I want to read you this quote. So this is from a number of articles. They keep saying this kind of stuff in one formulation and another. So this is a quote, COVID-19 pandemic has transformed our understanding of what is possible in terms of collective response to a global challenge. And that's what the great recess is about. Successful or unsuccessful collective response? They are assuming successful, of course. And I think they have been successful in the sense of what they've discovered. And I'm curious to see what you think about this. What they've discovered is that we'll go along with pretty much anything, that they can shut down, shut us down in our homes, lock us down, close everything, keep us from work, and we just roll over. I think that's what they've discovered. Yeah, that doesn't sound like what they're saying, though. Well, not in those terms, what they're saying is we discovered that we can take collective action, lock everybody up and everybody goes with it. Oh, I see. Yeah, no, no, I see what you're saying. Because just to me, it's sort of obvious how bad the collective action was. And let me just say something about the conspiracy thing, because I think this is a complete dodge. So as you're saying, the great reset is advocated by these very influential people. So what would it mean to say it's a conspiracy? The only thing that you could say is that you'd be exaggerating how influential it has been thus far. But the essential idea I would describe as global fascism. I mean, that's what it is. And so, I mean, it's basically a bunch of people who are saying we should have global fascism there in a very influential position.  They haven't been that influential yet. But it's like, no, we're trying to stop them from being influential. So it's a total non-position to call it a conspiracy theory. And so what's interesting is, OK, you have this campaign for global fascism. Sometimes I think of it as a pseudo-scientific fascism. And part of the problem is that the whole capitalism side is characterized as anti-scientific, whereas capitalism makes science possible and is based on the science of human nature and what production and flourishing require. But there's this whole false alternative between pseudo-scientific global fascism and then supposedly unscientific global capitalism. But if you look at the pandemic, just you just look at what has what's the most optimistic thing that's happened is the development of a vaccine. Can anyone really say that this is the? I mean, maybe they're saying this, but it just seems obvious that the lack of vaccine, the lack of PPE, just all of this is clearly a lack of capitalism. I mean, it's just that's just the way. So you could say there are things people can say that you've addressed, that Ankar has addressed in his article, like there are things about, oh, well, capitalism has no means of dealing with people who are demonstrably dangerous spreading infectious diseases. And then we'll say, well, no, that's not true. If you can define something as a rights violation, the government can get involved. But just in terms of the freedom to come up with cures, people, I mean, that is a total failure of the pseudo-scientific fascist establishment that there were all these things, all the sand in the gears and all this prevention of stuff. And the thing anyone would have to give Trump credit for if they gave him credit for anything. He doesn't deserve credit for much with this thing is like, okay, he got some bureaucratic stuff out of the way. There's just a theme here where like the fascism and central government dictation of things is clearly causing massive problems. Capitalism is clearly causing massive good things. And yet the solution is, let's completely get rid of capitalism and give people complete control. Yes. And they of course are taking credit for the vaccines. They're taking credit through, and again, while the Trump administration did take away some barriers, most of them are still in place and we still don't have, for example, home testing for a buck a piece and stuff like that, which was scientifically available, but not approved. But then there's the whole warp speed thing. So they take it as all of this, the whole vaccine thing is a proof that you could have public-private partnerships to get stuff done, because they use all of it as public-private, right? So the government funded these vaccines, you know, the one in Europe is out of Oxford University and it was funded by the British government, it was funded by the U.S. government. The U.S. government has spent hundreds of billions of dollars on upfront buying the vaccines so that these companies can develop it. And generally you're right in identifying this as fascism. It's not typically socialism. What these people advocating is not directly the state ownership of the means of production. So they're not advocating, for example, that all these like Pfizer become a government company. What they're advocating for strongly is, oh yeah, we want corporations, but we want to completely control them. We want government-private public partnerships, which is just fascism, which is just means government control over the means of production. So they really are fascist and they view the vaccines as an example of the success of fascism. And what about like, okay, so that makes a little sense to me, so what about the lack of PPE or the lack of testing? Is anyone really arguing that if we weren't a lot freer, we wouldn't have like, it'll be a lot easier to produce PPE and it'll be a lot easier to produce. I mean, the government is just pointing a gun at us and saying you cannot do home testing. But of course they're arguing this, right? Because they say, you know, if only we'd had better central planning. If only we'd had a COVID czar from day one, then he would have immediately, just like in World War II. And you know, the status love to use World War II as an example. You know, we would have taken over GM. We would have stopped building those evil cars. We would have take, I mean, I'm just making this up, right? But they would have taken over a factory and we would have forced them to make PPE any end. We would have used the managerial ability of GM, right? We admire the managerial ability of GM. But what we need is a central planner to allocate in the common good and the public interest how resources need to be deployed. And if only we'd done that at the beginning of the thing, there would have been plenty of PPE. Just like there were plenty of tanks in World War II, right? We did that in World War II. We got lots of tanks by using this methodology. So, you know, they're mildly sophisticated.  Right. Well, okay. So then I would just say, yeah, it's interesting. Cause you know, you've been in more of this. I know a lot about the climate part of this, which I know we'll jump to in a second. But I mean, I thought since the beginning of this, that pro-freedom people really need to make clear that this is a failure of the anti-freedom side in a whole. And that, and partially that means explaining a fro, you know, what Ankar talked about, like a pro-freedom approach to infectious disease, like that kind of thing. But also just how, if only we had health capitalism, like all these issues of like, all these things that don't apply to any other feel like, oh, shortages of capacity.  Nine months into something that everybody cares about. It's just- And as I pointed out on shows, you know, the whole, even the idea that hospitals don't have emergency capacity is all a product of government because it has to be approved by, every time they expand by one bed, they have to get an approval of the government. That, you know, everything about this crisis. And I think I did a, I've done some shows where I've described how a capitalist economy would respond. It's complicated because who knows how a capitalist, all we know is that it would respond and respond a thousand times more efficiently. You can imagine the role of health insurance companies would have in a truly free healthcare system. You could imagine what hospitals would do and how clinics and how doctors would respond higher pharmaceutical. But of course, then in a real emergency, they would respond like a hundred times better than what we can imagine. And in ways we can't even imagine, that's the beauty of markets. Yeah, I mean, there are at least, I mean, but at least there are just these obvious, almost Soviet style failures that, you know, can't, we just know even with a less regulated part of the mixed economy that we wouldn't even expect. But nobody is making that argument. So I make the argument, you know, John Cochran, the economist makes it once in a while. I don't see a lot of kind of the libertarian economists really engaged in these issues. Unfortunately, maybe I'm missing it, but, but you don't, I mean, this is that, we saw the same, if you remember, we saw the same things during the financial crisis, right? We were like, no, this isn't a market failure. And it was like nobody else speaking about this. Even the free market economists were for a long time, quite silent about the causes of the financial crisis and who dominated?  