CALIFORNIA MENTAL HEALTH PLANNING COUNCIL



CALIFORNIA MHSA MULTICULTURAL COALITION (CMMC)

IN-PERSON MEETING MINUTES

Thursday, December 11, 2014

9:30 A.M. – 5:00 P.M.

Holiday Inn

300 J Street

Sacramento, CA 95814

Facilitated by: Elizabeth Kosier

CMMC Members Present:

Jim Gilmer, Co-Chair

John Aguirre

Michelle Alcedo

Jamila Guerrero-Cantor

Janet King

Yvette McShan

Masa Nakama

Ahmed Nemr

Mari Radzik, Ph.D.

Melen Vue

Beatrice Lee

Gulshan Yusufzai (conference call)

Crystal Crawford (conference call)

Nga Le (conference call)

Poshi Mikalson (conference call)

Raja Mitry (conference call)

Viviana Criado (conference call)

Rocco Cheng, Ph.D. (conference call)

Public Present

Sally Douglas Arce- (conference call) Katherine Elliott

Marina Augusto- Aimee Sisson

Laura Leonelli Pete LaFollette

Andrew Cheng

Staff Present:

Michael Helmick

Stacie Hiramoto

Erin Reynoso

I. Introductions – Ice Breaker

Co-Chair Jim Gilmer opened the meeting. He invited the CMMC members and audience to introduce themselves, and to share something that people don’t know about them.

Sharing Our Stories: Michelle Alcedo

Ms. Alcedo was born in northern Luzon in the Philippines. When martial law was declared in 1972, her father sought to move the family out of the Philippines. He immigrated to the United States in 1973; the rest of the family followed the next year. The family settled in Gardena into a multi-ethnic community.

Ms. Alcedo attended UC Santa Cruz and earned a degree in Modern Literature. After backpacking in Europe for two months, she returned home and, at that time, came out as gay. She proceeded to move to San Francisco and became involved in the social justice movement.

For her first job Ms. Alcedo worked with a documentary film production company, making films for school-age children on LGBTQ issues. As a community organizer, she also organized trainings for youth providers and educators across the country.

Ms. Alcedo returned to the Philippines to spend time with her elderly grandmother who was living with dementia. Returning to San Francisco, Ms. Alcedo began working with older adults through the Family Caregiver Alliance. She realized she wanted to work with LGBTQ older adults to create change within her own community; she has been involved with Openhouse for seven years.

Ms. Alcedo now provides cultural humility training across California for the National Resource Center on LGBT Aging. She is also working with an Openhouse project to build 110 units of affordable senior housing units that is welcoming to the LGBT community. A yearly art show is one of the prominent events held in the community.

With her partner, Monica, she recently took an enjoyable trip to Southeast Asia.

II. Review of Today’s Agenda

Ms. Kosier walked the members through the Agenda and corresponding packet. The group agreed to reduce somewhat the two-hour time allotment for the committees.

Review of Meeting Notes from the June 19 CMMC Meeting

Ms. Mikalson requested a punctuation change on page 9 from “Trans-Gender” to “Transgender.”

Results of September 29th Meeting Evaluation

There was no feedback on the evaluation results (included in the packet).

III. Update on the California Reducing Disparities Project

A. The CRDP Draft Strategic Plan – Ruben Cantu

Mr. Cantu stated that the California Pan-Ethnic Health Network (CPEHN) has been given the green light to begin disseminating the Statewide Strategic Plan to Reduce Mental Health Disparities at the November meeting of the Mental Health Services Oversight and Accountability Commission (MHSOAC).

It has been sent to over 3,000 CPEHN advocates and stakeholders, including the California Reducing Disparities Project (CRDP) partners to forward to their networks. Ms. Hiramoto has sent it out to her extensive mental health advocate list as well. Links to it are available on the website.

CPEHN is currently planning the Public Comment period, which will include at least five community forums. Consultant Ignatius Bau is helping to develop the forum agenda, ensuring that they are interactive and conducive to feedback. The Public Comment period will be scheduled sometime around the end of January through the end of February. Mr. Cantu expressed hopes for an abundance of input. In addition to the community forums, CPEHN will also accept comments and feedback via email, fax, mail, phone, and so on. Mr. Cantu sought feedback on the content of the plan rather than proofreading-type edits.

When the Public Comment period is over, CPEHN will review all of the feedback and decide what can be incorporated. Once revised, the Strategic Plan will be vetted with the rest of the CRDP partners, then approved by the Office of Health Equity (OHE) and the California Department of Public Health (CDPH). CPEHN will develop an Executive Summary – a more condensed version that can also be disseminated. Further down the line, CPEHN plans to hold a large statewide CRDP final conference, which will focus on developing strategies of implementation for the plan’s recommendations.

