The second Older Adults' Forum On Mental Health Issues was held in Washington, D.C., on May 12 through May 14, following by two years the original organizational meeting. This meeting resulted from the persistence and perseverance of the first forum's attendees with the full support and encouragement of the Bazelon Law Center. It was based on recognition of the need of older adult mental health consumers for an advocacy mechanism through which this grossly underserved population might finally speak with a united voice for the needed improvement of the nation's mental health service delivery system. With this in mind, the title "Our Own Voice," suggested by a consumer member, was given to the meeting and subsequently was adopted as the slogan for the organization that was formed.

The meeting was attended by 25 consumers and family caregivers who had attended the first meeting. Two additional consumers were invited from the states of New York and Pennsylvania because of their participation in an ongoing federally funded project to address the training of primary care physicians in the identification and appropriate treatment and or referral of older persons with symptoms of mental illness.

Also in attendance were 14 invited representatives from various organizations related to and/or supportive of the issues affecting older consumers of mental health services.

FRIDAY, MAY 12

Welcome and Ice Breaker - Hikmah Gardiner
The meeting began with introductions of attendees and an inspiring greeting from Hikmah Gardiner, an older adult consumer and director of the Do Drop In Center of the Mental Health Association of Southeastern Pennsylvania. Ms. Gardiner stressed the importance of older adults breaking out of their "quiet desperation" by organizing a senior group to speak out nationally and in each of their states regarding their needs and problems.

Why Are We Here? - Trudy Persky
Trudy Persky, a social worker and former project director for Mental Health and Aging in the Philadelphia Office of Mental Health, and above all a dedicated and effective senior advocate, identified critical issues related to older persons with mental illness. She did this in the context of a presentation of a brief historical perspective of what has occurred nationally since the early 1960s in regard to the mental health service delivery system as it related to older adults. Notably, from its inception in the early 1960s the system has tended to overlook and underserve older persons. In addition, deinstitutionalization, which could have resulted in improved community services to older persons in their own personal residences merely resulted in "trans-institutionalization" of the population from state hospitals into nursing facilities, with little or no improvement in their quality of life. With more and more funding responsibility being transferred to the states, little emphasis was placed on the special needs of the older population, especially those with dementia and those who experienced symptoms of mental illness after the age of sixty.

To complicate matters further, the federal government has chosen to limit the coverage of mental health services to 50% as opposed to 80% for physical health services, thereby discouraging the delivery of services to this population, as well as discouraging older persons from seeking out what services are available. In recent years, with the vast majority of older persons eligible for social security benefits, they have generally not been eligible for Medicaid-funded services, because their limited income from social security raises them above the poverty level classification required by most state Medicaid programs. These funding problems have been further complicated with the introduction of managed care to the mental health system. With its reliance on capitation payments to service providers, there is little or no incentive for the provision of outreach and early identification services needed by older persons to prevent eventual hospitalization and long-term residential care.

Even legislation that has had the potential for improving services and quality of life for older persons with mental illness has been ineffective due to failure of federal enforcement of its provisions. This is true of the 1987 Nursing Home Reform Act, commonly referred to as OBRA 87, and its mandate of preadmission screening and annual resident review (PASARR), which provides a mechanism for identification of mental health problems in persons being considered for admission to nursing facilities and recommendations for meeting their mental health needs if they are admitted. Unfortunately, few state quality assurance teams monitor and enforce the requirements of this process. In addition, in some states, nursing facilities refuse to accept as residents persons who present mental health problems because the funding formulae fail to provide incentives for providing the extra care they may require.

Currently, estimates of 18% to 25% of older persons are in need of mental health services. Most common problems are clinical depression, anxiety, dementia and delirium. With the aging of the population, ever increasing numbers of this population are found to be affected by long-standing schizophrenia and bipolar disorders. All of these are further complicated with co-occurrence of multiple physical health problems and many others with co-occurring alcohol and substance abuse problems, frequently with late-life onset.

The suicide rate for older persons is the highest of any population group, with 21% and higher of all suicides being accounted for by this population, which represents only 13% of the overall national population. Despite these problems and statistics older adults account for only 7% of psychiatric hospitalizations and only an estimated 6% of the nation's community mental health caseloads. In short, this population, despite its significant need for mental health services, remains the most underserved population group in the nation. Furthermore, despite census data indicating it is the fastest growing segment of the population, the mental health systems across the country choose to ignore the current need for increased service delivery to this population. Thus the major issue is that of current underservice and future exacerbation of the problem due to an ever increasing population.

