How to Start A Peer Driven Room & Board Coalition

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How to Start A Peer Driven
Room & Board Advisory Coalition
Cynthia White, M.F.T.
Chief Advocate, Patients’ Rights
County of San Bernardino
Call to Action
Due to unfortunate circumstances, Room &
Boards came to the forefront of Patients’
Rights attention
Consumers were being taken advantage of in a
variety of ways – fiduciary, poor standards
CoSB-DBH stopped using existing list-which
historically gathered from all over and not
verified
Federal Fair Housing Act
FHA defines discrimination as “a refusal to
make reasonable accommodations in rules,
policies, practices or services , when such
accommodations may be necessary to afford
(handicapped) person(s) equal opportunity to
enjoy a dwelling.”
The Continuum of MH Housing
Independent
Living
Medical ,
Supervision or ADL
Care needed
Stabilization needed
Locked
facilities
Board
& Cares
Room
&
Boards
Housing Costs in SB County
Board & Care *900-$1,086 per month
Def: Facilities that provide 24-hour non-medical care for adults ages 18-59,
who are unable to provide for their own daily needs. Adults may be
physically handicapped, developmentally disabled and/or mentally
disabled.
Room & Board ** $350-$700 per month
Def: a place to live which includes bed, electricity, water and food. For
adults who are able to provide for their own daily needs.
SOURCE: * Community Care Licensing, Title 22
** DBH Homeless Program
Peer Driven Room & Board
Advisory Coalition
Mission Statement
To provide Room & Board consumers a
resource tool to assist in renting healthy, safe,
well managed and quality room and board
housing.
Values Statement
• To recognize the dignity
and worth of all human
beings
• To acknowledge that
clients are the experts of
their experience
• To empower consumers
to develop leadership
skills
• To promote and
encourage consumer selfadvocacy skills
• To facilitate a positive
partnership between
consumer and room and
board operators
• To advocate for
consumers of room and
board facilities
• To educate consumers on
available resources
• To actively participate in
monthly coalition
meetings.
Wellness & Recovery includes…
Steps toward Self Determination
Setting goals for symptom management,
work, education, socialization and housing
Accessing information to make informed
choices
Acquiring confidence and developing a sense
of personal accountability
Being woven into the community
Empowerment is the key!
Wellness and Recovery promotes selfdetermination – including housing choices
Room & Boards are a popular choice among
mental health clients due to:
-Limited, fixed income
-Meals are included
-Socialization opportunities
-Affordability
Client Issues with Room & Boards
 Quality of housing
 Quality & quantity of
food
 Not getting what you
paid for
 R&B operators as the
payee
 Poor or NO record
keeping of P&I money
 Rude and discourteous
treatment from staff
 Arbitrary rules
 Lack of accountability
 “Oral” rental
agreements
 Increased number of
tenants over time
 Arbitrary evictions
R&B Operators had issues as well
 Disruptive behavior
 Agency contacts in the
home
 Unreliable payments
 Destruction of property
 Complaints from
neighbors
 Uncooperative,
demanding tenants
 Drug/alcohol issues
 Security issues
 Police involvement
 Getting a bad
reputation
Provider concerns…
Providers want to be able to provide a location
that is safe and reputable
Ethically responsible for client safety upon
discharge
Housing is essential to client wellness
No means to “report” or “complain” on R&B’s
Seeking solutions that are client centered
Background Work to be Done
Check with your Local Housing Authority for
any considerations
Review city requirements – Fire Clearance,
Business License
Identify a location for regular meetings
Develop goals of Coalition (different than
Mission Statement)
Identify current R&B Operators in county
Seeking out Participants
1) Solicit participants from local Clubhouses
2) Seek current Providers of Behavioral Health
3) Encourage NAMI members to participate
4) Allow community members and volunteers
to join
5) Seek agency participation – e.g. local
community groups, homeless services
6) Find existing R&B Operators
First Steps as a Coalition
 Mission Statement – what are you hoping to accomplish?
 Code of Ethics – define your standards.
Conflict of interest? Adherence to rules necessary for
participation.
 Membership requirements
Application, site review, attendance, fee?
 Define Training Necessary – conduct needs assessment
from Consumers, Operators, Providers
 Develop a Complaint Resolution Committee
Governing Board
• Decide what titles you want to have
Director, Chairperson, Co-Chair and a
Complaint Resolution Committee Chair?
• Establish the guidelines for election and
participation. Establish roles for each position.
• Encourage regular participation so members
can benefit from the trainings.
Additional considerations…
 How often should you hold meetings?
 Where are they to be held? Can they move locations for
large counties?
 How long will the meetings be?
 What are the standard meeting agenda items?
 Define your training schedule after needs assessment is
done and line up presenters
 Remember Cultural Competency considerations
Sample Meeting Agenda
Welcome
New members introduction – Self
PTSD – How to recognize and help – Pts. Rts. Staff
Discharge Considerations – SB Community
Hospital
Recipe of the Month – a healthy alternative
Low Cost Socialization Ideas - Various
Cultural Competency Insights – Office of Cultural
Competency
Other topics we have shared…
Board & Care vs. Room & Board
Depression – Taking positive steps
Communication 101
Preparing for an Emergency – Developing
Action Plans for the Room & Board
Disaster Preparedness – Taking care of those
in your home
Being Culturally Sensitive
The Process
 Consumer seeks independent living arrangement
 List is provided via clubhouse, case manager, or
mental health provider
 Consumer is guided through available options
based on personal needs
 Consumer makes selection and calls for interview
 Consumer makes selection(s) – appropriate
information sheet(s) is provided
 Consumer visits location and enters into rental
agreement with operator
Maintaining the List
Operators are asked to call by Monday at noon
any changes to their vacancy status
New lists sent electronically each Tuesday to
all recipients that have been trained on the
process – (note: operators do not get lists)
Operators can be suspended or removed
from list if they do not comply with Coalition
guidelines.
Paperwork…
Interest/Application Forms
Site Review Forms
Complaint Resolution Form
Room & Board Comparison List
Lessons Learned…
 Membership drive must be ongoing
 Operators stop attending once their houses
become full – have a participation policy
 Develop Resolution Committee quickly
 Line up several presenters of information based
on training needs assessment
 Provide a consistent day and time for attendance
 Be willing to “hand over” the process to the
community
Questions?
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