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MINUTES - STATE OF NEVADA BOARD

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					            STATE OF NEVADA BOARD OF OCCUPATIONAL THERAPY

                             MINUTES OF PUBLIC MEETING

                                       January 20, 2007
                                      Las Vegas, Nevada

Members Present:      Penelope (Penny) Fairbanks, Ronda L. Moore, Kathryn Staley, Elizabeth
                      (Liz) Straughan, David Tanabe
Members Absent:       None
Staff Present:        Loretta L. Ponton, Executive Director, Henna Rasul, Deputy Attorney
                      General
Public Present:       Betsy Aiello, Ryan Arnold, Pegi Feyge


The meeting was called to order at 11:05 a.m. by Loretta Ponton, Executive Director. Loretta
welcomed the new Board members and thanked the out-going members in attendance. A
quorum was confirmed.

Approval of the Agenda – Liz made a motion, seconded by Penny to approve the agenda as
presented. The motion passed.

New Board Member Orientation – Loretta explained this is a joint meeting of the out-going
members and new members. At the conclusion of the orientation the Board will be electing new
officers and the meeting would be turned over to the new Chair. Loretta introduced herself as
the new Executive Director. Loretta explained she is under contract with the Board as the part-
time Executive Director, the contract began September 1st and this is the second Board meeting
since she began. The Board office is in Loretta’s home, the position is a home-based position.
All original documents are retained on site, six file cabinets full; the Board owns a computer
system, telephone system and copier/fax. The old records are in records storage at Puliz Records
Management and Storage, explaining one of the first tasks was to organize records and come into
compliance with records retention requirements. Ronda asked if there is back-up of the
computer system off-site. Loretta answered not currently and explained the computer had very
little records on it, she is in the process of building the databases, current information was
available but no historical records were saved. Current licensees’ data are on the verification
lists on the website which are updated every Friday. Of more concern would be the original
licensee files which will be addressed at another time, with recommendations and options. Liz
stated that at one time the Board had requested that back-up be provided to the Attorney
General’s office. Loretta stated to her knowledge that had not been done. Betsy explained that
over the past few years there was a lot of discovery of things that had not been done. The
transition has made even more discovery of various things. Loretta continued that the Board
does have separate phone and FAX lines, and most of the calls are answered personally as she is
working in the Board office about 6 hours a day. Loretta was commended on the
professionalism of the Board packet.

Betsy stated she and Loretta worked together to put together a historical perspective on the
Board for the past six years. Betsy explained the Board members came on as a total turnover and
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because of that fact, term limits now are not staggered. It took quite awhile to figure out what
was happening. The Board discovered over the last couple of years, there really wasn’t a
business operational function within the Board office. The Board was not operating under the
State Administrative Manual which is the state rules, policies and procedures on how the Board
should be operated. Time was spent on updating things one at a time. The Board has come from
a socially centered Board with wonderful customer service but not a lot of oversight to a Board
that needs to have accountability. Some issues came up a few years ago where it really became
evident that this was a problem. The Board initially began working on the financial things,
updating to the state guidelines for travel and accountability, the Board looked at how the
financials were being reported and recorded, the Board got a bookkeeper for double checking
and oversight; the bookkeeper also reformatted the financials in a more business format. Checks
are signed after they have been made out with backup to support the expenses with copies
provided to the bookkeeper. The Board also started looking at contracts and where things were
purchased, and began asking questions. We worked with our state purchasing contact, who
reviewed all our contracts and vendor purchases and provided information on the correct
procedures for contracts, request for proposals, and how to purchase in accordance with state
procedures. A contract tracking system was established so we know when we have to put out a
request for proposal and to meet state contract deadlines.

Betsy stated the Board was under the impression there was a policies and procedures manual,
some policies had been brought to the Board for approval. When the Board transition was
occurring, it was determined there was no written procedures manual. One of Loretta’s first
assignments is to develop those procedures.

The Executive Director’s work performance standards were very minimal and not outlined in the
state format. The Board obtained an example from the Social Worker’s Board and those have
been updated, we needed something for the request for proposal for the Board Executive
Director. The Board worked as a group to develop the request for proposal and worked with
state purchasing to go through the proper process to procure the Executive Director. A request
for proposal has to be issued at a minimum every four years.

Betsy continued, to get a contract written, on the Board of Examiners agenda, and approved by
this Board, the Board will need to move pretty quickly. One thing that needs to be followed up
on is the annual assessment for the Executive Director. The current contract is only a one year
contract, so if you want to do a sole-source renewal you will have to vote on it by the July
meeting to get it to the Board of Examiners in time. Betsy suggested the Board may want to
have someone from state purchasing come to provide an orientation on contracting or maybe
Loretta can do that.

Ronda asked for clarification if Loretta has only a one-year contract. Betsy explained that the
Board made that decision when they did the request for proposal because they didn’t know how
well it would work out. Loretta’s on her second meeting, there has been no assessment of her
but what you see is evident, it will be up to this Board what they want to do. Pegi added that
they also wanted to give the new Board the decision making power. Betsy stated there is a one-
year contract that started September 1st and ends at the end of August. The contract may need to
be voted on in April or set a special June meeting, in the past the Board had to have several
special meetings to get the contracting done.
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Betsy continued, another thing the Board did is attend the National Board for Certification in
Occupational Therapy conference. They give a lot of information on Boards. This year they
actually focused on Boards working as a business. A lot of Boards are realizing they are like a
business and have established quality indicators. When we came back, we added to our meeting
about the same time Loretta started, information on what types of calls the Board receives. From
that, it was discovered that a large amount of the calls coming in were for license verification,
that information is available on our website, except the temporary and provisional licensees, so
Loretta added a referral message to the answering machine directing them to the website. The
Board hasn’t officially adopted any indicators; you may want to look at actual business practice
indicators to be adopted such as phone call complaints, licensure tracking time. Another thing,
when you do have a license action, it has been reported to NBCOT but there is a requirement to
report to the National Practitioner Data Bank also. This Board has not done that, the federal law
has been in place 16 years. The policies and procedures will help with that, when there is a
sanction you do ABC.

