Reducing the NC\u27s Overreliance on Psychiatric Residential Treatment Facilities to Provide the Care and Treatment to Children with Mental Health Disabilities (Coste).    Advancing Racial Equity in the Criminal Justice Syste

Campbell (Moderator), Ashley

Coste, Joonu

Earls, Justice Anita

Lechner, Jennifer

Wicclair, Leigh

Campbell University Law School

Joonu-Noel Andrews Coste Attorney at Disability Rights NCEqual	Justice	Works	Fellow,	sponsored	by	an	Anonymous	Donor	Reducing	the	NC's	Overreliance	on	Psychiatric	Residential	Treatment	Facilities	to	provide	the	care	and	treatment	to	children	with	mental	health	disabilities.		Campbell	Law	class	of	2019	Joonu.Coste@disabilityrightsnc.orgJoonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorWe are in a liminal period – a critical junctureWhen	day	comes	we	ask	ourselves,		where	can	we	find	light	in	this	never-ending	shade?	The	loss	we	carry,			a	sea	we	must	wade	We’ve	braved	the	belly	of	the	beast	We’ve	learned	that	quiet	isn’t	always	peace		And	the	norms	and	notions	of	what	just	is		Isn’t	always	just-ice		And	yet	the	dawn	is	ours		before	we	knew	it		Somehow	we	do	it		Somehow	we’ve	weathered	and	witnessed		a	nation	that	isn’t	broken		but	simply	unfinished	—Amanda	Gorman2Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorHealth Injustice is a Direct Consequence of DiscriminationWhile	there	may	be	some	identifiable	underlying	genetic	vulnerabilities,	a	picture	of	“racial/ethnic	health	disparities	due	to	differential	loss	of	health	insurance,	poorer	quality	of	care,	inequitable	distribution	of	scarce	testing	and	hospital	resources,	the	digital	divide,	food	insecurity,	housing	insecurity,	and	work-related	exposures”—all	direct	consequences	of	race,	disability,	class,	and	age-based	discrimination—will	emerge	as	the	most	significant	driver	of	mortality	and	COVID-19-related	disability.		Monica	Webb	Hooper	et	al.,	COVID-19	and	Racial/Ethnic	Disparities,	323	JAMA	2466,	2466	(2020)	3Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorPsychiatric Residential Treatment Facility (PRTF)10A	NCAC	27G	.1901	SCOPE		• (b)	A	PRTF	is	one	that	provides	care	for	children	or	adolescents	who	have	mental	illness	or	substance	abuse/dependency	in	a	non-acute	inpatient	setting.		• (c)	The	PRTF	shall	provide	a	structured	living	environment	for	children	or	adolescents	who	do	not	meet	criteria	for	acute	inpatient	care,	but	do	require	supervision	and	specialized	interventions	on	a	24-hour	basis.		• 	(e)	The	PRTF	shall	serve	children	or	adolescents	for	whom	removal	from	home	or	a	community-based	residential	setting	is	essential	to	facilitate	treatment	Judicial	Review	of	admission/continuing	admission	-	N.C.	General	Statutes	§§	122C-121,	224	–	224.4.	Admission	is	based	on	youth	meeting	eligibility	criteria	in	the	clinical	coverage	guidelines	for	Medicaid	or	private	insurer.4Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorPRTF ProvidersFor-Profit	Providers	in	NC• Strategic	Behavior	Health,	Inc.	(174)	• NOVA,	Inc.	(42)	• Alexander	Youth	Network,	Inc.	(48)	• Thompson	Child	and	Family	Services	(24)	• Cornerstone	Treatment	Program,	Inc.	(36)	• Premier	Health	Services,	Inc.	(12)	• Premier	Services	of	Carolina,	Inc.	(12)	• Universal	Health	Services	(18)	• Canyon	Hills	Treatment	Facility,	Inc.	(24)Non-Profit	Providers	in	NC• Whitaker	(18)	-	State-operated	• Eliada	Homes,	Inc.	(24)	• Children's	Hope	Alliance	(9)5Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorPRTF ContextResident	characteristics• Racial/Ethnic	minorities	• Multiple	disabilities	• Low-income/Low-wealth	• In	care	of	County	Department	of	Social	Services/Post-Adoption	• Juvenile	Justice	involvement	• Trauma	• BoysPayment•Medicaid	• Private	Insurance/Tricare	• Out	of	Pocket6Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorClient Story: Legal Issues Part 1 of 3Action• Failure	to	provide	basic	necessities	–	clothing/shoes	• Interfering	with	clinical	treatment	plan	• Extended	wait	to	communicate	with	father	• Failure	to	de-escalate	mental	health	crisisLegal	issue	Implicated• Child	Welfare	-	Neglect	• Abuse,	Violation	of	ADA	/	Olmstead	mandate.	