ROUGH DRAFT 9-15-11, Outcome Measures for Centers for 
Independent Living – An IL NET Resource Presented by ILRU

>>  MIKE HENDRICKS:  Just to let you 
know, we'll start in 2 minutes, for our 
online friends.
Let's start back.
Our friends on line are with us.
Bob and I are going to do this session 
together.
We used to watch Monty python.
Remember when they said now for 
something completely different?
Anyway, now for something completely 
different if you have your handouts here 
that we have been using and you turn to 
this one, pulling it all together, you 
notice it is mighty skimpy.
There's basically a cover page, a 
picture of the yellow brick road showing 
us at the end, then nothing at all.
That might reflect how much Bob and I 
know.
Might be an accurate reflection of our 
knowledge.
Or it might be a reflection that this is 
basically your session.
We are at the end of the yellow brick 
road.
We have done all the steps starting from 
the very beginning, figuring out what 
the heck we mean by outcome and 
difference between that and output.
We have gone all the way through.
We have OUR information.
We have actually been using it both 
inside and outside the CIL.
We are at the end of the road.
We wanted to be sure there was time to 
cover things you thought we hadn't done 
a good enough job on, need to spend more 
time on, or more questions have come up 
or whatever.
So we took those questions you gave us, 
what, Tuesday.
We have built them in.
We actually have more PowerPoints up 
here than you have.
Let me say that again.
We're going to be showing you some 
PowerPoints that you don't have.
Because we made them up trying to 
respond to your questions.
Let's see what we have got.
It's not to say this is all we're going 
to cover.
We'll cover anything you want.
Like I said, it's your time.
But let's start off, if you can, with 
whatever you already told us you want us 
to cover.
Let's start that way and we'll see what 
else we have. 
 >>  Mike, by the way, this new 
presentation is already put on the Wiki.
If you all want to access later, you can 
follow along. 
 >>  MIKE HENDRICKS:  Carol, I'm glad 
you said that.
Yes, thanks to the wizardry of people, 
not me, other good people, they have 
taken these PowerPoints that you don't 
yet have in your hands in paper, they 
are on the Wiki.
You can get them there.
They are also on the online feed, if I'm 
not mistaken.
People who are watching online, you will 
see the same PowerPoints that we're all 
seeing here in the room.
Good.
Anything else, Carol?
That was good, thank you.
Let's start off here.
Bob and I, like I said, we're going do 
this together.
One of your questions was how can we 
select good outcomes.
That is a big question.
You can imagine.
Let's try to talk about it a little bit 
and for each of these see what other 
ideas you might have.
First thing we would suggest, first of 
all, remember what a outcome is.
You saw this slide before.
I hope you are all very clear that 
outcomes are benefits or changes for 
participants during or after program 
activities.
It's different from the outputs, which 
is the volume of work accomplished.
Okay?  It's the benefits or changes that 
we're looking for.
That is what outcomes are.
Then we suggested some particular 
sources that you might go to.
We suggested that it was not a good idea 
to just go to program staff and ask them 
what they thought the good comes would 
be.
That it would be really good idea to go 
to a lot of different people.
That is a way we think, in fact that is 
probably the main way we would suggest 
you develop what you might call, 
quote/unquote, good comes.
Get a lot of different perspectives on 
it.
We also made suggestions about writing a 
outcome statement, how to write it.
Again, our suggestion is a target group 
plus a present tense verb, then whatever 
it is you want to happen.
So that combination of remembering what 
a outcome is, sources of where to go to 
brainstorm, then how to write them up, 
is kind of I think, that maybe all we 
can suggest about how to, what was the 
question exactly?
How can we select good outcomes.
This is our session.
This is an open session.
Somebody else, maybe the person who 
asked the question has an idea.
Maybe somebody else has an idea.
Anybody have anything?  Bob, you have 
something?
Anything anybody wants to add to this?
This is like a group brainstorming 
session together.
Yeah, Dan has something here.
We're open to everybody's ideas.  That 
is why it's a workshop. 
 >>  This is Dan Kessler from Alabama.
A couple of ways you might want to 
select is to look at the new program 
you're implementing, not quite sure how 
it's going to work out might be one way.
Another might be you're looking at some 
changes to some staffing programs, not 
quite sure what direction to go, whether 
to continue or make adjustments, that 
might be another way as well.
I guess maybe looking at the priorities 
of the center for a given year might be 
way of going about that process. 
 >>  MIKE HENDRICKS:  I like that, Dan.
You're taking a slightly different angle 
and saying of the different possible 
outcomes you might be looking at, how 
to, you're focusing on the word select 
here. 
 >>  Right. 
 >>  MIKE HENDRICKS:  How to select 
which of many.
You're saying maybe a new program, maybe 
a program having some problems, 
something like that.
I think that is good.
I like that.
Other ideas about selecting good 
outcomes?
Your next question was can you go over 
the logic model again and how indicators 
fit on it.
I'm not going to do this slowly, don't 
get me wrong, but quickly because I 
think a lot of us now have it probably 
since this question was asked.
Let's do it real quickly.
So remember the logic model is a 
conceptual chain of inputs leading to 
activities, leading to outputs, leading 
to different levels of outcomes.
That is conceptually what a logic model 
is.
This is the way we tend to draw them out 
with the inputs down here at the bottom.
Remember, think the next slide says if 
then.
Yes, remember if then, if these 
activities, then this outcome.
Down here it would be if we have these 
inputs, then we can do these activities.
If we do these activities at a certain 
level we will have outputs showing how 
hard we're working.
If we work hard we'll start having these 
different outcomes.
If then logic working its way up.
I got to thinking that maybe part of the 
confusion was in this first part, we 
were showing you inputs, activities, 
outputs and outcomes, all four 
components of maybe what you call the 
full logic model.
Certainly here we show all four 
components.
Yet in my opinion at least, the 
essential stuff are the activities and 
outcomes.
So when I kind of in reality do logic 
models, I tend to focus on the 
activities and the outcomes.
That may be what confused someone.
Here you see we just have activities 
going up to outcome then this outcome 
then this outcome.
Here we have activities with outcomes 
above it.
Maybe somebody got confused.
Maybe they were looking for inputs and 
outputs and not seeing them.
I don't know.
Here is, forgive me because when I 
transferred this slide over, I 
completely lost the color for some 
reason that I'm not capable of fixing.
This was the task forces proposed by the 
model for the CILs program.
You can see it also has activities or 
activity boxes, as someone pointed out.
