Welcome Welcome Everyone. My name is Cheryl San Juan and I have had - - PDF document

Welcome

Welcome Everyone. My name is Cheryl San Juan and I have had the pleasure of managing the Refugee Clinic at Mosaic for the last 5 years. I am delighted to be your emcee for today’s All Staff Meeting. 1

Land Acknowledgement I realise many of you are seeing this for the first time, and every journey begins with a single step. From this point forward, and in accordance with the recommendations from the Truth & Reconciliation Commission, we want to pay homage to the indigenous heritage of Canada. Taking time for Land Acknowledgements is just one of these recommendations, and in keeping with this I would like to begin our event by acknowledging that here in Calgary we are on the traditional territories of the people of the Treaty 7 region in Southern Alberta, which includes the Siksika, the Piikuni, the Kainai, the Tsuut’ina, and the Stoney Nakoda First Nations, including Chiniki, Bearspaw, and Wesley First Nation. Calgary is also home to Métis Nation of Alberta, Region III and we wish to acknowledge and welcome Indigenous and Métis visitors to Calgary. In the end we are all Treaty people and reconciliation is the hope for the future. Land Acknowledgement Resources: 2

University of Calgary: https://www.ucalgary.ca/indigenous-strategy/resources/territorial-acknowledgements [1] Siksika is pronounced “Sik-sik-a” (please use the short i for both vowel sounds in pronunciation) [2] Piikani is pronounced “Pē-gun-ē” (please use the long e for both vowel sounds in pronunciation) [3] Kainai is pronounced “K ī -n ī” (please use the long i for both vowel sounds in pronunciation) [4] Tsuut’ina is pronounced “Soot’ ina” (Please use the long o and short i for the vowel sounds in pronunciation) [5] Chiniki is prounounced “Chin-i-kee” (Please use the long i for the last vowel sound and short i for the first two vowels) Calgary Foundation (video): https://www.youtube.com/watch?v=7re1r0FY- 4Y&feature=share&fbclid=IwAR30X3X4z0LyXLrfBZ3RUgHKw4isKfE6BCh9_FlcpIve4 3emkk_sT3JY9qU 2

Agenda This is our agenda for today and we are very pleased to have our HSAA Representative Michelle Bogdan here with us as our guest. 3

Welcome & Who We Are I would like to begin our program today by looking at Who We Are here at Mosaic. An organization is a composition of it’s people, the values and standards we hold

• urselves to individually and collectively. For me, perhaps like many of you, after

several years in acute health care, what drew me to Mosaic was the grass roots approach to understand & meet the needs of our local population Why I continue to be part of Mosaic and stand here today alongside you is the people, the population we serve our fluidity and ability to tailor our service delivery. It is truly our collective efforts, Clinical and Non-Clinical which are contributing to tangible, positive effects on population health across east Calgary. 4

Who We Are Let me continue that train of thought by acknowledging that our Mosaic name is truly reflective of ourselves and the communities we serve. We currently deliver care in nearly 30 languages, which is truly incredible! 5

Who We Are At the heart of our efforts are Our Patients. As of the end of this last year, we had over 350 thousand patients linked to a family doctor within Mosaic PCN and over 50 thousand+ patient visits took place. 6

Who We Are Visits for patients like Bill. I have a short video here of Bill, a Mosaic patient living with diabetes who was so grateful for the care he received from his TEAM that he sent a letter to the clinic expressing how their care impacted him. That letter prompted us to invite Bill to speak at our Data to Decisions events recently about his experience with Mosaic, and here is a part of what he shared. 7

Who We Are His TEAM. The impact that his team made on his health and his family. Let me share a second short video now, where Bill talks more about this TEAM. 8

Who We Are As Bill notes, our members like Dr. Kim are at the epicentre of this care and our patient medical home, and we now have over 350 members and 110 clinics associated with Mosaic. 9

Who We Are Their TEAM, which Bill spoke about so fondly in relation to Nurse Sharon Parmar, and the relationships and trust that our members and health care professionals exhibit has lasting impacts on our patients. Bill’s story is just one of the 50 thousand from this year, and all of these experiences would not be possible without all of you in this room. As of 2018, we have a total of 190 staff at Mosaic, 80 percent of whom are Clinical Health Care Professionals and 20 percent of whom are Non-Clinical Team Members providing better health for all every single day! 10

Who We Are So to each and every one of you – YOU make all of this happen. And on behalf of the Mosaic Leadership Team and Boards WE thank you. I would now like to invite our Executive Director Nicole Gleeson and our Medical Director, Dr. David Oliver onstage to speak to Where We are Going over the course

• f this year.

