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    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
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    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
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    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
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      • Alcoholism & the Immune System & Mental Health
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      • 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

"Secrecy is for losers" -- But openness requires Supports

1/22/2022

 
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Biden got hammered this week for his open statements on Ukraine and Russia.

Ronald Reagan was criticized at various times for being both too harsh and too naive when it came to the Soviet Union.

Extremes do help us CLARIFY issues, the WORLD STAGE helps us to CLARIFY issues.

One of the things that we've talked about is creating a world in which it SAFE for POLITICIANS to be HONEST.
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Erechtheion in Athens
​If you would have asked me 5 years ago what it is going to take for politicians to be HONEST 
  • I would have said those LYING DOGS just need to be HONEST.

I would not have had the INSIGHT of DANIEL PATRICK MOYNIHAN that:
  • We have to BUILD THE SUPPORTS for POLITICAL OPENNESS.
​Why is OPENNESS so important?

TRUE INCLUSIVE PROBLEM-SOLVING rarely occurs in the absence of OPENNESS.
  • SECRECY, CONFIDENTIALITY often are important in HOSTILE ENVIRONMENTS.
  • The PARADOX:  If we're not BUILDING THE SUPPORTS for OPENNESS --- we can become TRAPPED.
​Some people with cognitive disabilities are trapped in the Criminal Justice System & Homelessness  --- 2 of the potential KEYS are Lying in PLAIN SIGHT ---
  • STATE OLMSTEAD COMPLIANCE, and
  • Increased Federal Technical Assistance & SUPPORT

DISABILITY HOUSING & EMPLOYMENT ---Are the KEYS to Olmstead Compliance & Long Term Stability

1/21/2022

 
​Both Feds & the States need to --- STEP UP
​There's a real need to bring States to the Table on Olmstead Compliance.

Largely, the US Department of Justice (DOJ) has conceptualized that as a job for the Nation's Protection & Advocacy System for People with Disabilities (Disability Rights Network) which includes state offices and a national support center.

DOJ and the Disability Rights Network have done a lot in this area --- but they are stretched thin.
FEDERAL ADMINISTRATIVE ENFORCEMENT of
OLMSTEAD
  • We think the authority is already there to do that.
  • Because it can be CONTROVERSIAL --- a Federal Law specifically authorizing such Administrative Enforcement as a last resort when Technical Assistance efforts have failed may be considered necessary.​ 
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​Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails
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[I can relate to the guy on the receiving end of this.]

​At some point in all this --- somebody is likely to say that people with cognitive differences / disabilities NEED TO GET A JOB.

WE AGREE.

That is going to WORK OUT so much better if we are CONSCIOUSLY identifying and addressing  STRENGTHS and WEAKNESSES.

HINT:  The WEAKNESSES may be coming in areas  of EXECUTIVE FUNCTIONING.
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OlmsteadRights.org
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​STATES & DISABILITY ORGANIZATIONS, FAMILIES and INDIVIDUALS need to have a COME TO JESUS, ABRAHAM, MOHAMMED, GOD, REASON discussion with the FEDS on DISABILITY HOUSING.  

The most obvious answer is to allocate the financial responsibility for disability housing between the States and the Feds --- similar to Medicaid.

In a de facto way, that is already going on --- but with no ACCOUNTABILITY for PEOPLE with DISABILITIES.
If HUD was able to secure additional funds for those states that had an Olmstead Plan addressing housing with:
  • Measurable (Numeric) Goals
  • Reasonable Time Frames, and
  • Funding to Support the Plan
​that could help.
COORDINATED LEGAL ACTION could help facilitate some of this. 
  • A Comprehensive & Effectively Working Olmstead Plan is a DEFENSE to a Legal Action brought under Title II of the Americans with Disabilities Act --- 
  • If States such as Colorado were willing to enter into a good faith STIPULATION that the State does not currently have SUFFICIENT HOUSING & SERVICES for:
    • People with Disabilities who are Institutionalized, and
    • People with Disabilities who are at great risk of Institutionalization such as is inherent in homelessness
  • The Feds would be willing to enter into THREE-WAY talks with STATES and ADVOCATES to bring HOUSING & SERVICES to SCALE.

The Rolling Heads in Colorado's Crappy Mental Health System

1/15/2022

 
  • Robert Werthwein & Sharon Raggio are gone and Carl Clark @ MHCD is still there, really?​
  • Most know that there is a SIGNIFICANT LIMIT to what these kinds of EXITS are going to accomplish.
  • BUT we also know that things can't go on the way they have.
 
