Speaker's Report      Ruth Krueger

Speaker-Elect's Report      LaDawn Neary

Past Speaker's Report      Jonathan Lee

Treasurer's Report      Barbara Kingry Fedak

Secretary's Report      Michelle Porter

Parliamentarian's Report      Mary Reinesch

Publications Committee Report      Michael Jackson and Laura Lucas

Actions to Increase Membership      Vijay Deshpande

Standardizing the Profession      Lucy Kester

Partnership for Success      Claude Dockter and Denise Johnson

I'm excited to meet again and formalize some of the work we have been talking about on the list serve and to discuss what's hot and what's important to our profession. The most recent surveys of the HOD have all contained requests for a return to focus groups and a time to network in the house. We are committed to providing this time in Keystone. As we looked back since changing to a two-day house meeting, we have finished early enough to allow us to put focus group/ networking time back into the agenda on the second day.

The topics for the focus group for this meeting will allow you to choose which area you are most interested in. The topics and questions I'd like you to think about and formulate prior to coming to Keystone are:

• Affiliate Best Practices/Behaviors -- to include state membership, competition, profit sharing, web sites, and how can the HOD help move this profession in the right direction, etc.
• Future of RC Education/Recruitment & Retention -- to include the wave to move to a BS minimum, barriers to completing the registry, strategies to lure students, partnering with hospitals and schools, etc.

I truly believe that this body of delegates has the ability to find the answers to the problems that are plaguing us right now. We need to put our brilliant minds together and come up with some concrete solutions that we can take back to our states to help the state affiliate and the AARC. Not only with increased membership -- which is always the strength that holds us together, but also, where and what we want to decide as the important things to put our energy and focus on this year and in the years to come. See you all very soon! [Top]

Panic has set in! I was thinking about what my responsibilities will be in Keystone and what I will have to work on between then and Tampa. I just realized that there is less than four months between the two meetings! There's lots to do and so little time in which to do it -- Chair and Committee appointments, Committee Charges and Budget issues to start with. But I know with all of the dedicated members of the HOD, my fellow officers and Pat Lee, everything will fall into place.

So, I'm starting with you all to help me get things going. In Keystone I will be distributing the 2003 Committee Appointment Information Sheet. Please start thinking now about which committees you may be interested in serving on or chairing. This information sheet and the chair and committee member evaluations I get back after the summer meeting will help me in determining the makeup of each committee.

In addition, the 2002 Committee Chairs will be receiving a list of their charges for the year that I would like updated. You all know best which charges are no longer necessary and what new charges would be useful. So please help me to continue advancing the direction of the committees through these updates.

Barb and I have already talked a little about the HOD budget and once the 2002 Chairs have had a chance to review her data, we will work to see if the HOD can reduce our budget even further. I know the 2001 Chairs and Barb did lots of work at trimming the budget, so we'll see where/if we can make any more improvements.

In the meantime, I will be in contact with David Shelledy to go over his goals for 2003 and work on my objectives as well. I am open to any suggestions that any of you have, so please share them with me.

Together, with all of you, I'm looking forward to a successful 2003 for the HOD. (Thanks, I think my panic attack is over). [Top]

Our Keystone meeting will be here before we know it -- by the time you read this most likely.

In preparing for our meeting, be sure to review the coming applicable resolutions with your State Society Board, keep them informed and give them an opportunity to share their issues with you as their ambassador to our AARC leadership. We must keep the communication flowing in both directions, so as to promote a united and cohesive organization of professional engaged and active in our governance.

Take time to review the reports in the Meeting Handbook, write any questions you have on the report itself so these will be handy in the meeting. If you are new to the HOD, you will get a good overview of our work at HOD orientation. You will meet fellow delegates and officers. Don't be shy. Introduce yourself to others and get to networking as there is truly a great wealth of knowledge, experience, professionalism and new ideas within the House and Board. Remember we all became involved with the AARC because we care about our profession.

