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HomeMy WebLinkAboutMINUTES - 06221993 - IO.5 J To: BOARD OF SUPERVISORS I .O.-5 5E ` Contra FROM: INTERNAL OPERATIONS gOMMITTEE Costa County y,ati� 40 DATE: June 14, 1993 _ .. A C'(1U'T SUBJECT: APPOINTMENTS TO THE MENTAL HEALTH COMMISSION AND RELATED ACTIONS SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1 . ABOLISH the existing Mental Health Advisory Board, effective June 22, 1993, pursuant to the requirements of AB 14, Chapter 1374, Statutes of 1992, and express the Board of Supervisors ' profound and sincere thanks to the members of the Mental Health Advisory Board for their dedicated service to the County and the mentally ill residents of this County. 2 . ESTABLISH a Mental Health Commission of 16 members, effective June 23, 1993, to serve in an advisory capacity to the Board of Supervisors . 3 . INDICATE that the Mental Health Commission shall be constituted as follows : One member of the Board of Supervisors shall be a member of the Mental Health Commission and shall serve for a three-year term or until replaced by the Board, of Supervisors on the recommendation of the Chair of the Board. Each member of the Board of Supervisors shall have three nominations to the Mental Health Commission. 4 . DESIGNATE not less than four seats on the Mental Health Commission for consumers who are receiving or have received mental health services and not less than four additional seats for the parents, spouse, sibling, or adult children of consumers who are receiving or have received mental health services . CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD FFT APPROVE OTHER SIGNATURE(S): C, SUNNE WRIGH� McPEAK ITH ACTION OF BOARD ON June 22, 1993APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED Contact: PHIL BATCHEO .CLERK OF THE BOARD OF cc: See Page 5 SUPERVISORS AND COUNTY ADMINISTRATOR BY �'� ( DEPUTY I I .O.-5 5. STAGGER the seats on the Mental Health Commission so that the initial appointments include a one-year appointment, expiring June 30, 1994; a two-year appointment, expiring June 30, 1995; and a three-year appointment, expiring June 30, 1996 from each supervisorial district. 6 . SPECIFY that, after the initial terms expire, all terms shall be for three years . All terms shall expire June 30 in the appropriate year. 7 . DETERMINE that, in order to. insure that the appropriate number of consumers of mental health services and family of mental health consumers are seated on the Commission, the individual members of the Board of Supervisors shall forward their nominations to the Internal Operations Committee, which will retain the right to interview the nominee(s) and insure compliance with the compositional requirements and the ethnic diversity recommendation in State law. The Internal Operations Committee shall only be able to return a nomination to a Board member in a situation where appointing that individual would violate State law or would create a substantial ethnic diversity problem in terms of the composition of the Commission. 8 . AGREE that, following the initial appointments to the Mental Health Commission, each Board member is encouraged to involve the Mental Health Commission in all subsequent recruitment and screening for applicants . All future vacancies will be filled in the same manner, by forwarding the Board member's nominations to the Internal Operations Committee for its review and subsequent recommendation to the Board of Supervisors . 9 . DETERMINE that the duties of the Mental Health Commission are adequately defined in Welfare and Institutions Code Section 5604 .2, specifically to include only the following: * Review and evaluate the community's mental health needs, services, facilities, and special problems. * Review any county agreements entered into pursuant to Section 5650 of the Welfare and Institutions Code. * Advise the governing body and the local mental health director as to any aspect of the local mental health program. * Review and approve the procedures used to insure citizen and professional involvement at all stages of the planning process. * Submit an annual report to the governing body on the needs and performances of the County' s mental health system. * Review and make recommendations on applicants for the appointment of a local director of mental health services . The Commission shall be included in the selection process prior to the vote of the governing body. * Review and comment on the County's performance outcome data and communicate its findings to the State Mental Health Commission. * Assess the impact of the realignment of services from the State to the County on services delivered to clients and on the local community. * The Board of Supervisors reserves the right to assign additional duties or authority to the Mental Health Commission from time to time. -2- I.O.-5 10 . DECLINE at this time to place any absolute limits on the number of terms a member may serve on the Mental Health Commission, while encouraging Board members to take into account the length of service of members when making recommendations for appointments to the Commission. -, 11. RECOGNIZE that the following appointments do not provide the degree of geographic, racial or ethnic diversity that the Board of Supervisors would like to see on the Mental Health Commission and request each member of the Board of Supervisors to carefully consider the need for greater geographic, racial and ethnic diversity when making appointments to those seats whose term of office will expire June 30, 1994 . 12 . DETERMINE which member of the Board of Supervisors should be appointed to the seat representing the Board of Supervisors on the Mental Health Commission, for a three-year term ending June 30, 1996 . 13 . APPOINT the following individuals to the Mental Health Commission, as nominated by the Supervisor indicated, to the type of seat indicated, for the term of office indicated. Representing Supervisorial District I : Joan Bartulovich 7102 Donal Avenue E1 Cerrito, CA 94530 Type of seat: Family member Term of office: June 30, 1994 Taalia Hasan 1300 Amador Street, Room 18 Richmond, CA Type of seat: Family member Term of office: June 30, 1995 Cynthia Miller 105 Jose Lane Martinez, CA 94553 Type of seat: At-large Term of office: June 30, 1996 Representing Supervisorial District II : Patrick A. Risser 326 Glacier Drive Martinez, CA 94553 Type of seat: Direct Consumer Term of office: June 30, 1996 Marie Goodman 3331 Brookside Drive Martinez, CA 94553 Type of seat: Family member Term of office: June 30, 1995 Dennis Lepak 2730 Geneva Street Martinez, CA 94553 Type of seat: At-large Term of office: June 30, 1994 -3- I.O.-5 Representing Supervisorial District III : Wayne E. Simpson 897 Dolphin Court Danville, CA 94516 Type of seat: Family member Term of office: June 30, 1994 Suzanne Strisower 3159 Lippizaner Lane Walnut Creek, CA 94598 Type of seat: At-large Term of office: June 30, 1995 Ralph Hoffman 60 Saint Timothy Court Danville, CA 94526 Type of seat: Direct consumer Term of office: June 30, 1996 Representing Supervisorial District IV: Violet Smith 1103 Temple Drive Pacheco, CA 94553 Type of seat: At-large Term of office: June 30, 1994 Joan Sorisio P.O. Box 612 Clayton, CA 94517 Type of seat: Family member Term of office: June 30, 1995 Veronica Vale 4819 Clayton Road, #16 Concord, CA 94521 Type of seat: Direct consumer Term of office: June 30, 1996 Representing Supervisorial District V: Maria Puente 2212 Peppertree Way, #1 Antioch, CA 94509 Type of seat: At-large Term of office: June 30, 1996 Linda Trowsdale 2824 Honeysuckle Circle Antioch, CA 94509 Type of seat: Direct consumer Term of office: June 30, 1995 Anne McClarren 99 Adams Court Oakley, CA 94561 Type of seat: Direct consumer Term of office: June 30, 1994 BACKGROUND: Law enacted in 1992 requires a substantial reorganization of the Mental Health Advisory Board (MHAB) . This law is AB 14 (Chapter 1374, Statutes of 1992, amending Welfare & Institutions Code Section 5604) . In the past, the MHAB was required to consist of 17 members with a variety of tightly controlled professions and other categories which had to be represented. Because of the need to insure that Individuals were representing the proper category, most appointments to the MHAB went through the Internal Operations -4- I .O.