Our next speaker is Lisa Vig. Dr. Vig is an associate professor of medicine at the University of Washington. She practices geriatrics and palliative care at the VA Puget Sound Healthcare System, where she is also chair of the Hospital Ethics Committee. Dr. Vig completed her MD at NYU and her residency at Northwestern University. Dr. Vig's research focuses on end-of-life decision-making. She's currently involved in a project to learn more about advanced care planning in patients with advanced kidney disease. Please welcome Dr. Vig.  In the last couple years, I've talked about research projects that were completed. This year I am working on three projects that are just getting started, so I'm not talking about any of that. But I'm gonna talk about a clinical project that I've been working on. And this is actually more of a work in progress than we've heard here, so it's gonna be a little different. But I'm hoping you guys can give me some helpful tips as we go through this. And so a disclaimer, because I work at the VA, that what I'm gonna talk about does not represent the views of the Veterans Health Administration or the National Center for Ethics and Healthcare. And I don't have any financial disclosures either. So a little background to get us started about this. There's evidence in the literature about the effect of ethics consultation in intensive care units. There was a randomized control trial a while ago now, but it found that there were decreased number of ICU days and number of life-sustaining treatments in the consultation group in comparison to the usual care group. If we look at the effect of palliative care in the intensive care units, a recent systemic review found that most studies that they looked at found decreased hospital and ICU lengths of stay in patients who'd had a palliative care consult. And Dr. Toll mentioned this earlier, but the Institute of Medicine's report that came out a couple months ago, one of the things they mentioned was that our healthcare system is set up so that a lot of people get lots of procedures and aggressive care at the end of life that they may not necessarily want. So I think both ethics consultation and palliative care consultation may be one way to help with this. So in ethics, we talk about contextual features. So I figured I would also give you guys some contextual features. So I'm one of the VA ethics fellows and as part of that fellowship in the first year, we participate in the University of Chicago's Clinical Ethics Fellowship, which was great. Thank you for the opportunity. I appreciated that, that was really fun. Got over my fear of flying, got a lot of frequent flyer miles, et cetera. And in years two through four, we have protected time for ethics work at the VA. The chief of staff at our facility, i.e. my big boss, suggested that I round in our medical intensive care units. So he said that, so I took it on. But I'm also a palliative care and a geriatrics attending. And so I wear these different hats and I've found it sort of hard to just wear one hat only. And so we're going a little digression here. So in putting this talk together, I was trying to figure out, well, what hats do you have to represent each different discipline, right? And so I thought, well, in ethics, we do a lot of slew thing, right? And so the Sherlock Holmes, that's the ethics hat. Just bear with me. In my geriatrics clinic, a lot of my old guys wear that hat over on the right. So that's the geriatrics hat. And palliative care is all about living life to the fullest and having fun. So I found the festive red hat. You will see these hats again as the talk goes on. So back to the project. This is a clinical project where I attend morning rounds in the medical intensive care unit once a week as an ethics advisor. And my aims for the first year of the project were to evaluate the feasibility and acceptability of attending rounds once a week. And also to start trying to figure out how I could figure out if the project really is having any positive and negative effects. So let me give you a little information about our ICU. So this is at the Seattle VA hospital. There are 18 beds that are shared between critical care and the cardiology teams. It's a closed unit, meaning if there's a patient on the medicine floor who gets sick, who needs to go to the ICU, they come to the ICU and the MICU team takes over their care. That changed a couple years ago. There are almost a thousand admissions per year and the average length of stay is about three days. The medical staff in the ICU. So there's one attending. There are 10 different attendings who rotate every week. There's usually one to two pulmonary or critical care fellows who rotate monthly. One to two medicine residents who rotate monthly. Occasionally there's a sub intern and there's a physician assistant who's there one week on, one week off. And there are pictures here that I've put to make the slides more interesting. These are pictures from the internet because I think it's illegal to take pictures within a VA facility. Maybe I should have tried for fun, who knows. The docs are not the only people on rounds though. It's a pretty big group with lots of different disciplines. So the other people on rounds include the bedside nurse, the respiratory therapist, a dietician. Within the last two months, we've gotten a pharmacist who attends rounds, which is fabulous. The chaplain like me comes once a week and a family is present, they also join rounds. So it gets to be a pretty big group. So my plan for the first year was to attend morning rounds once a week to gain acceptance and trust of the team. And while they're answer ethics questions, bring up some ethics issues that they may not have thought about and make quick teaching points without slowing down the team because they're really busy. And they didn't ask for me to be there. Other services I could provide during the year would be to answer palliative care questions, make points relative to palliative care and geriatrics, and also serve as a liaison between the ICU team and both the palliative care team and the geriatrics team. So if one of their patients ends up in the ICU after rounds I can call them to let them know what the ICU team was thinking, et cetera. So this is the hard part of this. Does this really make a difference? How do I figure that out to go back to the chief of staff to let him know so he decides whether I get to keep doing this or not? So what are the appropriate outcome measures? Are they patient family outcomes, staff outcomes, trainee outcomes? So let me start with some process measures for you guys. Between September 2013 and August 2014, I was able to attend around 39 times. So sometimes they're meetings or other things that get in the way of going. I rounded on 218 patients. Now because of the notes I took, I couldn't tell for sure if there were patients who were there multiple weeks. So this is not 218 unique patients. The mean was five patients per week with a range of one to 10. And rounds lasted anywhere from one hour to three and a half hours. Who were the patients? I think this represents probably a usual MICU population. So 63 years old with a pretty wide range. Most were men because I'm at the VA. About 40% were intubated and on ventilators and about 8% were receiving pressers. I kept track of the comments I made on rounds trying to get a sense of what kinds of comments I was making. And so of the 218 patients, I made comments on 99 patients which is about 45% of the time. And you may say, well, that's not so much. And that's true, but you gotta remember another contextual feature is that I am a shy introvert. So when I figured this out, I was actually pretty impressed that I'd made that many comments. And so looking at the categories of comments, and I think we could probably spend a whole another 15 minutes sort of arguing about which bucket each comment went in, but I tried. And so this, oh, okay, here we go. This is what I came out with. Of the 99 comments I made, 25 of them were ethics comments, 42 of them were palliative care comments, 10 of them were geriatrics comments, and 20 of them were sort of more than one comment that encompassed two different areas. Let me give you some examples. So what I categorized as an ethics comment were often questions about legal decision makers that either they asked me or I asked them. In our electronic medical record, we have a way to actually pull up somebody's advanced directive if they've brought one in, which I'll show you. And so sometimes the team would be talking about a patient who to meet in sound like they were in very good shape. And so we'd look to see if they had a directive and actually pull it up. And sometimes I'm hoping that was helpful to the team to get a sense of what the patient had thought. And also for the trainees to know where you actually find this in the medical record. Palliative care comments, sometimes I would ask questions after hearing all this awful stuff about the big picture, or ask about the patient's trajectory to try to get the team to recognize that despite everything being done, maybe the person was sort of slowly getting worse instead of getting better, or ask about the goals of care. I also made recommendations about symptom management issues. Geriatrics comments had to do with, they would present somebody who was, frankly delirious and the room is totally dark. So saying, well gosh, shouldn't we maybe turn the lights on if the person is delirious during the day? Or we had a few older patients who didn't have their hearing aids with them. And through our audiology service, you can actually get a little device called a pocket talker, which can help facilitate communication. So this is just our medical record and what the