Peter: 00:04 Peter Brissette your hosts if you do have questions please hit the questions box and go to the interface and we’ll try to answer those during the meeting here today. I actually introduce the executive vice president of the Colorado Assisted Living Association. Mr. Corky Kyle to kick things off.
Corky: 00:24 Well happy new year everybody we’re just getting we’re getting ready to start our program here. And we’ve got quite a bit to go ahead and cover and give you an update of the year in review not only to tell you the accomplishments that we had in 2017 but we’ll also be coming up those accomplishments have in 2018. As you can see from the view on your computer screen there for the Web we’re going to be talking about educational accomplishments regulatory involvement legislative involvement and the very important dates that we’ve got coming up in 20 18. So let’s go ahead and get started our educational accomplishments that we had this year. We
Corky: 01:11 had two very very successful conferences each one of those conferences set a new attendance record for our higher educational offerings to our members and nonmembers very excited about that.
Corky: 01:29 It says a lot about the association meeting the educational needs of the members the legislative involvement that we had last year we went through the legislature. We emerged unscathed. We had no adverse legislation affecting assisted living industry in Colorado which was very very good. We covered in excess of 40 different bills. That in some way affected the industry. So your legislative committee and your government affairs chairman Clark grap did a supreme job in representing the industry during that time. Right now I want to go ahead and turn it over to our President Bill Bowles. And let him talk about the regulatory element that we had last year. Bill it’s all yours.
Bill: 02:31 Thanks Gorki. Hi everyone. We also have. Online here. Nicole Schivonne. She’s a college board member and she’s been involved with all of the town hall meetings as well and had been a part of the regulatory review. Let me let me just start by saying that it’s been a very volatile year. And there is a lot of change is going to be exacted on our industry. And. What I’d like to do is just kind of give you a summary of what I’ve experienced at these health department town hall meetings. And Nicole please please chime in if you have something additional to add from your perspective. The audience at these meetings and I’ve been at every every one of them and predominantly I would say up to 90 to 95 percent of that audience is has been comprised by small owners and operators.
Bill: 03:43 Whether that is an individual or group that owns one bad community or ten bad communities they’re all considered the small providers and folks that Kallah has is really representing in the field. I’ve only seen on a couple of occasions a corporate monolith like Brook Dale or sunrise attendees meetings and they’re not very engaged and I think that’s telling because it gives an indication that these regulations are going to have a far far greater reach into the operations and finances of the small providers. And while it would be a tremendous opportunity to have all of these individuals to join up with Kalah and I’ll go into that a little bit later on in our approach to recruit some of these smaller fote smaller providers. But one of the things that has occurred to me is that as the state is going through with their slides and their town hall meetings they are focusing on very specific areas that the regulation.
Bill: 04:57 And unfortunately these meetings are only two hours long so they are just barely barely touching the surface of a lot of the the more considerable changes. And what I found is that the audience is almost attending with the perspective of learning about the regs. Very few individuals in the audience have read it and gone through those regs such that they would have the opportunity to make comments because the state is taking comments on those regs and I told Randy Kerkin that it’s refreshing to me to see folks go into those town hall meetings with marked up copies of their regs with Dog Years and post it notes and things like that because it indicates to me that they’re actually reading the regulations and they’re not they’re not satisfied with allowing those regulations to be imposed on them but they are taking steps to go through the record themselves.
Bill: 06:03 And so predominantly what they’ve been discussing at these town hall meetings is the. Changes in the training training of the administrators. They’ve been going through it again very very high level and asking for comments. And if the meeting goes so fast. That.
Bill: 06:23 Folks don’t have an opportunity to read those regs on the fly and so they’ve been discussing points in the new rec in the new regulations but they’ve also been discussing the second part of their presentation has to do with the fee increases and why those fees need to be increased and it was the same is the same presentation that they did at the Kallat fall conference. And so it’s not much of a surprise but I think that. Again.
Bill: 06:56 There hasn’t been a whole lot of comment. And I think that from from our standpoint we need to be able to write position paper with some of these other other items. Nicole what’s your what’s your impression of these town hall meetings.