-5 Committee in order to insure that they met the proper criteria. In addition, the MHAB has traditionally been heavily involved in recruiting candidates for the MHAB, interviewing all applicants and then making recommendation to the Internal Operations Committee for subsequent recommendation to the Board of Supervisors . The new law substantially liberalizes the composition of what is now called the Mental Health Board (MHB) by eliminating the specific professions which must be represented. However, the law requires that: "Fifty percent of the board membership shall be consumers or the parents, spouse, sibling, or adult children of consumers, who are receiving or have received mental health services . At, least 20 percent of the total membership shall be consumers, and at least 20 percent shall be families of consumers . " The name of the new Board is also changed from the Mental Health Advisory Board to the "Mental Health Board", although the Board of Supervisors is allowed to constitute the Board as either an "advisory board" or "commission" . The size of the Mental Health Board is also left up to the Board of Supervisors . While the law specifies that the Board shall consist of 10 to 15 members, it also indicates that, "Nothing in this section shall be construed to limit the ability of the governing body to increase the number of members above 15 . " In addition, the law requires that, " . . .there shall be an equal number of appointees by each member of the board of supervisors. " Finally, the law requires that one member of the Mental Health Board shall be a member of the Board of Supervisors. On March 16, 1993, the Board of Supervisors declared its intent to abolish the Mental Health Advisory Board and establish a Mental Health Commission which complies with the amended State law. Each member of the Board of Supervisors has been asked to nominate three individuals for appointment to the Mental Health Commission. The above recommendations will establish the new Mental Health Commission and make the necessary appointments. These appointments will leave the newly constituted Mental Health Commission heavily concentrated in Central County and with a lack of adequate ethnic diversity, the vast majority of members being Caucasians . We are, therefore, urging Board members to keep this in mind in nominating members a year from now for the seats whose terms will expire June 30, 1994 . cc: County Administrator Health Services Director Acting Mental Health Director Pat Russell, Secretary to the Mental Health Commission Diane Frary, Staff to the Mental Health Commission County Counsel Auditor-Controller -5- X0, S s --------- BOARD OF SUPERVISORS CONTRA COSTA C01LJNTY TOM POWERS 0 '• 1}4 SUPERVISOR,FIRST DISTRICT SOT;,• =_-, .�. T'4•COUil� CONTRA COSTA COUNTY MEMORANDUM RECEIVED MAY I 1993 DATE: May 10 1993 �T y ' OFFICE OF TO: Internal Operations Committee COUNTY ADMINISTRATOR FROM: Supervisor Tom Powers SUBJECT: Mental Health Commission The following are the names of three individuals I recommend for appointments to the Mental Health Commission: ' Taalia Hasan Joan Bartulovid"'I Cynthia Miller 100 -37th STREET, ROOM 270 • RICHMOND, CALIFORNIA 94805-2136 • TELEPHONE (510) 374-3231 FAX (510) 374-3429 E CONTRA COSTA COUNTY fi .. .... MENTAL HEALTH ADVISORY BOARD 595 CENTER AVENUE,SUITE 200 MARTINEZ,CAUFORNtA 94553-4639 :25 Phone(510)313-6414 Sp9- ---------- co April 23, 1993 Supervisor Tom Powers District I 100-37th Street, Room 270 Richmond, CA 94805 Dear Supervisor Powers: On March 16, 1993, the Board of Supervisors approved the AB 14 (Chapter 1374, Statutes of 1992) implementation plan which abolishes the current Mental Health Advisory Board (MHAB) effective May 25, 1993, and forms a sixteen (16) member Mental Health Commission. The MHAB has advertised, recruited, screened, and interviewed candidates for the Mental Health Commission. To represent your district, the MHAB is forwarding its two (.2) recommended candidates with suggested terms of office for each candidate. The appointments must be staggered in one, two, or three year increments. our recommendations are based on the AB 14 requirements for commission composition, which includes the following: 1. Members shall be Contra Costa County residents; 2 . One member of the Board of Supervisors shall be a member of the Mental Health commission and serve for three (3) years; 3 . A minimum of four (4) members shall be consumers who are receiving or have received mental health services; 4. A minimum of four (4) members shall be parents, spouse, sibling, or adult children of consumers who are receiving or have received mental health services; 5 . Other members shall have knowledge of the mental health system; 6. Composition shall reflect the ethnic diversity of the client population in the county; and 7. No members of the commission or his or her spouse shall be a full-time or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCorquodale contract agency. A351 (10/91) Supervisor Tom Powers April 23, 1993 Page 2 1 Further Mental Health Advisory Board/Commission requirements include the following: 1. Members shall be 18 years of age; 2 . Members shall be available for late afternoon meetings; 3 . Members shall participate in at least one standing committee; 4. Members shall participate at least ten (10) hours per month; 5. One member shall function in the Child Advocate role and chair the Children's Committee of the Commission; 6. One member shall function in the Older Adult Advocate role. You must select three candidates, who together meet the total of the legislation's requirements. The MHAB's recommendations to you are based on the required total Commission composition. The persons selected from your district are as follows: Joan Bartulovich Taalia Hasan Family Member Family Member One-year term Current MHAB Member Represents ethnic diversity Two-year term Attached are the two applications of the full complement of candidates interviewed from your district by the .MHAB. We will continue to recruit for one more West County representative. Please make your final selection and forward the nominations to the County Administrator's office by Wednesday, May 5, 1993 . If you ish to discuss this with me, I can be reached at 313-4101, or you may wish to discuss with the MHAB staffperson, Diane Frary, who c n be reached at 232-7139. Si r , Dennis Lepak, Chair pr Attachments cc: C. L. Van Marter Mark Finucane Lorna Bastian or e Ai r&*0 e.d YK el CONTRA COSTA COUNTY �d/�//✓/t �� ;-_ MENTAL HEALTH COMMISSION APPLICATION FORK F-40a fxded y PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 .1) Describe your experience and knowledge with the Mental Health system. 2) Who is the Supervisor from your district? 3) List the community board(s) or volunteer activities in which you have been involved. 1. 5. 2. 6. 3 . 7. 4. 8. 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month.) 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30.) YES NO (over) 6)Please, check the cate(joriaa in which you fit. , (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member oft the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 1" 3. souse of a past or current consumer of mental health services. 4. sibling of a past or current consumer of mental health services. fir U.,J� 44- " 5. Adult Child of a past or current consumer_ of mental .health services. 6. Knowledge about, and interest in, mental health--services = 7) What do you believe you can/will contribute to the Mental Health Commission? Joan Bartulovicfi - 7142 Dona!Ave. ADDRESS: EI Cerrito,CA 94534 CITY: / } l PHONE: C < Q 1 � >ORM.AP' Pat Russell: My handwriting is terrible, but-I do have a pc, which is why I have made this separate page. Your kind indulgence. 1. My experience with the mental health system: The first time John Jr. had a psychotic break, about age 14, he was hospitalized in Kaiser Richmond. No doctor mentioned schizophrenia (perhaps because they knew it would mean John's expulsion from the system). Neither did they say it was substance abuse related. Subsequently he was hospitalized at Kaiser a second time. We thought John's problem was because he was "neurologically handicapped." About age 20, when he was still in high school, he became eligible and began receiving SSI and Medical. During the five years he had a private psychotherapist AND a private psychiatrist, he thrived. About 1984 I first heard the word "schizophrenia," but the psychiatrist did not mention AMI or any support group. When providers refused to accept MediCal, John began to decline severely and has never achieved what tie had at that time. He was hospitalized in Martinez briefly where Dr. Hartog mentioned AMI. We joined AMI-CC in 1986. After several "5150's" in which he was immediately released to the streets without care, in 1988 we finally managed to get a "5150" to stick and John was placed in Crestwood for a year and a half. Upon release he was placed in Nyumba Chuki in Richmond, which was a disaster. He also attended Partial Hospital and later Rubicon, both of which he hated because he is a "normal dult" and not like the others. He has been board and cares since Nyumba, except for two months in unsupported independent living in a retirement home in Oakland which was beautiful, but his lack of assertive skills made him easy prey for the criminals in the neighborhood. He let them into the building; they stole everything he had, copulated in his bed, and threatened him with bodily harm if he did not submit to sexual abuse. He says he bought them off with cigarettes. He continues to have his meds prescribed by Dr. Fidler of Partial, but does not participate in psychotherapy, vocational training, etc. A second son, neurologically handicapped, with attention deficit disorder, not a consumer of any MH services or SSI or MediCal, is about to go to prison. 2. Tom Powers is the Supervisor of our District 1. 3. Please see attached summary 3.1 AMI-CC (Chair, Housing Committee) 3.2 CANHC-ACLD various board positions 3.3 St. Mark's Church, Richmond (formerly) 3.4 St. John the Baptist Church, El Cerrito, (30 years) not on council, but devoted. 3.5 Rubicon Housing Committee Advisory to Board. I would like to be on HIP's Advisory Committee when they form it. 4 and 5: Until the end of 1993 I can give as many hours as required. After 1993 I can give as many hours as any other working person, but WILL be able to attend meetings as early as 3 p.m. 6. See your sheet. 