So one final point about this in terms of persuasion, as I have a term I'd like to use called arguing to 100, which basically means that you, like 100 is the ideal or the goal that everyone is agreeing to. And so like in, there's, you know, the goal of equality and then the evil negative 100 is inequality. And like, you don't wanna play that game. You don't wanna agree, oh, equality is 100. And then sort of start arguing, oh, this policy doesn't decrease equality as much as you think or that kind of thing. And so with, you know, part of the great title, capitalism, the unknown ideal is the idea that like a capitalist society is an ideal. And part of that is always having an exciting vision of what that looks like. And then also looking at the existing society and look at, oh, look at how the capitalist elements are making possible all of these amazing things. And I think sometimes when people feel like the dominant thing is against them, so the dominant thing is anti-capitalism, then they think the solution is just to react to the individual charges. But it's actually much more powerful if you have your own positive ideal and you say like, this is what we're actually for. This is what we need to move toward. And then this evil is going against that. And that's, I think a lot of the free market people are very reactive versus having a vision of a positive world. And without that vision or without clear positive policies to get there, you can, I mean, you can just sort of move backwards more slowly. Yeah, and you can't inspire, you know, particularly young people want idealism. They want a vision. They want something they can fight for. The socialists, you know, they keep, the socialists keep altering their vision. So, you know, now they have a whole story about worker-owned factories and how wonderful they would be. So they keep, every time something fails, they alter their vision and they have any, but they always have an ideal. They always project some form of utopia out there that people can get excited about. And I agree with you completely. Outside, other than, you know, than random, you know, in gold's gold, obviously, there's the ideal has not really done that and never does that. You know, I've talked about the fact that the left, for example, on healthcare, the left has always said, we know what we want. And they've said this publicly. We want 100% socialized healthcare. For 100 years, they've said this, right? You can go back to the 30s and you can find this. We can't get it all at once. So we're just going to chip away and we're going to keep compromising in that direction. But that's where we want to go. We all know that. We all acknowledge. So everybody's to the left of Bernie Sanders in terms of their ideal, they're just compromising on how to get there. The right has never said what we want is 100% private healthcare. And look what a beautiful, here's how it would work and here it goes. They've always said, we don't want that. We don't want what the left has, but we want it a little bit. And every time the left wins, the right embraces that program, Medicare, whatever, and then just fights a rear-guard action constantly. And there's no vision. There's nothing to strife towards. So you have to lose when you don't have a vision. Yeah, and there must be a lot just because morally the ideal is collectivist. So like how are you going to have, if your ideal is collectivist, the way it works is, okay, the people trying to set the policies to get to the ideal, which means government control of it. Well, it's just a human nature isn't good enough for that. It's not good enough. And so then what ends up happening is it becomes these appeals to imminent disaster. So it's just, oh, if Medicare gets passed, like let's say in the 60s, like no healthcare is going to work and everything is going to be totally dysfunctional. And then guess what? The world doesn't end. And so then they embrace it and say, well, of course, Medicare, who would challenge that iconic American institution? But no, we don't want this prescription drug thing or whatever. But it's always like, yeah, we accept where we are in the progression and then we kind of make this overblown claim that literally the world is going to end with the next regulation versus, versus no, like we could have a much better world where we would have so much of an opportunity to be healthier. And there will be all these cures that are discovered. I mean, just think about examples. I'm sure you know people like this. People very close to me like this where a sibling or a mother or father dies of something that then is completely curable 10 years later. And you just think about what is like, and I just always think those bastards, those status, like we would have definitely had this cure had it not been for them restricting freedom. And, but that's part of the perspective of having like an ideal of, oh, this is what would happen if we had health freedom. And you're right that the ideal is rooted, has to be rooted in a moral vision. And the problem is that 90% of people on the right or more have the same moral vision as the left so that they can't construct an ideal out of the altruistic morality that they hold. What we need today, what I call the new intellectual would be any man or woman who is willing to think. Meaning any man or woman who knows that man's life must be guided by reason, by the intellect, not by feelings, wishes, whims or mystic revelations. Any man or woman who values his life and who does not want to give in to today's cult of the stare, cynicism and impotence and does not intend to give up the world to the dark ages and to the role of the collectivist. Broads. All right, before we go on, reminder, please like the show. We've got 163 live listeners right now, 30 likes, that should be at least 100. I figure at least 100 of you actually like the show. Maybe they're like 60 of the Matthews out there who hate it, but at least the people who are liking it, I wanna see a thumbs up, there you go. Start liking it, I wanna see that go to 100. All it takes is a click of a thing whether you're looking at this. And you know the likes matter. It's not an issue of my ego, it's an issue of the algorithm. The more you like something, the more the algorithm likes it. So, you know, and if you don't like the show, give it a thumbs down. Let's see your actual views being reflected in the likes. But if you like it, don't just sit there, help get the show promoted. Of course, you should also share and you can support the show at youronbrookshow.com slash support on Patreon or Subscribestar or locals and show your support for the work, for the value, hopefully you're receiving from this.  So, yes, like, share, subscribe, support. Like, share, subscribe, support. There you go, easy. Do one or all of those please.


So it's one thing I'm out of, and one thing I'm out of when it comes down to the youth right now is the minds.  That's the only way. If we can get them to start thinking a different way, send their minds somewhere else besides this right here, this gonna kill them. The biggest drug on the world, that you won't even gotta take everybody on it right now. That's right. Everybody on this drug right here, this drug right here is killing everybody. This drug will get you killed. This drug can get you money. This drug will mess you off. And this drug right here, they give it to the kids too. Yeah, we on boss talk one on one, one on one. Yeah, we gon' talk. Thank you. Thank you. OG Percy. I got one. Yeah, I wanna ask you that same question. I wanna ask you on a way to where the area that you affect, the people that you around, cause he's coming from a California standpoint, you here in Texas, and what he said really, it revolves around government period. But what would you do to help influence the youth and our people from going into those situations? It's one thing I'm out there. One thing I'm out there when it come down to the youth right now is the minds.  That's the only way. If we can get them to start thinking a different way, send their minds somewhere else besides this right here, this gonna kill them. The biggest drug on the world, that you don't even gotta take everybody on it right now. That's right. Everybody on this drug right here, this drug right here is killing everybody. This drug will get you killed. This drug can get you money. This drug will mess you off. And this drug right here, they give it to the kids too. The kids got the same drug right here. They walk around with it every day in their pocket. You know what I'm saying? This right here, it's the mind changer. This whatever you look at it's what's on your mind. The only way to get the youth back is to change their minds.  They don't, this is a bad drug. You need rehabilitation. Get them back down to um, um, dig in gardens. Tell them. Tell them. You know, everything started off, telephone and tell a Negro. That's how, that's the quickest way, man. That's how it used to be.  What are you? How can we help to our youth, our people from going into those conditions? Man, I feel again, one thing that I see that we need to do, I wanna be able to support and pay people like OG Percy, Mevin, Supreme. I wanna pay these guys over compensating them. Hundreds of thousands of dollars a year. Use these guys as youth mentors to go back into the hood.  Ain't nobody better than one of us to go back in there.  Now we don't have to necessarily do everything, but we wanna be a facilitator. I wanna get these guys and pay them. And so the world, my job is to show the world why these guys are priceless, right? We come out of prison. And I tell people all the time, man, and one thing that I have a burning desire, the one thing I ain't gotta explain, I know these guys. We know why what we need to do. And we know why we need to do it. I ain't got to explain to these guys why they need to tell these kids why they stay out of prison. See, because if I can't talk to them, he can. If he can't talk to them, he can. But we don't have nobody who really will support these guys because they don't look at them and they're gonna judge them by his past and they're gonna question his ability, they're gonna question his character. But instead it says you need to back him, you need to support him financially. You need to enable these people because the kids really, the behind closed doors, this is who they look up to, this is who they listen to. And I tell people all the time, what really makes your OG? When you have somebody following you and you already know, people follow me. I don't pay nobody to call me no OG. I don't ask nobody to call me no OG, none of that. They do that out of honor and a privilege but they do that because they watch me and they see that. And what I try to do is try to limit my talk and show them by asking them what 50% of what I do was talk good, the other 50% of what I do is back up what I say. Or at least do everything I can to do that. You feel me? So what I'm trying to do is to show everybody that I know that just because I've been in prison. Yeah, we on boss talk one on one, one on one. Yeah, we gonna talk.


