Fifth Annual Michigan Mental Health & Aging Conference. Formerly the OBRA Conference. May 6-7, The Kellogg Center

Transcription

1 Fifth Annual Michigan Mental Health & Aging Conference Formerly the OBRA Conference May 6-7, 2008 The Kellogg Center Michigan State University East Lansing, Michigan Continuing education credits available for nurses and social workers New this year: Register on-line at Sponsored by the Michigan Department of Community Health Coordinated by the Mental Health & Aging Project A program at Lansing Community College

2 Welcome to the Fifth Annual Michigan Mental Health & Aging Conference This conference is designed to address the continuing education and training needs of clinicians in Michigan s community mental health system who work with older adults with mental illness, dementia, and/or developmental disabilities. Professionals from other service networks who serve older adults are also welcome to attend. Note: Individuals responsible for PASARR evaluations may obtain reimbursement for all conference-related costs through the regular PASARR billing process. The annual meeting for OBRA Coordinators will be held at the Kellogg Center the afternoon of May 5th. Additional details about the meeting will be sent to Coordinators by the MDCH Office of Specialized Nursing Home/OBRA Programs. Please share this brochure with other colleagues in your agency and community who work with older people. The brochure can also be downloaded from the MHAP website at

3 Fifth Annual Michigan Mental Health & Aging Conference Page 1 Agenda for Tuesday May 6 7, 2008 Table of Contents 2 Intensive # 1 Integrated Treatment of Co-occurring Mental Illness and Substance Abuse in Older Adults 2 Intensive # 2 Non-Alzheimer s Dementias: What They Look Like and Implications for Care 3 Intensive # 3 Older Adults and Pain: Assessment, Management, and Treatment 3 Intensive # 4 Interventions for Depression in Late Life 4 Intensive # 5 Thinking Outside the Box: A Functional Transition Program 5 Agenda for Wednesday 6-7 Workshop Series A 8-10 Workshop Series B 11 Advisory Committee Members Presenter Directory 14 Overnight Accommodations 15 Registration Information 16 Registration Form 17 Accounting Department Information

4 AGENDA Tuesday, May 6 th Advocacy Organization & Vendor Exhibits (Tuesday Only) Visit the exhibits and sign up for prize drawings. Book Display (both days) Visit the Mental Health & Aging Project library display 7:00 8:30 am Registration and Continental Breakfast 8:30 8:45 am Welcome Ed Dore, MPA Chief Deputy Director Michigan Department of Community Health 8:45 10:00 am Keynote Address: Promising and Evidence- Based Practices for Older Adults with Serious Mental Illness Stephen J. Bartels, MD, MS, Professor of Psychiatry and Community and Family Medicine, Dartmouth Medical School. Director Centers for Senior Health and Aging at Dartmouth, and State of New Hampshire Bureau of Adult and Elderly Services Frederic Blow, PhD, Professor and Research Professor, Department of Psychiatry, University of Michigan and Director, National Serious Mental Illness Treatment Research & Evaluation Center, Department of Veterans Affairs, Ann Arbor Recent studies have demonstrated that the lifespan of adults with serious mental illness (SMI) is years shorter than that of the general population and that they are much more likely to be placed in a nursing home at an earlier age. These individuals are generally not benefiting from the changes in the provision of healthcare that are helping other adults to remain healthy. The presenters will review the evidence base and describe effective interventions to help older persons with SMI improve their health, wellness, and functioning. 10:30 am 12:00 pm Concurrent Intensive Sessions: Part I 12:00 1:00 pm Lunch 1:30 4:30 pm Intensive Sessions Resume: Part II 4:30 6:00 pm Reception 1