Q & A

Pete Lafollette of Ventura County commented on the Reducing Disparities project, Phase 2 in particular: the Client and Family Members were the original catalysts of the Mental Health Services Act (MHSA). He would like to see a civil rights approach or comparison.

Ms. Hiramoto reminded that CMMC that they are among the first – before the general public – that get to see and comment on the Strategic Plan. Later in the meeting Ms. Criado’s committee would review the extensive comments made at the CMMC meeting last year. Mr. Cantu noted that much of that feedback had not been incorporated into the current version, because it was already in the approval process; it is at the top of the stack of feedback that he will commence reviewing after the Public Comment period.

Ms. Kosier asked about the statewide conference; Mr. Cantu said it would probably happen this summer at a location to be decided.

B. Phase 2 of the CRDP – Dr. Aimee Sisson/Office of Health Equity

Dr. Sisson covered the following material.

• Phase 1 of the CRDP focuses on developing a Strategic Plan to reduce mental health disparities in five populations.

• Phase 2 focuses on implementing the Strategic Plan, with an emphasis on funding community-defined evidence programs.

• Currently Phases 1 and 2 are both in progress.

• The goal in planning Phase 2 has been to stay true to the original project design; the main informing document is the CRDP Strategic Plan.

• In addition to receiving guidance from the recommendations in the draft Strategic Plan, the CRDP has been guided by interviews with key informants within the CDPH and targeted communities.

• Also contributing guidance is the CRDP Brain Trust, an informal advisory committee comprised of subject matter experts.

• The recent community forums and today’s presentation are part of the public vetting process.

• Dr. Sisson presented the Phase 2 Vision and anticipated five-to-ten-year outcomes.

• The four core principles are:

o To do business differently

o To build community capacity

o Fairness

o Systems change

• The program components are:

o Pilot projects (~60% of funds)

o Evaluation (25%)

o Technical assistance and training (10%)

o Infrastructure (5%)

o Administration

• Dr. Sisson explained a chart depicting how the five components fit together into the overall Phase 2 program. Five pods represent the five target populations.

• Each target population pod has five to seven pilot projects to be spread geographically across California. Each pilot project is supported by a population-specific technical assistance provider and population-specific evaluator. Each pilot project is associated with its County Mental Health or Behavioral Health.

• The pilot projects are community-defined evidence programs that will implement, expand, and evaluate an existing promising practice in order to demonstrate that that practice is indeed effective. The projects must address mental health prevention and/or early intervention.

• The pilots will receive approximately $200,000/year for four years during implementation. They will receive an additional $60,000/year to evaluate the program.

• Recognizing that the decision to allow counties to be eligible for Phase 2 funding is somewhat controversial, Dr. Sisson explained why it was done.

• The CRDP project team is proposing that the evaluation of Phase 2 occur at three levels: Pilot, Population, and Statewide.

• Technical assistance for the pilot projects will take one of two forms: Administrative and Evaluation. It will be different for the Capacity Building pilots and the Implementation pilots.

• The Infrastructure component has been developed to address policy and systems change; to create a CRDP Advisory Committee; and to establish education, outreach, and awareness coordinators at the state and local levels.

• Based on the proposed program design, the CRDP project workers anticipate overseeing approximately 60 new contracts and grants in Phase 2. Staff will be needed to oversee the contracts, as well as the evaluation design and implementation. Administrative funding will come from outside the $60 million MHSA allocation.

• Dr. Sisson described the Phase 2 logic model which depicts how it intends to achieve its goal of reducing mental health disparities.

• Turning the proposed program design from theory into reality is going to involve multiple solicitations through which potential providers and pilot sites can apply for funding. The solicitations will be rolled out in stages.

• Public input is being obtained in three different ways: information gathering, draft solicitation review, and opportunities for the bidders to provide feedback on the requirements during the procurement process.

• Dr. Sisson encouraged CMMC members with any additional questions or comments to contact the CRDP website, to view the CRDP Phase 2 website, and to take the 10-minute survey for potential pilot projects.

Mr. Gilmer pointed out a narrative matrix in the meeting packet containing frequently asked questions. He requested the members to peruse Question #18: Where does the CMMC fit into the forest?

Q & A

Ms. King asked about the work of the statewide evaluation team. Dr. Sisson explained that the team is comprised of at least six people for each of the five target populations. They will be working closely with each of the pilot projects.

Ms. King asked how the statewide evaluation team will be selected. Dr. Sisson answered that there will be one solicitation going out specifying that the overall team needs to have cultural competence in each of the five populations.

