Lake Joseph Meeting

CNIB Programs & Services Committee Meeting

Saturday, November 24, 2007, 3:30 pm CNIB Centre, Toronto

Present: Myra Rodrigues, Chair; Jane Beaumont, Clint Castle, Cheryl Crocker, Al Jameson, Meredith Ripley, Rob Sleath, Barry Styles

Regrets: Pietro Bozzo, Eric Hanna, Dianne McConnell, Omer Melanson

Guest: Gene Lechelt, Chair, National Research Committee

Staff: Geoff Fitzgibbon, Margaret McGrory, Jane Parsard, Jim Sanders, Dennis Tottenham, Sandra Millington (Recorder)

1. Welcome and Introductions Ms. Rodrigues welcomed Jane Beaumont as a new member of the Programs & Services Committee, followed by self-introductions.

2. Consumer Products & Assistive Technology (CPAT) Geoff Fitzgibbon, Director, Business Operations, welcomed the opportunity to meet with the Programs & Services Committee.

Assistive Technology – A plan has been endorsed by senior management to resell technological products across the country.

This model has been successfully operating in Alberta for over 20 years and will be rolled out in a few provinces starting in January. Two senior managers have been assigned to ensure the rollout is done properly. Vendors are on board and there is no conflict of interest.

Consumer Products - CNIB used to have a chain of stores across 46 service points where people could purchase products. Two years ago, Ontario Division changed to a mail order model. This past April the rest of the country transferred with exception of two stores in Saskatchewan and Alberta where government contracts require a physical presence/inventory. 2

Mr. Fitzgibbon outlined problems encountered since the launch that have adversely affected the level of service. These include:  The change to the mail-order model in April coincided with changes to the ACCPAC accounting application that runs all sales. This resulted in significant disruption to the ability of CPAT to keep adequate inventory in stock and caused an accumulation of back- orders.  Reorganization of CNIB that came into effect April 1.  The phone system in use is antiquated and cannot distribute calls and provide the usage statistics needed to manage processes properly.  The number of incomplete orders is linked directly to the availability of stock. Recently one of the main suppliers in China had a two-month stoppage in production.  It is difficult to filter the ACCPAC database to identify and contact customers who have a product on back-order.  The on-line ordering web-store is undergoing final user testing and all orders are being entered into the accounting system through a feature of the web-store.

The President & CEO has requested that Bill McKeown, Vice-President, Government Relations & Business Enterprise, review CPAT operations and report on his findings. Management is prepared to revisit some of the assumptions, including closing of the sales outlets.

Mr. Sleath noted that Wendy Gibbs, Vice-President, Development & Communications, had informed the Board that the new Public Service Announcements (PSAs) would focus on 1) Library audio books and 2) consumer products. He suggested delaying the launch of the PSAs until the problems are fixed. Mr. Sanders noted that Cossette Communications has already booked air time.

Ms. Rodrigues advised that VISA charges are backlogged to July. Mr. FitzGibbon reported that staff shortages and the high volume of incoming calls caused a backlog in processing credits for returned items. Additional staff have been hired to clear the backlog.

Mr. Jameson stated that fixing the model must be a priority and asked if it would be reasonable for the committee to expect resolution by mid- January. Mr. Tottenham advised that management is committing resources to resolve issues by the end of January. Mr. Fitzgibbon also offered assurances that problems will be worked out by then. 3

3. Library Ms. McGrory reported on the following initiatives:

Increase Number of Library Clients – On target to meet set objective with 16,300 clients registered for talking books service. There are 9,200 Daisy titles in the collection (6,900 English; 2,300 French). Prior to digitalization, there were about 24,000 analogue titles in the collection (English and French). To bring the digital collection up to pre-digitalization level would require an investment of about $2.8 million over two years.

Customer Satisfaction Improvements – The implementation of a new Voice-over-Internet Protocol (VoIP) system and two new positions have resulted in over 90 per cent of incoming calls to the Readers Services Call Centre being answered live. Three years ago, over 90 per cent of calls went to voice mail.

Due to the fact that many clients do not have answering machines, there is a perception that CNIB does not return voice mail messages. As well, people do not always leave their area codes which makes it difficult to return calls. Mr. Sanders reported that this was an issue identified by Bill McKeown in his CPAT review. One solution might be to find a way to easily involve the local offices to follow up on these calls after three unsuccessful attempts to reach a client.