advanced directive, it's just like looking at an x-ray, you can pull it up. And this is way too small probably for you guys to read, but the VA has its own advanced directive that I actually think is pretty good and pretty helpful. One of the sections has all these awful situations where you sort of imagine yourself in that situation and decide whether you would want life sustaining treatment, whether you wouldn't want life sustaining treatment or whether you're not sure. And these don't answer all the questions, but often looking at the directive and seeing if the person has checked off, yes, yes, yes, yes for everything, no, no, no, no, no, or something else can be helpful to the team. And if you guys wanna find this, if you just Google VA advanced directive, you'll get a PDF of it so you can look at it. There's another section which I also think is really good where it asks how strictly you want your preferences followed. So is this making any difference? So one thing I thought I could look at for this presentation was to look at new consults, new ethics consults and new palliative care consults coming in from the ICU. So I'll tell you a little about that. So looking at new ethics consults from the ICU, if I looked at the 12 months before I started rounding, three had come in 12 months after seven. So you could say, oh, look, it's doubled. Yeah, but the numbers are so small. I'm not gonna take credit for that. But then I thought, well, maybe it would be fun to look at the day of the week the consults came in. Okay, so the orange bars is before I started rounding and the consults are coming in on different days. And after is after, the blue bar is after I started rounding. And so I will tell you that the day of the week that I round in the ICU, any guesses? It's Wednesday. So maybe, you know, you could argue, you know, trying to think of going to my chief of staff and making this argument. Could I say, well, I suggested it on Wednesday and sometimes they listened to me and sometimes they hemmed and nod for a couple of days. I don't know. If we look at the palliative care consults that have come in from the MICU. So in the six months before I started rounding, 32 came in, six months after 48 came in. So that's a big jump. And if we look at our total consults, it hasn't increased that much in this period. So maybe I could take some credit. Again, looking at the day of the week beforehand, consults are coming in all the time. After in the blue bars, again, I'm rounding on Wednesdays. So I think I can take credit for some of those that have come in on Wednesday, but who knows. Another thing that I've found has been really helpful about this project is I have developed a new ethics elective for our palliative care fellows. And so one of the activities they do during this elective has come with me on rounds in the MICU. And what I try to encourage them to do when they're on rounds is sort of step back and try to observe a different interdisciplinary team in action. They've seen our palliative care team in action, but to see a different team and try to see how they're interacting and what's working well and what's not working well because palliative care is all about teamwork. Another thing I try to get them to think about is how they would contribute to rounds as a guest. We aren't a member of that team or a guest of that team. And also to help them think about how to coordinate care between patients they've seen in the unit and the palliative care consult team. So conclusions, has this made a difference? Well, I mean we can say that there are increased ethics in palliative care consults coming from the ICU. Other things I could look at that I haven't looked at yet is within the VA there are all these surveys that are done. There's something called the integrated ethics staff survey so that every two years a survey goes out to the staff about the ethics environment of the facility and their questions about familiarity with consulting ethics, questions about end-of-life care knowledge and skills. And I think we recently did one of these and it just came back. So one thought I had was I can look at the results that came in from the MICU staff and compare that to two years ago and see if there's any difference. That would give me some information about staff outcomes. Another survey is the bereaved family survey so that anybody who dies within a VA facility, the family member gets a survey a couple months later asking about that patient's end-of-life experience. So that might be a way to look at whether patients dying in the ICU, the family is seeing the experience any different now than prior to the rounding. So next steps, I think I need to go back and talk to the ICU attendings to find out from them if this is helping them, if I'm just slowing them down and frustrating them, et cetera. One option would be to expand the teaching, doing some kind of assessment of the MICU trainees' ethics knowledge and then based on that, coming up with some teaching sessions for them. Although they're often so busy getting an extra hour may be different. Here at the University of Chicago, you guys have a lot of surgery involvement in ethics which is fabulous. At our facility, we don't really have any surgery involvement. Nobody on our ethics committee, et cetera, and I would really like that. I don't think the surgeons are unethical, but I would really like to sort of involve them more and maybe one of the ways to do that is to find a way to start rounding in the surgical ICU. So that's basically all I've got for today. But if you guys have questions or comments or tips for how I go to the boss and explain that this is helping, I got my pen, I'm ready to write it down. Thank you. Or maybe you guys just wanna get to lunch. I understand that too. I know, but that's why we gotta hurry up. We're all gonna be hypoglycemic. Noreen McGrath from MedStar Washington Hospital Center in D.C. We've been fortunate enough to have the staff that we can actually round clinically in all of our ICUs on a weekly basis. And so we've been able to see a similar benefit that it increases our consults and heads off some of our ethical dilemmas early on. One of the things we've been cognizant though is trying to be careful about whether being embedded in those ICUs then compromises our ethical judgment by being part of the team and being well known by the team. Do you have any thoughts on that? You know, having just done this for a year, I've been really conscious of not being a member of that team and trying to be sort of accepted and trusted by them but not seen as one of them. I don't know if that makes sense. But I don't, I'm just trying to think if I really thought I was part of that team, if I would respond differently. As an outsider, I think I'm more comfortable sort of asking about the patient or looks like they're about to lose decision capacity. Oh, who's the legal decision maker for this person? I don't know. Do you feel like they've been open to those kind of conversations when you're standing at the bedside? I think there was someone from our institution who did it years ago who had maybe a more forceful personality than me and one of the attendings actually said, you're more gentle about this, so they aren't as offended. But I don't know. Thank you. No, thank you. I wanna go back to the pie graph that you showed when you looked at the number of indications like palliative care. It's just what you showed in percentages. So. Or this is numbers. It's not percentages, it's numbers. Numbers, excuse me. And they're two in the gray that I didn't talk about, which I can mention. So it adds up to 99. So one of my questions that I thought of during your presentation was, did you look at what were the disease classifications or the diagnoses that were most common coming up either under ethics or palliative care, number one? And number two, when you approached going into the MICU with this collaborative team, did you have in the initial stages any period where you would meet with them in a conference room and go over what the process that you were offering to the team would be? And the reason I suggest that is, did you have discharge planning at all involved from the onset? And then did you have any metrics on the number of days that prior patients were in the MICU? And then to look at outcomes on how the MICU length of stay might have changed? So I have the old length of stay. I can, you know, next year ask them to get that for me again to compare. It's so short, who knows if it'll change. Before I started, when I applied for the VA FX Fellowship, initially I went and talked to the head of the ICU at that point to see if he'd be interested and he was and then once I had finished that first year I went back to the new head of the ICU and talked to him and his co-leader and just asked them if they thought that would be okay. But did you have a sit down discussion with like pharmacists, dietician, those individual? Okay, thank you. Yeah. Last question. Great kudos that you are rounding in the ICU. As an intensivist, I think your input is so valuable to the team. I mean, it's a multidisciplinary team that rounds on patients as we have pharmacists and nutritionists, et cetera. I think your input is valuable. So don't be timid, get into the SIC also. And also your question about being embedded, whether that compromises your ethics standpoint or something, I think not. You are a member of the team for that patient and no matter what your outlook is different. Now, just as an aside in the ventricular assist device world it is now part of the requirement that on the multidisciplinary team of the ventricular assist devices there be a palliative care physician. So like it or not, you will be part of the team. Yeah, thank you.