Andrew Cheng, Lead Consultant, emphasized that the CRDP project workers have been gathering much input before they begin, particularly through the community forums. The selection criterion is especially important for stakeholders to provide feedback upon.

Dr. Sisson explained to Ms. King that the team could consist of seven organizations (if a subcontractual mechanism is chosen) or it could consist of just seven people.

Mr. Mitry encouraged the inclusion of spiritual leaders or healers in the evaluation process; there may be a very relevant role for them because of their understanding of mental illness in their communities. Dr. Sisson agreed that faith-based organizations and individuals play an important role in mental health prevention and early intervention. They could be included at every step of the evaluation process, from planning to implementation to sharing of results.

Dr. Radzik asked about projected dates for 2015. Dr. Sisson replied that they are thinking early to mid-2015; Phase 2 is rolling out in stages. The team is committed to not having Phase 2 get ahead of Phase 1. They intend to have fairly long response periods for all of the solicitations so that there is plenty of time for the word to get out and for people to develop a proposal and response.

Ms. Guerrero-Cantor asked about using surveymonkey to describe potential pilot projects. Dr. Sisson explained that surveymonkey provides some context and explanation of what might be a pilot project – but there is also a place where respondents can tell about their potential pilot projects.

Mr. Aguirre noted that relationships are being encouraged between pilot projects and the county departments of mental health. However, tribal leaders in his community do not have that relationship, but want to apply for project funding. Dr. Sisson responded that the intent is not to penalize any group that has a poor relationship with their county; the project intends to incentivize that relationship without penalizing the lack thereof. She stressed the importance of fairness. Mr. Cheng asserted that they are open to suggestions regarding this issue.

Mr. Aguirre pointed out that some tribal lands have borders in more than one county. Do they need to have support from all the counties in that case? Also, what about organization doing regional work? Dr. Sisson responded that the CRDP project workers have not made those determinations yet and thanked Mr. Aguirre for raising those issues. She felt that the larger the collaboration, the better.

Mr. Gilmer pointed out that the definition of county collaboration could be broad; some of us may have relationships with multiple agencies – schools, law enforcement, Boards of Supervisors, and so on. Dr. Sisson replied that again, the project workers have not made that determination. However, she appreciated the fact that community-based organizations are working with more than just county mental and behavioral agencies.

Mr. Gilmer expressed concern that the project would examine whether any proposals from counties truly align with CRDP. Mr. Cheng responded that the project certainly wants valid collaboration, rather than superficial relationships, from the county agencies – the county must have an active role in the delivery of services and the effectiveness of programs. Dr. Sisson requested ideas from the CMMC on what constitutes meaningful collaboration.

Mr. Gilmer commented on the importance of local regional organizational structure for the public outreach, education, and awareness-building components. He expressed concern that the term “local” has not been defined. He hoped that “local” could include “regional” and could be self-determined by groups according to how they want to organize. Mr. Cheng noted that the area that has received the least amount of thought to date is indeed infrastructure – but it is one of the most important pieces because it addresses the bulk of the recommendations that have come in to the Strategic Plan on system changes. He explained why the county level has been considered the appropriate model.

Ms. Hiramoto informed the members that the packet included a helpful summary of what the CRDP is and is not. Members can use it when they are out in the local communities, talking with stakeholders.

Ms. Hiramoto also sought to clarify that people applying for the pilot projects must already be doing the practice. Dr. Sisson confirmed that the pilots need to be already existing because the project seeks to validate community-defined evidence.

Ms. Mikalson had received feedback that the information is quite overwhelming. Each time she herself hears it, she has more questions. She thus felt that the survey and the Public Comment may not have captured everything that people would be asking or needing.

Ms. Lee stated that if more funding becomes available in the future, she would like to see it go towards infrastructure to build capacity. With the RDP, they are really looking to improve the system.

Ms. Lee asked if there is going to be a review of the Selection Panel, and if so, what the makeup of the panel will be; will there be open solicitation for individuals interested in sitting on the panel? Mr. Cheng responded that there will be two different types of solicitations. For the Statewide Evaluator, Technical Assistants, and Infrastructure pieces, the project will try to stay close to the state model. For the pilot projects, those involved are not used to going through the state system; that will be more of an RFA or grant process.

Laura Leonelli commented on county relationships: this could be a very relevant aspect of long-term capacity building and strength building. She also recommended the California Stakeholder Process Coalition, which has developed a very detailed definition of meaningful stakeholder engagement.

Ms. Elliott voiced concern that in some cases, communities feel a lack of trust toward the counties – and community organizations serve as a neutral zone or safe haven. Asking them to be brokers with the counties might conflict with their reputations as community advocates.

Ms. Augusto responded that there are indeed many cultural brokers in the county system. County workers who are trying to move health equity efforts forward could be very useful as part of a team for bridging.

