draft minutes clear board of directors gratz park inn ... · rose mccool asked that the minutes be...

DRAFT MINUTES CLEAR BOARD OF DIRECTORS

Gratz Park Inn Lexington, Kentucky

June 4-5, 2007 Those present were: President: Budd Hetrick, Deputy Bureau Chief, Idaho Bureau of

Occupational Licenses Members: Jayne Bunn, Assistant Section Chief, DHHS, North Carolina DFS

Health Care Personnel Registry Kristin Hellquist, Director of Policy and Government Relations, National Council of State Boards of Nursing Caroline MacIsaac-Power, Registrar, College of Opticians of Ontario Rosemary McCool, Director, Division of Registrations, Colorado Department of Regulatory Agencies

Kate Nosbisch, Deputy Executive Director, Virginia Board of Medicine, Department of Health Professions

Linda Waters, Vice President, Consulting Services, Prometric Deborah Worrad, Registrar and Executive Director, College of Massage Therapists of Ontario

Facilitator: Judy Burtner, Judy Burtner & Associates Recorder: Kathryn Burruss, KB & Associates Auditors: Randy Breeding, Principal, Dulworth, Breeding and Karns

Cory Reitz, Manager, Dulworth, Breeding and Karns Staff: Pam Brinegar, Consultant

Janet Horne, Office Manager Adam Parfitt, Executive Director

Stephanie Thompson, Senior Program Coordinator Call to Order President Budd Hetrick called the meeting to order at 9:10 a.m. Board members Jim Dunsdon and Ruby Brice McClain sent their regrets at not being able to attend. Kristin Hellquist participated in the meeting via conference call. Approval of Minutes The minutes of the April 17, 2007 board teleconference were reviewed and an omission was noted regarding the board member who seconded the motion under “Executive Transition.” Rose McCool asked that the minutes be amended to reflect that she seconded the motion. Kate Nosbisch moved and Jayne Bunn seconded a motion to approve the minutes of April 17 as amended. The motion passed. The board then turned to the minutes of its May 15, 2007 teleconference. Kate Nosbisch moved and Jayne Bunn seconded a motion to approve the minutes of May 15. The motion passed.

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Financial Reports The board received the February and March 2007 internal management financial report. Clarification was provided about what constitutes tailored training programs, and how salary costs are assigned for staff time spent on CLEAR’s training products. A question about CLEAR’s investment policy regarding its reserves prompted a review of relevant direction as contained in CLEAR’s Policies and Procedures document. Adoption of FY2008 budget Adam Parfitt presented a draft budget for FY2008, noting those line items with a marked variation from the previous year’s budget. Discussion followed regarding conference revenue and the practice of locating the annual meeting in a city with strong host state support. The board reiterated its preference to hold a hosted meeting, at which a host agency might provide substantial conference attendance. Where this is not possible, alternatives will continue to be considered. Following discussion a motion was made by Deborah Worrad, with a second by Kate Nosbisch, to approve the FY2008 draft budget. The motion passed. Board Vacancy The board considered the vacancy created by Kate Nosbisch’s election to the position of President Elect. Kate Nosbisch noted that the recently revised bylaws are clear on this subject and she made a motion to fill the current board vacancy until the end of its term following the 2007 conference, which was seconded by Rose McCool. The motion passed. A second motion was then proposed by Kate Nosbisch, with a second by Caroline MacIsaac-Power to invite Ernie Atkins to fill the vacancy. The motion passed. Staff Report Stephanie Thompson reported that CLEAR has so far received 68 conference registrations, 32 for the Atlanta NCIT Basic and 30 for the Specialized, and that three registrations have been received for the Executive Leadership Program. She noted that speakers for the opening and luncheon sessions have now been finalized and that both are under contract. She also reported on the most recent webinar offering concerning Ethics and the Mobility of Professionals. Following the staff report, board member Kristin Hellquist joined the meeting. At this point, President Budd Hetrick welcomed facilitator Judy Burtner and recorder Kathryn Burruss and work began on organizational and strategic planning. (A separate report from these activities is attached). At 4:45 p.m. Eastern Time, the meeting was adjourned until the following morning. Call to Order At 9:05 a.m. Eastern Time, President Budd Hetrick called the meeting to order and welcomed Randy Breeding, Principal, and Cory Reitz, Manager, from the auditing firm Dulworth, Breeding and Karns, and Janet Horne, CLEAR Office Manager. External Auditor Report A report from Randy Breeding followed, in which a broad overview of CLEAR’s financial controls was provided, as was a review of recent regulatory changes, including changes to terminology routinely included in audit reports. It was noted that the term “reportable conditions”, used previously to identify areas of potential

