Potential Website Contributors
      • Contact
  • Blogs
    • Val's Blog
    • Val's Blog 2
    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
    • NEURO-DIVERSITY Wednesday
    • Olmstead Law & Order Thursday
    • Translational Medicine Friday
    • Translational Love, Relationships & Neuro-Diversity Saturday
  • Orchid's A-Z Index
    • Crisis Services in CO, the US & Around the World
    • Assertive Community Treatment & Flexible ACT Index
    • Housing & Homelessness Index
    • Criminal Justice
    • Innovation Index
    • For More: See the Main Orchid Index Page
  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
  • Research & Translational Medicine
    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
      • Racial Discrimination & the Immune System & Mental Health
      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System