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Where We’re Going & How We’ll Get There (Nicole Gleeson, Executive Director) Thank you so much Cheryl and congratulations on your next exciting challenge within Mosaic as our manager of Attachment, Transition and Integration. We all share something in common, our passion and dedication to enacting our mission, vision, and values. That means, improving better health for all and working withal of our communities to do so. It is really difficult to say no. what that has lead to is all of us feeling that we are just doing so much and not enough at the same time and we all share that. And we have face very exciting rapid growth and I think we can all be so proud of what we have accomplished but that has not come with

• ut its growing pains and in the words of someone that isn’t in this room today but

that has lead to some very difficult growing pains and I feel like are in the awkward teenage phase. I can assure you that I have witnessed the evolution of this work and what that will actually mean to you; how do you know when you are going to see and feel that we have a strategy and we have tactics to map that that’s going to feel like we are not giving you mixed messages. That if you talk to one manager you don’t get a different message from another; that if you talk to your manager and then see your director that you don’t get a mixed message; you are going to see alignment, you are going to see improved communication, and in fact you should 12

have already started to see that. And one example is in the staff satisfaction survey results, I can remember staff satisfaction survey results from years ago, and they are still informing some of the decisions that we are making today. That information is not being lost but you have never known or potentially realized that we are still discussing or working on something and that’s where we need to ensure that that communication loop is full circle and bi-directional. I am up here today to say that I believe that you are going to start to see, hear and experience this and that is what the strategic and tactical planning work will mean to you. You’ve also seen that a part

• f that work what we have needed to do as a leadership team is continue to develop

no different than what we say is important from each one of you in terms of professional development as your leadership team we need to grow and develop as

• well. And so that’s why we felt it was important to share with you the most recent

work that we have done which was the Crucial Conversations training and that was to ensure that we could have really great conversations with each other, with you, with

• ur stakeholders, with our patients, with our board so that’s some of the work that we

are doing. You will start to see that the tactical planning work is coming back to you and saying can you tell me what you are doing how you are going to do that and by when that’s not to come and feel like we are questioning the work that you are doing that is so important that we can ensure that we can make sure that you have what you need to do that, that you have the right infrastructure, and that we capture that work with data and with the context to ensure that can celebrate it communicate it and to ensure that it can continue so when we ask you those questions it is so you can help inform the how we are going to get here, because I see this as a real

• pportunity instead of somebody coming up and telling us here is the road map of

where we are going to achieve success you guys are laying that road map for us and this is part of the work we are doing. So that’s truly what the strategic and tactical planning will look like to you So part of that has also been a focus on our organizational development and human resources so some of you have asked, and you may have noticed we recently sent

• ut an all staff communication because we recently had the departure of one of our

clinical directors so I have been asked so when is the posting for the new clinical director going to go up that was actually a planned departure and 2-years ago we embarked on that 2-year transition plan and again it wasn’t that is was always clear to you but as a previous clinical director and being in the organization when we had 3 and 4 it felt really difficult to work together and so moving towards having 1 clinical director is where I wanted us to get to and I where I really think we need to be. I am very excited to say that we have 3 directors within the organization, Kristi Jenson, Director of Clinical Operations, Peter Rymkiewicz, Director of Measurement, Evaluation and IT, and Shawn Graham, Director of Business Operations and I really believe that that is the structure that will move us forward. So that director position has been transitioned to HR so we are really excited to embark on the HR structure that will help us finally get to the projects that we have wanted to get to for many year. We are going to focus on this journey on that development in Hr and as an 12

• rganization. And that really means continuing to address our structures and our

process that influence all of our ability to do our job and motivate us and engage us in

• ur work.

