Blog Archives

LIVING IN THE WILD, WILD WEST -- COLORADO & MARIJUANA

3/12/2017

I think marijuana presents such a quandry -- we've tried criminalization -- that doesn't work. I'm not really convinced that what we are doing now works either -- but we shouldn't go back to criminalization.

     Marijuana appears to be a miracle drug for some people with epilepsy and maybe other conditions and may even help some mental health conditions.

https://www.scientificamerican.com/article/can-cannabis-treat-epileptic-seizures/

http://time.com/4573129/marijuana-cannabis-mental-health/

   AND for some people with mental health conditions it can make them much worse.

http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/cannabis.aspx

Colorado is funding some marijuana research, but the amount and quality of information we need is staggering.

We'll probably ultimately get it -- but how many years/decades will it be?

We need a lot, lot more research and information --- until then it looks like it truly is going to be The Wild, Wild West in Colorado when it comes to Marijuana.

FAILURES IN mental health care & housing --

3/11/2017

HOW inadequate MEDICAID & HOUSING CREATED THE
DE-INSTITUTIONALIZATION DEBACLE
& WE'RE ONLY PARTIALLY FIXING IT

   We are reaping the whirl-wind because of the neglect of mental health and substance abuse concerns, people's lives have and are being destroyed because of it.
We are partially coming to terms with the long term effects of gross neglect of many in our communities due to mental health and substance abuse concerns.
   It is NOT just CO Medicaid where this has been a huge problem -- it is the failure of States nationally to adequately fund intensive mental health treatment such as Assertive Community Treatment and Housing which led to the De-Institutionalization Debacle in this Country and kept it going.
     Hopefully, some of this will be addressed in Colorado by:

the Olmstead Compliance Work Group proposed by the Governor' Office.
the "Comprehensive" Behavioral Health Care Plan Group mentioned in the Governor's State of the State

AND we really need a special ACT group/sub-group -- this has a lot of complexity and we are proposing that the group deal with Parity, Olmstead, and Civil Rights Issues of Assertive Community Treatment in Colorado.

It is really a cliche to say that de-institutionalization was a disaster. We've known that -- we've known it for a long time.

AND we've also known that it was failure to provide sufficient community treatment and housing that led to the disaster.

AND somehow we don't connect the US de-institutionalization disaster to our poorly designed Medicaid programs and our inadequate Housing Programs or in a partial way.

In any case, if we are going to completely fix this debacle -- we are going to have to consciously and openly connect the dots and provide the intensive mental health treatment under Medicaid that people desperately need as well as the Housing under various housing programs.

IT IS TIME TO INTEGRATE

3/11/2017

(NOT JUST PHYSICAL & MENTAL HEALTHCARE, BUT THE STATE MENTAL HOSPITAL SYSTEM, COLORADO MEDICAID'S COMMUNITY MENTAL HEALTH PROGRAM & HOUSING)

WE REALLY NEED TO UNDERSTAND THAT:

COLORADO'S MENTAL INSTITUTES,
COLORADO MEDICAID'S COMMUNITY MENTAL HEALTH PROGRAM, &
HOUSING

Need to be integrated into ONE SYSTEM forming a Whole--- Coordination Has NOT Worked.

Further, budgets for housing need in part to be tied to the needs of people with mental illness including:

those discharging from the mental institutes and
those on Medicaid and
those Medicaid is enrolling who are homeless as well as other homeless populations and recently incarcerated populations.

Some of that is going on. If current housing budgets aren't sufficient, we need to be looking for outside funding.

The services that Medicaid Community Mental Health provides need to be tied to those needed by people with mental illness to live in the community, including:

those discharging (or trying to discharge] from the Mental Institutes,
recently/currently homeless
recently released from incarceration
those in nursing homes

The intensity level of the services needed is often greater than what is currently available on a consistent basis under Colorado Medicaid and that is why we are so insistent that the discrimination end and Colorado Medicaid make available Assertive Community Treatment (ACT) to all where "reasonably medically necessary."