Nicole: 07:16 I would agree with your assessment completely. OK. I think a lot of people are. There’s a good majority of people coming in at plannings to be educated on what the new regulations are about instead of coming prepared.
Nicole: 07:34 We do see some that are compare prepared and I do agree that it is a majority of small communities only that we’re seeing these things yeah that’s absolutely right.
Bill: 07:46 There have been some really good comments made from folks very passionate about passion about what we’re discussing.
Bill: 07:57 So what. Moving forward what what we have planned to do is that we are going to essentially broadcast the January 5th meeting in Broomfield and we’ll be sending out. The Web address and the instructions of how on how to log into those. But. What I would like to encourage everybody on the phone is to spread the word to either attend this meeting in Broomfield. Or log on to the Web site. And unfortunately you’re not going to be able to make comments or ask questions during that Webcast. But. I can’t stress that strongly enough that the new regulations are. Accessible on the Health Department Web site. And if you don’t have a copy of those we can publish that Web site for you and send it out. But I would like to encourage you as strongly as possible to review those regulations in detail especially with regard to all of those items that the the increased responsibilities on the administrator.
Bill: 09:14 The definitions have changed quite a bit of the memory care portion of it has been changed quite a bit. And again there are so detailed that it’s very difficult for me to go in and give a point by point or a blow by blow guide of what to review but suffice it to say that from a staffing standpoint as far as your administrator is concerned. Those those responsibilities are going to increase. And so in addition to training of new administrators and I would like to go through a couple of a couple of things that I plan on submitting to the Kalar board as far as the callup position statement on these new regs. So and again one of the. One of the main points is of course the responsibility of the of the administrator and one of the things that has occurred to me is that there is in the new regulations.
Bill: 10:22 There is there are some things from a safety standpoint that I am going to recommend that they that through the life safety group to make sure that these regulations are in concert with the like the regulations because in some areas there is the perception that of contradicting statements or ambiguous statements. By. Other definitions such as guardians that’s a little bit ambiguous in the reg as well. There’s still some outstanding language in the regulations having to do with CPR and it’s it’s my my impression that the regulation is essentially requiring that assisted living communities conduct or perform CPR. And. There is there’s a little bit of controversy from a policy standpoint in some communities.
Bill: 11:27 Following the line of thought that CPR does more harm than good based on what literature says in terms of the effectiveness of CPR. One of the other things that I am going to include in my position proposal is that the administrator training right now I feel is prohibitive for small communities because right now they’re requiring a five year experience. For new administrators that don’t have the education requirements so in my mind that that’s definitely going to have to be renovated. And from an organization standpoint a large facility might just again not really have a concern about it. But small communities will have their pool of of administrators diminished just extensively so that’s something we need to pay attention on.
Bill: 12:34 And again because that because the new regs are so detailed it’s very difficult for me to go right on a line by line basis. So Bill you might know. But they’ll you may want to share with people that we are in the comment stage for all the rules and regs and that if anybody as they go through there has questions. That they go ahead and write those up and send those into them so that they can gather those all up and used in the ultimate whatever the final draft is going to go ahead and be done and you might also want to touch on a timeline that people have to get these things in as well as.
Corky: 13:22 What the timeline is going to be for the future implementation next year when these will go into effect. OK thank you Corky.
Bill: 13:35 And I can I can even go one better. I think that in terms of efficiency I can offer two things that Corky is correct that the review period is still in process right now and that’s. Evidenced by the fact they’re still having their town hall meetings and they are soliciting comments written comments and such. But. I would like to put put the college board out there as a resource that if you do have questions or comments that we might be able to help you put those comments into context a little bit. Just based on the work that we’ve been doing and attendance at these town hall meetings in so that we can actually help you clarify the concerns and questions you have so that they can get full attention of the state. In addition with the position papers that the College Board is going to submit we are definitely open and encouraging you to include your comments and concerns on that position paper.