7. See attached summary: Investigating funding for supported independent living, advocacy, lobbying, creating awareness of mental illness. qt6 _i�4 f vtj rl .. J� . ... �/e ..•vim. - . ';CONTRA COSTA COUNTY ADVISORY BO, .ARDS, COMMWIONS OR COMMITTEES K�z �t�a APPLICATION FORM rnlriFSii: ;Fii:Il3�i%rrur:tii.v ti.. Name of advisory board applying for Pet, 4CAV/ e Q Application Form must be typed or hand printed. ��- Name of Applicant: Joan Bartulovlch 7102 Donal Ave. Home Address: El Cerrito,CA 94s3o Home Phone: Business Address. — or one. Signature. ew Date: Personal Experience, Skills and Interests Education/Background: Occupation (student, for pay work, not for pay work, retiree or similar): Community Activities: Special Interests: Information: L File completed application with Clerk of the Board, m 94553. artinez, CA . 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 4. Meetings may be held either in the evenings or during the day, usually once or twice a month. 5. Some boards assign members to subcommittees or work groups requiring additional time. hMw i ne rsoard of Supervisors Contra gid*'"a County Adm�ntstratiori Building ,Lo �� cAA tax�rrt 651 Pine St., Room 106 cou Martinez, California 94553 fty Tam Power, 1st Disuict Nancy Q Fanden,2nd District PAVm L Schroder,3rd District Swm Wright McPeak,4th District Tom Tonakson,Sth District r The County Board of Supervisors has established advisory beards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications_ If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following; 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be . considered; and 3. File the completed application with,the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. 9 Phil Batchelor, Clerk of the Board Joan Bartulovich V 7102 Donal Avenue El Cerrito, CA 94530 (510) 529-1134 MAR 8 1993 CONTRA COSTA CCUNTY SUMMARY ACAMH ADMINISTRATION Because two of our three children are neurologically handicapped, I joined the California Association for Neurologically Handicapped Children(later merged with the national Association for Children with Learning Disabilities) 27 years ago and served on the CANHC-ACLD board for about ten years until I went to graduate school and received scholarships from the Orton Society to study diagnosis and remediation of the learning disabled. Our younger son, barely literate, also has attention deficit disorder. The elder son was diagnosed schizophrenic (dual diagnosis) in 1984. In 1986 I joined the Alliance for the Mentally Ill (National, California, Contra Costa County, and recently FAMI of Alameda County) and the American Schizophrenia Association. I have been involved in advocacy, lobbying, and creating awareness. This year, as newly appointed chair of AMI-CC's Housing Committee, I am studying about special needs housing, supported independent living, foundation grants, and proposal writing and visiting residences for the mentally ill in Davis, San Jose, Stockton, Richmond, etc. Our house is the site of AMI's West Contra County Care and Share meeting (the fourth Monday of the month, 7 p.m.). EDUCATION M.A. Education, Secondary and Post-secondary, San Francisco State University 1979 Reading Specialist Credential (K through 12), SFSU, 1979 Early Childhood Education Specialist Credential, SFSU, 1973 B.S. English, University.of San Francisco, 1965. EMPLOYMENT At the present time I am entertaining a career change and spending my time as I wish. 1980-1993 Medical Research Department, Miles Inc. Berkeley. Secretary. Formerly grants administrator. Used WordPerfect, Lotus, GEM to wordprocess protocols for clinical studies, papers for journals, statistical and technical reports, spreadsheets, graphics for case report forms for clinical studies and for poster presentations at scientific meetings. 1978-1980 Los Medanos College, actually in employ of Pittsburg Adult School. Taught developmental reading, basic education, basic survival skills and GED to adults (15 to 57) with cerebral palsy, learning disabilities, etc. 1973-1978 Berkeley Unified School District- teacher primary grades and Adult School. ET - CONTRA COSTA C(jIIN'1'y MENTAL HEALTH COMMISSION APPLICATION FORK FA�iG y PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH C014MISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. C'0 Y`V C l VN-V c S c7 G i` i7 r 1—�r5 � G��wvL F-� �.h✓� 2) Who is the Supervisor from your district?. p p •ate� - 3) List the community board(s) or volunteer activities in which you have been involved. — . r. '.t 1�_ -L s. . 2 • 1 @�JC�% .� 6. 4. e,,�AL-�A u �e�(.v►�i , a . 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month.) 5) Are you able to attend late afternoon meeting (NOTE: Mental Health Commission meetings are held at 4: and all committee meetings are at 3:00 or 3:30.) YES NO (over) 6) .,,.Please chock the catego=ies - in Which you fit, (NOTE: As per . the Mental Health Commission Bylaws, no member of the board or. his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract .. agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a pa or current consumer of mental health services. 7__ 3. Suouse of a past or current consumer of mental health services. 4. sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental health services. _ 6. Knowl a about, and. interest .in, mental health :services 7) What do you believe you can/will contribute to the Mental Health Commission? / & n- rc vl X D_ Vf VC. 40 tL 4U, 4 ADDRESS. CITY: \� y PO y •. : 1:ONTRA COSTA COUNTY ADYLSORY,BOARDS, COMMISSIONS OR GO&Q1r nTm. : Name of advisory board applying for Application Form must be typed or hand printed. Name of Applicant: 0'a_kV6_ �kc o_ 1 Home Address: Home Phone: Business Address: 13 Co AYYu"Cr t4 V-M AT Work Phone:,510 Signature: Date: 3-- ?ersonal Experience, Skills and Interests Education/Background: (�nde ,rc�uc�-e cl�f�, P�bllGt�c�Mln��'�o+n. Ftp _r_&Y'S in P05++t0As., huwxa_A �)-e_yuwcs Occupation (student, for pay work, not for pay work, retiree or simflar): 'E,,4evelfiZCc Community Activities: _ (Yr ember' p f Qom" +A gnat A aA� Geo\, +0 p emar raA-k t✓. PcLY"i-y 5. 5� 6_-Ak-f 1 Cann N\VA --rz Special Interests: au k6, �Rar-� � i �Y1� I v\.k4,k�P 1L��.�' a � poor CAAA\dY e_n c_V-\_4 +V)-P,\r I vti af-cez5%h, u Ca ��4 o aformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups req=ng additional time. County Administration Building' 851 Pine St., Room 108 ; Martinez, Califomia 94553 Tan Powers, ist District Nancy C.Fanden.2nd 0sstrirz Hobw L Schroder.3rd District Sunne Wright MCPeek.Ah Oistrxx Tom Todakson,Sth Oistnct The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject .matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors snakes appointments from among those who submit applications.}. _... _- = Jf you are interested, live or work in the county, tr and have the necessary time, you may wish to submit an application. If so, please do the following,- 1. ollowing1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board COUNTY ADMINISTRATION BUILDING CONTRA COSTA COUNTY 651 PINE STREET,ROOM 108A n BOARD OF SUPERVISORS MARTINEZ,CA 94553-1293 (510)646-2080 FAX(510)646-1396 F I1N JEFFREY V. SMITH SUPERVISORIAL DISTRICT TWO MEMORANDUM Date: June 9, 1993 To: Claude Van Marter From: Nancy Hobert, Jeff Smith' s office Subject: Mental Health Advisory Board Appointments The persons selected from District II for the Mental Health Advisory Board are: Pat Risser (Direct Consumer) 326 Glacier Drive Martinez, CA 94553 372-4725 Marie Goodman (Parent) 3331 Brookside Drive Martinez, CA 94553 372-0545 Dennis Lepak (Public) 2730 Geneva Street Martinez, CA -94553 228-2797 (home) 313-4101 (24 hours a day) . . ..CONTRA :COSTA :.COUNTY _MENTAL'HEALTH COMMISSION- .�/[ �•1 SC/�•Q APPLICATION FORM 60 IN it f Cays�.+�rte, PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORM TO MENTAL HEALTH, PAT RUSSELL, 595 CENTER AVE. . SUITE 200 , MARTINEZ. CA 94553 . (Resume optional) 1) Describe your experience and knowledge with the Mental Health System. Jut- 2) Who is the Supervisor from your district? 3) List the community board(s) or volunteer activities in which you have been . involved. (1) R6 aj Inc P-0� 5) wteuj - CO." (2) MR A.J66J. 15�• �.�tiv-c�.c'i-o (6) Aj -ttt �-P. D.S►'v -e1-baa (3).M,s.,,J 4C6,,%"65-n crt- D E -- (4 A c8) P" j--O-e� P - ce" 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE : Mental Health Commission requires a minimum of 10 hours/month. ) 3 0 ,w.a 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30. ) YES NO of r.Lease cnecx the category(s) In WIIJ.C]2 you rit- . '� %_, - . (NOTE: As., per the Mental-._._Health ,:Commission B)F-Laws., ' no member �f .. the,,,-board­orthis or her spouse_ shall . be a full-time or part-tije couAi�-eim'ployee­of a,county-imental.,health zervice, an employee of the-State Department of Mental Health, or an employee of, or a member of , the governing body of , a Bronzan-McCourquodale contract agency. ) (1) Past or Current- Consumer of mental health services. (2) Parent of a past or current consumer of mental health services. (3) Spouse of a past or current consumer of mental health services. (4) Sibling of a past or current consumer of mental health services. Y_ (5) Adult Child of a past or current consumer of mental ff health services. x (6) Knowledge about and interest in mental health services. 