Community Services Board and Subcommittee Application

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Last Name

Home Address

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Preferred Email Address

Expectations of Board or Subcommittee Members:

Each county in New York State is required under NYS Mental Hygiene Law to have a Community Services Board (CSB). The primary function of the CSB is to develop and approve the local services plan and advocate for services in Lewis County. Members are appointed by the County Legislature and shall represent the community interest in all the problems of persons with mental disabilities and shall include representatives from community agencies for persons with mental illness, developmental disabilities, alcoholism and substance use.

Composition of Community Services Board:

1 Certified psychologist or licensed physician (whenever possible).
1 Licensed physician (whenever possible).
1 Lewis County Legislator.
6 At-large members.

Term Length: Four years (eligible for a second four-year term).

Board Meetings: The second Tuesday of each month at 7:30 am at the Human Services Building (5274 Outer Stowe St., Lowville, NY 13367).

Subcommittees shall advise the community services board and the director of community services regarding the exercise of all policy-making functions vested in such board or director, as such functions pertain to the field of services for the particular class of mentally disabled individuals represented by such subcommittee. In addition, each subcommittee for mental health shall be authorized to annually evaluate the local services plan and shall be authorized to report on the consistency of such plan with the needs of persons with serious mental illness, including children and adolescents with serious emotional disturbances.

Composition of Subcommittees:

Each subcommittee has six community member seats and three Community Services Board representative seats. Agencies who contract with Lewis County Community Services for services are expected to recommend staff for appointment to relevant subcommittees.

Term Length: Four years (eligible for a second four-year term).

Subcommittee Meetings:

The Substance Use Disorder and Mental Health Subcommittees are currently meeting together on the fourth Tuesday of the month from 8:30‒10 am in the Human Services Building (5274 Outer Stowe St., Lowville, NY 13367).
The Developmental Disability Subcommittee is currently meeting every other month on the first Friday from 10‒11 am in the Human Services Building (5274 Outer Stowe St., Lowville, NY 13367).

Board or Committee of Interest (select all that apply):

Community Services Board

Substance Use Disorder Subcommittee

Developmental Disability Subcommittee

Mental Health Subcommittee

Please answer the following questions regarding your interest in serving on the Lewis County Community Services Board or subcommittee.

Why do you want to be a member of this board/subcommittee?

Please list any organizations, professional associations, service or social clubs that you are already involved with.

What skills, connections, resources or expertise do you have to offer?

Do you currently have any felony convictions? If yes, please explain.

Can you commit to the time requirements needed for meetings and activities, including in-person meeting attendance?

Who is your current employer? If retired, please list former employer.

Please list any potential conflicts of interest you may have.

Have you served as a Community Services Board (CSB) or subcommittee member in the past?

Yes

Which one, and for how long?

Working on the CSB or a subcommittee may expose you to stakeholders or consumers of services. It is important that those served be afforded dignity and not be encumbered by undue stress and relational issues. Do you agree to maintain professional boundaries and rapport?

Yes

Working on the CSB or a subcommittee may expose you to sensitive information. It is important that the privacy and confidentiality of those served, be maintained. Do you agree to maintain confidentiality and contribute to ensuring privacy?

Yes

It is important that members be in good community standing and that there are no ethical issues that would harm consumers and/or stakeholders or detract from the work of the subcommittees. If there is any issue that might impact the quality of your work, will you discuss this with the Director of Community Services?

Yes

Community Services Board Candidates Only

If you are applying for consideration for the Community Services Board, please select all that apply:

I am a licensed physician.

I am a certified psychologist.

Mental Health Subcommittee Candidates Only

If you are applying for consideration for the Mental Health Subcommittee, please select all that apply:

I am or was a consumer of mental health services.

I am the parent or relative of persons with mental illness.

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Thank you for your interest in serving on the Lewis County Community Services Board and/or subcommittee. Your application will first be reviewed by the Community Services Board before a final recommendation is made to the Lewis County Board of Legislators. If you are recommended by the Community Services Board for appointment, you will be required to meet with members of the Lewis County Board of Legislators prior to appointment. If you have any questions about the status of your application, please contact the Community Services Department at (315) 376-5858.

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Community Services Board and Subcommittee Application