Betsy stated the Board may want to look at an addendum to the contract, there is a lot of research
that when the Board put out the request for proposal determining the amount of hours the
Executive Director would need to work, there was not an awareness of the amount of research
that would be required. This could be a one-time thing, that once you have a strong policies and
procedures manual that meets the code of federal regs and the Nevada revised statutes, you will
have to update them but you won’t have the amount of research that is necessary at the
beginning. The Board may want to look at the actual hours vs. what was in the request for
proposal and the pricing. I know from my work with Loretta that she is putting in quite a bit
more time, I have asked her to do things and the transition has made us a lot more aware of what
needs to be done.

Another recommendation is continually shifting to more electronic systems. Shifting to renewal
through the web on-line, paying on line. The past Executive Director didn’t feel that is where
the Board needed to go. I think the Board needs to address these things. Loretta has already
done some research around that. If routine processing things can be done electronic, then other
work can be done in other realms. That would be a recommendation.

Another recommendation is what you have already talked about, the fact that it’s a home-based
office, there really isn’t foot traffic, but the back-up issues need to be worked on. How is the
office going to be accessed if something happens? I don’t feel it needs to be put out in a business
office, if the back-up and access issues are worked out.

Other concerns, this Board has had the AG’s office as our investigator in our hearings and
complaint process. The Board has recommended that be reviewed. Having the AG’s office as
our investigator and not having either an outside OT investigate or having the Board investigate,
the Board is asked to make decisions with no knowledge. One issue to consider is if one of the
Board members is the investigator, you have five members and you have to have three to vote.
Other boards have hired investigators, or you may want to hire an ex-OT but they would
probably have to be trained in investigations. Loretta has been tasked to look at how other states
have done this. One of the outcomes of using the AG’s office is that the Board has not wanted to
take action so you may have an OT out there with a complaint hanging over his head that may or
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may not be valid. The complaint process needs to be looked at. Historically there have been
very few complaints, however, over the last two or three years as the state has grown, the
complaints have increased. Only one has come to hearing.

Ronda stated that there are other possibilities that could be considered, that a professional
occupational therapist could work with the AGs office and provide insight on the standards of
practice. Ryan stated that is direction they were going when we thought that a Board member
could sit in on the investigation and then come back and say whether the Board should proceed
or not to. The Board was asked to take recommendations without enough information to rule on.
Ronda stated that makes sense, you may want to loose a board member and have the report put in
language you can relate to. The AGs office is on the legal side and they could explain the other
side. Betsy added that the Board will still have to make recommendations when they don’t know
the facts. Ronda stated people shouldn’t be afraid of that; you will have enough information to
decide what to do. You will have the minimum, no matter what.

Betsy continued that over the last three years the Open Meeting Law was really tightened and
that has made a difference on how the Board has worked historically. In the past the Board has
had sub-committees and workgroups to come back and make recommendations. You can’t
casually talk to Board members under the new law and instructions. The AG’s office can advise
you of what you can and can’t do, when you are in question.

A legislative session is just starting. Historically the AG’s office has let us know when there is
legislation around things like the open meeting law that affect the Board. Last session, Betsy
stated, she got called regarding a scope of practice massage therapy bill going through that would
affect the OT scope of practice. She found out the day before it was heard, contacted the AG’s
office to ask if she could submit testimony as the Board Chair. There is not really anyone to
track legislation. Betsy stated she gave a copy of her testimony to Loretta so, if in the future, you
need to write testimony you will have an example. The AGs office tracks testimony related to
Boards in general.

Betsy continued with an explanation of what had happened with continuing education. The
Board saw its mission as protecting the public, not specifically the OTs or OT practice. In the
past the Board had sponsored continuing education seminars, and when the Board came on they
continued with one or two of them. What they found was that unless you kept it really general,
not enough OTs could go to them. The Board started questioning stress management, laughter is
the best medicine. If you offer that year after year, and the OTs aren’t taking by themselves
occupational specific classes, are we really protecting the public? The Board decided to let the
OTs take the responsibility of determining the appropriate continuing education. Liz mentioned
to Loretta the possibility of reimbursing for continuing ed or up to a certain amount to each OT.
These things could be an administrative nightmare in tracking and accounting, you would have
to track the amount of money going out, and you would have to determine whether it was a valid
course for reimbursement. Ronda asked if the Board was considering paying OTs for their
continuing education. Betsy explained that these were only potential options. Liz added that in
rural areas there are not as many continuing education opportunities or options. Ronda asked if
they were talking about travel that the Board would pay so they could go to. Liz answered no,
that was not the intent, maybe a registration fee or voucher. Betsy continued saying they should
consider any legal issues that may arise, are there going to be issues with who you decide to pay,
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what is the intent of the Board. Betsy added that since the Board has money, they may want to
cut the licensing fees as another option, instead of reimbursing for continuing education.

Ryan stated that Betsy did a pretty good summary of what the Board had been through. Ryan
added that the continuing education issue was a big challenge for them. The Board wanted to
give back to our licensees, but came up with the ethical issue of giving them an easy out, you
really want them to go out and find the education that will help them.