7) What do you believe you will contribute to the Mental Health Commission? A UP I GO-E- OWD &XWWCA-I PEP-SPECTIVE AS A ' CL'EQI-4EAtA ILY AJJD &C_TjLfE_ VDLV9-jft-k At4 i Uorg -> z)O ---FOP, A,_qStAW6- V�70 ?AS 155 ME-<- -n ME? 7A I- a r A I-T-H eu Em—( s 12C_ RF_PPfE5EPT'F_t> WS A rPrIk- AIOD At)F_QUkT-k_ M Name: Address: 324 r,-i_AC_I �PL QP_, City: A=T-i tj r-2- I C-R- '74551 Phone: s-7 x- LI -7 A S- 2-23-93 C0WRA COSTA COUNTY ADXLSORl' AOARDS, COMMISSIONS . . APPLICATION FORM. ..- RECEIVED � 2 5 F .me of advisory board applying for Mental He t Application Form must be typed or hand printed. j CLERK BOARD OF SUPERVISORS CON-TPA CneT1 Co. :ame of Applicant: Patrick A. Risser Tome Address: 326 Glacier Dr. Home Phone: 372-4725 Martinez, CA 94553 usiness Address: Work Phone: ignature: Daie: February 23, 1993 rsonal Experience, Skills and Interests ducation/Background: I have twenty years experience as a mental health client. I have worked as a mental health worker on an acute inpatient unit, I hav served on local, state and non-profit advisory boards and boards of directors. Locally, I have been a director for the mental health patient ' rights program and currently sit on the Board of the Mental Health Assn. ccupaton (student, for pay work, not for pay work, retiree or similar): currently unemployed by choice - do occassional independent consulting in the mental health and disability field ommunity Activities: Board member for mental health association and mental health consumer concerns. Member of the Contra Costa Network of Mental Health Clients, member Contra Costa Mental Health coalition, member MHAB ad hoc planning committee xcial Interests:reading in philosophy, science fiction, computer and mental health fields I ormation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. (?,4 JA% . - .� `� ^..V� .. � 'r f �f w,���..,�yY .• ,� . , ,:F .:.. .. �-. ,.. .��,_.y Z _i,�. .. ..... �..� ._ _..�r =. ':. :.. .._: .:: ...': ,'. CONTRA COSTA COUNTY �w KENTAL HEALTH COMMISSION APPLICATION FORK PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE. COMPANION FORM TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER A4ENU'Ey SUITE 200 MARTINEZ,, CA 94553 1) Describe your experience and knowledge with the Mental Health system. (X -BGG -•'C 2) Who is the Supervisor from your "district? � 3) List the community board(s) or volunteer activities in which you have been involved. r r 1. SG 5 6. 2 . 411 3 . 7• 4. 8• 4) Now many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a m,n i mum of 10 hours per month.) 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30.) YES v'r NO (over) 6) Please check the categories in which you fit. (NOTE: As per ` .A '. the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1.. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. r/ 3. spouse of a past or current consumer of mental health services. 4. sibling of a past or current consumer of .mental health services. 5. Adult Child of a past or current consumer of mental health services. 6. Knowledge about, and interest in, mental health services. 7) What do you believe you can/gill contribute to the Mental Health Commission? 61 01 CITY: K{SS'3 PHONE: _337� PORAL." CONTRA COSTA COUN'T'Y ADVISORY=BOARDS, conn MONS"OR-COMMMEES APPUCA.TTON FORM Name of advisory board applying for Application rm must be typed or hand printed. Name of Applicant: Home Address: 3S31 / ' ��' t Home Phone: 37,?- Business Addresss. Work Phone: ------ Signature: Date: Personal Experience, Skills and Interests EducationlBackground: ..4'lC4� Occupation (student, for pay wor�k,,j not for pay work, retiree or similar): Community Activities: Special Interests: •� '`' aformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. s.a ouaro of z5upervisors uOC�I}tra Cotu*y Administration Building 651 Pine St., Room 106 Martinez, California 94553 COJIY TomPa" i st Oistrkt !fancy C.Fand.n.2nd Oistrict 111o0ut L Schroder.3rd District •�f/I Sunnie Wright MCPeak.4th District Tan TatakWn.Sth OistriCt The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs Serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applicatio= . If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following; 1. Review the listing of advisory boards, committees and commissions (set~ back of this letter), and identifv those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board CONTRA COSTA COUNTY r/r���cE �F•• I�� MENTAL HEALTH COMMISSION APPLICATION FORK PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORM TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. s''//Jcc, 9 gs C 02 z- S y m. o �r14A6 rw6 - 1 RI� U(� �2�� • 2) Who is the Supervisor from your district? S/-I/ Tk 3) List the community board(s) or volunteer activities in which you have been involved. 1. 43)T 17j. O L'r�"a x' 13 D • 5. 2 . w,C,c , X0LA mit SenQtUL au2NALf 6. 3 . 6-X(9, yoAlij !FU2-hCG g 7. 4. y YL/ A 1-4- TA S ' 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month.) 20 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4: 0 and all committee meetings are at 3:00 or 3:30.) YES NO (over) 6) Please check the categories in which you lit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. spouse of a past or current consumer of mental health services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental.health services. 6. Knowledge about, and interest in, mental health services. -- 7) What do you believe you can/gill contribute to the Mental Health Commission? kI LJZA) 4t2. 1?-A t J0 � S 1ftttCz,44/t ' CO n 1-17t-L' WC)C-N 0 r5 Ham: ADDRESS: 2-7 3-z) G L,k)t A ST' PHONE: _ I 1 FO r CONTRA COSTA COUNTY ADVLSmr--BOARDS, CONN. OR COrrlff rrEES APPLICATION FORM Name of advisory board applying for Application Form must be typed or hand printed. Name of Applicant.. Home Address: ��3� -'U Ti�12 t Home Phone: .-2-�S Business Address: S° S QQkA C A<` 111/��-�`f' Work Phone: 0) Signature: Date: Personal Experience, Skills and Interests Education[Background: j`s, u o ' Ca Cott..., Occupation (student, for pay work, not for pay work, retiree or similar): Community Activities: /-I NA /3 Special Interests: -1��"A4, fiJ)A 6A- °s 1S j Va A Eitge ' N .fl . i �{ oa►-1.'�C.��`•t S "f CkILVKJCV� rt chiA(., 9 CAU-t 1t fnformation: 1. File completed application with Clerk of the Board, 551 Pine Street, Room 105, Martinez, CA 94553. �. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. 1. Meetings may be held either in the evenings or during the day, usually once or twice a month. !. Some boards assign members to subcommittees or work groups requiring additional time. r--Igocfv*`" i inn ouara OT zjupervisars (,..intra «*". . - ld County-Administration Building - - fast 644.=n 651 Pine St., Room 106 MaMnez, Caiifomia 94553 CO^ Tan Powers tst District Nancy C. Fatulan,2nd District Robert L Schroder, 3rd District •� j Sunno Wright McPeak,40 Oistrict Tan Tonakson,5th District _ The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications,. If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following; 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board y111'*�' CONTRA COSTA COUNTY MENTAL HEALTH COMMISSION Fi4,r1�� APPLICATION FORK PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. Worked extensively with local M. H. Director and his Deputy 1985-1988 , concerning MH Budgets, and priortizing dollars towards the most disabled of seriously mentally ill . Active in AMI-Contra Costa County past 10 years , and with State CAMI for past 5 years on legislative issues. Presently Co-President of AMI-Napa State Hospital . 2) Who is the Supervisor from your district? Gayle Bishop 3) List the community board(s) or volunteer activities in which you have been involved. 1.AMI-Contra Costa S. AMI-NSH, CO-President since 4/92 Religious Outreach for Mentally 2.CC Coalition for Mentally Ill 6. 111 to several churches Appeared on TV and Radio as 3 .CAMI-Legislative Committee 7- Advocates for mentally ill Past Board Member, AMI of 4.Volunteer, B & C, Davis 8- Contra Costa . 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month.) 20 hours 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30. ) YES X NO (over) 6) Please check the categories in which you fit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall .be a full= or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. x 3. Spouse of a past or current consumer of mental health services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental.health services. 6. Knowledge about, and interest -in, mental health services. 7) What do you believe you can/will contribute to the Mental Health Commission? With a .financial background, can provide meaningful analyses of budgets , and alternatives for Commission review. Have an understanding of CC' s MH system, and can make recommendations for improvement that are cost effective and measurable NAME: Wayne E. Simpson ADDRESS: 897 Dolphin Ct. , Danville 94526 CITY: PHONE: 820-2163 po�aar CONTRA COSTA COUNTY ADVISORY BOARD6, COMMISSIONS oRcommmms APPLICATION FORM Name of advisory board applying for Mental Health Commission Application Form must be typed or hand printed. Name of Applicant: Wayne E. Simpson Home Address: 897 Dolphin Ct. , Danville 94526 Home Phone: 820-2163 Business Address: Retired Work Phone: Signature: ��� —,cc �c �-as�� Date: March 16, 1993 Personal Experience, Skills and Interests Education/Background: MBA, Harvard Business School (Finance Major) BS, Texas Christian University (Accounting Major) Certified Public Accountant Former Chief Financial Officer .for large corporation Occupation (student, for pay work, not for pay work, retiree or similar): Retiree Community Activities: Active participant in Contra Costa Coalition for Mentally Ill, active in AMI-Contra Costa and State AMI (CAMI) , served on CAMI ' s legislative committee, now serving as Co-President of AMI-Napa State Hospital; have been active in Religious Outreach to Mentally Ill (presented at several churches) Special Interests: i Improving the level of care and quality of life for those suffering from serious mental illness . Our County is woefully behind others in this mission. Information: 1. File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. '. