The Torkel Saga 2059: August 2016

20160815-M: Charter Information

Introduction To Augment Measurement Results

Title Eliminations – Alternate Titles for Introduction

Jeff Gibbs – MA – An Anti-helper in Health & Human Services – Special Needs - Introduction

Keith E Torkelson, MS - Red Badge of Courage

Jeff Gibbs A Master of Arts (MA) – Kicking Off Online Presence – An Introduction

Executive Summary

This report addresses measuring about two helpers in the scope of Health & Human Services. Our ProHelper is Oswaldo Escalante (RAS) and our AntiHelper is Jeff Gibbs (MA). We here at MSG or Mentalation Solutions Group try our best to keep the data elements out of our introductory narrative section. Yet in practice we find it beneficial to include a bit of data to support our descriptions. In addition, we decided to include an invoicing (BillMakerMSG) element in both our results and introductory pieces. In sum we have included about thirteen (13) tables. We hope that our shared finding will contribute to program improvement as measured (AMB) by improved CMS Stars scores,

Hyperlinks

To Our Results

Gibbs Study 2016 Results For Summer Quarter

Introduction (This)

Gibbs Study Introduction For Summer Quarter 2016

Inspiration

Director Hale (OCHCA-BHS) discusses in public that consumers might better leverage their lived experiences. In the realm of spirit: We here at MSG take some inspiration from “The Big Foot” [See Image]. Numerous others inspire us including but not limited to: Family, Peers, and Jeff Gibbs himself.

The Intent

Define shortfalls so other present and future human service workers may avoid them and know how challenging their missions in Health & Human Services is or will be. Share a unique case. Create a case study so we may include it in our portfolio. In terms of a case study this one is fairly substantial at some odd fifty (5) pages when the results section is included. The Program which with we ally really doesn’t have the tools in place to rigorously evaluate their help.

Subjects

The primary subjects in this study are: Oswaldo Escalante (Helper-01), Jeff Gibbs (Helper-04, and Keith E Torkelson (Consumer). The “we” is any people in our recovery network that may participate as needed in our recovery. The “I” is the client-consumer Keith E Torkelson

In-Kind Support – Housing Support

Would we here at MSG help Jeff Gibbs with what we ask of him? If given enough advanced notice and good health: We would help Jeff Gibbs with his housing and moving! Because we care about people even if we don’t like them.

Motivation

I hope this evaluation will encourage Jeff Gibb’s to stop disappointing me. He is not very good at client-centered services, thus we have changed the focus to him. If we met Jeff Gibbs in public we would never give him our phone number. Email is fine though. This report is AVEY approved. We have been annoyed with Jeff Gibbs one too many times. Our conscience and mission are clear. We now appreciate Jeff for his willingness to be our test subject for further study into win-win service partnerships. We expect that Jeff Gibbs would have nothing to do with us if it were not a client prescribed by work. Oswaldo appeared to enjoy being with us in and out of the office.

Paraprofessional Development

Like teaching public school, development of a health & human services worker begins and ends at home. Jeff needs some development on personal time about his special methods. He really isn’t practicing anything he is proud enough to share via hard copy or online. The 2020s will hopefully usher in the rewards for accountability and transparency. This study is to help Jeff move forward a bit.

Evidenced Based Methods

Jeff states things that are unsupported by evidence. For example he will endorse a doctor whose only performance records are found online such as at the Vitals website. Whatever he is doing is unsupported by evidence. MSG suggests he leverage The Program’s prescribed Satisfaction Assessments to begin assessing his impact about helping his consumer accounts.

This Call May Be Recorded

We here at MSG have developed most of our Quality Control methods in conjunction with computer related technical support. Since the year 2000 we have worked over the phone with: HP hardware support, software support, and printer support. We have worked with TeleScan on server support, Netgear on networking support, and a vendor on T-1 reliability support. We know what a good call about. We know what fixes and solutions are about. We have hundreds of technical support transactions under our belts. I hindsight in the context of computing we fix or solve just about everything. Jeff Gibbs has yet to make a good call to us. He causes more problems than he solves. There is a benefit to corporate about our quandary with Gibbs. Corporate issues us an Annual Consumer Satisfaction Survey (ACSS). If we control for Gibbs’ shortfalls by leaving him out of the picture we can honesty score The Program higher.

Company People

How is it that our client is a company person? We have submitted all our program assigned (prescribed) materials including the Annual Consumer Satisfaction Survey. We have participated in a manner that earned us a high performer rating by several Reps at The Program. Knock-on-wood: Our attendance at “The Office” for over four years is perfect. We want our program to be the best on the block. We are willing to participate where possible to improve The Program as measured by (AMB) its’ CMS Stars scores. When necessary we supply information to quality assurance administered out of corporate. QA indicates that we are helpful. We try to see solutions where there are problems supported by evidence. And most of all: We truly appreciate the elements of “Our Program” that work.

AnnoyMan - Assignment - Health Fair Outcomes

Jeff assigned our client to attend and participate in a Health Fair on Friday August 19, 2016 located at “The Center”. We attended even though we did not need to. MSG has a long history of coordinating and evaluating events. We collected up our data from last year’s (2015) Health Fair and collected the new data set for this year (2016). We were going to rush our findings into this report yet now we feel it better to cache it for later. We will say that this event scored higher than last year’s event. Jeff coordinated and participated in a pretty good event. AnnoyMan is a product that MSG is developing for release in 2017.

2012-2014 Observations

We did not earn Jeff Gibbs as our case manager until mid 2015. Yet we have been observing him helping others prior to 2012. In 2012 we enrolled in The Program for which Jeff Gibbs works. In hindsight our first case manager – Oswaldo Escalante – was exceptional. As we watched or observed Jeff Gibbs while we were partnered with Oswaldo: We said to ourselves we hope not to be put in a position to have important transactions with Jeff Gibbs. After Oswaldo if given the choice we would have selected Derek C. Jeff in a fashion operates in a vacuum while only showing courtesy to those assigned to him. Basically if Jeff doesn’t have to partner with you he doesn’t really care about or acknowledge you.

00A-Strengths Up Front (SUF)

20150718-SAT > For - Jeff Gibbs > From – Keith Torkelson (Email)

Greetings Jeff G!