She also stated that Kimberly Knifong is a member of the California Stakeholder Process Coalition, and that many of their documents and suggestions could be very useful in the process.

Mr. Lafollette inquired as to whether the CRDP is sufficiently appreciative of whole-person approaches to recovery as opposed to medical or pharmaceutical approaches. Dr. Sisson stated that the project is indeed looking for community-defined evidence from holistic programs, especially with an approach of prevention and early intervention.

Ms. Arce agreed that not all counties are at the same stage in dealing with the five identified groups, and having truly sincere outreach with the community. She wondered if the project addresses collaborations with individuals in the criminal justice system, as well as those with addictions or multiple challenges. Mr. Cheng replied that a unique facet of CRDP is its robust approach to looking at potential pilots – including niche communities.

Ms. Hiramoto asked about other groups such as the County Behavioral Health Directors Association (CBHDA) to which this presentation has been given, and the kind of feedback they received. Ms. Augusto responded that the team has been working primarily through the Ethnic Services Managers for feedback on what the county role could be in this process. They will be in contact with Robert Oakes at the CBHDA to give a similar presentation.

Mr. Gilmer addressed the critical county collaboration issue: even in the individual population reports, county relationships with each of the Strategic Planning Workgroups (SPWs) is well-documented. There is much more of a journey ahead to make this more effective. There is tremendous angst and concern among SPW members to make this valid and measurable – not just surface.

Mr. Gilmer continued that he had participated in the League of United Latin American Citizens (LULAC) report in his county. He encouraged the CRDP team here today to plumb the county collaboration issue deeply. Ms. Augusto appreciated Mr. Gilmer’s point. She pointed out that the CRDP project is only funded for four years, possibly five. The issues of sustainability and dollars are also present; most of the funds go to the counties. Leveraging the funds must also be part of the communication.

GENERAL PUBLIC COMMENT

Dr. Radzik said that she had brought some materials from the Center for Strengthening Youth Prevention Paradigms program at Children’s Hospital in Los Angeles.

Mr. Mitry suggested that CRDP also contact the California Mental Health Services Authority (CalMHSA) as partners in the project. Ms. Augusto responded that they do meet with CalMHSA on a monthly basis.

Mr. Gilmer commented that the African-American SPW was one of the partners that presented to the MHSOAC along with the other SPWs a few weeks ago. They have a DVD entitled “Beyond the Beat and Lyrics: African-American TAY Males in the Mental Health System.” The link is on the CalMHSA website.

IV. Director’s Report

Ms. Hiramoto announced that at the last MHSOAC Community Forum, an extensive report was presented to the MHSOAC from LULAC. The report detailed the difficulties the Latino community experiences in accessing appropriate mental health services in Ventura County. Ms. Hiramoto was struck by the fact that some of those difficulties are not unique to the Latino community. She encouraged the CMMC members to take a look at the report.

Mr. Mitry asked if the LULAC report has been distributed to groups such as the Little Hoover Commission. Ms. Hiramoto replied that at a special hearing of the Little Hoover Commission on the MHSA in September, the Racial and Ethnic Mental Health Disparities Coalition (REMHDCO) and the National Alliance on Mental Illness (NAMI) were the only community providers asked to speak. Ms. Hiramoto will indeed forward the LULAC report to the Little Hoover Commission.

Mr. Gilmer mentioned that while the primary focus of the report is the Latino community, it points to the need for a multicultural collaborative coalition in Ventura County.

V. Administration Committee Report

Co-Chair Ahmed Nemr reported on the following.

1. Report on the CRDP at the MHSOAC Meeting of November 20, 2014

Due to Senator Lou Correa’s efforts, the CMMC finally had gotten the chance to give a presentation at the MHSOAC meeting. The Commissioners had appeared interested and asked many questions. Ms. Hiramoto noted that Mr. Nemr’s excellent PowerPoint presentation was in the packet under Tab 5. She felt that the Commissioners had asked basic-level questions, and that they had gained a much better understanding of the CRDP.

2. Black-Out Dates

Mr. Nemr stated that the committee had decided to follow the current practice of having staff and co-chairs do their best not to schedule meetings on holidays and cultural days. He requested members to mark their 2015 calendars with the days they cannot attend meetings, and return them by December 31.

New for 2015: Two-Day Meetings

Mr. Nemr stated that starting in 2014, the CMMC in-person meeting will extend to a day and a half.

(4.) Member Names on the CMMC Stationery

Mr. Nemr stated that members not wishing to have their names included on the CMMC letterhead can request this to staff.

Mr. Tripp expressed dismay that after a group consensus had been reached on the matter, one member would request to have all names removed from the letterhead.