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. I. Meetings may be held either in the evenings or during the day, usually once or twice a month. >. Some boards assign members to subcommittees or work groups requiring additional time. i ne noara or supervisors "Ira County Administration Building Costa 651 Pine St., Room 106 Martinez, California 94553 Cajay Tom Pawra. 1 st District Nancy C.Fanden,2nd District Robot L Schroder, 3rd District t •� Stafne Wright McPeak,4th District Tom Tartahson.5th Oistrict The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the-people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications.. , If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following, 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board CONTRA COSTA COUNTY SrAtfejowee MENTAL HEALTH COMMISSION /yf,# APPLICATION FORK C�rCEsc PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. �o e- 7M-t (Q�/©V ArVnc-ATS # �-wif !o Mc- roJtJ Z.o� 2) Who is the supervisor from your district? 3) List the community boards) or volunteer activities in which you have been involved. Ps?�t1�NT10 Get E--t tSScD 2. !.)i 1.1C.rS Gj� U�1.T�s'L 6. 3 . 7. 4. 8. 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a m *n * z m of 10 hours per month.) 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:3 and' all committee meetings are at 3:00 or 3:30.) YES NO ANAL cO Hc)o Oe- (over) 6) Please check the categories in which you fit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a _ county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. C past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. Sipouse of a past or current consumer of mental health. services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental health services. 6. Knowlece about, and interest in, mental health -services 7) What do you believe you can/will contribute to the Mental Health Commission? 1 MIA� 4- &' &y 1A /9QJA- AAM 4"�f W'J'� rY7"_bA ADDRESS: �l �/f�l (���� LAI, CITY: GUS _Z1K1!Jr_ PHONE: ��� 97ZX FORAL" +CONTRA COSTA COUNTY" ADVISORY BOARDS, COMMMONS OR COMMTITEES APPLICATION FORM Name of advisory board applying for � �1-I �CaGt,aC7 CT' ` Application Form must be typed or hand printed. Name of Applicant: -5)Z QQ- a Home Address: �3/5r/ Z/t/. �, Home Phone: q30-8778 10��ur �i �4 9v5' Business Address: 1&p3 !'X)E7t5Pmn- I#Lw,- Work Phone: 932–909 Z Signature: � � � • q¢�lf IF Date: Personal Experience, Skills and Interests Education/Background: /a-� AO z et -Z" 19" t LZ( Cfd?- t 3 Occupation (student, for pay work, not for pay work, retiree or similar): &00-61 Community Activities: , Special Interests: aformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. I 1110 oval u ul oupot visors t.-Altl[d Cie*of on owd County Administration Building Costa `' • ` 851 Pins St, Room 106 Martinez, California 94553 COJV Tan Ptrwers.tst Dien'kt Haney C.Failden,2nd D*rks Pkibett C Schroder.3rd District t +�,/j Sunt Wright MCPeak.4th District Torn Tatakaat.Sth D+suiet The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some arc selected because of their expertise in the-subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge: _ The Board of Supervisors makes appointments from among those who submit applications,: - If you are interested, live or work in the county, and have the necessary time,you may wish to = submit an application. If so, please do the following, 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board !� CONTRA COSTA COUNTY VA441W4 MENTAL HEALTH COMMISSION APPLICATION FORKF PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORM TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. 11 Se-r ✓1C-t-, 9 S,4cQ- /9617 1 `iay,�►� / s�if'� l.2cc� s �}c re,�t�•ex-�� �a✓7deye� jn 15u Pjnee-'c-�nT .pra t-ess'r�n . � �ra ✓Q 4�ss do r!Q ✓�/�� f�r /,Ja r� a t S7� J6se 3 h P/Ta pSyC�lrafir�c w ,�9 in 2) Who is the Supervisor from your district? 3) List the community board(s) or volunteer activities in which you have been involved. 1. �7 ream tib k. N 5. 2. Qan✓rIle Creeks C0'It,4 .11 6. 3. Pan ✓,1 f C. T a(,G 7. 4. S. 4) Nov many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission _. requires a minimum of 10 hours per month.) 7-6 Az ei r5g 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30. ) YES NO (over) rig 6) Please check the categories in which you fit. (NOTE: As per the Mental Health Commission Bylaws, . no member of the board or his or her spouse shall be a full- or part-time employee of a count mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract .agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. Spouse of a past or current consumer of mental health services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental.health services. 6." Knowledge, about; - and interest in, mental health' services:" 7) What do you believe you can/will contribute to the Mental Health Commission? Cwt G -tr--t is Or -e 1-74 P 4>_ '1 e r%e.g , l +1 J-� h Q w !j'k Ole f ✓e c—y -S'S,S✓tii„S (f.9 , TX ti z of PA NAME: Q � � �7 0�Y M C n n ADDRESS: GQ 11 r V m d 7 n:4 Co u r--r CITY: �G-ZnV� PHONE: 0) FORM" r CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS ORcommrrnEES APPLICATION FORM lame of advisory board applying for 0 ft-fa I 14 e'i-r;x Gor vv7?,,, Application Form must be typed or hand printed. Name of Applicant: Home Address: 4d S'ai ''t" T''"°�'� }� �au�{ '~ Home Phone: Business Address: Work Phone: --f Signature: � !�,( —_� Date: 'ersonal Experience, Skills and Interests Education/Background: Occupation (student, for pay work, not for pay work, retiree or similar): Community Activities: y- _�q yo 1.Ge h I p /98 V - "rat✓n o rG P"L't d.!!e� -- 6e prnv,11er — /�EM / c�^I'1 nUrf1 'J��`.e i� ��ih3frr �aHann.fTGC. Special Interests: Ser✓i G2 4 6 �ta✓.e- S6ris� e-XX.4 iformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. The Board of Supervisors Contra CW* Wd . County Administration Building C )std (4 OWUh 851 Pine St., Room 106 Crit Martinez, California 94553 i�}� Tan Powers,tst Doom Nvi yr C.Fallen.2nd district Hobert G Schroder.3rd District ' Sunt Wright btePeak.4th Datrict Tan Todakson.5th Matriet The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications .. If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following, I. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board I0. ,NNE WRIGHT McPEAK Contra Board of Supervisors . r upervisor, District Four r 2301 Stanwell Drive Costa Concord, California 94520 County (510)646-5763 (510) 646-5767 (FAX) �ltlirS (_:Osla vv�. RECEIVED APR 29 199: Office of County .Administrator TO: Claude Van Marter, Assistant County Administrator FROM: Sunne Wright McPeak DATE: April 28, 1993 RE: Mental Health Commission Appointments I have reviewed the recommendations of the MHAB for the three persons to be appointed to the Mental Health Commission from District IV and approve the selection of Violet Smith (knowledge of mental health system), Joan Sorisio (family member), and Veronica Vale (consumer) . :ksm SE L CONTRA COSTA COUNTY MENTAL HEALTH ADVISORY BOARD 595 CENTER AVENUE,SURE 200 MARTINEZ,CALIFORNIA 94553-4639 :4 Phone(510)313-6414 Spq-COU' April 23 , 1993 Supervisor Sunne McPeak District 4 2301 Stanwell Drive Concord, CA 94520 Dear Supervisor McPeak: On March 16, 1993, the Board of Supervisors approved the AB 14 (Chapter 1374, Statutes of 1992) implementation plan which abolishes the current Mental Health Advisory Board (MHAB) effective May 25, 1993, and forms a sixteen (16) member Mental Health Commission. The MHAB has advertised, recruited, screened, and interviewed candidates for the Mental Health Commission. To represent your district, the MHAB is forwarding its three (3) recommended candidates with suggested terms of office for each candidate. The appointments must be staggered in one, two, or three year increments. Our recommendations are based on the AB 14 requirements for Commission composition, which includes the following: 1. Members shall be Contra Costa County residents; 2 . One member of the Board of Supervisors shall be a member of the Mental Health Commission and serve for three (3) years; 3 . A minimum of four (4) members shall be consumers who are receiving or have received mental health services; 4 . A minimum of four (4) members shall be parents, spouse, sibling, or adult children of consumers who are receiving or have received mental health services; 5. Other members shall have knowledge of the mental health system; 6. Composition shall reflect the ethnic diversity of the client population in the county; and 7 . No members of the Commission or his or her spouse shall be a full-time or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCorquodale contract agency. A351 (10/91) Supervisor Sunne McPeak April 23 , 1993. Page 2 1 