12, 30, so I'll call to order the Green Mountain Care Boards meeting of July 14th, 2023. We rescheduled this meeting from this Wednesday due to the flood. So thanks for waiting. Some of our staff and board members have had some displacement and are dealing with that. And we, we've looks like we may have lost our building at least temporarily. Anyway, so I wanted to thank everyone at the care board for helping each other out. And Chris in largeness for scrambling to find me a place to do the hearing. We've also heard about some challenges that many others have had, including Johnson health center, Jenna's promise and Copley hospital. And so I just want to express our thoughts are with all those folks. And the challenges are real. We've had a lot of people ask me here at the board about volunteering to help as have a lot of people across the state. And so a huge acknowledgement for all those folks who are helping their community and their coworkers and those trying to provide care and help everyone. So a tough week, but it's, it's great to see that a lot of people are trying to make efforts to help their community. Given the realities of our the blow, our beautiful state has taken this week. We are without our executive director bear today. So all highlight a couple of things before we get into the meat of the meeting today. The 1st is public comments for rate review those started on May 9th, and they'll continue until July 24th and folks can submit comments. The other green mountain care board public comment page or the healthcare advocates website. We have 2 upcoming rate review hearings on Monday, July 9th, starting at 8am. We have a hearing on the rates that have been submitted and then on Wednesday, July 19th, so the 17th and 19th Monday and Wednesday of next week, both starting at 8am. We also have additional public comment forum that we will host on Monday, July 24th at 4.30pm and we have 1 agenda item today, and that's the 1 care Vermont fiscal year 24 budget guidance, which are health policy project director Michelle Sawyer and staff attorney Russ McCracken will present and before I turn it over to them, we'll turn to approval of the minutes from June 28th 2023. Is there a motion to approve those minutes? I'll move approval. I'll second. Any board discussion and all those in favor, please say aye. Aye. Aye. And the minutes are unanimously approved. I received an update this morning from Miss Sawyer, Mr. McCracken, and I think we're going to focus the discussion on 1 care's budget guidance to the non executive compensation issues. And it sounds like we're still waiting for a couple pieces of information in response to our requests. And once we get those that we have the information we need, we'll go back to that issue. So for now, I'll turn it over to Miss Sawyer and Mr. McCracken. Thank you chair Foster and thank you Julia for driving the slides today. All right, you can go to the next slide please. So the agenda for today will review the public comment received on the certified ACO budget guidance. We will review some proposed changes that have occurred since the last time we looked at this guidance. We'll touch on the executive compensation benchmarking just briefly and then we'll get into motion options. Next slide please. I also wanted to sneak in a timeline here. So obviously we have not yet issued the ACO budget guidance. Generally, we try to do that by July 1 of each year. But due to the subpoena that has been delayed, but we have a potential vote slated for this meeting. So that may happen. And then it is expected that one care will submit their budget to us October 2 in the fall. There will be a hearing in November. A staff presentation as well. And the vote will the Green Mountain Care Board will vote on the budget in December prior to the start of the fifth school year. Next slide please. We received public comments from five different parties. Thank you all to thank you to all of you who submitted public comments. We really appreciate your contributions and your thoughts. The topics generally covered the data analytics transition. They covered the executive compensation that some were around the subpoena itself and others discussed the number of attributed lives served compared to the one cares budget. Next slide please. So these are the proposed changes to the guidance since the last time the staff presented the workbook will start there. So tab 6.7 and I'll stop and say all of this is publicly available on our website. Should anybody like to see what these changes changes and compass. We added in a few additional columns to collect salary benchmark data for each of the executive positions. And then we just made several technical edits as well to that workbook. The narrative portion of the guidance. We started with part one the ACO budget targets. We made an edit to the budget target instructions to give some context around the purpose that these serve. And I'd like to speak to that now. This year the section of the guidance has been expanded significantly. So it's important that we understand what these targets are and what they are not. The intent of budget targets is to signal to the ACO as it's creating its budget for the following year what the Green Mountain Care Board would like to see. The targets are indicators to be used by one care in developing and preparing its proposed budget. It is the hope that this will improve the clarity of the board's priorities and reduce the amount of modification necessary to the ACO's budget after their submission. As the note on the slide says there is no penalty if the ACO does not meet a budget target. However they will be expected to justify why they did not meet it. The targets will assist the board in determining whether to approve or modify one care's proposed budget. If a budget target is met the ACO can expect less scrutiny on that particular area of their budget. So a target in other words is not a mandate or binding like a budget order would be. No matter what the ACO submits in their budget it can be modified by the board through a budget order. And the inclusion of budget targets or whether or not an ACO meets those targets does not impact the board's ability to modify the budget. Alright so then also a technical change was made with the language in the in many of the budget targets. We just changed the language from shall to must as shall is legally more appropriate for an order. Next slide please. Additional edits to budget targets number two we removed the Medicare FPP target recognizing that it's not within the ACO's ability to influence the achievement of that target at this time. For budget target number five we clarified the definition of PHM payment reform payments to be inclusive of FPP and bonus payments. Budget target number seven is the one which links variable compensation to the achievement of quality and cost metrics and we added language there saying that at least one metric should tie back to the benchmarking report. And in number eight we added a target for the ACO to submit a plan to the board describing how it plans to increase provider accountability for quality performance. So that wraps up the changes to the budget targets. The next section is the reporting requirements. We added a sub question in section five which is the risk model section. There was a question asking the ACO to discuss program goals strategies opportunities and limitations for the following. There was a list of items there and we added one to improving access to behavioral health services. Next slide please. In section six which is the budget section the financial section we've made an addition to question seven we're looking for an explanation of how the ACO determines the outsourced services are at fair market value. Also in this section we added a question around administrative expenses. Describe the administrative expenses incurred in connection with implementing each of the population and payment reform programs as well as data and analytics work. We added another sub question in section six around executive compensation for each position. Explain how salary benchmarks were determined and utilized when budgeting the base and total executive compensation. Justification for executive compensation shall include reference to an analysis of the ACO's performance. In section seven which is the population health section we added a question for a description of the impact of each population health program on containing costs improving access to care and or improving quality of care. Citing specific and measurable changes observed in these areas and then throughout the narrative there were other minor edits made. Next slide please. So as the discussion around executive compensation at OneCare has continued I did want to review what we do know about how these salaries are set. UVM health network which handles HR related functions for OneCare uses a variety of third party surveys to determine salary benchmarks and you can see the four listed out. And it has been explained to us that the process includes comparisons to ACO executives wherever data exist. For example if they're benchmarking OneCare CEO they have a list here of different titles that they might search for within each one of those surveys. Next slide please. We also know from the policy that they had provided with us that base salaries are targeted at the 50th percentile of the national peer group. Individual salaries will be administered with ranges with structured midpoint set the median and then there's a 50% spread from minimum to maximum. And then also regional data is taken into consideration when placing individuals into their respective ranges. And then when it comes to performance based variable pay they are looking at the 65th percentile target to award when there have been the achievement of strategic and operational objectives. So the total cash compensation for the executives they they aim for the 65th percentile but it may be below at or above depending on the three items listed here. The positioning of an executive salary within the appropriate salary range the performance of the network and its affiliates and then other criteria. Next slide please. So that's what we knew and the staff had requested some additional information and OneCare declined to share that information. So on June 28th the Green Mountain Care Board sent a subpoena directing OneCare to produce all of the following documents relating to compensation benchmarks utilized in connection with establishing and or targeting compensation for OneCare CEOs vice presidents and directors. All documents sufficient to identify the dollar amounts of the 50% for OneCare CEO VPs and directors. All documents sufficient to identify the