Ronda stated the Board has done incredible work. They should be very proud.

Ryan added the other most traumatic thing this Board went through, we are leaving the new
Board in the best hands possible, we really loved our previous Executive Director but a number
of things happened that opened our eyes and the Board needed to make a transition. There’s no
way we would leave the Board in that type of shape. There is really no reason to know a lot of
this stuff, until little things popped up and then a big thing popped up. The Board decided we
had to take some action. It really tried the Board. Betsy added that Loretta checked with the
Governor’s office and found out that since we all started 3 months late; they said we could sit for
another term. Most of us got emotional, because it was very traumatic, we were very very fond
and the Board had wonderful customer service and out in the community there was a lot that
wasn’t known, and it was very tough. We felt it was time for new and energetic people, to be
fair to the Board and the OTs in the state; we needed to leave and pass the torch.

Ronda said that time will pass, and they would be eligible for re-appointment before long. Betsy
stated Liz is proof of that; this is her second tenure on the Board.

Loretta stated the new member appointments are for three years, not two as originally noticed.
The members should have received corrected appointment letters from the Governor’s Office.

Betsy asked if the members would like to introduce themselves. Loretta agreed and asked the
Board to introduce themselves and give their background and what there strengths are coming to
the Board.

Betsy began stated she has been an OT for 27 years, licensed as an OT, six years ago moved out
of the hospitals, four years of which she was doing non-traditional OT services in the waiver
program setting up assessments to keep people out of living in institutions and getting home
community based services such. The last year Betsy has been an insurance company director for
the state children’s health insurance, Nevada Check-up Program, now basically an administrator.

Henna Rasul introduced herself as the deputy attorney general (DAG), she has been with the
attorney generals office almost six years and assigned to the Board a little over a year. Ronda
added that the DAG, in addition to the ED, is one of the best assets for the Board. Betsy added
that Henna had helped the Board understand what was needed.

David Tanabe has been an occupational therapist for 14 years and has been at University
Medical Center in Las Vegas for the last 9 years; a senior therapist for the last 4 years with his
passion being burn care. He has been working toward getting the UMC burn care unit accredited
on track for 2008, getting staff trained.
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Ronda Moore is an attorney and has worked with Henna in the AG’s office and has worked with
several Boards and commissions, professional licensing boards, then moved into natural resource
agencies. From there went to the Secretary of State’s office doing elections. Now Ronda is
working with the Truckee Meadows Flood Project as a consultant. Ronda stated she is pleased
to be here and willing to learn about occupational therapy, she knows a lot of things about how
licensing boards work.

Liz Straughan began practice at Washoe Med with Betsy and Pegi, working in northern Nevada
and Carson City before relocating to Las Vegas in 2000. Liz works for the Clark County School
District and has served previously on the Board in its early years.

Pegi Fegye graduated from San Jose State in 1974 and moved to Reno in 1979 and has practiced
occupational therapy since. Pegi stated she is leaving the Board.

Penny Fairbanks stated she moved from Wisconsin to Nevada 16 years ago. She has been the
Nevada state representative to AOTA; she has been active in NOTA and is now new to the
Board. Penny has been working at Saint Mary’s in Reno, recently retired and is now a per diem
staff member.

Kathryn Staley stated she is a COTA, graduated from the COTA program in Las Vegas in 2000.
She was appointed to the Board in January 2006.

Ryan Arnold is a government affairs consultant in Las Vegas and was the public member on the
Board for the last six years. Ryan stated it has been an honor to have been on the Board.

Loretta Ponton stated she was recently hired as the Executive Director, beginning September 1 st.
She is recently retired after almost 20 years in workforce development, working for the
Nevadaworks Board. She worked 17 years as the Director of Operations at Nevadaworks, and is
pleased to be working for and enjoying her work with the Board. Loretta stated she is now self-
employed, working as Lorylynn Ltd., starting as a tax preparation service in the early 1980’s and
moving over the years through full financial services into administration.

Loretta asked the Board if they had any questions on the materials provided by the AG’s office,
the Open Meeting Law Manual, the Boards and Commissions Manual and the law and
regulations, stating she would be happy to answer any questions they may have on the
documents. It was stated the regulations could be obtained from the website and the NRS is
available on the State’s website.

Loretta continued, the Board is a regulatory board to regulate the practice of OT, to protect the
public, which should always be kept in mind. Sometimes when we look at all the paperwork, it’s
easy to think, how does this affect me as an OT. Having not been an OT, Loretta stated she may
interpret things differently than what the Board may. Loretta stated, as Betsy alluded, there
really was not much direction when she took the position; she really had to do the job to see what
was necessary before she began development of the policies. Loretta stated she is always open
to contact by the Board, and is a resource for the members.

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In the development of the Board packet, she stated she addressed each agenda item separately.
She expects each Board meeting will have new policies and will ask for direction on which areas
need to be addressed next. Loretta continued that she is also working on operating procedures,
different than policies, procedures tell how you actually conduct an activity, how do you issue a
license. Some of the decision the Board will make will affect those procedures, such as if we are
going to move to electronic renewal of license applications.

Liz asked a question regarding the Open Meeting Law in relation to projects, where there may be
only two members, and whether they had to have more Board meetings with fewer Board
members present in order to accomplish a specific project. How does the Board do small
projects?