Once again the need for effective advocacy to address these issues is the main issue that has to be highlighted. Without such advocacy the situation will merely worsen.

Participant Comments Regarding Critical Issues

• AARP and NAMI should get more involved.
• We need parity mental health with physical health care, and more alternatives to nursing homes.
• We need a national consumer organization with state representatives.
• Federal government should mandate that states specifically address older population in required plans and reports and use a reasonable portion of mental health block grant funds to develop specialized mental health services for older persons.
• States should pay more attention to mental health service needs of the older population.
• Nursing homes are not places for people with mental health needs - we need community resources and choices.
• We need to wake people up to mental health needs, and educate to remove stigma.
• We should include dementia as part of our advocacy because it is so prevalent, and family and other advocates must speak for people with dementia.
• We should use the Olmstead decision to increase access to community-based care.
• Our agenda should be inclusive and respectful of each other.
• Lack of coverage for prescription drugs, and needs of people who are divorced.
• We need follow-up services after nursing home discharge.
• People who live alone need someone to talk to.
• We need appropriate medication.
• Number of older adults is increasing - we need more resources to keep people in their communities.
• True parity means the right to say no to treatment.
• Some medications can be problematic, and providers don't always pick up the problems.
• Older adults need more services and financial support for assistance - not enough support for elderly.
• Federal program with consumer advisory council is important.
• This process should be consumer-centered.
• We need a state scoring system to see how services to older people are improving
• Medications can be mis-prescribed. Side effects are a problem.
• Increasing dependency can lead to depression - we need more education about the aging process.
• Managed care has too many restrictions.
• Family members can take advantage of older adults financially.
• Nursing homes sometimes over-prescribe drugs.
• States should be encouraged to include older adults in depression screening day.
• Need to address problem of long waiting lists for psychiatric help because professionals are leaving the field due to low reimbursement levels.
• We should not jump into joining another group just to get added clout.
• We need a nationally prominent spokesperson.

Joint Presentation: Fundraising and Program Development:
Margeau Gilbert & Ingrid Komar, Presenters

In addition to providing various hand-out materials that were distributed to the participants, the speakers highlighted a number of significant issues that we should keep in mind when we consider the important planning of activities related to fundraising. These are listed below:

• Background - importance of strategic planning: All activities should be related to a well thought-out plan developed and approved by the organization.
• It isn't just a matter of depending on reason and logic in our fund requests. Rather, we have to develop ways to make people with mental disabilities "sexy" to fundraisers. What is in it for them?
• There are plenty of places that will give us money! We must give funding sources a project, not an idea
• Even an individual "angel" will want a concrete plan of action
• Initial product can be modest, like a newsletter or website.
• Be creative about connections - kids' organizations might be interested in elders because kids have mothers.
• Chat up your prospects.
• Value even small donations.
• Even if funding sources don't require reports, let them know what you're doing and keep in touch regularly.
• People give to people, not causes.
• Eyeball-to-eyeball is how you get the dollar.
• Never let a funder out of your grasp. Send Christmas cards.
• Find user-friendly foundations and then educate them.
• This isn't a sexy issue, so do homework on foundations.
• Foundation's annual report will list previous grants - try to find where you fit in.
• Don't try to force a proposal on the wrong foundation
• Submit applications to different foundations - but no cookie-cutters or shotguns
• Tell foundations when you've been funded by someone else - but be honest about rejection.
• Look at foundation guidelines to determine how much money to ask for.
• Rule of 5: anyone who can write a check for $100 can write a check for $500 if you move them there in time
• Www.foundationcenter.org
• Funding sources like "warm fuzzies" like direct services, which are easier to quantify than advocacy.
• New organizations don't get 3-year grants, so identify first project and have second year on the back burner.
• Write a letter of inquiry, then try to get face-to-face contact.
• Regard rejection as a "temporary postponement", not an unsuccessful conclusion.
• Regard anyone you meet is a potential funding source.
• Consider individuals as well as organizations - don't overlook anyone
• Diversify your funding base as soon as possible - don't rely on one funding source.
• Apply the 20-80 rule: 20% of the people give 80% of the $
• Individuals will always be the biggest source of funding
• Networking is crucial: consider such devices as wearing t-shirts identified with the organization.

