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Table of Contents Upcoming Meeting Agendas______________________________________________
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Notes from the Jan. 31, Feb. 1 & 2 F2F Steering Committee Meeting. February 1, 1999 February 2, 1999
Consumer-Operated Services Steering Committee Meeting Notes 1:00 - 6:15 p.m. Embassy Suites Washington, D.C. Telecommunication Issues Vicki Fox Wieselthier, Communications Director, MIMH E-mail address: soehngep@mimh.edu Ms. Fox Wieselthier reported that the Coordinating Center is using a combination of technologies to facilitate the work of project and to share information nationally and internationally. Inquiries about the project have been received already from Australia, the United Kingdom, and Germany. Because technology can include or exclude people, Ms. Fox Wieselthier's job is to increase participants' comfort levels and ensure that no one is excluded. Project participants who have extensive experience using technology can help by remembering that they may be communicating with colleagues who haven't used technology extensively and therefore may need some background information. At each meeting participants will be asked to complete a communications survey that will be used to determine their level of knowledge related to technology and the types of technical assistance needed. The Coordinating Center is developing an accurate record of project progress that will enable it to examine how decisions were made and how changes have occurred over time. Technology can facilitate openness that can lead to a new level of inclusiveness. Project Communications Tools
The web site carries a calendar of events and activities, progress reports,
Each subcommittee has its own page on the web site.
Chat is feature that has not yet been used on the web site. Additional information about how to use chat will be distributed soon.
3. Technical Assistance (TA) Manuals
4. Newsletters The Coordinating Center will produce several newsletters. William McKinnon of the Center for Mental Health Services (CMHS) acknowledged Ms. Fox Wieselthier's tremendous contribution to the project. He said the level of technology being used far exceeds what has been done by other multi-site projects. Discussion of Steering Committee Roles & Procedures Ruth Ralph, Steering Committee Co-Chair Sally Rogers, Steering Committee Co-Chair Jean Campbell, Coordinating Center, Principal Investigator Dr. Campbell offered for discussion a draft of proposed Steering Committee policies and procedures. The following was agreed to:
Identification of Voting Steering Committee Members Ms. Rogers indicated that there had been some confusion about membership on the Steering Committee. The policies and procedures will help clarify who is a voting member. The following individuals were identified as voting members of the Steering Committee: Philadelphia Principal Investigator: Joe Rogers Principal Investigator Alternate: Mark Salzer Consumer Representative: James Scott Consumer Representative Alternate: Terrence Means Tennessee Principal Investigator: Tom Summerfelt Principal Investigator Alternate: Sita Diehl Consumer Representative: Louetta Hix Consumer Representative Alternate: Vacant Maine Principal Investigator: Ruth Ralph Principal Investigator Alternate: David Lambert Consumer Representative: Jean Risman Consumer Representative Alternates: Lawton Mann and Jerry Bradley Connecticut Principal Investigator: Susan Essock Principal Investigator Alternate: Jo-Anne O'Connor Consumer Representative: Yvette Sangster Consumer Representative Alternate: Ed Kramer Iowa Principal Investigator: Sally Rogers Principal Investigator Alternate: Vacant Consumer Representative: Jean Stofer Consumer Representative Alternate: Vacant California Principal Investigator: Steven Segal Principal Investigator Alternate: Carole Silverman Consumer Representative: Vacant Consumer Representative Alternate: Vacant Illinois Principal Investigator: Patrick Corrigan Principal Investigator Alternate: Sarah Lickey Consumer Representative: Diane Maxwell Consumer Representative Alternate: Carol Mussey Florida Principal Investigator: Diane Cote Principal Investigator Alternate: Vacant Consumer Representative: Sally Clay Consumer Representative Alternate: Vacant Ms. Rogers suggested that voting members not rotate votes on various issues. If the principal investigator designated by the site is not the person who signed the grant application, the federal government will decide who will serve as principal investigator. The consumer representative doesn't have to be a current consumer of services, but must represent the consumers at his/her site. Sites are encouraged to provide technical assistance and support to the consumer panels so that the consumer representatives are as knowledgeable as others involved in the project. Ms. Ralph said in Maine the consumer representative will train the alternate for the next year to help bring him/her up to speed. Overview of GFA and Multi-Site Goals Jean Campbell - Coordinating Center Perspective The Coordinating Center serves in the capacity of a liaison--it is an extension of federal government. Dr. Campbell encouraged participants to read a handout entitled Orientation for COSP Multi-Site Research Cooperative Agreements and to consider adding the Team-Based Task Execution to its list of rules for communications. She also distributed a list of definitions of the COSP roles and responsibilities that was extracted from the government's guidelines for applicants. Dr. Campbell stressed that learning is the core objective of this project and that learning should guide decision-making. Study sites must be willing to participate in the extensive work required to develop a set of multi-site questions and a study design. They must also be willing to modify their site study designs to make them congruent with the multi-site study design. This is an expectation of the federal government. The responsibilities of the Coordinating Center include:
Types of Technical Assistance Available Through The Coordinating Center
Betsy McDonel, CMHS - Federal Perspective Ms. McDonel indicated that she would like to see the Team-Based Task Execution formally adopted by the project and added to its ground rules. Ground rules should be posted on large newsprint at each national meeting and participants should point out when a violation occurs. The study sites are involved in two projects -- the individual study sites effort and that of the multi-site. There must be buy-in to both pieces. Data need to be meta analyzable so that comparison with other SAMHSA-funded projects is possible. Joe Rogers pointed out that the federal government seems to have difficulty in using the massive body of knowledge being generated by multi-site projects to impact policy. He suggested that some discussion take place about how CMHS can do this and cited the ACCESS project as an example. Ms. McDonel pointed out that the ACCESS project is not complete and its full impact won't be realized until a year after the program closes. Neal Brown, CMHS, stated that the government needs to do a better job of translating what has been learned into practice. He said this is a goal and pointed out that during the course of the four years of this project, participants along with the federal government should think about the end product and identify ways to transfer learning into practice and policy change. This project will help describe how the system can be tailored to meet the needs of consumers. Mr. Rogers suggested that if the project is to have impact on how mental health services are provided that the group needs to begin talking with the Alliance for the Mentally Ill and others within the next several months. Ms. Fox Wieselthier, who was involved in the ACCESS project, said that what was learned from ACCESS was disseminated in a limited area and not shared with other governmental entities that fund similar programs. We should look at what other government agencies deal with the issues we are identifying and inform them how they can change their funding to better meet the needs of the clientele. After a lengthy discussion, Mark Salzer raised the question: Will the study sites go beyond what is required to answer other questions of interest in a consistent manner? The co-chairs stated that this was an important question that needs to be addressed when there is more time for discussion. William McKinnon, CMHS - Quarterly Reports Mr. McKinnon explained that the quarterly reports required from the study sites provide information to the federal government about the status of the project. He distributed a proposed sample format for the report and asked sites to send to him feedback. The report should not exceed five pages and the first one should be submitted by March 30, 1999. Mr. McKinnon shared information about the continuation application that sites will be required to submit to receive funding for the next fiscal year. Mr. Brown stated that by mid-March the sites would probably receive their application for continuation packet. They will have 60 days to complete and return the application. Goals for This Meeting & Activities for the Future The following tasks were identified as goals for the current and future Steering Committee meetings:
As soon as a common protocol is ready, those sites that are ready to begin may do so. Dr. Campbell reminded participants that the common protocol has to be formatted, field tested and then staff must be trained to administer the common protocol. Greg Teague proposed that the Coordinating Center draft a proposal for how long it will take to complete the common protocol. The proposal should define specific tasks and identify who will do what. Mr. Brown stated that sites could proceed with their enhancements (capacity building) while the common protocol is being developed. Subcommittee Progress Reports Employment/Demographics Subcommittee Group Patrick Corrigan This group's first task was to identify a demographic measure and distribute it for feedback. Two demographic substance abuse assessments will be distributed, and feedback on cultural sensitivity is needed. There was a big debate over whether to use a 20-item substance abuse questionnaire or a 4-item one. We could aim for a DSM-R IV diagnosis for substance abuse or ask a few questions to see if the person has substance abuse issues. The group can not make decisions on the employment measure until the logic model has been drafted. There was discussion about whether consumer-operated services would affect employment attitude, satisfaction with work, etc. Housing Subcommittee Group Gregory Teague The group has done some review of several measures. There are three issues that will be challenges for the logic model: (1) what is the definition of housing, (2) what are we trying to measure (social environment, satisfaction, etc.), and (3) psychometric properties – what measures might be used that are sensitive to a change in housing status over