Maybe that was part of the confusion.
Then the question was where do the 
indicators fit.
The indicators, remember the Christmas 
tree ornaments hanging on the tree.
The indicators, that is what we measure 
to define what we mean by the outcome.
You can see how they hang on the 
outcome.
There's an indicator for each outcome.
Or maybe two indicators or three.
As many as you need.
That is a quick review and how the 
indicators connect.
Anybody want to say something else about 
that?
Yeah, we do. 
 >>  I have a question on that process.
I'm glad you went through this again. 
 >>  MIKE HENDRICKS:  We did it because 
you wanted to.
This is your session. 
 >>  Thank us.
So it was activities then inputs.
Then you keep going up. 
 >>  MIKE HENDRICKS:  Go back. 
 >>  I keep thinking about going back to 
our strategic plan. 
 >>  MIKE HENDRICKS:  Inputs first. 
 >>  Inputs first. 
 >>  MIKE HENDRICKS:  Then the 
activities. 
 >>  Okay, I keep thinking going back to 
our strategic planning, making sure it's 
addressing outcomes.
Using this process. 
 >>  MIKE HENDRICKS:  Great. 
 >>  With our strategic plan, which I'm 
sure will need some work.
But so often I think that we get stuck 
because we go all the way through this.
The first step is inputs, and we don't 
have the necessary inputs. 
 >>  MIKE HENDRICKS:  Ah. 
 >>  You have gone all the way and you 
go wow, this is really cool, all laid 
out for us, but a lot of things in the 
inputs category that are not available 
to us.
Then you go back and adjust it for what 
is realistic.
Do you continue to dream and hope you 
find a money tree?
What is your suggestion there? 
 >>  MIKE HENDRICKS:  Remember, it's a 
logic model.
Going back up 1 bit here.
It's a logic model and supposed to be 
logical.
So for instance, you're really saying 
when you develop this piece of paper, 
you're really saying, if we have these 
inputs, then we can do these activities.
So what you're saying is sometimes you 
look at it, and you don't have all the 
inputs you need to do those activities.
Well, that is illogic, right, a logical 
gap, a flaw.
That is a huge advantage of doing a 
knowledge lotic model.
You see that, my gosh, we don't have the 
right inputs for our activities.
That is what you do.
You stop and you say something has to 
give.
Either we can't do that activity or we 
have to get more inputs or something.
There's this mismatch between them.
That is exactly one of the ways you 
would use a knowledge logic model to ask 
yourself, does this make sense.
Sometimes it won't.
Yeah, okay.
Anything else about that?
I know what I wanted to say.
You were just talking about sometimes 
when you look at a program and you don't 
have the inputs, Dan Kessler was talking 
to us at the break about what I 
mentioned about the implementation 
training we did at the cil Congress.
He has actually watched it, poor guy. 
 >>  Not the whole thing. . 
 >>  He was surfing one night. 
 >>  Yeah. 
 >>  MIKE HENDRICKS:  Surfing parts. 
 >>  Yeah. 
 >>  MIKE HENDRICKS:  Actually if you're 
interested in implementation, if you're 
interested in looking at whether you 
have got out there what you think is out 
there, Dan's feeling was that it was a 
pretty practical, sensible step-by-step 
process we laid out there.
You might want to check that 
implementation part of that Wiki out.
I think it would be maybe helpful.
Next question, can indicators measure 
qualitative outcomes?
I'm at a disadvantage because I'm not 
exactly sure what the person met by 
qualitative outcomes.
I'm thinking, tell me if I'm wrong 
whoever did it, maybe they meant 
something like can you measure feelings 
or attitudes.
More squishy things that aren't like 
behavior you can actually see.
You know, the condition of the streets 
or something like that.
I thought maybe that was what they were 
saying.
If that is the case, then I would say, 
heck, yes, absolutely.
Like for instance, in our field test, we 
measured whether people felt they were 
more independent.
Right? . 
 >>  BOB MICHAELS:  Right. 
 >>  MIKE HENDRICKS:  So number and 
percent of CIL consumers who feel more 
independent.
Number and percent of parents who 
appreciate, these are just made up, 
obviously.
Who appreciate what the CIL has done for 
their child.
Number and percent of city council 
members who have a hospital attitude 
towards us.
You can see who typed this.
Towsards the CILCs.
(Laughter.). 
 >>  You can measure squishier things, 
you know, than hard behaviors or 
conditions, things like that.
Now, you might ask the question, how do 
you measure them?  The answer is, again, 
there are people who make a living who 
build whole careers in knowing how to 
assess attitudes, how to check values, 
things like that.
It's extremely doable.
Extremely doable.
If the person who asked that question, 
if I misunderstood and you want to do it 
again, that is fine.
If I have gotten it sort of close.
Bob, you want to add something? . 
 >>  BOB MICHAELS:  Yeah, does that 
reduce the amount of options you have 
when you're talking about the sources of 
data? 
 >>  MIKE HENDRICKS:  Let's think about 
it.  A darn good question.
These are your indicators.
Remember we talked, first you develop 
the outcome.
Then you develop the indicator of that 
outcome.
Only then do you start asking yourself 
where am I going go, what is the source, 
where am I going to go to get that 
information.
So you're saying if you have this kind, 
does it limit the possible sources? . 
 >>  BOB MICHAELS:  Certainly would.
So I'm trying to think, I mean you 
pretty much have addressed.
I'm trying to think what else would 
work. 
 >>  MIKE HENDRICKS:  If you want to 
know about consumers who feel more 
independent, yeah, certainly that is the 
obvious thing is to go talk to 
consumers, right?
And parents and city council members. 
 >>  BOB MICHAELS:  There isn't 
something you can observe. 
 >>  MIKE HENDRICKS:  If you were 
observing, like number or percent of 
city council members who vote some where 
towards a CIL, that is a different 
indicator, isn't it. 
 >>  BOB MICHAELS:  Yeah. 
 >>  MIKE HENDRICKS:  That might be go 
look at voting records might be the 
source.
Or observe city council meetings or 
whatever.
But if the two have a positive attitude, 
yeah, you may well be right.
That might be specifying then pretty 
much what your source has to be.
Like I say, it's have doable.
(Phone ring).
Let's go to the next question if we can.
Can we give more examples of IL outcomes 
and indicators.
Probably not without worrying people to 
death.
But I think maybe that question got 
asked before Bob had told that in your 
materials, there is a sheet of the eight 
outcomes the task force used and the 11 
indicators for those.
