Meeting Minutes of

The Governor's Council on Behavioral Health

1:00 P.M., Tuesday, November 13, 2007

The Governor's Council on Behavioral Health met at 1:00 p.m. on Tuesday, November 13, 2007, in Barry Hall's Conference Room 126, 14 Harrington Road, Cranston, Rhode Island.

Members Present: Richard Leclerc, Chair; Neil Corkery; Leo Cronan; Sandra DelSesto; Mark Fields; James Gillen; Mitch Henderson; Peter Mendoza; Anne Mulready, Karen Kanatzar; and Reed Cosper.


Members Present: Craig Stenning and Gene Nadeau, Department of Mental Health, Retardation and Hospitals (MHRH); Mary Ann Ciano, Department of Elderly Affairs (DEA); Elizabeth Gilheeney, Department of Justice; and Colleen Polselli, Department of Health.

Staff: Corinna Roy, Mary Ann Nassa and Elena Nicolella.

Guests: Maureen Mulligan, Melissa Siple, and Lisa Clark.

Once a quorum was established, the Chair, Richard Leclerc, called the meeting to order at 1:10 p.m. After introductions were conducted, Richard entertained a motion to accept the Minutes of October 11, 2007. Peter Mendoza motioned to approve the minutes and Sandra DeSesto seconded the motion. All were in favor, and the minutes were approved as written.


Sandra DelSesto distributed a summary of the October meeting's PowerPoint presentation in Word RI Council on Behavioral Healthcare Youth Advisory Board Proposal (See Attachment I).


Richard opened discussion regarding recommendations members may have regarding some of the suggestions made at the last meeting involving youth on the Governor's Council on Behavioral Health and the details of how that would work.


Sandra reviewed Attachment I which reflects the goals and objectives that were illustrated in the PowerPoint presentation of October 11th. Sandra introduced Maureen Mulligan, the Director of the Rhode Island Teens Institute out of Initiatives for Human Development to answer any questions. Based on an issue raised by Mitch Thompson about the importance of having youth input into the decisions made by the Council, the Youth Advisory Board suggested a format that would provide comprehensive input. The format would establish a Youth Advisory Board of the Council on Behavioral Healthcare with specific goals and appropriate staff support with a process by which the information would be shared and used by the Council. Jessica Lopes, Assistant Project Coordinator at Initiatives for Human Development (IHD) who attend last month's meeting suggested that separate more convenient meeting times two to four times a year be arranged for example, after 3 p.m. Sandra stated at the October meeting Janet Anderson mentioned that she had a grant under which she might be able to provide some support to this venture. Sandra also appealed for a stipend of $10 to $20 per meeting for transportation and refreshments.


Anne Mulready asked if it would be possible to retrieve feedback from youth who actually utilize behavioral health services. Sandra stated that one of their tasks would be to do focus groups with youth that were receiving services.

Maureen Mulligan added that it would be a group effort with adult support. They connect through e-mail and the Teen Institute has a My Space page that they communicate through beyond the meetings. Sandra stated that the Council would be expected to pose key questions to them about behavioral health, and they would decide on their own venue for answering the questions.


Richard suggested that a linkage be made with DCYF to query other existing advisory groups. Sandra stated that at the last meeting Janet seemed to think that this was different. Richard stated he would not want to repeat the process. Karen Kanatzer asked about the timeframe for its development. Sandra stated that if the Council approved with a stipend, she could see it getting started in January of 2008.


Corinna asked what kind of staff support was being sought after. Sandra stated within the budget, it would be a small amount of money to pay a person to mentor the group who is experienced working with youth. She suggested that in the beginning that a Behavioral Health staff person to introduce them and enlighten them regarding the responsibilities of the division and the Council.


Richard Leclerc stated that the key questions are funding, establishing a charter work for the group and coordinating information from DCYF so that there are no reinventions of their work. Richard stated that without these fundamentals, the Council will need to reconsider.


Richard suggested that the Council take a moment and think about any issues and ideas that would be good for this group to undertake.


Reed Cosper stated that with all apologies, he does not believe during this budget cutting that it serves the Council's mission to support money to have youth input into useless endeavors and that we should be discussing money going to address the needs of homeless mentally ill people. Therefore, as the planning board, Reed thinks that we should talk about how to spend the resources that are available and how to redefine ourselves as something other than just another interest group.