Plan to share your update from the Keystone meeting with your State Board as well promptly after you return. You'll likely be all fired up with all the energy that emanates from our meetings, so be sure to pass the fire on in your professional community when you get home!

And now a brief note about our meeting site (this was seen on the BOD list serve, and I thought you should be informed): The Colorado State Department of Fish and Wildlife is advising hikers, hunters, fishermen, and golfers to take extra precautions and be on the alert for bears while in the Dillon, Breckenridge, and Keystone areas. They advise people to wear noise-producing devices, such as little bells, on their clothing to alert but not startle the bears unexpectedly. They also advise you to carry pepper spray, in case of an encounter with a bear. It is also a good idea to watch for signs of bear activity. People should be able to recognize the difference between black bear and grizzly bear droppings. Black bear droppings are smaller and contain berries and possibly squirrel fur. Grizzly bear droppings have bells in them and smell like pepper spray.

See you all soon!! [Top]

During the past month committee chairs whose committees have budgets were sent their budgets for this year. When we meet in Keystone I will provide these chairs with the current status of each of their budgets so that they are aware of where they are for the year. My goal is that by providing this information they will be able to advise LaDawn and me of their needs for 2003. We will be working on the new budget after the Summer Meeting and will look forward to their input.

I have recently received the AARC Financial Report for April and membership remains a primary concern. Membership revenues were 12% below budget for the month and remain down 15% for the year. Given current trends there is a projected shortfall of $275,000. by year's end. Current membership is at 30,703 and had been projected at 31,057 for April 2002. The bottom line is that it is critical that we attract new members to maintain the budgetary projections for 2002.

Publication revenues were up this month because RC advertising had an exceptional month and is 22% above budget for the year. While not doing quite as well AARC Times advertising is still above budget by almost 8%. Member subscriptions are down slightly due to a lower membership base and nonmember subscriptions are up over last year due to rate increases but still trail the 2002 budget by 40%.

Total product revenue is 44% below budget year to date. Anticipated sales in videoconferencing and promotional items have not met expectations so far but on a positive side the sales of promotional items to date is ahead of last year and 2001 was a record year for those items.

Again, monthly and yearly expenses are below budget year to date being 11% below budget. Keep in mind there is only so much trimming of expenses that can be done and it is commendable that expenses have continued to be kept below budget. A full financial report will be given by the AARC Secretary/Treasurer at the summer meeting.

I want to conclude this report by asking that you keep in mind this information as you review and consider resolutions. A resolution may have merit but must be balanced with the facts of what the financial impact to the AARC would be. I hope that you have all read the financial impact information that was sent out last week so that you can make use of this information to formulate decisions about the resolutions coming before you in Keystone. [Top]

As we continue preparations with only a few days left until the summer forum, I am constantly reminded of all the hard work and effort that goes into these meetings. There is so much that is done before the meeting starts; even as we finished the meetings in San Antonio, preparations for the summer HOD meeting were started. I never realized all the "behind the scenes" work that goes into the HOD meetings until now.

The e-vote process is one issue that will be open for discussion at the upcoming HOD meeting. A copy of it was e-mailed to you for review and should be included in your agenda books. There was much discussion on our list serve about the e-vote and hopefully we all will come to Keystone ready to discuss and implement this process.

The AARC and the HOD are constantly trying to find ways to save money and time. As we all know, being a delegate can take time from our work and personal lives. Attending meetings twice a year away from home, reading several e-mails weekly, and serving on HOD and/or AARC committees are just a few requirements of the position. The e-vote process is a way to help offset some of the time we spend at our HOD meetings. By utilizing the e-vote, we will leave ourselves more time at HOD meetings to discuss other difficult issues that face us as respiratory therapists and members of the HOD and the AARC.