So something else that is a significant change to the organization is the unionization and collective bargaining process as you know Michelle is here to join us as we are partners in this journey. Many of the questions you are coming forward with in the staff satisfaction survey or staff meetings or when I have seen you a lot of those elements will be address in the collective bargaining agreement that said its going to take some time to reach that end point but I want to assure you that both HSAA as your representative and us as your employer are working together and bargaining in good faith to reach that outcome. So more specific details on certain elements that you have been asking such as what is the consistent way we are posting job descriptions to what will the development look like what will the performance appraisal process look like are elements that we will reach consensus on. But that process is happening and we will continue to keep you updated on that. The other element that I wanted to speak to is the financial evolution of mosaic it is absolutely been that, not only have we had significant change within our own organization but at the same time we have had a significant amount of chang e in our external environment and that includes the direction from Alberta health as our funder and policy changes in regards to how we are funded as well as new provincial objectives. All of that lead to us needing an understanding of how funding works within our

• rganization and it has been a 2-year journey of ensuring that we have more

transparency, influence and accountability over our budgets, and it is the very first year that I can say that you have influenced that budget that you will continue to have influence over that budget in terms of your managers will now actually see report that will tell them is your department over or under budget and having that information is so critical to ensure that we can be responsive and adaptable in taking advantage of the funding that we do have and making changes where and when they are needed and that is some very exciting work that is happening. And on that note, this change in our financial transparency, influence and control impacts us as an organization in ways such as what you have been saying in staff surveys for years. By having this information it has allowed us to address our space strategy. 2-years ago I created 4 ideal requirements in regards to space – consolidate the refugee clinic that is currently spread over 3 different sites, we need to consolidate the 2 administrative sites, we need to ensure that we do lease-hold improvements to all of our existing sites to make sure they can continue to be the environment you need them to be so you can continue to do your work. And I am so excited to say that we will be celebrating the opening of our newest community clinic, temple, next month – 2-years

• f work. I am also excited to say that we have been able to retain surplus funding for

the consolidation of the refugees clinic (2-year plan); and the Administrative Space (within this year). There are very specific requirements around keeping surplus funding and we have to apply to keep these dollars. 12

The staff satisfaction process is so important. We are trying something new, theme it, take it back to you, creates the road map for the tactics we embark on over the next

• year. We are tweaking. Highlight the info from that is so important on a small and

large scale. All of the little details matter – in regards to the space focus groups, for me I don’t think about paint colour but what I heard from our mental health team is that paint colour matters…too bright of a colour makes a difference, a dimmer switch, improved white noise mechanisms make a difference, we are trying to integrate things such as this feedback. You may not see it come to fruition immediately but you plant the seed – I continue to encourage you to keep providing feedback. Digital workspace – We have been listening for the past 4-years. We cannot move forward unless we have a more consolidated intranet. Our practitioners are tired of charting in numerous different platforms, if I get another password, I’m going to explode, its inefficient. We have been working over the past 2-years on what this will look like. Ah has approved us to retain funding to ensure we can implement an

• intranet. Have patience while we start this journey – we will have bumps along the

way – this is the first step. WE are securing support to be able to implement this. We have an election coming. We don’t know what the outcome of the election will be and we don’t know the impact of that outcome on us but I can tell you that I don’t think any party is denying that Primary Care is what is needed in our health care

• system. Any party that is elected will have challenges in how they spend the health

care funding but we started over a year ago to have a collective government relations strategy so we have been meeting with all parties to ensure that they know what a primary care network is and what we do and specifically when we meet with people within our catchment area we are educating them on mosaic. I can tell you that those conversations have been so positive. This is the first time since I have been with Mosaic that we have had collective key messaging as a PCN, as a zone, and as a province. I cannot say thank you enough, I truly think that there are exciting things that are coming to fruition that will be meaningful for you. And I want you to be proud of being able to finally get to this place because I think that there have been moments along the way where I have been doubting if wed ever reach this point and we have so I thank you and I just ask that you please continue to be patient with us, and please continue to voice your thoughts, and your contributions because they matter. 12

(Dr. Oliver David, Medical Director) Driving towards the east…Dawn of a on a new beginning of patient centred care where our role is to support, guide and empower people to be able manage their health. When I was involved in the initial planning of the PCN - we were on a road, not sure where it was going/ there was no map or gps we did know that what we were doing as Family Doctors was not longer working. Stress and anxiety was high and at times unmanageable. We needed help. Early on the vision was clear but the road has been winding. As the PCN grew and evolved it is now clear that the road leads

• home. The patient centred medical home.