Further Mental Health Advisory Board/Commission requirements include the following: 1. Members shall be 18 years of age; 2 . Members shall be available for late afternoon meetings; 3 . Members shall participate in, at least one standing committee; 4. Members shall participate at least ten (10) hours per month; 5. One member shall function in the Child Advocate role and chair the Children's Committee of the Commission; 6. One member shall function in the Older Adult Advocate role. You must select three candidates, who together meet the total of the legislation's requirements. The MHAB's recommendations to you are based on the required total Commission composition. Because of the overwhelming response from over 30 qualified candidates, the nomination decisions made by the MHAB's Organizational Development Committee were difficult. The persons selected from your district are as follows: Violet Smith Joan Sorisio Veronica Vale Knowledgeable re: Family Member Consumer Mental Health Current Chair, Three-year term Current Chair, MHAB Adult MHAB Ad Hoc Committee Planning Committee Two-year term One-year term Attached are the eight (8) applications of the full complement of candidates interviewed from your district by the MHAB. Please make your final selection and forward the nominations to the County Administrator's office by Wednesday, May 5, 1993 . If you wish to discuss this with me, I can be reached at 313-4101, or you maLreached iscuss with the MHAB staffperson, Diane Frary, who can t 232-7139. i e Dennis Lepak, Chair Attachments cc: C. L. Van Marter Mark Finucane Lorna Bastian CONTRA COSTA COUNTY MENTAL HEALTH COMMISSION APPLICATION FORK ���a►c E.+7jC' ZC �E•�� PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION. 595 CENTER APENIIE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. L ��/ Gt c,�.Le.e•+i'c /�/[a•.J��rs- /k�aa•�-e.r �e. �A �' �-K /y/q i r. �`1 Gf��•J/ C. /sly /VH ejWPQrit"+te 4..7 e- AuA. -r fs (r//.) PIC..t fx t 0yeftZi2s �5e c-: - �tt-""by' Tsa.s* rd -cam w/Gic[/+ oe ..L'Pa.0 &I- 4004044"Ofi'ry -�••ida I+1N fit/.... w.a.{ __Caa,sSa.0 a raf�.re�.a.... fo T•.a..a� it � Qrae/ ��2 Vs.�rl /►S CS/, oto-.r:�q sil :4C .r Imo.( CX7FJi✓c iMNo/u e.rs+o.cZ` a.ri7�K /o7hCs.- C4>/N•M L4r4 i)Ly 4 7 grafi i Gl Q•ti•( i.d i7t. 7�,�a /ff N i l i Ji Or. is. C�..t..� (.s1 �..,.��. 2) Who is the Supervisor from your district? 3) List the community board(s) or volunteer activities in which you have been involved. Past: �-'t-- U"e.«n!•.n.!v-7 As5a.:.-w Im-rA /'arm 5• /+9 HA f3 2. A.V.A.C.- .�.~.c �4ba.s� G.lifs'o.�. 6. 3• 7• 4. ccc ��....� .t `wo»..,. Ve�.f St•►t� C�a:[•t Car• Sf...--cr �.,,...-:�« 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month.) 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30. ) YES . X NO (over) 6) Please check the categories in which you fit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. Spouse of a past or current consumer of mental health services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental health services. 6. Knowledge about, and interest in, mental health -services' = 7) What do you believe you can/trill contribute to the Mental /J Health Commission? �I �MtIMi�NCfit_� �D xery,*"s TSI' pe.0Gle. ", /sce.sa.�� /CiS.t�i�inCx Gs.••C 741 70"C Al . VI*d AV)& �N i �� .t/G/IIS //i O�A.Mr i w fsaafl Oa.. � /`cSeire� ( ��fs�C ems► as 2t' ;,o sov�.-.�......Z ems...-•e..�r� a«,.0 ex��is..+t+� !�-. �.�[�.+i..tiltp.`'�/c..� sl�..� Its�w��-,4i•�y. ADDRESS: //o.� 7r�.+�/e CITY: 1°ate �4 9yrs/G PHONE: tlrlo) 9,00 - Pour CONTRA COSTA COUNTY ADVISORY BOARDS,`COMMISSIONS OR COMM=ES APPLICATION FORM Name 'of advisory board applying for Contra costa County Menta 1 Health Advisory Board Application Form must be typed or hand printed. ` Name of Applicant: (Mrs. ) Violet E. Smith Home-Address: 1103 Temple Dri\,�e; Pacheco.-- (.AHome Phone: 680-1632 Business Address: none Work Phone: Signature: Date: Nctivember 25, 1991 Persona Experience, Skills and Interests Education/Background: B.A. , Psychology, U. C. -Berkeley, 1948 M. A. , Clinical Psychology, U. C. -Berkeley, 194or Occupation (student, for pay work, not for pay work, retiree or similar): - Retired (Nov. , 1986) from my position as Exec. Director of Contra Costa Crisis c.< Suicide Intervention Service. Prior work included 10 years as consultant, project director .and program trice-president of Pacific Consul tants,, a private firm doing social research for Vov' t agencies, (s ouv) Community Activities: While working with Crisis & Suicide Intervention, I was active In the Unemployment Resources Task Force, A.V.A. C. , and the Task Force on Home lessness. Since retiring, I have served on the CCC Grand Jury and on tlie League of Women Voters State Committee on Child Care. Special Interests: I have always been interested in human service programs, primarily from the standpoint of assessing and'-*or ensuring their effectiveness in the unduplicated delivery of necessary services. Professionally, I especialy e3njny research. evaluation and. networking Personally,...l 1 i e. _. . to spend time with my ch:. lden and grandchildren and to read, ' bow; , play golf and socialize. nformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisorybodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the.evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. i The. Board of Supervisors Contra Guk of `.a 9oirr+`f am trat County lldminycx. County Administration Building •Costa-` t415)646237t 651 Pine St., Room 106 i Count Martinez, California 94553 County :Tma.Powils„1st Otsuict 1 Nancy C.Fa din.2nd 04uic$ Milt L SCK*or,.Zld 013tt1Ct Sunni Wilght MtPsak,Ah 01suict Tess To 10=n.5th 01suki r4 K The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications. If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. if so, please do the following; 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered: and 3. File the completed application with the Clerk of the Board who will process your application. Applicants arc requested to call the Clerk or the Supervisor of their District for information regarding.current and upcoming vacancies: Phil Batchelor, Clerk of the Board Occupation (continued) : and 9 years as Director of non-profit agencies, including the Berkeley Nursery School for Retarded Children, the Evanston (Illinois) Mental Health Society, and Berkeley School Resource Volunteers. CONTRA COSTA COUNTYv,�"/ �� so ejS1a MENTAL HEALTH COMMISSION //d Nwr APPLICATION FORK Am"y G E/N�Ee. PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORM TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. he AV 0q 14 e s i e e s 2) Who is the Supervisor from your district? 3) List the community board(s) or volunteer activities in which you have been involve-d/. I. 2. 3 . p s 7. QS kl c e 4. 8. 4) Nov many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month. ) 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30.) YES NO (over) e' 6) Please check the categories in which you fit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. spouse of a past or current consumer of mental health services. 4. sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental.health services. 6. Knowledge about, and interest in, mental health services.: ' 7) What do you believe you can/will contribute to the Mental �j Health Commission? arth, o e �' e CSO sL22 4,22Z to e lax ADDRESS: IPO. 6,0)e, 61.2— CITY: 9 �_l. 7 PHONE: la 7 Z -,22 22 2, PORX" CONTRA cosrA couNTY ADvismy BOARDS, cOmmissIONS 0RC0mNnTM APPLICATION FORM Name of advisory board applying for MENTAL HEALTH COMMISSION Application Form must be typed or hand printed. Name of Applicant: JOAN S O R I S I O Home Address: P.O. BOX 612 Home Phone: 67 2-229 2 CLAYTON, CA 94517 Business Address: Work Phone: 825-1921 2190 MERIDIAN PARK BLVD, Signature: SUITE Q CONCORD, CA 94520 ..Date:_MARCH2�9 , 19�93 Personal Exwricnce,. Skills and Interests Education/Background: REGISTERED DENTAL ASST./ AA REAL ESTATE SALES PERSON SOFTWARE INSTRUCTOR BOOKKEEPING/ACCOUNTING SOFTWARE Occupation (student, for pay work, not for pay work, retiree or similar): BOOK -KEEPER /SOFTWARE/GENERAL LEDGER Community Activities: PHOENIX PROGRAMS BOARD MEMBER /past ALLIANCE FOR THE MENTALLY ILL CONTRA COSTA COUNTY PAST VICE PRESIDENT HOMELESS REGIONAL ADVISORY COMMITTEE, VARIOUS OTHER COUNTY MENTAL HEALTH GROUPS. Special Interests: GOLFING, SKIING, WALKING, NATURE, GARDENING. aformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional. time. ne Board of Supervisors (;ontra P" Ciatic N�a . County Administration Building C Costa 851 Pine St., Room 106 �� Martinez, Callfomia 94553 Tom Powers, tst District Nancy C.Fanden,2nd District Plabeit L Schroder,3rd District I Surma Wright MCPeak,4th District Tam Tortakson,Stn oiatriet The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications- If pplicationsIf you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following, 1. Review the listing of advisory boards, committees and commissions(see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board CE MAR g 1993 CONTRA COSTA COUNTY CONTRA COSTA COO MENTAL HEALTH COMMISSIONp �NISTRAT1aN APPLICATION FORM o66v 4 4 0W. c X141V7 :7 PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMP ON FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. /i0• Qf4i�i C`�f �A�ifuf L{/'LG�C. 2) Who is the supervisor from your district? SU AIAl4F R ef'La-k 3) List the community board(s) or volunteer activities in which you have been involved. 