A portal for those Sixty+ will be launched next week, containing relevant information for people in that age group.

Buy Rather than Build – The Library is purchasing titles from other English-speaking libraries for the blind and augmenting the French collection with purchases from France, Belgium, and Switzerland. Regular teleconferences with these partners take place.

Mr. Jameson asked if clients complain that the collection is too small. Ms. McGrory noted the collection is geared to popular reading and in no way matches that of a public library. Clients don’t complain, they just go away. Ms. McGrory added that the Library does not have resources to survey its clients on their satisfaction level. Ms. Parsard advised that the current Client Satisfaction Survey was developed by the Research Department in collaboration with Services & Operations and a similar process could be used for the Library. 4

Ms. Rodrigues inquired what percentage of the books are for children/youth. Action: Ms. McGory will provide this breakdown to Committee members.

Initiative for Equality Library Access (IELA) - On October 2, the Federal Government announced the release to Library and Archives Canada of the first funding for what is now called the IELA. The total amount is $3 million over three years. CNIB is participating in the consultative and planning process along with the other stakeholders and consumers to help shape the strategy for the Initiative, which covers three areas: 1) accessible portal 2) service model 3) publication clearing house.

4. Client Relationship Management System (CRMS) Ms. McGrory reported that Messrs. Sanders and Tottenham will meet with Lighthouse officials in New York on December 4 to sign the licensing agreement for the Electronic Vision Rehabilitation Record (EVRR). Lighthouse’s “statement of work” is due next week for review and sign-off and delivery of software is expected within the next two weeks.

A project charter outlining scope and deliverables and a GANTT chart have been developed. New positions related to the project have been posted externally and internally.

Due to the systems challenges related to finance, CPAT, and fund development, some deliverables are outstanding and the senior management team has decided that no major initiative can be undertaken until these are completed. The EVRR implementation is expected to take 18 months from start to finish. Mr. Jameson questioned when the project will actually start, noting that the National Board considered CRMS to be a priority. Mr. Tottenham noted a stable environment is necessary before taking on a project of this size and more information will be available at the next Programs & Services Committee meeting.

This portion of the meeting adjourned. 5

Sunday, November 25, 2008, 8:30 am Westin Prince Hotel, Toronto

1. Welcome and Introductions Ms. Rodrigues welcomed Lee-Anne Cross, currently Manager, Quality Service, Ontario Division, to the meeting. Ms. Cross will assume the position of Associate Director, Service Development, in December. At that time, the current Professional Practice Leader (PPL) positions in Ontario will transition to National.

2. Additions to Agenda Mr. Sleath requested the meeting discuss reselling of adaptive technology.

3. Minutes of June 19, 2007 Meeting

Motion: It was moved by Mr. Sleath, and seconded by Mr. Castle, THAT the Minutes of the June 19, 2007, meeting be accepted. Carried.

4. Programs & Services Six Month Report The report was pre-circulated.

Mr. Tottenham advised it is necessary to discuss what kind of information should be included in the report. Currently there is some duplication. For example, research activities are also covered by the Research Committee. Perhaps in future their report could be attached to the Programs & Services Report instead of summarized within. Government Relations and the Library are other areas where there is duplicate reporting. Thought also has to be given as to what kind of information the Committee would like to receive, what metrics should be used to evaluate programs and services, etc.

Mr. Jameson urged members when reflecting on what to report to the National Board to concentrate at most on four or five important items.

Mr. Tottenham provided the following additional information:  Service levels and new referrals are expected to reach target levels, with a 5% increase in direct service hours.  There are a variety of ways to contact CNIB to receive information, such as web page, various 1-800 numbers, etc. These are not 6

tracked in terms of service hours and we need to determine how to capture services provided by these options.  Fairly consistent service is provided in independent living, low vision, early intervention and library services, but we need to look at the services provided in the areas of deafblind, employment, counselling and technology. Employment in particular is largely dependent on government funding.

Services & Operations 2008/09 Operational Plan  Calls for increase in service staff by 30.  There are many government submissions under review and the current thinking is that they will be included in the operational plan but not included in the budget until funding is confirmed.