Strengths - I would like to take a moment to point out some of what went right with our meeting. The time spent with me was exceptional even though I did not indicate so. Rather than trigger a blunted affect you got my emotions stirring (psychodynamics). The net fatigue and anxiety for me was tolerable. I valued what you said about yourself including the size of your caseload. You were both kind and gracious. I got to debrief with Jessica who I have never really talked to in over 3 years. In the future I must avoid addressing family [control for family] because as you probably can tell I might benefit from therapy (LMFT). Oh! And thank for the email Friday. Hope you had a nice weekend – See you in about a month for 15 minutes – Keith Torkelson

00C-Strengths Paid Work – Educated – Email Competent

Derived from Berkeley Training Associates (BTA) Material

	-
	BTA – Strengths Category	Oswaldo	Jeff	Client
	-
1	Physical Health	PASS	PASS	Working
2	Use Of Community Services	PASS	ASSUME PASS	PASS
3	Social Relationships	PASS	Not Really	PASS
4	Psychological Strengths	Working	ASSUME PASS	PASS
5	Skills	PASS	Not Really	PASS
6	Clinical Risk Management	Working	Not Really	Working
7	Substance Use	PASS	ASSUME PASS	PASS
	-
		100%	57%	100%

Table f- BTA Derived Strengths Assessment - Last Reviewed 20160821-SUN

A few years back we here at MSG were drafted to help BTA with their treatment planning library (TPL) system. We were provided with over four hundred pages of documentation to evaluate. One of the categories was “Strengths”. Each category was stratified into multiple items. Actually for “Strengths” there are about twenty-five (25) pages of items (questions). As the scores indicate in the table above See Jeff does have some strengths after all. We do wish to state that if Jeff were enrolled in an Applied Case Management class with us at the university we would advice him to drop the class.

Strengths - Further Fleshing

Again, we have arrived at the challenge to find substantial strengths about Jeff and his services. Each time we fall short. We have caught ourselves in the old school of deficits. For gaining objectivity we retrieved some information from a project we worked on for the OC Health Care Agency (Dr. Horner). From May to June of 2011 Dr. Horner enlisted our aid in evaluating The Berkeley Training Associates (BTA) Treatment Plan Content (TPC) Lists. Of about seven (7) lists we selected a couple to analyze. One of these lists BTA’d “Strengths” Section by Stan Taubman, PhD, LCSW (BTA, March 15, 2011). The lists were for use by The State of California County Treatment Plan Coalition. Response needed by June 15, 2011. In the table above we applied the strengths material to our study.

BTA = Berkeley Training Associates

PASS includes: PASS / Working / Assume PASS

00D – Needs Improvement (Strength Virtuosity)

	-
	Potential Strength	Oswaldo	Jeff
	-
01	Communications Skills – Email	PASS	PASS
02	Communications Skills – Verbal	PASS	Needs Improvement
03	Development On Own Time	PASS	Not Evident
04	Education	PASS - RAS	PASS - MA
05	Friendly	PASS	Needs Improvement
06	Helpful	PASS	Paradoxical
07	Meaningful Contribution	PASS	Needs Improvement
08	Online Presence	PASS	Needs Improvement
09	Promising Practices	PASS	Needs Improvement
10	Proven Track Record	PASS	Needs Improvement
11	Transparency Credentials & Education	PASS	Needs Improvement
	-
		100%	27%

Table – Some Virtues About The Helping Professions - Finalized: 20160821-SUN:

Activities Of Daily Living

Yesterday, August 19, 2016, we got observed Jeff Gibbs in action. Our goal was to collect up observations encompassing more of his strengths. We concluded that he probably would score high on Activities of Daily Living or ADLs assessments.

01A-Attendence Message Via Email (Jeff scores high on his emails)

From Meeting 01 – Orientation to a New Helper

Jeff Gibbs > To > Keith Torkelson > Jun 24 at 4:39 PM (2015)

Great Keith! Sorry I missed you today. I absolutely will meet with you next Tuesday at the time you mentioned. That's perfectly fine. Also, you can always call or meet with me anytime as things arise M-F 830-5pm (other than each Thurs 2 to 5 when I will be in meetings). Thanks for utilizing the Health Fair today. Much appreciated. I'm glad we could provide that gift card for you. I am available to help you with a variety of issues, so rather than listing them here, I just check in with you next week when we meet. Sound good? (-: Take care, and have a good week/weekend as well.

01B-Perfect Attendance

As of August 4, 2016 our client prides himself since 2012 (June) for keeping all of our program related appointments. On average this is more than two per month. Part of the policy that we as “Program” users agreed to was keeping our appointments. Our attendance is 100% and we expect our helpers to meet that standard. As you can see in the note from Jeff above he missed an appointment with us and offered no acceptable excuse. It was only our third appointment. By the end of June (2015) he had an attendance rate of 66%. We knew then that there were going to be issues. In addition he also assigned us to attend a Health Fair. We dropped everything to satisfy his assignment. Yet when we assign him to help with Housing: He said: “No!”

01C-Data Segue - Segue - Verb

Move without interruption from theme to another. As in most cases we co-develop measurement elements with text elements. For the most part we separate measurement data elements from our narratives or introductions. Data and discussions are embedded about each other. On a few occasions we present data in the narrative or introduction. We just counted more that ten (10) date elements in this document. We need improvement. Yet still we try our best to minimize any segueing between data and narrative.

01D-ProgramNet2012 (PN2012)

	-
	Task (Services and Supports)	Oswaldo E PN2012	Diana M PN2012	Jeff G Preventive Request PN2016
	-
1	Accompanied me house shopping	YES		Said NO
2	Arranged transportation	YES	YES	NO
3	Found suitable housing (contingency)	YES	YES	SAID NO Described Barriers (Deficits Based)
4	Helped me restored medicine with most promise		YES	Really don’t want him involved
5	Helped me with finances and resources	YES	YES	NO
6	Took me up to contribute meaningfully to program	YES		NO
7	Accept invitation to see what I do for the county	YES		NO
8	Visits at place I rest	YES	YES	NO
9	Wrote for me helpful letter(s)		YES	Unnecessary

	Satisfied with Help	YES	YES	Marginal

Table – Comparing Individualized Program Services and Supports – ProgramNet2012 V ProgramNet2016

01E-Satisfied with Help

We call the service and support package delivered by Oswaldo and Director Diana M ProgramNet2012 (PN2012). The County (HCA-BHS) indicates that Safety Nets are desirable. Overall PN2012 was highly effective. When we were assigned Jeff Gibbs in the middle of 2015 we tried to sell him on the idea that we needed ProgramNet2016 on deck if needed. As the table indicates Jeff said NO! We would like to thank Oswaldo E and Diana M for all their help.

