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Quality Domain	Client Meaning	Provider Meaning
Safe	I will not be harmed by the health system.	The care my client receives does not cause them to be harmed.
Effective	I receive the right care, and it contributes to improving my health.	The care I provide is based on best evidence and produces the desired outcome.
Client Centered	My goals and preferences are respected. My family and I are treated with respect and dignity.	Decisions about my client’s care reflect the goals and preferences of the clients and family or caregivers.
Efficient	The care I receive from all providers is well coordinated and efforts are not duplicated.	I deliver care to my clients using available human, physical, and financial resources efficiently, with no waste to the system.
Timely	I know how long I have to wait to see a provider or for assessments or care I need and why. I am confident this wait time is safe and appropriate.	My client can receive care within an acceptable time after the need is identified.
Equitable	No matter who I am, what I have, or where I live, I can access services that meet my needs. I am fairly treated by the health care system.	My clients and the populations I serve are provided differential approaches to access and service delivery as required in order to address systemic barriers and societal injustices ensuring every individual has access to the services they need, positive care experiences and outcomes, regardless of location, age, gender, race and other determinants of health.

Meditation Session with Michael Dunn

Michael Dunn

Michael Dunn has worked in the field of mental health for over 15 years and has served in a variety of positions ranging from street outreach to senior leadership. He is passionate about quality improvement, ethics in mental health care and working together with service recipients. Michael is also an avid meditator and has taught classes at the Jampa Ling Kadampa Buddhist Centre.

B2-2: Equitable Care/Access

Angela Robertson

Executive Director
Parkdale Queen West Community Health Centre

Angela Robertson is the Executive Director of Parkdale Queen West Community Health Centre. Parkdale Queen West is a community-based health service organization serving mid and west Toronto. Angela is dedicated to people and communities facing discrimination, poverty, and marginalization. Angela is a founding member of Blockorama, which focuses on forging a space for Black and other racialized LGBTQ+ people and allies at Pride and has served on numerous community Boards. Angela has been recognized for her social justice work by the YWCA, Fred Victor Centre, and Urban Alliance on Race Relations, NOW magazine and was honoured by York University in 2017 with an Honorary Doctorate of Laws degree for her social justice work.

A4-1: Patient Experience Measurement for Quality Care in Ontario

Client Experience Data Presentation

Patient/client experiences are a rich source of information for designing and implementing a high quality health care system. Measuring patient/client experience improves our understanding of care needs and preferences, and supports a person-centred approach to care delivery. In Ontario, there are gaps and inconsistencies in how patient/client experience is measured across and within care settings. Federal (e.g., CIHI), provincial (e.g., Ontario Health), and provider organizations and associations are working to develop an approach and tools to ensure that we are collecting comprehensive, valid and timely data on patient/client experience with health care. This presentation will share the experience of developing a coordinated patient/client experience measurement strategy and associated opportunities and challenges.

Dr. Gail Dobell, PhD

Interim VP, Health System Performance and Support Patient Experience Measurement for Quality Care in Ontario

Dr. Gail Dobell is Interim VP in the Health System Performance and Support portfolio at Ontario Health. In this role, she leads indicator development, selection, and analysis, as well as benchmarking projects across all health care sectors. She holds a Master’s degree in Gerontology and a Doctorate in Social and Behavioral Sciences from the School of Nursing, University of California, San Francisco.

B2-2: Understanding and Delivering Equitable Care: Collection of Sociodemographic Data in Ontario

This presentation will give an overview of how Ontario Health and the Centre of Excellence propose to use sociodemographic data across Ontario to understand and inform the delivery of health care across the province. It will also explore how and when organizations should collect client information including race-based data, what to consider when asking clients about their demographic characteristics, the value in collecting this type of data and how the data can inform care and planning at the organizational and provincial levels. The presentation will also touch on the plans for sociodemographic data collection in the MHA sector.

Maria Papadimitriou

Co-lead, Equity, Inclusion, Diversity and Anti-Racism
Ontario Health

Maria Papadimitriou is the Co-lead, Equity, Inclusion, Diversity and Anti-Racism at Ontario Health.

Maria is an adult education specialist with a Masters in Behavioural Neuroscience (MSc) from Queen’s University and a Masters in Public Health (MPH) from the Mailman School of Public Health at Columbia University.

Maria’s expertise is in leveraging policy and collaborative strategy to execute social change within organizations and across systems. Throughout their career, Maria has partnered with people who use drugs and their caregivers to develop and deliver non-stigmatizing services, improve workforce capacity and transform systems to be more effective, compassionate and inclusive.

