In attendance: Bob Quinn, Marcella Sanchez Petado, Silvia Perez, Maureen Mina, Chuck Hughes, Brian Fraser, Emma Cummings, Catherine Birtalan.

I. Welcome and introductions.

II. Cohesiveness was the focus of a lively discussion.

III. A list of acronyms used in mental health venues may be requested from Chuck Hughes or Eric Baizer.

IV. The HUB (Peer Recovery Learning Center – PRLC) in Santa Barbara at the Garden Street apartment complex.

A. Questions that arose.
1. Who will run the PRLC?
2. How can a meeting be called of the original PRLC planning group, in order to discuss who will be hired?
3. What is the current role of the original PRLC planning group?
4. What is the date that the new PRLC contract will be up for review?
5. How can all consumers support each other in the PRLC planning process countywide?
6. Why are there regional divisions among consumers in Santa Barbara?
A discussion followed in which it was recommended that consumers from the three Santa Barbara county “regions” meet and support each other as they exchange ideas and plans.
7. How, where and when will the consumer and family support positions at the HUB be advertised?

B. The new HUB/PRLC contract.
1. Is different from the contract for the now-closed Fellowship Club.
2. Will take a lot of work to put into place.
3. Most consumers who spoke up during the planning process said they want non-traditional hours, but it appears that the hours that the HUB will be open are the same as at the Fellowship Club.
4. There is a DRAFT of the HUB charter available for review.
5. In the MHSA budget, each Santa Barbara county region will have funding for 2 half-time positions, but only for 6 months each. Each regional PRLC will have a consumer and a family support position.

C. Suggestions.
1. Consumers arrange their own county-wide group to meet and make a list of recommendations for how to proceed with the SB HUB/PRLC, as well as PRLC programs in Lompoc and Santa Maria.
2. Review of the current contract holder by a consumer committee.

ACTION: Maureen will check with John Truman about how to call a meeting of the original countywide PRLC participants.

ACTION: Maureen will book a room and Maureen and Silvia will coordinate on a countywide consumer meeting of the original PRLC committee.

V. A subcommittee of the Consumer and Family Member Advisory Committee (CFMAC)
A. At the CFMAC meeting this week in Solvang, a recommendation will be made to create a subcommittee to address county mental health budget issues. These are suggestions for the subcommittee –
1. Members of the CFMAC may volunteer to be on the subcommittee, with a recommendation that people “self-select” according to their ability to be an active member.
2. Training should be provided to members of the subcommittee, so that they can understand the mental health budget and participate meaningfully in budget discussions.
3. Persons from the community may be invited to mentor members of the subcommittee.
4. A training may be requested from ADMHS about how to read and understand the mental health budget.
B. This agenda item is suggested instead of reviewing all the questions asked of Ann Derrick at the November 2008 SB Regional Empowerment meeting, in the interest of time and in order to focus on one important issue now.

ACTION: At the CFMAC meeting on Thursday in Solvang, Catherine will propose a budget subcommittee that will work with ADMHS (Alcohol Drug and Mental Health Services).

VI. Action Items from the November 2008 SB Regional Consumer Empowerment meeting.

ACTION: Catherine will continue to work with Ann Derrick on the actions items.

VII. Mental Health Services Act (MHSA) funding.
A brief discussion focused on the impression that MHSA funding may be a risk during this California budget crisis.

VIII. Prevention and Early Intervention (PEI).
A. There is a conference call next Wednesday from 8:30-9:30am. Eric Baizer has reserved a room in Public Health.
B. There is currently no stakeholder meeting scheduled to review the PEI component of the MHSA.
C. A comment was made that consumers and other stakeholders are not being kept informed of the status of PEI.
D. It appeared that a PEI working group had been scheduled for this morning, but there was no notification of interested parties.
E. According to the MHSA, there is supposed to be a series of stakeholder meetings, followed by a public presentation.