Loretta answered, when there are small workgroups, technically two members are not a quorum,
however, if you discuss something and then call a third member that may create a potential of a
violation. Loretta’s recommendation would be to assign a member of the board to certain
activities such as the newsletter or regulation or policy development and work directly with the
Executive Director, one on one, so that person can provide the input on the specific function or
activity during the development stage and answer questions when there is a meeting. If the
Board can identify areas they want to target, then the Board can assign a point of contact member
for each area. That member will be the contact for the Executive Director. That will facilitate
moving things along, and everyone can participate in a project. For example, Pegi did a fantastic
job as editor of the newsletter, that was a project.

Loretta asked if there were any other questions. She continued with the next agenda item.

Election of Chair – Loretta asked for volunteers or nominations for Board Chair. Kathryn
nominated Liz; Liz asked Kathryn if she would volunteer for chair. Kathryn indicated she would
accept a nomination for vice-chair, not chair. Penny made a motion to appoint Liz Straughan as
Chair of the Board of Occupational Therapy; Ronda seconded the motion. The motion passed
unanimously.

The meeting was turned over to Liz as the new Chair of the Board.

Election of Vice-Chair – Liz opened the discussion and nominations for Vice-Chair. Penny
made the motion, seconded by Ronda to appoint Kathryn Staley as Vice-Chair of the Board of
Occupational Therapy. The motion passed unanimously.

Approval of the Minutes – Liz asked for any corrections, revisions or comments on the minutes
of the meetings of July 15, 2006, July 29, 2006 and October 21, 2006.

Betsy indicated on the minutes of July 15, 2006, a clerical correction to 2.1 to remove the
repeated words “made a”; in the minutes of October 21, page 4 of 12 under Executive Director’s
Report, change the word “transactions” to “transition”. Betsy informed the members the minutes
of July 15 were hard to understand as they were transcribed by an individual who was not
present at the meeting. Ryan agreed and stated that the essence of the meeting was correct.



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Pegi added a correction was also necessary on page 5 of 12 of the minutes of October 21st; add
the missing word “take” to paragraph three, third line to read “the board is not asked to take
action”; and page 9 of 12, mid-paragraph change “review” to “reviewed”.

Kathryn made the motion to approve the minutes of the July 15, July 29 and October 21, 2006
meetings as amended. Ronda seconded the motion; the motion passed unanimously.

Presentation of Service Awards – Liz complimented the out-going board members stating it’s
amazing what has been accomplished and was grateful for their knowledge and addressing the
challenges as they moved forward. Loretta presented the awards, and expressed regret that
Tonda Finley could not be there to receive her award. Loretta thanked the out-going board for
their help. Kathryn thanked the members for helping her when she came on the Board, stating
they made it easy for her. Ryan stated he is glad Kathryn is staying on to continue their legacy.

Betsy stated they all would be available if they have questions. Liz thanked the members and
said that would be very helpful going forward.

The meeting was adjourned for lunch at 12:10 p.m.
The meeting was reconvened at 12:40 p.m.

Executive Director’s Report – Liz called on Loretta to present the Executive Director’s Report.

Loretta indicated the written report is in the Board packet. Loretta stated in follow-up to prior
board meeting items, telephone contacts average 6-10 per day; approximately 25-30 hours per
week is the time spent on Board activities, sometimes more.

Loretta reported an attempt was made to obtain enough information to perform a reconciliation
of records; Henna provided copies of the documents the AG’s office had; which was compared
to the Board records and the audit reports for 2003 and 2004. There was not enough detail
available to perform a full reconciliation of the records.

At the last meeting the Board discussed the cash reserves; the Board has over $500,000. Loretta
did research on cash reserves, and stated she would not be making any recommendations on
changes to cash reserves. Until the Board decides on changes that may need to be made on how
the Board operates, which may be increasing expenses, or whether to reduce fees, no action
should be taken at this time until the Board knows what direction it may want to go in the next
year. The Board may be able to consolidate funding, under another agenda item, Nevada
Collateral Pool, which will make it a lot easier to manage.

Liz asked in terms of Loretta’s work hours and the contract, is there a provision for working full-
time, would there be reimbursement for that. Loretta answered the contract is a fixed fee at
$2,500 per month, which was identified in the proposal process to cover 74 hours per month. In
reality, the work load is more 110 to 120 hours, maybe a little more, per month depending on
what type of interaction and activities are needed. Betsy added that they had gotten a time
estimate from the previous Executive Director, that’s probably what time was being spent then,
but with the transition, there was discovery that the job definitely takes more time. Some of it
may be a one-time thing, like the policies and procedures manual, it takes a lot of research and
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lot of hours. The result is the hours being spent are quite a bit more than what was estimated.
The group may want to look at an addendum to the contract, especially with continuing
education validation hours that will need to be addressed and how that’s being done. Betsy
continued, we asked her to keep track of the time she’s putting in, so we could have an idea.
There are activities that were not expected when we drafted the contract, she is doing more than
what was envisioned. Loretta added that the previous Executive Director also had a contracted
administrative assistant to help with some of the clerical functions, such as the filing, at $15 per
hour for a total of about $4,500 per year. Betsy stated the current contract could have an
amendment and that would go to the Board of Examiners.

Ronda suggested the Board consider having Loretta conduct a survey of other Boards who have
equivalent licensees, number of licensees, a salary survey and assessment of full-time. Other
Executive Director’s have an ability to hire temporary staff if they need it and to hire assistants.
That should be looked at and bring it back to make recommendations. Loretta added one of the
things to keep in mind is that the position is an independent contractor and not a salaried
employee. Betsy stated that maybe they should look at this like a start-up business, when you go
into an on-going office there is established policies and procedures, this is more like a start-up
expense. Loretta stated she will do the survey and bring it back to the next board meeting. Liz
asked that Loretta document her hours so the Board could look at what is being done and fair
reimbursement. Ryan stated that maybe Loretta should be asked to come back with a proposal
which would help her and makes sense based on the rules and regulations.