Grant-writing is time-consuming - the organization will need help with this

• Find and use a common grant application - the sample in the folder is specific to D.C., and there are other samples specific to other states.
• Program directors are looking for opportunities to throw things away. Don't send binders or too much material. Don't use jargon - be clear and specific: who are you? What will you provide? What is your mission? What won't you do?
• 501c(3) process should be pending - and tell them it's pending.
• Keep financial records in order.
• Keep relationships going - don't always solicit.
• Consider regional funding

Application Steps:

1. Get guidelines
2. Call program officer
3. Try to get application in a couple of weeks early
4. Call to make sure application was received and see if you can answer questions
5. If more than one person writes grants, the language and substance should be the same
6. Use samples in the packet - but personalize them

Elements of a proposal:

1. What are you going to do?
2. How?
3. By whom?
4. How will it be evaluated?
5. Operating expenses should be less than 20% - Be careful about disparities in salaries.
6. Proposals should use terminology that funding sources use ("older adults" "elderly," etc.)
7. Distilling information into 3 pages is difficult but essential.

SATURDAY, MAY 13

Panel Discussion: Values and Vision: Consumer and Caregiver Perspectives Panelists:
      Paolo Delvecchio
      Josselyn Winslow
      John Piacitelli
      Margeau Gilbert (Moderator)

Paolo delVecchio noted that this is the 30th anniversary of the modern consumer/survivor movement. He went on to remind the participants of the movement's eight fundamental values:

1. Respect and dignity
2. Mutual support: "Helper's principle," Equal power balance.
3. Diversity: Recognize strengths: cultural, gender, geographic diversity
4. Education/empowerment
   • We can learn from everyone
   • Empowerment through knowledge
   • "Each one teach one"
5. Social action and advocacy
6. Be strengths-based: Emphasize strengths of consumers, not weaknesses
7. Responsibility - Both to peers and to society
8. Choice and self-determination
   Having a say in decisions that have impact on our lives
   Person-centered and person-directed
   Individual, not system makes decisions

Paolo also cited R.W.Johnson's 4 basic principles on self-determination:

1. Freedom
2. Authority to make decisions
3. Autonomy/independence
4. Responsibility

Josselyn Winslow spoke to the role of the family, highlighting the following points:

• Self-determination is big issue for families
• Important to discuss personal choices with the persons with dementia before the disease process progresses to the point where they are unable to be involved.
• No one chooses to be a family caregiver, but people need someone to stand up for them. People with Alzheimer's Disease are slow to get help - early diagnosis can help
• Because persons with Alzheimer's Disease can live 8-10 years, we need more community supports because it is one of the most expensive diseases a family can encounter

John Piacitelli noted that in his many years of working in the mental health system the older adult consumers have lacked an organized, articulate advocacy group to speak to their numerous needs. As a result older consumers, unidentified consumers and their family caregivers have suffered from the lack of accessible, affordable and age-appropriate mental health services. There have been strong aging and strong mental health advocacy groups (AARP, NCOA, NAMI) but they have not chosen to advocate for the older population with mental illnesses. He predicted that until the older population itself, and others concerned about their needs, specifically approach the state legislatures and congress, state and local administrators and planners of mental health and aging services, and insist on development of needed services, the older population with mental illness will remain underserved and/or inappropriately served.

He stated that he envisioned that day when every city and town in America will have services and programs that are customized to the unique mental health needs of older persons and their family caregivers. However, that day will not come until we have an organized advocacy organization in each of the states. He warned that "as long as we consumers appear to be satisfied with subsisting on the crumbs off the table of mental health budget planners and administrators, instead of insisting on having a full loaf of resources and benefits, older consumers will continue to lack the nourishment needed to sustain and promote our mental health."

John concluded by emphasizing the importance of whatever advocacy organization we decide on being be as inclusive as possible in its membership requirements. Otherwise we will suffer from the loss of the energy and wisdom of such non-consumers as Irene Kaziesko, Bob Bernstien, Willard Mays, Todd Ringlestien, Josselyn Winslow and many others who have contributed so much to past efforts in providing for the mental health needs of the older population.