• Civil	rights	of	minors	in	24-hour	facilities/state	license	requirements	for	staffing	• State	licensing	requirements	for	training/competency7Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorClient Story: Legal Issues Part 2 of 3Action• Charged	in	juvenile	court.	• Transferred	to	new	facility	• Failure	to	provide	dental	care	and	glasses.	• Physical	abuse	by	staff	member	• Failure	to	obtain	medical	treatment	and	failure	to	allow	child	to	call	family	members/counsel.Legal	Issue	Implicated• Juvenile	Justice	–	ADA,	capacity	• Medicaid,	ADA	/	Olmstead	• Child	Welfare	-	Medical	Neglect	• Child	Welfare	-	Abuse	(CPS),	Criminal	Investigation	(Sherrif),	Licensing	investigation	(NC	DHHS/DRNC)8Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorClient Story: Legal Issues Part 3 of 3Action• Failure	to	identify	need	for	IEP.	• Failure	to	provide	judicial	review	of	continued	admission	• Dismissal	of	charge	in	juvenile	court	• Discharge	to	lower	TFC	-	more	freedomLegal	Issue	Implicated• IDEA	-Right	to	FAPE/child	find.	• Due	Process	/	state	statutory	right	to	review	• Juvenile	Justice	-	Capacity	to	proceed	• Child	Welfare	-	DSS	permanency	order,	Medicaid,	ADA	/	Olmstead,	IDEA9Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorSystemic Approach to Ending OppressionTo	Oppress:	to	unjustly	treat	or	control	To	Marginalize:	to	treat	as	insignificant	or	peripheral	Three	critical	questions	Where	is	the	power?		What	are	the	cognitive	frameworks	guiding	the	flow	of	power?	How	do	we	interrupt	the	oppressive	coupling	of	ideologies	and	power?	10Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorFreedom• Kant	–	Innate	Right	of	Freedom	-	“Independence	of	compulsory	will	of	another.”		• Locke	–	The	law	of	Nature	"teaches	all	mankind	who	will	but	consult	it,	that	being	all	equal	and	independent,	no	one	ought	to	harm	another	in	his	life,	health,	liberty	or	possession."		• Two	predominant	groups	of	organizing	principles	of	State	Power		• Philosophical	liberalism	(individual	unit	of	analysis,	life,	health,	liberty)	• Economic	Capitalism	(private	property	ownership	and	rights,	Profits,	losses,	labor,	wealth,	capital	accumulation)	• Social	theory	(hierarchies)	wrap	around	each	bundle	of	principles,	with	the	State	Power	serving	at	the	core.	Give	Form	and	Expression	in	society	–	identifiable	as	living	conditions.11Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorEquality?12Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorBecoming Conditions-focused  vs.  Social Identity-focusedNo	one	is	just	one	thing.	-	Edward	Said	• Socially-assigned	identities	are	what	are	normalized	in	our	society	as	"identifiable."		• Conditions	and	socially-assigned	identities	arise	at	the	intersection(s)	of	power.	• Intersectional	analysis	shifts	what	we	see	as	"fixed."		13Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorThe Legal System as an Epistemic System• Power	of	the	State	flows	through	the	law	and	gives	form	and	expression	of	social	theories	(hierarchies)	and	ideologies	(treated	as	facts)	through	oppositional	dialog.	