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THE EXTREMES TELL US A LOT ABOUT OUR SOCIETY -- MORE THAN WE WANT TO KNOW

11/13/2019

So what we see is a Substitute Teacher losing it -- and these are pretty much going to be the FACTS relied up by the Criminal Court and any Civil Action.

Seeing Authority Figures or anyone in over their heads IS NOT PRETTY and can be HORRIFIC.

With such extreme behavior, we might focus on the individual issues of this teacher. That is not necessarily wrong.

It is WOEFULLY INCOMPLETE and won't by itself solve the PROBLEM.

Classes need multiple paraprofessionals, especially with substitute teachers and especially with "special needs" students
Law Enforcement need behavior support experts in:
- brain injury
- mental health
- substance, and
- developmental disability

Teachers and Law Enforcement face MULTIPLE RECIPES for DISASTER.

Most of these situations don't rise to the level of the Texas Substitute Assault Disaster or the Denver Jail Michael Marshall Tragedy -- or we don't know about them.

Preventing those disasters and tragedies is A LOT MORE than bringing an individual or entity to JUSTICE.

It's providing STAFFING & RESOURCES -- and that implicates US.

AND don't think we can get by on "TRAINING" alone -- when we don't provide Additional Staffing & Resources.

April 12, 2019

No Colorado school districts meet federal safety standards for behavioral health staffing, investigation shows

Texas Substitute Teacher charged with Assault of Special Needs High School Student

City of Denver Settles Lawsuit in Death of Michael Marshal in Denver Jail

THE EVIL SOCIETY GAMES REVISITED: DISABILITY LAWS, RESOURCES, CORRUPTION & TRANSPARENCY

P.S. The blog above is a broad reference to a mandatory report I made as a Substitute Teacher regarding inadequate staffing of an Affective Needs Class resulting in neglect and possible past abuse student on student.

As far as I know Colorado Child Welfare MAYBE referred this to the School Board.

We consider staffing such POLITICAL ISSUES but they are @ the HEART of SAFETY & WELL BEING for People with Disabilities and really for ALL OF US.

This isn't just Colorado Child Welfare -- this is the Colorado Department of Public Health & Environment, too with regard to Health Facilities.

STAFFING is considered so politically charged because it almost always implicates FUNDING.

However, the failure to address STAFFING is why most OVERSIGHT AGENCIES never get to the root cause of any problem.

"TRAINING" is often the EASY & INEFFECTIVE FIX.

Staffing

Doc Vader on Nurse Staffing Ratios

THE RELATIONSHIP BETWEEN CERTAINTY & PREDICTABILITY IN THE LAW AND RESOURCES & STAFFING

11/12/2019

Certainty and Predictability are 2 big things the law has to deliver on, and 2 big things Disability Civil Rights Law rarely does.
We first approached HCPF* regarding their Fair Housing Problem this summer -- have they resolved it -- NOT to our knowledge -- and that is pretty par for the course.
Further, Colorado has yet to comply with Olmstead -- and we brought that up and provided documentation over 5 years ago.
  We don't care what OATHS these politicians took -- their primary loyalty is to themselves and to the next election cycle -- AND AS A SOCIETY WE CREATED THIS -- the politicians didn't. Further, this ripples down to Executive Agency staff.
Well, we've got separation of powers -- we've got an INDEPENDENT JUDICIARY, right?
If you've got the money -- they've got the time. Further, DOJ would be happy to have you as a Private Attorney General because the US Dept. of Justice doesn't have the resources to adequately enforce these Disability Civil Rights Laws.
  Of course, the problem is neither do you.
Ideally, DOJ would like the Federally-mandated Protection & Advocacy Offices in every state to do the investigations and bring the cases, but the P&A Offices don't have the resources to police widespread non-compliance and bring enforcement actions.
After bashing the Executive Agencies @ both the Federal and State levels --- it really makes more sense to provide COMPREHENSIVE ADMINISTRATIVE Support and Enforcement @ the Federal and State Levels.
  Right now Colorado has a Cognitive Disability Emergency in the Criminal Justice System. Both HCPF & CDHS** need more RESOURCES & STAFF to deal with it.