Bill: 14:44 If they resonate with with the board and so far. So far the comments have been very very good even even things in this rag that other people have seen that I haven’t seen and I’ve been a part of the development from the very beginning. So there is a lot there. So. Essentially when it’s all said and done the state wants to have every single comment into them by January 10 and their intent is to take all of the feedback that they have received. All of the comments that have been sent in mailed in e-mails in addition to the comments that have been made at the town hall meetings they are going to incorporate that into. The new regulation with the intent to have a final final draft presented back to the Alar committee on January 19.
Bill: 15:49 The state has scheduled an all day meeting on January 19 to present these new regulations. Well the final draft that has inclusion of. The comments that have been made and really it’s going to be a time of debate because I’m not quite sure the process. That they have followed of what to incorporate from you know from a change standpoint they may they may take. Aggregate comments. That. Are relatively the same and then implement that change in the reg. I’m not. Clear exactly how they’re going to do that. Once that we have some type of consensus after the January 19th meeting they are going to be scheduling the the final draft of the regulation to be submitted to the Board of Health. And they’re going to make the appointment in February.
Bill: 16:48 That meeting will then take place in April and the April meeting before the Board of Health. And I believe Randy said it’s going to be held at the Health Department. That is a public meeting. However they are not. It is not an open forum. They’re not going to allow any comments just because that what has been submitted to the board is the final draft. Once that the Board of Health approved that document. The. The regulation will go into full effect in July. Now it’s the the intent of the health department to have a graduated implementation of the new reg however they they are going to be conducting training after after the appointment after the meeting in April is is is made. So there are a lot of opportunities to to comment on this. And they’re also going to be training that’s conducted by the state.
Bill: 17:58 One of the things that I might add is that we’re working with Randy Kirkland all to conduct the very first training on the new regulations. Before or after immediately following our spring conference. So for our members they will have the first opportunity to participate in a training program that is going to be folded out to the rest of the industry and this is not something that we have experienced that are conferences where Elaine and D just simply stand up and it’s not going to be seminar based it’s going to be the exact training that they’re going to be doing throughout the state.
Corky: 18:39 And that’s right Phil and that should be kicked off and that’ll be part of our conference our spring conference that very first program for everyone to learn about the new regs so we’re going to be. We will be the first one.
Bill: 18:57 So Nicole do you have any comments about what I just said or any insight.
Nicole: 19:05 No not at all. Just to really emphasize the fact that it’s vital that. We get the. Interaction and suggestions regarding. The caller’s. Statement. To the hope department regarding our concerns regarding any regulation it’s important that we get. Everyone’s involvement and collaboration with that to come up with a good statement for the core member core membership Treehaven Yurek. Right. Not a threat that’s what he says. Boy. But. I mean other than that I think I think that that other than really being involved in that last. Broomfield town meeting and voicing your concerns is really vital because they are listening they’re very much listening and taking what we have to say in the consideration we want to make sure everyone heard and represented appropriately in the process. But I have.
Bill: 20:17 Good reason. So are you going to talk about the. Yeah I that’s exactly. I was just going to mention something that Randi had said during the last town hall meeting. I think it was in Pueblo or coral springs. Randy had indicated that. Well let me back up at one of the final Alar committee meetings. There was an interesting consensus among providers not only in the committee but also in though with those who were participating as just general attendees that. The industry was asking for a one year survey cycle. And. To me that would that was very interesting because what came after that the comment was that the it wasn’t the impression of the health department that with a one year survey cycle that that improved compliance. And so what they’ve done in and it is based in statute in the enabling legislation it does indicate that assisted living communities be surveyed once a year in the state of Colorado.
Bill: 21:34 So balancing the resources necessary to be able to survey every single assisted living community. They are pressing and I believe that probably be over 700 here very soon. That it’s an unreasonable expectation in terms of resource allocation from the Health Department to be able to conduct those annual surveys. So something that Randy said which kind of surprised me is that they’re instead looking at a three year survey window. So that’s one of the things and I don’t know what effect that’s going to have on the the rate increases. Nicole what’s your what’s your impression of the discussion of the rates. Because again Randy was saying that the ramp up proposal for relicense year and change of ownership an initial license or costs were still in the proposal stage.
Bill: 22:34 So to me it was kind of ambiguous and you’re right it’s very what it very much was.
