NYS OMH’s Multicultural Advisory Committee (MAC) meeting

I participated, together with other members of The Citywide Mental Health Project (Bert Coffman was wearing his many hats), in the MAC meeting (via phone conference) this last Tuesday. What follows is my personal take on the meeting discussions. These are the headings:

Who attended the meeting?

Where are the consumers?

Topics discussed

SH, crime in SH and licensing

Changes to the SH Guidelines = No CAB (consumer advisory boards)?

Who attended the meeting?

Ms. Moira Tashjian, Director of OMH’s Housing Development department attended the meeting by invitation of the committee, although I have the distinctive feeling that OMH wants her to be in this cultural committee, even though housing per se is not a ‘cultural’ issue directly. If I understood correctly, she will be attending the monthly MAC’s phone conferences. I welcome her participation and consider it a plus for us to be able to ask questions directly to officers of the OMH.

There were three (?) providers of supported housing (SH) services from different NY regions: Mr. Huygen from the NYC area, I didn’t get the names of the others, sorry.

Where are the consumers?

Apart from me and my group (Bert Coffman was wearing his many hats), there were no other recipients of services or their representatives. This is a salient point given that this ‘advisory’ committee, as all State and citywide mental health ‘consumers advisory boards’, are for the purpose of ‘giving recipients a voice in our mental health-policy-making system’. I’m sure you can guess why I put those words in curly marks. Read my document The elephant in the NY State mental health system if you can’t guess it.

The lack of consumers (I will call them ‘recipients’ from now on because ‘consumers’ does not describe what we are in this system) participation, in my view, make these boards de facto tools for the providers. Do they need these policy tools when they already have trade organizations and high paid lobbyers, and when they DIRECTLY help write many of the rules that affect us?

I know that Mrs. Frances PriesterMoss (coordinator) is trying to increase recipient’s participation in the committee. I have some ideas that would guarantee participation, but it requires for Ms. Tashjian to help us with the CABs in the programs. More on this below.

Topics discussed

SH, crime in SH and licensing

Ms. Tashjian informed us about all the new projects for housing for the mental health community. I believe her report will be made available soon for public information. She also went over what I call OMH’s SH ‘licensing’ scheme. As some of you know, I have asked her to explain to the public why more than three-quarters of housing are being privatized by un-licensing them, and to tell them that unlicensed means not regulated and no legal rights for the ‘tenants’ in it.

I didn’t get the answer I was awaiting from her. Actually, the whole enchilada about SH and unlicensed housing got more entangled when she discussed the issue of what level of ‘functioning’ is required for each category of housing.

Some of the providers brought the issue of recipients with history of violence been referred for SH. Ms. Tashjian alleges that a history of violence and low functioning are not impediment for acceptance into SH. I claim she is in the wrong there.

OMH is as explicit about levels of functioning requirement for each housing modality as its contradictory actual practice is. Just go online and read OMH’s RFP (request for proposal), each requests spells what type of ‘population’ a particular SH project is made for. This issue of housing people with severe mental health problems in SH, which is for people more ‘stabilized’ and able to function in the community with less supervision (that’s why OMH makes them ‘unlicensed’)  has been discussed in court many times, the last time was in the DAI v. NYS OMH case.

I didn’t want to raise the issue due to not enough time, but I did mention that this policy of housing people with violent history makes the CABs in the programs a necessity so that we can help the providers develop ways to cope with the situation.

I asked her if she was aware of the May incident where a recipient of SH in Brooklyn was murdered INSIDE the building by the woman’s also SH recipient lover. She said she ‘heard’ about it. Did anyone blink? Was the incident reported, as mandated,  to her for investigation on quality of services (could it have been prevented, etc.)?

Look, there is not enough housing to comply with OLMSTEAD, so OMH has been ‘dumping’ (excuse the expression) everybody everywhere. Just as it did when the people demanded to close the chambers-of-torture called psych hospitals of the 1970s; the state dumped the patients to the street. Now, they dump everybody in the few housing. OMH doesn’t care about the ‘unintended’ consequences of its policies. The courts tend to protect them.