WE NEED THE STATE TO STEP UP TO THE PLATE RE: ADSEG IN CO JAILS & PEOPLE WITH DISABILITIES

3/10/2017

Well, things could always be worse -- we could have a public mental health system like Mississippi -- and we don't.
Things could be better and we could have a public mental health system like Connecticut or Massachusetts -- and we don't.
   Our big gripe isn't that we are not perfect.
   Rather it is what we perceive to be some pretty persistent Colorado State bad faith and unwillingness to address certain problems. We actually thought we were going to get past this in early January with the Governor's Office and the promise of an "Olmstead Compliance Work Group."
     Well, the Governor's Office hasn't been willing to talk to us since. We all get that people in the Governor's Office are busy, but this had all been preceded by very determined stonewalling on the part of the State on the issue of Assertive Community Treatment.
     State officials wouldn't even answer a question whether they had an objection to creating a waitlist for ACT for over 18 months -- AND they NEVER did answer it..
   So what is the context for all this? -- Well, there are a lot of people with mental illness and substance use issues who are homeless and subject to incarceration, and some of them subject to administrative segregation in Colorado jails.
Well, what is the gold standard for intensive community mental health treatment -- ACT -- and it is NOT available to all where reasonably medically necessary in Colorado.
   So from our perspective, the issue of AdSeg (administrative segregation/solitary confinement) in Colorado Jails involves the State as well -- because many of the people with mental illness and substance use issues would NOT be there if they were receiving adequate treatment and housing in the community.
But we can't just expect to deal with multiple complexities of administrative segregation in Jails in an Olmstead Compliance Work Group -- we need the State to step up to the plate so we can stop violating the human rights of people with mental illness, brain injury, and developmental disability that may be subject to administrative segregation in Colorado jails.

We are requesting the Governor appoint a:

Diverse Work Group to Develop Alternatives to Administrative Segregation in Colorado Jails for Vulnerable Populations & Reasonable Plans to Meet the Need for the Alternatives Identified

WE NEED STATE ACCOUNTABILITY FOR PROVIDING SUFFICIENT HOUSING FOR PEOPLE W/ MENTAL ILLNESS

3/9/2017

“Even with his help, there was a lot to go through, a lot of meetings, lot of appointments,” he said. Moomaw added that if a person is not willing to work for it, it won’t happen. Missing one appointment can ruin the process. “They’ll boot you out and start over.”

LC Moomaw

Reaction to the Denver Post Story:

"Contacts" are important and for some people that may be all they want or need.
However, most people with serious mental health or substance issues want and need a lot more "help" than that.
There is more "help" available" BUT for some people it is STILL NOT ENOUGH AND THEY DO WANT MORE.
Some people really need access to something like the Vancouver Intensive Treatment Unit (whether they are involved with the Criminal Justice System or not) on the Front End (see YouTube Video below).
Further, our Systems are exceedingly complex and time-consuming, and sometimes needlessly so. The person may get frustrated and just abandon the "process."
Olmstead is not going to apply to every homeless person out there AND it is going to apply to those with disabilities and there are a lot of those. That means ultimately State responsibility.
We need a State Plan that can & should be very collaborative to bring housing to scale to meet the need of people with serious Mental Illness. If we want to cobble something together, that's fine.
Just telling people with Serious MI to Trust the State, the City, the Non Profit, the Feds -- is no substitute for real accountability.

DENVER POST
BY ELLIS ARNOLD

The teams have made more than 2,500 contacts recommending mental health, substance abuse and housing programs in each quarter of 2016, said Julie Smith, a spokeswoman for Denver Human Services.

Denver plans to spend $47.6 million on homelessness programs this year — the most it has ever spent, said Jenna Espinoza, a city spokeswoman. It spent $40.7 million in 2015.

The city is also seeing its social impact bonds plan, a program to fund permanent housing with private investments, house more homeless since January at a coalition-managed apartment complex and through landlords across the city, Smith said..

The plan is expected to house 250 chronically homeless by 2018.
Federal funding to the metro area for permanent and transitional housing programs has jumped from $16 million in fiscal year 2013 to $23.7 million in 2016, and the area is expected to request about the same amount for the next fiscal year, said Cathy Alderman of the homeless coalition

http://www.denverpost.com/2016/08/11/denver-progress-on-homeless-housing/

there has to be confrontation

3/8/2017

On the use of Administrative Segregation/Solitary Confinement on People with Disabilities in Colorado Jails;
Colorado Medicaid's Frighteningly Inadequate Mental Health Program:
- Failing to provide adequate intensive community mental health services such as Assertive Community Treatment
- Failing to provide adequate peer services
- Failing to provide adequate supported employment
Colorado's failure to provide adequate housing for people with disabilities to meet the need and comply with the law.