IX. Workforce and Education Training (WET).
A. The state has approved the plan of Santa Barbara ADMHS for WET programs.
B. The implementation process has started.
C. At this time, Ann Derrick is working on the job description for the new Consumer Empowerment Manager.
D. Questions that arose.
1. Why is the implementation committee so small, with so few people from North County?
2. Why is there no perceived input from consumers on the job description for the new position of Consumer Empowerment Manager?
3. How can consumers be assured that their input is taken seriously regarding suggestions about MHSA planning?
4. Will the new Consumer Empowerment Manager be included at the Executive level of management?
ACTION: Catherine will draft a letter for review by Santa Barbara, Lompoc and Santa Maria regions that would ask the following questions of Ann Detrick, with courtesy copies to John Truman, Cuco Rodriguez, John Truman and Eric Baizer.
1. How can we arrange for more consumers on the WET implementation committee especially from North County?
2. How can we be involved in writing the job description for the new Consumer Empowerment Manager?

X. MediCal applications are not being processed quickly.
A. There appears to be a shortage of MediCal eligibility workers.
B. A recommendation was made to alert the Supervisors and other elected officials about this fact.

ACTION: Maureen will draft a letter to the Supervisors and other elected officials about the need for more MediCal eligibility workers, so that people can access MediCal services more quickly.

In attendance: Russ (last name?), Maureen Mina, Maria, Marcella Sanchez Petreus (spelling?), John (last name?), Chuck Hughes, Catherine Birtalan, Art DeAngelo, Anne Gogle, Ann Detrick. Later in the meeting, we were joined by Suzanne Grimmesey-Kirk and John Truman.

I. Welcome and introductions.

II. Minutes of the 10/09/08 SB Regional Consumer Empowerment Meeting were distributed. It was decided to review the minutes later in the agenda, because Ann Detrick, ADMHS (Alcohol, Drug and Mental Health Services) Director is attending our meeting to discuss concerns.

III. Concerns addressed to Ann Detrick.
A. Will the MHSA (Mental Health Services Act) WET (Workforce Education and Training) position for a Consumer Employment Supervisor have an advocacy and empowerment component? Will there be a separate Consumer Empowerment Program Manager? Although it has been heard that there may be two consumer management positions open, one that focuses on consumer employment and one that focuses on consumer advocacy, Ann understands that in reality there is only one position open, that of a Consumer Empowerment and Employment Supervisor, which will have consumer advocacy and empowerment responsibilities built in. Chuck distributed copies of “Duties of Consumer Empowerment Program Manager”, which was compiled by Sharon Kuehn, former ADMHS Consumer Empowerment Program Manager.
ACTION: Ann will clarify whether there will be two consumer management positions open or only one.

B. What will happen to consumers currently on custodial crews when VTC (what is this?) and Work, Inc. contracts aren’t reviewed? Is there an additional funding stream available?
ACTION: Ann will find an answer to this question.

C. Rumors that the Calle Real Clinic may be closing. Ann stated that this rumor is not true.

D. How is the over-billing of MediCal by probation, public health and social services being addressed? During discussion, Ann pointed out that some of the billing problems date to the fiscal year 2002-2003 and are being appealed to the state. She also pointed out that the Supervisors are expected to discuss the budget deficit, as well as ADMHS self-disclosure of budget problems, at their November 18, 2008 meeting in Santa Barbara.

E. With limited resources available for services, who advocates for consumers who are less able to advocate for themselves when consumers are “in competition” for the same services? How do you suggest that these clients get services? Ann acknowledged that ADMHS does not know of everyone who needs services and that fact, in itself, is a challenge to be met. With a limited amount of resources and many people in need, another problem is how to manage what resources are available. Two specific questions were asked of Ann:
1. Because SB ACT has capacity for only 100 consumers and PathPoint has capacity for only 130 consumers, what services are available to consumers #231+ who need and would benefit from SB ACT and PathPoint services?
2. What are the real and current benefits available to the consumers who were formerly served by Mainstream, Arlington and Work Training Programs, based upon the limitations of the replacement services?
ACTION: Ann asked to meet with Catherine to review the numbers.
More than once, the point was made that some consumers are not able to advocate for themselves and may not be receiving the services that they need. On the other hand, some consumers are advocating well on their own behalf and are receiving adequate services. Concern was expressed about a perceived inequity of services being provided since 11/1/08, with the question again asked, “Who advocates for consumers who are less able to communicate for themselves?” There was no answer provided. Ann stated that there is clearly a need for more outreach.
ACTION: Ann and Catherine will both gather information about consumers in need and meet to discuss the issue.