Ms. Mikalson stated that her concern had been for people who have a conflict of interest or who work for agencies that might not approve of the content of the letter or email. She had recommended a professional-looking CMMC letterhead; the group could choose to include member names in the signature line. She continued that if certain names are removed from the roster because of a conflict or lack of group consensus, it looks as if they are not members.

Mr. Gilmer stated that each time the CMMC had gone through this process, there had been much discussion regarding who wanted to be named on the letterhead. He supported Mr. Tripp’s comments wholeheartedly.

A discussion ensued.

Ms. McShan felt that when an individual joins a group, the group consensus wins even though the individual may sometimes disagree. Ms. Mikalson responded that the last group of advocacy letters that had gone out from one committee, had not been brought to the coalition as a whole.

Mr. Tripp noted that CMMC member names are posted on the website; the membership is not a secret.

Ms. Mikalson felt that taking member names off the letterhead is not a solution: the heading is “Members” rather than “Supporters of this Letter.”

Ms. Hiramoto clarified that she is willing to remove names from correspondence on a letter-by-letter basis. She explained the last three letters that had been sent.

Mr. Aguirre supported the practice of including member names on an organization’s letterhead as professional.

Ms. Guerrero-Cantor addressed the issue of communication within the CMMC. If an urgent correspondence is pending, the committee chairs could call their members to approve the correspondence. Mr. Gilmer noted that text messages are also effective.

Ms. Kosier sought to establish that the letterhead practice given by Mr. Nemr at the outset of the discussion was a settled practice.

Ms. Kosier sought to establish that the Administration Committee now needs to clarify whether a non-response from a member means yes or no (following the case-by-case practice).

Mr. Nemr brought the discussion to a close; the final outcome was that the letterhead will remain as is. The CMMC will honor any request to have a member’s name removed. At the next Administration Committee meeting they will discuss two issues: whether to remove names on a case-by-case basis, and whether the absence of a response to email means yes or no.

Ms. McShan felt that either the group is together or it isn’t; we actually keep stigmatizing ourselves.

(3.) Draft PEI Regulations

Mr. Mitry reported that the two issues for comment at the upcoming MHSOAC meeting on December 18 were disaggregation of demographic data and measurement of duration of untreated mental illness.

He asked if the CMMC wanted to make a strong position statement that this aggregated demographic data should be required of counties to collect, and kept in the proposed language of the regulations. Mr. Mitry stated that a conference call would be held possibly Monday afternoon to finalize wording.

For the second issue, Mr. Mitry stated that a workgroup was in progress at the MHSOAC. He said that individuals with first episode psychosis experience significant delays before receiving treatment, so duration of untreated psychosis (or an illness such as that) is important because of its relationship to treatment outcome and implications for prevention efforts. Mr. Mitry asked if the CMMC wanted to address this issue as well.

Ms. Hiramoto noted that this was an instance in which the CMMC did not know what the MHSOAC language looks like. Did the CMMC want to form a subcommittee to develop a draft letter for the whole body to review? The alternative was for individuals to speak during Public Comment at the MHSOAC meeting.

Mr. Gilmer stated that the issue has been discussed at the MHSOAC for the past six to 12 months. He supported forming a workgroup to turn out a position as soon as possible.

Ms. Mikalson asked if the MHSOAC would accept a position from the CMMC verbally or in writing. Ms. Hiramoto responded that they would take either or both; a written position along with public testimony is quite a bit more powerful.

Ms. Mikalson supported having a workgroup. Disaggregating data really involves mostly adding categories under race and ethnicity as well as sexual orientation and gender identity as a whole. The pushback is that the counties say that they don’t have the capacity to do it.

She continued that for the measurement of duration issue, the disparity communities wish to self-report their duration and have that taken into consideration. However, the counties are asking for a different way of defining duration.

Mr. Mitry agreed that it is an important issue: the longer a condition goes untreated, the poorer the outcome is known to become.

Ms. Hiramoto had understood that the counties had many concerns about duration and they did not want to collect the data at this time. They are meeting for an entire afternoon to discuss the sole issue of duration of untreated mental illness; they may be able to compromise.

Ms. Kosier asked CMMC members to state if they disagreed with the action to form a committee that will draft a position on the two issues. No one stated disagreement.

Those volunteering for the committee were Mr. Mitry, Mr. Nemr, and Ms. Mikalson. Mr. Mitry requested to call it a workgroup. Ms. Criado requested to have someone approach Dr. Nikki King about the workgroup. Ms. Hiramoto will send out the email for CMMC members to review.

VI. Strategic Plan Committee Report

Chair Viviana Criado reported on the following.