5 #1 Integrated Treatment of Cooccurring Mental Illness and Substance Abuse in Older Adults A substantive percentage of older people with mental illness have cooccurring substance abuse disorders. Similarly, a significant proportion of older adults with primary substance abuse disorders have mental health problems. With the aging of future generations, particularly the Baby Boomers, it is expected that the prevalence rates for co-occurring disorders will increase. The presenters will provide an overview of the prevalence of these disorders, identify key elements of a comprehensive assessment, and describe effective treatments for working with older adults, with an emphasis on mental illness cooccurring with alcohol and medication misuse. Stephen J. Bartels, MD, MS; Frederic Blow, PhD #2 Non-Alzheimer s Dementias: What They Look Like and Implications for Care The course of various non- Alzheimer s dementias, such as Dementia with Lewy Bodies (DLB) and Frontotemporal Dementia (FTD), will be the focus of this session, beginning with an overview of the effects of changes in the brain and cognition on functioning, behaviors, and intervention efficacy. The presenter will describe brain pathology, course, stages of brain structures affected, cognitive and behavioral changes, and interventions, including how they differ from Alzheimer s disease (AD). Participants will increase their ability to recognize the disorder, to provide assessment, and plan interventions. The presentation will address the use of environmental interventions and communication strategies with persons with dementia and their caregivers, including tips for individualizing interventions. Shelly Weaverdyck, PhD 2

6 #3 Older Adults and Pain: Assessment, Management, and Treatment #4 Interventions for Depression in Late Life This session will focus on the recognition and management of pain in older persons, who frequently do not receive adequate treatment for their pain. The presenters will address the undertreatment of pain in older persons as well as the complex issues involved in managing pain in people who have dementia, mental illness, and/or a co-occurring substance abuse disorder. Participants will learn about pharmacological treatment of pain and complimentary therapies that may be effective. This session will also address the use of Cognitive Behavioral Therapy and support groups for people experiencing chronic pain. Participants will also learn about resources available for helping older persons manage pain. Joseph McCarthy, LPC, NCC, CAC-1, CAAC; Regina McClurg, MSW, LMSW Late-life depression can be addressed and treated effectively. This intensive will focus on the appropriate use of medications and how to use behavioral and cognitivebehavioral therapies to assist older adults with depression. Participants will learn about the use of medications to treat individuals with depressive symptoms, including a review of the newer medications, common side effects and recommended usage. In a session targeted to clinicians in practice settings, participants will learn about the basic model of behavioral and cognitive-behavioral therapies and how these approaches may be used with older adults. The presenters will provide clear guidelines for a brief assessment of depression and discuss behavioral treatments for effectively treating depression, including relaxation, mood monitoring, increasing pleasant events, and bibliotherapy. Randall Christenson, MD; Suzann Ogland-Hand, PhD 3

7 #5 Thinking Outside the Box: A Functional Transition Program Clinicians providing specialized services in nursing homes face challenges in helping a person with a developmental disability or a serious mental illness attain a higher level of independence. The resident may feel boxed in by the nursing home environment, and the clinician may feel boxed in by the limitations of traditional service approaches. A Functional Transition Program (FTP) enables the clinician to think outside the box and develop an individualized approach to help the person achieve the goals expressed in their person-centered plan (PCP). It also encourages the individual to explore alternatives to nursing home placement and opportunities for leading a more independent life in the community. Participants in this workshop will learn how to develop an FTP, identify individuals who may benefit from an FTP, and address barriers to greater independence. The presenters will also discuss how to incorporate the FTP into the resident s nursing home care plan and how to bridge the gap between the nursing home and the community. Suzanne Bailey, MA, MSW, LMSW; Karen Cooper, OTR; Jodell Gay, COTA; Debra Stapleton, COTA 4