*HCPF (Colorado's Department of Health Care Policy & Financing)
** CDHS (Colorado's Department of Human Services)

MEDICAID NETWORK ADEQUACY& OUR CRIMINAL JUSTICE CRISIS

11/10/2019

One of the primary populations that has to be targeted for Medicaid Network Adequacy is the Justice-Involved population.
That group has a lot of:

Brain Injury
Mental Illness
Substance Issues, and/or
Developmental Disabilities

Those aren't easy to treat.

Further, many people who are Justice-Involved have one or more of those concerns.

    Mental Health Centers in Colorado had to have specific directions from the Department of Health Care Policy & Financing to treat people with Brain Injury & Mental Illness and Developmental Disability & Mental Illness.

Colorado Mental Health Centers still routinely dump their most difficult clients on the Criminal Justice System.

The fact is Mental Health Centers are in over their heads.

Further, our Executive Agencies may be as well.

This is such a HUGE PROBLEM that people operating in Government have to feel EMPOWERED to Fully Address the Problem.

   Further, Mental Health has to be FULLY INTEGRATED with the rest of MEDICINE -- it can't be this little FIEFDOM off by itself -- and be EFFECTIVE -- we've started that process -- we need to do a lot more.

  Ironically, the truth is Mental Health Professionals were some of the few Medical Professionals that were willing to deal with highly reactive mental health patients.

Other Medical Professionals just saw everything through a lens of Mental Illness and referred the person to the Mental Health Professional -- THAT'S ONE OF THE REASONS PEOPLE WITH MENTAL ILLNESS DIE 25 YEARS EARLIER OF COMMON HEALTH PROBLEMS.

  So if we don't provide a higher level of care in sufficient quantity-- and Colorado and most states don't -- those people are going to end up in the CRIMINAL JUSTICE SYSTEM regardless of what the law says.

That's why some of Colorado's Mental Health/Criminal Justice Initiatives have been LESS THAN EFFECTIVE -- we just haven't provided the care at the level necessary,

   Part of being EFFECTIVE is understanding the SERIOUSNESS of the PROBLEM and UNDERSTANDING when you've got an EMERGENCY.

[Parenthetically, a lot of our OUTRAGE towards Law Enforcement is the consequence of putting them in situations without sufficient Staffing, Training or Support.

Further, if you have to be Aggressive to do your job -- you're going to become more Aggressive with more "aggression cells."

So TRAUMA is part of it -- but AGGRESSION is as well. That is one of the reasons why law enforcement have their own mental health problems.]

Aggression: Humanity's Ultimate Double-Edged Sword

EMERGENCY FUNDS --PEOPLE DYING & DECOMPENSA-TING DUE TO SYSTEMIC STATE FAILURES ---IS AN EMERGENCY

11/8/2019

For governments and citizens, cognitive disability among younger people and adults -- is a huge problem.
For older adults with dementia -- that is a HUGE COST, while there can be aggression associated with that -- one's more likely to see WANDERING -- also these people are generally at the end of their lives.
Well, wandering isn't dangerous to others --mainly to the person. We might be most concerned that the person stop driving.
  So when we talk about the Healthcare Costs and Custodial Care Costs of Dementia --- IT IS THROUGH THE ROOF.
BUT it's MOM or DAD or GRANDMA or GRANDPA -- we're gonna pay it and our representatives damn well better provide that funding.

Now we get to younger people and adults with cognitive disabilities who may have many more decades of life left, even though people with mental illness die 25 years sooner than the general population.

Further, some of these folks have not had an opportunity to endear themselves to their families over a lifetime.

Even people in their own families may not know what to make of the person -- THIS PERSON IS IRRESPONSIBLE, BAD, etc.

   Even if we have more understanding --- SOMETHING MORE IS GOING ON HERE -- we don't always have better treatments than we do for dementia.

   FURTHER, as a Society we're afraid of the truth -- to HONESTLY acknowledge the reality of the situation means we would have to fix it or manage it more humanely -- and --

RECOGNIZE AN EMERGENCY WHEN IT'S STARING US IN THE FACE.

Additionally, it is becoming more and more clear that our great filter in the Criminal Law-- INTENT -- is suffering its own BREAKDOWN.