I hope to see all of you in Keystone in a few short days and look forward to discussing and implementing the e-vote process. [Top]

Ruth Krueger has asked that I introduce myself to the Delegates as the Parliamentarian. I have been a respiratory therapist since 1977. I have actually worked in respiratory care longer than that time as an OJT. In 1980 I accepted a position at the local college as a clinical instructor for the respiratory care program. In 1985 I graduated with a BA in Education while teaching. Later that year I accepted the Director of Clinical Education position with the same program and have continued in this position since that time. Like most of you, I enjoy my profession and try passing that on to our students.

Each time we come together for our meetings we feel as though we are well prepared on the issues at hand. We review the resolutions, the committee reports with their recommendations, and the officer reports, but there is one more item we should review quickly before we come to the summer HOD meeting. It is the Delegate handbook (which we just received a couple of weeks ago) and the parliamentary procedure, which is included in the text. Yes, I'm sure there are some who have been to several of the HOD meetings and feel we are up on all of the proper procedure. There may just be one or two things we have not been so clear on and a quick review of the material would only help with having order for the meeting.

I thought what I might do is give you the reference pages found in the hand book which could help save you some time. Just a basic review of Parliamentary Procedure is available on pages 25-29. This discussion saves you time because it is just the basics.

House Rules are a little lengthier, but each section is well covered and won't take long to review. As the introduction of the Delegates Handbook says, be very familiar with the house rules to understand the HOD process.

I am looking forward to Keystone. It should be a great time to keep the networking going. This is a great group to work with and I am glad to be among such caring respiratory therapists. [Top]

The jobs of The AARC Record Editors include: (1) Scanning for & touching up errors in grammar and punctuation; (2) Pre-publication interception of volatile prose; and, (3) Assuring timely submission of copy to Pat Lee.

Many years ago, I observed a significant tiff between two delegates. One, an editor, failed to clean up embarrassing grammar & spelling errors before publishing the other's article. Copy submitted for this issue of The AARC Record contained impeccable spelling. Some submitted copy contained run-on sentences that were sub dividable into four. Generally, the authors' points were clear. Thank you, all, for submitting articles.

Regarding volatility in submitted copy, no jousting was discerned by the editor. Certainly a lot will be said in Keystone regarding the resolution about the CRT Credential. Heartfelt and sage arguments both for and against the current system have already been expressed. I cosponsor a simpler resolution. Tengamos una conferencia maravillosa del verano en Puerto Rico.

Regarding timely submission of copy to Pat Lee, I failed. [Top]