01F-Compliment Oswaldo

In a manner this paper has a dual function. 1) Compliment Oswaldo E and 2) Cope with the inefficacy (A NoResource) of Jeff. The Program and our program differ a lot. Last, we still haven’t solved the issues for which we asked Jeff to help us with. If we had we probably would have only written a paragraph or two on Jeff clarifying his merits (MSG-StrongMan) in contributing to ProgramNet2016.

01G-Stars Distribution

Figure – The Program CMS Stars Distribution (MSG, 2016)

01H-CMS Stars - Control

Actually in terms of control this is our centerpiece. Above is our (MSG, 2016) Centers for Medicare & Medicaid Services (CMS) Stars distribution for The Program. Since 2012 we here at MSG have had the opportunity to evaluate The Program and its’ contractors. Since 2012 The Program has been given a steady 3.0 of 5.0 stars by CMS. Stars are a cumulative scoring about many factors and elements. We have yet to comprehend CMS Stars scoring in its’ totality. It is the performance of people that deliver programs that earn stars. Our report addresses The Program people that that have fed or feed CMS Stars. Below is our latest equations for calculating CMS Stars.

HEDIS = The Healthcare Effectiveness Data and Information Set

CAHPS = Consumer Assessment of Health Plan Study

HOS = Health Outcomes Survey

CMS Stars = HEDIS + CAHPS + HOS

01I-Levelling About Stars

-
AII	Specialty	2012-2013 “stars”	2014 “stars”	2016 “stars”
-
BSL	Psychiatrist	4	4	3.5
C_M	PCP	3	4	>4.5
Corporate QA Team	Quality Assurance	3	4	3.5
Dentist-01	General Dentistry	>4		>4.5
Dentist-02	General Dentistry			3
D_M	Director	>4
J_G	Helper			<3
O_E	Helper – SUD	4	4
Ophthalmologist	Eyes			>4
Optometrist	Eyes		>4.5	>4.5
S_E	Director			<3
TQN	Dermatology	>4.5	>4.5	>4.5
-
Overall Program By Us	“stars”	4 or More	3.5	4 or More
CMS for The Program	Stars	3	3	3

Table – Scored August 5, 2016 – “star” Fit for The Program Helper Population (Network)

Last Reviewed: 20160821-SUN:

01J-Stars, “stars” and “Stars”

In our studies we use a few incarnations of Stars: CMS Stars, our “stars” and online rating “Stars. ”For every person we found that scored a value greater than 3.0 (Stars) there is to be found a complimentary person scoring below 3.0. JG or Jeff Gibbs is one of the persons in the organization that we score below 3.0 stars. People falling into the red zone in the distribution graph might very well be replaced during The Programs quest to better its CMS Stars score by let’s say 2017 (goal 4.0 stars). This report is our way of helping The Program out. Note the service and support elements that we leveraged to have “The Program” work for us earned from us here at MSG a program score of more than 4.0 “stars”. In addition, the way we calculate individual “stars” is different than the way CMS calculates program level Stars. We would like to thank The Program for all its help – we and our client have gained substantially since our enrollment back in 2012.

01K-Stop Gap – Refer to Better Helper

After our second meeting with Jeff Gibbs we expressed our discord with Jeff to another program helper – Jessica. We said that our partnership with Jeff was not working out. Rather than help us remedy the situation she said “give it another chance”. Since we had observed Jessica for two or more years we wished that she would have said I will make this right – I will help you. As indicated above Jeff had an unexcused absence from our next meeting. We have continued to do our part with little tangible service or support from Jeff. Jeff has little if any documentation that supports he is an effective helper. A good place to see performance of workers would be the employer’s newsletter. We have three of them now and Kudos to Jeff is not in any of them.

01L-Strategy Change

As the table below outlines we have been fairly rigorous when it comes to planning and assessment per Our Program’s prescribed materials. When other program members see us planning they ask: “What are you doing?” and/or: “Do you work here?” Oswaldo and I would spend at least one day per month in discussions focused about our newest plan or progress on the plan in effect. We have never received a quantified evaluation and trend report about any of our plans. So we here at MSG are changing strategies. Rather than being self centric or client centered by planning and evaluating ourselves we are going to release a comparative study about our current helper – Jeff Gibbs (MA). After dust settles (most likely in Fall Quarter) we will entertain the notion to review this body of work so Jeff may develop a strategy for self-improvement. [INSERT PLANNING WORK DONE TABLE]. We hope he creates an evidenced based and effective method to practice (promising practice).

02A-Prescribed Planning Work Done & Resources


AcroCode Or AII	Description Helpers and Helping Materials	In Words or Phases

AE	Ali E (Helper-02)	“Let’s move forward”
AII	Anonymous Identifying Information
CPRP	Collaborative Personal Recovery Plan	Underused
DM	Diana M	Helpful
FV	Francis Villa (Helper-03)	Lied “I am going to be around here for awhile”
JG	Jeff Gibbs, MA (Helper-04)	Marginal & Inappropriate
OE	Oswaldo Escalante, RAS “Ozie” Helper-01	Clean – Loyal - Willing
PSP	Personal Service Plan	Underused
QOL	Quality Of Life	No Feedback
TKC	The Kline Coalition	Hopeful

ALL	= PSP + CPRP + QOL	Waste of Time Not applied properly
AT#	Approximate Transaction Number

Table - Acronym and Abbreviation Key – Last Reviewed: 20160821-SUN:

Planning Cycles - Iterations

Since June of 2012 we have driven (client-driven) approximately seventeen (17) incidences of planning cycles.