benchmarked percentile for a total compensation for OneCare CEO VPs and directors and all documents relating to how the award of variable compensation in 2022 was structured to achieve specific and measurable goals. The support the ACO's efforts to reduce cost growth or improve the quality and overall care of enrollees and decisions to award 100% of available variable compensation for FY 22 for all OneCare's executives including its CEO vice presidents and directors. Again the subpoena is available on our website if you wish to review the language yourself. On July 7th the Green Mountain Care Board received. Thank you Julia. Several documents in response to the subpoena. The submission is available on our website. Most of the submission was duplicative of materials already received from OneCare as part of the certification eligibility verification process. The new information include rolled up compensation data meaning that it was rolled up into categories rather than by individual salary information. So instead of each vice president position being listed out it was rolled up into a category of vice presidents and likewise for the director level instead of individual director level information it was as a group all directors. It did include the dollar amounts of the benchmark 50th and 65th percentiles but it lacked explanation of what the benchmark is how it is determined and the percentiles at which the actual salaries are set. Next slide please. On July 11th the Green Mountain Care Board followed up to OneCare that responsive documents to the subpoena need to include source documents and communication that show exactly what the benchmark is. On the 50th and 65th percentile numbers it needs to include source documents and communications about the selection of the benchmark the methodology used to develop the benchmark and the determination of the appropriateness of the benchmark. We're looking for source documents explaining the content of the rolled up chart meaning attachment A which should include at least A by individual position OneCare executives their base compensation variable compensation 50th and 65th percentile of the benchmark and actual percentile of individual compensation on the benchmark and B documentation sufficient to understand why the rolled up chart doesn't align with the base salary and variable compensation that OneCare provided as part of its revised budget. Also looking for documents and communications related to the discussion of awarding FY22 variable compensation to OneCare executives and the decision to award FY22 variable compensation at 100 percent. At this time we have received some documents from OneCare that came in after hours last night and the staff are working on their analysis. Next slide please. We did want to walk through some considerations for the board when deciding whether and how to cap executive compensation. These are merely areas for you to ponder on while you make your decision. So the first is the affordability and administrative expenses. By limiting OneCare's administrative expensive expenses the board prevents these costs from being passed on to Vermonters. As far as compensation as organizational performance incentive by linking executive compensation to OneCare's organizational performance such as you know benchmarking metrics. The Green Mount Care Board can increase leadership's incentive to improve organizational performance. When it comes to the ability to hire and retain staff limiting executive compensation to the median for similar positions could affect the ACO's ability to hire highly qualified experienced candidates. It could also impact staff productivity morale and retention which could result in increased administrative costs related to leadership and staff transitions as well as an increase in non-wage benefits such as paid time off. And then there's the preservation of hierarchy of pay scale focusing on executive positions alone risks upsetting the hierarchy of pay scale. Either subordinates may have higher salaries than their direct supervisors or salary reductions could trickle down to mid and junior level staff. Just things to think about. Next slide please. So we would like to present the board with a menu of options for today's potential vote. I'm going to walk through each one. The first option is to publish the FY 24 OneCare budget guidance with the proposed changes that we discussed earlier. But remove both budget targets six and seven which are the two targets that cap executive compensation at the 50th percentile and set 40% of the variable compensation being tied to quality and cost performance respectively. By removing these targets the board could evaluate what OneCare submits in the fall with that additional context and more information on how 2023 performance has been to date. Like I mentioned earlier the removal or inclusion of budget targets does not determine the board's authority to modify an ACO's budget. So number two similarly we could publish the guidance with the proposed changes but with placeholders for budget targets six and seven. Essentially this would allow the board if you choose to do so to wait for any additional information before setting budget targets associated with executive compensation. Once the board is more certain with the direction they would like to go we can add these targets into their guidance before the October one submission date. Option number three is to publish the guidance with the proposed changes as currently drafted which we will review on the next slide what budget targets six and seven look like. And then option number four. I've mocked up some alternative language that we'll see in a couple of slides that allows some more flexibility in these budget targets as well. So next slide please. So option number three is the one where we where you could vote to keep the guidance as it is currently drafted. So budget target currently reads budget target six currently reads the ACO shall cap the total compensation in FY 24 for the ACO's executives VP or and sorry VP level and above or director level and above. At the 50th percentile of the benchmark used by the ACO to establish its executives compensation. Budget target seven currently reads the ACO must structure the variable compensation of executive compensation. Variable portion of executive compensation so that at least 40 percent is tied to one cares FY 24 achievement of specific and measurable goals related to the ACO provider network performance and cost and quality metrics. Quality metrics must align with the ACO clinical focus areas as long as those priorities or focus areas are consistent with the APM quality framework. And at least some of the metrics include areas identified in the March twenty twenty three benchmarking report as needing improvement. That is as drafted. Next slide will look at option four with a more flexible language. Budget target six says the ACO shall target the base compensation in FY 24 for the ACO's executives VP level and above or director level and above at the 50th percentile of the benchmark used by the ACO to establish its executive compensation. Variable compensation shall be targeted at the 65th percentile. One care must provide complete justification of any salaries awarded above these targets. And then budget target number seven the ACO shall structure the variable proportion of executive compensation so that some portion is tied to one cares FY 24 achievement of specific and measurable goals related to performance in cost and quality metrics. Quality metrics should align with any payer program quality priorities or ACO clinical focus areas as long as those priorities or focus areas are consistent with the APM quality network framework. And at least some of the metrics include areas identified in the March twenty twenty three benchmarking report as needing improvement. Next. Well let's go back to back a couple of slides to the four options and I'll hand it back over to you chair Foster for any board discussion. Sure. I guess I'll go first with a question Miss Sawyer there. I didn't pull this up before the meeting I should have checked it but there was a letter to us about certain budget targets. I think it was received from one care and they were requesting that we didn't have particular budget targets. Can you remind me which budget targets that was referring to. I would also have to pull that up to be able to speak to it. If you want to give me a minute to do so I certainly can. That's OK I was looking while you're speaking and I didn't find it. We can come back to that. OK I guess I would just say for myself I would support going with option one on the list that you have and not including the budget targets as of today for six and seven. Other than that I didn't have any other questions or comments and I'll turn it over to the other board members. I can go ahead and jump in. My apologies if there is loud noises in the back because as I mentioned at the top of the meeting I have some basement deconstruction happening to get the wet stuff out. I'm certainly fine with going with option one. I think getting additional information and having some more time to think about it would be helpful for me. I did want to just make a note about in the proposal that I had posted which Michelle quite frankly had a lot of what I would call technical drafting suggestions. That Michelle has incorporated the one substantive piece unrelated to these options is the suggestion to include a plan regarding provider accountability because I think if what we're looking for is to have improvement in the quality of the project. Data in particular that's really the work of the provider network and so I think ensuring that the accountability is consistent throughout the organization is necessary. Now I don't know what that should look like which is why I had suggested a plan. So I just wanted to add in a little note about the rationale for why I suggested that. I could get support option one. I agree with Robin. I think having some further information would be super helpful. I just want to also note. Thank you Michelle. I really felt like the background information as to how the budget targets are viewed by the board and the board's authority in and around the budget and budget targets was very helpful context. But I agree. I think there's a lot of a lot of evolving information on this topic and I think more time to review the information and that we're getting from one care and have some strong consideration of the implications of that would be helpful so I could go with one. That would be fine. May I just ask a clarifying question because I view one as publishing the guidance with the proposed changes but not having any targets for