Participants' Comments Regarding Issues Raised by Panel Members

• Advance directives are not always requested and are not always honored.
• People don't listen to perceptions of pain from people with mental illness.
• We must seek ways to empower people who aren't able to make their own choices.
• We should be able to rely on funding from the federal government, not just foundations.
• States are spending fewer dollars on mental health services today than in 1955 when dollar amounts are adjusted for inflation.

Possible action items:

• Advance directives
• Block grants/state funding

Panel Presentation: The successful development of a national advocacy group,
Presenters:

Barbara Huff
Brian Coopper
Gail Daniels

FFCMH started ten years ago from a meeting of 75 family members and 25 professionals who determined major issues required formation of the organization

• need for public education
• lack of community-based services
• lack of service coordination
• custody issues
• lack of family support

18 participants signed a document promising to devote time to development of an organization. These 18 spent 4 weekend in the first year at Naomi Karp's home to establish bylaws, incorporation, membership decisions, etc. Bylaws have changed a lot since then.

First steering committee became board of directors.
FFCMH started with a few existing state groups funded by CASP and others that were just starting. It now supports local chapters that do the work.

Some existing mental health organizations originally said this couldn't be done because people with children in crisis don't have enough energy.

• FFCMH started by working with other groups on advocacy issues - they always looked bigger and stronger than they were.
• At the time of its founding it was the only organization which specifically addressed children's mental health issues.
• Other organizations refused to take on children's mental health issues, so there was need for a separate group - but now they have carved a niche and have good relationships with other groups.
• It was decided that this organization should be as inclusive as possible, very diverse and would focus on serving kids with mental health problems at all stages of their development.
• There is now a family organization affiliate in all but 4 states and has grown from 75 people to a current membership of over 1200.
• It focuses on technical assistance, policy, research and training for family members.
• Office is diverse like its constituents, includes welfare-to-work parents on its staff, which consists totally of family members, with the exception of the accountant..
• Community-based services for children and families has become most important issue for FFCMH - including surrounding issues like education.

Funding has come from foundations, but Federation has been overly reliant upon federal dollars.

• 501c(3) exemptions were established by end of first year.
• It is the policy of the Federation to accept no funding from pharmaceutical companies.
• Portland State University provided conference calls for the board (funded by CMHS and Department of Education).
• After 3 years received 5-year grant from Casey Foundation for $300,000.
• Flexibility of $ is as important as amount of $.

Barbara advised that it is important to look far into the future because benefits won't be immediate.

• Originally the Federation was concerned that it would be taking "other peoples' money." Our group has to get past that. We need to keep in mind that no organization currently places value on older adults just as was true for children's organizations.
• FFCMH started like we are - with a few supportive groups
• Advocacy requires coalitions among groups
• Don't spend energy making everything a battle but pick the battles that we can fight and win.

Gail Daniels reminded the group that very young children are innocent enough, and older adults are wise enough to understand that everyone is alike regardless of ethnicity.

The District of Columbia chapter's motto should serve as advice to our group; namely, "We bear it better when we bear it together."

Brian Cooper presented the group with the following points of encouragement and advice: Elements of a successful organization:

• well-defined vision, mission, values and goals
• sense of consensus and compromise - picking battles
• Define membership - must be consumer-centered
• Have good people
• Strategic planning - if you don't know where you're going, you'll probably end up someplace else
• Bylaws, incorporation, 501c3
• Have fun

WARNING: This is challenging work - not all groups succeed, e.g., some groups that no longer exist:

• National Mental Health Consumers Association.
• National Association of Psychiatric Survivors
• Virginia Mental Health Consumers Organization

We should contact the American Association of People with Disabilities, an existing organization that is under-funded, but striving to grow.