8 AGENDA Wednesday, May 7th 7:45 8:30 am Registration (for those who did not register on Tuesday) 8:30 8:45 am Welcome Sharon Gire, MSW Director, Michigan Office of Services to the Aging 8:45 10:00 am Keynote Address: When We Give Too Much: Addressing Compassion Fatigue and Burnout Patrick Arbore, EdD 10:30 am 12:00 pm Workshops (Series A) 12:00 1:00 pm Lunch 1:30 4:30 pm Workshops (Series B) 4:30 pm Conference Ends Dr. Arbore will examine the challenges and rewards of working with older adults, describe the symptoms of compassion fatigue and burnout, and discuss how to develop methods for coping with stress in our professional and personal lives. Patrick Arbore is Director and co-founder of the Center for Elderly Suicide Prevention and Grief- Related Services, a program of the Institute on Aging in San Francisco. Dr. Arbore is nationally recognized as a presenter on a variety of topics, including elderly suicide prevention, alcohol and aging and post-traumatic stress disorder in older adults. 5

9 A Series 10:30 am 12:00 pm A 1 OBRA 101 New OBRA evaluators and OBRA service workers will receive an introduction to OBRA and the PASARR process. This workshop will focus on the fundamentals of PASARR. Mary Rehberg, RN, BSN, MA, LPC A-3 Appropriate Use of Psychotropic Medication in Older Adults or Nursing Home Residents The presenter will review medications that are used for treatment of psychiatric symptoms, with an emphasis on those that have been more recently developed. Expected results and potential side effects will be addressed. Time will be allotted for questions. Mike Engel, DO A-2 The Nursing Home Survey in the OBRA Process An overview of the Michigan Department of Community Health nursing home survey process, including examples of how OBRA recommendations are reviewed and included in the survey, will be presented. In addition, the top 10 most frequent citations will be reviewed. Meredith Lindsay, LMSW A-4 Strategies for Assisting Individuals with Advanced Parkinson s Disease This session will provide an overview of the commonly seen physical, emotional, and cognitive dysfunctions in Advanced Parkinson s Disease. Case studies will be used to highlight helpful strategies for assisting individuals with this disorder to cope with the complex challenges they face. Participants will learn to anticipate common symptoms of Parkinson s, to recognize side effects of medications, and to use non-pharmacological interventions to deal with symptoms and/or side effects of medications. Louise E. O Donnell, RN, MS, NP 6

10 A 5 Mobilizing Community Networks to Support People with Dementia and Their Families This workshop will feature two CMH programs that have modified the wraparound process to help adults with dementia, who exhibit acute behavioral symptoms of distress, remain in the community. Presenters will describe how the programs are structured, how community partners are involved, and how strengthbased problem-solving is implemented. Plans to continue these programs after funding ends will be discussed. Julie Dowling, MSW, LMSW; Marja Salani, RN A-6 Understanding the Journey of Recovery Recovery is the goal for mental health practice in Michigan s public mental health system. Participants will learn about Recovery as it relates to mental illness in older adults and how peers have enhanced services in the mental health system by moving through mental illness and supporting others through various stages of Recovery. Ernie Reynolds, CPSS A 7 Communicating with People Who Have Developmental Disabilities All people have the ability and right to communicate. Despite a variety of significant physical, cognitive and related developmental challenges, care providers can make communication possible. The presenter will discuss sensory, interactive and technology-based options for people with disabilities. Lynn A. Sweeney, MA, CCC-SLP A 8 The Ants Go Marching One by One: Culture Change in Long-Term Care The ants go marching one by one, hoorah, hoorah. The field of long term-care is changing as well, hoorah, hoorah! Culture change in long-term residential care communities is no longer simply a dream, it has become reality. Culture change involves changing the way the organization looks, the way people are treated and the way each individual is being challenged personally and professionally. Participants will examine the term culture, identify the need for a culture change movement, and describe the steps needed in order to assist an organization in the transformation. Todd Walter, MSW 7