And so it started with a business plan and a handful of staff to now the 210 plus people that we have here today, each with a skill set, a passion to make a difference and willingness to do that little bit extra. And with that the work we do as individuals and ultimately as the PCN - is highly regarded across the province and the country. Educating and supporting the person sitting in front of you has collectively allowed 13

the health of the people of NE/SE of Calgary to improve. It has not been easy - there have been challenges and with each one there has been maturing and growth in the organization. There is a certain resilience that develops as we overcome each challenge and even as we approach an election - ( don’t forget to vote) - keep in mind there may or may not be a change at the top - the work we do and the people we serve will remain the same. I think we are well placed to manage what lies ahead. 13

Nicole: There were a number of questions that were submitted in advance of the meeting. We have chosen a handful that we will speak to today given our available time, and will provide additional detail on other questions as a follow up from today’s event. I will go first, and then each of the Directors will read out the question they will speak to and provide our answer. 1) How can Mosaic PCN provide more transparency when it comes to job

• pportunities? There appears to be a lack of communication about when and where

positions are posted. ANSWER (Nicole): This is an area we recognize where historically we have grown quickly and operated with a high degree of autonomy in each portfolio. This ability to be nimble and act quickly while a benefit in some ways, also contributes to the lack of transparency and unity around postings. Moving forward, you will see improvements in this area which will be clarified through our collective agreement such as consistent posting of

• pportunities on our Mosaic website, and postings up for a minimum amount of time and

including a closing date. I speak to this accountability on behalf of the Leadership Team and our hiring managers. On the staff side of the equation, it may feel like less communication than you currently receive, however you will have a single source of 14

information related to job postings. What you may have had historically which will not happen in the future is a heads up or individual notice about positions. All staff will have equal notice of and access to postings via the website. This includes Zone positions as well. 2) How can Mosaic PCN demonstrate more accountability and increase trust with staff when it comes to areas that staff identify as needing improvement in our organization? ANSWER (Peter): I would go back to the foundations of what we are as an organization so we deliver care and we do that through a healthy group of both clinical and non‐clinical staff and what that means is that we took quite a different approach when it comes to taking the feedback from the staff satisfaction survey this year and how we were going to reach out to you to create a strategy towards staff satisfaction. I put down a few steps that we have undertaken: Acknowledge that we are all employees of MPCN and we started with the staff satisfaction survey and the analysis of that work, that information came to the Operational Leadership team (Managers, Directors, Executive Director and Medical Director); planning sessions took place – recognized that we need to co‐design a staff satisfaction strategy if we were going to get anywhere with improving satisfaction for our organization. the first round in feedback we have received (10 out of 12 teams have met and provided feedback back up to OLT; 6 of 10 have identified their 5 priorities. We are going to go back and collect the remaining 2 teams feedback. WE don’t want to move forward until we have all of the

• feedback. At this point we are committed to ongoing communication and making sure we

co‐design the staff satisfaction strategy with you; so you will be part of the next steps. 3) Where are we at in the development of more clinical guidelines, procedures/processes to ensure that there is a standard quality of care we provide to patients? Additionally what mechanisms or measures of accountability are in place to ensure that these are adhered to? ANSWER: [Shawn] We have an Operational Policy & Procedures Committee currently in

• place. The committee identified, some time ago, that Mosaic really did need to do a

complete review of our policies and procedures and guidelines – some of them were out of date, missing p and p, The end goal of the project it to get a wide ranging list of Policies, procedures, and guidelines which covers all of mosaics needs both clinically and non‐

• clinically. We want to ensure compliance with all legislation and industry specific regulations

and standards. Another goal was to end up with professional looking documents, content that was accurate , complete and current and very importantly was easy to read and

• understand. It was also really important that this project not take years to complete we

wanted to move fairly quickly on this. So the solution we identified was to hire an external policy consultant to lead this project ‐ the OPPC is supporting the project and working closely with the policy writer and we are asking for support from the subject matter experts, which are many of you in this room, to ensure that these documents are as accurate as they can be. It really is a team effort. The policy consultant has been hired and the work has

• begun. We expect that 12‐months from now the content will be complete. This project will