Further, the Mental Health Profession has problems that go beyond the PUBLIC MENTAL HEALTH SYSTEM.
  • ​It is going to be EASIER to DESIGN a BETTER SERVICE SYSTEM --- if we have a better idea about what we're talking about with regard to NEURO-DEVELOPMENTAL & PSYCHIATRIC DISORDERS.
  • AND that is undergoing some CONSIDERABLE REVISION ---
    • ​It's not so much that our current explanations are WRONG (sometimes they are ) --- it's more that we've taken the first 1 or 2 links in the CHAIN of CAUSALITY that we've come across --- and thought we had the whole thing.
      • ​Further, that's a lot of what we're doing in our criticism of the PROVIDERS and the STATE.
      • It's not exactly wrong, but if we want to CHANGE this --- it is not going to be sufficient.
      • ​There are BIG SYSTEMIC CHALLENGES.
 
Historically, States and Providers and FISCALLY CONSERVATIVE State Legislatures have done a complicated Kabuki Dance in which the NEEDS of INDIVIDUALS and FAMILIES have been sold down the river to maintain the ILLUSION that laws were being complied with and needs met.
  • ​CERTAINLY a lot is being spent but we SHOCKINGLY have not prioritized those with the greatest needs.
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Robert Werthwein resigns from Colorado Office of Behavioral Health. Photo Credit: Denver Post
From ColoradoPolitics.com:
  • Robert Werthwein to step down from state Office of Behavioral Health  (Dec. 9, 2021)
​
  • Werthwein was never the issue with Colorado’s behavioral health system (Dec. 27, 2021)  
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Sharon Raggio --- Former CEO of Mind Springs -- serving the Western Slope

​From SummitDaily:


County leaders across Colorado respond to Mind Springs Health CEO’s resignation

‘One person didn’t create this system and one person’s resignation isn’t going to fix it’  (Jan. 4, 2022)
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Dr. Carl Clark --- CEO of Mental Health Center of Denver

​From Axios Denver:

​The CEO Carl Clark took a $819,340 salary in 2019, more than 10 times what the average clinician earns.  (Dec. 6, 2021)
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Mixed Bags 
Orchid Themes & Symbols

CO Coalition for the Homeless 2022 Legislative Priorities & Financing Disability Housing, Intensive Services & Addressing "ASYNCHRony" in the Work Force

1/14/2022

 

  • Financing Disability Housing is a Huge Problem
​
  • Financing Intensive
      Assertive Community                Treatment at SCALE is
      a Huge Problem.


  • Having ASYNCHRONOUS Strengths and Executive Functioning Challenges is a HUGE Problem for many people with NEURO-DEVELOPMENTAL and/or PSYCHIATRIC DISORDERS.
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​Disability Housing
  • Right now this is a SHARED SOCIETAL RESPONSIBILITY --- and that is not necessarily a bad thing even though Olmstead places the ultimate responsibility on STATES.
  • Funders of Disability Housing:
    • ​the FEDS
    • the STATES
    • MUNICIPALITIES
    • FOUNDATIONS & PHILANTHROPIC INTERESTS
    • BUSINESS SUPPORT 
  • We need the FEDS to hold the STATES' FEET to the FIRE​ 
  • BOTTOM LINE:  We can't continue to have people with serious cognitive disability who are HOMELESS
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​Medicaid Intensive Services such as Assertive Community Treatment must be brought to SCALE.
  • Intensive WRAPAROUND Services are important for people with significant EXECUTIVE FUNCTIONING CHALLENGES.
  • ​BOTTOM LINE:  Housing First is not going to be enough for some to many people even if that is where you start.

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​Addressing ASYNCHRONY in the Work Force
  • People are coming with Executive Functioning Challenges --- we and they didn't expect, but they often also have STRENGTHS that we and they didn't expect either.
  • We need to expand our UNDERSTANDING of the NEEDS and STRENGTHS of the DIVERSE LEARNER to the DIVERSE WORKER, ENTREPRENEUR, etc.

When is the polis administration going to comply with olmstead?

1/11/2022

 
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The Polis Administration (as with many Administrations before it) --- doesn't appear to know how to comply with Olmstead --- POLITICALLY -- even if the practical mechanics are not as hard as States are making it.