Continuous Quality Improvement (CQI) Programs  A national program staffed by Lee-Anne Cross and the Professional Practice Leaders will take effect in December.  Need to incorporate the best of what the divisions are currently doing in CQI. Benchmarks must be more consistent.

EVRR  Part of the rationale for EVRR is to increase service capacity by 30 per cent. Mr. Tottenham explained that staff spend considerable time on case coordination. With EVRR, a standardized assessment will be performed electronically leaving more time available for direct service.  Ms. Parsard advised at the start of the service transformation, 400 staff were providing an average of 440 hours of direct service. This was way too low and efficiencies have brought the average up to 600 hours. It is anticipated that EVRR will increase the hours to 700, and post-implementation to 1,100 hours.  Four hundred to five hundred staff will be involved coast to coast.  There will be some challenges but it is a wonderful opportunity to develop consistent standards, assessment tools, etc.

Outreach/Awareness  A priority is to raise CNIB’s profile in the medical community and a number of the research initiatives are geared in that direction.  Ms. Parsard noted that the new Vision Health Guide is in the hands of just about every optometrist and ophthalmologist nationwide. Drs. Gordon and Gold have facilitated 50 workshops across the country and will continue in 2008. 7

Action: Ms. Millington will circulate a schedule of forthcoming locations.  Mr. Jameson noted need to get the word on CNIB services out to the marketplace. He has informed Mr. Sanders of a PSA he saw on Australian TV that talked about Macular Degeneration and the importance of seeing an ophthalmologist on a regular basis. Action: Mr. Tottenham will follow up with the Research and Communications Departments on doing something on public awareness of ADM.  Ms. Crocker advised that Canadian Blindness Association (CBA) has done a brilliant job on outreach in Alberta and encouraged people to look at some of their activities. They are also working with the aboriginal population.  Mr. Tottenham reported that a number of studies point to the fact that once vision loss is confirmed, referral and treatment should happen right away. CNIB is doing a much better job of reaching people more quickly. The current registration and referral benchmark is two weeks or less if possible; however, if there is a urgent need for intervention, clients can jump the line.

5. Service Statistics Ms. Parsard reported  People are coming to CNIB at about the same rate as last year.  There is a three per cent increase in new clients but the actual number of people receiving service and number of hours being provided is down. This is due to staff being bogged down with backroom activities that take away from professional time.  Last year 30,000 clients were serviced, dropping to 24,510 this year. There is no concern at the moment but we need to pay close attention to the third quarter statistics and then consider our options.  Assessments are client-centred with clients identifying their goals.  There has been an influx of dollars in Ontario and Alberta toward early intervention services which is resulting in early referral of children. Staff are examining the 13% increase in children’s services division by division.  The working age group is down since there are not a lot of specialized programs for working age adults.  Employment services is a good model but there is no funding. It was put in the budget last year as an enhancement but not approved. BC has lost its provincial funding. 8

o Mr. Sleath noted that BC Division did receive a letter of intent but two advocacy groups opposed the government’s decision to give CNIB funding and it was decided to go through a tendering process. o Mr. Tottenham reported that Mr. Sanders has met with the new President of the Alliance for Equality for Blind Canadians (AEBC) in an effort to improve that relationship. o Ms. Crocker noted that employment services is a core service of CNIB and should be an important consideration for budget allocations and strategic direction.  Mr. Tottenham advised that the National Government Relations Department is working with the Directors of Services & Operations on how to position CNIB with the provincial governments. Divisional boards must be involved in this initiative. Action: Ms. Millington will circulate a document on positioning CNIB with provincial governments prepared by the Government Relations Department.  Mr. Sleath reported that an ophthalmologist associated with the Eye Van had advised him that we could do an amazing job of dealing with diabetes in the north by expanding the Eye Van program. This would involve leveraging the service we have and making it more comprehensive. Mr. Tottenham advised consideration is being given to researching patients with diabetesrhinopathy who visit the Eye Van.

6. Client Satisfaction Survey, Pilot Test Results Ms. Parsard noted that the Client Satisfaction Survey is a key performance indicator on services. The Service Development Department worked with the Research Department to develop a tool for a pilot project in Ontario in the north and southwest regions. Measuring tools used by Vision Australia, Royal National Institute for the Blind and Lighthouse were first reviewed.

