Blog Archives

inadequate Cognitive disability Systems National scandal

1/31/2020

Multiple state disability system failures are leading to unnecessary tragedies.
Upon release from a Colorado jail, young man's family took him to Wisconsin to access housing.
BUT he didn't have time to access services, and now he is in a Wisconsin jail and a Wisconsin man shoveling his sidewalk may have been assaulted.

OUR COGNITIVE DISABILITY SYSTEM IS A NATIONAL SCANDAL.

Many of our criminal justice and gun debates are DIRECTLY RELATED to this NATIONAL SCANDAL.

ROCKY MOUNTAIN PBS & 9NEWS COMING OUT WITH ANOTHER REPORT ON CO MENTAL HEALTH

1/31/2020

It appears this report is going directly at the issue we have been highlighting: the EXPENSE of many people with serious mental illness is being borne by:

Law Enforcement
Municipalities, and
Counties

THE PROBLEM: IT IS THE LEGAL OBLIGATION OF THE STATE to pay for housing, placements and services for people with serious disabilities.

Colorado is hardly the only state in a CRATER when it comes to funding cognitive disability:

Housing
Placements, and
Services

Like a lot of states our defense is often -- "we're spending a lot of money" -- and we are.

BUT the SCALE of this NEED got away from us a long time ago -- and we haven't had the COURAGE to systematically get the data and provide for the:

Housing
Placements, and
Services

needed.

Now law enforcement, municipalities and counties are starting to rebel by going to MEDIA regarding what is really going on.

Nobody is against INNOVATIVE PRACTICES. But what Colorado and other states are doing isn't INNOVATIVE -- it's IMMORAL.

THE CRYING NEED FOR FEDERAL LEADERSHIP--TO BRING HOUSING, SERVICES & PLACEMENTS TO SCALE FOR PEOPLE WITH COGNITIVE DISABILITIES

1/31/2020

A BIG part of how we got into this DISASTER is that our Researchers have discovered that COGNITIVE DISABILITIES among humans are A LOT more common than we thought.

AND our treatments for those COGNITIVE DISABILITIES in 2020 are often still less than perfect -- although we are getting new insights all the time.

WHAT DOES THAT MEAN: The need for long term care for thousands of younger people with cognitive disabilities that may last the next 40 or 50 years.

It is not very clear this is SUSTAINABLE. We NEED a MASSIVE RESEARCH EFFORT-- which we have begun.

Theoretically, we have a lot of the federal laws we need:

ADA/Olmstead
Medicaid Network Adequacy
Mental Health Parity & Addiction Equity

We do need to end Medicaid discrimination in failing to fund housing for people with disabilities needing long term care and eliminate the Institute for Mental Disease Exclusion Rule.

All of this goes to FEDERAL MANDATES for COMPREHENSIVE CONTINUUMS OF CARE for People with Cognitive Disability.

In Colorado, we don't have sufficient:

Housing
Placements, or
Services

Colorado and other States must invest in the administrative infrastructure to provide housing, placements and services to SCALE.

Right now Colorado's Medicaid Programs for People with Cognitive Disabilities SUCK.

We have a very progressive governor who came in wanting to tackle education -- STATE COGNITIVE DISABILITY POLICY IS ON FIRE -- and I haven't seen anything that convinces me this is going to be adequately dealt with in Colorado or elsewhere without FEDERAL LEADERSHIP.

AGGRESSION & SEXUALITY: THE NEED FOR BIOLOGY IN CRIMINAL JUSTICE

1/26/2020

Some academics are making the point that life today is much less violent than in the past.

While for some people, it is still pretty violent -- human history is marked by violence and atrocities -- so for some of us it does seem better.

When we think about the extremes of War -- we think of the "DOGS of WAR" -- that are unleashed.

I'm probably not the first person to submit that those "DOGS of WAR" are biologically powered, and a BIG CONTRIBUTOR may be that the more AGGRESSIVE we become, the more AGGRESSION CELLS we get, and the more AGGRESSIVE we become -- and it does become the proverbial vicious cycle.

In Modern Times, we tend to think of sex and aggression as quite separate things, but they seem to be quite intertwined in our biology in very complex ways.

Further, while there are some general observations to be made, we are starting to find specific biology associated with different types of sex crimes such as sexual abuse of children and pedophilia.

So when we think about the criminal law, it is more about the need to add, rather than subtract.

The criminal act and criminal intent are still relevant -- BUT they are BIOLOGICALLY driven.

That doesn't make the need for SAFETY less, and in some cases that increased understanding may make the perceived need for SAFETY greater.

Two of many excruciating aspects of current knowledge are that:

we often fail at prevention and
sometimes our after-the-fact treatments are partial or non-existent.