A lot of people in the Criminal Justice system did INTEND the crime -- for a lot of those people decision-making and emotional regulation maybe severely clouded and dysregulated by brain injury, mental illness, developmental disability, etc.

With respect to substance issues -- some of those problems arose as a way to cope with brain injury, mental illness, and/or developmental disability when we don't have great treatments or there isn't access to what we have.

Most people with cognitive disability do NOT need hospital or custodial care, some people do.

Many people moving from a jail or prison need to "step over" to custodial care to make arrangements for any "step down" or to stay at that level if desired and appropriate.

Some people need to "step up" to hospital care.

  For both of these categories -- WE ARE FACING AN EMERGENCY.

It's time to put out the WILDFIRE for the benefit of:

individuals,
families,
communities, and
law enforcement

ANOTHER DISABILITY SCANDAL IN COLORADO DUE TO LACK OF RESOURCES --IN ONE OF THE TOP ECONOMIES OF THE COUNTRY

11/7/2019

Woman dies by apparent suicide in Pitkin County Jail

A Woody Creek woman who had been awaiting in-patient restoration services after being found mentally incompetent to stand trial in August died by apparent suicide Sunday evening in the Pitkin County Jail.

Jillian White, 64, was arrested in August on a $200,000 cash-only bond after failing to turn herself in to Pitkin County authorities. Her attorney, Denver-based Jennifer Longtin, had requested an extension of an Aug. 9 deadline to find her client private in-patient mental health services instead of the state-run Colorado Mental Health Institute at Pueblo, or CMHIP.

District Judge Chris Seldin denied that request.

On Friday, Longtin filed a motion with the court in which she announced that she had found a private facility that had accepted White and requested the court release her client to that facility, the District Attorney’s Office confirmed.

Because the motion has been suppressed, however, details are unavailable to the public. White had been scheduled for a court appearance Monday, during which time that motion presumably would have been heard and decided.

White wasn’t the only inmate awaiting services from CMHIP, which has been the subject of two lawsuits because of months-long waiting periods that in turn lengthened inmates’ time in jail, Pitkin County Sheriff Joe DiSalvo said.

“She is one of four people that fit into the extremely mentally ill category that we have in our jail, and it’s not the right place for them,” he said.

“We’ve lost somebody, and she lived in our community. I’m not sure it’s all her fault. I’ve got three other people in jail that are as [mentally ill]. I’m not cut out for that.”
DiSalvo said as much to the Pitkin County commissioners in a budget presentation he made in October.

“The mental health aspect of it is overwhelming,” he said during that meeting, in which he requested eight additional deputies but only three were approved.

“We had one lady who was with us for three or four years, was very high maintenance. We’re not mental health professionals. We’re far from it, but we’re dealing with mental health things.”

County Manager Jon Peacock acknowledged that the facility, built in 1984, is in need of security updates to better serve a more demanding inmate population.

“The real challenge — and we’re not the only community; this is a nationwide challenge — is that the demand for mental health services throughout communities and the criminal justice system has increased, and I think that’s true in our community,” he said.

“We’ve invested in making sure that we have better continuum of mental health services in the community. Do we need to do more? Yes. Does that include the jail? I think so.

There’s all kinds of challenges with licensing and who can provide that service and what level of service. In cases where folks are deemed incompetent to stand trial, right now, there are very few options.

“Like the hospital in Pueblo, you’re relying on behavioral health organizations. We do have jail-based case work and such, [but] that’s not the intensity and level of care [at CMHIP]. And there is, frankly, a gap that the state needs to figure out how to fill to reduce these waiting times,” he continued.

. . .

County Commissioner Chair Greg Poschman offered condolences to all involved, noting that local mental health advocacy organizations are actively working to ensure affected community members have access to support. In addition to its relationship with MindSprings via the Pitkin Area Co-Responder Teams, or PACT, program, the county also contracts with the Aspen Hope Center to respond specifically to fatalities.

“I do know that our mental health services are working on reaching out to the people who were there and providing help however they can. Everyone is being very responsive,” he said.

“Clearly, what Joey has told us, something like 70 percent of inmates in the jail have, how he described it, as severe mental health patients. You have to ask, is this the best place to put somebody with a mental health issue?”