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concern regarding financial controls in place, is being replaced with “significant deficiency”. Board members then asked Randy Breeding and Cory Reitz a number of clarifying questions, including whether items 2.2 (Utilize best practices in policies/procedures to review financial and operational efficiencies) and 2.3 (Implement budgeting that brings operational expenses in line with financial resources) of CLEAR’s 2005-9 organizational plan have been met. Randy Breeding stated that they had and consequently the board instructed that these two items should be removed from the plan. Additional discussion focused on the financial controls that CLEAR has in place, during which Randy Breeding noted that the primary controls (which separate the assets as they move through the organization) have been maximized to the extent possible in an organization of CLEAR’s size. He stressed the importance of secondary controls (for example, a review of financial statements by a committee or CLEAR’s Board of Directors) to a small organization such as CLEAR. Further discussion focused on the financial reports received on a monthly basis by the board and whether these provide too much detail. Randy Breeding discussed different operational models about who might review these detailed reports, but stressed that some group within the organization should be responsible for this task. Discussion followed regarding the appropriate body to review the statements and suggestions included the Executive Committee, a small group of board members, or the entire board. There was general agreement that when agreeing to serve on a board of directors, one has a responsibility to review financial documents and to raise questions as appropriate. It was agreed that further discussion is necessary in this area. Mr. Breeding concluded by noting that the monthly financial reports received by the board are clean and accurate, and encouraged dialog on at least an annual basis between CLEAR’s Board and the auditing firm it employs, in order that the auditor’s report can be fully discussed. Kate Nosbisch thanked Janet Horne for her exemplary work and Randy Breeding and Cory Reitz for their presentation. In the general discussion that followed, it was agreed that the Board Member Eligibility Validation form, a signed copy of which CLEAR is required to have on file for each board member, will be the first agenda item in place for the new board. CLEAR’s disaster planning preparations were also discussed, with information provided about an internal document Janet Horne has prepared. It was suggested that additional thought be given to language about preparedness in the field (such as during training programs or meetings). President Budd Hetrick then invited Judy Burtner to continue the strategic planning process. (A separate report from these activities is attached). The meeting was adjourned at 2:05 p.m. Eastern Time. Respectfully submitted,

_________________

Adam Parfitt

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Actions of the CLEAR Board of Directors Taken During its

June 4-5, 2007 Meeting

1. Approved the April 17 minutes as amended and May 15, 2007 minutes as read.

2. Approved the FY2008 budget. 3. Approved filling the board vacancy until the end of the current term. Ernie

Atkins will be invited to fill the vacancy.

4. Approved removal of items 2.2 and 2.3 from CLEAR’s 2005-9 Organizational Plan.

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Task list resulting from the June 4-5, 2007 meeting of the

CLEAR Board of Directors

1. Mark the draft FY2008 budget as approved 2. Remove items 2.2 and 2.3 from CLEAR’s 2005-9 organizational plan

3. Include future board agenda item regarding the appropriate entity to review

CLEAR’s monthly financial statements

4. Schedule conference call with Board of Directors and auditors to discuss FY2007 audit report

5. Staff to review emergency preparedness document for content on “in the field”

issues

6. Support areas of focus/action for 2007-8 arising from the June 4-5 strategic planning process

7. Support assessment of current membership recruitment process

8. Revise environmental scan to include new items

9. Include Board Member Eligibility Validation Form on agenda for the first

meeting of CLEAR’s 2007-8 Board of Directors

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Summary

The Council on Licensure, Enforcement and Regulation Board of Directors Meeting

June 4-5, 2007

Gratz Park Inn

Lexington, Kentucky

Present: Pam Brinegar, Jayne Bunn, Kristin Heliquist (by phone), Budd Hetrick, Janet Horne (June 5), Caroline MacIsaac-Power, Rosemary McCool, Kate Nosbisch, Adam Parfitt, Stephanie Thompson, Linda Waters, Deborah Worrad, Judy Burtner (facilitator), and Kathryn Burruss (recorder).