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have a profound impact on all of us and you can expect to have a very thorough list of policies, procedures, and guidelines. 4) With consideration to a move to a unionized environment, what implications are there are on job security? What is the likelihood of layoffs? ANSWER: [Nicole] I assume the way the question is phased there is a concern that moving to a unionized environment may lead to layoffs. While layoffs can occur regardless or a unionized or non‐ unionized environment, preventing this from happening on any type of mass scale has been and always will be a goal in the organization. It is way too early in the collective bargaining process to determine any type of causal relationship between unionizing and layoffs. Should layoffs happen for any reason, the details of how that is handled would be in the collective agreement alongside any type of termination and grievance process. It is important that we as Mosaic and HSAA understand your priorities and I encourage you to reach out to your representatives to chat more. ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ ‐‐‐‐‐‐‐‐‐ OTHER QUESTIONS – Not addressed at the in person meeting due to time constraints – watch for answers in future newsletters. 1) How can Mosaic PCN provide more support and opportunities to internal staff that are looking to advance their careers? There appears to be a lack of positions that support internal professional growth in leadership and especially for those without prior management experience. 2) How can Mosaic PCN provide more recognition of dedicated staff in addition to Years of Service awards and kudos? Can leadership support nominations of professional discipline college awards (APEX for pharmacists, CARNA Excellence for RNs, etc.) and local community awards (Calgary Community Achievement, Avenue Top, etc.)? 3) With new initiatives and increasing workloads, how can Mosaic PCN better assess and address staff burnout? How do we promote and ensure job satisfaction? 4) What current/future plans does Mosaic PCN have to collaborate with other PCNs? 5) How can Mosaic PCN promote and enhance staff cohesion apart from individual team meetings? Can there be more formal opportunities for teams that work indirectly with one another (CDM and MHT/SW for example) to connect? 14

What We’ve Achieved I would now like to ask the radical Rachel and Marvellous Michele will join me onstage to speak to some of our Highlights over the past year. 15

Rachel: Thank you Cheryl. Over the course of the past year, we know all 190 of you have been working at ensuring that our patients receive the best care possible as we continue to advance the medical home. While this section is by no means an exhaustive list of everyone’s achievements and we don’t have photos for everything, we want to speak to a few great highlights from the last year, and we encourage you to take lots of photos of your work this year! 16

Rachel: In 2018 our members continued to lead the way on demonstrating leadership of the Patient Medical Home. One example of this is Dr. Churcher’s Family Practice was recently recognized by the Alberta College of Family Physicians. This work is supported by Mosaic in so many ways from our Clinicians to Evaluation & Improvement Facilitators, PCC Educators, Physician Liaisons and all of us here today. 17

Michele: And in the last year, we grew! Over 20 new positions were created within MPCN and we welcomed amazing doubled the size of teams like our Community Health Navigators and our Mental Health and Social Work team. In addition, the Mental health team decreased wait time by half by piloting a triage process and introducing a pre‐care workshop for potential patients. 18

Rachel: The kinesiology team created a “Move More Move Better” class and Active Adults celebrated their 5‐year milestone. 19

Michele: The PCC program continues to expand and increase adoption of Patient Medical Home Ronald McDonald Care Mobile increased service dates supporting even more young Calgarians 20

Rachel: Now if you’re like me, this type of slide scares you a lot, that’s why we are so grateful for people like the Evaluation & Measurement team who continue to support us by leading the way on data collection and statistical analysis in PCNs. This enables us to support evidence based care delivery such as exceeding the provincial goal of 80% of physicians established or actively working on their panel. 21

Michele: The ECME Team became the Engagement Team, welcoming additional members and continuing the strong connections with our member physicians, our staff and our community. The Foot Care Program changed it’s model and created a passport for patients to enable increased self management of their care. 22

Rachel: Refugee Clinic held its first planning session day and continues to lead the country in best practices for refugee health, while supporting a panel size significantly higher than anticipated with more complex patients. 23

Michele: Last and certainly not least in terms of achievements over the past year:

• The Pain Clinic improved access and collaborated with East Calgary Health Centre to
• ffer group classes
• Heart Health decreased from 12‐ to 8‐week program to improve access
• Access Clinic is exceeding expectations in comparison with it’s previous launch and

improving collaborations with PLC Emergency Department and DI and family 24

physicians.