Hopefully that will help the person who 
asked the question.
Yes, sorry, we write it here.
There's the list of the field test 
outcomes and indicators in your 
materials.
I thought if you want to, if somebody 
wants to throw out a outcome, we can 
together see if we can brainstorm an 
indicator.
Anybody have a CIL outcome they want to 
throw out that hasn't been discussed?
I'll start with one. 
 >>  BOB MICHAELS:  Yeah, the one this 
morning. 
 >>  MIKE HENDRICKS:  Let's do that.
What exactly was that outcome? . 
 >>  BOB MICHAELS:  Number --. 
 >>  MIKE HENDRICKS:  Not the indicator, 
though.
Remember the outcome. 
 >>  BOB MICHAELS:  That people with 
disabilities are employed. 
 >>  MIKE HENDRICKS:  People with 
disabilities are employed.
There you go. 
 >>  BOB MICHAELS:  Full time or 
something. 
 >>  MIKE HENDRICKS:  There you get into 
the indicator.
What do we mean?  How would we measure 
persons with disabilities, and we'll say 
the CIL works with, not all, but the 
ones the CIL works with, are employed.
Help me come up with an indicator of 
that.
Like we said the other day, you can't 
measure just that.
You have to have more meat on the bones 
to figure out what you're going to 
measure.
What would be an indicator of that?
Anybody.
I'll call on you if you don't volunteer.
You're smiling, you must have an answer.
Give it a shot.
Come on.
Use your microphone, introduce yourself.
Give it a shot.
Start off with number and percent of. 
 >>  Nancy Mcfar land from opportunities 
for access in Alberta, Illinois.
I was thinking number and percent of 
consumers who are still employed after 
so many months.
I would put number of months in there. 
 >>  MIKE HENDRICKS:  Let's just 
friendly push you.
What do you mean by employed? 
 >>  Employed, yes.
Employed, I would say full or part time.
I think I would make it two different 
ones.
Even part time employment is employment. 
 >>  MIKE HENDRICKS:  Interesting.
It's Nancy? 
 >>  Yes. 
 >>  MIKE HENDRICKS:  Nancy is having 
two indicators.
One full-time employment, one part time.
Perfectly legitimate if she thinks that 
will give her the information she needs.
What would then be the full-time 
employment?  Number and percent of? 
 >>  Number and percent of consumers who 
are employed full-time for, say, 
3 months at least. 
 >>  And part time, how might that be 
worded? 
 >>  Number and percent of consumers 
employed part time for, I would say, 
3 months also on that. 
 >>  MIKE HENDRICKS:  What does part 
time mean? 
 >>  Part time would mean approximately, 
I would say approximately 15 hours to 
20 hours a week. 
 >>  MIKE HENDRICKS:  Okay.  So again, 
if I'm the totally unfamiliar person 
trying to measure this, you have to tell 
me.
What is the minimum I'm looking for 
here?  How many hours at least? 
 >>  Min number of hours for part time 
would be 15 hours. 
 >>  Number and percent of persons with 
disabilities. 
 >>  Number and percent of persons with 
disabilities employed. 
 >>  MIKE HENDRICKS:  At least 15 hours 
a week. 
 >>  For 3 months. 
 >>  MIKE HENDRICKS:  There you go.  
Those are good candidates.
Another candidate?
Someone else I can humiliate?
You did actually great, thank you. 
 >>  Only one thing I would add to that.
That is minimum wage. 
 >>  MIKE HENDRICKS:  Ah.
What do we think?  Does it have to be a 
minimum wage job?
Bob, your outcome, did your outcome say 
minimum wage job? . 
 >>  BOB MICHAELS:  No, it didn't. 
 >>  MIKE HENDRICKS:  This is a 
fantastic example.
So glad you said that.
Fantastic example of what I mean by the 
indicator defines the outcome.
The indicator defines exactly what we 
mean by the outcome.
Now, if we decide that the indicator 
should say minimum wage job, then we're 
defining Bob's outcome in a certain way.
If we don't include minimum wage, then 
we're defining Bob's outcome in a 
different way.
So it's really important here, isn't it.
This is what I meant by the indicators 
are critically vital because they will 
define what we mean by the outcome.
Was that a hand?
It is, please.
I'm glad you said that, Mary, it's 
wonderful. 
 >>  Just to build on it.
If it was my question, I would want to 
know for the part timers how many people 
maintained SSI or SSD benefits and how 
many people were working part time who 
were not on that.
I don't know if I have to specify.
What that is getting at is the level of 
income.
Minimum wage would probably maintain 
SSI, SSD at 15-20 hours.
Somebody at higher income would be 
phasing out of that with work 
incentives, et cetera. 
 >>  MIKE HENDRICKS:  You're saying you 
might need to be really careful about 
the kind of part-time job you're trying 
to help people get?  Is that right? 
 >>  The indicators would reveal what 
the success we are having and tell us 
something about the inputs and the 
activities and the outputs that we are, 
and those values, whether we are 
directing people one direction or not. 
 >>  MIKE HENDRICKS:  I like that.
You're thinking ahead.
What if we do pretty well on this.
What are the implications for the 
people.
I like that.
Okay.
Anything else about that indicator? 
 >>  Mike?  Over here.
Carol. 
 >>  MIKE HENDRICKS:  Thank you. 
 >>  We have a comment from Cheryl about 
this discussion.
She said, could have indicator about 
number employed at or above SGA level, 
could at several months. 
 >>  MIKE HENDRICKS:  Anybody knows what 
SGA. 
 >>  Substantial gainful activity. 
 >>  MIKE HENDRICKS:  You all know.  I'm 
the one who doesn't.
Does that make sense?  What she said?
Excellent comment.
Thank you for that.
Excellent.
You can see, yes.
One more, this is great. 
 >>  This is Joan from Corvallis or 
Salem, Oregon.
Seems we ought to say 15-39 hours so we 
define what part time is.
Otherwise we included everything. 
 >>  MIKE HENDRICKS:  Really good.
I missed that completely.
You're right.
If we have one full time and one 15 and 
above, some people will be double 
counted.
Excellent, that is the kind of of 
glitches you can get into.
That is good.
Yes. 
 >>  If we're going to get into this at 
this level, I think we need to add the 
component of integrated employment.
You could be working in a sheltered 
workshop, obviously, at minimum wage.
We're addressing the quality of 
employment.
If we go down that road. 