Ronda stated, there is no need to reinvent the wheel, but we are not in the business of saying we
got a great deal, we are going to work you to death, that’s not what it’s about. Betsy restated that
the proposal was based on their best knowledge at that time. Ronda agreed, stating, however,
that if Loretta is working beyond the scope of the contract because the contract did not provide
for the number of hours actually needed to do the job, then the Board needs to do something
about it so she is fairly compensated.

Loretta continued with the financial reports, providing details on what has been going on at the
Board. Betsy directed attention to the detail on the last page showing actual checks paid with the
memo column so the Board would know exactly what was being paid. Ronda asked for
clarification on how the payments are made. Loretta explained that checks require two
signatures, previously both Board members, Loretta was added as one authorized signatory to the
account and every check is then also signed by a Board member. Loretta prepares and writes all
the checks, deposits all fees at the bank, prepares all the back-up documentation and provides
copies of everything to the bookkeeper. Loretta stated she will be working with the bookkeeper
this next month to reclassify some small revenue and expense items, the numbers are correct in
the financials, some minor changes in line item classifications are needed. The bookkeeper
provides the Board a Quickbooks file which can be reviewed by line item.

Loretta stated the financial are status reports of where the Board finances are at that period of
time. The year end audit is the official record for the year.

Loretta continued with the Newsletter status. The newsletter master had to be completely redone
due to the changes in the Board contacts, which was the reason for the delay in mailing. There
have been about 6 returned due to wrong addresses and another 6 licensees have updated their
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addresses as a result of the newsletter. Newsletters are usually issued quarterly. Loretta
recommended the next newsletter introduce the new Board members, with a paragraph on each
and the article would be on new Board policies if approved. Pegi added that anybody can submit
articles for the newsletter. Loretta also stated that she had been contacted by an individual who
was interested in advertising in the newsletter, if the Board was interested. Ronda stated that
maybe with the Board’s professionalism thrust, a mailing to interested parties asking what they
would like to see in the newsletter, or inviting articles might want to be considered. Liz asked if
a member would like to volunteer to work with Loretta for the newsletter. Loretta explained the
role would involve contributing to ideas for the newsletter, reviewing drafts and editing. The
newsletters are mailed to all licensees, 618 currently. There are no written guidelines for the
newsletter; the space is limited to the current format. Betsy stated they shouldn’t compete with
NOTA or AOTA; they should have more of a regulatory emphasis. Loretta stated it is a great
venue for getting out “what we can do for you”. Liz asked if the newsletter could be sent out
electronically or added to the website. Loretta explained the website does have a newsletter link;
however, the current newsletter could not be uploaded due to a corrupt file. Liz asked if the
Board should continue the mail-outs or go electronic only. Betsy responded that not everyone is
competent on computers, nor do they check the website regularly. She would recommend they
continue the mail outs of the newsletter. Loretta added that it is a goal to move to electronic
means, in fact the “FAQ” link on the website has been updated just yesterday in response to
repeat questions from the public. A question was asked if it is sent to hospitals or others, Loretta
answered only if they request to be added to the mailing list. Discussion was heard regarding
who at the hospitals would be the appropriate addressee; also if the rural areas, Ely or Elko, were
being covered. Loretta stated they are mailed to all licensees statewide and out of state. Kathryn
stated that in Winnemucca she has never seen one show up. Ryan suggested that might be a
good article for the newsletter to reach out to see what the interest would be. Loretta stated on
the next newsletter she will target some of the employers, and during the renewal process, will
start developing a database of employers based on the renewal license employer information.

Penny volunteered to be the contact for the newsletter.

Liz asked if they had to vote on this, she was informed that work assignments don’t need to be
voted on. Ronda suggested that maybe Henna could provide at the next meeting an overview of
the differences between “actions” that the Board needs to vote on and have to be noticed on the
agenda, and “actions” that are administrative in nature that don’t have the same requirements. In
general, Ronda explained, if the action affects the rights or responsibilities of licensees or the
public health, safety and welfare, it will have to be voted on and noticed in the agenda. But if it
deals with office procedures, guidance to staff or assignments to Board members, the Board
chairman likely has authority to give that direction. Regardless, she said, it would be very
helpful to get Henna’s advice and counsel on the issue.

Loretta continued with licensure statistics, stating it is normal to receive 4-6 applications per
week. She stated it will be interesting to see how many licensees renew at the end of the year;
with an additional 100 licensees added during the year, the numbers could really grow if
everybody renews.




                                          Page 10 of 17
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The Board letterhead was included in the packet. Members were asked to review and make any
changes they wish. Penny asked that she be listed as “Penny” instead of Penelope. Ronda asked
to add her middle initial “L.”, Kathryn, David and Liz had no changes.

It was suggested the new board address be highlighted in the next Newsletter.

Loretta continued to the next item, license format, explaining that the licenses expire every year,
and have to be reissued to every licensee. Loretta recommended the Board change the license
format - the effective date of the license would be the original licensure date; the expiration date
would be replaced by a stamp or card with the expiration year which would be reissued upon
renewal. Loretta explained that those licensees who are currently licensed, the original licensure
date is available in the database. Expired licensee information is not in the database. There is a
hand-written listing of all licenses issued by license number and name only. There are no dates
of issuance listed; the hard copy files would be the only resource for obtaining that information.