11 B Series 1:30 4:30 pm B 1 Working with Older Survivors of Traumatic Experiences A significant number of older adults have experienced trauma during their lives and persons with a serious mental illness are even more likely to have had traumatic experiences. This session will explore issues related to older adults and trauma, including signs that indicate that a person may have experienced trauma. Participants will learn about treatment approaches that can be effective in working with older survivors. Patrick Arbore, EdD B 3 An Enigma Wrapped in a Conundrum: Surrogate Decision-Making in Michigan Participants will learn whether there are answers to the question: if an individual is unable to participate in treatment decisions, who can make what decision when? The appropriateness and interrelationship among durable power of attorney, living will, do-not-resuscitate declaration, family consent, civil commitment, and guardianship will be discussed. The presentation will also cover provider mandates of the Federal Patient Self-Determination Act and the Michigan Dignified Death Act, the role of the probate court, and psychiatric advance directives. Brad Geller, JD B 2 Motivational Enhancement Approaches to Helping Older Adults This workshop will include a brief conceptual overview of Motivational Enhancement (ME), a review of the core principles, and an introduction to specific skills that the clinician can use to assist older persons to manage conditions whose outcomes can be greatly influenced by lifestyle or behavior change. Participants will learn about ME approaches to guide consumers in making choices to improve their health, including weight loss, exercise, medication adherence, substance use, and other concerns related to wellbeing. Darren Lubbers, PhD 8

12 B 4 Strategies for Assisting Individuals with MS People with multiple sclerosis (MS) who are in need of in-home or infacility care, as well as their caregivers, struggle with the complex physical, emotional, and psychosocial needs associated with advanced MS. This session will address the pathophysiology and variations in natural history of MS that impact the work of CMH care providers. Participants will learn to distinguish functional impairments requiring CMH intervention from those seen in the majority of individuals with MS, to evaluate usual MS management strategies for appropriateness for the client requiring CMH services, and to anticipate care challenges associated with caring for the home-bound/infacility individual with MS. Louise O Donnell, RN, MS, NP B 5 Long-Term Care in Michigan: Choices and Changes The face of long-term care is rapidly changing. Michigan is a leader in developing programs and services to help people who are eligible for nursing home care live at home in their communities if that is their preference. In this workshop, participants will receive an update on current initiatives, including the Long-Term Connections (Single Point of Entry Programs), Self Determination in Long Term Care, and the Nursing Facility Transition Project. Nora Barkey, BSW; RoAnne Chaney, BSW, MPA; Ellen Speckman-Randall, MA 9

13 B-6 A New Age for Old Age: Aging Adults with Developmental Disabilities As a growing number of individuals with developmental disabilities are aging, both opportunities and challenges are created for those individuals, their families, and the systems who are involved in their care. In this presentation, these opportunities and challenges will be explored, with a focus on identifying important aging issues and related mental health factors, as well as developing proactive approaches to promote wellness, affirm individual strengths and abilities, allow for aging in place, and optimize quality of life. David Laman, PhD; Sue Gabriel, PMHNP, APRN-BC B 7 Helping People Find Their Voices: Working with a Range of Communication Abilities All people have the ability and right to communicate. Ability and opportunity to communicate are important factors in health, wellness and stability of an individual. This presentation will provide information about working with people with a range of communication abilities and will explore a continuum of strategies to improve life for people who are speaking and non-speaking. The presenter will discuss sensory, interactive, behavioral, and technology-based options for people with communication challenges. Participants will learn to apply basic assessment and intervention principles in order to support listening, following directions, and expressing wants and needs, regardless of degree of communication, cognitive or physical challenges experienced by the person. Information will be provided for appropriate additional support and cross-referral. Lynn A. Sweeney, MA, CCC-SLP B 8 Exploring Culture, Values, and Ethics in End-of-Life Care Growing diversity in long-term care and our public commitment to provide optimal care to all requires attention to the individual s personal culture, values and ethics. Through presentation, interaction, and reflection, this session will address end-of-life (EOL), culture, ethics, and the need to attend to difference, including our own. The presenter will review current thinking on culture and EOL care/treatment and will explore potential cultural difference and controversy in end-of-life care. Spirituality will be addressed and participants will be encouraged to critically examine approaches that aim for consumer-centered EOL choices and experiences. Margie Rodríguez Le Sage, PhD, LMSW 10