There is not enough housing (money goes to ‘stupid wars’), it’s a policy issue. We NEED to discuss this policy as a community.

 Changes to the SH Guidelines = No CAB?

The SH Guidelines will be “updated”, according to Ms. Tashjian, (shall we say) ‘modernized’ to live up to the new millennium (my words). Are the current ‘guidelines’ that state that providers of SH must allow for consumers to participate, this is a direct quote, “in the policy making of the program” to be eliminated?

Ms. Moira brought this information about the changes when I asked her if she could help us to make providers comply with that guideline. She said that she needed to do more “research” about these CABs. I asked her directly to tell me if she was intending to eliminate that particular guideline; her answer was that she couldn’t answer at this point until she reads the guidelines.

When I asked her if she is mandated to inform the recipients about these changes or call for public comments before making the changes, she said that “the providers will be informed”. The context of the answer is that the “SH Guidelines” is for the providers. Whatever changes made will affect you without your consent or knowledge.

I think I also told her that I would consider eliminating the CAB provision to be a BETRAYAL to us recipients of mental health services. I may have used the word “BACKSTABBING”, I don’t remember which one I used. I was just blown away when she mentioned the changes to the guidelines. You can imagine.

None of the providers took a stands to protect the CABs.  I hope they were as blown away as I was and will stand with us if OMH tries to eliminate the CABs provision.

But, more than anything, I hope that Ms. Tashjian has the presence of mind to NOT take a step that will be construed as an attack on our right to have a voice in the programs.

In a time when we are been blamed for the violence in our society, we need to INCREASE our voice, NOT TO HAVE IT SILENCED.

The CABs inside the programs would allow us to reach out for the recipients that OMH supposedly wants to be integrated in the policy decision-making system; it would allow us also to spread information to them. With the problem of lack of housing and having to mix recipients with differing ‘functioning levels’ CABs make more sense as a tool to help maintain quality of services. Working with the providers, the CABs could save $$ to the state by using the rich human power energy and experience currently going to waste and untapped in these programs. Voluntarism can be organized through CABs to improve quality of services.

The only reason I can see for OMH to eliminate the CABs is if they are afraid that we will bring to light all the issues of abuse, disrespect and neglect in the SH programs of all types.

Should they do it, it will confirm my claims that our mental health system functions within a culture of abuse.

Let’s work together to stop the stigmatization and abuse of people with mental disabilities.

NY elections: Gambling, propaganda and empty skulls. (Updated: Empty skulls applies to the people of Washington State.)

Yeap. This is going to be one of those testy posts.

NYorkers voted 57% in favor of making the state a casino mecca.

How did they make that decision?

The same way that the Washingtonians voted against their own interest and defeated a bill that would have required the labeling of genetically altered foods: they listen to the mermaids singing. In NY- politicians like Gov. Cuomo and state legislators who themselves got millions in campaign donation from foreign fat casino moguls.  In Washington, Monsanto and other corporations spent 0ver 11 millions in the campaign. We the people have NOTHING to win in these bets, only the moguls and our ‘misleadership’ (as the  guys from Black Agenda Report call politicians) win.

There will be homegrown compulsive gamblers, billions of dollars will be sucked out of the state to the foreign homelands of the moguls… Money spent in  casinos is money that does NOT circulate in the community. Don’t expect your misleadership to tell you that.

No significant $$ goes to mental health services to treat the compulsive gamblers because, hey, we want you to gamble, why cure you? That would cut into the profits.

There’s a reason why OMH in NYS, as in many other states, compulsive gambling is NOT considered a mental illness.  Your compulsion doesn’t qualify you for any services because, well, the government took you by the hand to the doors of perdition (with advertizing and ‘regulating’ casinos’ comps) knowing that casino gambling creates addiction and destroy lives. Admitting that gambling is addictive and a disorder that requires services would be admitting that it is the government who is causing this problem.