With suicide rates spiking in recent months, Poschman, DiSalvo and Peacock all commented that mental health needs are communitywide.

. , ,

While Pitkin County’s suicide rate is typically reflective of Colorado’s average — which ranks seventh in the country for highest per-capita suicides — Pitkin County Coroner Steve Ayers has been particularly busy since Oct. 10, he said.

“It’s been less than a month, we’ve had all those cases. Four confirmed suicides, one pending investigation and three other deaths,” he said, adding that White’s case likely won’t be resolved for another six to eight weeks, pending toxicology reports.

“[It’s death] case 38 for the year, so we’re quite a bit above our average.”

In the last 10 years, 2014 and 2017 saw the highest number of suicides in Pitkin County at seven, according to the Colorado Violent Death Reporting System.

“There’s not a family or individual that I met in my life that has not been affected by mental health issues, and some very severely,” Poschman said.

“We all try to do what we can, and we’re all looking for solutions and still, these things happen. I guess the best thing we can do is speak to your loved ones and your friends and don’t hesitate to ask them how they’re doing. Mental health first aid trains someone to flat-out ask, ‘Hey, are you thinking of harming yourself?’”
If you are struggling with a mental health issue and need help, please contact
Aspen Hope Center (970) 925-5858
Mind Springs Health 1-844-493-8255 or text “TALK” to 38255

Click Here for Full Article

It is really hard for us to realize we are in the middle of a crisis when that crisis is impacting people we really don't care very much about.

And we would deny that -- yet we make split second decisions about who is part of our "in group" and who is part of the "out group."

And it is not like we aren't doing anything-- right?

We've got all kinds of Task Forces and Groups trying to address the issue.

While we might very well create task forces to look @ long range solutions to wildfires -- we would put out that wildfire.

That's what we need to do with regard to cognitive disability and the Criminal Justice System.

At a minimum that means providing ad hoc secure therapeutic placements for people in Colorado Jails and Prisons who meet Colorado Medicaid's criteria for Long Term Care due to a need for Supervision.

Where possible placement out of the jail or prison should be made as quickly as possible.

Further, Jails and Prisons are deliberately de-humanizing environments -- to teach people a lesson.

Unfortunately, that backfires more than it works.

BUT some hospitals or placements may need additional SECURITY.

It is MUCH BETTER to have a humanizing environment with SECURITY, than a de-humanizing environment [cell] with SECURITY.

Fortunately or unfortunately, children or adults with the greatest needs -- need the most ATTENTION.

We've talked about EMERGENCY FUNDING before for Mental Health, and it was sought to assist CMHIP.

We need the State and the Governor's Office to put together an Emergency Proposal to address the State's Emergency Cognitive Disability Challenges in Jails.

That could also dovetail with preventing Administrative Segregation of people with Cognitive Disabilities in Jails.

Redemption Beyond 2ND CHANCES --TO addressing underlying needs

11/7/2019

Oklahoma's release of over 450 prisoners in 1 day was an act of REDEMPTION.

Part of what had to be redeemed was the Oklahoma Justice System.

Further, even though some states like Colorado are ahead of Oklahoma in Reform efforts -- the work is hardly done for any state, including Colorado.

Further, we are on a Spiritual Road to Redemption & Caring for Each Other by way of Reality.

We won't get to our destination if we can't handle the REALITIES of:

Brain Injury
Mental Illness
Substance Issues
Developmental Disabilities
The Compounding Effects of Aggression, and/or
Trauma

Crap Justice & Crap Services -- They Often Go Together

COGNITIVE DISABILITY & CRIMINAL JUSTICE: BEYOND BARE ASSERTION

11/5/2019

What does it mean for the mental element of the crime to be clouded by:

brain injury
mental illness
substance issues, and/or
developmental disability

We can keep ignoring it and saying it is not an excuse in most cases -- BUT that has a HUGE COST for:

the individual,
the community
& law enforcement

Further, the evidence is mounting that our traditional construction of criminal intent is FUNDAMENTALLY FLAWED.

We've got some broad Constitutional Concepts that could help -- BUT many judges and prosecutors are already open to other PLACEMENTS if they are safe.

