1. How to Start A Peer Driven Room & Board Advisory Coalition
Cynthia White, M.F.T.
Chief Advocate, Patients’ Rights
County of San Bernardino

2. Call to Action
Due to unfortunate circumstances, Room & Boards came to the forefront of Patients’ Rights attention
Consumers were being taken advantage of in a variety of ways – fiduciary, poor standards
CoSB-DBH stopped using existing list-which historically gathered from all over and not verified

3. Federal Fair Housing Act
FHA defines discrimination as “a refusal to make reasonable accommodations in rules, policies, practices or services , when such accommodations may be necessary to afford (handicapped) person(s) equal opportunity to enjoy a dwelling.”

4. The Continuum of MH Housing
Locked facilities
Board & Cares
Room & Boards
Stabilization needed
Medical , Supervision or ADL Care needed
Independent
Living
Always emphasize that the consumer must have funding for a room and board, and they must be ready to live independently.

5. Housing Costs in SB County
Board & Care *900-$1,086 per month Def: Facilities that provide 24-hour non-medical care for adults ages 18-59, who are unable to provide for their own daily needs. Adults may be physically handicapped, developmentally disabled and/or mentally disabled.
Room & Board ** $350-$700 per month
Def: a place to live which includes bed, electricity, water and food. For adults who are able to provide for their own daily needs.
SOURCE: * Community Care Licensing, Title 22
** DBH Homeless Program

6. Peer Driven Room & Board Advisory Coalition Mission Statement
To provide Room & Board consumers a resource tool to assist in renting healthy, safe, well managed and quality room and board housing.

7. Values Statement
To recognize the dignity and worth of all human beings
To acknowledge that clients are the experts of their experience
To empower consumers to develop leadership skills
To promote and encourage consumer self-advocacy skills
To facilitate a positive partnership between consumer and room and board operators
To advocate for consumers of room and board facilities
To educate consumers on available resources
To actively participate in monthly coalition meetings.

8. Wellness & Recovery includes…
Steps toward Self Determination
Setting goals for symptom management, work, education, socialization and housing
Accessing information to make informed choices
Acquiring confidence and developing a sense of personal accountability
Being woven into the community

9. Empowerment is the key!
Wellness and Recovery promotes self-determination – including housing choices
Room & Boards are a popular choice among mental health clients due to: -Limited, fixed income
-Meals are included
-Socialization opportunities
-Affordability
This begins the section on “selling the idea” This is why we are doing this Coalition, and why room and boards are used by our clients

10. Client Issues with Room & Boards
Quality of housing
Quality & quantity of food
Not getting what you paid for
R&B operators as the payee
Poor or NO record keeping of P&I money
Rude and discourteous treatment from staff
Arbitrary rules
Lack of accountability
“Oral” rental agreements
Increased number of tenants over time
Arbitrary evictions

11. R&B Operators had issues as well
Disruptive behavior
Agency contacts in the home
Unreliable payments
Destruction of property
Complaints from neighbors
Uncooperative, demanding tenants
Drug/alcohol issues
Security issues
Police involvement
Getting a bad reputation

12. Provider concerns…
Providers want to be able to provide a location that is safe and reputable
Ethically responsible for client safety upon discharge
Housing is essential to client wellness
No means to “report” or “complain” on R&B’s
Seeking solutions that are client centered

13. Background Work to be Done
Check with your Local Housing Authority for any considerations
Review city requirements – Fire Clearance, Business License
Identify a location for regular meetings
Develop goals of Coalition (different than Mission Statement)
Identify current R&B Operators in county

14. Seeking out Participants
1) Solicit participants from local Clubhouses
2) Seek current Providers of Behavioral Health
3) Encourage NAMI members to participate
4) Allow community members and volunteers to join
5) Seek agency participation – e.g. local community groups, homeless services
6) Find existing R&B Operators

15. First Steps as a Coalition
Mission Statement – what are you hoping to accomplish?
Code of Ethics – define your standards. Conflict of interest? Adherence to rules necessary for participation.
Membership requirements
Application, site review, attendance, fee?
Define Training Necessary – conduct needs assessment from Consumers, Operators, Providers
Develop a Complaint Resolution Committee

16. Governing Board
Decide what titles you want to have Director, Chairperson, Co-Chair and a Complaint Resolution Committee Chair?
Establish the guidelines for election and participation. Establish roles for each position.
Encourage regular participation so members can benefit from the trainings.

17. Additional considerations…
How often should you hold meetings?
Where are they to be held? Can they move locations for large counties?
How long will the meetings be?
What are the standard meeting agenda items?
Define your training schedule after needs assessment is done and line up presenters
Remember Cultural Competency considerations

18. Sample Meeting Agenda Welcome New members introduction – Self
PTSD – How to recognize and help – Pts. Rts. Staff
Discharge Considerations – SB Community Hospital
Recipe of the Month – a healthy alternative
Low Cost Socialization Ideas - Various
Cultural Competency Insights – Office of Cultural Competency

19. Other topics we have shared…
Board & Care vs. Room & Board
Depression – Taking positive steps
Communication 101
Preparing for an Emergency – Developing Action Plans for the Room & Board
Disaster Preparedness – Taking care of those in your home
Being Culturally Sensitive

20. The Process Consumer seeks independent living arrangement
List is provided via clubhouse, case manager, or mental health provider
Consumer is guided through available options based on personal needs
Consumer makes selection and calls for interview
Consumer makes selection(s) – appropriate information sheet(s) is provided
Consumer visits location and enters into rental agreement with operator

21. Maintaining the List
Operators are asked to call by Monday at noon any changes to their vacancy status
New lists sent electronically each Tuesday to all recipients that have been trained on the process – (note: operators do not get lists)
Operators can be suspended or removed from list if they do not comply with Coalition guidelines.

22. Paperwork… Interest/Application Forms Site Review Forms
Complaint Resolution Form
Room & Board Comparison List

23. Lessons Learned… Membership drive must be ongoing
Operators stop attending once their houses become full – have a participation policy
Develop Resolution Committee quickly
Line up several presenters of information based on training needs assessment
Provide a consistent day and time for attendance
Be willing to “hand over” the process to the community

24. Questions?