It was suggested that the pocket card that is issued could be duplicated with the expiration date
and placed with the license. Another suggestion is a peel off sticker to place on the license. Liz
stated that the license format should look professional; it should be done on high quality paper.

Loretta continued explaining the temporary and provisional licenses are half-sheet in size and
there is no differentiation between the two in the format. Loretta suggested making the two
different, maybe in color, and they would continue with an expiration date as they are short term,
six month periods.

Loretta stated she will move forward with the development of new license formats and bring
recommendations back to the next meeting.

Board Banking – Liz asked Loretta to present.

       State of Nevada Collateral Pool – Loretta explained she was requested by the Board to
find out what options were available for consolidation of the Board bank accounts. After
conducting extensive research, Loretta found that the Treasurer’s Office has a program, the
Nevada Collateral Pool which was the result of legislation passed in the 2003 20th Special
Session. What this does is allow financial institution to pool collateral to cover public funds
invested in their institutions. This in affect eliminated the necessity for small Boards and
Commission to maintain separate bank accounts under FDIC insurance when the totals reached
$100,000. Currently, four of the Board’s accounts are already covered through the Nevada
Collateral Pool; Bank of the West is not a member of the Nevada Collateral Pool.

The Board has the opportunity to transfer all funds into one financial institution, Loretta
recommended Wells Fargo Bank as they have the checking account and a savings account. The
Board is not limited to what they can do with the funds; they can put the funds into CD’s, money
market or savings accounts.

Loretta explained that to join the collateral pool, the banks agree to provide collateral of 103% of
public funds invested with those agencies. The Board is required to provide bank account
numbers, but not bank balances. The banks roll all the public funds together, document the
                                          Page 11 of 17
Approved 3-3-07
collateral and report in total to the State Treasurer’s office daily. Betsy asked if this would alert
the state to the amount of money the Board has in its accounts. Loretta explained the bank
reports one number, in total for all public funds, to the state.

Ronda asked if Loretta worked with the Treasurer’s office and the state Budget division to
determine what they could do with the funding. Loretta answered yes, she works with both.

Loretta was asked if this was an action item. Loretta responded that yes, it was an action item.
Although the funding is already being reported by the banks, the action item would be
authorization to consolidate all the funding into one institution under the auspices of the Nevada
Collateral Pool.

Loretta was asked why Wells Fargo is being recommended as the Board’s primary bank. Loretta
stated they are responsive, they currently have the checking account and a savings account, they
have provided exceptional service, they have been recommended by our website support firm for
merchant services, which will be discussed later on the agenda.

Liz asked for a motion. Kathryn made the motion, seconded by David to consolidate all Board
funding at Wells Fargo Bank, a member of the Nevada Collateral Pool Program. The motion
passed unanimously.

Ronda made a motion to direct the Executive Director to close the accounts at Bank of America,
Bank of the West, Nevada State Bank and US Bank with all funds to be transferred to Wells
Fargo Bank. The motion was seconded by Penny, motion passed unanimously.

Bank Account Signatories – Loretta asked the Board to designate new signatories for the Board
bank accounts. The current signatories are Loretta, Kathryn and both Betsy and Pegi who are
both leaving the Board. Loretta recommended at least one more Board member be designated as
an authorized signatory.

Penny made the motion, seconded by Kathryn, to designate those members residing in the Reno
area as signatories on the Board bank accounts along with the Executive Director. The motion
passed unanimously. The authorized signatories would be Ronda, Penny, Kathryn and Loretta.

Betsy clarified that she and Pegi would no longer be signatories; however, they most likely will
have to accompany Loretta to close the accounts as Loretta is a signatory at Wells Fargo only.

Wells Fargo Merchant Services – Liz asked Loretta to present. Loretta explained that adding
merchant services allows the Board to accept charge cards in payment of fees through our
website. Wells Fargo has provided a proposal which gives two options; option 1 requires the
addition of a payment page to our website for renewals on line or payments on line. The funding
would be directly deposited to our account, less the merchant services fees. The second option
works similarly, however it is not accessible on the website. The charge card information would
have to be provided to the Board office, and staff would then input the information. Loretta
recommended Option 1 as the Option 2 would require more staff time and would increase
administrative requirements; the web page option would not. Loretta explained the price
difference to the Board is nominal between the two options. Ronda stated the Board should not
                                           Page 12 of 17
Approved 3-3-07
have people’s credit card information, it’s not appropriate. Loretta continued the website option
utilizes a secure on-line payment system called “Authorize.net”. An estimate of costs would be
approximately $3,500 per year if everyone uses the on-line payment system for renewals, the
cost includes monthly fees and transaction fees. It’s a great customer service and has been
requested by licensees.

Loretta was asked if this would be separate from filling out forms and having entire applications
on-line. Loretta explained that merchant services allows payment by credit cards. The entire on-
line application process should also be considered, and would be the next step in automating the
website. This is the right time as the renewal period is coming up soon, in mid-May. The ability
to do new licensing would need to be looked at. The renewals would be the first step. If the
Board could get this portion, renewal applications on-line, this year it would be great.

Loretta continued, the Board charges a processing fee of $50 for licensee mailing lists. This
could also be automated on-line through the merchant services account.

Ronda moved to accept the Executive Director’s recommendation on agenda item 10 in regards
to merchant services to approve Wells Fargo’s Option 1, which requires the addition of a
payment page to the website where an individual can pay on-line with a credit card. The motion
was seconded by Kathryn; the motion passed unanimously.