02B-Prescribed Plan Elements = “The Program” CPRP - PSP - QOL

	-
AT#	TimeStamp	Partner Helper	Prescribed Planning Elements	Primary Focus or Comment
	-
01	20120906	OE	ALL – Baseline (BL)
	20121128	OE	PSP Only	Address Phase I Wellness

	20130301	OE	QOL Only
	20130709	OE & DM	ALL	Address Phase II Integration
05	20130602	OE	QOL Only
	20130813	OE	CPRP Only	Address Phase III Successful Living
	20140106	OE	CPRP - QOL
	20140614	OE	CPRP	Left The Program for Betterment

	20141217	AE	CPRP - PSP
10	20140908	AE	CPRP - PSP
	20150415	AE	CPRP - PSP	“AE” Promoted to Corporate

	20150421	FV	ALL	Lied about length of commitment

	20150623	JG	CPRP - PSP	Re-orientation
		JG	Interval	Said “No” and Key Absence
	20160124	JG	ALL
15	20160327	JG	ALL	No Feedback as Appropriate
	20160711	JG	ALL	Retain plan due to lack of interest
	20160711	JG > Self	Strategy Change - JG Profile	Address Graduation
17	20160801	TKC/MSG	Plan to Publish in August	Go Ahead to Post

Table - Planning Cycle and Prescribed Materials (Partners and Assessments)

Last Reviewed: 20160821-SUN:

02C-Barriers V Hurdles-Prevention V Crisis Management

The product we were in need of developing in partnership with Jeff Gibbs was a step up on The Program’s SafetyNet2012 product. For the most SafetyNet2012 delivered by Oswaldo and Diana M was highly effective. It centered about living arrangements and helping us move. History indicates for us that prevention is more cost effective than crisis intervention. We here at MSG are planning ahead (advanced planning) to have places to go (graduate) and flourish. We have achieved to many gains to sacrifice them now. The Program has helped us insurmountably. It would be a shame to lose their investment. Our client asked Jeff to help us with housing and he said: “No I can’t help you”. He described all the barriers (deficits based) for us to move rather than the necessary hurdles to overcome (strengths based).

02D-Pages Predicted from Outline (1:10)

At this time we are only going to address our outline (introduction) items 1-10. Based upon the number of items in the scaled down outline we predict this report will come in at about thirty-five (35) pages. Please reference invoice (billing) below and in results section.

03A-Cost Containment

One of MSG’s reasons to get Jeff Gibbs on board was that he could get credit for any cost containment about our case for fiscal year 2015/16. By helping us he would have been able to participate in preventive actions that have been keeping our client out of the hospital. We believe that The Program itself doesn’t have much incentive to keep people out of the hospital. We think it is Medi-Cal that provides for hospitalization. Cost and billing is an area for The Program to grow in transparency.

03B-Data Rich – Gibbs Data Base

For this report we have been collecting information for more than four (4) years. We have created more than ten (10) assessment tools. In the data section (posted separately) we address a selection for battery. We only feature one of our assessments – The Partnership Assessment Tool (RDA Modified). It is very likely this study is a one time only venture. Meaning the idea of a life coach did not sell itself. Even if we were to get referred to a promising helper we probably will not assess the partnership with the rigor we applied to Oswaldo Escalante and Jeff Gibbs.

03C-Save “The Program” Some Money

Because The Program for which Jeff Gibbs works for is not accountable or transparent online we have no idea of how their measures and finances work. We do have a little insight at to how their quality assurance operates. If we were Jeff’s supervisor we would we would just discharge him. At some point in the scheme it is likely he likely costing them more than he contributes (Reference Stars Distribution).

03D$-Time Spent & Invoicing

Somewhere along the line between Oswaldo and Jeff we discovered that we were spending more time on the partnership than our partner. So to keep things in perspective we are going to invoice Jeff Gibbs for this report. [INSERT INVOICE]. Anyway we here at MSG look at it this report has value.

03E-Case Study

Ever since becoming severely anxious in 1988 we have been collecting information on our own case study about our own case. We are about half way through its’ presentation [INSERT LINK BELOW]. This is a case study of an anti-partner in the domain of Health & Human Services. We have been hired into a couple of jobs that were not a good fit. Jeff Gibbs is young enough to get on a better track for him. If he were a friend we would go over this material directly with him. Yet our role here is external quality review (EQR) and advocating for ourselves.

03F-Case Study

Health Education and Welfare (HEW) - A Twilight Zone - Integration - "Kid's First" - By Various

http://ktork46.blogspot.com/2015/03/health-education-and-welfare.html#!/2015/03/health-education-and-welfare.html

04A-Stopgap at Jessica - List of the Associates – Score Sheet

Once again we tried to get out of our association with Jeff.

-
Program Associate	Role	TimeFrame	Star Fit	Rating
-
Francis V	Intern	2015	<3.0	Lied
Jeff G	Case Manager	2015-2016	<3.0	Impotent

Oswaldo E	RAS	2012-2014	>3.0	Helpful
Diana M	Director	2012-2014	>3.0	Trustworthy
Derek C	All-a-round	2012-2016	>3.0	Helper of Choice
Ali E	Psychologist	2014	>3.0	Efficient

Jessica	Lead	2012-2016	3.0	Distant
Sophia E	Director	2015-2016	3.0	Invisible
Go V	Med Nurse	2012	3.0	Pleasant
-

Table – Scored July 6, 2016 – “star” Fit for The Program Helper Population (Network)

Last Reviewed: 20160821-SUN:

04B-Dynamics

After our second meeting with Jeff we asked Jessica, whom we had faith in, to help us with a new helper to replace Jeff. She said give it more time or another chance. We probably would have delegated this report permanently to the back burner if we were re-assigned. So if Jeff thanks anyone more than us he needs to thank Jessica. The score-sheet above a near replica of material already addressed. Yet between the two there are slight differences demonstrating that: “The Program” (environment), and the people engaged (agents) and we (host) are constantly changing. Hopefully this study will be the low for all engaged.

05A-Weigh Introduction Items

We composed a huge outline of all that we wished to ponder and share only to determine that is it worth our while to weigh them and initially only share about high weight items.

06A-Motivation to Formalize Notes (20160725-M)

We began formalizing our notes on July 6. 2016. This in when we phased down on collecting data and moved to drafting this introduction. The primary motivation here is to help The Program improve its CMS Star ratings (3.0 of 5.0 for 2016) by 2017. We here at MSG have been keeping notes with regards to our face-to-face (F2) Program transactions about our Program helpers since 2012. The measurably lower quality, supports and services, from our last helper (Jeff Gibbs) inspires us to share some of our notes with the recovery community. We hope this study and associated report(s) will lead to improvements about The (Our) Program, including Our Programs continuum of service and support products. It has been difficult to share this material because we prefer to share about excellence. We have run the results by a few people. They indicate that this material is at the heart of self-advocacy and worthy of publication (sharing). For all: This for us – MSG - is an accountable and transparent activity o:).