COMING TO TERMS WITH THE ADSEG TORTURE EMERGENCY IN COLORADO JAILS

3/8/2017

If we really made this a PRIORITY, we might find we could do this less expensively and better than we think with:

State of the Art Medication Management;
Tapping Into Inmates to Look Out for One Another -- Idaho Prisons are doing that.

http://www.idahostatesman.com/news/state/idaho/article115232453.html

Almost every organization has an issue with Staffing--- are we using AdSeg to compensate for Lack of Staffing or Adequately Trained Staff?
Have the person evaluated for placement on a appropriate Medicaid waiver that could be incorporated into an immediate plea agreement if acceptable to the parties.
If other Medicaid long term care placements such as a nursing home would be appropriate and agreeable to the parties that could be incorporated into an immediate plea agreement if acceptable to the parties.
Have the person evaluated for intensive mental health services (Assertive Community Treatment needs to at least be available here) and housing. If agreeable to the parties incorporate into an immediate plea agreement.
Medicaid could establish a special Single Entry Point presence as well as the work of the Mental Health Centers in Colorado Jails.
Etc.

Val's Note:

A fair number of people with cognitive disabilities have expressed a great deal of anxiety about "Probation" and the fear of being "Set Up for Failure."

It is so anxiety producing that they often would rather do the time than be put on probation. I do think this implicates the Americans with Disabilities Act.

We would suggest in lieu of "Probation," relevant services to the person meeting the person where he or she is AND providing for Safety of the Community.

THE CRITICAL- NEED FOR SUPPORT ACROSS THE LIFE SPAN

3/6/2017

We are such big fans of SB 21 which came out of the Legislative Oversight Committee regarding People with Mental Illness in the Criminal Justice System.
The bill would provide $2.7 million in housing and supportive housing re-entry services for people with mental illness re-entering the community from jails and prisons.
While our advocacy efforts are focused on behalf of people with "mental illness" who are homeless and/or incarcerated because we feel people finding themselves in that situation have been so grossly neglected by traditional systems, we also support SB 68 which would make it easier for elementary schools to hire mental health professionals, etc.

Dr. Patrick Fox, Colorado Office of Behavioral Health

The State has been engaged in many efforts to improve the situation of people with mental illness in the criminal justice system through the Colorado Department of Human Services, largely spearheaded by Office of Behavioral Health Clinical Director Dr. Patrick Fox. We have tried to acknowledge them and we would be wrong not to -- they are of immense importance.

     We are going to take this opportunity to mention an aspect of the national debate over the years we really haven't concentrated on too much.
   Sometimes with limited resources -- and there are always limited resources -- the argument is made, "Well, we're just going to have to write the adults off, and put our resources in the children."
  We have to support people across the life span.
If we are not supporting the parents we're hurting the kids.

Mental Health Colorado

Andrew Romanoff, President & CEO of Mental Health Colorado

Two of the bills slated for action at the State Capitol take aim at mental illness, from different directions.
Senate Bill 21 would provide housing assistance and reentry services for Coloradans who have serious mental health or substance use disorders and are transitioning from incarceration. Such programs reduce homelessness and recidivism. The bill, sponsored by Sen. Beth Martinez Humenik (R-Thornton),
Senate Bill 68 would make it easier for elementary schools to hire mental health professionals, train staff on substance use prevention, and connect students to counseling and treatment. The bill is sponsored by Sen. Nancy Todd (D-Aurora).

OKLAHOMA CITY, MURDER OF CO DOC HEAD TOM CLEMENTS, ETC. -- The need to REACH OUT TO EVERYBODY

3/6/2017

  Well last night I was watching PBS' documentary on the Oklahoma City bombing.

      I was born in Oklahoma City and was in my law office on the morning of the bombing. Two of the women from our Church were killed and close friends who worked for the Water Resources Board and Small Business Administration were injured and scarred -- in more ways than one.

   What I really remember were several days of everyone driving around with their headlights on as if they were going to a funeral -- of course, many were. The grief seemed overwhelming and the trees seemed to grow much taller to comfort us.

   The thing is it is now 20 years after the bombing, and we needed a documentary to tell us what somebody thought it was all about -- because Lord knows we didn't know.

   AND that is often the case with the message sent by acts of violence. The message received is really, "We better take this guy out."

   I'm such a fan of Stephen Covey quotes, one of which is, "If you are not both winning in your marriage, you're both losing."

        Well, there's a lot of truth to that in society too -- we can't discriminate against people to make someone else happy AND we can and should be reaching out to citizens to help them succeed in our often less than fair society.

   Because if we don't reach out and support our citizens, they are going to seek that support where ever they can find it AND in some cases that can be very, very dangerous.

1 year-old Baylee Almon -- killed in the Oklahoma City bombing.

trying to "reason" our way to more Justice

3/4/2017

The Proof is in the Pudding. It sounds so simple -- it is revealingly true -- Things are either working or they are not.