Broadway's My Beat from Times Square to Columbus Circle, The Gaudiest, The Most Violent, The Lonesomeest Mile in the World. Broadway's My Beat with Larry Thor as Detective Danny Clover. Through sequined loud speakers on Broadway to get all the happy out, and the crowd walks in holiday cadence, conditioned by age, measurements, and the size of the pocketbook. And it's all there in the shop windows, mechanical clown, tin man dancing a jig on a tin box, and toy army, precisely to scale, mechanized, some with parkas and skis for the difficult terrain over the raw cotton battlefront. And eyes are bright with hope and desire, and the wish made on a neon star. But in the place where I was, holidays coming is marked only by the rise of empty liquor bottles in trash cans, alley off of Third Avenue. And this winter's late night marked by horn of the moon stuck through clump of clouds. And this, the boy lying unconscious, and Detective Markovan. Name's James Barton Danny, here, his wallet. Lots of identification here. Address lives on East 58th, 1212.  Whoever did it to him was pretty systematic, Danny, worked him over real good. Who reported it? Officer Farm called it in walking his feet. Danny. Christmas season, a kid 19 beaten in an alley. Well, whoever did it wasn't a mugger. The kid's got maybe 60 bucks in his wallet, he wasn't beaten for money. What happens to a kid this age gets dragged into a sewer like this and worked over? Nice looking boy, why is that? Sure. Ambulance ought to be here in a second, Danny. Think the kid will live? Boy, it's cold. The winter's still, city and chill, play of wavering reflected night lights. And the boy's part of it, beaten, flung against alley litter. Skyward, the fleet curve and fall of a December star. The sounds of night fury are muted now in the soft keening and whirl of river wind. And not too distant, clack of a woman's heels on pavement. Slow walking. Then running, then lost in a sudden cry of wind. Just called for, laid gently on a stretcher. Received into drifting night, carried away. So leave there. The remnants of sleep, the half-dream. And in the morning, the call to headquarters, the report on the boy. Jimmy Barton's still in shock. You'll be notified when it's all right to talk to him. So go to a place, the boy's address on East 58th. Show a badge, get a door open. Walk in. And Jimmy Barton's apartment is early December sunlight on ceramic vases of cut flowers. His bed, neatly folded down and arranged for sleep. Is this a basket of fruit, an open box of candy on nightstand, another unopened on shelf below. And in bureau drawers, knitted things. Heavy woolen sweater, complete with design of stag with antlers. Woolen socks, argile, arranged neatly as the pattern and color. Shirts, monograms, handkerchiefs, lemon, hand rolls. What is? There'll be naughty what you're doing. Jimmy's such a neat type. He'll have a spell when I tell him a thief must up his brains, a child of flip. Who are you? A girl who leans against doorways, languidly, like this, and chats brightly with thieves. Don't you tell? I'm for police, I... I also chat brightly with policemen. Trump. This girl across the hall type will stick my nose into any of my neighbor's affairs, lately mostly Jimmy. And my name is Ina Small. In a German cellar, kick-eye was once on, used to call me Ina Kleiner, like a nightingale. Cute, huh? How long have you known Jimmy?  Jimmy did a prank, which you must consider the boy's night, too. We found him in an alley last night, beaten, unconscious. It'll take me a minute to get out of this. How shall I dress to call on Jimmy, policemen? Black? He's badly hurt, we don't know for a while. Tell me, how long have you known him? He moved into this apartment maybe five months ago, July. I was neighborly. I brought him bread and salt for his new home. He lives here alone? More alone, and across the hall, me. His clothes, his things. They're nice, expensive looking.  He deserves expensive things. You know where he works? Work? Jimmy works? Not every one my time. Other times, I wouldn't know. Anything else you can tell me about him?  Well, Jimmy was hurt before, you know. I didn't know. Yeah, some automobile accident in March, I think he told me. Something he was laid for a while. We had to sit out dances. Look great. If Jimmy's dying, I want to be very... We'll let you know, Miss Small. Thank you. Neckles? Officer Neckles? There's a bench to rest your troubles on, lad. Oh, you, Danny Ladd. I don't know if it's the lieutenant. Oh, Neckles. Oh, beautiful. And you, Danny? Okay. Hey, something you ought to know, Danny Ladd. What? There was a debate here amongst the boys in record.  It was touch and go, I can tell you. Also, I took the affirmative side of the bitter controversy. I thought it was something you'd want to remember. Now, what else can I do for you, Danny Ladd? Well, a point on an automobile accident last March. Involved the boy named James Barton. Barton, last March of an automobile. Anything you want. I mean, just as you said, Lieutenant. Oh, it's theater. Accidents, intersection, 93rd and Lexington, 129 a.m., 8th March, 1951. Jim, Barton 19, hit by Club Coupé, compound fracture of both legs, possible internal injuries, coupé driven by a Charles Rosson of 1840, 60, 62. Is this the one you want to look at, Lieutenant? Never mind, Nichols, I'll take it with me. Anything you want, Lieutenant Ladd. That's right. I'm from the police. My name's Clover. Yeah? Uh, may we talk inside? If you believe we should, of course. Please come in. Thanks. Now, what is it? What a boy named James Barton. Oh, please. What? I just refuse to talk about it anymore. Oh. For months after it happened, newspaper reporters, insurance adjusters, traffic safety engineers, now you. Now there's a difference. James Barton's been hurt all over again. Well, what do you want me to do? I don't want you to do anything, Mrs. Rosson. Boy's been hurt, we're trying to find out why. The way we do things like this is to...  I know, I know. I'm glad you do. Let's get on with it. As if you already don't know. All I'm asking you is your version of that accident. My husband and I were coming home from the evening. My husband was driving slowly, but fast enough to break that boy's legs when he stepped in front of our car. We took him to a hospital. He admitted that he was at fault and absolved us. I haven't heard from him since. Now what? How about your husband? What about him? Do you know whether he's seen or heard from James Barton since the accident? No, let's call him at work and find out, shall we? Well, never mind, I... No, no, no, let's call him. Let's get rid of that boy's name around here once and for all. Charles? No, no, I'm all right. Listen, Charles, there's a policeman here. About that boy James Barton again. Well, he's had another accident or something. Anyhow, the policeman wants to know whether you've seen or heard from that boy since. That's what I told him. Well, good-bye, honey. See you tonight. All right? All right. Does that answer your question, Mr. Clover? All right. Thanks a lot, Mr. Charleston. Back to headquarters now through the prime when afternoon stands still for two hours. And when you get to where you're going, it's suddenly dark and to the office with the details and paperwork and the cigarette on the edge of the desk. The coffee's sent out for and drank. Reports to make and the quiet policeman pocket days then. The latest report from the hospital, Danny. James Barton might not die. Danny. Yeah? All that loot in that kid's room. What do you mean, his clothes? Such expensive stuff. And as far as we can find out the kid didn't have a job, that makes it loot. Thanks, Michael, and now I know him. You think maybe the kid's a thief, a young virtu... Danny! Here, the report just came in communication. Thanks, you know. Who? The man who was driving the car that ran in the last march to House Wilson. What about? He ran the corner from his office in the alley. That's where he was just found, shot to death. Listening to Broadway's My Beat, written by Morton Fein and David Friedkin, and starring Larry Thor as Detective Danny Clover. Until December when, the year moves swiftly to the place of its dying, and Broadway arranges its emotions for the occasion. On planned flux, the current emotion, suitable for Christmas past, Christmas present, Christmas future. And this, in high places, strategies are being shaped so that Santa will not bypass the boys. And Broadway walks by, glances out, hurries to buy the last-minute gift for the last-minute girl. The time is short, kid. Think fast. There must be something no one else has thought together. And at headquarters, new winter day, the patter of tired feet, the sound of manly giggles, as ribbon packages are stashed away in lockers. And in my office, Sergeant Gino Tartaglia will be able to suggest them for the holiday season.  Don't fight me in this, Danny. Simply do as I say. One shoe off will be sufficient if modesty insists. I have tape measured ahead. What is this, Gino? Please, Gino, tell me. My eldest, Christina Tartaglia. She made me promise I would get your foot size unbeknownstly. I chose this method. Tell Christina's size, eleven and a half, Gino. I know, I know, Danny. But taking into consideration the Christmas present my eldest is knitting for you is a pair of space socks. Space socks? Therefore, in revealing to her your size foot, I must also take into consideration the layer of air which must be knitted in to offset the forces of cosmic energies with their nutrients and quotas. Such were the instructions I received from Space Cadetist 3ZXL Tartaglia. Danny, I must- Later, huh, Gino? Well, if you wish to fork the progress of the scientific mind, to work, shall we, Danny? You may measure me, Gino, but later, huh? Perhaps later. Now, to work. In the matter of Charles Walton deceased of a thirty-eight caliber bullet in an alley back of his office, these items and sundry investigations through it that he was a man respected in his line of business machine tools, that his bank account was commensurate with his type income, neither too large nor too small, but tidy, that his life insurance was placed with the firm Adler Insurance Brokers on Madison. Danny Clover speaking. Margaret and Danny, two things. Just got work from the hospital. Get Jimmy Barton's fine. He's setting up. And the other thing, that girl, minus small, you know, lives across the hall from Jimmy. Yeah, I know. What about her? She's down to emergency hospital visiting the beat-up boy. I thought maybe- Yeah, right away. Anything else, you know? Nothing. I had finished. I may go now. Well, don't talk, Jimmy. I'll be back. You can measure my foot. We shall see what we shall see. Don't forget your muffler, Lieutenant.  