06B-Paraprofessional Development

Back in early 2009 our client trained for 160 hours as a certificated paraprofessional mental health worker (PMHW). At this point it is unlikely that he or we will train as a professional by either completing veterinary school (UCD) or completing our secondary education teaching credential (CSUF) programs. As the dust settles we have changed roles. One of these roles is a meta-professional health worker generalist (MHWG). We used to Para Doctor Clayton Chau now we are hoping to Meta Doctor AS Kline. Another role is developing our external quality review (EQR) talents. The report is part of our ongoing meta-professional development.

06C-Promising Practice Proofs

We entered into the social approach to Health & Human Services in November of 2008. By 2009 we had discovered and became embedded in the promise for the Mental Health Services Act (MHSA-California Proposition 63). The MHSA language was powerful if not revolutionary. One of its strongest features is that it promotes vertical and horizontal measurement. All Jeff needs to do is understand that he is part of the inappropriate service sector. He might best charter out on a course of self-improvement. Unlike the OC Health Care Agency that supports growth his agency may not help him. Thus growth would have to occur on his own time. His overburdening caseload leaves him little time at work to develop. His agency may not compensate for personal growth. Without evidence we can’t get away promoting services and supports that are not promising bordering on good.

06D-Robbin’s On Non-profits

Back in fall of 2011 we took Introduction to Health & Human Services (HHS), earning an A. We had a guest lecturer named Bruce Robbin’s. Bruce was director at the time of the Straight Talk program and delivered on the Gary House project (real sad population). He described the HHS non-profit sector. Basically he stated: “Non profits have trouble getting and retaining high quality staff”. The Program as of August 2, 2016 (Tuesday) that retains Jeff Gibbs is a non-profit. We might draw an argument that more than half of those who are retained (four or more years) by Jeff’s program are not high quality staff,

07A-Alternatives – Derek – CalOptima – MHA

The Program is a “Medicare approved” Health (Advantage) Plan. The Program has “developed several benefit plans that allow each plan to meet the special needs” of the accounts. You've visited this page many times. Last visit: 4/26/16. If our client went with another helper it would be Derek. It we went with another provider it would most likely be CalOptima. We are already participating with the Mental Health Association or MHA-OC.

Independence Day by Keith Torkelson
Consumer Art

07B-Dreams

We just checked Jeff’s Program’s website. There is nothing indicating that Jeff participates in The Program. It is usual and customary in Health Human Services to include online staff bioses. We have watched and at times transacted with another Program helper – Derek C. After four years of dust settles: Derek appears to be the only Program helper that has actually helped us since Oswaldo (and Diana). We are also researching CalOptima as a replacement just in case we are dropped for advocating and telling the truth. Last month (July 2016) we signed up for a relatively new program called The Wellness Center – West. This program run by the Mental Health Association (MHA) is intended to fill gaps that Jeff’s program leaves open.

08A-Danger and Opportunity

As always the danger is that if I share the truth The Program will drop us. We are looking into the local CalOptima program as a contingency. For 2016 CalOptima OneCare is a 3.5 Star program. For over one year we have been sharing about The Program anonymously. This way we could develop our external quality review (EQR) methods without having Our Program get in our face. Director Hale of the Orange County Health Care Agency in public often tells us consumers to leverage our lived experience. Having an under-performing program and helper gives us the invaluable opportunity to share with the intent for offering free meaningful help. We here at MSG have targeted: Agencies, programs, positions, and people. There is a pretty fair amount of turnover within Health & Human Services. People that we grew relationships with have moved up, over, or away. So for a bit we are focusing on people. Of dozens of reviews of people Jeff is only the third (vis-à-vis McCapes and Gerry A) to score unfavorably.

[PDF]-OneCare 2016 Medicare Star Ratings - CalOptima

CalOptima 2016 CMS Stars
Oct 18, 2015 - 2016 Medicare Star Ratings

08B-External Quality Review Specialists (EQRS)

We discovered in 2006 how powerful assessments were in conjunction with proven program material. In 2009 we were indoctrinated as a volunteer into the Orange County Health Care Agency. We believed that assessment, as in education, is key to better outcomes. Early on our goal was to find – borrow – steal – modify – create assessments PRN (as needed). With those we created we wished to apply them at least one hundred times. Since then we changed to applying numerous assessments PRN at least once. Using our External Quality Control findings we attempted many routes for advocacy. We have resolved several issues with The Program’s corporate. There is no vehicle in place to share this with corporate thus we are going to share it directly and increase our online presence. We want Our Program to be “Better Than Ever”.

08C-In Defense

In defense of Jeff Gibbs I would say Our Program is sustaining a CMS Stars Score (2016) of three (3.0 of 5.0 Stars). The Program has really not improved since 2012 when we began keeping record. The three star agency for which Jeff works probably does not have high expectations for him. He probably hasn’t been giving enough time for personal development. The Program also caters to some of the most disabled people (our PeerLoad) that we have run across since 1989. They are definitely driving some degree of caseworker burnout and blunted affect. The Agency doesn’t share much about its’ employees and their merits as does the Orange County Health Care Agency. Compare by perusing the HCA What’s Up Newsletter. Lastly, as Bruce Robbins’ also said “non-profits” such Jeff’s Agency “do not pay well”. Non-profits are for the way up to higher paying jobs and the way down for pre-retirement (giving it back).

08D-Link to OC-HCA What’s Up Newsletter

Orange County, California - What's Up Newsletter - Health Care Agency

http://ochealthinfo.com/about/admin/newsletters/whatsup

Employee Spotlight – Mike De Laby Flies to the Rescue; Two Behavioral Health Programs Win Top NACo Honors - You've visited this page many times. Last visit: 7/10/16

08E-Harm Reduction

Back 2014 we here at MSG penned our Harm Reduction policy. Simply the policy was that if a person seemed misrepresented we would retract some materials. This study will be shared via one or both of our blogs. Blogs are interactive. If a person responds with a solid argument we will retract the target material and leave their comments. It the fields of Advocacy and External Review it is very hard to tell the truth and save face.