Karen Kanatzer suggested that the kids be asked how the system has failed them. She believes there is some very valuable information that can be learned. Karen mentioned that the Parent Support Network has an active youth group called Youth Speaks, and they have a youth director and an assistant. They give public presentations both nationally and throughout the state. Sandra suggested in converse that they ask the question "Where has the system supported them."


Craig Stenning stated that we need to look at the general landscape and allow them to describe what they think their strengths and weakness and gaps may be. Because of the specific focus on youth, he thinks that the issue of under age drinking and driving needs to be explored because we continue to respond to it from an adult perspective.


Richard and Craig noted that changing the meeting times may cause a problem with creating a quorum. Richard suggested that a meeting could be held outside of the Council meetings with members of the Council to attend to listen to presentations and information.


Richard suggested that an ad hoc committee be formed to look at priorities and format along with retrieving information from DCYF regarding available funds. Karen Kanatzer, Mark Fields and Elizabeth Gilheeney volunteered to serve on the ad hoc committee along with Richard. Richard asked Corinna to invite the entire council via e-mail. With the holidays approaching, he suggested that a meeting be held prior to the next meeting. Sandra DelSesto stated that she would contact Janet Anderson regarding the funding.



Based on recommendations made at the previous meeting, the following individuals volunteered to serve on the subcommittee which would meet two to three times between January and July to review what should be included in the block grant application: Mitch Henderson, Neil Corkery, and Liz Earls who was volunteered by Neil, Anne Mulready, and Sandra DelSesto. Richard stated that everyone would be notified and included via e-mail.


Jim Gillen made a suggestion that a full-scale public media campaign be launched with a positive face on recovery. Richard stated that in terms of the block grant there are statutory requirements and obligations that could vend to such a project. He suggested that a subcommittee be created with a recommendation to come forward.


Craig Stenning stated that this is an issue that has merit, and approximately six years ago there was a media campaign called "Change Your Mind," which was a well-funded initiative and ongoing for a three-year period. Craig stated that these types of initiatives are very expensive and the difficult part is coming up with the funding. He emphasized that these are the kinds of endorsements that need to continue because of the constant changes which occur every five years in a new population, a new set of parents, a new set of kids, and a new set of decision makers. Corinna Roy stated that there may be some opportunity for some funding through the Access to Recovery Grant (ATR) because there is a need to do some public notices related to trying to get providers and other community members involved in it. Jim Gillen asked if there would be a public launch for the ATR grant. Craig stated yes there will be and is included in his report to follow.


Corinna reported that she would be submitting the implementation report on December 1.



No one was available from DCYF to make a presentation.



Craig reported that it is a critical time for Rhode Island with regards to federal funding because SAMSHA is up for reauthorization. All of the federal grant programs that fall under SAMSHA are also up for renewal in regards to their authorizations. Recent information from Washington is that all of SAMSHA appropriations were attached to another larger appropriations bill, and it appears that if it passes in this format, it will probably face a Presidential veto. After a conference call scheduled today at 3 p.m. with all of the state substance abuse directors, Craig may have more information to report.


Reed Cosper asked if there was any information Craig could report on the Medicaid Rehab Option. Craig stated that they are still in the process of reviewing the comments that each state has submitted. Craig stated if the Council would like a presentation on Rhode Island's comments about that it could be arranged at the next meeting.


Craig reported that they have been able to meet all of the benchmark deadlines for the first 30 days of the ATR grant which were basically a laundry list of federal forms and requirements and submissions that needed to be made. He stated that they are still on target for a February initiation of individuals actually in treatment receiving vouchers. On Thursday, November 15th the first general open meeting will be conducted at DATA with faith-based organizations (See Attachment II Letter of Invitation to Meeting of Faith Based Community Organizations). There have been a number of detailed meetings over the past 30 days with DCYF and the Department of Corrections (DOC). Meetings have been conducted with the federal technical assistance people who will be helping with the establishment of the mechanics of the voucher, as well as Government Performance and Results Act (GPRA) other data requirements that are necessary.


Craig reported that there will be a public kickoff at some point in the future and Wesley Clark, Director of the Center for Substance Abuse Treatment, has asked to come to Rhode Island to initiate the kickoff himself. Craig is waiting to set up a date agreeable for both his office and the Director's office. This would not only be a media kickoff, but would also include half-day training for both recovery providers and treatment providers. Craig anticipates this will happen some time in December.