Good luck. You are going to need it.

But what do you expect? These are the same politicians (Cuomo) who told you they were creating an Ethics Board to keep our bureaucrats honest, but then decided, after you were not paying attention, that it was not such a great idea after all and ‘sabotaged’ themselves. See Cuomo’s Office is said to rein in Ethics Board he created.

Oh well.

With marijuana, at least you can claim it is ‘medicinal’. What positive effects on your body can you claim about gambling on machines fixed to suck your money out of your pockets with their hypnotizing visual ‘themes’ and repeated-at-nauseum ringtone-like excerpts  of famous TV shows songs? With loaded dice and roulette balls? Jobs? Really? Have you studied the stats of job creations by casinos in NJ? I mean REAL stats, not the ones cooked for you by the misleadership. And don’t ask me for the data now, it’s too late for that. Go look it up yourselves if you want to know.

What’s the point of digging the right data and the right interpretation of the data for you  if you are going to listen only to the magic words of your elected misleadership ‘come, trust me, it’s good for you’?

Propaganda is like  the flakes we sprinkle over the water in the fish tank for the captive, starved fishes: they look up and say ‘yum’ and go in an eating frenzy an eat and eat a lot of nothing mixed with water and start pooping all over the tank. Well, something like that, sort of. Ok, bad metaphor.

Look, the point is that propaganda is like a solvent that melts your brain and leaves your skull empty ready to receive  anything that the politicians and the corporations want you to do. People don’t think, they follow instructions.

People, YOU MUST THINK.  WAKE UP.

New York State Lags on Firing Workers Who Abuse Disabled Patients

In this NY Times article, Mr. Hakim seems to have understood that there is no point in arguing against the mental health system, or OMH/OPWDD. He threw the proverbial towel on them and is now focusing on the unions. The state came with a new law (Justice Center) that is more of the same loopholes to protect everybody but leave us VOICELESS. It’s a SCAM is what it is. The unions are the tip of the iceberg of the culture of abuse in the NYS mental health system.

Let’s be fair: the mentally ill is food for the big and small sharks equally.

Look, in ALL of the mental health system’s rules, old and new, the MANAGEMENT and PROVIDERS are off the hook from responsibility for abuses on the recipients of services. Abuses happen in their watch. Some of them are directly responsible for abuses, and most of them ENABLE the abuses. It’s what I call ‘the culture of abuse in the mental health system’.

Under those conditions, I too would want the union to stand for me if the supervisor, who knows what I do and laughs at it, is going Scot free.

The Justice Center was intended to stop the NY Times ‘complains’ AND to avoid the federal government from doing an investigation on the state’s practices. That explains why the Justice Center is WORSE than what we had before: now people THINK that SOMETHING was done with the issue of abuse when in actuality it’s worse.

Nothing was done. It just made it MORE DIFFICULT for us to report, and it provides MORE protection to the ‘providers’ and workers. There is LESS transparency.  See my comments to the Justice Center law in this blog.

OMH privatization of the mental health system, Cuomo’s surrendering the functions of government to the private sector, THAT’s where the problem is, politically speaking.

A policy system per logic has to put the responsibilities of failure of the policy on those who write and enact them. In this case, the NYS OMH/OPWDD system. Privatizing, reducing the mental health workforce and reducing their salary and benefits is a recipe for disaster. You can’t write ‘moral codes’ (as Justice Center pretends will do)  for those workers you hire  because, them been the lowest of the lowest, you know they are the cheapest.

I think Mr. Hakim should take a closer look at how the system protects the providers and managers. They are the one who must respond for their ENABLING abuses.

 

Fighting terrorism: governments brand citizens as terrorists.