F. Regarding closure of Calle Real clinic during the county furlough, has outreach been done to let clients know specifics of the plan? If meds run out, will ER help? Is CARES fully staffed to handle this period? Ann understood that flyers had already been posted at the clinics throughout the county and that consumers had already been notified by their case workers of the closures and about the availability of alternate services. However, by asking all the consumers present at this meeting today, it was demonstrated that NO ONE had heard from their case managers or seen flyers at clinics about the furlough and/or alternate services. Only by word of mouth among consumers and family members has anyone been made aware of the furlough and closures.
During discussion with those present at this meeting, Ann and Suzanne Grimmesey-Kirk (MH Adult and Children’s Division Chief) developed a friendly, informative draft letter to be mailed to consumers as soon as possible. These were suggestions made today for contacting consumers about the upcoming furlough:
1. A friendly, informative letter should be sent to all ADMHS clients from Ann Detrick as soon as possible, offering clear information about resources that are available during the furlough.
2. Telephone calls should be made to all ADMHS consumers about the furlough and about alternate resources. A recommendation was made to ask Hope Line staff to use a portion of their work time to call some of the consumers, with the remainder of the calls made by ADMHS staff.
3. Flyers should be posted prominently at all clinics as soon as possible, offering friendly, informative information.
Also in the discussion, the Hope Line was asked to serve as a resource during the furlough, addressing questions and concerns about the availability of services. It was noted that in the South county area, the furlough will affect only those consumers who receive services at the Calle Real clinic. It was further noted that the CARES clinics in North and South county regions will be available 24 hours a day for services, and there will be limited availability of services at the Lompoc clinic. The SB ACT clients will not experience a reduction in their services. The PHF (Psychiatric Health Facility) will be open.
A question was asked about protocol for delivery of services during the furlough. Ann responded that the delivery of services is individual for each client, with no overall protocol. A recommendation was made to develop a standard protocol for delivery of services to clients in the event of future furloughs.
In addition, a recommendation was made to determine how the local police force is able to avoid a furlough, based upon safety needs. If the SBPD (Santa Barbara Police Department) can avoid a furlough, why can’t ADMHS also avoid a furlough, based upon safety needs?
ACTION: Suzanne and Ann will draft a letter and send it via e-mail to members of this group for review and comment prior to mailing. Also, a mailing list of all ADMHS clients will be developed for creating mailing labels.

G. What is the status of Propay? Is it closed? People are in need of Propay services now. Is there any movement in regards to a proposed fee? Ann congratulated consumers for making the Supervisors aware of the Propay fee issue, because as a result of their advocacy, presently there is no fee charged. However, because of staff cuts, the Propay program may not take on new clients. In addition, Ann asked how consumer groups can be involved in determining who can manage their own finances without using Propay? Chuck recommended that the Peer Recovery Learning Center (PRLC) offer money management classes.
ACTION: Ann said she would contact the PRLC about offering money management classes.

H. Please explain the process to involve consumers in the development of MHSA’s PEI (Prevention and Early Intervention) component. During discussion, it was recommended that the Consumer and Family Member Advocacy Committee (CFMAC) be used as a resource for greater consumer involvement. Going two steps further, a recommendation was made to formulate a sub-committee of the CFMAC as a working group with the ADMHS administration. After that, the CFMAC would bring the discussion to consumers at large. Maureen noted that in Alameda County, there is a spirit of working together between administration and consumers, where everyone “rolls up their sleeves” and develops programs together. Chuck recommended that consumers be involved during the early stages of MHSA programs, rather than being informed after drafts have been developed.
During the discussion, Ann suggested that interested persons attend the MHC (Mental Health Commission) meetings as a way of participating in the decision making process. It was noted that the MHC meetings do not lend themselves to dialogue and a different forum must be developed. To start the process of consumer and family member participation, Ann offered this as an example of initial outreach by ADMHS –
1. This is what we learned about…(a particular project, or the budget process)

2. This is what we are thinking about…(a particular project, or the budget process)
At the very end of our meeting today, John Truman (ADMHS Special Projects Division Chief) was asked to join us. Graciously agreeing, John was informed of the request that the CFMAC form a subcommittee to work with ADMHS administration in the process of decision making that involves consumers, including the budget process.