Opening Ceremonies

Michelle Rossi

Vice President, Planning and Delivery
Ontario Health

Michelle Rossi is Vice President, Planning and Delivery in the Clinical Institutes and Quality Programs division (previously HQO) at Ontario Health. Michelle is also Ontario Health’s Executive Lead, Mental Health and Addictions Centre of Excellence, tasked with leading the team that is setting up the new Centre within Ontario Health. Prior to working in the agencies Michelle spent a number of years at Queen’s Park, including in the Office of the Minister of Health and Long Term Care as Director of Policy.

Greetings From MHA Centre of Excellence

Michelle Rossi

Vice President, Planning and Delivery
Ontario Health

Michelle Rossi is Vice President, Planning and Delivery in the Clinical Institutes and Quality Programs division (previously HQO) at Ontario Health. Michelle is also Ontario Health’s Executive Lead, Mental Health and Addictions Centre of Excellence, tasked with leading the team that is setting up the new Centre within Ontario Health. Prior to working in the agencies Michelle spent a number of years at Queen’s Park, including in the Office of the Minister of Health and Long Term Care as Director of Policy.

Opening Ceremonies

Jill Shakespeare

Senior Director
Provincial System Support Program at CAMH

Jill Shakespeare is the Senior Director of the Provincial System Support Program at CAMH. She is a values-driven and passionate people-leader, with a strong commitment to inclusion, social justice, and health equity. She has worked extensively in the health, settlement and social services sectors, supporting implementation and improvement at the organizational, community and systems level. Jill has supported a wide-range of organizations in the mental health and addiction system by championing equitable solutions to complex system challenges. Jill is deeply committed to driving change that centres the needs of those made marginal by the system. She holds an MSW from Laurier University and is currently completing her MBA at the Rotman School of Management at the University of Toronto.

A4-3: Improving Clinical Services Using Client Feedback

Client Experience Data Presentation

This presentation will highlight the value of including client feedback in the quality improvement process. Participants will be given examples of different types of client feedback that has been utilized at ADSTV, such as OPOC and EBD, which was collected to help inform service delivery changes. Participants will receive information on how to gather and utilize client feedback in QI processes within their own organization.

Heather Elliott

Addiction Services of Thames Valley
Manager of Quality Improvement and Professional Practice, Privacy Officer

Heather is the lead of the Clinical Quality Improvement Team at ADSTV. She ensures clinical quality service delivery through data analysis, mentoring, coaching and monitoring adherence to professional practice standards.

A4-2: Using OPOC Data as a Springboard for Equity-Focused Quality Improvement

Client Experience Data Presentation

The Ontario Perception of Care Tool for Mental Health and Addictions (OPOC) is a comprehensive survey that explores perceptions of care and service delivery across several health quality domains. Using OPOC data effectively requires a thorough understanding of how OPOC survey results are interpreted, compared to other information sources, and used to inform quality improvement activities. In this session, the presenters will explore a process for reviewing OPOC results and demonstrate OPOC data analysis with a dual focus on health equity and quality improvement.

Derek Chechak

Centre for Addiction and Mental Health,
Evaluator, West Region, Provincial System Support Program

Derek Chechak is an Evaluator in the Provincial System Support Program at CAMH who has supported the implementation of OPOC since 2016. He is a Registered Social Worker, with degrees from King’s University College at Western University, and his PhD from Memorial University. Prior to joining PSSP, he worked in tertiary mental health care and provided clinical leadership for a regional employee assistance program.

Shandy van de Light

Centre for Addiction and Mental Health,
Implementation Specialist, Northeast Region, Provincial System Support Program

Shandy van de Ligt is an Implementation Specialist in the Northeast regional office with the Provincial System Support Program at CAMH, who has supported the implementation of OPOC since 2017. She is currently working towards a Masters of Education in Adult Education. Before joining PSSP, she worked in various clinical and leadership positions in community and hospital mental health.

PhebeAnn Wolframe Smith

Centre for Addiction and Mental Health
Equity Coach, Northwest Region, Provincial System Support Program

A Settler based in Wiikwedong (Thunder Bay), PhebeAnn Wolframe-Smith is an Equity Coach with the Provincial System Support Program at CAMH, working with the OPOC implementation team. She holds a PhD from McMaster University. Prior to joining PSSP, she worked in research administration at Lakehead University.

Sustainability: How to keep all those great improvements you made

Generating improvement through your quality improvement work is so exciting. Seeing things get better and watching your data show improvement is a real rush. Why then do we sometimes feel like we are right back where we started a few months later? Sustainability is the key and this session will help you to see how it can be and should be woven throughout your QI projects.

