PAULA MCELWEE: Here are some more things that we're catching up with related to our, if I can get back there. Related to our comments that you guys had. Some lingering questions from earlier this week. One of the examples that was on the PowerPoint related to the California system had the board approving the organizational chart and job descriptions for the organization. And someone raised the question is that too much hands on for the board. And that's a question you're gonna have to answer at your own organization. You're gonna need to sort out your own roles and responsibilities. Many centers, the board sets the structure, the executive director does the daily hire. So a lot of them the board would approve the organizational chart, but the executive director would do the job descriptions. And so that was an interesting one, because it wasn't exactly how some of you do that. But certainly you can do that. We're hoping Audrey will give us your chart of responsibilities for our Wiki page. If you'd email it to one of us, we'll get it posted for you. That would also be good. Yes, Maureen? MAUREEN RYAN: Can we, could you say something about, I had a couple questions people were asking about supposedly a new thing that RSA has to approve an executive director before it's hired? PAULA MCELWEE: Well, it is an interesting thing, it's been actually there for some time in the contracts and regulations that RSA has the responsibility to approve key contract personnel. And that's actually how it's worded, is "key personnel." So you have to make a, you know, kind of sort that out with your program officer at RSA. But, what is happening now is that RSA is being very clear that a final hiring offer should not be made until RSA has approved the executive director that the board is wanting to hire. Now, they're not going to review all of your applications. So don't send them all your candidates. They just want when you have someone that you think you want to hire, before you make that final hiring offer, RSA is asking that they see and approve the qualifications of that person. And qualifications, they are looking at the résumé you send and the job description you send. So you're still determining the qualifications. They are also running the background check against whether or not this person has been put on the list of people who can't contract with the federal government anymore. AUDIENCE MEMBER: Yeah, I just went through this, and it was after I was hired. And it's basically just that last point is all they really checked, is to make sure I wasn't on the federal list. PAULA MCELWEE: Yeah. That's their main purpose for doing it, is making sure that you don't have key contract personnel that the federal government has determined should not contract with them. However, there have been a couple of situations where when, if the hiring is with a center that is on a plan of corrective action plan, if the center's on a corrective action plan, they do sometimes look at any element in the corrective action plan related to that. So, especially the IL philosophy piece, and in a very small center the confirmation that the person, the person's hiring does not put the center in a position where the 51% of their management staff doesn't have disabilities. So they will ask you questions about that sometimes, if that's been an issue in the past. So yeah, that's a, that's an interesting one, though. It kinda took us by surprise when it started happening. But that's what's happening at this point. So. And we've added a number of other links and items to the Wiki page, and some of us have some notes, and we'll be doing that over the weekend or early next week, as well. So be sure to check back. The Shewhart plan that Richard mentioned yesterday, the plan, do, check, and act or adjust. The link to that has been added and we'll continue to add some other things there. Based on your feedback, we're gonna go back to the drawing board and put together an alphabet soup resource. We realize that any given room we have people who are new to our group, even if they may not be new to management. And so, when we talk about ADAPT or NCIL or whatever, have not always been, we've tried to remember to tell you what these things stand for, but, we decided maybe we ought to pull that list up again. So that's based on your feedback, and we will be doing that. There was a question about how to work with a specific board committee. In this case it was a board program committee. And we are not, we don't have time here to get into the board and committee roles. We have a number of board trainings related to those kinds of things. But we might want to just say this: That whatever committees that you have within your organization, those are decided organization by organizations, some boards are too small to really have effective committee structure. Other boards really work well with committees. Some committees are in your bylaws, and you need to follow your bylaws related to that. So you may have bylaws that require a finance committee, for example. And the, you may also have situations where your board committees are more loosely organized or ad hoc committees on different kinds of times. Richard, did you have a comment on that? RICHARD PETTY: Important point: Failure to follow your own bylaws with respect to committees or for that matter almost anything else will become a finding on an RSA site visit report. So, be very sure not just to follow federal regulations and guidelines, but your own bylaws, and that is a frequent problem. PAULA MCELWEE: It's also true with policies, your own policies and procedures. So sometimes you have a policy and procedure that requires let's say a board committee, but if that committee hasn't met, then that could be a finding, because you're not following your own requirements. So, yeah. Good point. So keep that in mind. One participant asked why the states don't follow the same procedures as RSA for dispersing funds. And unfortunately, there is, is not just one answer to that, because the different states have a lot of leeway in how they structure that process. Also, the part B money that is typically, flows through the state, that money has some different requirements than the Part C money that comes in direct grants to the organizations. So there's also that issue. One of the things, for example, is that we're not allowed to carry over unspent Part C money into the next year. If we've got money that we haven't spent. But in some cases those Part B funds have a different cycle, two-year cycle, and so there is some carryover option there sometimes depending on how the state handles it. We have noticed that when RSA has put a CIL under conditions, they always inform the state as the designated state unit of that status, and often the state will follow suit. So when RSA moves a center to reimbursement rather than drawing down the funds as you spend them, the state often also moves you to reimbursement. Which means, again, your cash flow becomes really a tough situation for centers. So, so we have seen that. During the time we talked yesterday about measurable indicators, Maureen mentioned an indicator about direct service time. 85% direct service time. And one of the questions made us realize that maybe there was a little confusion about time and effort reporting. So what she was talking about was not the same thing as time and effort reporting for your PAR. That's a Personnel Activity Report. Which you're required to do in order to properly allocate the time of each staff person. So you have to record time based on cost objectives. Typically that is interpreted as funding source. But you have to have a record of how much time people worked where so