I. Some consumers want more social activities. Others want employment. A request was made to offer social activities of a higher caliber than currently offered. It would seem that the new Consumer Empowerment and Employment Supervisor would be responsible for consumer social activities. Ann commented that the Consumer Advocacy Coalition (CAC) monthly calendar is a good example of how to inform consumers of social activities and recommends that the PRLC follow that example. “The sky is the limit” commented Ann, regarding consumer activities. It was asked when the PRLC will be open. Ann said that startup is expected in January 2009.
ACTION: Ann will get an update on the opening of the PRLC.

J. Is there any mechanism to track the progress of consumers who have been discharged from County services?
According to Ann, there is currently no mechanism to track consumers who have been discharged from County services. She noted that there is no way to know if the persons who have been discharged in the past 12 months really are in need of services. By way of contrast, Ann spoke about a different mental health program that did not consider discharge of clients as a positive event and required clinical staff to respond to questions about why persons were discharged and how much effort was made to avoid discharge.
ACTION: Ann said she would put on her “to do list” a program for outreach and tracking of persons who are discharged from County services.

IV. Other business
1. Consumer Advocacy Coalition flyers were distributed –
a. The monthly CAC flyer and November calendar.
b. The flyer for a 12/3/08 Town Hall Meeting, to which everyone is invited and encouraged to attend.
2. Ann was thanked for attending the meeting today and for her active participation in collaboration at the last two SB Regional Empowerment meetings. Gratitude was expressed for her willingness to listen and to actively participate in dialogue at our meetings, as well as her offer to find answers to our questions and concerns.
3. Chuck asked John Truman about the use of a room for the Teleconference Call scheduled for the morning of 11/21/08. Agreement was made to use the former office of Sharon Kuehn.
ACTION: Chuck will verify the time of the meeting for John Truman.
4. Maureen requested the use of a large room for the upcoming Empowerment Dialogue. (No date discussed.)
ACTION: John Truman will help find a room.
5. Our two new attendees were warmly welcomed to our meeting today.
6. Attendees were asked about including their last names in the minutes of this meeting. After discussion, it was decided that when signing in at each meeting, each attendee will list how his/her name should appear on the minutes for that meeting.
7. Everyone was asked to review the minutes of the 10/9/08 SB Regional Empowerment meeting for discussion at the December meeting. After discussion, it was decided to prepare future minutes in a summary form, rather than great detail.
8. Our meeting location today was pre-empted by ADMHS staff, who said that we were to use Room 260 instead of our long-standing us of Room 261.
ACTION: Maureen and John Truman will find out why we were told, at the last minute, to use a different room, and how to avoid such changes in the future.

I. Welcome and introductions.

II. Review minutes of 9/11/08 SB Regional Consumer Empowerment Meeting.

A. Comments and corrections.

1. Correction – Mavis’ last name was misspelled.

2. Correction – A correct description of a dialogue between ADMHS staff and consumers is ‘an empowerment dialogue’.

3. Correction – Consensus more accurately means a simple majority.

4. Comment – Give the full name of acronyms used.
WET means Workforce Education and Training.
ADMHS means Alcohol, Drug and Mental Health Services .
MHSA means Mental Health Services Act.
DMH means Department of Mental Health.
OAC means Oversight and Accountability Commission.
AORRS means Adult and Older Adult Response and Recovery Services.
EQRO means External Quality Review Organization.

5. Comment – skip a line between sections of these minutes.

6. ACTION: Catherine will distribute copies of the minutes of the SB Regional Consumer Empowerment meetings at the Consumer Advocacy Coalition meetings.

B. As corrected, the minutes were approved. (Chuck motioned; Anne seconded).

III. Review of action items from 9/11/08 SB Regional Consumer Empowerment Meeting.

A. Meeting minutes.

1. ACTION: Catherine will prepare the minutes in a timely manner and ask for input from attendees to make sure that all information in the minutes is accurate.

2. ACTION: Chuck will work with Art De Angelo of Prop 63 for Me and with Roger Thompson of the Consumer Advocacy Coalition to see that meeting minutes of these two consumer organizations are posted on sbclients@yahoo.com.