The committee has developed a timeline for completion of the deliverables. They include letters generated by the committee:

• A letter to the MHSOAC in response to Dr. Sisson’s CRDP Phase 2 presentation at the last meeting.

• Letters to the Office of Health Equity (OHE) and the California Health and Welfare Agency stressing the need to release the Draft Strategic Plan. (This has since been accomplished.)

The committee has also identified evaluation as a key component of the Strategic Plan upon which to focus. Ms. Criado invited the members to comment.

Ms. Elliott stated that the committee had presented Deliverables 4d and 4e at the meeting and had integrated CMMC member comments.

For the sake of transparency, Ms. Hiramoto asked the CMMC to consider whether the three letters could be used to satisfy Deliverables 4b and 4f. Ms. Criado asked if any members opposed this action.

Dr. Radzik stated that she did not oppose; she felt that the work CMMC does – such as composing letters – takes a great deal of time and energy. We need to show the powers that be that these are projects that come through the CMMC; they are deliverables.

Ms. Elliott commented that this also reflects that the CMMC is responsive to changes coming through the pipeline.

No members objected.

Regarding the release of the Strategic Plan, Ms. Criado asked what the CMMC wants to do in response. Ms. Hiramoto noted that the Public Comment period opens in January and community forums will be held; does the CMMC need to come together again as a body, or do members want to attend the forums individually?

Ms. Criado doubted that a full coalition review of the Strategic Plan again was necessary. Other options related to the Deliverables would be to monitor the quality of the forums, to monitor the process of how OHE is incorporating the feedback from the forums, and to produce a report with recommendations.

Mr. Aguirre agreed that the CMMC does need to submit something in writing for the record, even if it is just a repeat of 2013’s report. Mr. Gilmer agreed, and stated that having someone physically present at the forums to offer it, gives a face to the document.

Dr. Radzik suggested summarizing the data from the letter of August 27, 2013 – making it into a narrative. Ms. Hiramoto stated that Mr. Cantu does actually read all of the data, and that having a cover letter that a CMMC member could present at each forum would be effective. The CMMC could probably fund two people to attend each forum.

Regarding the role of the Strategic Plan Committee, Ms. Criado summarized that the CMMC members apparently agree on the need to present a summary in writing at the forums. The next step is how to translate that action into a deliverable; the committee would like to discuss that further.

Mr. Aguirre ascertained with Ms. Hiramoto that Mr. Cantu has not yet integrated the data contained in the August 2013 letter.

Mr. Gilmer clarified that this document in full should be attached to the new summary.

He encouraged new voices from the CMMC to speak at the forums.

VII. Emerging Leaders Committee Report

Chair Mari Radzik reported on the following.

Regarding the topic of the Pipeline to Prison project presentation or special report – after discussion, the committee feels that would not be an appropriate project for an Emerging Leader to take leadership. However, they can inform and assist on such projects.

Mr. Gilmer noted that criminal justice is a huge focus of MHSA and 1415 – youth as well as adults in the system. Rusty Selix and the Public Policy Committee have it on their agenda, and Darrell Steinberg’s new institute will be a magnet for foundational support.

Mr. Gilmer continued that even if Emerging Leaders do not take the lead on this issue, the CMMC may be looking for opportunities to collaborate.

He had observed that protests in New York over the chokehold death of Eric Garner had consisted of young people. Their protests are organized not by large organizations but by social media.

Ms. McShan noted that looking through history, every time change has been made, it has come about through young people.

Ms. Guerrero-Cantor brought up the idea of creating a special project on this issue – research-based or action-based – that could be a deliverable for the committee. Dr. Radzik suggested taking this idea up in a committee phone call. Mr. Tripp noted that the committee had been leaning toward a group mentorship.

Ms. Leonelli commented that the California Mental Health Planning Council (CMHPC) is also very interested in this issue. Their Continuous Systems Improvement Committee, which she staffs, will be having presentations at their San Diego meeting in January. Ms. Leonelli offered to provide CMHPC support to the CMMC. She also invited all CMMC members to the meeting.

Dr. Radzik stated that the committee’s second issue is recruitment: the committee needs another Emerging Leader. Committee members are reaching out to possible candidates from the DHH population.

Ms. McShan suggested recruiting a young African-American male.

The group discussed having six people on the committee rather than five.

Mr. Tripp noted that the original process was time-consuming. He suggested delegating authority to the committee to make recommendations that they would bring back to the full coalition for approval. There were no objections.

Dr. Radzik moved on to the topic of retaining Emerging Leaders. Does the CMMC really support them? Taking a day off work to attend CMMC meetings can be difficult for some young people. Could there be a stipend or honorarium to help offset the financial burden; or weekend meetings?