Fiscal Year 2007 Budget Revision – Liz asked Loretta to present this item.

Loretta stated she has reviewed the individual line items of the budget and is recommending
revision of the budget, increasing the revenue to more accurately reflect the income levels
coming in, and decreasing the expenditures based on actual and anticipated through year end.
Ronda asked what period the fiscal year covers, Loretta answered July 1, 2006 through June 30,
2007; the revision is to the current year budget.

Loretta explained the recommended line-item revisions in both income and expenditure line
items and the basis for recommending revisions. Ronda asked if the Executive Director line item
was one staff. Loretta explained that July and August costs were for the previous contractor and
the contracted administrative assistant, September costs added the new contract amount; there
was an over-lap of one month during the transition. Betsy stated that in her agency, they are not
allowed to go over a line item, stating the OT Board has never done that, it’s more of a general
target. Loretta added that she had contacted the State Budget office regarding how much leeway
the Board had in the budget process and was informed that the Board has total control on how
they would like to develop or modify their budget. Loretta continued, the Board could establish
the budget and just recognize the differences and choose not to make changes.             Loretta
recommended that at least semi-annually the budget should be reviewed against actuals. The
Board could choose to measure budget expenditures in total, as long as the total expenditures do
not exceed the budgeted expenditures, or choose to measure each line item individually, it’s the
Boards choice. Ronda asked what the standard of practice was in this area of budgeting in
Loretta’s professional opinion. Loretta answered that in her experience, the budgeted
expenditures should be established at the total budget level, allowing for individual line item
discrepancies as may be needed based on actual operations, as long as the total expenditures are

                                         Page 13 of 17
Approved 3-3-07
not exceeded. Revenues are not as much a concern but should be projected as accurately as
possible; more revenue than budgeted is acceptable.

Liz stated the Board has made some significant changes in how they are operating that will affect
the amount of money that will be expended; and that it’s not a bad thing to have those
expenditures reflected in the budget. Ronda added that because they are a public agency, the
more they know about actuals, understanding the budget and go through the differences the
better; the most transparency and simplicity of understanding the better.

Ryan added that it would be good for the new Board to see the differences between the new
changes that are being adopted and what the old budget was. They can then look at what is
working and what is not, where to make changes and adjustments if needed, after a complete
budget cycle. That will give two true perspectives to look at; the Board doesn’t have that right
now.

Liz stated they are looking at leaving the budget where it is or making changes per
recommendations and asked for any more discussion.

Ronda asked what changing the budget really means. Ryan answered the changes would avoid a
negative balance. Liz asked that if they were to vote to make the changes, where would it go.
Loretta answered the budget vs actual line items on the quarterly expenditure report would be
updated and at the end of the year, the auditor will do a budget vs actual analysis. If there is a
great deviation, an explanation must be provided to the auditor. Loretta continued that the
premise behind the budget is to provide a planning document for the coming year. The current
budget reflects what in previous years was approved, and has not been adjusted significantly
based on actuals. An example is the interest income line item. It has not been changed to reflect
the increased interest income being earned over the years. Loretta stated there have been
significant changes during the year and the changes they will be making today, with the addition
of merchant services for example, will also affect the budget. The revisions are being presented
to reflect the new directions the Board is taking. It is not necessary to make the budget changes
now; the Board can wait and incorporate any changes into next year’s budget.

Liz stated that with all the changes that are happening, it may be better to stick with the budget
that has been approved, then at the end of the year the Board will have a full picture of what they
actually did. Loretta added, she agreed, these documents can be used as an update, mid-stream
analysis of what is happening. Loretta was asked what the balance forward amount reflected.
Loretta answered it is the balance of all cash in the banks at the end of the year. The balance
forward is the excess of revenue over expenditures.

Liz continued that it doesn’t seem to be the Board’s wish to change the budget at this time.
There will be no action taken.

Contract Renewals FY 2008 – Liz asked Loretta to present. Loretta explained that the Board
has contracts for both audit services and bookkeeping services. Because of the time it takes to
develop the contracts, present to the Board of Examiners for approval and get the contracts back,
the Board is being asked to consider renewals at this meeting.

                                          Page 14 of 17
Approved 3-3-07
        Audit Services – Machen & Associates, LLC – The Board is required to have an annual
audit of the Board’s financial records. Machen & Associates, LLC has been the auditor for the
last two years, and is eligible for renewal for two more years; the contract would be a one-year
contract. Machen & Associates has provided a proposal for audit services at a cost of $2,200
plus actual materials costs. The audit contract for last year was $2,500 and actual cost came in at
$2,250. Loretta proposed to renew the contract with Machen & Associates, LLC for a cost not to
exceed $2,500.00.

Ronda made the motion, seconded by David to renewal the contract with Machen & Associates,
LLC for audit services for FY 2007 with a maximum contract amount of $2,500.00. The motion
passed unanimously.

        Bookkeeping Services – Numbers, Inc. – Liz asked for clarification on the dates of the
contract. Loretta explained the contract period would be July 1, 2007 through June 30, 2008.
Loretta stated the proposal received from Numbers, Inc. is extremely reasonable, $250 per
quarter, for professional bookkeeping services. Loretta continued the previous contract amount
was for a total of $1,500.00 to allow for additional services, which the Board may require if we
go on-line with accepting credit cards, and Loretta recommends a renewal at $1,500.00 for next
year also.

Kathryn made a motion to accept the Executive Director’s recommendation to renew the contract
with Numbers, Inc. at a total cost of $1,500.00. The motion was seconded by Ronda and
unanimously approved.