 >>  MIKE HENDRICKS:  Think it's a good 
comment and I think you do need to go 
down that road.
Again, back to the point.
We are defining what Bob meant by his 
outcome.
If you think only a certain kind of 
employment should be counted, then by 
gosh, our indicator has to be very 
specific about that or else we won't be 
getting the information we want.
See what I mean now?  Starting to see 
the indicators are the real heart of 
this process.
You really need to spend time on your 
indicators.
Think we had this table, then I'll come 
back to you.
Someone at this table, I think it was.
Go ahead, please sir. 
 >>  Yeah, thank you.
I was going to make the comment that 
really this whole issue of integrated 
and nonintegrated is big, and I'm glad 
somebody brought it up.
The other one, if you intend to use the 
data later on to get grants there are 
some standard definitions about what 
full-time employment is.
Usually it's considered to be 32 hours 
or more.
And when part time employment can be 
anywhere, I have seen some definitions 
that go town as low as three or 4 hours 
a month.
You might want the look at those 
definitions again and say if we get this 
done and if we want other funders to 
look at it, how much should we 
standardize our definition of things 
like full and part time. 
 >>  MIKE HENDRICKS:  Great suggestion.
I didn't think to mention.
You're so right.
We have to be sure anyone who looks at 
our indicator in the future will accept 
it, will accept that that indicator 
makes sense to them too.
You're saying if there's some standard 
definitions that our audiences will be 
focusing on, then we're making a big 
mistake by coming up with our own 
definition that is different.
Really good.
I like that.
Over here. 
 >>  I wanted to clarify something about 
if the outcome is people are employed. 
 >>  MIKE HENDRICKS:  Uh-huh. 
 >>  We all talk about a lot of 
different variables.
Integrated, nonintegrated, full time, 
part time, what was full tile, what was 
part time.
We're talking about a lot of indicators.
I know from my experience, I have people 
who don't want to work more than 5 hours 
a week but they have been doing that for 
5 years.
I would count them as employed.
I guess what I need clarification is 
that we could have all these different 
variables, whether they were part time 
this, part time that.
All those different things could be 
indicators that would all meet that one 
element. 
 >>  MIKE HENDRICKS:  You could, I 
wouldn't recommend it.
I thought the distinction between part 
time and full time was a significant 
enough difference that probably makes 
sense, at least to me, to have one 
indicator and a second indicator.
Maybe not to you, but to me that seems 
to make some sense.
These other things we're talking about 
though, like for instance, what is the 
definition of part time, what kind of 
employment, in what kind of a setting, 
that seems to me more like decisions we 
ought to make that would apply to both 
indicators.
Sort of further specification of what we 
mean by each indicator.
You may feel differently.
That is fine.
I think --. 
 >>  It all needs to be integrated and 
all needs to be a minimum wage. 
 >>  MIKE HENDRICKS:  Whatever you 
decide. 
 >>  Yeah. 
 >>  MIKE HENDRICKS:  Think your 
instincts are right.
Better not to have 12 microindicators, 
you know.
I think your instincts are exactly 
right. 
 >>  BOB MICHAELS:  You know we had 
really interesting discussions about 
this when we got into the area of the 
overall outcomes.
We talked about that communities being 
accessible.
What does that mean?
We started playing with that indicator 
to try to figure out what that meant.
What does it mean to be a hundred 
percent, housing to be a hundred percent 
accessible?
Well, hundred percent of new homes built 
into the community are adaptable.
You know, employment, the unemployment 
rate for people with disabilities was no 
higher than employment rate for 
everybody else.
So we just did that and started going 
through those.
Then realized, wow, we're not there at 
all yet.
And that is how we started.
There's no way we're going to go up to 
being fully accessible, a fully 
accessible community.
So you know, it may sense to what we did 
then. 
 >>  MIKE HENDRICKS:  Yeah. 
 >>  BOB MICHAELS:  To go down lower.
Because if you set your goal up here to 
be the same unemployment rate as 
everybody else, well, you might, you 
know, in 80 years, but only if we had 
thought of the things first.
Pat. 
 >>  I'm thinking that, this is Pat from 
Georgia, I'm thinking we should set that 
goal for voc rehab though.
Sort of joking and sort of not.
But you know, the fact is that when you 
look at the rate of participation of 
people with disabilities in education 
beyond high school, that is the area 
where I feel we have in fact improved a 
lot.
As we know, education and employment are 
distinctly connected.
And so from the perspective of the world 
of people living, pushing people to get 
education and helping them to understand 
that they have opportunities, 
educational opportunities, to me is a 
very definitely a role for centers.
It's one of those intermediate outcomes 
that ultimately result in employment.
So to me it's more of a goal that is 
suited, sorry, I said the word goal.
Do I get find? 
 >>  MIKE HENDRICKS:  We'll talk later. 
 >>  Okay.
If we set that outcome, intended 
outcome, it's more in line with what 
it's about rather than VR.
Does that make sense? . 
 >>  BOB MICHAELS:  Was that a good 
exercise? 
 >>  This is my favorite.
The scenarios you have, if they would 
have been IL programs, I would have came 
away with this training a lot more.
I heard from other states in the room 
about different programs that IL-CILs 
do.
It would give me a different perspective 
instead of going back to my center and 
possibly within my state and giving a 
perspective that, you know, I think I 
would have walked away from this 
training with a lot more guts and 
material, you know. 
 >>  MIKE HENDRICKS:  You mean instead 
of the after school program for kids?  
You would have rather have it focused on 
CIL? 
 >>  I think I would have walked away 
with a lot more opinions with my 
copartners in the room and may helped my 
center out.
For newer directors I'm sure it would 
give them a lot more. 
 >>  MIKE HENDRICKS:  Good feedback for 
the next time, thanks.
Let's just in the interest of time go to 
the next question.
Instruments that are valid and reliable 
to measure CIL outcomes.
I think the question was do they exist 
out there already.
You know, can we just draw on them.
Do we have to make them up ourselves.
I honestly can't answer this question 
because I'm not an IL expert like a lot 
of you are.
Bob and I, when we started working with 
the task force, we looked for stuff.
We looked a lot.
We tried to steal, we talked about brag 
and steal, we tried to steal the best 
ideas but didn't see a bunch.
The only advice we could give would be 
the NCIL task force members, and we can 
get you a list if it's not on the Wiki, 
those people were chosen because they 
know this stuff, especially research 
side.
Other experts in the IL field, whatever 
literature you think would be the proper 
place to go.