Mr. Gilmer supported the idea of a stipend from the CMMC.

Dr. Radzik announced that the next morning at the hotel, Mr. Tripp was offering a training (a deliverable) for the Emerging Leaders on suicide. All CMMC members were welcome.

A second option for a deliverable would be participation in the State of the State Report – inform, assist, analyze data, and so forth. Another option would be to explore taking research work and sending a person to give a presentation at a conference. These would both be resume-boosters for an Emerging Leader.

Mr. Gilmer commented that when TAY youth come to speak at MHSOAC meetings, they have the attention of the Commissioners. We need to co-empower young people to be up front in this way.

Ms. Hiramoto acknowledged the work of Mr. Nakama for the excellent presentation he had given.

Ms. McShan stated that she would like to hear the Emerging Leaders be able to speak in their own voices as Mr. Nakama had.

Mr. Tripp gave an overview of his upcoming training entitled “Suicide Talk.”

Mr. Lafollette mentioned some eclipsing issues: school shootings, the gun industry’s response, racially-involved violence. The overall delivery of mental health services is still stuck in the early twentieth century. It is an unprecedented time for recovery consumers to be in the forefront in demanding basic sound policy in mental health.

The group established that the proposed stipend for Emerging Leaders had been recommended to be brought before the committee to be fleshed out, then brought back to the coalition as a whole.

VIII. MHSA Assessment and Recommendations Committee Report

Co-Chair Michelle Alcedo reported on the following.

The committee is well into coordinating the State of the State Report V. The next topics are Self-Identified Women and Transition Age & Older Adults.

Ms. Alcedo directed the members to the draft list of Key Informants for both groups. The committee hopes to have interviews completed by the end of January. The lead for Self-Identified Women will be Ms. Reynoso unless someone else steps forward (the lead’s job is to conduct one or two interviews).

Ms. Elliott asked if anyone had a reaction to the term “Self-Identified Women” – she asked for emails on the subject.

Mr. Mitry voiced interest in the term; are there Self-Identified Men as well? Ms. Alcedo assured him that there were. The term refers to people who have a different gender identity than the one assigned at birth.

Ms. Guerrero-Cantor shared that when she had interviewed Dolores Huerta, the first question Ms. Huerta had asked was the meaning of “Self-Identified Women.” Ms. Guerrero-Cantor agreed with Mr. Tripp that some clarification of the term was needed.

Ms. Mikalson stated that she was not totally comfortable with the title. Somewhere in the report an explanation of who or what a woman is would be warranted. Ms. Alcedo said that while no transwomen are being interviewed, people who work with transwomen are.

Ms. Alcedo answered Dr. Radzik that all the interviews will utilize the same list of questions. Dr. Radzik requested to interview transwoman Christina Quinonez; the committee was pleased with that idea and will discuss it.

Mr. Aguirre asked if the purpose of the report was to explain what providers seeing, or to give the consumers’ perspective. Ms. Elliott responded that because of time limitations, the committee intended to speak to providers/community experts rather than going out to the trans community; but of course transwomen themselves could be included.

Ms. Elliott requested confidentiality for the interviewees. Before publishing, the committee will call to obtain permission to use names. Mr. Nemr suggested to have the Key Informant list collected at that point in the meeting.

Ms. Alcedo supplied the definition that she had sent to Ms. Elliott and Ms. Reynoso: For the purpose of this report, the term “Self-Identified Women” is intended to include transgender/transwomen, cisgender women, and others who identify themselves within the spectrum of the gender identity of women... Ms. Alcedo continued with the definitions.

Mr. Nemr asked if the term was common. Ms. Alcedo replied that in her place of employment they use the term regularly to expand the notion of gender, in order to attract a broader community of people who can benefit from their services. Mr. Nemr preferred using common language that can be understood by everyone.

Mr. Aguirre felt that emerging language is acceptable language; it provides an opportunity to educate the general public.

Ms. Hiramoto confirmed with Ms. Alcedo that the term includes traditional women who have been born as women.

Ms. Alcedo answered Ms. Leonelli that “cisgender” refers to someone whose gender identity is congruent with their earth-assigned gender.

Ms. Mikalson stated that the term “cisgender” was invented because of the need for an opposite to “transgender,” in the same way that the term “heterosexual” came after the term “homosexual.”

Ms. King asked if this was the last State of the State Report and was answered that it was not.

Mr. Gilmer stated that if the committee is proposing a new term and thereby educating the public, they might touch base with a few more individuals to get a feel for whether they identify with the term or not.

Ms. Alcedo said that the intention behind introducing the term “Self-Identified Women” was to broaden rather than create confusion. This definition was not final for the report.