09A-No Assessment Interpretation

There have been some large strides in assessment driven services and supports. Unfortunately, many agencies collect up assessment results and never report back to the test taker (consumer-client-account). We have been waiting for our CMS Health Outcomes Survey (HOS) results for the year 2014 since 2014. Remember the HOS feeds into the CMS Stars scores. Into Jeff’s’ agency we have submitted over seven (7) Quality Of Life (QOL) assessments. With Oswaldo (Helper-01) we would use the QOL as one of the documents to guide our monthly discussions and share kudos. Our client has yet to hear back interpretation of any of our QOL assessments from Jeff. By now we were hoping to discuss trends and advanced planning. If Jeff cannot handle snapshots how will he be able to: Address series’ of assessments, determine trends, and discover where he can be of help and level his own resources.

09B-Titles - Titles Used by The Program Helpers

-
Title	Legacy 2012	Current 2016
-
Care Coordinator	STRONG	Weak
Case Manager (Paperwork)	STRONG	Weak
Case Worker (Direct with clients)	STRONG	Weak
Group Leader	STRONG	Weak
Lead	STRONG	Weak
Life Coach	STRONG	Weak
Master of Art (MA)		STRONG
Personal Services Coordinator	STRONG	Weak
Program Director	STRONG	Weak
Registered Addiction Specialist (RAS)	STRONG	Weak
-

Table – Performance by Title – Last Reviewed: 20160821-SUN:

09C-Confidence & Trust

When we met Ozie we knew he went by multiple titles. But it took us a bit to figure out what he could do. When he identified as a Recovery Addition Specialist (RAS), we determined that he was certified. The body that regulates him had a RAS Ethics policy. When we saw the policy we came to a common ground of what he could do for us. Jeff is a non-certified provider that also makes him a paraprofessional. We can find nowhere specifying what he is supposed to be doing. He is completely invisible online (online presence). When compared to Ozie and Ali - Jeff appears to be stuck. He indicates that he manages cases. It appears he does the paper work assigned to him and really isn’t linked to the “measurements” about him directly to the clients. It scares us to think he may be approved to coordinate services. [REFERENCE CONSUMER SATISFACTION SURVEYS]

09D-Titles & Roles Not Demonstrated by The Program Helpers

-
HHS Title	Note

Advocate
Community Partner
Data Analyst	Working Directly with Clients
Health and Human Services Worker
Housing Specialist	Unmet Needs & Service Gap
Measurement Specialist
Paraprofessional
Partner
Peer	Except Ozie
Peer Provider
Professional Developer
Project Specialist
Quality Assurance Specialist
Sponsor
Teacher
Therapist
Worker
-

Table – Health & Human Services Skill Sets

09C-Low Expectations-Superiority

The Program underutilizes the proactive models for: Community partnerships, paraprofessional development, partnership, peer-run and peer-to-peer integration. There is a huge consumer-provider movement underway. It is very likely, how Ozie was as good as he was is that he was a consumer-provider about substance use disorder (SUD). This is an opportunity to blame The Program for Jeff’s shortcomings. What Jeff indicates is that how and what he is assigned limits his resources to be of help. Sounds good except Ozie could find time and resources to help us out. Jeff actually gives you the impression that he is superior to the clients (accounts). The Program has had such low expectations for so long that some of the accounts might appear inferior.

10A-Coping with Failure to Sell Needs

Changing perspective here, the bottom line is that for over the course of a month (July 2015) we failed to sell our needs to Mr. Gibbs. Sometimes little things don’t sell well while big things do. This is an example of a big thing for us that didn’t sell. What we were trying to develop with Jeff was a Housing Assurance Policy (HAP) as a pre-emptive and preventative strike. This paper is part of our HAP. We have gained so much centered about living arrangements that we would like to not suffer catastrophic loss (AKA and episode) again – ever. In addition, avoiding catastrophes may save money. We admit we are not professional self-advocates yet. To make up on this shortfall we rely on our ever-improving skills as External Quality Review Specialists (EQRSs).

11A-Burnout and ProQOL

At one point (probably meeting #2) while trying to evaluate Jeff’s value as a resource for us, we asked him if he took a Professional Quality Of Life (ProQOL) assessment. He said “yes”. That is as far as it went. In reality we really desired to get a copy of his latest ProQOL. It would have helped us confirm his level of expected burnout. The Program has a prescribed Quality Of Life (QOL) assessment. The basic prescribed QOL might best be replaced with the more strengths-based ProQOL. Before we go to print we are going to run a ProQOL for Jeff Gibbs (Fully Executed: August 4, 2016).

11B-Professional Quality Of Life (ProQOL-Stamm)


Timestamp	Screening Description	(Raw) Percent (Items)	Interpretation

2015-Summer	Date Queried	Not Reported	Disinterested

20160804-TH	Overall	(85) 57 (30)
	Score MAX =	150
SUBSCALES

20160804-TH	Compassion	(21) 42 (10)	LOW
20160804-TH	Burnout	(32) 64 (10)	AVERAGE
20160804-TH	Secondary Traumatic Stress	(32) 64 (10)	AVERAGE

20160804-TH: ProQOL Scores for Jeff Gibbs, MA: Last Reviewed: 20160821-SUN:

11C – Strengths-based Tendency

We scored ourselves on February 12, 2016. We come out about the same as Jeff with the exception that our Compassion sub-score is higher (AVERAGE). On the day that I asked Mr. Gibbs about his self-scored ProQOL he could have provided us his results and we could have included some of his input in this report and thereby increase our objectivity. You can find a good rendition for B. Hudnall Stamm’s (2009) Professional Quality Of Life (ProQOL) at the following link. It is a really good instrument in that it has a strengths-based tendency.

11D-[PDF] - The ProQOL 5 Self-Score - Professional Quality of Life

http://www.proqol.org/uploads/ProQOL_5_English_Self-Score_3-2012.pdf

By B. Hudnall Stamm, 2009-2012.

14A- Page for A Page – Keeping a Case Binder

In 2012 The Program started a case binder fresh on us. It contains a lot of our defects. After even one year we knew our helpers could not process the appropriate materials to carry over. When we met Jeff our intent was to fast track him for about six (6) months. At the same time we had a need to address. The results were that he was unreliable (as measured by absenteeism during orientation) and he said no "I can't help you". Something or things have changed substantially since the personalized product line for 2012 (ProgramNet2012) was delivered on us. Not only has the program not improved (as measured by CMS Stars) some things that worked have gone the wayside. Our Program case binder is about 400 pages. The binder we have on Jeff is more like 150 pages. So if it pays we still have 250 pages to add to his (this open electronic) binder.