See this week’s news headlines:

“Thousands fill German streets to protest Berlin’s NSA spying involvement”

“EU’s response to NSA? Drones, spy satellites could fly over Europe”

“Kiwis on the march: Thousands turn out against new spy powers in New Zealand”

“Fracktivists: At least 15 arrests at anti-fracking rally outside London”

“US approves drones for civilian use”

“FBI admits to flying drones over US without warrants”

The point? Governments have stopped functioning for the people and have become the toys of the big corporations. What the people want is totally IRRELEVANT to our ‘leaders’. The representatives of corporations in governments have branded their citizens as ‘terrorists’ that need to be spied-on 24/7.

That’s why in the USA,  NY State Office of Mental Health has turned the names of all people in the mental health system to the FBI.

It’s all related, it’s not COINCIDENCE.

Cuomo Agrees to Plan for Housing Mentally Ill, Ending Legal Battle

This is breaking news in the NY Times. Cuomo Agrees to Plan for Housing Mentally Ill, Ending Legal Battle

This is an agreement to ´right´the wrongs committed by many NYS adult homes providers and that NYS judge that made that appalling decision in the case DIA v NYS-OMH etc in April last year. This agreement is a step forwards towards moving the people in those ‘homes’ of horrors to the community.

Am I personally happy and satisfied with this? I don’t go jumping with joy without first taking a quick glance to the text of the so-call ‘agreements’ and new laws to ‘protect’ people with disabilities of all kind. Why? Because one thing are the sound bites we get in the media about how great a new law is, another is the TEXT and the IMPLEMENTATION.

Now, with this agreement, everybody relaxes and forget about it. Just like with the Justice Center, we will assume that the government is looking to protect us. Nothing happens unless you threaten the government. Not even this agreement, the result of years of court battle with the state.

OK. I will NOT sour your joy. IT IS A STEP in the right direction.

I will tell you where we must put caution in this agreement.  You can read the agreement on your own here courtesy of Judge David L. Bazelon Center for Mental Health.

Suffice it say that the agreement WARNS those Adult Homes providers previously caught abusing the mentally ill that they should not interfere with their residents in this process of moving them out, or they ‘will be punished’. Adult Homes are going to lose $$ and they want to keep their houses of horror filled. That there is a NEED for a warning to them should tell you a LOT. (See page 8, part 4 in the agreement.)

First quick notes:

From “definitions” (pages 4 and 5):

1. You have to be 65 years old or under to qualify for the benefit of the agreement.

2. The agreement MAY take 4 or 5 years to be completed. If you are 62 now and you HAVEN’T been relocated within the next two years, you may not qualify anymore. Or at least the agreement doesn’t clarify that. This is a question that those of you in Adult Homes (AH) MUST ask the people involved in this agreement.

3. As usual, the agreement applies to AH that are LICENSED, per Social Services Law Article 7. If you are in an unlicensed one, you may have problem qualifying for the agreement. YOU MUST SEEK CLARIFICATION ABOUT THIS.

4.  AH with LESS than 80 beds do not qualify for the agreement. It (“transitional AH”) has to have 80+ beds AND  a “mental health census” of 25%. If you are in a small AH, you may want to confirm that it qualifies for the agreement.

5. “Impacted” AH are those in NYC with 120 beds or more AND a mental health “census” of 25%  of the population of the AH.

MENTAL HEALTH STATUS: Not so fast baby.

To qualify, a mental health evaluation to measure your level of functioning will be implemented. This is where the ENACTING may go astray, leaving people who are not dysfunctional ‘enough’.

1. Must have a mental diagnosis based on THE MOST RECENT DSM book.  I would say, tread with caution here.

• ‘what if I my diagnosis is not in the book anymore? They removed some and added new ones.’ See my point?

2.  Excluded from the agreement are people with developmental disabilities, mental illness due to brain damage, and “SOCIAL CONDITION”. I’m as lost as you are on that last one. Looks like a loophole to keep people in. Must check the DSM bible for clarification.