• Mosaic Medical Clinic worked on quality improvements around billing and scheduling
• Our IT Team kept us connected and efficient through technology and started work on

strategic initiatives such as the digital workspace

• Primary Health Care Team continues to grow and expand to more member clinics
• Primary Care Navigation Nurse and Nurse of the Day were created and celebrating a

successful start ‐ 500 patients have already been seen

• We continue to work on Strategic and Tactical Planning ‐ including ongoing engagement in

relation to staff satisfaction survey results. And we make time to celebrate and have fun like our annual holiday party! 24

Rachel: And to close out this section, I want to share a reminder for everyone that we enjoy great benefits here, and in my personal experience so far this year I have: Received an acupuncture treatment Met with a naturopath Went for facial microneedling Met with my therapist Had 2 deep tissue massages Visited my chiropractor 3 times Got a cleaning, check up and cavity filled and got fitted for a mouthguard Had oral surgery Saw an optometrist for follow up because I had laser eye surgery last year that I had used a combination of my Manulife benefits and my health care spending account to pay for. All of these things were either fully covered or 80% covered by insurance and I encourage all of you to take advantage of our great benefits and if you have questions about these, reach out to Eri to chat more. 25

Rachel: Now that you’ve heard my story of some of what keeps me here, let’s celebrate individuals who have achieved some major milestones in years of service. If I could please have Dr. David & Nicole back on stage as well as the presenting managers. For the award recipients, if you could please re‐join us at the end of the presentation

• nstage, we will do group and individual photos then.

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Nicole: Celebrating 5 years of Service in the Mental Health Team, we want to congratulate:

• Michael Williams
• Jan Jelinek
• Jassim Al‐Mosawi
• Rita Wall

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• Dr. David: Celebrating 5 years of Service in the Prevention & Promotion Team, we want to

congratulate Tajinder Singh

• Dr. David: And Celebrating 5 years of Service in the Refugee Health Team, we want to

congratulate: Shayesta Noori & Eric Norrie 28

Nicole: Celebrating 5 years of Service in the Prevention & Promotion Team, we want to congratulate: Jackie Zimmerman & Claire Izcovich Nicole: And in the Women’s Health Team, congratulations to Samantha Herba 29

• Dr. David: Celebrating 5 years of Service, congratulations to our Human Resources Advisor:

Eri Fujio

• Dr. David: Celebrating 5 years of Service in the Business Operations Team, we want to

congratulate: Glenda Galger

• Dr. David: And in the IT Team, we want to congratulate: Muhammad Manzar
• Dr. David: And last but not least in our 5 year awards, congratulations to: Cheryl San Juan

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Nicole: AND Now, I am so excited to present our FIRST EVER in the history of Mosaic, 10 Years of Service Awards. Because we’ve never been in this situation before, we looked at a few different ways to recognize this great achievement and the item that we landed on is not here today, but will be presented to these individuals at their team meeting. Congratulations to Crystal Axworthy We would like to congratulate Crystal Axworthy for her 10 years of service with Mosaic Primary Care Network. Over the last 10 years as a Registered Dietitian, Crystal has made an amazing impact on the lives of pediatric patients and their families through her work in the Pediatric Lifestyle Program, Care Mobile, and Children’s Health Clinic. We thank Crystal for all of her contributions to the growth of Mosaic and commend her passion and dedication to her work with children and their families to live a happy, healthy lifestyle. Nicole: AND Congratulations to Laury Scheerschmidt: Nicole [I’ve been told that] 10 years of experience is a small number compared to the pairs 31

• f shoes Laury owns. But just like she has found a home at Mosaic, she finds a way to wear

these all so fashionably! Through her journey at Mosaic, Laury has supported multiple portfolios in our organization,

• ften wearing a number of hats on a daily basis, including a striking red fire warden hat!

In all honestly and sincerity though, we are truly grateful to have a wealth of knowledge at the Medical Clinic in understanding history behind many of our processes, policies and understanding WHY. Thank you Laury for willingly supporting our operation on a daily basis, you are a true asset to our team. 31

Cheryl: Congratulations to all of our award recipients. That concludes our agenda for today, thank you all for coming and in closing I want to say “We hear you and we want to continue to hear you – keep coming to us with your comments because that is how we can continue to make things better.” Thank You all and have a wonderful day. 32