six and seven for executive comp at all and no plan to revisit those targets. I viewed option two as publish the guidance with the proposed changes but allow for a revisitation of budgets targets six and seven which are related to executive comp at a future date when we get the information that we requested through the subpoena. So I just want to understand where the other board members are because it sounds like folks are aligning around to but I hear people saying one. So I get I think I'm just a bit confused. I think I think you're right. Yes. I didn't quite. Yeah. I think I what do you mean when you say placeholders like an actual number or is it just sort of a blank that will fill in when we get the information. Yeah. Just has the right idea by placeholder I mean I when we publish the guidance there would be budget target number six and it would say something to the effect of to be determined and issued by the Green Mountain Care Board at a later date. Just to as a stronger signal that there will likely be guidance in these for six and seven just not currently. I got it. So we could still go back and have nothing which which is number one or we could have put something in later. Yeah. OK. So Jess I'm sorry. I meant number two. OK. In that case I'm supportive of option number two as well for the reasons outlined from others. I am as well. I mean I think one and two both allow the flexibility to come back and think about it. One wouldn't define specific targets but we could have the discussion to define the specific targets and have the discussion which I think could be helpful. So either either would be OK with me. We have a sense of the timeline for a revisitation. I suppose it depends on what we get when we get all the information that's been requested from the subpoena. Is there a hard stop timeline when we must make that decision about budget targets six and seven. I don't believe there is a hard and set date. I would ask Russ to chime in if he feels otherwise but I don't believe there is a hard deadline. However we know that the next hard deadline is October 2nd for them to submit their budget. So it in order for them to take those targets into consideration we would certainly want to provide those targets as much in advance as we could prior to that date. Thank you. Miss Sawyer Miss Bulls sent around the public comment I had asked about and it was refreshed my memory. The letter was relating to the proposed budget targets that were at page seven of the draft guidance. Which is all of them. Page seven contains all of them. OK. Yeah. Yeah. Right. I have nothing else on my end. If any other board members do please go ahead. If not I think we can move on. I see Miss Raider Walke have your hand raised. I'll do the motion language and public comment. Thanks. Michelle you pull up the motion language. Right. Before we go to the motion I will take health care advocate and public comment. So Mr. Fisher I saw you here. Do you have any public comment or any comment. Yeah I do. Thank you Mr. Chair and members of the board. Let me just do sound check of people hearing me OK. Thank you. Well we're maybe on a bit of a different page than clearly the majority of the board. We think it's super. It's very important to be very clear with any regulated entity about what the rules are. And so I suppose you know the questions by member homes about sort of timing reflects on this. I think that that it's very important if the board is not going to define exactly what it's looking for here. That the board come back to it in a timely way so that one care or I'm going to just say it brought that one care can know how to comply know what the board is looking for. You know we stand by our public comment that we submitted on June 26 which recommended clarifying that position should be included what position should be included in the executive compensation targets called on the board to determine what benchmark to use. That should be a board decision and to connect 100% of variable compensation to specific measurable goals rooted in quality improvement in population health. I was on my way to saying that I thought that those were closest to option three or that option three was would be the easiest to adjust to align with what we're calling for here. I suppose option two also does because it gives you an opportunity to come back to it but we stand by those positions. I think I have articulated and we have articulated the reasoning behind those positions well enough in the past and I'm not going to repeat myself now. Other than to say that there may be standards in the health care industry that that current practice is aligned with and that it looks normal and commonplace. To have these levels of compensation and these and the and the variable compensation as has been discussed here. But from our vantage point it's thinking about it from the vantage point of the Vermonter who's trying to get care and trying to pay for their care. It's it's hard to align these practices with those values with those values of working for monitors and so that's what motivates us here. Thank you, Mr. Chair. Thank you very much. And does anyone else from your team have any comment or just just okay great. I'll turn to public comment on this radar wall I can see your hand is raised please go ahead. Thank you, Mr. Chairman. As all of you know I've had various roles in Vermont health care reform, including working with Robin to write the statute that established this board and that was in the context of a proposal from a governor to create a single payer system in Vermont. Which would not have been a holy public entity. As in most countries or places where there is a single payer system. It would have involved some sort of public private partnership. But that did not come to fruition the Green Mountain care board nonetheless came into existence and continues to exist. But it doesn't run the health care system in Vermont. Do not have a publicly owned health care system. We have a privately owned health care system that competes in a national health care economy for talent. And so when we set compensation in any component, whether it's a small little rural hospital or at the academic medical center at the or at the ACO, we are competing for talent. International market and that has been our singularly most challenging aspect of operations as health care providers in the last couple of years. How do we attract people, retain people, pay adequate compensation and still live within the regulatory system that we are kind of uniquely. Subject to in Vermont. There is no other regulatory scheme like this in the United States. And I fear that this has gone off the rails in terms of losing track of the purpose of the ACO, which is really to organize private health care providers to work better together. They're not a government entity, but they're organized for the greater good.  And if you were in any other state, I think you would see that there is nobody else trying to do what one care is doing. Obviously I'm biased because I'm chair of the board and I'm part of the UVM health network, but I just think that you've lost track of what the role of the ACO is and the role of the board itself. It's not your role to set compensation for a private not for profit corporation. The public utility commission does not do that for Green Mountain power or any other electric utility. And you don't set the compensation of the CEO of Lupras was healed of Vermont of United health care of any other insurer in the business. And for some reason you're thinking that this is a significant thing. And I would just say like above all, this is a distraction from the important work that the ACO should be doing and is trying to do to improve the quality and affordability of health care for Vermonters. And to focus on this issue, when there's six and a half billion dollars worth of health care expenditure that we could refocus for better health, better outcomes and lower cost trends is, to me, a really sad thing. Thank you, Ms. reader walk. Your comment. Sharon got one, I think your hand is raised. Miss got one is your hand raised. Sorry. I just was saying my my lip got I have a fat lip, but I wasn't going to I tried to push the mic without the video but now that you've seen my face. It's all it's all done. You see it. I think that there was a consideration I didn't hear regarding a benefit of of capping executive compensation and that is I did hear there's a potential for decreasing morales and having there be a trickle down of attack of other salaries. But I do know that employees that don't make that level of pay or aren't rewarded for as much of what they do. I think it could do the opposite. I think it could be a motivator as they see potentially one care being more in alignment with the mission. I think that the resistance that the ACO is giving to providing information and the delays are are are something to consider. You know, it's pushing the vote down the road like kicking the can down the road. It's not the board's fault for having to delay in this. But I think that's just a bad indication of those in leadership of the ACO and then certainly yes maybe maybe we'll lose a few executives in these higher positions but I see that as an opportunity. It might actually give room for someone who clearly would not be working for the money. I think that what each of the salaries are getting right now is is more than plenty for a nonprofit and a nonprofit in health care where we all really should be putting those we serve above all else. Thanks. Thank you very much for your thoughts Ms. Gutman. Ham Davis. Let's go ahead. Thank you Mr. Chairman. I'm really happy to see on in the game. Thank you very much. She says that they're you're off the rails. I don't think you're any even in sight of the rails. Here's what you really need one care for Montpour. You have to get the financing change from from fee for service to capitation. You cannot do that without some kind of a gizmo to make it possible. That's what a ACOs were designed for in the National Obamacare legislation. If you that's what they have to do. Now they can't do it all. They've been blamed for all of the failures. Here's just a metaphor you might think about if you want to paint a house. OK. And you really need two things. The first thing you need is scaffolding. OK. Scaffolding.  