B. Through Eric Baizer (ADMHS Departmental Analyst), Cuco Rodriguez-Rodriguez (MHSA Program Manager) answered the following questions –

1. ‘Will the county hire a Consumer Empowerment Manager?’ Answer: ‘There is no MHSA requirement to hire a Consumer Empowerment Manager.’

2. ‘Are we entitled by MHSA guidelines to have a Consumer Empowerment Manager?’ Answer: ‘Page 58 of the Santa Barbara County Workforce Education and Training (WET) Plan includes a request for funding for a Consumer Empowerment and Employment Supervisor. This plan was posted to www.admhs.org on 7/7/08, subject to a 30-day public comment period and discussed at several recent meetings of the Consumer and Family Advisory Committee. ADMHS will recruit for this position if/when the California Department of Mental Health approves the WET plan, which we hope is very soon.’

C. Discussion about setting up an empowerment dialogue for consumers with ADMHS executives.

1. ACTION: Maureen is in the process of setting up such a meeting, working with John Truman (Special Projects Division Chief).

2. A recommendation was made to use a portion of our monthly SB Regional Consumer Empowerment Meeting time for an empowerment dialogue, possibly having our meeting from 2:00 – 3:00PM and then having the empowerment dialogue with ADMHS executives from 3:00 – 5:00PM.

3. A recommendation was made to have very clear questions to ask ADMHS executives and that the questions be given to ADMHS staff prior to the empowerment dialogue, to facilitate the best use of everyone’s time.

D. Chuck distributed two lists of California Department of Mental Health representatives.

1. County Operations North and South Regional Listing.

2. MHSA Contact List.

E. Representatives of each consumer group informed their members about the 9/26/08 teleconference, “Clients as Business Partners Contracting to Counties”.

F. Discussion about the fact that consumers are needed on the OAC (Oversight and Accountability Commission).
1. The following questions were raised:

a. When and where are the meetings held?

b. How are consumers notified?

c. ACTION: Bob will encourage the California Network of Mental Health Clients to communicate with its members through e-mail, to inform them of OAC meetings.
d. ACTION: Maureen will report on (Maureen, I have blank space here…………………………………………….)

G. Regarding the POQI (Performance Outcomes and Quality Improvement) survey:

1. Maureen recommended that the SB Regional Consumer Empowerment Group take on the POQI survey as a project in the future.
2. The next POQI survey will be available to consumers in Santa Barbara the first two weeks of November 2008.

3. A different approach this year involves a letter to be sent to consumers, asking them to go to the county clinic to complete the survey.

4. ACTION: Anne will review the POQI survey from a sociologist’s standpoint.

H. Chuck distributed copies of the EQRO (External Quality Review Organization) report, dated November 17, 2006.

1. Chuck expressed disappointment that there is no narrative attached, as was the case for the preliminary summary. Chuck noted that the preliminary report and summary have been removed from the EQRO website.

2. ACTION: Chuck will attempt to find a copy of the preliminary EQRO report and summary

I. Maureen talked to Marianne Garrity (ADMHS Deputy Directory) about the latest Medi-Cal audit report.

1. There was discussion about perceived county billing practices and that corrections are being made and trainings are being held to enable staff to be more efficient, in order to bring in more revenue.

2. ACTION: Maureen will……………………………………………………………………

J. Chuck distributed copies of the SB Board of Supervisors response to the SB Fiscal Year 2007-2008 Grand Jury Report on ‘Inpatient Psychiatric Treatment 16 Beds …And Deeper in Debt’. There was no time for discussion.

K.When asked how consumers may participate in the ADMHS budget process, Tom Alvarez (ADMHS Fiscal Director) stated that the subject will be discussed at an ADMHS executive meeting on Thursday, October 16, 2008, after which time he will contact Catherine with an answer.

L. Through Eric Baizer, Cuco Rodriguez-Rodriguez answered the following questions about the status of the PEI (Prevention and Early Intervention) component of the MHSA.

1.‘What is the status of the PEI component of the MHSA?’ Answer: ‘The PEI process is being finalized. Consumers will be among the various stakeholders giving input on what they desire in the plan within state guidelines.’

2. Future of Consumer Groups. How can we work better together?

* Ann noted that at the 9/8/08 Consumer Advocacy Coalition meeting, 4 members of Prop 63 4 Me were present, as well as Chuck from MHSA OurWay.