Now you just lie back, Jimmy. The boy looks boys, doesn't he, Mr. Clover? How do you feel, Jimmy? Don't take your fingers away from my cheek, I know. Real good. That's how I feel, Clover. Who beat you up? Now, don't you make him think of a pleasant thought is what my Jimmy needs. Yeah. Who beat you up? I better tell him, honey.  I guess. I don't know who beat me up. I was attacked from behind. I never saw him. Poor Jimmy. It was awful. You remember a man named Charles Ralston, Jimmy? Sure. What about him? Once he hit me with a car, it was my fault. Wet night all over, I stumbled into his car. What are you building? Since the accident, have you seen him? No. Did you know Mr. Ralston was dead? Dead. Last night, he was murdered. What about it, Jimmy? I know. Yeah, baby. Peel me one of those oranges you brought. Sure, honey. Mr. Ralston murdered him. And you beaten up? And once the two of us had an accident together. Now look at us. That's what I mean, Jimmy. Another thing. What do you do for a living? He saw the pretty stuff in your room, baby. Don't worry about me, Clover. How long has it been since you've had a job? Well, since that car accident last night. Used to work in a filling station before that. Now I can't face it. Thanks, Jimmy. Thanks, baby. I really need an orange or something. This fella's upsetting me terribly. Trails his hand gently through the boy's hair. Bites her lip. Muses over his problem. Then comes up with a solution. The box of candy she had brought. Opens it. Makes a decision. Bites into it. Takes the orange out of his hands. Feeds the candy to the boy.  Believe the happy convalescence. And into December streets, walk it. And against background of Winfraid Tinsel, Winfraid crowd, pose the violence. The murdered man, Charles Rolston, a man who in March of last year had run down a boy. Boy, Jimmy Barton, who used to work a filling station but couldn't face the thought anymore. A 19-year-old boy with nice apartments, expensive things to wear to touch. Boy found beaten and $60 in his pocket. Boy with girl, Ina, boy without job. Run down nine months ago by Charles Rolston, beaten two nights ago, assailant unknown and enjoying every minute of it. So go now to a place to ask a question. Adler, insurance brokers, and Madison. Mr. Adler is highly pleased to meet you and won't you have a seat? His face will only take another minute. These shavers, electric and all are boom. A boom, Mr. Clover, to the male civilization. I must relate to the running to people and my thoughts on this subject. Here, see you later. Come on over here and see him like he... Look, Mr. Adler, I did move. Move, I can tell you. When I get through with her, Mrs. Cremat will tell you the same thing, I'll tell you. What? Aunt Lake Cremat, our newest widow. Husband tripped in the shower bed this morning, died on the way to the hospital. So I am pumping my face. I know my way right now to tell Adler. Poor Mrs. Cremat. Husband's insurance, all hers. It'll perk her up. Let's face forward to newly rich widows, huh, Mr. Clover? You're through now? Mmm, like a baby. Yeah. What's your problem, Mr. Clover? Charles Rolston. Fine fellow. Murder I read. You want to check on his insurance, huh? See, I'm way ahead of you. All right, tell me. Well, my opinion is you should mark up another tree, Mr. Clover. All Rolston characters, 10,000. 20 year life. These days, 10 grand is hardly worth coming for, isn't it? But the taxes, court costs, et cetera, et cetera. His wife with beneficiary? Why aren't you saying about that? Tell me. A year ago, she wasn't. Four months ago, she wasn't. Now, she is. Regardless. The Rolston's had a boy, 18, Charles Jr. He was with beneficiary. A year ago, it happened to him in Korea right away. Mr. Rolston wanted to change beneficiary to his wife. She wouldn't hear of it. She said keep it for her son. All right. The mothers in my business do that sometimes. They don't believe their boys are really killed. They just lost, not dead. Three months ago, Mrs. Rolston came around to the war department's way of thinking and the husband. So she let her husband make her beneficiary. Rolston carry accident insurance liability. Oh, you mean about when he ran down the kid James Barton? That's right. Yeah, he carried. We didn't pay a red cent. Mrs. Rolston wanted us to pay, but I outlined to her how the boys were up and down. It was his fault. So she was just being foolish. It didn't really penetrate them. No? No. I think she paid off all the boys' hospital bills, sent them books, California for things like that. Look, Mr. Culver, if you knew how anxious the widow gets, she hates to be kept away. Yeah, you're told me. Have fun, Mr. Adler. Come in, Danny, come in. Have a chair. What can I do for you this evening? How long has it been since you were at the hospital to see Jimmy Barton? Five this afternoon. He told me you were in this morning. He said you upset him. Upset him. I have a theory about that boy. Fun. Someone could beat him over the head with a baseball bat and he would become unconscious. But as far as beating him over the emotions, he would only grin at you. The layman phrase for it is, uh, tough cookie. A real hard boy, Danny. How badly was he hurt? Contusion. It was. He'll be released tomorrow. Could it be done tonight? I think so. Well, think about it right now, Dr. And tell me. All right, I'll release him. Good. Meet your phone, Dr. Help yourself. Danny. Danny, Markerman. Yeah. Jimmy Barton is going to be released from the emergency hospital. Salem. Right. You'll be where? Waiting to hear from you in my office. Oh, sure, Danny. Where it's warm, huh? That's right. I'll turn up the heat and think about you, Markerman. Thanks, Dr. Oh, the word was warm. The office. To look through a window out on the word was cold. Cities seen through beads of moisture. Crowd fleeing to a thousand places. Winter lights that speckle winter sky with colors and fleeting shapes. Winter building gray and stark. All of it framed in a patina of wet. Look at it. Wait for it. Danny Clover. You can come out now, Danny. The lady's apartment. You're right there. The phone call came out over here. Oh, sorry. Yes, I do. Oh, that's too bad. We want to tell Jimmy how glad we are he's up and about your apartment. What are you talking about? You got another way of saying it, Danny? Just let's go inside, Mrs. Well. The men. They're here. Please. Make yourself at home. How do you feel, Jimmy? Claire says I look awful. He does. Claire was going to make me a poultice. Isn't that what you call it, Claire? A poultice? Mr. Clover. Yeah? He didn't do so much. Yeah, we were worried. Yeah. That's right, Jimmy. Worried why a 19-year-old boy gets beaten up lands in a hospital. That's civilization for you, isn't it? What are you doing here, Jimmy? I'm going to tell you something. I really don't know. Honestly. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I really don't know. Honest. Jimmy. Honest, Claire. I got out of the hospital. I figured it was what you'd like me to do. Call you. Come over here. But I got to tell you, too. I don't know why. We're pleasant, Jimmy. The monogram shirt, the knitted sweater. It's hard of it. Not all. Jimmy. I think you better go home. Why? Just go. Stick around, son. Why do you want me to go home, Claire? Boy. She doesn't want you to be hurt. I'm not going to be hurt. That's all over. You want to tell us who beat you up now? He keeps eating you guys, don't it? Not especially, Jimmy. We know. Well, huh? Listen, you two. It's got to end now, Mrs. Ralf. You can't protect him anymore. And it started ending when your husband beat him up. Claire. What? They figured it out themselves. I didn't tell them. And that's what worries us, son. A kid gets beaten up by an older man in normal procedures to come running. Why didn't you? It would have spoiled a good thing. What are you talking about? I'm old enough to be. His mother. Yeah. Yeah. His mother. Yeah, that's what it is, Claire. His mother. Substitute of this boy for your son who was killed in Korea. What is it? You lied to us, Jimmy. When you said you hadn't seen the Ralphsons after you walked into their car. Well, after all, well, I figured I owe this lady something. This lady? This lady? You got a blast giving me presents, taking care of me. Why shouldn't I do something you asked me? Like lighter cops, even when it had murder in it.  She did. I still got presents. And that's... that's all that counted? Sure. I'll just see what's happened to me. All I know is Claire gave me an allowance that made her happy. But not her husband. He got sick of it. Beat you up.  Claire. What, Jimmy? Is that what you want? To be my mother? Yeah. That's a fresh one. Jimmy. Are you sorry for me? What happens to that insurance you're supposed to get now? You think you'll get it? Knocking over Mr. Ralphsons and me? I could sure you just thought I'd ask. Forget it. It's a clock hour, the time of going home. But in a while, the night will dip down and touch the streets, and there'll be fury again. Rack and roar, and proud. The puppet dance into the furnace of light. Directed by Danny Clover, with Charles Calvert as Tartaglia and Jack Krushen as Muggevin. The program is produced and directed by Elliott Lewis. The musical score composed and conducted by Alexander Courage. In tonight's story, Paula Winslow was heard as Claire Walson and Sam Edwards as Jimmy Barton. Featured in the cast, Welvina Temple, Steve Dunn and Tom Holland. Alexander speaking.