One care is the scaffolding. You need a painter. And that is the Green Mountain Care Board. And the all this stuff I have never seen in sixty two years a more crazy blizzard of bureaucratic stuff about do this do that. And the other thing you don't have if you don't want one kid if you don't want an ACO then say so. And the but what you're asking it to do is just simply not possible. Thank you. Thank you for your comment Mr. Davis. And that's the other any other hands. So I think Michelle we can go to the motion language. Can I ask a quick question before you go. Michelle could you go over again the placeholder language. I'm assuming that's where Ellen's going. So I just wanted to be clear on what that's actually going to say. Sure. As I have it drafted it says to be determined and issued by the Green Mountain Care Board prior to budget submission. What will be determined. Exactly. The the target itself. So the way I have it listed out is budget targets one through five and then that's what number six says in brackets and number seven says the same in brackets and then continuing with eight and nine. And just to maintain the numbers that we've been referring to throughout this entire process try to keep those stable. OK. Can you just go back to the six and seven so I can see the full text of six and seven. So it will say the it'll. So in the bracketed part it will say to be determined or it'll say at the to be determined. Just. Sorry. I just want to make sure I understand what we're voting on. Sure. Sure. Exactly. So it's you know budget target six in a bracket to be determined and issued by the Green Mountain Care Board prior to budget submission. And the same number seven or seven I see. So you'll take out all of the text of six and seven and just put to be determined. Exactly. OK. So apologies if I could just jump in I think for clarity the text that you're looking at in six would be removed and inserted would be a bracket that would say any target or benchmark regarding a cap of total compensation to be determined and added. And then similarly with seven the text you're looking at would be removed and inserted would be a bracket that says any target or benchmark regarding the structure of variable of the variable portion of executive compensation to be determined and added. Thank you Russ. Yeah. Thank you Russ. OK. So before you make a motion I'll just clarify where I'm at. So where I'm at is I'm not ready to cap total compensation. I am in favor of clarifying the existing guidance on variable compensation. So if you so I'll just if you make the motions so that we're doing six and seven together I'm going to vote no if you break them up I would vote no on six and yes on seven. So breaking it up would allow me to vote for part of the motion if you're going with option to. I just wanted to put that out there. Sorry. Can you say that again so make sure I got it. Yeah. I can actually yeah. So if the option that folks are thinking about is option to where we come back to determine the targets then if we could vote on each of the budget budget targets to be determined separately then what I would then I will vote yes I want to know on the other if you combine them I will have to vote no on vote. I see. Right. Well I think for today's purposes would you want that to be part of today. I mean I think it would be something that we do when we get the information we would I think probably take them up six and seven separately and vote on them. But for today it would just be that we're going to look at them when we are ready. Yes except that I think for me I think what the motion would be is that we will for sure be coming back to six. Right. So I would prefer to vote no on that now just to be clear that I'm not in favor of the cap. I see. You know because it indicates that there will be a cap it's just not determined. Actually may I just jump in here. I'm not sure that it does Robin. I think it indicates that if we want to put any guardrails or specific language around total compensation it doesn't necessarily have to be a cap. It could be a target. It could allow. I mean I think there's a lot of language that could potentially be put forth for budget target six that doesn't necessarily imply it has to be a cap. At least that's what I heard Russ and Michelle saying. So that's why it'd be better to have the actual language so that we know what we're voting on. I think Russ if the language were to be if the board chooses to deter to target total compensation. Right. Instead of cap could you use the word target. It could be inclusive of a cap but it's not necessarily the only option there for budget target six. Would that be OK Russ. Well I think that's a question for the board could vote on but the placeholder could say bracket any benchmark or target regarding total compensation. Total executive compensation to be determined and issued. And regardless it's a target. It's not a budget order. So it's not capping right. This is a target that is not actually a cap. True. But it sets a presumption that the ACO will come in to meet the target or explain why they are not. So in my mind it's what I would call in legal speaks somewhat of a burden shifting. A burden shifting type of instruction in the guidance. So I had interpreted the motion myself as not requiring anything as to these other than that they'll be discussed and decided in the future. Not that it actually is signaling necessarily that there'll be a cap or a target at all. Just that that was to be determined. I don't know if I interpreted that wrong but that's how I was reading it. OK. I mean if people if that's people's understanding I'm fine with that. That's my understanding as well. Language. Yeah. So as long as the legal team can put that's all of our understandings then I think the legal language can support that understanding. Yeah. I think member Lange your concern is you don't want a target or a cap. And so you're concerned that by voting for this this would lock in a vote that there is going to be some sort of target or cap. And I don't I don't interpret that way. I think there can be discussions and there should be discussions around no cap or no target or what that should be. That's how I am viewing this. OK. Yeah. I guess that's why I guess that's why if you option one and option two similarly and that option one we would always have the option to go back and give additional targets if needed. And we discussed that as potentially being an option or option two sort of sort of specifically states that we would go back and purposefully discuss this with the option of having targets out of that discussion. So to me that the option one and option two aren't hugely different other than two signals a little bit more that we're going to and kind of commits us to to try to work that out which I think is appropriate. And if it's helpful I can read the placeholder language again as I have it. So for six replacing the text with placeholder language that says any benchmark or target regarding total executive compensation to be determined and issued. And then seven any benchmark or target regarding structure variable portion of executive compensation to be determined and issued. And I think use of any in that context doesn't commit the board to having one. Does there may be one. Thank you Russ. And Russ just to clarify the way you have option seven written sorry a target seven written with an option two. Are you finding that the only thing that we would be discussing there is the proportion that would be related to specific. Targets I'm sorry I don't have the language in front of me. I'm sorry Julie if you could flip back to the thing it's the next slide. Yeah. So the placeholder language as I saw it was a any benchmark or target regarding the structure of the variable portion of executive compensation to be determined and issued. And in structure. I think that captures both the what's listed here is 40% and then what it's tied to. Okay thanks. Okay is everyone ready for the motion set. Right. Sorry go ahead. Mr. Kraken. Sorry I'm sorry to interrupt again I just wanted to clarify that the motion language here. It covers the entirety of the guidance including the final changes which are around the targets number six and seven but it's a motion to approve all of the one care guidance which is as you know a lot more than just those two particular targets so I was going to make a process suggestion that if the board takes this up as a motion that there be an option for discussion public comment and anything further before before the vote because the scope of it is broader than just the executive compensation portion. Yeah that's fine. I had understood it was a lot broader and I and I the focus of it was actually not executive compensation today but I'm happy to open up public comment on that again. So I'll make the motion and then we can do that. So I moved to approve the one care fiscal year 24 budget guidance as presented by staff with option number two regarding the executive compensation targets. I was second. And I'll just note that I omitted the bracketed because I don't think there were additional changes that were made to the garden guidance writ large. So I'll turn it to public comment as to the motion and the broader guidance beyond the executive compensation if there is any. Ms. Raider walk I see your hands raised. I'll just reiterate this is not a public health care system like you might have in the United Kingdom or Canada or any other place that we might hope to be in. This is a private health care system run by private organizations largely and you're trying to regulate one. And I hope you'll pay attention to the implications in a national health care economy. Thank you. And Ms. gutland. Yeah just quickly. I know that there's other ACOs in our nation and I know that they're doing better. So I applaud the board for doing due diligence to do whatever they can to make this succeed. The other thing is I don't like hearing that there's kind of already one vote to never cap when there really is yet to have information to base that vote on. I think as a person you know that makes decisions herself I like to base it you know on data on facts on history. And it's not like you can't ever change. But right now we're looking at I think a pretty challenging situation with the ACO as it is and executive compensation should be incentivizing security. And it hasn't. So that's all. Thanks. Thank you. Okay. Is there any other board discussion on the motion or are we prepared to vote. Right. All those in favor please say aye. Aye. Aye. Aye. Aye. Aye. Aye. Aye and the motion carries. I don't know how to properly thank you, Miss Sawyer and Mr. McCracken for all your work on all this. But thank you. I hope you guys have a great afternoon and thanks for doing this for us. Just seeing what else we have on the agenda today. That looks like nothing else, so I'll ask if there's any other old business or new business to come before the board. Okay. Is there a motion to adjourn? So moved. Second. And all in favor. Hi. Hi. Hi. Thank you and have a good afternoon.