Note: This summary reflects only the facilitated sections of the meeting. It does not include the work that was conducted when the Board conducted the business of the association in its official capacity.

Objectives

1. Discuss the results of the Objectives Report Card & Strategic Approaches Priority Ranking survey identifying potential areas for action

2. Review an updated environmental scan focused on external and internal forces that are or may have an influence on member organizations’ capacity to implement their missions and do their work

3. Identify the areas for action agenda for 2007-2008 and provide guidance to committees and staff relative to those areas

Objectives Report Card & Strategic Approaches Priority Ranking Results Judy Burtner reviewed the results of the Objectives Report Card & Strategic Approaches Priority Ranking Results. Each member received a copy of the report in their meeting packet so a summary of the Report and comments are not included here. Members responded to the following questions as a means of processing the report and its results and also to provide additional information since the survey return rate was sixty percent:

1. Do the results match your viewpoint/perspective? 2. What are you most pleased with? 3. What are your concerns? 4. Where are there some opportunities and/or a need for action?

The Council on Licensure, Enforcement and Regulation Board of Directors Meeting June 4-5, 2007 Gratz Park Inn, Lexington, Kentucky

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The following comments were made under each question: Match in viewpoints/perspectives There appeared to be agreement that the results matched the viewpoints and perspectives of those present (including by phone). Pleased with

1. Our purpose has been outward-facing—focused on the external. We have not always focused on what we are doing.

2. Identified projects and services must meet member needs to remain financially viable.

3. The comment about the need to look at moving outside of Canada and the United States to address member needs.

4. There is a recognized need to build on services and products. 5. There is a concern regarding membership retention efforts and how successful we

have been. 6. Membership retention requires providing relevant information to members and the

need to increase members beyond current locations. 7. There is a sense of Community and it is representative of all markets. 8. New services and products need to be developed. 9. Pleased with desire not to micro-manage finances. 10. Getting to be more proactive and not just reactive to issues.

Concerns and questions

1. Are the strategic directions in the current plan the correct ones? 2. Concerned we are not making the best use of our time, resources when we focus too

much attention on the details and not the “big picture.” 3. There is a lack of recognition of the activities that have been devoted to service and

the retention of members. 4. United States and Canada—it’s not either/or—we are big enough for both. 5. How do we expand to new areas and make most of the membership feel that what is

happening is relevant to them. How does the Board address this? 6. I have no particular concerns about the comments that were made. CLEAR devotes a

lot of time to addressing member needs and suggestions. Overall, CLEAR can improve and is improving.

7. Think of United States and Canada as one. We need to get beyond North America to include others from other countries/continents.

8. How to bring other countries in? We tend to look for those countries/systems, which use our model. We may want to include other models in our thinking.

9. We need to be more international. Is the organization drawing back from an international focus?

10. Need to put into place an international focus. 11. Need to promote having something for all (in response to comments from

conference) 12. We need to keep current members happy while reaching out to other countries. 13. We don’t have an idea of the variety of regulatory systems around the world. We

need more education on the systems so we can determine what their needs are, how CLEAR can help, and what they can do for CLEAR.

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14. Strategic Plan does not speak or is not clear as to what will happen with the new Board members and their orientation.

15. We need to connect the data points—international conference sessions are not very popular. Are we marketing correctly (this could be an issue of a lack of integration)? Are we not formatting the conference in a way that members can see the relevance and value? If we feature a country, we need to make the competition of conducting other sessions at the same time kept to a minimum.

Opportunities

1. There is a need for commitment from the Board relative to the international issue. There is a need for a framework, direction, and an action plan.

2. We need to link international issues with practical application. 3. Conference program track model—is it appropriate? In spotlighting other countries

we need to strike a balance between nuts and bolts and what the participants can take back with them.