Hello and welcome to the session in which you would look at the SEC reporting requirements. Now the SEC is an important topic on the CPA exam, whether you are taking DEC or FAR. And in this session, I will cover several topics about the SEC, the SEC roles, reporting requirement, the 1933, 1934 acts, and forms that you will need to file with the SEC as a company. So it's very important that you have a good understanding of the role of the SEC because you might have questions whether it's on BEC and sometimes even on REG. Somehow, BEC is involved somewhere. So that's why the SEC is an important topic for the CPA exam overall. Now whether you are studying for your CPA exam or you are an accounting student, I strongly suggest you take a look at my website farhatlectures.com. No, I don't replace your CPA review course. I can't do that. I'm a useful addition to your CPA review course. I explain the material differently than your CPA review course, which will help you with your CPA review course, which will help you with your CPA examination. Your risk is one month of subscription. That's what you do if you decided to try me out. Your potential gain is passing the exam. And if not for anything, take a look at my website to find out how well or not well your university doing on the CPA exam. I do have resources for other college courses as well. Please take a look at my website. If you haven't connected with me on LinkedIn, please do so. Take a look at my LinkedIn recommendation. Like this recording. Share it with other. Subscribe to my YouTube. Connect with me on Instagram, Facebook, Twitter and Reddit. So it's important to understand the big picture. Why the SEC exists and when did it exist? Well, the SEC existed as a result of the 1929 stock market crash. The government wanted to restore confidence in the stock market. So what they did, they created this federal agency to what? Regulate trading. Why? Because people lost confidence in the stock market. So there we go. The government said we're going to create an agency that's going to oversee the financial market. And if you understand this big picture, you will understand why the SEC asked for certain material. It's basically to prevent fraud and misrepresentation to the public. So when when brokers when individuals sell stocks to the public, you want to make sure that the public or investors are informed. So the SEC role is to make sure those investors are enrolled are informed. So what tools does the SEC have in order to do so? Well, you have the Securities Acts of 1933, which will cover IPO, IPO stand for initial public offering. And what is initial public offering? It's when the company first go public. For example, Facebook now is a public company. But up until 2012, I believe, Facebook was a private company. So before they go public, before they go public, before Facebook sell their stocks to the public, they have to issue something called a prospectus we'll talk about which it's part of the registration statement. So the 1933 deals with IPOs and deals with something called the prospectus which we'll talk about. Another tool at the SEC disposal is the Securities Act of 1934, which can talk about those little bit more in details. The 1934 deals with the secondary market. So once Facebook is publicly traded, okay, now it's traded. People are buying and selling Facebook. It's no longer a new issue, a new issuance. Then the company will have to issue 10K, 10Q, 8K and many other forms. Then they follow the SEC Act of 1934, which we'll talk about little bit more in detail. This is just an overview. Then the SEC has something called regulation SX, which is covered financial data, financial means, dollar amount, such as financial statements, notes and schedule. They also have regulation SK, mostly covered non financial data such as disclosure, standard and certain aspects of the corporate annual report. It doesn't mean they don't cover financial, but a great degree non financial for the SK and they have many other forms that are required. So those are the tools that they have. Let's start by looking at the SEC Act of 1933. Once again, here you are dealing with the IPO. So before a company can go public, what do they have to do? They have to file what's called registration statement and the registration statement has two part. One part of it has called the prospectus and what's the prospectus? Basically provide information, information to investors to make an informed decision. Just give the information to the investors because they're going to be investing money in your company. What does the information involve? It will involve disclosure about the securities offers. Just tell us about the securities that you are selling. Information similar to what's filed in an annual filing. Now you might be saying what's included in annual filing? We'll see in a moment. Okay. Audited financial statements. So the financial statements which will be part of the annual filing will be audited. And as an auditor, this is the riskiest type of audit because when you go public, everyone is relying on the auditor because the company did not have their financial statement publicly, their financial statements are not public yet. So there's a lot of heavy work on the auditor's part to make sure they do a good job. Obviously they'll have to also talk a little bit about the risk factor, which is also that's also part of the annual report. Just what risk factors do they, does the company face? So basically any other helpful information, any other helpful information will be disclosed in the registration statement, which is in the perspective, which is part of the registration statement. The second part of the registration statement is something we called basically different agreements relevant to securities, articles of incorporation, major contract, legal opinion, agreement with the underwriters. So basically other information that's helpful to the investors. That's what we are doing. Now bear in mind that securities stocks cannot be offered to the public until the registration is effective. And what is the registration effective? 20 days after filing. So you file and 20 days later, the company can sell to the public unless there's an amendment basically, oh, hold on a second, we made an error, or there's a stop order. So basically the SEC said, no, you cannot sell it for some reason. Okay, now meanwhile, there's something called red herring and red herring is the preliminary prospectus. So you can show the investors certain information about your company, but not everything that is called the red herring before, before the SEC agrees for you to sell it. So this is all you need to know pretty much about the Securities Act of 1933. So once your stocks are traded, so once the stock go public, now you follow the Securities Acts of 1934. This is called the Secondary Market. Secondary Market means your stocks now is traded. Now you have to issue financial report on regular basis. So who follows, first of all, who follows the Securities Act of 1934? List securities on national securities exchanges. So if your stock is traded on a national exchange, such as the NYSC, New York Stock Exchange, or NASDAQ, then you have to follow the Securities Act of 1934. If you have at least 500 shareholders of equity and total gross assets exceeding 10 million, now you fall under the Securities Act of 1934. And if you're already registered with the SEC of 1933, so if you follow the 1933, you're going to have to follow the 1934. What forms do you need to file? Well, here are the forms. There are many 10K, 10Q, 8K, and those are usually mostly tested on the exam. It doesn't mean the others are not 11K, Form 3, 4, and 5, Form 20F, 40F, and 6K. And the reason those are in green because those are for foreign companies and we'll talk about them in a moment. Now I'm going to go over each form, especially the one in red, a little bit more in details, just to kind of tell you what they are. When you hear the form 10K, that's an annual report. That's the annual report. 10K equal the annual report. When do you have to file the 10K? Well, depending on your size, the company size. So we have something called large accelerated filers. Who are the large accelerated filers? If you have 700 million in market capitalization, how do you measure your market capitalization? It's the number of shares that you have times the stock price. And if the number of shares outstanding times the stock price is more than 700 million, you are considered large accelerated filers, you have to file your annual report 60 days after your year end. Now your year end could be December 31st, could be the end of March, could be the beginning of July, whatever your year end is, it could be calendar or a fiscal year. Then we have accelerated filers, accelerated filers, the market cap or market capitalization for short, market cap for short or market capitalization. If you have 75 million to 700 million, you have 75 days to file.  