3. “Must have a  SUBSTANTIAL FUNCTIONAL disability WITHIN the PREVIOUS 24 MONTHS before the date of the agreement.” Do you know what a “substantial”  functioning disability means? I suggest you look it up if you want to get out of there. Plus, it is ‘within’ the last 24 months of the agreement. Better check it out how that may affect you too.

4. Who will determine your disability, your substantial functional levels that will ALLOW them to put you in a supported housing?

• a determination by SSA that you receive benefits due to mental illness will not be enough.
• A “Health Home agency” AND a  MLTCP (managed long-term care Plan) will be in charge of the process of evaluating your qualification for the agreement. Even if SSA says you are disabled, these people may determine that you are not ‘substantially‘ dysfunctional and may disqualify you. See #5, subsections (b) i and ii on page 5.

So don’t assume that you automatically qualify to be relocated out of the AH just because you are there.

“PERSON-CENTERED PLAN”. Where have I heard that before??

Right, those of us in Supported Housing (SH) are struggling with “person centered support”. Welcome to our struggle. But, I will NOT deny that chances are that, if you make it to a SH, you may be better off than there. Just don’t come here thinking ‘wow, I made it. I’m out of danger’. Nope.

Now, I couldn’t find the dates for the agreement. If any of you find that info, please, forward it. It’s important to you, if you are in one of those homes,  because of the transition schedules. You don’t want to be left out.

My take about this:

1. This is a good step forward.

2. ALL THESE PEOPLE who are coming to the community are going to face the reality of what we have here: SH is over 80% unlicensed. This means, you have NO LEGAL PROTECTIONS there. People centered treatment does not exist. It’s a craps shoot.

3. the ‘culture of abuse’ that exists in those AH will relocate in the community, following our new ‘freed’ peers, with those workers who will get jobs from there to here.

4. TODAY MORE THAN EVER  we need to ORGANIZE our people. For ‘people centered ‘ services we NEED TO BUILD THOSE CABs.

5. Never has the state given ANYTHING without a fight. The NYS WILL BE crying ‘BROKE’ to avoid completing this agreement and creating housing for them. If you want to trust them 100% despite what history shows us, fine.

This is my first reaction to the agreement. Sorry if I sour your joy. I doubt it, though.

CONGRATULATIONS TO THE FORMER DIA.

GOOD WORK.

Welcome And good luck for those of you moving here to the community ‘with us’.

Like we used to say in the ’60s: the struggle continues.

Re: NYS Law 7400 creating the Justice Center for the Protection of People with Special Needs#5

29 3. (a) when any allegation that could reasonably constitute abuse or 30 neglect is received by the register, the register shall accept and immediately transmit notice of the report orally or electronically to the appropriate state oversight agency and, as appropriate, to the director or operator of that facility or provider agency. (i) upon acceptance of a report of abuse or neglect by the vulnerable persons’ central register, promptly commence an appropriate investigation;

I know it looks as if I were against everything, but that is not the case. It’s difficult for people who have been entangled in the bureaucratic web while trying to resolve problems with it to not recognize the problems that these ‘new solutions’ create. Case in point, the above quote from the BILL 7400.

This new bill eliminated the Commission on Quality of Care because the commission was doing nothing. The commission would receive complains and dismiss them as ‘not reasonably constituting abuse’. By their own account in 2011, out of a bit less than 10k complains, they “screened” only 250. That means that they found the other 9k plus complains to be ‘not reasonably constituting” abuse. Yet, the commission was eliminated because there was abuse and they did nothing meaningful, they even didn’t include the cases denounced by the NY Times because those cases were in ‘not licensed’ programs and not licensed programs were not part of the commission’ surveys.

So now a clerk is going to receive some complains over the phone and make a decision right then and there that the complain “reasonably constitute abuse”. Then “(i) upon acceptance of a report of abuse or neglect by the vulnerable persons’ central register, promptly commence an appropriate investigation;”. That means that if they don’t accept the report, nothing will happen.