Beyond that I'm kind of at a loss of 
what to suggest for you.
Does somebody out here have or online, 
somebody have suggestions of where to 
go?
The question was some instruments, 
meaning like survey instruments or 
interview guides or questionnaires or 
observation checklists, something like 
that.
Already been done so you don't have to 
reinvent the wheel.
Pat my know something here. 
 >>  The one that came to mind, and it 
has to do with nursing facility 
transition.
The federal money follows the person 
project has an interview, quality of 
life interview survey that is given to 
the person while they are still in the 
nursing home and 6 months later and I 
think maybe a year later.
So it's got, it's very outcome oriented 
and asks questions like did you decide 
what you had for dinner last night.
Those are the kinds of things that are 
indicators of a person's choice and 
control.
So that to me would be one of those 
things that you could pick up from the 
CMS website or the AVRC website that 
would be a real easy thing. 
 >>  MIKE HENDRICKS:  Good.
You got that suggestion from Pat.
Sounds like a good one. 
 >>  BOB MICHAELS:  When we first 
started doing this, we had a number of 
different states and even Canada.
You know, a different country, telling 
us we're already doing outcome measures.
So we went to them and said give us what 
you are doing and let us see it, we want 
the try to incorporate it.
But within a very short period of time, 
we were way ahead of where they were.
So we didn't do a lot of that.
In fact, many places now are watching us 
to see what we are coming up with.
So we really are leading the field here.
You need to be proud of that. 
 >>  MIKE HENDRICKS:  Their next 
question was more about the definition 
of at risk. 
 >>  BOB MICHAELS:  Now, I have it right 
here. 
 >>  MIKE HENDRICKS:  Go for it. 
 >>  BOB MICHAELS:  You have that 
definition in your training manual that 
was in your folder.
I'm going to go ahead and read it.
Please bear with us.
A second approach is more technical but 
comes from the legal case.
So use it as you need to.
You can decide a person is at risk if he 
or she meets the level of care criteria 
needed for nursing home admission in 
your community, and you also faces any 
one of these three other situations.
Is likely to require admission to a 
nursing facility within the next 
120 days.
Has a primary caregiver who has a 
disability.
Or is over the age of 70.
Or faces a substantial possibility of 
deterioration in mental and physical 
condition or functioning if either home 
or community based services or nursing 
facility services are not provided in 
less than 120 days.
If a consumer fits these criteria, then 
you ask yourself, then you yourself can 
decide if he or she is at risk.
Simple, yeah? 
 >>  (Laughter.) . 
 >>  BOB MICHAELS:  This was the hardest 
definition for us.
We have gone through it and through it 
and through it.
There was the University of 
Massachusetts was that. 
 >>  MIKE HENDRICKS:  Right. 
 >>  BOB MICHAELS:  They put in to do a 
research project that would key in on 
this for identifying what is at risk.
Actually coming up with definition.
We actually got an advisory board and 
they didn't get the grant.
But somewhere along the line this has 
got, we thought that maybe CMS would 
have it and would have something like 
that.
They didn't.
So at this point we don't have anything.
But it's one of those areas that needs 
some attention.
Somewhere down the road, not too far in 
the distance, we're going to get it. 
 >>  MIKE HENDRICKS:  Just realized, for 
people on line maybe this is their first 
week working at a CIL and they don't 
know what this is about.
It's at risk of being institutionalized.
There are persons with disabilities in 
the community that are not at risk of 
being institutionalized.
A lot of them in this room for instance.
A lot of of them are at risk of being 
institutionalized.
Knowing who is which is really really 
important.
Not only for our outcome management 
efforts, but also politically.
So that is why Bob and I say that this 
is a really important issue for the IL 
field.
I know there are people in Washington 
looking at budgets these days, and they 
are going to want to know, are you all 
really saving us money by keeping those 
at risk people out of expense of 
institutions?
You can't answer that question at all if 
you don't know who is at risk out there 
in the community.
I'm just, frankly, as methodologyist, I 
was really surprised at how little 
agreement, if you would say, there is in 
the IL field on how, I expected a much 
clearer definition.
Maybe Fred has it.
I expected a much clearer definition.
Bob and I both really think as a field, 
IL has to work on this more than it is.
We were both very disappointed that this 
grant to do just that, this grant was 
going to try to figure out better ways 
to identify people who are at risk.
We were very disappointed the grant 
wasn't funded because we just think it's 
really needed. 
 >>  Fred Johnson, North Carolina.
In North Carolina, the percentage of 
people who are at risk of being 
institutionalized is nearly a hundred 
percent. 
 >>  MIKE HENDRICKS:  Nearly a hundred 
percent. 
 >>  Especially if you are a person, not 
necessarily a person with a disability, 
but if you are a person who has, for 
example, fallen or had an accident on 
your property, you go to the hospital, 
they ask you if you have anyone at home 
to provide you with any kind of 
assistance.
If you say no, and you can't find a 
service to the provide that kind of 
attendance, then they funnel you in a 
nursing facility. 
 >>  MIKE HENDRICKS:  If I can interrupt 
and say you're doing exactly what we 
think needs to be done.
If a person has fallen, if a person 
doesn't have provider to care for them, 
and something else.
You had three of them there.
Then you would say they are at risk.
But there's not consistency or agreement 
around the country about what those are. 
 >>  Exactly. 
 >>  And that is because, and this is 
for down the road, Charlotte, North 
Carolina, so much is tied into Medicaid 
funds and that is the state by state 
problem. 
 >>  MIKE HENDRICKS:  Hmm. 
 >>  Waivers and vouchers and other 
things that North Carolina doesn't know 
anything about.
So it is not possible to have a federal 
definition that is going to help 
anybody. 
 >>  MIKE HENDRICKS:  You think it's 
not. 
 >>  I don't.  Because I know that the 
people, Fred is exactly right.
Just about everybody in North Carolina 
that falls down is at risk of going into 
an institution. 
 >>  MIKE HENDRICKS:  Okay. 
 >>  We have seen that over and over.
We may have friends in Massachusetts who 
say, well, no, we have this grade 
Medicaid or med care or whatever, 
waivers or vouches.
But we don't.
As long as it's a state by state option 
for those kinds of things, because so 
much of the funding is Medicaid, by the 
time we have a national definition, it 
would only be people.
That is the only thing they have in 
common. 
 >>  MIKE HENDRICKS:  I'll give you my 
personal opinion.
Bob may disagree.
Maybe they have already done it.