Yes, smaller companies, they have more time because the assumption is they have less resources to get their financial statement ready. And large accelerated filers because they are large, they are important, you want to let the public know about their numbers as soon as possible. So it is in the annual 10k audited financial statement. And I highlight audited, make sure you understand it's audited, it gets an audit. And those financial statements are certified by the CEO, the CFO of the company. And the financial statement would include notes, disclosure, schedule, summary of financial data, it's going to be the current year, as well as prior years, something called management discussion and analysis and DNA where the company talks about their performance, basically give their best picture under MDNA. So this is the 10k. 10Q, Q, Q implies that it's a quarterly report. So the 10Q is a quarterly review. Notice I hear I said review and I'm going to explain what a review is in a moment. Again, you have large accelerated and accelerated filers, the large accelerated and accelerated filers, they have 40 days after the end of the quarter. So if the quarter and December 31st, you have 40 days to file your quarterly numbers. If you are a small company, small reporting which is less than 75 million in market cap, you have 45 days. So what you do is you prepare financial statement on a quarterly basis, quarter one, quarter two, third quarter, those are called any any financial statement that's not a yearly, it's called interim financial statement. Interim financial statement means it's less than a year. And those financial statements are reviewed. Again, what is reviewed? Not again, reviewed is not audited. All what a review is, is you ask you ask questions about the company, you ask management questions, and you perform analytical procedures. So during the review, you don't audit the company. Basically, you put the numbers together as an auditor. And basically based on analytical procedures and inquiries, because you don't have enough time to audit the financial statement, because it's only for a short period of time. It's an interim financial statement. So the interim financial statement, we say they are reviewed. So simply put, you don't say they are in compliance with gap, you just say, I'm not aware that they're not in compliance with gap.  Okay, that's negative assurance. So what would the five quarterly report to include if there's any legal proceeding, you'll have to talk about this changes and securities and indebtedness of the company matters submitted to shareholders for vote, exhibit of the form 8k, what's 8k, we're going to talk about it next, anticipated effect of new accounting principles, if there's any new account, upcoming new accounting principle, like new revenue recognition principle, you might want to say, it's, it's upcoming, it's going to be implemented into quarters. And this will be the effect on the financial statement. Okay. 8k, when do you file the 8k, 8k is on demand, you could file it every day, or it may you may never file it depending on what happened. So this form is filed to report major corporate events. So what is considered a major corporate event? If you if the corporate asset acquisition or disposal, you bought a new like, and you bought a large part and another company, or you bought a new asset that's important, changes in securities and trading market, there's any changes in your securities or your trading of your securities, changes to accountant or financial statements, if there's any changes, you went went back and you made changes to your financial statement, your auditor, you changed your auditor, you change your CEO, corporate governance or management, for example, Chipotle hired recently a new CEO, the CEO that they hired was the four, the former CEO of Taco Bell, that was a major event. So they filed, so Chipotle filed an 8k to let the investor, investors know that we hired a new CEO who happens to be the former CEO of Taco Bell. Okay, this is one you file an 8k something like this, or any other major event that the company considered major. Let's talk about foreign related forms and specifically form 20f and 40f. Just like US companies, they'll have to file an annual report with the SEC, foreign companies would also have to file their annual reports. However, we have two types of annual foreign reports, 20f and 40f. Let's start with 40f. 40f, if you're a Canadian company, you will file a form called 40f. For anyone else, Mexico, Japan, Europe, Asia, anywhere else in the world, they will need to file form 20f. So simply put, the Canadian we have a special treatment for the Canadian, they file 40f. Everybody else file form 20f. Remember, F is for foreign, it's easy for you to remember on the exam day. Usually companies, foreign companies, they use the IFRS, the International Financial Reporting Standard. If they're not using IFRS, and obviously if they're not using gap, and they have to reconcile, so they're using some other method, which is very unusual because most companies use IFRS if they don't follow gap. Another form that's related to the foreign related, it doesn't end with F, it's called 6k. This form is filed semi-annually by foreign private issuers. Private issuers, it means they're not selling their stocks on a public, on a national exchange. This form is similar to 10Q and can contain unaudited financial statement. Remember, this is for, so if you're going to invest in them, you're privately doing so, so you don't want audited financial statement. You'll have interim period, MDNA, and certain disclosure. So they will have certain disclosures for those, for those type of filing. Other forms, we could have form 3, 4 and 5 required to be filed for directors, officers or beneficial owners of more than 10% of a class of equity. So if you are a major owner in a company, you want to let the public know that, for example, Warren Buffett, when he buys a large chunk of a company, we have to know about this, if they own more than 10%. So this is, this is the forms that they use, 3, 4 and 5. We also have form 11k. This is an annual report of the company's employee benefit plan. So if the company have an employee benefit plan, basically a 401k or some type of a pension, they report this. Usually it's a pension, dealing here with a pension. Then they report their figures about the pension. One more thing, there's something called shelf registration under the 1933 Act, because think about it. Do you have to file all this paperwork, the prospectus, the registration statement every time you need to issue new stocks? And the answer is no. Companies may file registration statement covering a specified period of securities that may be issued over three years of the statement. So you would file your paperwork and you have three years to sell your stocks. So you don't, you know, if you're, if you're, if you're not needing money now, you could wait until six months later or a year later. So the issue or the company that, that have those shelf registration, they don't have to file a new registration statement. They don't have to wait 20, 20 days and they don't have to prepare a prospectus. So what does that mean? It means they can do whatever they want to. Not everyone. The issuer only required to provide updating a amendment or defer investors to quarterly or annual statement. Here what we are assuming, you are a seasoned company. So you already have quarterly report. You have annual statement like Tesla. When Tesla wants to sell new stocks, they don't have to go back and go to the underwriter and start a new prospectus, get their financial statement audited again. Well, guess what, they're already up and running. And what they do is they might have, they might have stocks approved already by the SEC under the Shelf Registration Act. So when they want to sell additional stocks, they don't have to go back to the SEC. Okay. So shelf registration is available to well known seasoned issuers.  And here's a deadline for 10K and 10Q. Although I showed it to you earlier, but this is basically another picture of it.  And this is the 40 days for the quarterly review if you're large and accelerated filers, 45 days, if you are considered small. At the end of this recording, I'm going to remind you that this topic is important on the CPA exam. And once again, I do not. I do not replace your CPA review course. I am a useful addition. My material will help you along your CPA review course. Don't shortchange yourself. Your CPA exam is a lifetime investment. Take it seriously. Study hard. Good luck. The CPA is worth it. And of course, stay safe.


Sticking with Section 5A as well. Nevis taking on Bram, taking it to the first set between the Tigers and the Bombers, and the Tigers getting points by any means possible. Emma Bliss taps this one into the Bram territory, but then Bram quickly responds, taking 11-8 lead. Then Jessica Swanda keeps the Bombers off balance with this hit here for another Tiger point. The Tigers were trailing 17-10, but took advantage with the next service error, followed by a strong kill from Hannah Anderson. They end up falling tonight by a final of 3-0 to Bram. Their season is over. If you've enjoyed this segment of Lakeland News, please consider making a tax-deductible contribution to Lakeland Public Television.