you can allocate their time based on actual after-the-fact accounting of that time rather than a budget or an estimate. And that is something different from what she was talking about yesterday. So don't confuse the two and think oh, we only have to do 85%. No, that's what we're talking about. Richard has a comment on that. RICHARD PETTY: Just to be clear, that's 100% of the staff member's time gets reported on a PAR. PAULA MCELWEE: And has to add up to 100% no matter how many hours they work. If they work 20 hours, it is not 50% of their time. It is still 100% of their time is 20 hours. That make sense? So 100% of a 20-hour week is still a 20-hour week. So, it has to always say 100%. Now, if you're not recording time and effort and allocating staff salary across your funding objectives, based on actual time, you probably want to talk to us about that. So be sure to take advantage of the email address and phone numbers that are on these, these slide shows. I would be glad to help you with that. We have a number of resources and some sample forms and so forth. But this is one of those newer areas that some centers still haven't caught up on. RICHARD PETTY: Paula, let me just underscore this. It's not probably. If you're not doing it, and you need help doing it, do talk to us. There, we have training on the Web that will give you an orientation, and we can lead you to forms and other information about it. It's huge. It's probably the way that you can lose more money faster than any other thing. Salaries are your largest expense in almost all cases and if a reviewer comes in and finds that you have, and this is your own auditors, too. If they come in and find you aren't doing this or you aren't doing it properly, the money goes away, and trying to reconstruct time and effort reporting is incredibly difficult because when it does come time for you to certify those forms are correct, someone will quite legitimately ask, how are you sure that they are correct. If you did them two years late in trying to catch up, they are going to say, how do you know that was correct? And it's going to be hard for you to say that, so by all means, this is, this is probably one of the greatest risks that you have in your risk management is to not have these done if they are not. You need to get them done. PAULA MCELWEE: This is something that some centers have still not caught up on and it is the biggest payback when there is a payback required for using funds inappropriately. If you can't determine how much of the time of your staff should be allocated to each of your funding sources and how you got to that figure, you don't have that documentation, they can say, then we are not going to pay your salaries. Your salaries are your biggest expenses, as Richard said. Keep that in mind and do call or email and we will help you through that process. Another comment, we may revisit this before the end of the day but at the end of the day yesterday, there was some anxiety around the possibility of the outcomes and indicators that were, that the NCIL task force has been working on, might be required by RSA and just a follow up thought around that. As a field, we work very hard to be proactive about the things we feel are important and want to address, and this is not RSA proposing this stuff. This is us proposing ways that we can measure ourselves. So be sure to understand that your membership organizations, like NCIL, like APRIL, are places where a lot of activity is happening that has national impact. The discussion we had yesterday is one of those emerging areas and it, and it has not been, you know, finalized and there is still time for input but you are members of that organization and that's an important thing to remember, is that a conversation is still unfolding and you still have input, so make sure you talk to your NCIL representatives or committees related to that. Richard has something else? RICHARD PETTY: Let me add a little more. We didn't have as much time as we might have yesterday and there are a couple of points that can be made clearer. These are your peers who served on this task force for a number of years and they reached out to the field time and time again, and they are still those, the task force staffing has changed some, not staffing, but the membership has changed some. But without a doubt, Pat Puckett or Dan or Kelly, I am sure would welcome your input and your thoughts. If you haven't attended to this before and you do have concerns now, then by all means, reach out to them. Because this is not someone else imposing something on the field. This is the field doing its very best to get ahead of what will be imposed sooner or later. If the independent living program moves to the Administration on Community Living within the Department of Health and Human Services, we can expect, we can almost guarantee, that we will march into outcome measures from the perspective of the Department of Health and how they are implemented in healthcare because that is an arena that is fully embracing outcome measures. If we march ourselves into that arena unprepared and unready to implement something that we have put together, they will be glad to help us put something together and we may not like it. In fact, it's very likely we won't like it. So I urge you, if you haven't been able to attend to this before and you have concerns about it, if you did not go to one of the trainings, if you didn't participate, if you did not respond to all of the announcements that Bob and Kelly and so many others sent out, please, by all means, reach out to Pat, reach out to Kelly, reach out to Dan and share your concerns and let them be heard and let that committee, join that committee if you want to, so you can have a say as some final proposals are made. PAULA MCELWEE: Excellent. Yes. Maureen, comment. MAUREEN RYAN: Can we give like Kelly's email address or Pat, I have got them both, do you want to somehow put them up there or something? PAULA MCELWEE: We can do that, I don't know, or maybe somebody just knows it off the top of their head. Looking back there at Tim. Kelly@NCIL.org. K-E-L-L-Y. PAULA MCELWEE: That's Kelly Buckland in case you don't know who we are talking about there. It is important to remember that this is not an us-and-them kind of thing. We were presenting what we did yesterday because it fits the topic and it gives you some tools that have been considered for a great amount of time by our peers and so they gave you some ideas about things you might use locally but this is an us and us thing and we need to work together on what it is we want to emerge from it, both at our own personal center's level, as well as nationally of what makes good sense. So, let's all do that together, which is the best way to make that happen. I think that's all the questions and pieces that we have from yesterday. Comment from over here. AUDIENCE MEMBER: You may be asked to think about a question regarding what, if you are a betting person, what is the likelihood, would you bet on having the IL move into community living? Do you think that's happening? He brought it up, it was not me. PAULA MCELWEE: We don't know where that's going to go. If you are a betting person, is there anything this Congress that's done recently that you could feel like you can bet on? You know, I mean, we really, it's not been a very effective Congress no matter what your political party, so we don't know when or how for sure, so we will see, we will see. Other questions or comments? All right. Well, we are going to let Anne pick up from here, and Anne Weeks is going to talk with you about satisfaction customer or consumer satisfaction feedback and how that is used as a quality management tool.