4. CLEAR’s involvement in other countries represents an awareness of growth. 5. Research how other businesses have broken into other countries. Tap our vendors as

a resource, also other regulatory organizations. 6. Get members involved in shaping the organization and having ownership for what it

becomes. 7. Lack of revenue—we think of it as a “hold back” but need to think about revenue in

terms of what would we do if we had more revenue. 8. Focus on mentoring/sponsorship of groups, individuals from other countries. 9. Develop existing content to appeal to new domestic markets (North America). Look

at what we offer; expand and tailor it to groups we are trying to attract. 10. Step ahead of market (product and services) in conference content. 11. CLEAR—develop disciplinary procedures and be culturally sensitive. 12. Get away from relying on face-to-face activities only and include meetings through

technology. 13. Consider why the organization is not growing when others are growing. 14. Cultivate resources (revenue, speakers) to have a premier conference. 15. Regulation is an economic issue as well as a public protection issue. 16. Many organizations have similar products to the products of CLEAR. Is CLEAR moving

too slowly? 17. There is the issue of management versus governance relative to CLEAR’s Board of

Directors.

Environmental Scan Pam Brinegar reviewed the external environmental factors “piece” that she had prepared for the directors’ review. A summary of her comments is not included here since all present received the information in their meeting packet. Members were given the opportunity to add additional factors to Ms. Brinegar’s list of external factors. The following items were contributed:

1. There is an overlap in the scope of practice among professions. 2. There is a need for continued competency in the life of a career. 3. Immigration laws and labor mobility


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4. Federal encroachment on regulatory bodies (which has been a state function) 5. Is it time to re-educate/educate the statehouses that the reason to regulate is to

protect the public? Professions can not/should not be inappropriately regulated. 6. There is an expansion of professions to be regulated; some, possibly inappropriately. 7. Impact in America of the graying of the population and its impact on resources, labor

shortages 8. Continued competition—how to deal with federal encroachment 9. Labor shortages and member organizations not homogeneous—especially on the

health side 10. Diverse constituency groups (industry, state/provincial regulators, international,

associations etc.) represent a variety of interests and needs. This may require different resources to be developed and/or tailored to meet these needs.

11. Technology and information management 12. Credentialing and fraud—cheating on tests

Participants, working in small groups, identified the internal forces that are and will impact member organizations and their ability to do their work. Group 1

1. Changes in administration 2. Resources—decrease in people, money, and time 3. Under-funded programs 4. Technology—security of data/information 5. Staffing issues due to retirement and turnovers 6. Collaborative care—increasing/overlapping scope 7. E-health record

Group 2

1. Funding and lack thereof 2. Focus on mandates 3. Sunset laws 4. Management process of international applicants 5. Criminal background checks 6. Autonomous versus umbrella Boards/oversight groups 7. Governance Boards versus administration 8. Legislative change 9. Ability to participate—time and money

Group 3

1. Money 2. Consolidation of agencies and functions 3. Accountability focused within organizations 4. Limited human resources 5. Regulation has changed (example: from discipline to rehabilitation) 6. Creation of new organizations/professions represents challenges to existing

organizations and professions

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During the report-out session, a list of factors internal to CLEAR was created:

1. Perception of a narrow focus 2. Clarification of statement of purpose is needed 3. Board relates based on their own experiences and brings their own biases to the

issues 4. Lack of resources to cover the opportunities (to grow) 5. Lack of compelling common vision for the organization—emphasize public protection

with a position of more importance 6. Membership diversity 7. Too many “masters” (groups) 8. No boundaries 9. Too broad of a focus

10. What if the organization had more revenue? 11. What are the commonalities of all organizations/agencies and let that drive the

compelling/common vision? 12. Another common interest—we want to know what others in the profession are doing.

We don’t have to reinvent the best practices.

