PROPOSED CHANGES IN COLORADO’S CIVIL COMMITMENT LAWS
Catherine Strode, MPA Health Care Advocacy Program
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Moe Keller VP of Public Policy & Strategic Initiatives Mental Health America
Amanda Kearney-Smith, MS Executive Director Colorado Mental Wellness Network
PRESENTERS
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BILL DRAFT
•February 18, 2013
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INTRODUCTIONThree Colorado StatutesCivil Commitment HoldsConsolidationExtends Length of Mental Health Holds
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PUBLIC AND PERSONAL SAFETY
Adds “Substantial Probability” to Hold Criteria
Problems for Law EnforcementProblems for Parents and Families
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COLORADO’S SUBSTANCE USE RATES* Abuse Rates Higher Than National Average
All Age Ranges
*The Substance Abuse and Mental Health Services Administration
http://www.samhsa.gov/
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]COLORADO’S MENTAL HEALTH INDICATORS* Serious Psychological Distress at National Average
Major Depressive Episodes Above
National Average
*The Substance Abuse and Mental Health Services Administrationhttp://www.samhsa.gov/ 7
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ACCESS CHALLENGES
Lack of CoverageLack of Resources Lack of Short Term Care BedsLack of Community SupportsLack of Providers
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CRISIS CARE NEEDS“Danger to Himself or Herself”Increased Victimization*Continuum of CareIncrease Speed of Medicaid Approval
*www.ncbi.nlm.nih.gov9
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GOVERNOR’S INITIATIVES
‘Right Services at the Right Time’:•Streamline StatutesStatewide HotlineExpand Bed CapacityHousing VouchersCommunity Supports/ACT Teams
Medicaid Expanded For Substance Use Disorder Services
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GOALS OF STATUTE CHANGE
Quick Intervention and Stabilization
Integration of Mental Health, Alcohol and Substance Use Disorders
“Substantial Probability” Added As Third Criterion for Hold
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INTERVENTION CHANGES• 72-Hour Hold Increased to 5 Days
•Evaluation Required Within 24 Hours
•“Substantial Probability” Initiates Hold
•“Substantial Probability” in regards to harm to self
•“Probability” in regards to harm to others*
*February 18 Draft
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“SUBSTANTIAL PROBABILITY”
VS “SUBSTANTIAL RISK”
Bill RedraftedLanguage Changed
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EVALUATION CHANGES
Broadens Standard of Involuntary Commitment
Creates New Definitions: ‘Professional Persons’ ‘Designated Facility’ ‘Gravely Disabled’
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REVISED DEFINITIONS
Danger to Self or Others
Family Member
Gravely Disabled
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CRISIS CARE SCENARIO Client Profile
Client Condition
Inclusion of an Advanced
Directive (crisis plan)
Maximum 5 Day Hold Period
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CLIENT RIGHTS
Opportunity for individuals to request an evaluation
Ability to be advised of individual rights while under an involuntary hold
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EXTENDED HOLD SCENARIO Short-term Civil Commitment
Evaluation within 24 hours
Legal procedures for reporting
Least restrictive standards
Advanced directives
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STAKEHOLDER PERSPECTIVES
Individual
Family
Provider
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STATUTE CHALLENGES
Communication barriers
Translation into practice
Client payment
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PROVIDER CHANGES
Who can initiate?
Who can certify?
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BILL PROPOSAL
Sponsors/Timeline
Involvement of State
Departments
Implementation
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RESOURCES Colorado General Assembly Websitehttp://www.leg.state.co.us/clics/clics2013A/cslFrontPages.nsf/HomeSplah?OpenForm Treatment Advocacy Centerhttp://www.treatmentadvocacycenter.org/index.php?option=com_content&view=article&id=201&Itemid=136 Colorado Department of Human Serviceshttp://www.colorado.gov/cs/Satellite/CDHS-Main/CBON/1251575083520 Office of Behavioral Healthhttp://www.colorado.gov/cs/Satellite/CDHS- BehavioralHealth/CBON/1251578892077 National Resource Center on Psychiatric Advance
Directiveshttp://www.nrc-pad.org/• WEBINAR RECORDING www.advocacydenver.org
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YOUR QUESTIONS AND INPUT
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