Okay, we're back. We're live with talking tax with Tom on a given Monday morning. And Tom is the president of the Tax Foundation of Hawaii. And Tom, welcome back to your show. Nice to see you. Nice show. Thank you so much for having me on your show. Okay. Let's talk about tax this morning. Let's talk about something that has interested me in the context of Hawaii for a long time. And that's tax incentives. And I suppose I spring on that issue from the sad story of Act 221, which was intended to build a tech industry in Hawaii. And it was adopted by the Kaitano legislature back in, I think, let's see, 1989, I'm sorry, 1999, or perhaps the year 2000. And Linda Lingle beat up on that statute for 10 years and then finally forced it to sunset early. And with, you know, of course, confidence is the firmest pillar of justice. And she wrote in public confidence in the statute on a regular basis. And it never had a chance, you know, to do to do what was intended to do. So, and that's, I guess the counterpoint is, you know, from the legislature side of it, they, they saw the tax return, they saw the amount of money that was going out the door. And they, they turned colors a few times. So the question then became, well, what exactly are we allowing? And when they kind of took a look at what actually was going through, they said, well, geez, none of this was intended. Yeah, they were they I remember that. And that was an important issue. And one we should talk about today. I mean, here's the economy of the state. Here's all those kids leaving.  Here's a mono economy, only one thing going on tourism. And so this was an important attempt. And there were people in the ledge who thought this was the most important bill ever, ever passed this state of Hawaii, because it, it realized the dream of John Burns, the dream of George Ariyoshi, and all the governors for that matter, right on through Kaitano. And so the idea was to build a tech industry just like San Diego built a biotech industry back back in the 60s to make to make Hawaii a high tech place. And I have to say that when it failed, which was in 2010, because Lingold was campaigning to have it sunset early, supposed to sunset a couple years after that. When it failed, the tech industry failed. And I remember talking to all these young kids who would come from the mainland to participate in this great experiment in Hawaii, the building of a tech industry, and they were leaving. They were going. They had it. It was not just that, you know, there was no dollar and cents incentive that would bring capital into these startups. It was more than that. It was a statement by the state government, especially the governor, that they didn't care about tech. They didn't care about innovation. They didn't care about building an industry. They didn't care about broadening the economy. And these young kids said, well, you know, there's no future for me here. I'm leaving. I talked to a number of them. They left. So tax incentive is more than the dollars and cents. Tax incentive is a statement by government to say we want to do this and we're willing to put our money where our mouth is. But I agree with you, from the very beginning, even before, you know, company one had been established, even before, you know, there was any real opportunity for traction. The ledge and Lingold were making these, and Sean Howe, this Honolulu advertiser, was criticizing the statute because it wasn't it was costing too much and it wasn't returning anything right now. They wanted to see a return right now. And indeed, you know, the calculation was, gee, at one point it hit as much as 100 and 150 million altogether. By the way, that's a lot less than other tax credits that have been adopted. But people were excited about that. And I guess the argument from the public was something, those who opposed it because of all the newspaper articles and opinion pieces, they were saying, wait a minute, why are you giving a tax credit to these young kids doing tech? Why don't you give it to me? You're taking it out of my pocket and giving it to them. Wrong. I don't, I don't agree with that. I oppose that. And so there was this great big groundswells. We don't need no stinking tax credits. And for that matter, we don't need to incentivize development of a tech industry. And so that was the end of it. One of the problems at the time, of course, was that the technical aspects of the tax credit weren't really well-defined. There were, you know, like seven or eight different categories of what we called qualified tech businesses, some of which didn't sound like tech at all. One of the big stories in the beginning, for example, was the movie Blue Crush, which was, because movie development was identified as tech-related, I don't know how. But it was included in the same rubric and it was eligible for the same credits. And that's kind of what happened. The producers of the movie got a smart lawyer to write in and the department had to rule that the movie was eligible. Well, I totally agree there were abuses. And Blue Crush was clearly notoriously one of them. It was also the drop-down corporations, where a wealthy local corporation could create a subsidiary and have the benefit of this tax credit, where, you know, I think it was more intended for startups, not a drop-down subsidiary.  There's a section, I'm sure you're familiar with it, Tom, in the federal regulations, as if this is intended as a tax avoidance scheme, then it can't be used for that purpose.  I mean, you stop loopholes with changing the statute or building regulations that effectively deprive people who shouldn't have the benefit of a particular exemption or a tax credit. That was not done. Instead, Lingo was out there, Lingo was out there trying to punish investors. I remember, I remember the campaign by Lingo. They were regulating by audit. Yeah, right. And they had to turn their pockets out. They had to show you their tax returns. I mean, make public disclosure, I think. They had to bend over and reveal things that ordinary taxpayers, ordinary investors, didn't have to reveal. And it was obviously intended to discourage. It was not intended to actually help the development, the refinement of the statute. It was intended to discourage investors. And guess what? You can scare away investors pretty well. Hawaii has a great record of scaring away investors, including now. What I enjoy most, and I'll stop after this, is the article in the paper written by Sean Howe. It was a banner headline, and it said, Act 221 investors found to be wealthy. Get that, Tom. Found to be wealthy. This was a kind of, you know, journalism that we had in those days. It was the kind of position that Lynda Lingo was taking to punish investors. And after a while, there were no investors. So you can't be rich. The idea of a wealthy investor, that is really something. Of course, most investors in the world are wealthy. So that was ridiculous to make that headline and write that article. However, let's talk about the policy. Would you agree with me that however the mechanics of the statute worked, and they tried hard, maybe with some success and some failure too, they tried hard to incentivize the tech industry. Because everybody, at least in the line of governors anyway, and lots of the legislature enough to pass the bill, felt that it was a good thing for Hawaii. That's why they passed it. But don't you agree that that that was a worthy, worthy goal, worthy target for the state economy? And it was worth a tax credit. And if the tax credit, you know, was not doing the job intended either too much too little, then you tune it up. That's what happened. That's exactly what happened in San Diego. Right. So when you want as a society to encourage certain kinds of behavior, you can do a couple of things. One, you can data. Two, you can penalize it. Three, you can incentivize doing the right thing. And this is one thing that the tax credit is used for. You know, sometimes I think tax credits are used for too many things that they shouldn't be used for. But this was one of the cases where it was used. Now, the problem is that when you have a tax credit, what you really want to do is you want to have some provisions that are very clear in what you're incentivizing. And, you know, the more things you try to do with it, you know, the more unrelated items you try to put in your laundry basket, the less clear it's going to be, and the more people who are skilled in such things can try to drive a truck through what you've built up, to get things that you weren't intending to be incentivized in under this tax credit. So one thing that you want to see happen is especially for, you know, to encourage a particular industry is you want the credit to taper off over time. And you want to stop it after X number of years, supposedly after the industry has had a chance to get established and get going. Because you can't have an industry running on tax credits forever. I think that's all true. And I would, I don't know exactly, but I would guess that's what happened in San Diego. And that was what was supposed to happen under Act 221 and other tax credits. But I think, you know, Hawaii does not have a good track record with this in terms of making it simple, expressing, you know, the purpose, expressing the need and making everyone understand it and avoiding loopholes that people could drive trucks through. And that's that's not, you know, a failure of concept. It's a fit. It's a failure of getting down into the details and writing a good bill. So how do you run it? Execution. Yeah. And of course, in executing it, it was a piece on 60 minutes last night about marijuana in Northern California, the Emerald Triangle, they called it. And there were there were there were and of course it's legal, right? But the state and the counties involved in that area have found ways to de-incentivize the growing of marijuana. And they have all kinds of little ways, you know, to stop the growers, especially the small growers. So it's a it's a it's a 1000 cuts is what it is. You can take a perfectly valid intention, a perfectly valid statute, and then you can cut at it, which is what happened here. For example, investors having to turn their pockets out. So you really need to have a focused program. You need to have the legislature and the governor, the leadership, if you will, remember why the thing was adopted in the first place and not try to pull the rug out from under it. Yeah, you're absolutely right. I mean, one of the one of the big problems that happened during Act two to one was there are, you know, there were changes made to it. For I think the wrong reasons. The, you know, the credit program was going was, you know, losing tons of money. And, you know, proponents came to the legislature and said, Well, it was, it was scheduled the sunset on X date. But let's have a few more years. Let's have maybe 10 more years. And, and they did get a couple of extensions through, not, not because really they, they had an industry that was viable and going, but because what they had was, let's say inaccurate and, and it wasn't really shitting the people that it was supposed to hit. And people were trying to fix it to make it better. Yeah, that was a certain amount of complaint going on in the community about a statute that only addressed a small subsection. But that was a subject and it should have been addressed. That was a subsection of the people who had built it. You know, in, say, 19 2000 or so, the kids were coming back from Silicon Valley. I could name some. They were there. They made some money. They had cut their teeth. They learned about technology. And they were ready to come back to Hawaii and build the industry. It was addressed to them. They were the, they were the intellectual property people. They were the vital, energetic, you know, generation who was going to do this. But when the bill got beat up that way, they stopped. They went into real estate. I'm serious. They went into real estate, gave up tech, gave up entrepreneurial activity. What a crushing blow this was to the future of the state. If you look back at, you know, our time here, our professional time here, if you want to see, you know, some of the big mistakes the state has made, that was one of them, crushing the opportunity. The other thing is it had, yes, it had a certain period of time before in sunset. And sunset, as you said, is appropriate for an incentive. After a time, you should not need it anymore. But they didn't know at the beginning how long it would take. In San Diego, it took decades. In this case, they only had a few years on it. And it was a guess. The whole idea at the outset was we don't know how long it's going to take for this to have traction. So we have to be flexible about the period of time.  