2. L' its ���t a �i &t4 6. 3.,ct GSC (. tic 7. 8. 4) How ,many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental health Commission requires a minimum of 10 hours per month.) Ila 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held at 4:30 and all committee meetings are at 3:00 or 3:30.) YES NO (over) 1, 0 —Please. check the categories in which you fit. (NOTE: As per the.Mental'Health Commission Bylaws, no member of the board or his or h-er spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract .agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. spouse of a past or current consumer of mental health services. 4. Siblinc of a past. or current consumer of mental health services. ✓ 5. Adult Child of a past or current consumer of mental.health services. 6. Knowledge about,--and -interest in, mental health- services. 7) What do you believe you can/gill contribute to the Mental Health Commission? ff NAME: ✓��oc�i�,� V4L_� ADDRESS: 5��/9 CLAY To N R p CITY: eo�+leoiPo cA 9�s� / PHONE: .. C510) 1v7� - 5313 FORMA r� Al CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS OR COMMITTEES APPLICATION FORM Name of advisory board applying for Application Form must be typed or hand printed. Name of Applicant: X5/q OA//Cf- E Home Address: 448/9 C Lf4 y TD Al R-D #�� Home Phone: Business Address:pyo A%SQ,di� Work Phone: Signature: Date:3 Personal Experience, Skills and Interests Education/Background: CUrr�j��� . �f�Gjyq �GO� yED�1rt�Ds 4'p 9a f fl ��ree /"7 Grq hoc 00..-n/z, t4zAdh 1fPAeo3c. So .Z�s �/� �iQT C.yiGD,DEIiELoP .c/q" 15/000(,may FOVG�j/o,t/ FTC, Occupation .(student, for pay work, not for pay work, retiree or similar): va allfo Alld'I), �Ya m rry: ja�b_ _ �s �radao�`�ah �oOr�iha fd�' :boy��e:�� tr �osri9� cf/i�a L' �o�/cc /flow ;q SrvoENT. Community Activities: . ha ve 1-.7c en So '6•`!/ Go a�� `q/r/s ih i'yl�C2dw h/o�ieS �c/rr� o� Goned-rz�, v� tle qs '4/'cl �er�6ey �pr 7�J 1C /ti ,eAdV V 7,v AW,I-d R;!F14r3E.e F09 TYE` L,0AJ7R,+ &S—, ,k Special Interests: e x,27-5 .Z�,rio.ei� a 7�ierG , �Ji�,eo t3�o�a�y A�� ttiN,tr f/ER•9�C�pES BRE- .DoIN6- T OvR �oN�s f 3'rie6-f{�.( s. fi/AND tdRi T iA/6- f VAI yS/S 4S -4 if aea y/ r-t;yCa Lo a= Y •¢�D i3Ri.✓ e,GjE�iiST,e y aformation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. 1 The Board of Supervisors Contra N County Administration Building Cla cO` 651 Pine St., Room 106 �� Martinez, California 94553 Tom Pavers, 1st District Nancy C.Fanden,2nd District Robot t L Schroder,3rd District t Suruw Wright McPeak.4th District Tom Todakson,5th District - The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. _ The Board of Supervisors makes appointments from among those who submit applications.:_ If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following, 1. Review the listing of advisory boards, committees and commissions(see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. 9A —�3 Phil Batchelor, Clerk of the Board /`I Jo' s IF CONTRA COSTA COUNTY r MENTAL HEALTH COMMISSION ,l',�l fl APPLICATION FORM PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORM TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. M;S. in Counseling Psychology and a nsive work experience in the field of ,rental health. 2) Who is the Supervisor from your district? Tom Torlakson 3) List the community board(s) or volunteer activities in which you have been involved. 1. Ala. Cty Jail Citizen's Advisory 5. 2. Marnber, Advisory comnittee CARE 6. Resource Canter 3 . Please see resume attached - 7. 4. 8. 4) How many hours per month are you able to participate in Mental Health commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours ger month.) 10 hours 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health commission meetings are held at 4:30 and all committee ; meetings are at 3:00 or 3:30.) YES X NO Please note: I can make it to meetings at 3:00 or 4:30 p.m:, but I must leave by 3-00 p.m. (over) 6) Please check the categories in which you. fit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county. . mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) -The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. 2. Parent of a past or current consumer of mental health services. 3. svouse of a past or current consumer of mental health services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of mental.health services. 6. Knowledge about, and interest in, mental health services "- X 7) What do you believe you can/will contribute to the Kental Health Commission? My knowledge and expertise in workincr with yarjoijS individuals, and families and knowing their specific needs and keeping M with the state of the art. NAME: Maria Puente aDDREss: 2212 Peppertree Wy #1 CITY: Antioach, Ca. 9.4509 PHONE: 757-8752 FORM-" { CONTRA COSTA couNTy ADvisoRy RoARDs, commmoNs OR comnmms APPLICATION FORM Jame of advisory board applying for Mental Malth ccrmdssion Application Form must be typed or hand printed. Name of Applicant: Plaria Puente Home Address: 2212 Per-rcertree !,Zy #1 Home Phone: 757-3752 Antioch, Ca. 94509 Business Address: Regional center of The Fast Bay Work Phone: 798-3001 x 1-06 1800 Sutter St. Suite 100 Signature- Con-cord; Ca. 94520 Date: ZVril 1, 1993 arsonal Experience, Skills and Interests --ducation/Background: B7;A. psychology U.C*.L.A.. awarded June 1976 M.S. cbunseling'PsycholoW C.S.U.H. awarded March 1988 )ccura,--on (student, for pay work, not for pay work, retiree nr similar): Casernanager - re .ornmunity Activities: Please see attached. sun*e pecial Interests: -,"iental Health, Education, please see resune attached. )rmation: File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. Meetings of advisory bodies may be.held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Sonic boards assign members to subcommittees or work groups requiring additional time. RESUME Maria Eva Puente 2212 Peppertree Dray #1 Antioch, Ca. 94509 (510) 757-8752 (h) (w) 798-3001 EDUCATION M.S. California State University, Hayward, Ca. March 1988. Major: Counseling Psychology B.A. University of California, Los Angeles, Ca. June 1976 Major: Psychology EXPERIENCE July 1992 to present. Casemanager. Fagional Center of The East Bay, Concord, Ca. Conduct Social Assessments on children and adults referred to RCSB, and provide case management ent services to disabled children in East County. Produce monthly newsltetter in English and Spanish. July 1991 to July 1992 Casemanager. Family Stress Oenter, Concord, Ca. Provided case management services to pregnant teens and their babies. Produced monthly newsletter in English and Spanish and served on the Long Range Planning Committee. June 1991. . Counselor. Amir House. Pittsburg, Ca. Group Home Counselor. Oct. 1989 to Feb. 1991 Social Worker. St. Anne's Maternity Home. Los Angeles, Ca. Provided counseling to pregnant teen residents and coordinated services with other de- partrrents. Also served on The Christian Effectiveness Conmmi.ttee. Jan. 1987 to August 1989. Therapist. The Bridge Counseling Center, Nbrgan Hill, Ca. Provided counseling to children, youth and families. Sept. 1986 to Dec. 1986. Ynntorship Coordinator. San Leandro Girl's Club, San Leandro, Ca. Provided career counseling to adolescentsand their families, facilitated intern- ship place-,rents. Sept. 1986 to Dec. 1986. Bilingual Consultant. Oakland Head Start. Part time. April 1985 to Sept. 1986. Counselor. Milpitas Unified School District. Milpitas, Ca. Working with the Title 7. coordinator, planned, organized, and implemented services for students and parents. Produced quat-terly newsletter in English and Spanish. August 1983 to April 1985. Senior Youth/Family Counselor. La Familia Counseling Services. Hayward, Ca. Developed and implemented counseling methods and techniques, conducted individual and group sessions with youth and thier families. August 1978 to August 1983 Service Coordinator, for the "Hijos del Sol" Youth Commr ponent of La Familia Counseling Services in Hayward, Ca. In addition to the responsibili= ties of the senior therapist outlined above, my tenure at La Fatmmilia Counseling Services also included supervising the youth commponent staff, monitoring program e3gDenses, and conducting research on counseling adolescents and their families. {I S� Page 2'resume of Ilaria 'Puente June 1974 to August 1974 Legislative Intern. Conducted research on farnworker health and sealskin legislation for Assemblyman Louis Pappan, (D-Daly City) . 1 PUBLICATIONS H_ijos del Sol: An Approach to Raza Comm ity Mental Health. Coyright 1981, (team authored) . Monograph 1. Methods and Techniques for Promoting Raza Ccnrmuiity Mental Health. Mbnograph 2 Volume 2 for youth. (team authored) 1983. LANGUAGES Speak, read, and write Spanish OJMMUNITY PARTICIPATION Commissioner, Alameda County Jail Citizen's Advisory CbnAttee. Appointed by the Board of Supervisors (1983) Received commendation for public service. Member, Advisory and Review Committee, 4-H Youth Program, Hayward, Ca. 1985 Member, Board of Directors, La Famila. Cbunseling Service, Hayward, Ca. 1986 Member, Advisory Committee, CARE Resource Center, 1992 to present MUMS i 1983, Hijos del Sol Youth Program received The Hayward First Youth Award. November 1992, Received the "Excellence in Service" Award. It was presented by The Board of Directors of The Regional Center of The East Bay. OTHER Graduate of 14MDEF Leadership Development Program Team Teach Sunday School for pre-schoolers at Holy Rosary Church in Antioch, 1992-'93 i a HOUSE OF REPRESENTATIVES WASHINGTON, D. C.20515 GEORGE MILLER 7TH DISTRICT,CALIFORNIA November 19, 1992 Maria Puente c/o Regional Center of East Bay 1212 Broadway, Suite 200 Oakland, CA 94612 Dear Maria: I am delighted to learn you have received the "Excellence in Service" Award from the Regional Center of the East Bay for your dedication and many contributions to the community. This is indeed an honor, and you can take great pride in this recognition of your efforts and accomplishments. Your commitment is a fine example of community spirit. I know that I am joined by your family and colleagues in appreciation of your outstanding service. Again, my sincere congratulations and best wishes. Sincerely, George . 