disclosures: 033895ea6447162ceec3ee1afed008446bf275b94f8b3e98b78345efcdfc79f7
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| 033895ea6447162ceec3ee1afed008446bf275b94f8b3e98b78345efcdfc79f7 | 2017/Sevigne,_Kym_Marie_8.3.17_-_CMR_6.02(3).pdf | 2017 | Kym Marie Sevigne | The Commonwealth of Massachusetts Executive Office of Health and Human Servises Department of Mental Health COMMISSION 25 Staniford Street -3 AH11:31 Boston, Massachusetts 02114-2575 CHARLES D. BAKER Governor KARYN E. POLITO (617) 626-8000 Lieutenant Governor www.mass.gov/dmh MARYLOU SUDDERS Secretary JOAN MIKULA Commissioner July 11, 2017 Ms. Kym Marie Sevigne 429 Moore Street Ludlow, MA 01056 Dear Ms. Sevigne: I am pleased to appoint you for a three year term to the Holyoke/Chicopee Site Board with an expiration date of July 11, 2020. Your participation as a volunteer advisor to the Massachusetts Department of Mental Health is very much appreciated. The Department is committed to developing a service system that reflects local needs and meets high standards of care. Advances in care and treatment for individuals with mental illness, together with recognition of the need to partner with consumers to sustain their recovery in less restrictive environments have shifted the focus of treatment to the community. The Department's Community First vision is one that is aligned with consumer choice and the DMH public mental health system has transformed to empower consumers and families. Overwhelmingly, their choice to achieve their recovery is living independently - with the right supports - - in the community of their preference. Your active involvement as a Site Board member is critical to the success of the DMH mission and our Community First Initiative. I have enclosed a copy of the regulations governing citizen advisory boards. You will note that all board appointees must participate in training and orientation activities. Also note that you must be sworn in by two "Commissioners to Qualify Public Officers" within the next 90 days. Information regarding this requirement is attached and I suggest you confer with your Area Director as to the best way of meeting this requirement. Also, please be aware that, because you are an employee of an agency that currently contracts with the Department, you are required by the State ethics law, M.G.L. c.268A, to file a disclosure form with the State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108. A copy of the form is attached. Additionally, you should not participate as a Site Board member in any matter relating to or affecting your employer. On behalf of the Department, I would like to once again thank you for your participation as a Site Board member, and wish you much success in this important responsibility. Sincerely, Jan Joan Commissioner Mikula Mileale cc: Julie Schwager, Western Massachusetts Area Director Brad Cole, Holyoke/Chicopee Site Director DISCLOSURE OF ELECTION OR APPOINTMENT TO AN UNCOMPENSATED POSITION RECEIVED AS REQUIRED BY 930 CMR 6.02(3) TE ETHICS COMMISSION IDENTIFYING INFORMATION 2017 AUG -3 AM11:31 Name: Kym Marie Sevigne Your phone: 413-519-0050 (c) 413-536-8200 (w) Your e-mail: Kym.Sevigne@state.Ma.US STATE: I already have a job with a state agency or another direct or indirect financial interest in a contract made by a state agency, and I will begin serving in an uncompensated position with the same state agency or another state agency. Write an X COUNTY: I already have a job with a county agency or another direct or indirect beside one financial interest in a contract made by a county agency, and I will begin serving in statement. an uncompensated position with the same county agency or another agency of the same county. MUNICIPAL: I already have a job with a municipal agency or another direct or indirect financial interest in a contract made by a municipal agency, and I will begin serving in an uncompensated position with the same municipal agency or another agency of the same city or town. The uncompensated position will be: Check one. Elected or Non-elected FINANCIAL INTEREST I ALREADY HAVE IN A PUBLIC AGENCY CONTRACT Do you already have I HAVE THE CONTRACT. the contract with a public agency, or I work for a public agency for compensation. does another person or entity have the A contract that I have with a state public agency (e.g., a grant) funds my work; contract? I have a contract for goods, supplies or equipment, etc., with a public agency. Write an I have another type of contract with a public agency. beside the appropriate OR statement. ANOTHER PERSON OR ENTITY HAS THE CONTRACT. I work for a person or entity (e.g., a business, non-profit or organization), and my work is funded by a contract between the person or entity and a public agency. I have an ownership interest in a private entity (e.g, a business or non-profit), and the entity receives funds because of a contract with a public agency. I have an ownership interest in a private entity (e.g., a business or non-profit), and the entity has a contract for goods, supplies or equipment, etc. with a public agency. A public agency has a contract or transaction with a private person or entity, and I have a financial stake in the contract or transaction. CONTRACT BETWEEN A PUBLIC AGENCY AND YOU Fill out this part of the form if the public contract is with you. Name and address RECEIVED of the state, county Massachusetts Rehabilitation STATI Commission ETHICS or municipal agency that made the Holyoke Area office 2017 AUG -3 AM11:31 contract. | 2017/Sevigne,_Kym_Marie_8.3.17_-_CMR_6.02(3).pdf |