MAINLY States just need to get started on that Olmstead Plan with MEASURABLE GOALS. Polis Administration is in ANALYSIS PARALYLIS ("SIT TIGHT & ASSESS")-- and we're NOT HAPPY.

If they want to do on-going research that's great -- BUT they need to get TO WORK on that Olmstead Plan with MEAURABLE GOALS --- NOW --- because it must be CONTINUALLY IMPROVED anyway.
BOTTOM LINE:  Colorado and other States need to get on with it and adopt REASONABLE PLANS with MEASURABLE GOALS to address BIG SHORTAGES.
FEDS we really need you to provide TECHNICAL ASSISTANCE to the STATES. 

​Some UNIFORM, EFFECTIVE ENFORCEMENT would be appreciated, too.
ORCHID'S 2022
CO COGNITIVE DISABILITY
2-PAGER

​

How Many Angels can dance on the Head of a Pin and the Free Will vs. Determinism Debate

1/4/2022

 
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See also:  SKIN IN THE GAME
There's a lot of "FIGHTING THE LAST WAR" in the Free Will vs. Determinism Debate.
  • ​In Modern America, it's become a lot about RELIGION vs. SCIENCE
    • ​There is a lot to UNPACK --- but HISTORICAL GRIEVANCE is in the MIX.  
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​We do need the Religious Folks and Science Folks --- BUT we also need the MODERN DOCTORS, LAWYERS, EPIDEMIOLOGISTS, LAW ENFORCEMENT, ORGANIZATIONS, INDIVIDUALS, FAMILIES & POLICYMAKERS to CONTINUE BUILDING that PUBLIC HEALTH  APPROACH to CRIMINAL JUSTICE.
  • ​Some of those people are Religious, Some of them are really into Science, Some of them aren't into Religion or Science, and SOME  "IDENTIFY" as both Religious and are into SCIENCE.
  • CRIMINAL JUSTICE is a PRAGMATIC APPROACH that is very much INFLUENCED by these PHILOSOPHICAL DEBATES --- but at the end of the day has to act without PERFECT KNOWLEDGE.
  • Further, we CAN'T WAIT for PERFECT KNOWLEDGE to IMPROVE our CRIMINAL JUSTICE SYSTEM both with respect to SAFETY and HUMANE TREATMENT.
Picture
​What does become CLEAR is that when we are LINKING these "FREE WILL vs. DETERMINISM" ideas to "MORAL RESPONSIBILITY" --- there are MORAL HAZARDS --- whichever way you go-- that are DANGEROUS.
  • ​So if we're not demanding certain STANDARDS of BEHAVIOR ---- that can get DANGEROUS quickly.
  • ​BUT if we're not recognizing the COMPLEXITY of ACHIEVING THOSE STANDARDS of BEHAVIOR that involve the INDIVIDUAL and go BEYOND the INDIVIDUAL --- that is a MORAL HAZARD.
    • ​We're often dealing with CHRONIC DANGEROUS BEHAVIOR --- that we're addressing as INDIVIDUAL BAD INTENT & INDIVIDUAL BAD ACTS --- that are more COMPLICATED than that.
      • ​BAD INTENT + BAD ACT = PUNISHMENT was quite SOPHISTICATED hundreds of years ago --- it's NOT in 2022.
Picture
Picture
​There's a certain nonsensical aspect to the CONSTRUCTION of the "Free Will vs. Determinism Debate" that has some aspects in common with  "HOW MANY ANGELS CAN DANCE ON THE HEAD of a PIN" --- LACK OF PRACTICALITY is right up there.
Picture
​We're assuming things to be in EVIDENCE --- that seem in fact DIFFERENT than what we are ASSUMING --- namely:
  • ​Both sides could probably agree that things SEEM to be CHANGING --- things are NOT STATIC.
  • The question of CONTROL that LIVING THINGS have over their BEHAVIOR looks much more a matter of DEGREE.
    • ​Is that "CONTROL" --- FREE WILL since it is DEPENDENT on the STRUCTURE of the LIVING ORGANISM and the ENVIRONMENT?
      • ​It DEPENDS on how we DEFINE "FREE WILL" --- those DEFINITIONS have changed over time. 
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​​​Furthermore, it appears that we are "LEARNING" to CONTROL our BIOLOGY and ENVIRONMENTS.
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    VAL'S BLOG 2
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    Val Corzine

    Executive Director of Orchid Mental Health Legal Advocacy of Colorado, Inc.

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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