Following the above review, the members identified the messages the above factors/issues send to CLEAR:

1. We are extremely diverse; we can’t do it all. We need to pick one or two things and do them well.

2. There is constant change in the regulatory system—new professions, regulations, and people.

3. Products need to assist members in dealing with the changes. 4. We need to be willing to give up things that are outdated. 5. We may be missing opportunities by just having a regulatory focus. What about

self-regulation and credentialing groups/professions? 6. Are we too narrow in our mission—who do we compete with? 7. We may need to re-look at strategic plan to see if there is a need to revisit our

mission. (We may want to define “regulatory” as including credentialing bodies as well as “regulating” bodies.)

Revisiting Statement of Purpose Members revisited their current Statement of Purpose, which reads:

CLEAR promotes regulatory excellence through its educational programs, networking opportunities, publication, inquiry, and other services for all those involved with the professional and occupational licensing community.

There was general agreement that it needed to be reworked to include the following phrases/words and/or their intent:

1. Share best practices 2. Neutral forum for education, networking, learning


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3. Broad appeal, higher level (best practices) for leadership training, investigator training, board training

4. Public protection—CLEAR is a resource to support members as they engage in public protection

5. Global offerings—market what we have to offer and focus the offerings

Vision Members decided they needed to do some work on a vision for the organization. Members were asked to develop their visions as if revenue or its lack was not an issue. The small group reports follow: Group 1

1. World-wide presence with satellite offices 2. Attendance/involvement with their regulatory meetings, etc 3. Enhanced communication—internal and external to include the use of a marketing

firm, public relations 4. Outreach to untapped markets 5. Paid, dedicated instructors, presenters, etc. 6. Full time paid board with “nice shoes and cars” 7. Regulatory research 8. Publication diversity 9. Regulatory process templates

10. International connectivity with data Group 2

1. Publication department—core content to be re-purposed for specialty audiences 2. Conference—competitive abstract process 3. Visit CLEAR’s members 4. Research department to conduct and publicize research 5. Board members have a broader understanding of 501(c)(3) organizations 6. Move to D.C. or have a D.C. office 7. Full time instructors 8. Full time marketing department 9. International office(s)

10. A government affairs branch Group 3

1. Meetings/conference outside of United States plus different places within US and Canada

2. Diverse products and services with global appeal 3. Consulting team to provide on-site expertise (tailored) information and

implementation 4. Smaller numbers for educational programs (<60 participants) 5. Marketing diversity—radio, TV, print, CDs 6. Staff and/or members face-to-face soliciting/educating new members


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7. Top notch perks with conferences/trainings—breaks, meals, gifts, etc. 8. Plenary speakers and others—big revenue fees 9. Broaden member awards to recognize excellence and contributions to regulation

10. Incentives for participation for members (e.g., buy one conference fee and get one free)

11. Sponsor potential new members and others to attend conference (fee and travel expense)

12. Sponsor CLEAR board members at other conferences 13. Reimburse CLEAR board members’ expenses and pay per diem 14. Broader support for instructors in programs—e.g., NCIT 15. Increase quality and diversity of conference sessions and training 16. Invite and support key players (political and businesses) to conference to ensure

they hear our regulatory messages Common Themes Members reviewed their work and first, identified the themes in the above work and then checked to see how well the themes fit within the objectives of the current strategic plan. It was found that all themes fit to some extent. A summary of the themes and their fit to an objective in the current plan were as follows:

1. Publications and marketing (1-1,2; 2-1) 2. Outreach—(existing/current) and potential (1-1, 2, 3; 2-5) 3. Support—full time instructional and needs (1-3; 2-2, 5) 4. Expansion/presence around world (1-2,3; 2-1) 5. Pay board (reimbursement of expenses) (2-4) 6. Research department—connecting with data (1-3; 2-1, 2, 3, 4, 5) 7. Communications (1-1, 2, 3) 8. Conference enhanced (1-1, 2, 3; 2-1, 5) 9. Government relations (1-3)

Potential Areas of Focus/Action for 2007 – 2008 Participants brainstormed potential areas for focus/action for 2007–2008. They were encouraged to review the work (objectives report summary, environmental scan, statement of work and vision) done prior to this activity in identifying their areas. Once they had individually completed their brainstorming, they were to choose the three items they thought should be a part of the 2007-2008 plan of work and rank them in priority order. The items were collected in three rounds with everyone giving their first ranked item, their second ranked item and then their third ranked item. Once all had been recorded the rankings were scored. Three points were assigned to first rank, two points for second rank and one point for third rank. What follows are the items in priority order with their ranking score in parentheses.