• Forms	and	Expression	=	Structures	and	Processes	by	which	we:	• Obtain	knowledge	• Evaluate	(competing)	knowledge	claims	• Test	(competing)	knowledge	claims	• Legitimize	(privilege)	knowledge	claims	• Delegitimize	(oppress)	knowledge	claims	• Use	knowledge	for	future	societal	formation14Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorCritical Intersectional Analytical Framework1Step	1:	Dialectical	determination	of	context.2Step	2:	Identify	oppressive	conditions	and	relevant	principles	of	power.3Stage	3:	Critical	Intersectional	Analysis	of	Controlling	Law15Three	StagesJoonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorAnalyzing for the Intersections of Multiple Social Identities within the Social Context of Co-Producing Systems of Power Start	With	-		Who	is	Identifiable?Race/Ethnicity	Ability/Disability	Age	Gender	Sexual	Orientation	Religious	AffiliationMove	To	–	What	are	Associated	Conditions	of	Oppression?Housing	–	location	and	quality	Education	–	access	and	attainment	Health	–	access	and	availability	Jobs	–	access	to	full	employment	Wealth	–	access	to	capital,	financial	institutions(Court)	Legal	System	(School)	Education	System	(Doctor's	office)	Medical	System	(SSI,	Unemployment))	Public	Benefits	System	(Bank)	Financial	System	(Store,	Purchases)	Marketplace	Then	Identify	-	Where	is	the	Social	Location	of	Oppositional	Dialog	Where	Oppression	Occurs?16Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorCritical Intersectional Analysis  Applied GenerallyCritical	Intersectional	Analysis	of	Controlling	Law1. What	are	the	core	principles?		What	are	the	forms	and	expressions	of	these	principles?		How	do	forms	and	expressions	change?	2. What	are	the	express	normative	aspirations	sought	through	this	legal	action?	3. What	power	differentials	(social	theories/ideologies)	perpetuate	epistemic	oppression	and	epistemic	resistance	that	interfere	with	dialog	among	equals?	4. What	is	the	effect	of	this	newly	observed	and	conceptually-generated	knowledge	on	real	people	in	real	life?		Does	the	effect	align	with	the	desired	remedy,	which	is	identified	by	the	oppressed	community	itself?Analytical	outcomes	1. Freedom,	as	expressed	by	State	Power	along	the	axes	of	liberalism	and	capitalism,	each	given	form	and	expression	by	social	theories	(of	hierarchy.)	2. Equality.	BE	SPECIFIC!	(ex.	Model	of	equal	well-being.	As	described	by	The	Beloved	Community.)	3. Normative	assumptions	(in	the	law	itself)	that	miliate	against	equality/perpetuate	inequality	in	oppositional	dialog.	4. In	what	real-life	ways	do	these	identified	normative	assumptions	play	out	against	the	normative	aspiration	sought?	17Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorMoving between Individualized Analysis and Systemic AnalysisEx.	Intersection	of	Liberalism	and	Capitalism	with	regard	to	race.		"Was	it	a	discriminatory	interaction?"	Ex.	Intersection	of	Liberalism,		Capitalism,	with	regard	social	hierarchy	in	the	space	of	the	legal	system.	"How	are	conditions	resulting	at	this	intersection	oppressing	peoples?"18Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorWhere Do We Go From Here?  Dr. Martin Luther King Jr. Corrective	Measures	(Theory)• Legislation		• Constitutional	Rights		• Human	RightsOrganization	(Praxis)• Give	shape	to	the	form	and	expression	of	the	legal	right.19Joonu-Noel	Andrews	Coste,	Attorney	at	Disability	Rights	North	Carolina	Equal	Justice	Works	Fellow,	sponsored	by	an	Anonymous	DonorBecoming Who We Long To Be As AmericansWe	will	rebuild,	reconcile,	and	recover		and	every	known	nook	of	our	nation	and		every	corner	called	our	country,		our	people	diverse	and	beautiful	will	emerge,		battered	and	beautiful		When	day	comes	we	step	out	of	the	shade,		aflame	and	unafraid		the	new	dawn	blooms	as	we	free	it		for	there	is	always	light,		if	only	we’re	brave	enough	to	see	it		If	only	we’re	brave	enough	to	be	it.		–	Amanda	Gorman20

English

Civil Justice Reform in the COVID-Era

bepress Legal Repository

https://scholarship.law.campbell.edu/cgi/viewcontent.cgi?article=1140&amp;context=clr_symposia

Civil Justice Reform in the COVID-Era

Abstract

Similar works

Full text

Available Versions

Campbell University Law School

bepress Legal Repository