* Chuck noted that communication is vital between the individual consumer groups.

* Recommendations were made:
a. Each consumer group should focus on different issues.

b. Minutes of our meetings should be posted on the internet.

ACTION: Catherine will record minutes of this meeting and send them to Maureen.

ACTION: Chuck will help Ann put Prop 63 4 Me minutes on the sbclients@yahoo.com site.

ACTION: Catherine will find out how to put CAC minutes on the sbclients@yahoo.com site.

c. All consumer groups should be represented at this monthly meeting as a clearinghouse of information.

d. Decisions of this group should be made by consensus. Maureen explained that
consensus means we all agree.
Maureen made a motion that decisions of the SB Regional Consumer Empowerment
Group be made by consensus. Seconded by Ann. Passed by consensus.

* Per Maureen, the draft WET program has a position open for a Consumer Empowerment
Manager, but ADMHS may try to build in a component as a vocational specialist
responsible for consumers.

a. Question was raised ¡V ¡§Will the county hire a Consumer Empowerment Manager?¡¨

b. Question was raised ¡V ¡§Are we entitled by MHSA guidelines to have a Consumer
Empowerment Manager?¡¨

ACTION: Catherine will contact Cuco Rodriguez about answers to these questions.

* Recommendation was made to have a power dialogue for consumers.

a. What do we want to ask about?

b. Any meeting needs to be well advertised in the local media.

ACTION: Maureen will find out about setting up a power dialogue meeting for consumers.

* Question was raised about the management level above Cuco Rodriguez.
Cuco ¡V Al Rodriguez ¡V Ann Detrick ¡V Mike Brown.

ACTION: Chuck will bring a list of DMH representatives to our next meeting.
3. ¡§How to Be an Effective Consumer Liaison¡¨ Teleconference.

* On Thursday, 9/25/08, from 1 ¡V 2:00PM, location to be determined.

* Maureen distributed power point pages about the teleconference.

ACTION: Representatives of each of the consumer groups will inform their members about the teleconference.

4. ¡§Clients as Business Partners Contracting to Counties¡¨ teleconference.

* On Friday, 9/26/08, in the morning. Time and location to be determined.

5. Consumers in Top Level State and Local Meetings.

ACTION: Representatives of each of the consumer groups will distribute applications for the OAC.

6. POQI (Performance Outcome Quality Improvement)

* POQI is a measurement tool that asks, ¡§How do you feel about services you receive?¡¨

* The survey is distributed to ADMHS clients at their appointments and has been considered to not be user friendly.

* Mandated by DMH, the POQI surveys are slated to be completed again in November
2008.

* Question was raised about whether we want to address the issue of POQI forms that are
not user friendly.

ACTION: Maureen will bring a copy of the POQI to our next meeting for review.
SB Regional Consumer Empowerment Meeting
Thursday, 9/11/08, 2:00 ¡V 4:00PM

7. Outside Audit.

* In November 2007, a private firm from the East Coast completed an initial review of the auditor¡¦s report ¡V an ADMHS report called an EQRO ¡V an External Quality Review.

* The report would be referred to Quality Assurance to follow up on recommendations.
ACTION: Chuck will get a copy of the EQRO for our next meeting.

* A state MediCal audit is done every three years.

ACTION: Maureen and Catherine will recommend a joint letter from all consumer groups requesting
the latest MediCal audit report.

8. Grand Jury/County Response
ACTION: Chuck will bring a copy to our next meeting of the county response.

9. California Client Summit in October asks how consumers are doing in the workplace.

* Although anyone can go and pay full fee, there are scholarships available.

10. Participation of consumers at the executive level budget meetings.

ACTION: Catherine will contact Tom Alvarez about how to make this happen.

11. Prevention and Early Intervention is the current MHSA component.

* We believe that consumers should and must be involved in all aspects of this component.

* Guidelines are written by the state. After that, counties work on their own guidelines.

ACTION: Catherine will call the MHSA liaison regarding the current status of the PEI component.

12. OARRS program in Santa Barbara.

* Initially intended to serve only older persons in Santa Barbara with mental illness, it has been expanded to serve a wider range of adults, with a new name AOARRS.

* There are services for only 100 adults, for those at risk of losing housing because of mental illness.