Luckily we have our Spiritual Traditions, and a tradition of care for the sick that goes back to prehistoric people and even the neanderthals.

We just have A LOT more knowledge now.

Science News: "Mapping Aggression in the Brain"

European Union: "Stop Rape In War"

Baycrest: Inappropriate Sexual Behavior in Dementia

A Candid Conversation About Sexual Aggression

The Brain Forum: "The Neural Circuitry of Sex & Violence" -- Caltech Neuroscientist David Anderson

Brainlinemilitary: "How Can Brain Injury Affect A Person's Sexuality"

CGTN (China Global Television Network) War Crimes Committed in China by the Japanese

Hannover Medical School, Germany

Child sexual offenders show prenatal and epigenetic alterations of the androgen system

Aggression: Humanity's Ultimate Double-Edged Sword

"OLMSTEAD" & COURT DEFERENCE TO STATE DISABILITY PLANNING

1/24/2020

In deciding "Olmstead" 20 years ago, the US Supreme Court was very aware that States were responsible for providing a FULL RANGE of services and placements -- not just in the community.

So while the Court did hold that unnecessary institutionalization of people with disabilities amounts to discrimination under Title II of the Americans with Disabilities Act -- it gave States some defenses.

Olmstead does not require a fundamental alteration of the STATE PLAN to serve people with Disabilities
- (which is NOT the same thing as the State's Medicaid Plan -- and can and should include HOUSING).
- Further a US Department of Justice findings letter found that bringing existing services such as Assertive Community Treatment to SCALE does not amount to a Fundamental Alteration.

States have a defense to an Olmstead action if they have Comprehensive, Effectively Working Plans to eliminate unnecessary institutionalization of people with disabilities.
- that generally now includes people being released from incarceration and people who are homeless or at great risk of institutionalization or homelessness.
- DOJ guidance and court decisions require:
  - Measurable Goals
  - Reasonable Time Frames, and
  - Funding to Support the Plan

So these are critical reasons why "Olmstead" is a STATE issue -- it is only the STATE that can provide the comprehensive, effectively working plan to eliminate unnecessary institutionalization and homelessness of people with disabilities.

STATE COST-SHIFTING TO MUNICIPALITIES & COUNTIES

1/21/2020

Municipalities & County Jails are the governmental subdivisions that are hit the hardest with homelessness and jail incarceration.
In both cases, there is cost-shifting from the States to municipalities and county governments.
The STEPPING UP Initiation to reduce/eliminate inmates with mental illness from jails -- requires STEPPING UP from everybody, especially the FEDS and the STATES.
Right now, the LEGAL OBLIGATION to provide housing for people with disabilities who are institutionalized or homeless or at great risk of those things is on the STATES.
That State Legal Obligation requires a comprehensive, effectively working plan with:

Measurable Goals
Reasonable Time Frames and
Funding to Support the Plan

So that sounds deceptively easy -- it requires quite an infrastructure within the State to do it -- and if that infrastructure isn't there -- it generally doesn't get done.
Well, so what? That leads to the incarceration, homelessness, and institutionalization of 1000s of people with disabilities. It can even lead to death or maiming.
Does anybody in State Government want those HORRIFIC CONSEQUENCES? -- no. Unfortunately, those consequences are NATURAL & PREDICTABLE -- and they are going to keep happening until we take Disability Civil Rights Laws seriously.

Channel 7: Man Sues Sheriff's Office After Psychotic Break and Gouging His Own Eyes Out.

SUPPORTIVE HOUSING: THE GOLD STANDARD IN LONG TERM CARE IN THE COMMUNITY

1/20/2020

NY Medicaid Redesign Team (MRT)- Using state Medicaid dollars for Supportive Housing

CSH (Corporation for Supportive Housing)

The 1999 ADA/Olmstead decision is intimately connected with Homelessness.

The State and municipalities need a Comprehensive, Effectively Working Plan to Provide Supportive Housing to SCALE.

[People with disabilities who are institutionalized or homeless (or @ great risk of those things) -- are the Olmstead target population -- and the legal responsibility is on the State.]

This is our pitch for the State to just comply with the law, or a team lawyers to take this on.

We are concerned about the Polis Administration and Olmstead Compliance .

In a lot a ways this is similar to Solitary Confinement in which Support is needed to eliminate it in jails and prisons.

We think States need a lot of SUPPORT to bring Supportive Housing to SCALE.

BUT Supportive Housing is too important not to pursue.

Confessions of "Pocahontas"

1/20/2020

As an Oklahoma native whose family made the RUN -- it is just not that uncommon for "white" and "black" Oklahomans to have some Native ancestry.

My maternal grandmother did have jet Black hair -- I don't.

When I think of all the places human beings have been -- those are MY STORIES.