Ms. Parsard then reviewed the findings of the pre-circulated report. Staff will continue to fine-tune the tool and by April 1, 2008, it is planned to have the survey available to all offices across the country to be used by specially trained volunteers. Mr. Tottenham advised it is necessary to ensure divisions have required resources in place to administer the program before proceeding with the April 1 roll-out date. He noted that it might be advisable to develop satisfaction surveys for the Library and CPAT 1-800 numbers as well.

Ms. Crocker observed that while the test question provides base line data, it is necessary to look at the next group and see if we have increased our responsiveness to consumers. We have to be clear on what we are trying to do and put it into context.

Ms. Ripley was intrigued as to why there was no appreciable difference between rural and urban clients, given that it is harder to get to rural people and provide service on the same level. Ms. Cross suggested their expectations might be lower and this influences satisfaction.

Central Toll-Free Number - Mr. Tottenham advised that a 1-800 contact centre is still being considered but we will not move to one number until we are sure we can manage it.

Action: The Committee will receive an update at the February meeting.

7. Client Complaint Process The revised process was pre-circulated.

Ms. Parsard noted that the original policy approved by the National Board in 1998 remains unchanged; however, processes have been updated to better reflect today’s environment, especially the increased number of options people have to voice their complaints, ie. phone, e-mails, in- person, etc. It is necessary to capture this information as it is the only way to track problems.

Mr. Tottenham’s advised that most provincial governments require that a complaint process be in place. People do not have to use it but it is there for those who want to. The current process is posted on the website and needs to be updated.

Ms. Beaumont asked if there are assurances that the time required to complete the complaint process is not affecting client service hours. She cautioned against imposing a burden on the front line staff, noting need to hold back bureaucracy and to determine at what point a complaint warrants documentation.

Mr. Tottenham reported that many other current procedures will need to be replaced and there are questions if changes in processes require Board approval. 10

Action: The Committee will receive an update at the February meeting.

8. Strategic Planning A document containing management input to the 2009-12 Strategic Plan was pre-circulated.

Mr. Tottenham advised that Board members, Divisional Board Chairs and the Executive Management Team will meet at Lake Jo in June to finalize the strategic plan for Board approval in September 2008.

In response to the question “Where do you see our ‘ideal future’ in five years?”, participants identified the following items:  Barrier-free access to available alternate formats  All core services, including employment, supported by CNIB and by governments  CNIB is the premier deliverer of services to people with vision loss  Minimize impact of vision loss (vision hope)  Prevention (vision health)  CNIB’s 100th anniversary is in 2018 – Need to think how we will celebrate this occasion and what has been accomplished  Improve communication to all stakeholders. Increased understanding and awareness will lead to other benefits.  CNIB is “top of mind” (marketing and communications). o Members were interested in knowing if CNIB comes up on Internet searches for information on vision loss.  Key Performance Indicators (KPIs) must be measurable  Need an annual national signature fundraising event, along the lines of the Terry Fox Run, Man in Motion, Run for the Cure, etc. o It was noted that “Myra’s Marathon” could perhaps serve as a model.

Ms. Crocker commented as follows:  CNIB is “vision health vision hope” and strategic directions should relate to one or the other of these. Any action that falls outside these two umbrellas should not be pursued, or pursued with the acknowledgement that we are going to do it anyways.  Key strategies are rather mundane and not very inspirational, ie. raise money.  Items should be prioritized. 11

 The strategic and operational items need to be separated with measurable indicators.  Key Performance Indicators must be quantifiable, such as hits on the website. If it can’t be measured, it can’t be managed.

Ms. Beaumont was disappointed that this strategic plan appeared to have the same problems as the current one does. She noted it is basically a shopping list that needs to be cleaned up quickly before it is widely publicized. Mr. Tottenham advised that the document had already been circulated to Divisional Chairs for information purposes.

Mr. Tottenham noted there is no expert on staff dedicated to strategic planning. People with expertise are needed to develop a framework.

Participants agreed the big picture has to come from the National Board, with the divisional boards focusing on enabling strategies.

Action:  Mr. Tottenham will advise Mr. Sanders and Ms. Gunter of the Committee’s concerns.  Ms. Crocker, Rodrigues and Mr. Styles will teleconference with Ms. Gunter and Mr. Tottenham on the need to develop a strategic framework.  The plan will be discussed further at the February meeting.