time. One measure on the list is being used in two other multi-site studies. This group was small in the beginning. Tom Summerfelt, Sharon Togut, Matt Johnsen, Jean Campbell, and Carole Silverman signed up for it but never received information. Loutetta Hix and Jo-Anne O'Connor expressed interest in joining this group. Social Inclusion Subcommittee Group Joe Rogers The group is discussing specific types of protocol for social inclusion. It is looking at social inclusion and breaking it down as well as social integration issues. The group has a written report posted on the web site. It looked at the instruments from all of the study sites. Some of the questions the group is interested in might be covered by the Empowerment Group such as "Does self-help improve a person's ability to utilize natural supports?" If Empowerment asks such questions, Social Inclusion won't. The group can come up with an extensive set of questions within a month, but it seems as through the Steering Committee is working toward a "thin" protocol. The group will provide its best shot and then the Steering Committee can reduce the number of questions if it needs to. Empowerment Subcommittee Group Carol Silverman The group is considering two major instruments to measure empowerment -- the Consumer Empowerment Scale which is more subjective and Center for Self-Help Research instrument which is more objective. The Consumer Empowerment Scale takes about 20 minutes and may be used in its entirety. Two sub-scales will also be used that look at personal empowerment, or whether the person can handle basic resources, and organizational empowerment which looks at the extent that a person is involved in organizations. The group would like to post the instruments on the web site. Ms. Fox Wieselthier reminded participants that to put copyrighted information on the web will require permission from the authors. The staff section of the web site can be used to post documents in draft so that they are not disseminated to everyone. Satisfaction Subcommittee Group Matt Johnsen This group reviewed a list of criteria. It talked about questions driving the research. In terms of satisfaction with services, is the project looking at global satisfaction or satisfaction with a specific program. The project is looking at consumer-operated services (COS) separate from traditional services. Satisfaction with traditional services could be measured at baseline and follow up, but could COS be measured at baseline? The project may be looking at satisfaction with COS at follow up. The group wondered whether to include a quality of life measure even though its wasn't one of the five required items? The group looked at 5 satisfaction instruments. After looking at all of these, it seemed as though some of them were not appropriate across all programs. It seemed that a combination of the CSQ and MHSIP might be used. Ms. Fox Wieseltheir raised an objection to the CSQ. It was stated that the MHSIP appears to be developing a literature that its psychometric properties are reliable. Dr. Campbell asked if it has been tested in peer programs. A few quality of life instruments were reviewed. FACES met some resistance from consumers. Dr. Campbell suggested that a question such as "How is your life going" could get at quality of life issues. The group is not at a point where it has specific items. A draft will be ready shortly. Cost Analysis Task Force Brian Yates This group is still grappling with some issues. It worked with the logic model group and got costs included as inputs. All 8 study sites have one representative on the Cost Analysis Task Force. This group has one of the most active listservs. The benefits list was approved by a number of sites--this is a list of about 10 questions to ask consumers. Feedback on this is needed by the middle of February. There is great concern about the timeline. Much work has been done with Matt Johnsen and his team to refine the procedures that make up each of the programs--this will help us define costs. The next step involves getting all sites on a regular two-week goal-setting cycle so that we can get feedback to each other. A concrete cost procedure is needed to determine how often we ask for costs (every six months, every nine months, etc.). This group would like feedback on cost measures and benefits measures from other subcommittees. Mark Salzer commented that its seems like cost is going beyond what is asked by the federal government and this is an issue. Can study sites keep track of all this? Dr. Yates indicated that some of the study sites wanted to add measures to capture what they were doing. Not all programs wanted to add measures. The federal government expects cost effectiveness to be measured. Ms. McDonel stated that the cost study will be one of the sexy outcomes of project. It was agreed that this is important. Perhaps it needs to be revisited to see how much it will cost and get an estimate of the time burden that will result from collection. Dr. Campbell said there was supposed to be an examination of patterns of service use. Research Theory Subcommittee Group Mark Salzer - Temporary chair A teleconference with 20 participants took place last week to discuss the goal of this subcommittee group. There had been no initial discussion about what products would be produced by the group. The Coordinating Center was working on logic model at the same time the group was. The following goals were identified for the group:
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