1. Outreach—involve potential members in leadership of CLEAR; peer-to-peer marketing (7 points)

2. Broaden existing services—NCIT, leadership, board training, to all regulatory markets; develop one new program a year; develop a one-, two-, three-year plan (7 points)


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3. Review marketing methods, develop and implement a marketing plan (6 points) 4. Market content to world; branding our unique offerings, look at different markets

such as credentialing; public protection (5 points) 5. International and domestic growth in other countries—executive director and

president visit other countries; identify a country, region, identify their needs and develop a plan to address them (5 points)

6. Develop a membership plan to include sponsorship, FARB, FSMB, NOCA, vendors (5 points)

7. Review the conference format and include international balance/not competition relative to an international focus (4 points)

8. Identify a compelling vision and market—core elements, inclusive of regulatory organizations and countries (4 points)

9. Increase the revenue for CLEAR (3 points) 10. Conduct outreach to untapped markets to include the certifying organizations (3

points) 11. Partner with a country outside of North America and hold conference there (3 points) 12. Gain commitment from the board for international relations (3 points) 13. Develop a concise strategy for use of revenues and human resources (2 points) 14. Review process for review of conference planning and the manner in which the

conference is conducted (2 points) 15. Align board/committees to accomplish strategic objectives (2 points) 16. Educate and re-educate state legislatures (1 point) 17. Recruit critical individuals internationally to advocate and be a liaison for CLEAR (1

point) The above areas were merged into the following four areas and decisions made relative to each.

1. Membership—Develop a plan for membership growth that includes untapped markets (certifying organizations), leadership involvement, potential international/domestic growth, membership outreach to other organizations, recruiting critical individuals internationally to advocate and be a liaison for CLEAR.

Decisions:

a. The International Relations Committee will pick a country or region, review

what it is doing relative to the work of CLEAR and determine how it fits with what CLEAR is doing, educate members to their findings, and suggest how the work can be incorporated into CLEAR’s plans, where possible.

b. Conduct an assessment of current membership practices, share with the board the results (what has been done, how it has been done, determine what worked and what did not work), and then send the results to the Communication and Membership committee to consider addressing the tapped and untapped markets’ needs.

2. Product and Services—Broaden existing services, leadership, board training, and

CLEAR using an online focus, when appropriate; all services are to be tailored to an existing market and marketed as such; review the conference location identification process and partner with others to hold conference elsewhere; educate/re-educate state legislatures; reach out to customers who are not members; give thought to different conference format (rethink the track format)

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and share suggestions with the board—conduct international sessions without conflicting with other programs/sessions; consider round table/interaction sessions rather than the lecture-format and work with coordinators to share changes with presenters; assure an international flavor throughout the conference.

Decision: Revise existing services to make them suitable for an untapped market. This activity would occur once the membership assessment has been completed.

3. Board—Commitment for international relations; develop strategy—use of revenue

and human resources; align board committees to accomplish objectives; develop a plan to increase revenue.

Decision: Develop clear expectations for each committee’s work by developing a written charge for each committee, standing and ad hoc. Each committee’s charge should include the objectives it is to address, a deadline for reporting back to the Board including when the Board wants to review plans relative to interim steps in the committee’s work. The bylaws are to be reviewed to see that the objectives/functions listed for each committee in the bylaws are in line with the strategic plan. All committee’s plans are to be approved by the Board before implementation.

4. Marketing—This area requires revenue and expertise to develop a marketing plan, thus this area may be a part of next year’s agenda/plans. The work would include a review of current marketing efforts and methods and their effectiveness, the branding of unique offerings, the development of a compelling vision with resources attached, research into ways to “break in” to other countries and methods used by businesses who have done it effectively, and the identification of other regulatory/certifying organizations. Decision: Tailor the current products to known existing markets (currently untapped).

Prepared by: Judy Burtner J Burtner & Associates 540-885-1288 [email protected] Kathryn Burruss KB & Associates 804/633-9397 [email protected]


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