So you know, the result is, you know, a lack of flexibility on this is fatal. And that's one of the reasons Bill died. Right. Anyway, so but let's talk about tax tax incentives in general.  There are 10,000 or fewer electric cars here in the state of Hawaii in a population of something, you know, 1.5 million, which has a total number of cars of over a million. So the percentage of electric cars against the incentive of all the cars is 1%. I get that right. 1%. Right. Now, if we want to be a tax credit for electric cars primarily federal, we give stuff like you know, giving them special license plates that pull out on free parking and, you know, entrance into the car lanes and stuff. But we don't give them monetary credit for electric cars. We did. We did. We gave them we gave them something over and above the federal credit. I forget the exact. It wasn't that much as I recall. It was it was several thousand dollars for a car and and and it was had a sunset on it and the sunset was pretty tight. And it came and went and it ended and that was that and it's only the federal credit. Now you can say the federal credit should be adequate, but it hasn't been somebody has to be watching this. We only have 1% of electric cars in the state. I mean, if I were king, if you were king, and we had decided that we wanted to have a fleet of electric cars that we wanted to really be green and not and not spend $6 billion or $7 billion on importing, you know, gas into the state to drive all these cars, we would do something. We would de disincentivize gas cars, fossil fuel cars, and we would incentivize electric and hydrogen cars. We haven't done that. So it should be or you would ban the fossil fuel cars. That's that's that's another thing or where you could enact mandates, which is, you know, we had talked about City Council Bill 25 to impose building requirements in all new buildings. And they would have required I think 25% of the of the stalls parking stalls in any new either residential or commercial building to be easy ready. I mean, that's that got got people going home. But that's one way to achieve that policy objective as well. I mean, what you what you need to do is kind of strike a balance between you know, being, you know, the carrot of the stick, so to speak. Oh, I totally agree. In other words, you know, if you were I were king, we wanted to do something about this, we wanted to change the numbers we want to be the state with the highest percentage of electric cars in the United States, we would find carrots and sticks both. And in a few years time, we would achieve our goal, we wouldn't need either carrots or sticks, because everybody would come along, they would have to know the problem is political will. I was the problem in 221. And it's the problem in electric cars. You know, for the life of me, I don't understand why on the one hand, we talk about electric cars, we tell everybody we have all these electric cars, but we don't. And on the other hand, we don't do anything about it. There's aside from, you know, allowing free parking at the airport, which is not entirely free, or free parking at meters, which is not entirely free. You know, we don't, we don't tell me if I'm wrong, we don't do anything. We don't do anything to incentivize this. And then we were surprised that we're behind the curve on it. This is not the only situation in which a tax incentive or some kind of other incentive or carrot or stick, you know, would change public conduct. But in Hawaii, everybody loves their cars. They love the sound of that engine. They love that big $70,000 truck or that huge SUV. They love to do it with fossil fuel. They're going to oppose the spending of big money for an incentive. They're going to oppose carrot and stick against fossil fuel cars, because they're invested in fossil fuel cars. Right. So there are, I guess, currently some, some things going on that may change the mix. The Department of Transportation has been kind of after this for some time because, you know, their highway fund is fed by fuel tax. So if you don't use fossil fuel, you don't contribute to the, to the maintenance or upkeep of the roads. And they say, Oh, this is a big problem. So we so they are they are now kind of going along the path of adopting a what we call RUC or road usage charge, which is going to be based on mileage, as opposed to based on the amount of gas you use. Yeah, is it happening? It's it's, it's, it's running down the tracks. Don't use that don't use that metaphor. Okay. Just try to keep that I open up something, you know, but you know, for example, I'll take another one homelessness. Okay, we really haven't done much on homelessness. Wayne Carisu, but he you know, has done a little village. But he's a he's a wealthy man. And, you know, he can afford to do it, he can afford to arrange things that you and I cannot arrange. And it's not too many like him. And so, you know, where exactly is the homeless village happening the next one? And can we have homeless villages for all the homeless? There are 1520 25,000 people that could use a homeless village. I mean, a good one, one that provides all kinds of benefits. And how do you do that?  But is there, I don't know the answer, maybe you do, is there a governmental effort in which governmental money is going into helping the homeless? And if not directly into the homeless? What about tax credits? For example, if I wanted to build a homeless village, how about getting the land free or cheap? How about a holiday from income tax or a holiday from real property tax or gross exercise tax for my efforts at helping the homeless? I don't think any of that really exists. So there's no real incentive or disincentive that's happening to actually make this happen. When are we going to learn about changing public conduct using tax and other incentives and disincentives? There's what I know is that there's a governor's coordinator on homeless. I know the guy, he's, he's, you know, Scott Marsh, he works out of the governor's office. And he's supposed to be, you know, building an interagency coalition between state and federal and county governments to address this problem. What has actually happened or come out of it? I'm not really sure. I think the operative word you use, he's out of the governor's office. Yeah, he has a little wee office there on the fifth floor of the Capitol. He doesn't have staff or if that staff, it's minimal. He doesn't have a budget. So is that, is that really the kind of effort that it will take to correct and to, you know, ameliorate the homeless problem? I don't think so. That's not enough. That's not a statement of, we really care about this. You know, what about giving him $100 million? Go for it, Scott. Do something. Figure out a plan. Make it happen. They're not doing that. Nobody's doing that. Nobody's doing that. That I agree with. So this is a huge big problem in the state. And we, you know, it's one of those, one of those sacred cow type problems where yes, we give it lip service, but we actually don't do anything. Yes, we, we like to see innovation and entrepreneurship and tech companies, but we don't do much to help them. You know, it's almost a religious concept. If God wanted there, if God wanted the homeless to be, could not be homeless, he would give them homes. God is not involved in this equation. Right? God is not involved in this equation.  If they have, even if they're not doing anything, they have no production and no, no, no life. Okay, so now it's better to do nothing and get this money as opposed to doing, you know, working McDonald's or Burger King or wherever it is and getting some minimal amount of money. So what do you do? And these fiscal questions are huge. Why? It's something that you and I talked about before a number of times. That is, the state can't pay its regular bills. So what, you know, the you got to have a plan, like San Diego, you got to say we want to we want to have a really terrific economy. We want the economy economy to hum. We want to have income here comes into the state, we want to be able to tax that. We want to have the money to, you know, pay for the right things. Unfortunately, we don't have a robust economy. A lot of the money in the tourism industry goes offshore. And the wages in the tourism industry are not, are not great. And so what what happens is, which has three or more heavily your year. Yeah, yeah, right. Well, so you know, the result is, we don't have an economy that yields a lot of tax. And by virtue of the economic activity. And so we can pay our bills.  And so you've got to do a jumpstart on things. You've got to build the economy. And I frankly do not understand why we don't do that. Do you understand why we don't do that? No, I don't understand why we don't do that. The COI executive council recently came up with a with a big paper on that.  They said, Hey, look, we really need to look at what we need to do to get the state back on track. I E, you know, we got we got crumbling bridges, we have maintenance backlogs, we have, you know, all this kind of stuff that has been neglected, and this is starting to fall into this repair. So what is it going to take to get us back to the status quo? And I think that the number that they came up with was like 80 billion dollars. You know, this is a kind of number that requires planning. There are people, I think in the legislature and elsewhere who deny that a problem exists. There's a problem. And they don't they don't understand about how tax either more tax or tax incentives can actually affect the economy and public, you know, perceptions, public conduct and public confidence in the economy. Anyway, I think we're out of time time. But it's been great talking to you. And I really enjoy the remote. And I hope we can talk to you again in a couple of weeks. Okay, great. Thanks so much for having me on the show. I'm Yamachika, President of Tax Foundation of Hawaii always enjoy Aloha time.