Think: do you have any idea of how difficult it has been for LAWYERS to convince JUDGES in civil court that an act constituted abuse? The Justice Center came as a result of the inability of our courts to protect these people. A whole agency (CQCA) was banished for doing a terrible job, but some how A CLERK OVER THE PHONE WILL DO A BETTER JOB AT ASSESSING THAT A REPORT CONSTITUTE ABUSE!. I’m not screaming, I’m just highlighting!

I just don’t see it, how is this bill any better at preventing abuse. I’m waiting to get someone to enlighten me.

Re: NYS Law 7400 creating the Justice Center for the Protection of People with Special Needs#4

30 (d) all records of the proceedings, the deliberations of the justice center medical review board and any testimony given before the board shall not be subject to disclosure under article thirty-one of the civil practice law and rules.

 43 s 556. functions, powers and duties of the board. (a) make a preliminary determination whether the death of a patient or 47 resident in a residential facility within the meaning of subdivision 48 four of section four hundred eighty-eight of the social services law, 49 which has been brought to its attention is unusual or whether such death 50 reasonably appears to have resulted from other than natural causes and51 warrants investigation;

The first quote from the new law tells you that the deliberations of the medical review board are closed to you just like an Inquisition, they are SECRET. The second quote tells you that you have no right to see on what basis their determinations about a death of a person under a provider’s care doesn’t warrant investigation. Well, it doesn’t say so, you just have to put the first quote together with the second to arrive to that logical conclusion. If the deliberations of the board are secret, “not subject to disclosure”, and they decide that a death doesn’t warrant investigation but you think it does, you can’t challenge their determination because you don’t know what it’s based on. Maybe you can challenge but it will be blindly because you don’t know which facts to challenge. And since you have no right to sue because there’s no cause of action allowed nor sue for damages, you are basically out of luck (assuming you are the living person).

So, what is this law achieving in terms of your rights to determine whether a loved one died due to negligence of the provider? Nothing. It only PROTECTS THE PERPETRATORS.

As I continue reading, I will make any corrections on my interpretations based on other facts I find in the many pages.

Re: NYS Law 7400 creating the Justice Center for the Protection of People with Special Needs

Those people who, like me, have had the misfortune of  having to represent themselves without a lawyer (pro se) in court, can tell by scanning through the new NYS bill purporting to ‘protect’ the “people with special needs” that it is simply more bureaucracy on top of old bureaucracy. Actually, the new bill makes it MORE DIFFICULT for these “people with special needs” to protect themselves. This NYS senate bill 7400 is basically a bill of rights FOR THE PERPETRATOR.

Again, I’m not a lawyer or anything of the sort, I’m simply expressing my opinions. But don’t take them as correct;  go ahead, read the new law! That’s a challenge, my friends, literally. It’s a challenge because the bill will challenge your ulcers, so to speak.
THE MOTHER OF ALL LOOPHOLES

Loopholes are the bread and butter of those who lobby our politicians. Lobbyists either draft the bills they want for their professional gains and give them to our lawmakers to sign, or lobby to draft loopholes in the bill if it is being created to control them. Well, you tell me if this is not like the mother-of-all-loopholes:

there shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any person on account of participating in good faith and with reasonable care in the communication of information in the possession of such person to an incident management committee, or on account of any recommendation or evaluation regarding the conduct or practices of any agent of a facility or provider agency.

The first loophole is in these words: good faith and reasonable care. Do you have any idea of how DIFFICULT it is for advocates (forget for the pro se!) to prove that a perpetrator, in any situation, but more so in mental health systems, acted NOT with good faith  and such perpetrator was ‘unreasonable’ in his/her professional behavior? The opposite of the legal concepts of good faith and reasonable care are ‘malice‘ and ”negligence‘. Well, good luck in trying to prove that a provider’s actions of ignoring an ongoing abuse in his/her facility was nothing but ‘unreasonable care’.