14 Conference Advisory Committee Suzanne Bailey, MA, MSW, LMSW Michigan Dept. of Community Health, Lansing Nora Barkey, BSW Program Coordinator MDCH Office of LTC Supports & Svcs Matt Beha, BA Mental Health and Aging Project, Lansing David Breyer, MS, LLP, LMSW, CAC-1 Bay-Arenac Behavioral Health, Bay City Marci Cameron, MA Dementia Care Program, Michigan Dept. of Community Health, Lansing Arlene Campanella, MC, LPC Clinton-Eaton-Ingham CMH, Lansing Julie Dowling, MSW Ionia County CMH, Ionia Eugenia Dumlao-Reedy, RN, MSN MDCH Nursing Home Monitoring Div, Lansing Mark Halvorsen, MA, LMSW Hiawatha Behavioral Health, St. Ignace Nancy Hayward, RN, BSN, MPH Lansing Community College, Lansing Chris Hennessey, MA, LPC, LMSW Mental Health and Aging Project, Lansing Bev Kluzak, LMSW Allegan County CMH Services, Allegan Anne Lawrence, LMSW Washtenaw County CSTS, Ann Arbor Catherine Macomber, MSW, LMSW Alzheimer s Association - Greater MI, Midland Carlton Nogle, LMSW Tri-County Office on Aging, Lansing Jackie Raxter, MA, CSW, LPC NSO/Older Adult Services, Detroit Mary Rehberg, RN, BSN, MA, LPC Michigan Dept. of Community Health, Lansing Ernest Reynolds, CPSS Northern Lakes CMH, Roscommon Carol Riddle-Wallus, LLP, LMSW, LPC Senior Services Inc, Kalamazoo Alyson Rush, LMSW Michigan Dept. of Community Health, Lansing Becky Schersten, MA, LPC, LBSW Gerontology Network, Adrian John Sczomak, PhD, LP NSO/Older Adult Services, Detroit David Verseput, JD Michigan Dept. of Community Health, Lansing Julie Wheaton, AMLS, LMSW Mental Health and Aging Project, Lansing 11

15 Directory of Presenters Patrick Arbore, EdD Director and co-founder, Center for Elderly Suicide Prevention and Grief- Related Services, Institute on Aging, San Francisco Suzanne Bailey, MA, MSW, LMSW Appeals Coordinator, Office of Specialized Nursing Home/OBRA Programs, Michigan Dept. of Community Health, Lansing Nora Barkey, BSW Project Coordinator, Long-Term Care Connections, Office of Long Term Care Supports and Services, Lansing Randall Christenson, MD Geriatric Psychiatrist Psychiatric Associates of West Michigan, Grand Rapids Karen Cooper OTR Occupational Therapist, Neighborhood Services Organization, Detroit Julie Dowling, MSW, LMSW Clinical Director, Ionia County CMH, Ionia Mike Engel, DO Medical Director, Birchwood Nursing Center, Traverse City Stephen J. Bartels, MD, MS Professor of Psychiatry and Community and Family Medicine, Dartmouth Medical School. Director Centers for Senior Health and Aging at Dartmouth, and State of New Hampshire Bureau of Adult and Elderly Services, Hanover, NH Frederic Blow, PhD Professor and Research Professor, Department of Psychiatry, University of Michigan, and Director, National Serious Mental Illness Treatment Research & Evaluation Center, Department of Veterans Affairs, Ann Arbor RoAnne Chaney, BSW, MPA Policy Manager, Michigan Disability Rights Coalition, Lansing Sue Gabriel, PMHNP, APRN-BC Psychiatric Nurse Practitioner, Developmental Enhancement, PLC, Jenison Jodell Gay, COTA Certified Occupational Therapy Assistant, Neighborhood Services Organization, Detroit Brad Geller, JD Assistant State Long Term Care Ombudsman, Michigan Office of Services to the Aging, Lansing David Laman, PhD, Founder and Director, Developmental Enhancement, PLC, Jenison 12