1 r Mlr Member of Congress 7th District, California [NOT PRINTED AT POVERNMENT EXPENSE) C ,47m ws,,AtE CONTRA COSTA COUNTY `��.5��E� MENTAL HEALTH COMMISSION 1 APPLICATION FORK PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 . MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. v -nu ratar,,nt -E, kr,rn. j0 � rlaT re rr� nf,� shaa�-f -fe m in a� I rn Q I ,17L a _ Z ' oQa,u.6 h fe. r hQs ,been rw 6hera �o� , �u� yen ir, va I vc,"G� w rY,h t}C',1�, 2) Who is the Supervisor from your district? "To ,rn Tn r 0 K 5 a h 3) List the community board(s) or volunteer activities in which you have been involved. 1. 5. 2. 6. 3 . 7. 4. 8. 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 10 hours per month.) / Of 5) Are you able to attend late afternoon meetings? (NOTE: Mental Health Commission meetings are held. at 4:30 and all committee meetings are at 3:00 or 3:30. ) YES NO (over) r 6) Please check the categories in which you tit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. x 2. Parent of a past or current consumer of mental health services. 3. Spouse of a past or current consumer of mental health services. 4. Sibling of a past or current consumer of mental health services. 5. Adult Child of a past or current consumer of'mental health services. 6. Knowledge about;, and interest-in, mental health services. X 7) What do you believe you can/will contribute to the Mental Health Commission? 1 I -L 0-m Q Cao m D A.S 510 n p,t e 1'Y1.n�'� � r d -E L a r Q n C1 m 6 t -V- K v- 0-.S r c,ad-c 'y)J a,-, di t-L K i V, �, ,, i t l�. h ea- r- s . T h av e. a_ d_e s+r e. +0 t- e ca..c 1 o LL± -'Lo O-L h-e r s i a i CA,n c sea r 0. mesSctoJ� of h o pe- or a be�t�r f u.tu.r e . ADDRESS: 2. 8'A_y CITY: An-+j oC�_ , CA q4 ,5 0 cr PHONE: 5 l 0 "1 5y - I I '2k 9 PORM.AP 4*7 CONTRA COSTA COUNTY ADVISORY BOARDS, COIMMMONS OR COMMITTEES APPLICATION FORM Name of advisory board applying for M e i-,*c�-L C n M m\'s S Application Form must be typed or hand printed. Name of Applicant: L_\Ncjo,� E, Y,ro tz-5dcLLe Home Address: 2Lt?�LL4 1-+OYNC 6LLcr-)e- G i r c 1 eHome PhoneC.51 0) -7 5 cl Ar\+iocV, , C-0ysoq - Business Address: Work Phone: Signature: Date: L4 Personal Experience, Skills and Interests Education/Background: Hi k 5c-)WDZ r'a0L`LA-;L e 17&&D r Pa-rt +1�ne� rrwcb �- Pcr-1-t 7t 1-4 e- L C e,9 e- - C e'o e-j c> m (C0 t Occupation (student, for pay work, not for pay work, retiree or similar ti V-0-CL... Bea U'tc"cl )4- C'J�Ito( 0 __0 je c>vi d et - t Community Activities: 1'r-'Uctuern e-y- �' &1A+k a-- Special Interests: x KcLoe_ 01. specc o,bu,6e- tjt'Eh, -t7hem- oma.-& he(-p CLt yaws Lt� the ka P4 LJ I Y) 01 5 o f brea-)::� the- C� c-le - u-:& oLzo r s - :77 t,�� v4 Lj o r 1< Lj im PK) YLj V4- Information: I- File completed application with Clerk of the Board, 651 Pine Street, Room 106, Martinez, CA 94553. 2. Members of some advisory bodies may be required to file annual Conflict of Interest Statements. 3. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. t. Meetings may be held either in the evenings or during the day, usually once or twice a month. i- Some boards assign members to subcommittees or work groups requiring additional time. -- The Board of Supervisors C' ontra �-«' mMs— County Administration Building CostaMd 646646-=6 651 Pine St., Room 106 Martinez, California 94553 Tan Powers. t st District Nucy C.ianden.2nd District t fhtbert t.Schroder.3rd District ;•��,� Sonne Wright McPesk.4th DistW Tats Todakson.5th District The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications.: _ If you are interested, live or work in the county, and have the necessary time, you may wish to submit an application. If so, please do the following; 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application. Applicants are requested to call the.Clerk or the Supervisor of their Districtfor information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board CONTRA COSTA COIINTY MENTAL HEALTH COMMISSION APPLICATION FORK PLEASE COMPLETE THE FOLLOWING AND RETURN WITH THE COMPANION FORK TO: PAT RUSSELL MENTAL HEALTH COMMISSION 595 CENTER AVENUE, SUITE 200 MARTINEZ, CA 94553 1) Describe your experience and knowledge with the Mental Health system. T A Lie- L�Gy-\ ,for Ae, 45-577" AG ;P/14 S. �L�v� be-Ln (lt/DI�LD� //1 �VZ-^ 2) Who is the Supervisor from your district? -- L 3) List the community board(s) or volunteer activities in which you have been involved. r 5. 37. 4. Me r n f 1occ- 1 e-krel. s. 4) How many hours per month are you able to participate in Mental Health Commission activities? (NOTE: Mental Health Commission requires a minimum of 20 hours per month.) 5) Are you able to attend late afternoon meetings? (NOTE: mental Health Commission meetings are held at 4:30 and all ..committee meetings are at 3:00 or 3:30.) YES NO (over) 6) Please check the categories in which you fit. (NOTE: As per the Mental Health Commission Bylaws, no member of the board or his or her spouse shall be a full- or part-time employee of a county mental health service, an employee of the State Department of Mental Health, or an employee of, or a member of, the governing body of, a Bronzan-McCourquodale contract agency. ) The Law requires representation from these groups. Please check those which apply. 1. Consumer, past or current, of mental health services. X 2. Parent of a past or current consumer of mental health services. 3 Spouse of a past or -current consumer of mental health services. .4. Sibling of a past or current consumer of mental health services. X 5. Adult Child of. a past or current consumer of mental health services. 6. Knowl� edge about, and interest in, mental health services" 7) What do you believe you can/will contribute to the Mental Health Commission? iclf"ll Stia�L �-�,L e 0E('/eki6-e. a 7C avid as in ADDRESS: A6• 13 OX 7O V CITY: PHONE: 77 c2c9d FORM-4y CONTRA COSTA COUNTY ADVISORY BOARDS, COMMISSIONS OR COMMTI'I`F.CS APPLICATION FORM Name of advisory board applying for Application Foran must be typed or hand printed. Name of Applicant: 3-65 -! SMA Home Address: 315!1/ G 5�`: Arr1; Ga. �o� Home Phone: 75 �oW Business Address:)L?6• boa( 770 44147 oCA Work Phone:7' 9 -32 36 Signature: • Date: 44 r� 3ersonal Experience; Skills and Interests EducationBackground:„r ka v c Cam ple j-t� 1 Sk ytfir o P Go/1t5(,,, Occupation (student, for pay work, not for pay work, retiree or similar): Community Activities: Pk()t-^;y pry y-j ,.5) a&y,�/,l c k ,4!ck body. Special Interests: �' / d L.J4f�f vv-u-45`'6 �'Wa`�/�l 1 /t.G f' Serilr C LS a . /c �-o �►c. t^� lJ� i L. Gformation: File completed application with Clerk of the Board, 651 Pine Street, Room 1015, Martinez, CA 94553. Members of some advisory bodies may be acquired to file annual Conflict of Interest Statements. Meetings of advisory bodies may be held in Martinez or in areas not accessible by public transportation. Meetings may be held either in the evenings or during the day, usually once or twice a month. Some boards assign members to subcommittees or work groups requiring additional time. The Board of Supervisors C' /ontra v �W*�, . County Administration Building Cksta 666= 651 Pine St., Room 106 Martinez, California 94553 colly Tan Powoo tst Diswid "ancy Q Fand".2nd Maria F1ot�art L Sc rodar.3rd DieWict t ,'•rj / Suri»Wright McPaak 4th Datna Tan Todabon.5th District The County Board of Supervisors has established advisory boards and bodies to help inform and advise county government on a large number of programs serving the people living, working or visiting our county. Individuals of all backgrounds, training and education are appointed to the advisory groups. Some are selected because of their expertise in the subject matter. Some because they are familiar with needs and feelings of the users of these programs. Others because they have special skills and knowledge. The Board of Supervisors makes appointments from among those who submit applications If you are interested., live or work in the county, and have the necessary time, you may:wish to submit an application. If so, please do the following, 1. Review the listing of advisory boards, committees and commissions (see back of this letter), and identify those to which you might be interested in seeking appointment; 2. Complete and submit a separate application for each board for which you wish to be considered; and 3. File the completed application with the Clerk of the Board who will process your application Applicants are requested to call the Clerk or the Supervisor of their District for information regarding current and upcoming vacancies. Phil Batchelor, Clerk of the Board