According to this bill, to convince the judge to accept to take a look at your complain, you first must PROVE to the judge that the provider was reckless and negligent. Otherwise, the case will be thrown out because this law states that you have NO CAUSE OF ACTION against a provider whose ‘errors’ are expected as part of the risks of the profession. In other words, instead of having a case to prove that there was negligence, you must prove that there was negligence to have the case heard in the first place.

The second loophole is in the fact that if the provider ‘misinforms’ the ‘investigating committee’ you have to prove that it was intentional. In other words, this bill tells you that from the outset you have no cause of action for damages, and that it is YOUR duty to prove that the information that should have been in a report but isn’t (or was misleading), was intentionally unreported.

I understand that people should be ‘innocent until proven guilty’, but the problem with this bill is that it TAKES AWAY YOUR RIGHT TO TRY TO PROVE YOUR CASE. You are simply being barred from court. Before this law, you could go and try to prove that there was negligence. Now you have to prove that you have a right to try to prove that you have a case. And the parts about ‘no cause of action for damages’ and ‘no monetary liability’ guarantees that hardly any private lawyer will take your case even if s/he can prove real damages.

Yeap, the new bill is protecting someone who is not you. Guess whom it is protecting?

Outline of the origins of the mental health Consumer Advisory Board

This is how I understand the historical development of the consumer advisory board (CAB):

Two events mark the origin and background of CAB:
a) the beginnings of our Federal public mental health policy system (‘mhp’ from here on) and
b) the Willowbrook Consent Decree.

Part I:
A: Beginnings of Federal Public Mental Health Policy System
1) No FEDERAL mental health policy existed before the 1960s because:
a) States controlled mental health services up to that time and
1.  their focus was on funding psych hospitals as the only place for treating the mentally ill.
2. support was for the  psychiatric profession only.
b) because Americans distrusted the federal gov dictating the states what to do. Sounds familiar?

2)  Pres. Kennedy credited with initiating the Fed mental health policy system.
a) started with address to Congress Feb 5, 1963.
b) the process he used was typical of the policy making
process: he ordered a study/research about the situation of the mentally ill in the nation, created a committee to advice him on solution, and presented to Congress his decision on how to try to solve the problem.
c) his focus was on:
1- De-institutionalization of psychiatric in-patients
2- moving them and services for them to the community
3- Prevention
4- assigning funds for those services. By assigning funds, he committed the government to his plan to solving the problem of mental illness.

That same year (1963) Congress passed his Community Mental Health Act: In that way started the federal public mental health policy.

3) His policy consisted in:
a) offering money to the states to participate in his policy, but the money came with a catch:
b) in exchange for the money, States must create an Advisory Council that would:
1. advice the states on what services the mentally ill needed and
2. include protection and advocacy as part of services.
3. be composed of, among others, consumer reps. This is the first federally mandated state mental health advisory council.

In this way WE got into the newly formed Fed mental health policy system.

4) Nine years later came the Willowbrook court case (1972). The
Consent Decree (agreement) stated:
“1. This Board [CAB] shall participate in the development of Willowbrook’s philosophy, goals and long term plans, advice the director on a regular basis…”
2. Membership shall include…residents or former residents.”

This CAB was not a mandate to other institutions but served as a model to our nation’s efforts to recover from the haunting history of state-run houses of horror for the mentally ill.

Summary:
These two events (fed mental health policy and Willowbrook) show how:
a) WE were called to participate at both levels of the nation’s new public mental health policy system: at the state and at the facility (program) levels.
b) the background behind the push to create CAB was:
1. Abuses at state’s facilities (policy of states’ ignoring the abuses).
2. Creation of fed mhp as a response to those abuses.
3. A recognition (implied in the laws) that without PARTICIPATION, the mentally ill were doomed to be oppressed by the same mental health institutions/facilities created to serve them.

