Putting mentally and physically disabled people into a Catch 22s is bad.  The state of Colorado has not addressed two Catch 22s that the legislature should fix this session before another shameful year goes by.

To refresh on Catch 22s: The term describes a collection of processes, thinking, and actions resulting in absurd consequences from which there’s no escape. Catch 22s are typically based on circular reasoning, irrational paradoxes, ever-moving targets, and physical impossibilities. Joseph Heller gave the concept this label in his World War II novel, Catch 22.

As an example, if individuals who may be mentally ill are arrested for a crime, from major to minor, those persons cannot litigate their cases until they are deemed competent. In Colorado, they remain in jail until there’s a place for them at the state hospital in Pueblo to be evaluated. Right now, the state consistently misses the timelines established to enable timely assessment.  

If these individuals are found incompetent, then they must receive “restorative” treatment to help them regain their health and resolve their cases.  These steps also involve timelines that the state is violating.  In the case of minor crimes, people who are not deemed mentally ill resolve their cases readily and go on with their lives.  Not so for the mentally ill.  Some mentally incompetent people who are in the hospital cannot get out, even though they could be treated on an out-patient basis, because they can’t meet bail.

Disability Law Colorado filed suit and won a case years ago to force the state to stop this Catch 22.  The state said it would, but it didn’t. Disability Law brought suit again and won.  The state promised to stop this practice but it didn’t.  In 2019 Disability Law brought the suit a third time and won. The court set a Consent Decree declaring that Colorado must fix the problem or face monthly fines for every month unfixed up to $10 million per year.  The state is now approaching its $10 million annual cap based on fines ranging from $100 to $500 per day per jailed inmate. The math is not pretty.

SB20-181, “Measures on Incompetent to Proceed,” is a beginning point in attempting to undo the Catch 22. It sets up a process whereby courts can manage minor offenses more timely and resolve civil cases of mentally incompetent individuals with dismissal.  

Recommendations from an independent monitor say the state should move from a bed-based model requiring hospital care to a community-based infrastructure for outpatient support.  But since March 2019 during the last General Assembly, it’s obvious not enough progress has occurred despite work by a Behavioral Health Task Force established by the governor and legislature and a Long Term Competency subcommittee.

The second Catch 22 for about 3,000 disabled Coloradans involves accessibility to home care.  These services are provided by Medicaid waiver programs serving people with different types of disabilities to help with daily living activities. The 3,000 on the wait list are those with intellectual and developmental disabilities (IDD). 

The providers of home IDD services rely on Medicaid for the revenue they use to hire, train and support home care workers. The reimbursements have not kept up with minimum wage increases, a problem exacerbated in communities that have raised minimum wage above the state standard.  They also have not kept up with cost-of-living upticks. 

IDD advocates are not asking for an immediate fix for all 3,000 affected individuals at one time. They’re offering a six-year, chip-away plan involving a $26 million investment from the state’s General Fund to serve 500 additional IDD individuals per year.  The federal government matches at 100 percent, leveraging the program and its benefits.

Alliance Colorado is an organization that supports IDD home care providers.  The association has identified individuals who have waited 12, 13, 14 years to receive this support. That’s a long Catch 22. 

Coloradans are known as adventurous, entrepreneurial, innovative and ready-to-go. Let’s add rational, generous and compassionate to the list.

Paula Noonan owns Colorado Capitol Watch, the state’s premier legislature tracking platform.