Board Policies and Forms – Liz directed the members to the Board policies and forms. Loretta
explained that she is asking for direction and clarification through development of policy to
assist in uniform application of licensing processes. Loretta explained that there was little or no
direction on the licensing process and procedures, that through actually performing the functions,
numerous questions came up. Loretta continued that she has conducted an analysis of the NRS
and NAC, the Board licensing forms and requirements and incorporated the findings in the
development of the policies.

Discussion and questions were heard regarding the verification of supervision and notification
requirements for both the licensee and supervising occupational therapist. Loretta explained that
out-of-state applicants and new licensees may not have obtained employment in Nevada at the
time of application. The intent of the policy is to require verification of supervision from
“Nevada” employment be provided prior to working in Nevada.

Ronda stated that what they should be looking at is what the law provides this Board to do; how
do the procedures comply with that. Ronda stated she did not feel they should be voting on
these, and she is not sure they are really policies, they should take these things and apply what
they know about the actual practice, take notes and analyze in their own minds, talk to Henna,
and decide how they are going to go forward.

Loretta added that in the development of the proposed policies, she did review NRS and NAC to
determine the minimum requirements. But then to meet those requirements, how are they going
to be implemented. The proposed policies were developed to assist in that.
                                          Page 15 of 17
Approved 3-3-07
Ronda continued, that if someone is going to come here to work, the job of the Board is to make
sure they are competent, safe, don’t have a criminal background in the past. The Board has to
figure out how they can assure the public they are doing their watch-dog role. This is a big deal.
Ronda stated Loretta is doing what she is doing, without the policies. Ronda continued she is not
ready to vote on these policies. Loretta is doing her job, if she has questions she is going to talk
to members on the Board and to Henna, do research and do what is right. All of us need to
understand this fully.

Ronda continued stating that whatever happens needs to be put out to the public, this is how it
works. That’s not something that gets done overnight. Everyone has to understand. Betsy
stated that these reflect what has been happening, but they haven’t been written down. Liz added
the regulations are in general, the question is how are the regulations going to be interpreted,
what policies is the Board going to have to be consistent in interpreting the regulations. Loretta
commented that there appears to be a real inconsistency in application.

Liz stated there appears to be two different thoughts. Loretta would like to have something to
provide guidance from the Board. Betsy suggested that maybe the Board would like to consider
another meeting to address the policy issues. Ronda asked Loretta if there was anything specific
that she needed at this time to continue to perform her job. Loretta answered, the renewal issues
would be priority, if the Board is to go electronic that needs to be addressed first. Loretta added
there is plenty of time to look at everything in detail, if renewals are going to be added on-line
there are things that need to be addressed such as signatures; are signatures necessary on a
renewal. Original applications contain signatures, picture of the applicant; original documents
are in the file. A question was asked if the child support certifications require a signature or not.

Loretta stated the policies could be considered at a later time, a special meeting can be set up for
those. Loretta summarized changes made to the application form, mostly administrative to assist
in the clerical aspects of the licensing process. A question was asked whether the application
would be on-line; Loretta answered the original application could be downloaded but requires
original signatures; the application could be completed on-line then printed for signature and
mail-in. Ronda stated if lines were being removed, it should be reviewed by the DAG and to
check to see if the child support certification can be incorporated or if a separate sheet is
necessary.

The Board raised other questions regarding work history, reference checks, recording dates of
employment and requirement for submitting copies of other current licenses. Henna referred to
Board’s NAC which requires submittal of copies of OT licenses held in other states.

Kathryn stated the Verification of Supervision form is very confusing, especially for the
supervisor. The form needs to be revamped and shortened. Discussion was heard on the
necessity for all the information, what it was used for and whether it was necessary. Kathryn
continued that she was unclear, as a COTA, what the responsibilities are in regards to reporting
and supervision. Discussion continued on the role of the COTA and the role of the OT
Supervisor in reporting changes.



                                           Page 16 of 17
Approved 3-3-07
Ronda stated it was very clear the Board needed to reach out to the licensees and educate them
on their responsibilities. It was suggested this issue might be good to address in the next
newsletter.

Penny made the motion to table discussion and actions on Item 13, Board Policies and Forms to
allow time to review and submit comments to Loretta. The motion passed unanimously.

Report from Board Chairperson – Liz stated she had nothing to report.

Report from Deputy Attorney General – Henna stated she had nothing to report.

Meeting Calendar 2007 – Liz directed the members to the meeting calendar. Liz stated the July
meeting date is in the middle of the summer, and asked if there would be problem if the date was
moved forward or back. Betsy explained the calendar was established but not set in stone the
Board could change that schedule. Liz then asked if the members would like to schedule a
special meeting for consideration of the policies and forms. Discussion of how to provide input
into the development of the policies was heard with a consensus that the Board would
correspond directly with Loretta who will then take all information and incorporate into the
documents for final review at the special meeting.

After review of the calendar, March 3, 2007 was established as the date of the special board
meeting for review of policies and forms. The meeting will be held in Reno. Loretta will
provide all the policies and forms in electronic format for review.

Discussion of the April and July meeting dates was heard. Members were asked to check their
calendars in regards to changing the July date and report back suggested dates to Loretta, the
April meeting will remain on the 21st as scheduled, a decision to change the location was not
made at this time.

Public Comment – None

Adjournment – Penny made a motion, seconded by Kathryn to adjourn. The motion passed.
The meeting adjourned at 2:50 p.m.




                                         Page 17 of 17
Approved 3-3-07

				
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