I don't just participate in Humanity figuratively -- but literally and cellularly.

SUPPORT: ENDING SOLITARY CONFINEMENT

1/17/2020

One of my great heroes is Sheriff Dart of the Cook County Jail in Chicago.
He has really been at the forefront of ringing the alarm bells regarding the high incidence of mental illness among jail inmates.
So I was not surprised to see that Cook County Jail eliminated Solitary Confinement.
I was surprised to see Local Media alleging inmates were still having a hard time accessing mental health treatment.
The Vera Institute of Justice has the very real potential to provide States and Law Enforcement the Support they need in constructing alternatives to solitary confinement.
Colorado has some restrictions on solitary confinement in prisons, we must eliminate the use of solitary confinement in Colorado Jails & Prisons.

[One of the things this 60 Minutes clip does not address is the Scientific Limbo many mental health patients find themselves in with:

a Diagnostic & Statistical Manual (DSM) that the National Institute of Mental Health is "agnostic" on,
Treatments that have stagnated
& costs that are through the roof.

Something is going to have to give. We need a REAL PLAN to deal with our Mental Health Crisis]

Sheriff Tom Dart says Cook County Jail is the first to end solitary confinement. Here’s what it looks like from the inside.

The Special Management Unit is supposed to be an alternative to isolating people who are violent in jail or break the rules, but a recent tour raises questions about how rehabilitative it is, especially for those in need of mental health care.

Safe Alternatives to Segregation Resource Center

WHAT ARE THE IMPLICATIONS OF ALL THIS BIOLOGICAL INFORMATION? AND WHO IS SUPPOSED TO HAVE THE BURDEN OF PROOF?

1/13/2020

    So we rely on the work of a lot of researchers -- BUT the attitude of most of these researchers is -- Well, once we get it completely figured out maybe the Criminal Justice System should incorporate this in Punishment Decisions.

    Stanford Neurobiologist & MacArthur Genius Award winner Robert Sapolsky is one of the very few who understands the POWERFUL TRAJECTORY of this KNOWLEDGE and it is the basis of his book -- "Behave: The Biology of Humans at our Best and Worst"

So if we place a SPECIFIC LEGAL OR EVEN DE FACTO burden on the Individual to prove his or her behavior IS the result of BIOLOGY -- what kind of lie are we living?

Well, I would argue quite a big one.

Further, it is a lie that does NOT promote SAFETY for anyone.

   Of course, much of our current knowledge brings KNOWLEDGE without ADEQUATE TREATMENT.

AND that is the ETHICAL DILEMMA of OUR TIME.

AND it is the basis of RESISTANCE to sufficient funding of LONG TERM CARE for Younger Individuals with Cognitive Disability.

    [The vast majority of people with cognitive disability in Colorado don't need Long Term Care -- but thousands of Coloradans do.]

DR. ROBERT SAPOLSKY IS A PROFESSOR OF BIOLOGY, NEUROLOGY AND NEUROLOGICAL SCIENCES, AND NEUROSURGERY @ STANFORD UNIVERSITY:

"You are never really going to understand what is going on if you get it into your head that you're going to be able to explain everything with this is--

the part of the brain

the childhood experience

the hormone

the gene

or the evolutionary mechanism

---That explains everything.

"It doesn't work that way. Instead any behavior is the result of biology that occurred a second ago, hours ago, days ago -- a million years ago."
. . . .

"O000h it's complicated. Well, that's very useful.

"How 'bout, 'OOOh it's complicated and you better be really careful and really cautious before you think you understand the causes of a behavior, especially if it's a behavior you judge harshly.' "
. ------Prof. Robert Sapolsky Stanford

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Val's Blog

inadequate Cognitive disability Systems National scandal

ROCKY MOUNTAIN PBS & 9NEWS COMING OUT WITH ANOTHER REPORT ON CO MENTAL HEALTH

THE CRYING NEED FOR FEDERAL LEADERSHIP--TO BRING HOUSING, SERVICES & PLACEMENTS TO SCALE FOR PEOPLE WITH COGNITIVE DISABILITIES

AGGRESSION & SEXUALITY: THE NEED FOR BIOLOGY IN CRIMINAL JUSTICE

"OLMSTEAD" & COURT DEFERENCE TO STATE DISABILITY PLANNING

STATE COST-SHIFTING TO MUNICIPALITIES & COUNTIES

SUPPORTIVE HOUSING: THE GOLD STANDARD IN LONG TERM CARE IN THE COMMUNITY

Confessions of "Pocahontas"

SUPPORT: ENDING SOLITARY CONFINEMENT

WHAT ARE THE IMPLICATIONS OF ALL THIS BIOLOGICAL INFORMATION? AND WHO IS SUPPOSED TO HAVE THE BURDEN OF PROOF?

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