14B-Graduation – Incidental Benefit

One benefit arising out of our helper refusing to help is that for the last six (6) months we graduated ourselves. As a consequence we have had to improve our coping skills. This paper is just one element of our improved coping. If it were not for Jeff Gibbs inspiration we probably would not have followed through on this task - a task daunting for us. Thank you Jeff Gibbs and our other community partners for the inspiration to sustain this good fight.

15A-Percentage Critical – E.g. Gerry A
(Technical Assistance and Committee Lead)

MSG has produced and published more than a dozen reviews of people. By head count our praises far exceed our criticisms. We have only criticized three people. By page count it would be about 30 pages of praise to less than one (1) page of critique. The only reason we do not critique and self-advocate more is that is can be really uncomfortable. As David Dobos MD (Kaiser, Circa 2000) once told us about our behaving critical and our sensible application of analysis: This may be “a sign that you are getting better” (at the time from depression). Currently we score rather low on assessments for depression such as a Personal Health Questionnaire – 9 Item (PHQ-9). In a manner our client is a depression survivor.

15B-Meaningful Use (The Gibbs Salvo)

For us here at MSG it would be meaningful use (MU) if we could cross apply both materials and methods developed for this study in future projects. It is more likely that we will work generalizing the methods we have discovered for this study. Much of what we address here was developed over two years working with Oswaldo (Ozie). At one point Ozie said he would like to work with us. Rather than slow, formative, and progressive our approach with this paper is vigorous and sudden. If it were military this work would constitute a shock and awe approach with hope of nurturing Jeff’s will to fight and develop. We have worked in the Human division of Health & Human Services since 2000. This area of expertise is very hard to elicit an awe reaction about. In other words workers in the field tend to be blunted.

15C-Volunteer to Help with Helper Performance Reviews

Normally MSG would continue to develop our tools used for this study. We would like to help Our Program improve horizontally and vertically. Higher CMS Stars scores would indicate improvement. Yet, we have worked a bit with corporate QC achieving only mixed results. In other words the time spent directly is not worth it. Another option is: Coach (tutor) Jeff Gibbs yet as we mentioned earlier he is only a candidate to “drop our class”.

15D-Skirmish and Catharsis

A skirmish might be defined as an episode of irregular analysis, especially about small or outlying parts of peoples. We here at MSG prefer engagement and fray. So into the fray we went with the intent to achieve catharsis or the process of release to an end for sustaining relief. In other words we are sharing our lived experience by venting for accountability.

15E-Company People

External Quality Review (EQR) Jobs for The Program

-
Job	Satisfaction	Status	Example
-
CMS Work of Behalf of…	Moderate	Closed	Annual Plan Documents
Dental Fee Schedule	Need to apply	Closed
Dermatologist Online Presence	High	Ongoing	VITALS dot com
Annual Plan Documents	High	Closed
Informed Consent	Moderate	Ongoing	Vaccines
Medication Errors	Low	Ongoing	Lithium
Newsletter	Low	Ongoing	Charter Issue
Optometry Referral	Moderate	Closed	Linked Self
Patient Portal	Low	Winding Up	Our Own
PCP Fraud	High	Closed
Unnecessary Testing	Moderate	Ongoing	HIV
VAPE Study	Low	Closed	Contraindicated
-

Table - EQRS Jobs for The Program

15F-Underperforming = Much Work
In the end we could not wish for a better program to practice our external quality review (EQR) skills about. In that we wish to contribute meaningfully to help The Program measurably improve their Stars (CMS) ratings we are in the end Company People.

15G-Feelings Library

During self-care time we process the feelings that we had for the day. More often than not we are afraid at day’s end. Most of our symptoms fall within the Anxiety Cluster. When we think about our feelings that involve Jeff the following come to mind. Feelings of: Dread, concern, annoyance, anger, and even hurt. Even before we were linked to Jeff and saw him moving about and transacting, we thought to ourselves oh no: Not That One! He actually has aggravated our symptoms. As mentioned above we suffer insecurity (anxiety) disorder. This paper might be considered a product of compulsion. But we just know that when we finish Jeff and we will be the better for it :o). Some suggest that it is not wise to pull other peoples covers. Yet, pulling covers (accountability and transparency) is what quality control and review is all about.

15H-Disappointment - Handshake

What is in a handshake?

10 Types of Handshakes and What They Mean | iDiva

http://www.idiva.com/news-work-life/10-types-of-handshakes-and-what-they-mean/15070642

Jul 6, 2015 - This article is about various types of handshakes and how to use that knowledge

“Just like handwriting, how a person shakes hand is also a clue to their inner nature. Nowhere will you find a larger variety in handshakes than at your workplace. So if you know what each handshake says about the person you are interacting with at workplace, you can put that knowledge to good use. Here are ten types of handshakes that you should know about”

15I-What is in a handshake?

	-
Handshake #		Ourselves	Jeff Gibbs
	-
01	Sweaty palms	Rarely	Rarely
02	Dead fish	Rarely	Demonstrated
03	Brush off	Rarely	Rarely
04	The two handed handshake	Rarely	Rarely
05	Controller	Rarely	Rarely
06	Finger Vice	Rarely	Demonstrated
07	Bone Crusher	Demonstrated	Rarely
08	Lobster Claw	Rarely	Demonstrated
09	The Top-Handed Shake	Rarely	Rarely
10	The Pusher	Rarely	Rarely
	-

15J-Handshakes Are Important

If you wish to see the interpretation of each please reference the link above. We were hoping to find some strength here for Jeff Gibbs. He only demonstrates three of the ten handshake issues that the author addresses. More often than not our client shake hands fairly well. He does demonstrate the “Bone Crusher” after a workout or if he is really excited to be with someone else. The last time our client shook Jeff’s hand he demonstrated the Lobster Claw. The interpretation for the Lobster Claw is as follows:

Lobster Claw:

“Like the claw of a lobster, the other person's thumb and fingers touch the palm of your hand. The person doing this fears connecting at a deep level and may have challenges building relationships. Take your time. Allow them to open up at their own pace.”

15K-Newsletter – A Place to Compliment the Help

In January of 2014 we asked Oswaldo if we could author and deliver a newsletter for The Program. Oswaldo secured approval for us and we were up and running by January 28, 2014. Yet we could never get anyone employed by the program to review our draft. After two issues we abandoned the project. On April 19, 2016 we picked up a company-authored newsletter. What we were looking for was a kudos section of those providing direct services. In particular we wanted to see what corporate thought of Jeff Gibbs. We use the OC HCA What’s Up newsletter as our standard of excellence. What’s Up does a very good job featuring staff.