When it comes to the Justice System -- It Is NOT Working on a lot of fronts and people know it -- AND a lot of that is it is very cumbersome, complex, expensive and we want it to do just way, way too many things.

Further, we are all about adjudicating disputes between individuals, NOT FIXING SYSTEMS that are creating repeat and multiple problems.

We have created at this point literally thousands of people who feel terribly wronged by the criminal and/or civil justice system AND our answer is usually:

More criminal and/or civil justice system; or
Lump It; or
Talk to your elected representative

Guess what, that's not working for a lot of people, especially a lot of poor people, racial and ethnic minorities and you add on to that an invisible disability -- and it's a mess.

We are trying to address the situation in criminal justice. The State is trying to do a lot -- we need to do a lot more.

There are other situations:

A lot of people have been severely traumatized, sometimes by individuals, sometimes by the State, sometimes both -- It could NOT be more unrealistic to think that trauma is going to dissipate on command, and in fact such notions from my perspective appear re-traumatizing. I'm NOT unsympathetic to "wanting to move on" but I think in certain situations parties need to find some accommodation for what may be a considerably long haul. We are aware of one situation that is so crying out for mediation if the parties are open to it.
Evictions/Invisible Disibilities/Assertive Community Treatment: With the permission of the person, we need to do all we can to ensure the person is NOT subject to eviction.

Futurity

New research based on brain scans shows that people who care about justice are swayed more by reason than by emotion.

According to Decety, one implication is that the search for justice and the moral missions of human rights organizations and others do not come primarily from sentimental motivations, as they are often portrayed.

Instead, that drive may have more to do with sophisticated analysis and mental calculation.

Decety adds that evaluating good actions elicited relatively high activity in the region of the brain involved in decision-making, motivation, and rewards.

This finding suggests that perhaps individuals make judgments about behavior based on how they process the reward value of good actions as compared to bad actions.

http://www.futurity.org/need-justice-based-reason-emotion/

[It seems outdated to view reason and emotion in isolation -- that is certainly not the way I experience it, AND for myself emotion is often the initial fire to try to get to some sophisticated analysis and mental calculation that is going to be needed for purposes of persuasion.]

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Val's Blog

LIVING IN THE WILD, WILD WEST -- COLORADO & MARIJUANA

FAILURES IN mental health care & housing --

HOW inadequate MEDICAID & HOUSING CREATED THE
DE-INSTITUTIONALIZATION DEBACLE
& WE'RE ONLY PARTIALLY FIXING IT

IT IS TIME TO INTEGRATE

(NOT JUST PHYSICAL & MENTAL HEALTHCARE, BUT THE STATE MENTAL HOSPITAL SYSTEM, COLORADO MEDICAID'S COMMUNITY MENTAL HEALTH PROGRAM & HOUSING)

WE NEED THE STATE TO STEP UP TO THE PLATE RE: ADSEG IN CO JAILS & PEOPLE WITH DISABILITIES

WE NEED STATE ACCOUNTABILITY FOR PROVIDING SUFFICIENT HOUSING FOR PEOPLE W/ MENTAL ILLNESS

DENVER POST
BY ELLIS ARNOLD

there has to be confrontation

COMING TO TERMS WITH THE ADSEG TORTURE EMERGENCY IN COLORADO JAILS

THE CRITICAL- NEED FOR SUPPORT ACROSS THE LIFE SPAN

Mental Health Colorado

OKLAHOMA CITY, MURDER OF CO DOC HEAD TOM CLEMENTS, ETC. -- The need to REACH OUT TO EVERYBODY

trying to "reason" our way to more Justice

Futurity

Author

Archives

Categories

Val's Blog

HOW inadequate MEDICAID & HOUSING CREATED THE DE-INSTITUTIONALIZATION DEBACLE& WE'RE ONLY PARTIALLY FIXING IT

(NOT JUST PHYSICAL & MENTAL HEALTHCARE, BUT THE STATE MENTAL HOSPITAL SYSTEM, COLORADO MEDICAID'S COMMUNITY MENTAL HEALTH PROGRAM & HOUSING)

​DENVER POST BY ELLIS ARNOLD

Mental Health Colorado

Futurity

Author

Archives

Categories

HOW inadequate MEDICAID & HOUSING CREATED THE
DE-INSTITUTIONALIZATION DEBACLE
& WE'RE ONLY PARTIALLY FIXING IT

DENVER POST
BY ELLIS ARNOLD