Alice Strachan

QI Specialist
Ontario Health

Alice has been a quality improvement specialist with Ontario Health/HQO since its inception. As a QI Specialist, Alice provides quality improvement capacity building opportunities and is also part of the EQIP Working Group. Prior to joining OH/HQO, Alice was a practice facilitator with the Quality Improvement and Innovation Partnership. She is an IHI Improvement Advisor as well as a Certified Professional Facilitator

B1-1: Counselling Connect - Counseling on connecte

Counselling Connect Counseling, on connecte (CC-CoC) is a partnership between 16 + Mental Health and Addictions community-based agencies. Since its public launch last May, CC-CoC has provided over 4200 bookings for a free phone or video mental health and/or addictions counselling session for youth, adults, children and families in Ottawa and the surrounding area. This presentation will present highlights from CC-CoC’s first year. We will briefly explain how CC-CoC first got off the ground, its funding context, and the collaboration that made it possible. We will then turn to clients’ and providers’ experience by demonstrating a client’s journey through the service. Third, we will address lessons learned, and changes implemented throughout COVID-19 with special attention to how data and evidence have informed CC-CoC’s development.

Natalie Duchesne

Project Manager
Counselling Connect – Counseling, on connecte

Natalie Duchesne (Ph.D.) is the owner of Connect2Knowledge and is passionate about helping not-for-profit service providers build more equitable communities. In addition to providing project management services to Counselling Connect, she has helped service providers increase access and equity during COVID-19 by supporting the implementation of a device loan project and by building staff capacity to deliver virtual programming.

Listen. REALLY Listen. (The Cornerstone of QI)

This has been a year of constant change. The world around us transformed rapidly. In the face of the uncertainty and upheaval caused by the COVID-19 pandemic, living our values has never been more important. Support House’s Centre for Innovation in Peer Support saw how having a strong set of core values allowed us to respond quickly to change and to continue to meet the needs of both clients and staff. We have always driven for responsive change in our system.

To truly harness the energy of people power and what it takes to deliver services that bring enormous value - means living those values. Every. Single. Time. It is more than a filter. It is a standard of caring to meet and exceed a benchmark of excellence that is based on human interaction, building relationships, being reflexive and reflective, being honorable and kind. Always aspiring to do the RIGHT thing – no matter how many barriers are in the way. Tenacity. Grit. Teamwork. Hard Work. True co-design in Human Services cannot seed, grow, or flourish without the humanity and humility to hear what people are saying, needing and/or wanting. Whether that be people receiving services, people delivering services or people working to create the policy, governance and/or funding. At Support House’s Centre for Innovation in Peer Support we thrive in the art of possibility.

Betty-Lou Kristy

Director
Support House’s Centre for Innovation in Peer Support

Betty-Lou Kristy is the Director of Support House’s Centre for Innovation in Peer Support. Support House’s Centre for Innovation in Peer Support provides wellness based, peer-led self-help and social connections programming to community members; and support to organizations who have peer staff, through training in peer-support program implementation, capacity-building, evaluation, research, knowledge brokerage, and quality improvement. As a result, the Centre has evolved to become a “Benchmark of Excellence” in peer support and the meaningful engagement of lived/living experience and family/caregiver co-design. The Centre has been awarded the 2017 Ontario Peer Development Initiative (OPDI) Innovators Award, 2017 AMHO President Shield Award and the 2016 Association of General Hospital Psychiatric Services (AGHPS) Celebrating Innovation Award.

Betty-Lou is a bereaved mother, in recovery for almost 20 years from alcohol/multi-drug addictions, trauma and mental health issues. Betty-Lou lost Pete, her 25-year-old son with concurrent disorders to an accidental opioid overdose in 2001. She has additional caregiver experience in supporting close family members with cancer, cardio, lung/COPD, diabetes and asthma. She has spent 15+ years as a provincial system-level, lived experience and family – advisor, educator, and advocate – helping to frame policy, governance, and programming. Previous to this journey her background was in corporate marketing.

Betty-Lou has over 15 years of extensive board governance training and experience. She has completed 3-6 year terms being a board director for Bereaved Families of Ontario Halton-Peel, Canadian Mental Health Association Halton (CMHA-HRB), Halton Alcohol Drug and Gambling Assessment Prevention and Treatment Services (ADAPT), Glen Mills Co-operative Housing Corporation, and Addictions & Mental Health Ontario (AMHO).

Betty-Lou is the recipient of several awards such as the 2009 Centre for Addiction and Mental Health (CAMH) Transforming Lives Award, the 2012/13 Ministry of Health and Long-Term Care Achievement, Commitment and Excellence (ACE) Award –Partner Relations for her work with the Ministers Expert Advisory Group Narcotics, and the 2016 Support House Employee of the Year Award. She was recently appointed as Chair of the Health Minister’s Patient & Family Advisory Council (M-PFAC).