15L-Here is the news!

This is not the time and place to thoroughly critique The Programs newsletter. We do wish to say one thing though. We evaluated on edition. There are eight pictures of eight people who have nothing or little to do with direct delivery of services. Not a single member is featured. Direct delivery staff is completely neglected. In the six pages almost everything is about old school medication management and compliance. With regard to medication what would be more effective would be instructions for the client on what to do when there is an error in their medication. MSG newsletter about The Programs was focused on quality assurance, measurement, real clients, and direct service (and support) staff. We also promoted some of The Program subsidies for the clients. The newsletter (as well as the website) might better include Staff Lists including staff functions. The newsletter might include a feature bios starting with the clubhouse program director.

15M-Prevent – Catastrophic Loss

For a Seriously and Persistently Mentally (Behaviorally) Ill (SPMI) person high on the list of priorities are: Medication, Finances, Food, and Housing, Since, we don’t get any service invoices other than for medication we do not know who foots the bill. We know that hospitalization and incarceration cost “The System” more than just a rent-a-room. We really don’t think The Program sustains any cost deferral for intensive versus economical housing. The Program has a website that includes a Housing Link [REVIEWED BELOW]. Yet the approach is near completely passive.

15N-Living Arrangement
Coordination Across Six Psychosocial Domains

This paper has at its’ core appropriate housing. That was what we asked Jeff for help with when he said “no” no-can do. Any program that is truly recovery oriented must have a strong housing program and the best of workers to administer it. It is fine to refer clients away for dental, eye surgery or therapy yet it is a grievance short fall it they cannot deliver appropriate housing and activities that go with it. There is even a movement called “Housing First”. SPMI persons are very likely to be at risk of homelessness. MSG finds that there are two main classes of consumer The Have Littlies and The Have Lots. It is harder to move a Have Lot.

National Alliance to End Homelessness: Housing First

http://www.endhomelessness.org/pages/housing_first

Solutions - National Alliance to End Homelessness

Housing First is a homeless assistance approach that prioritizes providing people experiencing homelessness with permanent housing as quickly as possible…

15O

“The Programs” Housing Update [APPLY TO PROPOSAL]

“The Program” has developed a library of useful informational links to help our members and providers discover community resources.”

Housing Resources - Evaluation Held Over For Future Work

-
Resource	Date Reviewed	Usefulness & Utility
-
Brand New Day Group Housing Guide Coming Soon
-
California State Licensed Housing Sites
Intervention America Sober Living Directory
The Sober Living Network
Group Home Listing
Residential Care Facilities
State of California Housing Listing
California State Licensed Housing Website
Residential Care Facilities
-
Section 8 Housing Program
Housing Choice Voucher Program Section 8
Housinglink.org
-

Table – Housing Resources – Retrieved from the WWW: August 5, 2016

“The Program” Housing Update [APPLY TO PROPOSAL]

“The Program” has developed a library of useful informational links to help our members and providers discover community resources.

“I will see you in a workshop” (MOMs) – Stigma and Marginalization

Here in Orange County we have a yearly conference administered by the Mental Health Association (MHA). The one full day conference is called the Meeting Of the Minds (MOMs). Back in 2013 we attended and sat at Our Program’s table. It was fun and we felt a part of. Earlier this year (2016) in passing we discussed the MOMs conference with Jeff. We told him we might sit at The Program table. His response was oh no “I will see you in a workshop”. We guess that it is too stigmatizing for him to mix with clients in public. At least when our client walked passed him that day he did not feel the degree of dread that we’ve grown accustomed to transacting with Jeff.

“My Guys”

Even though we didn’t enroll in The Program until 2012 we were aware of it since 2009. Several of our housemates (PeerLoad) were enrolled in the program. We remember in 2011 Dave D calling Jeff on the phone. Dave was usually in some state of conflict with Jeff. We took the position that the helper will help you. During 2011 Dave D was not really helped much by Jeff Gibbs. Transactional Analysis per Harris is something that interests us here at MSG. Jeff Gibbs fits into the Parent to Child transaction style. It really annoyed us when we heard him say about his case trustees they are “my guys” rather than my partners (Adult to Adult style). As far as carer style he is authoritarian rather than authoritative.

“No I can’t help you”

Part of the process for recovery is to ask others for help. Last year (2015) our client asked his new program helper, Jeff Gibbs – MA, if he would help us assure living arrangements on par with how Oswaldo Escalante – RAS helped us back in 2012. Jeff basically said he didn’t have time due to his overburdening caseload. In other words our program assigned helper said he could not help us. Our meetable needs as far as Jeff in concerned are not meetable.

Conclusion - In the face of Dallas-2016

“One must fall (usually in war) so that others may continue to ascend, dispose and keep up the good fight for the benefit of those not positioned to defend for themselves

(Kennedy, Zeek, 1961 – A Presidents Diary in Lunic)”

Appendix - Collaborative Personal Recovery Plan (CPRP)

CPRP Method (2011-2014)


CPRP Item		CPRP Evaluation Item	2011	2012	2014
		-

	FD#	Life Domain

01	10	Emotional Mental Health	Strength	Barrier	Strength
02	11	Physical Health	Barrier	Barrier	Strength
03	02	Living Arrangement	Barrier	Barrier	Strength
04	03	Financial	Strength	Barrier	Strength
05	05	Pleasurable Activities	Strength	Barrier	Strength
06	04	Relationships	Barrier	Barrier	Strength
07	06	Vocational Educational	Strength	Barrier	Strength

Sum=7		Strengths in Life CALC =	4/7*100=	0/7*100=	7/7*100=
		SLS =	57.1%	00.0%	100.0%

20151019: Table – Collaborative Personal Recovery Plan – About Our Client – Longitudinal
Last Reviewed: 20160822-M - (By MSG, 2015)

FD=Functional Domain (MSG Method)

CPRP=Collaborative Personal Recovery Plan

Yields – Strengths in Life Score (SLS)

Barrier can be substituted with Deficit or Hurdle

These Domains are supposed to be forte areas for Jeff Gibbs. The Program prescribes the life domains in this CPRP for collaboration. This is what Jeff Gibbs is supposed to be good at.

The End

#999

Imagery First Method

20160826 Added Labels