Fundraising Issues:

• Membership dues won't bring in enough $
• We must decide whether to accept pharmaceutical funding? (FFCMH does not, but NMHA does) consider: it's our $ that drug companies have - same with federal tax $
• We should diversify our portfolio so that no funding source owns us
• Funding sources want a well-defined, deliverable product
• Plan to demonstrate outcomes
• Make personal relationships with funding sources and other advocates

Independence vs. Affiliation:

• Affiliation gives strength in numbers, but so does coalition
• Coalitions can bring groups together on specific issues that are apart on other issues; e.g., NAMI, NAPAS, Bazelon, NMHA, FFCMH agree about use of restraints.
• Infiltrate existing national advocacy organizations to make sure they address older adults; NMHA has a CMHS grant to start National Consumer Supporter Technical Assistance Center - which has newsletter and other documents that could address our issues. "Consumer-centered" can have different definitions - we have to decide on percentage of consumers and maybe we have a professional advisory board (without voting rights)

Possible Action Items:

• Self-advocacy and peer-advocacy
• Advance directives
• Education of primary care physicians

Big challenge: Shortages of money, time and energy
We could start with a policy committee simultaneously with efforts to organize our group - Get invited to coalition meetings, etc. and show that we're bigger than we seem.

Workgroup Reports, Participants' Discussion And Actions:

Membership Committee
Final Recommendations To The Total Participant Group

Recommended Criteria For Membership

1. General membership is open
2. Board of Directors - controlled by consumers; primary consumers get at least 2/3 of vote and secondary consumers get 1/3
3. Primary consumers are older persons (60+) who have been diagnosed with a mental disorder
4. Secondary consumer is a family member of any age who is may be non-diagnosed, but who has taken care of an older person with a mental disorder.
5. There will be a technical professional group to provide needed consultation
6. The chair of the professional advisory committee would be a non-voting member of the executive committee and the board of directors.

Discussion Highlights
Question: Why should a member of the professional advisory committee be a member of the executive committee?

Answer: The board is made up of primary and secondary consumers. The committee would be available for advice, but not to vote. We therefore have an opportunity for advice, but no obligation to take that advice. The organization will still be controlled by diagnosed consumers.

Question: who votes right now about questions we are considering?

Answer: Among the participants, 19 people consider themselves to be primary consumers and 5 meet the definition for secondary consumers. They will be the persons who may cast a vote.

Action Taken:
Participants Voted Unanimously To Adopt These As The Membership Criteria
(These criteria may be modified in future via recommendations to the executive committee)

The Vision And Mission Statement By-Law Committee
Final Recommendations To The Total Participant Group

Recommended Changes To Drafted Vision Statement

1. "Older person" means a person 60+ years of age
2. Throughout the vision statement change: "mental problems" or "mental illness" to "mental disorder"
3. Add to vision statement: "...and ensures self-determination, choice, and the right to refuse treatment"
4. Change: "maintain their individual functioning" to "maintain the independent functioning of older persons"

Vision Statement with Recommended Changes:
All older persons—regardless of race, gender, creed, color, ethnic origin, sexual orientation, language, disability or age—who have or are at risk of developing mental disorders should have available to them and their family caregivers specialized services which are readily accessible and provided in the least restrictive environment and which maintain their individual independent functioning and ensure self-determination, choice and right to refuse treatment.

Action Taken:
Participants Voted Unanimously To Adopt Vision Statement As Presented With Recommended Changes

Recommended Mission Statement Changes

1. Mental disorder is a more inclusive term (to be substituted for "mental illness" mission statement)
2. "major source" substituted for "primary source" of information
3. Change objectives to "To decrease in older persons the stigma and fear of seeking mental health treatment by increasing awareness... ...
4. approaches to services and treatments including peer support programs needed by this population group."
5. "To advocate at all levels of government for full parity..."
6. Put at the beginning: "To promote self-determination and a person-centered system of care for older persons with mental health needs."
7. Add an objective: "To promote consumers and their family caregivers affected by mental disorders by promoting the development of accessible, affordable, age-appropriate and voluntary mental health services."