Hello everyone, my name is Mohammed Ali and I'm a professor at Athabaske University in Canada. Today we will be talking about what is mobile learning. Discuss mobile learning policies and look at the different technologies for mobile learning. So the learning outcomes for this session is define mobile learning, describe policies for mobile learning and identify mobile learning technologies. Here is a list of definitions of mobile learning. The first one was developed by an international committee, ISO committee, and it's a very general definition. It states that mobile learning is learning using information and communication technologies in mobile contexts. The other definition, one that I came up with in 2004, mobile learning is the delivery of electronic learning materials on mobile computing devices to allow access from anywhere and at any time. My colleague Jin Son from South Korea says mobile learning can be defined as learning using mobile and wireless computing technologies in a way to promote learner magicity and mobility. He's looking at learning from a mobile point of view. Other definitions include one by O'Malley and colleagues in 2003, and they say mobile learning is any sort of learning that happens when a learner is not in a fixed predetermined location. So the learner is mobile, they move around, so learning happens when the learner take advantage of learning opportunities offered by mobile technologies. And Mike Sharples and colleagues, they define mobile learning as the process of coming to know through conversation across multiple contexts amongst people and personal interactive technologies. So according to Sharples and colleagues, people is very important and the interaction is very important for mobile learning. So what are the characteristics of mobile learning based on these definitions? First, any time. Learning is any time because the student can take the mobile device and they can learn at any time. This is very important for different time zones around the world where people are a different time zone and they can learn at any time. They can learn anywhere in remote locations, they can learn when they're traveling, so students who have a long way to travel, they can actually use their mobile devices to learn. The learner is mobile, they move from one place to the next. In some cultures we have nomads where the young people will move from one location to the next owner living. So they should be able to use their mobile devices to learn. Learning contacts, which is very important for high level learning. So when people learn in contacts they can actually apply what they learn right away. Location based learning, when people need to find information and learn about local environment, etc., they can actually use their mobile devices to access information from the local environment. Just in time learning, people who work in industry and business, they can use the mobile technology to learn to access information and learn materials right away. So for example, if someone is in an industry using a piece of equipment, he or she can actually use the mobile devices to get some information or some training on that piece of equipment right away. And students are using mobile learning for formal learning where they can get credits for courses. And people around the world are using it informally where they can actually learn information to function in everyday tasks in their countries. So there are many many characteristics of mobile learning that people can benefit from in terms of learning, upgrading themselves, professional development, etc. Very important that we set standards for mobile learning. And I was part of an international committee to set international standards for mobile learning. And we had a committee consisting of representatives from Canada, South Korea, Germany and Luxembourg. And I was part of that committee to set standards for mobile learning. UNESCO just came up with some policy guidelines for mobile learning, which can be applied globally in different countries. And some of the highlights of the UNESCO policies are listed here. We need to train teachers on mobile learning. Previous training programs did not include training on how to use mobile learning, how to implement mobile learning. So we have to make sure we train teachers on how to design and implement mobile learning. And this could take the form of original teacher training program or it could be professional development of teachers. Very important to provide support to teachers who are implementing mobile learning because teachers don't have the expertise with the technology. And so they may need some technical help in terms of implementing mobile learning. We have to make sure we design efficient content for mobile devices. So rather than have lots of textual materials, we should have multimedia for mobile learning. Because multimedia, graphics, video, etc. convey more information than textual materials. Very important to ensure gender equality in mobile learning. Make sure that females have access to mobile learning materials. So they should have the technology so that they can access the materials anywhere anytime. For development countries, we have to make sure there's good connectivity so that if the student has to access the information from the internet, they can actually connect it to the internet at a good rate so that they can actually download the materials and launch from the materials. We need to develop strategies so we can provide devices to students who cannot afford them. All students in development countries can afford mobile technologies. So we have to find ways to make it more affordable or we have to make sure that we make the devices available for free for these students. And very important, we have to promote the safe and responsible use of mobile technology. Make sure that students use the technology in a responsible way. And one way to do that is to make sure we design courses to train, educate students on the ethical use of mobile technology. So when they do use the technology for learning, they will use it for learning rather than use it for other tasks. So yes, it's very important to have policies for mobile learning so that we can implement the mobile learning properly and we can implement it to meet the needs of all students. In terms of the technology, if we look at the history of technology, the first generation of technology was used to mail or send out information to students who are at a distance. So we will use the regular posts to mail information to students. Then when the telephone came about, then we had print with telephone support and that's where the student will contact the instructor, the teacher via telephone to answer any questions and to get help. Then we had the computers that came out, the personal computers, the notebook computers. Then we moved to the third generation of education, which is e-learning, electronic learning. And that's where students will access information using PC computers and notebook computers. And now we have mobile technologies, the tablet computers and the smartphones. We have the fourth generation of learning and students are actually using the technology to access information on their mobile devices to learn anywhere, anytime. So it's very important when we design learning materials we have to make sure that we design for delivery on any technology, for e-learning, for mobile learning. And we are moving to the fifth generation, which is ubiquitous learning and that's where the technology will exist everywhere. And students will learn, for example, from the wall in their homes, the technology will embed in the wall. It will be embedded in their devices in their kitchen, for example. So yes, the technology is evolving and we have to be aware of the technology. It's very, very important for teachers. There are many, many mobile devices out there and we have to make sure that we design learning materials for delivery on the different types of mobile devices. And one way we have been doing this is we built intelligent agents to detect the mobile device the student is using and it will actually design and deliver the materials based on the device. It will actually format the material for that device. So it's very, very important we do a responsive design so that we can deliver on any mobile device. And of course, the students have multiple devices, so students may have more than one device. And we have to make sure that they can use any of the devices to access the learning materials. The devices are changing at a very fast rate. It's going virtual, so you can actually project a virtual keyboard and make it as large as you want rather than use a small keyboard on the mobile devices. And this will be the same on the screen. You can actually make the screen as large as you want. By pressing a button, you will have a virtual screen and then you can turn it off. And they're talking about wearable devices where the device will actually be embedded in your clothes or in your watch, in your wristwatch that you can actually use to access mobile learning materials. In terms of the future of technology, according to a recent report by Future Lab by 2020, the technology will be embedded and distribute in most objects, so it will be everywhere. So as you move from one environment to the next, the device will actually detect you and it will actually prescribe the learning materials. We are looking at gesture-based interaction where a student will actually look at the device, look at the screen of the device and if they want to open a file on the device, they will actually point on the device and once they point on that file, they will just open the file so they don't actually have to touch the screen. So it will be gesture-based. They will look at the eye of the person, the expression of the person and they will actually interact with the person. And then we are looking at emotional computing and that's where the device will detect the emotion of the student and based on the emotion, it will prescribe the appropriate learning materials. So for example, if a student is not in a good mood and not in a state to learn, the system will actually not prescribe the learning materials for them. So we may be seeing emotional computing in education very soon. In terms of globally, we are seeing there is a shift from E to M where E is electronic and M is mobile. And when we talk about electronic, we are talking about PC computers and notebook computers, which are the larger computers. And when we talk about mobiles, we are talking about tablet computers and the small devices, which actually fits in your hand. And some people will call it a palm-top device. So we are seeing moving from electronic commerce to mobile commerce, electronic library to mobile library. You can access library materials on your mobile devices. You can get health information on your mobile devices. And a lot of games now are available on mobile devices. And a lot of young students are actually playing games on mobile devices. So yes, because of the shift from PC, notebook computers to mobile devices, we are seeing a shift from E to M. So in terms of other sectors of society, in the banking sector, one of their devices is to do banking. And we refer to that as in-the-pocket banking. So you take out your device from your pocket and you can do your banking. A library in everyone's pocket, you can actually use your mobile technology to access library information. Health information in everyone's pocket. You can access health information just in time health information on your mobile device. And this is very, very important is where there is not enough health services so people can actually use their mobile devices to access health information just in time health information. And so the question for educators and teachers are we ready for education in the pocket where we deliver learning materials on mobile devices so students can actually access their learning materials on their smartphones, tablet computers and learn anywhere anytime. Thank you very much.


The ship's nautical or otherwise photographic intelligence exploitation team or snoopy team is a reaction team that records and photographs any unknown contacts that approach the ship within a visual range for both intelligence gathering and documentation of the event. We have a couple different ratings that are part of the snoopy team. We have ISs as well as MCs and what they do is they go out and there are eyes for the combat direction center. Snoopy team is very important in the safety of the ship because we can't see who they are. We can't tell if that radar blip is a fishing vessel or a potential enemy combatant. So once they get within visual range we use the snoopy team to help identify who they are. From USS John C. Stennis, I am Petty Officer Lauren Howe.