Mr. Tripp mentioned another term: “Self-Identified Third Gender,” denoting an individual having both masculine and feminine energy and spirit.

Ms. King commented that another term has been well-embraced in the native community: “Two-Spirit.” However, some two-spirited community members do not like the term.

Mr. Mitry noted that OHE now has a new page called “Stakeholder-Generated Reports.” It includes information about the CRDP Strategic Plan and the five priority populations. He wondered if the CMMC State of the State Reports might be appropriate for that page.

Kimberly Knifong from OHE said that she would be happy to take this proposal to OHE leadership.

Ms. Alcedo informed Mr. Mitry that the MAC Committee is working on a dissemination plan. They hope to have it fleshed out by the next time the CMMC meets.

Ms. Alcedo continued that the MAC Committee was hoping that the CMMC would approve their Special Report topic of PEI Regulations; it would highlight the involvement and extensive work that the CMMC has been doing.

(The committee was asked about the Transition Age and Older Adults section of the State of the State Report. Ms. Alcedo confirmed that Mr. Mitry would speak about the topic. She added that the committee would look at the term “Transition Age.” Mr. Mitry suggested “Transitional Aging Adults.”)

Ms. Reynoso clarified that the Special Report is not a State of the State; it is an additional deliverable of the MAC Committee. It is shorter – about five pages – and it is supposed to deal with a policy issue.

Ms. King stated that as evaluations are an important part of Phase 2 funding, the CMMC could look for opportunities to provide technical assistance at the local level to Phase 2 grantees on their evaluations.

Ms. Elliott said that there is indeed a Strategic Plan deliverable for that; the exact question is What is the role of the CMMC in assisting with evaluation? She requested Ms. King’s assistance in fleshing out ideas. Mr. Gilmer volunteered to participate.

Dr. Radzik asked how the State of the State links in with the earlier topic of population disaggregation of data – it seems as if there is overlap. Ms. Reynoso replied that this report would highlight the work the CMMC has done on the topic.

The group clarified for Ms. Knifong that the CMMC is not considering doing a State of the State Report #6.

Ms. Kosier established that no CMMC member opposed the topic of “The CMMC & PEI Regulations” for the Special Report.

Ms. Reynoso spoke about the poster presentation given at the American Public Health Association (APHA) meeting. As OHE and CalMHSA had presented on MHSA initiatives, Ms. Reynoso felt that the CMMC should also attend in order to push for dissemination of all its work. Ms. Hiramoto said that for a CMMC member to attend the last APHA meeting, the compiled cost had been too high.

GENERAL PUBLIC COMMENT

Ms. Leonelli inquired about how to discern whether evidence-based practices are effective. Ms. King responded that this was a great opportunity for the CMMC to elicit responses from all of the populations that something is working. The populations can be empowered to think in ways that work for them; best practices can now be validated with their own sense of evidence. The result can be that best practices are sustained.

Ms. Leonelli agreed, but cautioned that it will take another few years for the whole CRDP process to go into effect. She said that the MHSOAC and the CMHPC were currently meeting so that their joint task force could establish priority indicators for determining change, progress, and success in mental health treatment. She wished that the current CMMC conversation could be heard over there to contribute its multicultural perspective.

Mr. Mitry stated that he had briefly attended their Performance Indicator workgroup that afternoon. He had brought up the importance of having them measure disparities, as one of their goals is about timeliness and access for cultural communities. They had supported Mr. Mitry’s point.

Mr. Tripp affirmed Ms. King’s statements. She had thoroughly questioned whether the Native American community had been able to vet the CRDP evaluators. Mr. Tripp noted that the community-based evidence and model were not based on ethnically diverse underserved and non-served communities. These issues have been ignored for years and years.

Ms. King commented that the CMMC is in the role of educating the system that is trying to change – not just pointing out what is wrong. How do we do evaluations that honor and respect the community being studied? Participatory research is probably the best answer, but has it been vetted in the community? The CMMC is in a position to serve as advocates for these communities.

Ms. Mikalson agreed with the comments of Ms. King and Mr. Tripp. She had attended three out of the four community forums, and observed a deep concern about how culturally competent, sensitive, and aware the evaluation team will be. Even the designation of promising practices for the pilot projects needs to be examined.

Mr. Tripp announced that the Sacramento Valley Two-Spirit Society has been founded by Jacob Dunlap of the Sacramento Native American Health Center. Mr. Tripp is serving as a volunteer assistant and consultant. The new organization held a successful Spoken Word event in November where poets shared their writings.

ADJOURN

Mr. Gilmer summed up the meeting as a great one with lots of synergy and good dialogue. He appreciated how the members value one another.

Mr. Gilmer adjourned the meeting at 4:20 p.m.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download