16 Meredith Lindsay, LMSW Health Care Surveyor, Nursing Home Monitoring Division, Michigan Department of Community Health, Lansing Darren Lubbers, PhD Program Leader, SAMHSA Family Psycho-Education Project Community Mental Health Authority of Mid-Michigan, Lansing Joe McCarthy, LPC, NCC, CAC-1, CAAC Director of Training and Performance Enhancement, Gerontology Network Grand Rapids Regina McClurg, MSW, LMSW Director, Apogee Training and Consultation Services, Touchstone innovare and Gerontology Network, Grand Rapids Louise O Donnell, RN, MS, NP Neurology Nurse Practitioner Coordinator, West Michigan MS Clinic, Grand Rapids Suzann Ogland-Hand, PhD Director, Center for Senior Care, Pine Rest Christian Mental Health Services, Grand Rapids Mary Rehberg, RN, BSN, MA, LPC Manager, Office of OBRA Programs, Division of Community Living, Michigan Department of Community Health, Lansing Margie Rodríguez Le Sage, PhD, LMSW Assistant Professor, School of Social Work, Michigan State University, East Lansing Marja Salani, RN Prevention Specialist, Copper Country Mental Health Services Institute, Houghton Ellen Speckman-Randall, MA Program Director, Michigan Follows the Person, Office of Long Term Care Supports and Services, Lansing Deborah Stapleton COTA Certified Occupational Therapy Assistant, Neighborhood Services Organization, Detroit Lynn A. Sweeney, MA, CCC-SLP Director, Sweeney Communication & Consultation Services and graduate faculty member, Central Michigan University, Mt. Pleasant Todd Walter, MSW Director of Resident Quality of Life, Burcham Hills Retirement Community, East Lansing Shelly Weaverdyck, PhD Director, Eastern Michigan University Alzheimer s Education & Research Program and Geriatric Consultant, Ann Arbor Ernest Reynolds, CPSS Northern Lakes CMH, Roscommon 13

17 Overnight Accommodations Please make your own hotel reservations. Identify yourself with the Mental Health & Aging Conference and ask for the conference rate. These hotels have blocked rooms for the conference dates their web sites may not show all availabilities, so call. The rates below do not include taxes. Kellogg Center conference site or Restaurant, fitness center, parking included in room rate Standard: $94 Deluxe: $104 Luxury: $114 Cut-off-date: April 9th Marriott East Lansing University Place (enter group code AGIAGIA where requested) or M.A.C. Avenue, East Lansing (0.7 mile from Kellogg Center) Near downtown East Lansing shops, art galleries Indoor pool, restaurant; 100% smoke-free environment $139 cut-off-date: April 6th Howard Johnson East Lansing or (use code CGMHA) 1100 Trowbridge Rd (0.83 mile from Kellogg Center) I-127 Trowbridge Road Exit Indoor Heated Swimming Pool and Whirlpool, free high speed Internet access, Hair dryer, ironing board & iron in room, free deluxe Continental breakfast $72 room or $92 suite cut-off-date: April 6th University Quality Inn, East Lansing or E. Grand River, Lansing (1.03 mile from Kellogg Center near Frandor Shopping Center) Free full hot breakfast, indoor pool, spa $74.95 cut-off-date: May 5th (if rooms are still available) Candlewood Suites, Lansing or Forest Rd (1.89 miles from Kellogg Center) Kitchenette w/full size refrigerator/freezer (and icemaker), dishwasher, range, microwave, Free High Speed internet access, Hair Dryers, Iron/Ironing Board, Laundry basket in each suite, Free Fitness Center, Free shuttle service $89 room or $109 suite cut-off-date: May 5 (if rooms are still available) 14