All right time for the camshaft I'm gonna wipe these off. Was it the journals? One less time. A little bit of oil. You know not too much at this point because we're gonna be putting RTV on the other side of the thing whatever you'll see and I don't want oil on the surface over here And we will get a chance to oil it up a bit more once everything is installed nice I'm gonna face the cam lobes down As much as I can You can see how on this side these are kind of up and this one's up all the way Same on this side over here. So I'm gonna just keep them down This will make my the rockers install a bit easier. Okay, I'm gonna do a bit more oil. I need to worry about this part now Actually, I might as well. So you see this here. This is what I didn't want Extra oil here. Well and the inside doesn't really matter I'm gonna be cleaning cleaning that again anyways. All right. I Guess this is called the Cylinder head deck. I don't know. Could be wrong. I probably am so I'm gonna apply a three millimeter more or less bead of RTV in this groove But what I'm gonna do I'm gonna do I'm gonna continue tiny bit here The instructions actually say Just to fill in this groove But then what about this part here? Here is the oil seal But what's what's over here? You know here here and then From here to here. So I'll show you what I'm gonna do Actually also trying to go on the edge Not just you know in the groove So it's got a stick out. All right. Happy with this now. I'm gonna take a little bit here and very little bit kind of continue it Under the flat surface and same over here Once this is installed you can actually wipe it off. It's gonna come out Where the oil seal will be And you can wipe it off. You want to watch out? You don't want this to be coming out here That's where the camshaft spins And you want you don't want to block this in any way. Okay, so very tiny tiniest amount on the flat surface So I can inspect it Make sure it's sticking out All around should be good Now a bit of oil just a drop Cool, you can see how our TV came out In few spots make over here Let me show you I'm sure gonna see that but Came a little bit there and almost nothing over here Maybe it will once it's torqued down. Now you can install all the bolts but Only these four outside ones These guys here get hand-tightened right now So snug these four make them snug and then just these just Lightly tight, whatever I'm gonna give these four a bit more just a tiny bit Leave those be okay, and then drop in the bigger ones now some of these are Outside Somewhere inside make sure the inside ones are clean. It's like it's just two on the inside So I actually have to wait one hour for their TV to dry up a bit and so it's It is late so 55 more minutes Before I can torque all of these down. Meanwhile, I can work on this Solenoid here right so I do have a new one which is already installed on the driver's side But this one I am reusing Before you put this back in take out this filter carefully Okay, this guy here Because this one is actually pretty clean, but a lot of times when these go bad sometimes this is just clogged Okay, so just break clean Break clean this and you're good to go. This actually seems pretty clean On the inside right, so I actually could not find the torque specs for these 10 mil bolts, but They are just 10 mil bolts after all so I'm just gonna do seven foot pounds of torque Notice again even for this little thing. I'm not Tightening one all the way even if it's seven just getting all of them Snug and then torquing it down Now I suppose I can do this cap this cap goes and dry Actually, let me wipe off actually no I can't I gotta torque it down never mind. Okay, these two get these Sealable washers. Okay, so I got to take these old ones out and I got new ones in The gasket set Well, I suppose now we can work on the on the rocker assembly and now I can drop oil Okay, okay, so we're gonna install the exhaust Rockers first so a little bit of oil on the valves All right clean those bolts The golden looking ones go on the exhaust rocker assembly And on the intake assembly we got black ones Which are longer Okay, now Still got oil on the valves now this one this was a bit tricky you got these pins Right over here They got to be pushed in and one just fell out see what I mean Shut the right back in now. There is no tension on these springs As you can tell There we go. Okay, so there's a pin here Here and inside there and there's a spring on this side. So these spring pin pin pin Spring pin pin pin in case you're wondering Okay, so this is good actually See if there was tension on these springs then This whole thing would you know if this would be sticking up We'll be so easy to put it and I'm gonna show you how to put these back on once this is bolted down again clean bolts I'm actually gonna wipe that RTV off where the seals go Before I forget That's really it. I gotta wait for that RTV to dry up a bit and Continue torque it down and continue. I cannot do anything else. I can clean up All right guys, so I did a few things cleaned up here and there installed the oil the oil filler neck And I still got a torque down this This guy here, but mainly I cleaned up. So now it's time to torque those down, okay, so we start with the torque once This is T40 and it goes EFGHIJ EFGHIJ Now the Ellen ones K these torque down to 7.2. It's gonna go straight to 7.2 K L M N O P Q and QR and that is it. Oh Yeah, these two S and T also to 7.2 10 mil bolts I said I saw what I say ST Okay, now the actual rocker assembly the 12 mil bolts all of them torque down to 18.4 and they go like this a B C D I have a yet set yet to 18.4 point four ABCD, you know, I have an idea. I want to move the engine closer to my computer screen It's the greatest idea I had so far today. All right now. I can see so a B C D E F G H That's it. Now. I never took these two out so they stay Now I'm gonna set it to 18.4 again And then I and J and these two torque down to 5.9 in case you're wondering these two 5.9 and these are these two are the last Then this one and this one now using this little Deep five mil socket. I'm gonna take The spring and you can see that nipple there Whatever kind of push it away and In it goes Easy no need for special tools done All right, so Now I can install the seals or check the valve clearance either or all right. I have a little bit of time Let's install this cap. Okay, this You sure it's clean it's gonna push it in with my fingers You know get it started and I can almost install it with my fingers with a small rubber mallet All the way this goes in dry guys I know I know but still make sure it's nice and flush you can grab a straight socket and kind of Measure it just look for equal distance We're good guys a little tip don't throw out your old Gaskets seals or rings whatever put them aside so you can match if you got the right part and kind of keep track of what you got a Install so this guy gets oil inside and outside now luckily for me. I have this Suck it. This is a one and a quarter Where's my hammer now this socket is cool because I can Tap it in all the way in it would actually go inside The outside diameter of the cylinder head all right guys I'm gonna call it a day today I'm gonna continue with the valve clearance and adjusting them I'm sure because I have to adjust every single one on the left head And I'm sure I'm gonna have to adjust every single one on the right head So not much left should before I go. I'm gonna drop some oil right on top of those Rocker here in those pins Alright, whatever is touching and moving and I already did drop oil and the valve Stems I guess they're cold right on top here and make sure you know when we will be measuring those clearances you want to you want to have oil there too, so The filler gauge won't scratch that too much. Okay All right, see you next time


Some residents of Riga Chikung Layout Community in Gabi Local Government Area of Cardinal State have called on the state government and other relevant authorities to come to their plight over an alleged illegal demolition of their houses by the state's urban planning and development agency. Plus TV correspondent Habila Dorofaiz report is presented from our studio. The ongoing demolition carried out by officials of the Cardinal State Urban Planning and Development Agency Kasupda in the community has thrown many residents into fear of the unknown, as some of the victims have lost valuables. The residents expressed their amazement to see nearly built structures that have met the government's requirements destroyed, especially in an area where the presence of people is needed to boost security and economic growth. Some of the victims recounting their ideals call on the state governor, Ma'lam Nasir Erifi and the Kasupda to please reconsider the plight of poor masses. The problem is that the issue of security has been solved, but there are many other factors that are becoming a problem for the city. And this is a very serious issue due to the lack of security services. This is something we should not forget about the people of the Cardinal State Urban Planning and Development Agency to address our surrounding problems. Even remember this idea and I don't know if it's over so Honesty speaking, I have a sleepless night I didn't sleep because Three years I cannot eat I cannot buy clothes If I get 3000, 5000 I come and put it By certificate of occupancy I presented all the document they need to Kasubda And they approved me to start building my house We have it And our own we have the paper for the processing from Kasubda Side plan whatever we have it Even now At any time if they ask me about it I will bring it for them And they are claiming that we are using democracy This is not democracy, this is a military system of government We prepare the military system of government than this democracy Kasubda as part of effort to follow the states land act and master plan Have demolished several houses