• As a member of the AARC since 1973 and a past delegate from Georgia, I would like to share some of my views regarding the membership dilemma. As we are aware that there are approximately 32,000 AARC members and twice as many non-members deliver respiratory care in the country. Rather than expressing my views regarding why there is such apathy in becoming a member of the AARC, I want to take a proactive role and address actions we can take to increase membership. I am fully aware that these actions have been discussed at various levels of the leadership.
• It is my personal experience that HOD has an invigorating effect on all delegates. Attending HOD meeting changes individual's perspective about the profession. All negative feedback received about the AARC from various sources is replaced by positive attitude and pride for your profession. From this experience, I would like for the HOD to consider strongly finding avenues to allow for younger individuals to be involved with HOD. A viable option is that all state societies to consider electing one member to the HOD for four years and have their President Elect represent as a second member of the delegation. The President elect gets a crash course on the operation of AARC which is very beneficial for him/her the following year when he/she takes the reins of their state society. Thus, for four years, one delegate and one new alternate delegate will represent the state affiliate every year. After the four years the society can elect a new delegate for a four-year term. The major objection to this approach is the loss of continuity. Let us face it, we had continuity for the past 20 years and yet, we have not succeeded in increasing our membership. The profession is in a dire need of increasing membership. Perhaps we have to take a bitter pill.
• It is time that the managers of respiratory care departments pull their weight. They must find ways to induce or encourage their staff to become members of the AARC. I am not promoting arm twisting policies or forcing them to be members. A manager is supposed to have the ingenuity to find solutions to problems. There are ways to encourage staff therapists to join AARC, such as, including professionalism as one of the elements of the staff member's annual performance evaluation.
• Many respiratory care departments provide CEUs required for the state license. I like it. However, now the therapists have no reason to become a member of the AARC. They also, do not have any reason to attend state society meetings. How about free in-service for AARC members and charge fee for non-members. By not promoting their staff to attend state society meetings the managers are doing a disservice to their staff as well as the profession. Students from all programs have complained that they receive a negative impression about the profession from burned-out therapists. The manager must make efforts to stop this negative feedback to the newcomers in the profession. I am not sure, but this attitude from burned-out therapists may be one of the factors for not having adequate applicant pool for many programs in the country. During their school years all students join the AARC as student members. Upon graduation they are employed. As soon as they get a job, they drop their AARC membership. I think department directors have to encourage and at times, insist on AARC membership.
• What about NBRC? Is it possible, perhaps illegal, to reduce their examination fees for all AARC members?
• Let us be cognizant that we have twice as many non-members as members (approximately 70,000 non-members against 30,000 members). Most practicing non-members do not get AARC Times and RESPIRATORY CARE. However, they have access to RC Advance, a free subscription. RC Advance is in direct competition with the AARC Times for advertising revenue. Notwithstanding, I think some of you in the leadership role should write a column, on a regular basis, in the RC Advance to encourage non-members to become members, as well as, provide information regarding what is AARC doing for them. Use it as a means to reach the grass-root therapists -- mostly non-members.
• Appeal to all National Home Care companies, such as Lincare, Apria, Rotech, American Home Patients etc. to encourage their employees (respiratory therapists) to become members of the association. Identify that it is in their interest that a strong AARC will assist them in addressing reimbursement issues through legislation. The latest action by the AARC's advocacy group should be capitalized. Moreover, the AARC is willing to offer them a group discount for membership. It is actually a win-win situation.
• In Buffalo, NY, a trade union represents respiratory therapists. Respiratory care is grouped with house keeping, cafeteria staff and security while the nurses and physical therapists are represented separately. This can give a wrong message to others about the value of our profession. I think it is time to take a strong collective approach than preaching.
• My views may be politically incorrect and provocative and may upset some individuals. So be it!

The field of Respiratory Therapy is making great progress with increasing its professional image by raising the education requirements for becoming a Respiratory Therapist, standardizing the practice of respiratory care through the AARC Clinical Practice Guidelines, and by obtaining state licensure. In addition, members of the PACT (Political Advocacy Contact Team) as described in the December issue of the AARC Times, have done much to "spread the word" about the contribution of the Respiratory Care Profession to healthcare all across the country. However, we aren't "quite there" yet. Currently we have 44 states, Washington DC, and Puerto Rico that have some type of licensure or practice act. We need to continue to focus on the states that do not yet have licensure. Once all 50 states have licensed Respiratory Care Practitioners (and I believe this will happen in my lifetime) it would be of great benefit to create some consistency among the various licensing laws, (e.g., consistency in educational requirements, competency documentation, and continuing education). If we are able to provide respiratory care from state to state in the same standardized professional manner, we can raise the national image of Respiratory Therapists and present a more united front on all major issues regarding the practice of Respiratory Therapy.

Perhaps we could accomplish this by establishing an AARC standing committee to review and categorize respiratory care licensing laws, and compile a list of the strong points of licensure laws that currently exist along with a list of the weak points of these laws. Realizing that there will always be individual state issues that will require individual state regulations, a model of the "ideal" Respiratory Therapy Licensure Law might be developed. This model could be used as a guideline or goal for states to work towards when their individual laws come up for renewal or revision.

Changes have been proposed to the Ohio Respiratory Care Law that would allow DME companies to be licensed under the same law. Cheryl West, AARC Director of State Government Affairs, has been consulted on this matter and it is still under consideration. Changes of this type and many others are occurring across the country, making individual state Respiratory Care laws increasingly variable.