18 Registration Information How To Register: Registrations will be accepted on a first-come, first-served basis until capacity is reached. We encourage you to register on-line at Or complete the registration form in the brochure and fax to Matt Beha at 517/ by April 21st. Payment is due April 28th. If your employer is paying for the conference, send a copy of the completed registration form to the accounting department and ask that they send us the Notice of Late Payment if the check will not be received by April 28th. Please follow up to make sure the check or form has been mailed. A confirmation memo will be sent to anyone who has registered. If you do not receive a confirmation by May 1st, contact Matt Beha to confirm that you are registered. For Those Seeking Continuing Education Hours (no additional charge) Nurses: Fill in your complete Social Security number on the registration form. This information will be kept in confidence. You are required to provide the last four digits of your SS number when signing in at the conference. Social Workers: Fill in your Permanent ID # from the State of Michigan. You are required to provide this number when signing in at the conference. Lansing Community College is approved as a provider of continuing education in nursing by the Michigan Nurses Association, which is accredited as an approver of continuing education in nursing by the American Nurses Credentialing Center Commission on Accreditation. Cancellation Policy The registration fee, minus a $20 administrative charge, will be refunded if the registration is cancelled by May 1st. No refunds will be made after this date. Any individuals who do not attend, but have registered without paying, will be billed $75 per day to help defray conference costs incurred by their registration. Fax Registration form to: Matt Beha at 517/ Mail check to: Lansing Community College MC 3500-MHAP (this internal address must be included) P.O. Box Lansing MI For additional information: Contact Matt Beha by at beham@lcc.edu or by phone at 517/ ADA Accommodations: If you require accommodations to permit your attendance or participation, please provide a written request to Matt Beha at the above address by April 1. 15

19 Print off, complete, and fax registration form to: Matt Beha at 517/ Registration Form Due April 21st Please print or type your name as you would like it to appear on your name tag: Name Job Title Organization Address City State ZIP Code Phone (Area Code) address Fax (Area Code) Please write (1) by your 1st choice and (2) by your 2nd choice for the Intensives and Workshops. Morning Afternoon Intensives Workshops Workshops May 6 May 7 May 7 All-day session A Series - 10:30 12:00 B Series - 1:30 4:30 # 1 A-1 B-1 # 2 A-2 B-2 # 3 A-3 B-3 # 4 A-4 B-4 # 5 A-5 B-5 A-6 B-6 A-7 B-7 A-8 B-8 Payment is due April 28th (Continuing Education & Contact Hours are included in the registration fee.) Nurse Contact Hours Social Security # Social Work CEs Social Work Permanent ID # $200 Two Day $125 Tuesday $125 Wednesday TOTAL DUE $ I require a vegetarian meal. 16 Mental health consumers may apply for scholarships to cover the registration fee. For further information contact Matt Beha at beham@lcc.edu.

20 Accounting Department Information On the back of this sheet is the registration form for a staff person at your organization to attend the Mental Health & Aging Conference. We realize that sometimes there is not sufficient time to cut and mail a check by the due date. If this is the case, please use the form below to let us know when we may expect your check. Your staff person will not be registered for the conference until we either receive a check or the form below by April 28th. Lansing Community College s Federal I.D. number is Please be sure you have our current address in your computer files. The address must include our internal mail code (3500-MHAP) to assure that we receive the registration form and check. Make checks payable to Lansing Community College and mail to: Lansing Community College MC 3500-MHAP (this internal address must be included) P.O. Box Lansing MI Payment is due in our office by April 28th. If this deadline cannot be met, please complete the form below and fax it to Matt at 517/ If you have any further questions, contact Matt Beha at 517/ or at beham@lcc.edu. Thank you! Name of Agency Notice of Late Payment Fax to Matt at 517/ Name(s) of staff attending conference The check in the amount of $ will be mailed on (date) Name of accounting department contact person Phone (Area Code) 17