Sandra DelSesto asked what defines recovery providers. Craig stated that it is a broad definition. In the application, examples of recovery services were listed and from within the field, it is anything that was once called case management or support services. Therefore, it could be transportation, daycare, babysitting, some time of initial housing support, a security deposit or the first month's rent but not ongoing housing. Craig stated that it could be any wraparound service where people that we have never been able to fund in the past, can be included. Craig reported that most states within the first round of states spent more in their vouchers in the recovery aspect than they did in the treatment aspects of it because the treatment capacity aspects of it has to be new capacity. Current capacity that is being funded either through state or federal dollars cannot be planted. Craig added that in the area of treatment, it is just as broad in definition. Craig stated that the full-range of treatment services that are currently either available or can be licensed will be available for an individual if that the assessment indicates that need, and any provider regardless of whether or not they have received funding in the past or not are eligible. The recovery providers will be certified to receive the vouchers. He stated that there is a need to expand the kinds of individuals and agencies that have been involved with that in the past, which will open the field to more faith-based organizations as well as some of the self-help and support groups that have been doing great work but not funded in the past.


Neil Corkery asked if it would expand pharmacological interventions and modalities. Craig stated "no" and falls under one of the few limited areas.


Neil Corkery inquired about the $1 million that was transferred into the budget for corrections. Craig stated that the RFI has been completed and at the Purchasing Office since October 16th and waiting to hear from them. The MHRH staff has been cleared to go to the ACI, and they are set to go when notification.


Craig reported that on Friday, November 9th there was a meeting at Rhode Island College hosted by the Center for Chemical Dependence and Addiction Studies which was designed to help with workforce issues and graduating students with a degree both in psychology and a specialty in addition studies. This program began a few years ago with two graduating students and in the past year's graduation there were sixteen students in the program, and thirty-two students are expected to graduate in this current year. Craig stated that the MHRH staff supports this initiative and there are three major initiatives that MHRH has with specialized workgroups in the area of workforce development, co-occurring populations and cultural competency.


Craig reported that there was press conference held a couple of weeks ago call "Housing Works," that was the highlights of success that has taken place in Rhode Island to try to build support to continue funding of an initiative that primarily with the work done by Riverwood one of the mental health organizations in the project called "Housing First." The concept of this project was to take some of the most chronic homeless individuals who have significant mental health issues and find them permanent support housing without a lot of upfront requirements. Craig suggested that a report demonstrating their success be included with the minutes (See Attachment III).


Richard Leclerc asked about the DHS initiative to have individuals with Medicaid enroll in the plan, Rhody Care, by April 1, 2008. Craig stated that there have been continued discussions, and they are attempting to define what it actually means and how many individuals would not be auto enrolled. Richard asked for the public when is the enrollment date. Elena Nicolella stated that they are still considering April 1, 2008 as the roll out date. Elena stated that DHS anticipates sending notification letters out in February.



All were in favor of the proposed schedule of meetings for 2008 and was adopted (See Final Version Attachment IV).


Reed Cosper stated that a lawsuit was filed about two and half weeks ago from his office to try to address the problem of mentally ill individuals being detained by legal rite in emergency rooms for three to five days at a time with no treatment. He stated that his office has not received any responses to date. He stated that they are trying to do it in an expedited way in order to receive an outcome sooner rather than later. Historically, between 1976 and 2001, if a person was detained in an emergency room under the Mental Health Law with no bed available, they were transported to Eleanor Slater Hospital (ESH) for provisional admission. In 2001 ESH revoked that protocol with nothing in place. They were sued at the time, and came to court with a contract with Butler Hospital. Reed stated that he believes that the problem has worsened with the new contract for the uninsured. Reed stated that he will bring progress reports on the suit to the monthly Council meetings.


Craig stated that because it is an ongoing lawsuit he was advised not to respond to this issue; however, he believes that the Department of MHRH would disagree with some of Reed's statements.



Reed also reported that there is an initiative to consolidate his office with other "so called" human right advocacy agencies, and he stated his opposition to this consolidation proposal.



There was no further business. Upon motion made and seconded, the meeting adjourned at 2:36 p.m. The next meeting of the Council is scheduled for Thursday, December 13, at 8:30 a.m. in the first floor Conference Room 126 at the Barry Hall Building.


Minutes respectfully recorded and written by:


Mary Ann Nassa

Secretary, Governor's Council on Behavioral Health


Attachment I: RI Council on Behavioral Healthcare Youth Advisory Board Proposal

Attachment II: Letter of Invitation to Meeting of Faith Based Community Organizations

Attachment III: Corinna Housing

Attachment IV: Final Meeting Schedule for 2008