A process for tracking each state's proposed changes to its law could alert the committee so that they can offer advice as to what other states may have in place for similar circumstances. The members of the PACT and the HOD may be helpful in tracking proposed changes. When changes to a law are proposed, the AARC Director of State Government Affairs could be notified to provide advice as to what might be the best way to go, keeping with the ideal model. At this point, the PACT member from the individual state, along with the state's AARC Delegate(s), could work with the licensing board to achieve a change in the law that would be consistent with our model.

Our ultimate goal is to provide the same quality respiratory care by equally qualified Respiratory Therapists throughout the United States.

I realize that, from reading through my own state's licensure law, the above suggestions present a formidable task that would not come to fruition easily or quickly. However, if such a project could be accomplished, I believe it would be of great benefit to our respiratory patients across the country as well as to the members of the Respiratory Care Profession. [Top]

This committee has been in existence for approximately 9 months. The committee was developed after a presentation by Mr. Ken Thigpen outlining the findings of a survey he conducted. The survey addressed the issues of General AARC membership, State Patron memberships, potential AARC membership and the financial impact all three are having on the AARC. The results of the survey opened the eyes of many HOD members. The following was the major theme of all questions being asked (on the house floor and during various networking sessions); "So what are we going to do about the information from this survey?" Thus the ad hoc committee was formed and committee charges assigned.

Before this article continues one should consider the following definitions in the context of the chartered affiliates' relationship with each other as they form the foundation of the AARC.

partnership: "the state of being a partner; joint interests".

partner: "one who takes part in an activity with another or others; a player on the same side or team".

success: "a favorable outcome; the gaining of fame, wealth etc.; a successful person or thing".

One could come to the conclusion Webster defines Partnership for Success as "individuals or entities with joint interests coming together to achieve a favorable outcome".

A "Partnership for Success" is the beginning of a new vision for the Chartered Affiliates and the AARC. We all know one cannot succeed without the assistance of the other. We need to all step up to the plate and work for win/win opportunities. We must all come to a realization what is good for one may not be good for the other. We must do our best to reinforce the perception of each Chartered Affiliate as an individual brick upon which the AARC is built. Each brick relies on the other for support. The AARC relies on the Chartered Affiliates for guidance on regional, national and international issues. The AARC relies on the Chartered Affiliates for its strength and knowledge to represent the interests of the Respiratory Care Profession. The Chartered Affiliates rely on the AARC for guidance and advocacy on regulatory and legislative issues (local and national). The Chartered Affiliates rely on the AARC to support local efforts with educational programs, clinical practice guidelines, and speakers for affiliate events. The AARC is the common voice of all the Chartered Affiliates. The AARC is the mechanism in which we (all respiratory therapists) will be able to experience the favorable outcome, the gain of fame and wealth.

The ad hoc committee charged with addressing "Partnership for Success" continues to address the charges assigned. We have assembled a short list of cost-saving and value added strategies. We also have a list of cost cutting measures taken by the AARC administrative staff on a daily basis. The lists will allow us to reflect on what has been accomplished and implemented to stretch the resources of the AARC.

The next charge that we are addressing deals with identifying "affiliate best practices". It will be in our hands as the elected representatives of our Chartered Affiliates to identify "affiliate practices" which are for the good of all affiliates and the AARC. To complete this charge a significant amount of work and discussion will need to occur. An epiphany of sorts will need to occur. We will need to step outside of our box, experience things from a different point of view. We will need to have a better understanding of what competition means and what affect it is having on our future as a professional organization. We will need to gain insight on how patron membership is impacting the affiliates (those which offer them and those who don't) and the impact patron membership is having on AARC membership. We will need to look at how we (HOD members), as leaders, communicate to our Affiliate BOD, to our HOD officers, and to the AARC BOD.

It is all very simple when we take the definitions (as stated earlier in this article) and apply them to the AARC and the Chartered Affiliates. It becomes complicated when we take into consideration past experiences, past rules, past regulations, perceptions, feelings, and fears. The hope is to have input from every affiliate during the focus group session to develop the list of "Affiliate Best Practices". See you in Keystone. [Top]