This new federal policy and CAB were created for US, NOT for the PROVIDERS. There is no language there referring to CAB as an ‘ancillary’ organism in the policy system; CAB is an INTEGRAL PART of our mental health policy because it was meant to be used by us to coordinate with the providers the program’s policies to prevent abuses of power by providers (private and government).

Part II: THE PROMISE CONTINUED
This promise of participation of the mentally ill in the mental health system continued with almost the same language, with all the other Congressional acts that followed Kennedy’s and Willowbrook. For example:

1- McKinney Act: [July 22, 1987]

-Section 11386: “BY REGULATION each provider must provide PARTICIPATION  of…homeless or former homeless…INCLUDING on the BOARD OF DIRECTORS or other EQUIVALENT POLICY MAKING entity of the  PROVIDER…[no money to the provider] “unless provider agrees – to involve the individuals and families THROUGH  employment or volunteer services in the CONSTRUCTING,          MAINTAINING and OPERATING THE PROJECT.”

[How many of you have participated in the “constructing or operating” of your supported housing?]

2- OMH Supported Housing Guidelines (Appendix Goal 4) says that providers must provide us with “formal input into program and policy decisions”.

Thus, de-institutionalization brought the services to the community and we were promised a place at the TABLE! a VOICE in the system to be heard and to make decisions on matters that affects us.

We have even being given the MECHANISM to do that:
a) the state advisory council
b) and the CAB!! But not allowed to use it as intended.

Instead:
– Willowbrook’s CAB turned into end-of-life decision-making
body for these people. NY State passed this bill:

“authorize the CAB to make end-of-life decisions… [for people] who lack the capacity to make their own health care decisions.” NYS-S3169 Feb 10, 2011

That bill shows how important and the extent to which CAB can be used: Consumers together making important decisions. [We wouldn’t use it to make “end-of-life decisions”, though. We don’t need death panels.] But this mechanism is being hidden from us, maybe because it is too powerful a tool to leave in the hands of the ‘loony’? We can ‘decide’ euthanasia for someone else but not how to devise a grievance procedure for us in our programs?

Part III: Policy systems

Definition of POLICY:
1. An informed CHOICE
a) in response to some problem in the agenda of government or organization.
b) includes all DECISIONS /NON-DECISIONS to do something
about the problem: it‘s a conscious decision. As when the federal and state governments chose to do nothing at the beginning of the AIDS crisis, or how states did nothing to protect those being tortured in psychiatric hospitals up to Willowbrook and even today are examples of policy: doing nothing or policy of inaction.

2. The IMPACTS of those decisions are part of the study of the policy intentions; they are FEEDBACK! Always part of policy analysis because of:
a) POTENTIAL FOR INFRINGEMENT OF INDIVIDUAL’S RIGHTS by the policy enacted.
b) CAB are part of that feedback to the policy system’s process. THAT’S WHY WE MUST PARTICIPATE on them.

Part IV: The CORE FUNCTIONS OF PUBLIC POLICY

There are three: Assess, policy development, and assurance. These functions will be used by the City-wide Mental Health Project to assess how CAB in our programs are fulfilling the purpose for which they were created.

Not all of the essential services under each function will be used because we do not have the capacity at this time.

A: Assessments
1. Establish goals to solve problems we identified in prog.
2. Test those solutions
3. Assess the impact
4. Use the results

B: Policy development
5. Inform, educate & EMPOWER our people about the
problems we confront in the program.
6. Mobilize our community/create partnership with
others
7. Develop/plan intervention strategies and support
for our efforts.

C: Assurance
8. Enforce laws and regulations
9. Link people to services needed/GOVERNMENT
10. Evaluate the effect, accessibility and quality of services.
11. INNOVATIVE SOLUTIONS.

This outline and plans to empower our CAB will be reviewed and further developed through out this month.