INDIVIDUALI-ZATION AS A WAY OF MANAGING HUMAN AGGRESSION

11/2/2019

American Society is a pretty AGGRESSIVE Human Environment.
Human Societies around the world can be pretty AGGRESSIVE.
There are external and internal factors that drive that.
Now Societies today actually are probably a lot less "AGGRESSIVE"/Violent than societies a thousand years ago.

The Challenge for Human Beings is the more Aggressive People are -- the more AGGRESSIVE they can become.

So if we put people in LAW ENFORCEMENT where they may be EXPECTED to be more aggressive -- they can become more AGGRESSIVE.

If some people in our society lack the SOCIAL DETERMINANTS of HEALTH and our dominant cult is MERITOCRACY -- they may have to become more aggressive to SURVIVE.

Looking @ our Leaders and Public Discourse -- one doesn't know whether to laugh or cry -- and then one looks in the mirror.

So COMPETITION has its place. BUT Human Beings have recognized for a LONG TIME that COMPETITION has its limits and the GOAL isn't COMPETITION -- its getting people into their STRENGTHS, and compensating for weaknesses where necessary and REAPING THE REWARDS.

By and large we do this for professional athletes --if not perfectly, there is a strong motivation to do something. We need that strong motivation for everyone else.

P.S. This is in many ways a riff off Individualized Precision Medicine.

Education.seattlepi.com: How Does Evolutionary Psychology Explain Aggression? "According to Live Science, humans are one of the most aggressive species on the planet. Paradoxically, humans are also one of the most compassionate species. "

Aggression: Humanity's Ultimate Double-Edged Sword

Inverse.com: Aggressive Human Roars Apparently Reveal a Lot About Physical Strength "That's enough, I'm coming for you."

BURDEN OF PROOF, INTENT & THE CRIMINAL LAW --THE NEED FOR MEDICAID JUSTICE INVOLVED CATEGORIES, PLANS & NETWORK ADEQUACY

11/1/2019

The reality is that we don't have time to construct logical proofs for every aspect of human life.
We trade in ASSUMPTIONS until those assumptions are proven wrong.
Nowhere is that more clear than the Criminal Law.
   We've had an ASSUMPTION for thousands of years that proving INTENT is the KEY to justifying PUNISHMENT and by extension achieving SAFETY.
Well, there is BAD INTENT out there.
  If we ask the question what is CAUSING the BAD INTENT there are a range of answers:

Still in some places of the world, the person is possessed by a DEMON;
The person is BAD
The person is EVIL
The person is ANTI-SOCIAL
The person is "INSANE" -- does not know the difference between right and wrong; does not understand the nature or consequences of his or her actions.

For sometime, the CRIMINAL LAW has been struggling with the INSUFFICIENCY of these and other EXPLANATIONS.

IN THE MEANTIME, Science, Technology and the Biological Sciences have been making rapid improvements in the 20th and 21st Centuries, and the pace keeps increasing.

Which brings us to 2019.

We now recognize that a majority of Criminal Defendants in jails have:

Brain Injury
Mental Health Issues
Trauma
Substance Issues
Developmental Disabilities, and/or
Often combinations of those issues

Most of these people INTENDED the CRIMES, know the difference between RIGHT and WRONG, and are at least NOMINALLY AWARE of the nature and consequences of their actions.

We're proposing the following Medicaid categories:

Justice Involved With Brain Injury
Justice Involved With Mental Illness
Justice Involved With Substance Use Problems
Justice Involved With Trauma
Justice Involved With Developmental Disability
Justice Involved With (Fill In The Blank, , +, +, +)

Medicaid along with other Stakeholders should develop Plans for Justice Involved People with Cognitive Disabilities.

States must have;

Housing,
Placements, and
Services

to address those needs.

By and large, the Cognitive Issues of Justice Involved Populations are MORE COMPLICATED than the AVERAGE Medicaid recipient.

Medicaid, HUD and States have to have SUFFICIENT PROVIDERS, HOUSING and PLACEMENTS to deal with these issues.

As we've been PRETENDING that People with Cognitive Disabilities aren't in the CRIMINAL JUSTICE SYSTEM --

We haven't provided the SUPPORTS to Individuals and Families, AND
We haven't provided the SUPPORTS to the PROVIDERS

,;
The burden of proof is always on the person who brings a claim in a dispute.

