Thank you for the opportunity to make comments on the proposed changes affecting members of our communities across the state with serious mental illnesses.

My question first of all is - "What is broken"?  And therefore, what are we trying to fix?

In the work that I do in the psychosocial rehabilitation program for our CSB, I see first hand, everyday, the evidence based on the small and incremental progress that attendance and participation in the program makes for our members.  They love this program and have a huge part in what makes it work!

We operate on a "hybrid" model - blending components of the traditional clubhouse model with individualized goal-oriented psychosocial rehabilitation principles.  This has proven effective over the years.

My greatest concern of transitioning to Clubhouse International is the heavy financial barriers associated with accreditation , trainings, etc.  I don't know how this is going to be possible for our CSB which serves 7 financially strapped rural counties.

I am also concerned with the employment component as our area already has such competition for entry-level type jobs.  

Maybe trying to fit this service (PSR/clubhouse) into a medical model is what needs to be examined?  We know that it greatly benefits the quality of life for those with serious mental illness.  Possibly there are block grant funds that the state can earmark for clubhouse/PSR for its public mental health services ?

Thank you for considering my comments.