Nicole: 22:41 I think Randy had said maybe it was from Everglow town hall meeting. But again don’t quote me on that because it could have been Colorado Spring. But he did say they knew rates were going up. Certainly most certainly they weren’t. Now exactly quite sure how high but that they did feel that getting everyone surveyed on a yearly basis was something that was not going to be. Plausible so yes I heard the same thing you did for certain.
Bill: 23:15 Well so we’ve we’ve pretty much outlined kind of the approach to the regulations and I want to just put out there in terms of the work that we did in 2017. It was a it was a tremendously collaborative effort of working with Nicole and some of the some of the just initial proposals that were that were just thrown out there by the state because I think when we went into these Alar meetings they included a lot of things in their regulation that they threw at the committee to see if it would stick. And one of the things was the limited nursing approach which were was just tremendously prohibitive to smaller smaller providers. And we in looking at it and analyzing it in depth. We were we were able to participate and rally the industry to have a positive effect on the change that was made to eliminate the lion’s share of that Elliman limited nursing approach.
Bill: 24:29 And I’m just I’m just extremely proud of the work that we were able to do to stand up to represent our members to to essentially get that thrown out because again it would have it would have changed the face of assisted living in the state of Colorado especially among Medicaid providers and smaller providers. So that is something that just I just can’t say enough about the work that we did with that. So I want to switch gears a little bit and talk about the with these new regulations and the changing environment of assisted living. We have conducted two two meetings to determine how that we want to approach reorganizing the Colorado assisted living association to be more effective and also to have the opportunity to include more of our members and recruit our nonmembers into the organization.
Bill: 25:37 And one of the things that that we heard that was consistent through both of those meetings was the need to. Begin working or have a stronger focus on our grassroots efforts in terms of of working with our members to work with other members and non members on a one on one basis and that has to do with promoting and marketing the things that Kahla has has done and the things that we are going to be doing in advertising the member benefits to nonmembers and being able to create that dialogue on that at that grassroots level so that folks can you can explain why that folks need to be a member of the Colorado assisted living association by virtue in example of the effect that we’ve had on the changes in these new regulations.
Bill: 26:37 And you know I don’t care for the word watchdogs but essentially we have been the gatekeepers for these communities and suggested to get higher numbers involved in a grassroots effort because we are sick we are a grassroots organization. So having said that I want everybody on the phone. We are going to put together typically the way that we have developed our our educational conferences. We have had a few people in the room discussing different topics and different speakers and we put the program together and based on the feedback that we had during our summit consensus summit meetings for lack of a better term is that we’ve heard from folks that we need to go further beyond our understanding of what the educational need is to be able to have more input from our members. So what we’re doing is we’re putting together a conference needs assessment task force and we’re going to be meeting probably the second week in January to determine and to do a very very thorough needs assessment to determine what we want those topics to be.
Bill: 27:59 We heard some very passionate commentary on the way that we have been partnering with the state in various sessions and again going beyond our understanding of what that need is I want to be able to put out there that we are going to include the voice of additional voices of our membership. So Corky is going to be sending out that solicitation and I think it’s you know it’s just based on time that is probably. A two to three hour effort and you’re not going to be on a committee. You’re not going to be signed up for anything lengthy. We essentially want to hear your voice. That’s that’s the bottom line of how to formulate our spring conference.
Bill: 28:53 So the second the second piece of that is that by virtue of meeting throughout the state at our town hall meetings we’ve been doing our best to engage the local folks for example on the western slope in Grand Junction. Down and Out in cars Springs and Pueblo and up north. We need to be able to reestablish our footing with those folks in rural areas that have these exact same concerns but don’t have the resources of being located in the Denver metro area. So that’s another thing that we’re going to be working on in 2018. Nicole do you have any any comments about the I. Don’t.
Nicole: 29:39 Think that what you said is exact man’s Hargate with all the discussions that we have had and all of our Klauber meeting with both members members and I look forward to getting from the task forces moving forward so that we can start to put some of our conversations into action. Yeah that’s that’s.