Forgive me if they have.
Someone needs to look across all the 
state definitions and figure out way to 
handle when you aggregate them together.
People in Washington do care about this 
question.
Lots of comments on that. 
 >>  I have a question.
Say the primary caregiver has a 
disability. 
 >>  MIKE HENDRICKS:  If the primary 
care giver has a disability, would that 
put a person automatically at risk.
I would say darn good question.
Do we as a field know the answer to 
that? . 
 >>  BOB MICHAELS:  That is part of this 
definition. 
 >>  I was asking why that, or how that. 
 >>  How and why did that get into the 
question. 
 >>  BOB MICHAELS:  Yeah.
I can't really tell you why.
We asked the state call to give us that 
definition out of the lawsuit in 
Louisiana.
So I don't know what he was thinking or 
what they were trying to accomplish.
I don't want to answer for him. 
 >>  MIKE HENDRICKS:  In the interest of 
time, let's take one more and let's move 
to the next question.
We can always come back to this if we 
have time. 
 >>  I actually think that at least in 
the area of gerontology there's been a 
fair amount of research on who is and is 
not at risk.
For example, cognitive impairment, 
seniors who have cognitive impairment 
places them at greater risk.
And when incon tinnant occurs 
consistently is the other variable.
Are you confused and do you pee your 
pants, or poop your pants, whichever.
Those are a couple things at least for 
the validated gerontology arena are 
clear factors.
I do not think there have been as many 
studies validated for people that are 
not considered seniors.
But I suspect that it would not take a 
lot to figure that out.
You know, the fact is that we know from 
the data that, in our state at least, 
the number of people under the age of 65 
that are going into nursing homes has 
increased over the last decade.
So when I started watching the Medicaid 
data, it was 11 percent.
Now it's up to close to 17 percent.
And the variables to me are so 
complicated.
Because a lot of it has to do with the 
cutback on rehabilitation services in 
the health insurance world.
I mean the average length of stay now 
for a newly injured paraplegic is 
18 days and quads have 32 days.
We were talking earlier about the old 
quads in this room, you know.
Sorry, the quads whose injuries were a 
long time ago. 
 >>  There you go. 
 >>  (Laughter.). 
 >>  Veteran quads, you know, got rehab 
four to 8 months. 
 >>  Yeah. 
 >>  So if you have the opportunity to 
learn how to live with your disability 
in a rehab environment, then you are, 
the impact on long-term care is 
lessened.
So it's extremely complicated 
variablewise to figure out exactly what 
leads to nursing facility placement. 
 >>  MIKE HENDRICKS:  Our task force 
found that.
It's very come indicated. 
 >>  BOB MICHAELS:  Yeah, yeah.
It's funny because you were saying four 
to 8 months for the rehab for the 
old-timers.
And I was in the field at that time.
People were complaining that that wasn't 
long enough. 
 >>  Really. 
 >>  BOB MICHAELS:  They were saying you 
know, I have 9 days of coverage on my 
insurance, and lo and behold, on day 
nine, I'm cured. 
 >>  Uh-huh. 
 >>  BOB MICHAELS:  Time to go home. 
 >>  Exactly. 
 >>  BOB MICHAELS:  You hear that over 
and over and over again.
But it really appears that, you know, 
when University of Massachusetts people 
were looking at this, they seemed to be 
really keying into activities in daily 
living, which really gets to what Pat 
was talking about.
That might be an area to take a look at 
all the different states really makes 
sense. 
 >>  MIKE HENDRICKS:  Let's go to the 
next question if we can.
Bob, this is for you buddy.
I don't know the answer.
How do our outcome measures relate to 
the current 704 report and other federal 
requirements for information.
I know it's in the 704 report and I know 
that, but I don't know this other part 
about other federal requirements for 
information. 
 >>  BOB MICHAELS:  Doesn't relate at 
all. 
 >>  Yet. 
 >>  BOB MICHAELS:  We should have Pat 
give this discussion about it.
We found she couldn't do it without 
saying the F word. 
 >>  MIKE HENDRICKS:  Federal? . 
 >>  BOB MICHAELS:  Any how, yeah, there 
isn't anything in there.
But it was really a nice thing they 
talked about yesterday, how they want to 
try to get with us to incorporate this.
You know, when we first started doing 
this, we had a lot of involvement of 
folks.
Then they just passed away as time went.
They just got away from it.
And so not paying attention, I shouldn't 
say not paying attention.
Just letting us do our work and they 
were doing theirs.
It was really irritating at times when 
grant they gave up and gave them to 
other people.
So NCIL has invested a lot of money in 
getting this done.
It's nice hearing linae talk yesterday 
about trying to find some way to get in 
there.
It's good to hear we don't need to wait 
for reauthorization, if that doesn't 
happen, we can go ahead.
I don't know what the impact will be of 
the ILA, the Independent Living 
Administration.
That is hard to tell.
There are probably people in the room, 
or were in the room, that know more 
about this than I do. 
 >>  Carol has something from online. 
 >>  There's a comment from Cheryl on 
this topic.
I thought I would mention.
It says I missed most of the 
presentation yesterday.
During the RSA presentation, was there 
any discussion about the direction of 
our 704 report as moving as it relates 
to outcome measures, and if so when will 
we see the changes in for reporting?
If not should CILs move to using outcome 
measures for its work plan. 
 >>  BOB MICHAELS:  Cheryl, you know, I 
was kind of alluding to, I could explain 
a little further, Linnae was in fact 
saying, asked a question about the 704 
report, and she said she was interested 
in making changes in the report and will 
work along with us in doing that.
She wanted to see whether or not those 
can be reauthorized because if it's 
reauthorized, then they need definitely 
to, they will need to do the indicators 
or the regulations again.  She didn't 
want to do it twice.
So there were just, you know, ordering 
that.
She was very interested in making 
changes and getting, and she was very 
much open to doing that.
That was great.
Anybody want to add anything else? 
 >>  MIKE HENDRICKS:  Kelly does. 
 >>  BOB MICHAELS:  Kelly. 
 >>  MIKE HENDRICKS:  Get a microphone 
over there somewhere.
Richard, hang on.
Kelly first then you. 
 >>  What I heard her say, Bob, was that 
she was absolutely committed to working 
with us on next steps. 
 >>  BOB MICHAELS:  Yeah.
Richard. 
 >>  I just was going to say for Cheryl, 
who may not have heard what we said 
earlier today, that watch for linnae's 
presentation as well as the other 
sessions that many of you missed 
yesterday.