9. Guide Dog Fund Ms. Parsard reported that over the years CNIB has received funds in varying amounts designated for guide dogs, which now total approximately $300,000. For the past five years, we have been operating a Guide Dog Assistance Fund to cover the cost of extraordinary veterinary expenses for working guide dogs that are not covered by the dog’s training school or under a pet insurance policy. Relevant information and pamphlet are posted on the website.

In 2005/06, there were 83 requests for assistance totalling $30,500 (upper limit $1,000); in 2006/07, there were 95 requests totalling $39,000 (upper limit $1,000 to January and then $500); from April to September 2007, there have been 39 requests totalling $10,600 (upper limit $500).

Management has been examining the expansion of the Guide Dog Fund to cover grants to schools that train guide dogs. Ms. Gibbs and Parsard and Messrs. Lillico, Sanders and Tottenham are managing the process. Ms. 12

Parsard has met with the Executive Director of BC Guide Dogs who offered to review the draft guidelines for a grant program to Canadian based schools. She plans to contact the Guide Dog Users Association to determine how many guide dog users there are in Canada.

Mr. Tottenham noted that this agenda item is intended to inform PSC members of the new initiative. From a CNIB perspective, it is a good thing to be able to use these funds for this purpose. The downside is the perception that CNIB will be seen as competing with guide dog schools for funds and for publicity. This initiative needs to be positioned so that it does not upset the guide dog schools.

Committee members noted that donors are being asked not to designate funds.

Mr. Sleath was not in favour of this proposal. He reviewed the history of the Mellish bequest which formed the basis for the Guide Dog fund, voicing several concerns. He believes the fund is a conflict of interest and should be liquidated. He further advised that contractually guide dog owners are not allowed to use their dogs to raise funds for another organization.

Action  Mr. Sleath will provide Ms. Parsard with a copy of the contract.  Ms. Gibbs will be advised accordingly.

Ms. Beaumont noted that sensitivities are high and she hoped CNIB would proceed carefully and listen to advice. Other members concurred.

Ms. Crocker suggested referring back to the strategic plan to determine if the project fits into the vision and strategic directions.

Mr. Tottenham reiterated that the item was raised at this meeting for information purposes; however, management will take Mr. Sleath’s comments into account.

It was suggested that given the high cost of veterinary care, consideration should be given to increasing the current maximum amount to $3,000 or $4,000.

10. CNIB as Reseller of Assistive Technology Mr. Sleath referred to Mr. Fitzgibbon’s report at yesterday’s meeting re CNIB entering the field of adaptive technology as a reseller. Mr. Sleath is 13 concerned that a supplier Agora leases space at the Vancouver Service Centre and staff often recommend adaptive technology that Agora sells. He can’t see them being happy if all of a sudden CNIB is a reseller of technology.

Mr. Tottenham explained that Mr. Fitzgibbon is responsible for a new functional area called “Business Enterprise” with the goal of raising funds and adaptive technology is one area under consideration. CNIB currently demonstrates equipment, performs assessments and in some cases provides training, while the company just sells the product. The model Mr. Fitzgibbon is suggesting has been operational in Alberta for the past 20 years. It will not be implemented in Ontario as the provincial government will only sell equipment through the Assistive Devices Program (ADP).

Service would be part of the agreement with the vendors. It is no different than expanding the CPAT product line. People will have a choice of going to CPAT or directly to the manufacturers. We should be giving all vendors the opportunity to be our partner. Ms. Beaumont suggested that the bigger issue is that entrepreneurs will see CNIB as unfair competition.

The Service & Operations team recommends that the model be implemented in a cautious, staged manner. With regard to Agora, the lease is coming up for renewal and they need to decide if they are getting value for the rent they are paying. It is their business decision.

Action:  Mr. Tottenham will bring the Committee’s comments to Mr. Fitzgibbon’s attention.  To be discussed further at the February meeting.

11. Closing Remarks Ms. Rodrigues thanked Committee members for their frank input to proceedings. She officially extended thanks to Dianne McConnell for her contribution while serving on the Committee and presented a gift of appreciation.

12. Date of Next Meeting Teleconference is scheduled on Tuesday, February 5, 2008, from 1 to 3 pm ET.

13. Adjournment