It is often associated with the Latin maxim semper necessitas probandi incumbit ei qui agit, a translation of which in this context is: "the necessity of proof always lies with the person who lays charges."

----Transnational principle of law: Trans-Lex.org; Wikipedia

BIO-MARKERS: THE TIMES THEY ARE A CHANGIN'

10/29/2019

First, Some Charity--sort of

The search for bio-markers in mental health has been long and frustrating, though more recently it has been yielding results.

That has led some clinicians and even researchers to question whether bio-markers even exist.

Although, the US National Institute of Mental Health and most researchers are heavily invested in finding and utilizing bio-markers.

The Psycho-Social/Interview Approach and the Bio-marker/Biological Approach are sometimes set off in opposition to one another.

However, the Approaches are not in opposition to one another or somehow exclusionary, but as different ASPECTS of the same thing: HUMAN HEALTH.

The problem is that we have focused so heavily on the Psycho-Social/Interview Approach out of NECESSITY that we don't have a SOLID FOUNDATION for our Mental Health Diagnoses.

That SOLID FOUNDATION is the BIO-MARKERS.

Further what we are utilizing now -- again out of NECESSITY -- are clusters of SYMPTOMS.

This is hugely problematic. It is like talking about the NATURE of a STOMACH ACHE when a lot of different things and combinations of things cause STOMACH ACHES.

This brings us to the University of Leiden. Just as Japan's RIKEN Center for Brain Science was announcing the discovery of a bio-marker for a sub-type of Schizophrenia, the University of Leiden boldly DENIED INFLAMMATION when it didn't see it in all cases of "DEPRESSION." Even further, the folks in Leiden threw into question all bio-markers.

Of course the point that other researchers have been trying to make is that our current categories are very BLURRED- and inexact.

So it is hardly all settled, right? So we don't have any choice but to put the BURDEN of IGNORANCE on INDIGENT DEFENDANTS WITH COGNITIVE DISABILITIES -- right?

Folks that is NOT the right answer. These kinds of problems really bring up issues of DUE PROCESS and FUNDAMENTAL FAIRNESS. It is not really clear our JUSTICE SYSTEM is capable of addressing such BIG ISSUES.

Further, if the US JUSTICE SYSTEM does finally address these FUNDAMENTAL ISSUES -- it may be long after STATE LEGISLATURES are well into that process-- and that process has already begun.

So using our LATERAL PROBLEM SOLVING -- we move from reforming the CRIMINAL JUSTICE SYSTEM to:

Measurable Goals for Housing, Placements and Services for People with Cognitive Disabilities
Reasonable Time Frames, and
Funding to Support the Plan

SANITY by any other name.

Brandi Carlile: "The Times They Are A Changin'

Japan's RIKEN Center for Brain Science

Neuroscience News: Japan's Riken Center For Brain Science Finds Hair Biomarker for Sub-Type of Schizophrenia

BIO-MARKERS -- THAT OUT-GROUP ISN'T AS DIFFERENT FROM US AS WE THOUGHT

The Mental Health Profession

We've just started to do genetic testing for some psychiatric medications.

Our Mental Health Profession needs NEW TOOLS if they are going to EFFECTIVELY address our MENTAL HEALTH CRISIS.

Further, Mental Health Specialists should be integrated with Neurology as both are being integrated with Immunology.

Domestic Policy

Bio-markers really corroborate what BIOLOGICAL SCIENCE already knows -- there are biological reasons why people and other animals do what they do.

They also give us potential avenues for treatment.

Of course, deciding who needs TREATMENT is a pretty big issue.

Danger to self and others or Gravely Disabled is a good if not perfect FILTER.

BUT we have to have the HOUSING, PLACEMENTS & SERVICES available to do that.

If we do that, many or our CRIMINAL JUSTICE CONUNDRUMS will go away.

On the other hand, it will FORCE a PROFOUND EXAMINATION of SAFETY.

Foreign Policy

Here, again Bio-markers could CORROBORATE Human Suffering and give us potential and more effective ways of addressing that.

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