Those should be up early next week.
The only limited factor is the speeds 
with which we can get transcripts of the 
captioning posted on the website.
As soon as we have those, everything 
from all two and a half days of the 
training will be up and available for 
people to view. 
 >>  MIKE HENDRICKS:  Another question I 
can't answer but I'm sure Bob can.
What does the new rehab plan say about 
outcomes, our approach, et cetera? . 
 >>  BOB MICHAELS:  I think when she 
says the new rehab plan, I think they 
are talking about the reauthorization.
I'm not sure exactly what they are 
alluding to.
As far as I know, doesn't have anything 
about any outcomes in the legislation.
Does it?
For them that know more than I do.
Shannon, does it say anything? 
 >>  Simple answer is no.
In our discussions with our committee, 
though, it all centered back around to 
the 704 report and how inadequate the 
collection of that data is to reflect 
our story.
So we still have time to go back.
As long as Linnae is willing to move 
ahead with this, I think we should, 
after all the information we gathered 
here today, and use Linnae as a friend 
do that. 
 >>  BOB MICHAELS:  Yeah. 
 >>  MIKE HENDRICKS:  Okay.
Might be, yeah, that was the last 
question that you submitted on Tuesday.
Maybe there's something else on 
somebody's mind.
This would be the time.
Let me mention.
I'm sure you're all thinking of one.
Let me mention where we are in the NCIL 
process, the task force process.
We have drafted a report of everything 
that has happened for the last 5 years.
It's all in one document, not even that 
big.
Dan Kessler has read it in his role as 
president of NCIL.
Tim Fuchs has read in his role as 
basically one of our wise people in the 
NCIL office.
Now they both think it's not so bad we 
have to start over again, which is nice 
to hear.
We're going to make some tweaks and 
start sending it out for wider review.
So that will be coming out to, first I 
guess the task force, then the 
participating CILs, then everybody as 
far as we're concerned.
Everybody.
In there we do talk a bit about next 
steps.
I'll say one of the first next steps is 
to basically kind of step back and ask 
ourselves, okay, those decisions we made 
three or 4 years ago about the logic 
model, the outcomes to choose, the 
indicators, very first, are we still 
comfortable with those decisions.
If at some point you look at our logic 
model or look at the outcomes we chose 
or look at the indicators we developed 
and you think you have a better idea, 
you probably do.
So share it with us.
I think we are really remiss if we don't 
step back and make sure we're 
comfortable with all that again.
So Dan may want to say something here 
too.
I just want to say, do not feel this 
train is hurdling down a track that you 
can't influence at all.
Folks in here or on line.
When you see our materials, give us some 
feedback.
Right?  You think that is fair? . 
 >>  BOB MICHAELS:  Sure. 
 >>  I do have a question.
Before I ask, I just want to thank Bob 
and Mike for your leadership over the 
past five or 6 years in this whole 
process.
I mean, when I first, you know, Bob did 
a workshop at the NCIL conference about 
five or 6 years ago and put up on the 
screen that, you know, this is going to 
probably take, you know, maybe in 2011, 
2012, 2010 we will be done with this.
Looking at, boy, we surely would like to 
have something before that.
I think you really made sure that we had 
a outcome or a product, I think, that we 
can, you know, NCIL can really be proud 
of and really can use.
So I just want to thank you for that.
Everybody else on the task force in the 
NCIL office, however you have been 
involved in it.
Certainly all those that went through 
those, again, the guinea pigs at the 
centers that really put themselves out 
there, okay, and took that risk.
I think that is, that took a little bit 
of courage to do that.
It's not always easy.
I did have a question, though.
And that is how would a CIL know that 
they are ready for doing outcome 
measures?
It's kind of like the question like when 
there's, when you have an audit, 
financial audit, there are certain 
things you have to have in place before 
you have a financial audit.
Or else you're not auditable.
Similar vein, in terms of outcome 
measures, what sort of things would you 
look for to determine whether or not a 
CIL is ready for all this? 
 >>  MIKE HENDRICKS:  I can give me 
thoughts and Bob may have other ones.
My thoughts would go back to yesterday 
afternoon's session on challenges, 
opportunities and first steps something, 
I think it was.
In there I think we had five things.
I'm doing this from memory.
Somebody from a handout can maybe help 
better.
Seems we had five things we thought you 
ought to do first in a CIL.
I would look at that.
One was top support from your CIL.
Board approval and stuff like that.
And there were some other things.
A person designated as the OEM 
coordinator with the time and resources.
Excellence question.
If I were at a CIL, I would look at that 
list and say are these feasible.
Can I do these things.
Maybe we don't have enough time.
Maybe we're all working too hard for 
anybody to be assigned as the outcomes 
manager and coordinator.
Maybe nobody has the time.
Or maybe the boss really isn't into it.
Know what I mean?
I think that is a first way I would 
start.
Maybe Bob has a better idea. 
 >>  BOB MICHAELS:  I tend to be more 
hard nosed than that.
I say damn right you're ready. 
 >>  (Laughter.) . 
 >>  BOB MICHAELS:  Really.
If you say, boy, do we have time to do 
it, no, you never have time to do it.
And do we have staff to do it?
No.
But you never have staff to do it.
You always have something else that 
would be good do first.
The tendency is to set it off.
Clearly outcome measures are where we 
want to go.
So you're going to have to incorporate 
at some point.
Now, you need to decide, you know, are 
we ready to do all eight or three or 
create our own?
You know, what makes sense for us.
I think you start now, you have all this 
information available.
You have all this next that has been 
tested and field tests and that.
No reason not to start.
Monday it will be available to you and 
archived.
All the information we have come up with 
the last five or 6 years is available to 
you.
No reason not to do it now.
There, I said it. 
 >>  MIKE HENDRICKS:  You said it.
Over here, comment. 
 >>  This is Joan from Oregon again.
Certainly some really nice work.
I'm hoping Oregon chooses to build and 
will work on that.
I'm wondering if there's interest in 
developing measures that everybody would 
use use or if you're proposing that 
everybody would more.
My guess is the answer is no but I 
thought I would ask. 
 >>  BOB MICHAELS:  At some point we're 
going to have to come back to you before 
we approach Linnae with what we want to 
do.
We're going to have to come back to you 
and say, what do you want to be judged 
on, what measure to you want to have to 
meet.
Because if we're going to talk about 
changing the 704, we're going to need to 
do it in a way that you agree needs to 
be done.