Bill: 30:08 That’s actually that’s excellent and that’s the point we want to be able to put our conversations and create action items in it and be able to organize the way that we have heard our members who are willing to participate and have the opportunity because there are a lot of people out there that have a lot of the diversity of experience in other in a lot of different areas that we represent. So one of the other things that we’re going to be focusing on in 2018 is developing and establishing a a board a Colorado Assisted Living board that has some. And I use the word diversity not in terms of dividing but in terms of different specialties. And so we’re going to be working on those so that we do have representation of different voices. And for example we’ve proposed that that we are able to recruit in a senior care attorney or senior elder law attorney perhaps somebody from the fire department somebody who has previously been employed by the state.
Bill: 31:29 But that’s that’s one of our goals in a team to recruit instead into place a very strong and diverse board that again allows us to go beyond our understanding of what we feel like the need is. So I think that’s it. Peter do we have any questions.
Corky: 31:50 Well Bill before we get into those questions let me touch on some of the big data that are coming up in 2018 so that people can go ahead and get these down and be aware of them. First of all if everyone the Colorado Legislative session starts on January 10 and is going to run for 120 days until May 7. And so your Government Affairs Committee will be monitoring the legislative session and acting on those things that may involve Busse effect both pro and con. So that will start on January 10. For all of our members out there please take this state down January 16. That is going to be the Kowa legislative reception which is going to be held that the Colorado Automobile Dealers Association building and that’s located at 20 to 90 East beer Boulevard and that’s going to run from five thirty to eight thirty.
Corky: 33:00 And so this will be an opportunity for everyone to visit with legislators talk about unique issues affecting the assisted living community so that’s huge. Everyone should have already received a postcard asking them to go ahead and save the day. The on January on January 5th there will be two town hall meetings you touched on one already which is in Westminster at Covenant Village 9 1 5 3 Jaros Street in Westminster. And then there is another one being held in Greeley. Ames college. At 5 4 1 20th Street Grealy. And so that will be another town hall meeting sponsored by CPA G. Immediately following that over at the Old Chicago restaurant Kalai is holding a membership meeting and we would encourage everybody to send his tenants at that meeting to attend and come by and visit with us.
Corky: 34:09 It’s going to be at the old Chicago the address for that is 23 49 left 29 Street in Greeley and so that’ll be an opportunity to learn more about what Cal was doing what the plans are the bill and has outlined. So that’s another opportunity there for people to go ahead and get involved with the association. And last but certainly not least the Kalar spring conference will be here in Denver and it will be on. April 26 and 27. So you want to put that down in your calendar and put it in your phone so that you’ve got that and be watching for more information that will be coming on that particular conference. We’re excited about this one because it is going to be the one that is going to go ahead and really kickoff what the new rules and regs are going to be all about.
Corky: 35:08 We also will be sending out a calendar of our lunch and learn meetings on various topics so I’ll be on the lookout for those. Those will be coming out we’ll be emailing those out to everybody. So that’s the start of the 2018 year. And we’ve got a lot going on.
Bill: 35:32 It’s going to be fun. Thanks Corky. I was I also just as a as a footnote to that. We we received feedback that our term brain food for our continuing education or for our our lunch and learns was a little bit of a confusing term. So that’s what Corky is talking about in terms of our lunch and learns.
Bill: 36:00 And those are essentially going to be the college education series that we’re going to continue to produce through the year. So Peter Dewey I want to also say I’m sorry about the legislative session with the changes in these new regs. There are some initiatives that we’re working on that could have could have downstream effects and could actually become a bill that the Colorado Assisted Living Association would develop. And so the whole purpose of the legislative reception is so that we can meet those legislators so that when they hear the Colorado Assisted Living Association they know who we are and they know what we represent. And it’s a great way to establish rapport with some of these legislators side like to encourage everybody to attend. And again from a grassroots standpoint please let your friends let let people you associate with. Let them know about the reception and please invite them because the more people we have there the greater impact we’re going to have on these folks. So OK. Peter do you have any questions for us.
Peter: 37:18 We have no questions at this time.
Corky: 37:22 OK. Very good.
Bill: 37:27 All right. So I guess that’s it. Nicole do you have any closing comments. I do not. Thank you.