ACTION TAKEN:
PARTICIPANTS VOTED UNANIMOUSLY TO ADOPT MISSION STATEMENT AND BY- LAWS AS PRESENTED WITH RECOMMENDED CHANGES INCORPORATED THERE IN (SEE BY-LAWS ATTACHED TO THIS REPORT)

THE FUNDRAISING STRATEGIES COMMITTEE
FINAL RECOMMENDATIONS TO THE TOTAL PARTICIPANT GROUP

Recommended Assumptions
We will exist.
We will apply for funding.
We will hire a grant writer.
Specifics will be worked out for determination of : Location, staff, salary, rent,

Miscellaneous Recommendations

1. Get organized with a budget, know what we are doing.
2. Agree on one thing in common to focus on as a unified front.
3. Get organized FIRST-set up an administrative function, make estimates of what we need.
4. Operating expenses are occasionally covered by some foundations. Like the CMHS seed money. We need a first year "launch" of our own administration.
5. Membership dues are another source of funding.
6. An executive committee should design a budget for seeking any September funds like Community action grants.
7. Fundraising should be diversified: corporate, federal, fraternal, religious, "angels." The title or name of our group should focus on aging more than mental health

Recommended Principles
We should network
We should have a strong group identity reflected in logos and posters and spokespersons.
We should focus on self-determination
We should be organized and develop and abide by budget
We should cost out what we plan to do

Recommended Ideas For Fundraising:

1. Use cost overage on existing events
2. Procure one single corporate funding source
3. Consider more help from insurance as sponsors - including political implications
4. Suggested organizations to approach: Aid Association for Lutherans and Brotherhood for Lutherans; other religious and fraternal organizations.
5. Start with who you know, consider local and state.
6. Consider matching [gifts]
7. Develop a Press Release-e.g., such as Bryce developed for a local press release about consumers who attended this conference.
8. Look bigger than who you are
9. Consider Community Action Grants from CMHS
10. Learn the timing for funding sources
11. Be careful with decisions about who we coalition with...stay independent, stay grassroots.
12. Choose Spokespersons such as: Mike Wallace, Patti Duke, Patch Adams, Al Siebert (A psychologist and advocate.)
13. Consider a product or mascot: like a Beanie Baby for sale
14. Consider selling other things identified with us.
15. Review age restrictions for memberships.
16. Include diversity.
17. Consider city-based fundraising.
18. Count on self-advocating.
19. Specifically emphasize self-determination
20. Investigate how to tie a fundraising campaign to survivors of abuse.

Recommended Actions

1. Outreach to Corporate, Govt., Religious and Fraternal Groups
2. Bryce will get a Community Action grant Application and submit it for us!
3. Take a stab at Federal funding as seed money, $150,000 per year.
4. Contact GE and find out about the corporate giving model used.
5. Encourage our members to pick one corporate structure - and use a model format and then approach various corporate sources. (Consider new companies that have merged.)
6. Look for an "angel" who wants to set up an endowment
7. Approach people for bequests.
8. Coordinate corporate outreach through some central administrative structure.
9. Use this same outreach for religious groups
10. Consider special mailings and soliciting funds on a particular holiday: July 4 or father's day. (Like KS NAMI valentines outreach). Claim some day for our own outreach.
11. Network fundraising in coalition with others even though we are independent.
12. Obtain training on fund-raising and grant-writing activities.
13. TAKE ACTION NOW

Additional Comments And Suggestions
Local fundraising should be for local use
Seek out corporate links for fundraising and centralize overtures for funding
Question was raised regarding giving priority to older adults v. mental health; the intent is to strengthen those linkages
Suggestion given to put out press releases to local newspapers regarding participation (make the organization seem larger than it actually is)
The workgroup saw connection between development and publicity
Is there an interim plan for fundraising? -BAZELON CENTER? NMHA? CMHS?
Controversial and non-consumer groups can still contribute
Group will draft boilerplate for a press release; circulate it through the Internet.
Will be most effective as a grassroots local initiative, not a Washington initiative.
Brian Coopper:- One technical resource guide is concerned with working with the media; It is available on the website: www.ncstac.org
Other useful websites: www.contac.org
The national mental health consumer self-help clearinghouse website: www.mhselfhelp.org
Mental Health Reports, CMHS newsletter and Mental Health Weekly might pick up stories

Action Taken:
Participants Voted Unanimously To Accept The Fund-Raising Strategy Committee's Report And Recommendations For Possible Future Actions By The Organization As Presented.

Comments And Suggestions By Observers And Guests

Willard Mays, Representing National Coalition on Mental Health and Aging, which is made up of representatives of about 50 interested agencies, suggested opportunities for the group to make use of in order to develop coalition with other organizations.

One thing the Coalition is lacking is a consumer voice. While some member organizations represent consumers, there is not a direct consumer voice. Three opportunities are being offered, assuming that this group decides to develop a national organization.