Again, I want to say this, we want to 
supplant information.
We don't want to supplement.
We don't want the 704 to become even 
more burden some for you.
We want to try to get rid of a lot of 
that stuff that doesn't make sense.
You know, doesn't tell our story, and 
put in stuff that we need.
Richard. 
 >>  Can I ask.
There, maybe that is on.
Okay.
First day Mike mentioned how we began 
the process by responding to the program 
review tool that had been issued and was 
out at the time from the federal 
government.
That has gone through some changes.
That seems germane to the discussion 
right now in terms of how we use and how 
we report and why we even consider a 
common approach to reporting.
So several things sort of to unpack 
there.
Mike and Bob, I wonder if you might 
address that.
That might be interesting to folks. 
 >>  MIKE HENDRICKS:  I'll take a stab, 
Richard.
If this isn't what you meant, say so.
You're talking about the PART score, 
results not demonstrated that the office 
of management and budget said.
That process does not exist anymore.
It's gone away.
They don't do that anymore.
So if you're concerned about being 
PARTed again, then that is not relevant.  
That is what they called it.
However, it's not to say something else 
isn't going to be existing that is going 
to look at results.
Absolutely there is going to be 
something at federal level, if not 
education or Congress or all three, 
somebody is going to be looking at 
results.
Bob is exactly right.
We cannot ignore this need.
Does that help?  Is that what you meant?
Yeah.
I think Mike over here. 
 >>  Mike Wallace.
I guess as a brand new center director, 
I was stunned to discover that we didn't 
have to do a lot more justification for 
the dollars we get in the first place.
I can't imagine that there won't be some 
congressional requirements.
We ought to put them on ourselves before 
they do.
Taxpayers have a right to know whether 
or not we're saving them money or what 
we're doing with it.
We can only expect more and more.
Seems to me the sooner we do this to 
ourselves, the better off we are.
Resistance as the old cartoon says is 
futile. 
 >>  You must be part of the board. 
 >>  Do we have information about the 
next phase of results oriented stuff at 
the federal level? 
 >>  MIKE HENDRICKS:  Last I heard, I 
have a friend very plugged into this 
stuff in DC.
Last I talked to him, which has been a 
couple months ago.
I can always check back.
He tells me they are not exactly sure 
what they were going to be ending up 
with.
They are playing with different options.
I can't honestly answer right now.
I can find out more if you want.
Maybe you all know.
Maybe you know what is happening within 
RSA or Ed.
Seems like Linnae would have said 
something yesterday if there was a big 
change happening there. 
 >>  Fred Johnson, North Carolina.
Just a comment.
One of my concerns has been from the 
very beginning in working at CIL and to 
establish a CIL in Raleigh, North 
Carolina, was what is our future as not 
only a single agency but as a network 
throughout the state and country in 
terms of, well, let me just say it flat.
I'm very proud that the centers that I 
understand in North Carolina are run 
essentially by people who come from the 
grassroots orientation.
I come from a grassroots orientation of 
nonprofit grassroots level advocacy.
The center didn't necessarily have the 
expertise in the field of business but 
it had the expertise in the terms of 
advocacy and stick too ittiveness and 
openness and willing to accept mentoring 
and run and take a position within our 
service area as effective and 
meaningful.
Personally, when it comes to responding 
to the feds, I don't give them a second 
thought because I don't have to as a 
staff member.
But I also use my awareness of the feds 
have given a man date as a center, which 
is unique, they have said go out there, 
change things in the system, change 
things with individuals that you can, 
work to be effective in this way.
Don't worry about anything else.
Just do it.
We leverage our dollars, we leverage our 
abilities and hopefully our integrity to 
the point to where we maintain an 
effective position within the state, 
within our service area, and within our 
brothers and sisters throughout the 
country.
My concern has always been that we will 
become a bureaucracy, which may 
eventually happen.
But I'm very proud right now that we are 
grassroots, very basic level advocate 
type of thinking in the centers.
Proud of that for ours and others as 
well. 
 >>  BOB MICHAELS:  Always been this big 
discussion that has gone on among the 
centers.
One center has become a certain size and 
take on a certain programs that they are 
going to be corrupted and become part of 
the bureaucracy.
I think that is a very real danger.
I used to, when people would ask me how 
I felt about it personally, I would 
always talk against it because I felt 
like, just because, you know, there's a 
certain size, it became unruly and 
there's nothing you could do.
I have changed over the years now and I 
don't feel that strongly about that 
anymore.
Because some of the centers have 
benefited and others, whether label or 
liberty or access living or the one in 
Topeka, these are some of the best 
advocates in the country.
They really haven't lost track of what 
it's all about.
So it doesn't have to be that way.
You can be a little agency and be 
bureaucratic.
You can be a big agencies and be 
bureaucratic.
But as long as you're willing to say no, 
I won't do that, you know, and reason 
it.
You can take away the program from me.
No matter how big it is.
Then we're okay. 
 >>  MIKE HENDRICKS:  I think we're 
pretty much at the ends of our sessions.
I'll leave the final word to the boss 
here.
I want to say you have been a great 
group to work with, a lot of fun.
I have really enjoyed it immensely.
I wish you good luck as you go forward 
on this important stuff. 
 >>  (Applause). 
 >>  BOB MICHAELS:  Okay, we have 
already thanked all our staff.
I want to thank all of you for 
participating in this event.
It's been great.
It's so wonderful, sorry to say, this is 
pretty much much it.
I'm doing a training, but this is pretty 
much it.
I said, we see the outcome thing for the 
event.
I consider this to be the culmination of 
everything we work on for all this time.
I'm going to be around.  Not that I'm 
going to be gone.
I'll still be doing classes.
But this, these are killers for me.
This has been a pleasure, something I'll 
look back on as wow, what an experience. 
 >>  (Applause).
(Standing ovation).
. 
 >>  BOB MICHAELS:  Thanks. 
 >>  Tim:  I want to thank you, Bob, and 
Mike too.
This has really been fantastic.
Quickly, I want to remind you all if you 
could fill out the evaluations before 
you leave, that is the last thing we'll 
ask of you before you go today.
You have the post survey and the 
satisfaction survey, if you can leave 
that on the survey.
We'll pick them up afterwards.I want to 
wish you all a safe trip home.
Thank you for being here.
Again, like we mentioned, NCIL board 
will be meeting in the Broadway room 
across the hallway.
If you want to join us, you're more than 
welcome. 
 >>  (Applause)