1. It is invited to join the Coalition and to designate a representative to attend meetings . The Coalition is also in the process of developing state and local coalitions around the country to which members of this group can pair up.
2. September 10-13, the Older Persons Division of NASMHPD will meet in Indianapolis. Jointly meeting will be state aging directors and substance abuse directors. A 1 hour 15 minute session has been scheduled during which older adult advocacy representatives of this group are invited to present.
3. The National Council on Aging and American Society on Aging, two of the largest professional aging associations will be meeting jointly March 8-11 in New Orleans. There will be a track on coalition building and mental health and substance abuse A workshop has been set aside for representatives of this organization to present on older adult advocacy.

Willard thinks that there are also some possibilities to support travel to the conferences for representatives of this group. Also, there may be an opportunity for a funding grant.

Todd Ringlestein (New Hampshire), President, Older Adult Division of the National Association of State Mental Health Program Directors, extended his invitation for members to attend the group's annual meeting this year. About 35 states usually attend this meeting.

Action Taken:
The Group Deferred A Decision On Willard's And Todd's Invitations And Suggestions Until Subcommittee Regarding Affiliation/Incorporation Makes Recommendations.

Action Taken Regarding Forming An Advocacy Organization
Consensus Resolved: To Form An Independent Advocacy Organization And Not To Affiliate With An Existing Organization.

SUNDAY, MAY 15

Development Committee
Final Recommendations To The Total Participant Group

Recommendations Of Things To Do Immediately

• Support coalition building
• Regional (Based on current representation at meeting)
  • Northeast: New York, Pennsylvania, New Hampshire, Maine
  • Southeast: Florida, South Carolina
  • Midwest: Ohio, Minnesota, Michigan
  • Southwest: Texas, Arizona
  • Central: Colorado, Oklahoma ok
  • West: Utah, California, Washington
• Suggested local groups located nationally
• Associations: NAMI, AARP, NMHA, NCOA
• Governmental: State Units on Aging, Area Agencies on Aging State, County and Local Offices of Mental Health, Substance Abuse, Developmental Disabilities
• Churches and religious and fraternal organizations
• Interested individuals of all ages
• Activities the national organization can address in immediate future.
  1. Public education might be a starting point for an initial fundable project
  2. Executive committee should identify a specific product - examples:
  3. Develop state and local development packet
  4. Publish newsletter and brochure for this group
  5. Use public TV, radio and newspapers to inform public about organization
  6. Seek funding for professional training programs
  7. Use public service announcements
  8. Public education campaign to increase understanding of mental health and aging
  9. Develop a website
  10. Take steps to hire staff soon.
  11. Establish a speakers' bureau
  12. Develop plan for recruiting members
  13. Seek funding for training program, national office and staff, 800 number
  14. Develop a plan for advocacy for
• Increase funding minimum to 10% for mental health services for older adults
• Transportation $
  • Improve health, mental health and social service systems
  • Programs responsive to older adults
  • Mobile services/outreach to personal residences and community places, restaurants/malls/boarding homes
  • Specialized services
  • Alcohol and drug abuse programs for older adults
  • Parity—HMOs
  • Coordination & communication between agencies
  • Streamline admissions/system

Action Taken:
Unanimous Approval Given To Accepting Recommendations For Future Consideration And Action

Nominations Committee
Final Recommendations To The Total Participant Group

The Following Slate Of Officers Was Presented To The Membership For Consideration For Election To The Executive Committee

President:	John Piacitelli
First Vice President:	Hikmah Gardiner
Second Vice President:	Barbara Blitz
Correspondence Secretary:	Barbara Brooks
Recording Secretary:	Janet Stiles
Treasurer:	Pat Goodrich
Assistant Treasurer:	Louise Bouta
Sylvia Caras agreed be the liaison to the adult consumer advocacy organizations

Action Taken:
Nominated Slate Was Adopted Unanimously

Consideration Of Name For The Organization:

Action Taken:
Unanimously Accepted The Following As Name For The Organization:

American Older Adult Mental Health Consumer Association (AOAMHCA)

Adjournment: The Organizational Meeting Of Aoamhca Was Adjourned At Approximately 11:00 A.M. With An Executive Committee Meeting Scheduled To Follow Immediately.