Humanizing, quality of life and reduction of harm are integral to her.

QI and Data Assessment

Naushaba Degani

Canadian Mental Health Association Ontario

Naushaba Degani joined CMHA Ontario on November 18th, 2019. She has worked in health system performance and evaluation for more than 20 years and has a PhD and an MHSc from the Dalla Lana School of Public Health, University of Toronto as well as a BScH from Queen’s University (Cha Gheill!). She comes to us from Health Quality Ontario (now part of Ontario Health) where she worked as the Manager, Performance Measurement supporting public reporting, quality standards and measurement for quality improvement. In addition to strong skills in data and measurement, Naushaba has a background in harm reduction, evaluation and equity assessment.

B1-2: Virtual Care/COVID-19

The Canadian Mental Health Association Halton Region Branch transitioned to virtual service delivery at the start of the pandemic in 2020. Learn how they have used and analyzed data from the Virtual Client Experience Survey (VCES) to examine the client perception of service, correlate client demographics and other factors with perception, and use the data to inform QI recommendations.

Ed Castro

Interim CEO
Canadian Mental Health Association Halton Region Branch

Ed Castro has over 27 years of experience in health services, focusing in addictions, mental health, health equity, system planning, policy development, and quality improvement, including Lean Six Sigma Black Belt certification. He is currently the Interim CEO with the Canadian Mental Health Association Halton Region Branch.

Megan McNeil

Manager, Case Management Services
Canadian Mental Health Association Halton Region Branch

Megan McNeil has worked in the mental health field for 18 years, moving from front line work in Case Management and Justice Services to her current Management role. She a certified Lean Six Sigma Black Belt and is involved in quality improvement initiatives within the Canadian Mental Health Association Halton Region Branch.

Angela Gaetano

Clinical Planner and Case Manager
Canadian Mental Health Association Halton Region Branch

Angela Gaetano, MSW, RSW, brings over 13 years of front line experience in mental health and addictions care and related services to her current role as the Canadian Mental Health Association Halton Region Branch’s Clinical Planner. A certified Lean Six Sigma Black Belt, Angela is a leader in the design and implementation of data-driven program development and quality improvement projects.

Using Data to move towards Equitable Care for All

Stefanie Stuart

Health Equity Specialist
Provincial System Support Program at CAMH

Stefanie’s work focuses on action-oriented and community informed approaches to equity through action planning & implementation, mixed methods participatory research & evaluation, education & development, and engagement. Currently, she works as a Health Equity Specialist at the Provincial System Support Program (PSSP) at CAMH. Stefanie earned her MPH from Queen’s University, and her BSc in Neuroscience and Biology from the University of Toronto Scarborough. Her work is grounded in the critical reflection, creativity, life teachings and knowledge gained from her culture and community.

Land Acknowledgement

Ru Tauro

Executive Director
Oak Centre Clubhouse

Ru Tauro has been working in the field of community mental health for close to 35 years. She is the Executive Director of Oak Centre in Welland, Ontario and the Lake House in Port Colborne, Ontario. At Oak Centre and the Lake House, she manages Clubhouse programs based on psychosocial rehabilitation principles that provide people with comprehensive supports in the community as well as opportunities to re-establish work skills in preparation to return to gainful employment or school.

Ru is the Co-Lead of the OCAN Quality Improvement Network which is a provincial group made up of 13 mental health and addiction organizations. The primary purpose of the OCAN QI Network is to look at how service providers can help their clients see the value of OCAN assessments for recovery-oriented planning, establishing goals, and goal attainment.

Ru is also involved with the OCAN Community of Interest through CAMH EENet. She also is a member on the Ontario Clubhouse Coalition and the Canadian Clubhouse Coalition. Oak Centre is part of an international Clubhouse community with 333 clubhouses in 33 countries world-wide.

Opening Ceremonies

Camille Quenneville

CEO
Canadian Mental Health Association Ontario

Camille Quenneville is the CEO of Canadian Mental Health Association, Ontario Division. Before joining CMHA Ontario, Camille channeled her passion for mental health care in senior leadership roles in the educational, governmental and children’s mental health sectors. She served as Director of Policy and Communications at Children’s Mental Health Ontario (2005-2012), Chief of Staff to Ontario’s first Minister of Children and Youth Services (2003-2005), and Director of Policy at the Ontario Public School Boards’ Association (1998-2003). Camille is an alumnus of the University of Windsor and the University of Toronto.

Opening Ceremonies

Adrienne Spafford

CEO
Addictions and Mental Health Ontario

Adrienne is a values-driven leader with 15 years of experience in public policy, advocacy, communications, and stakeholder relations. Passionate, focused, and collaborative, she is well-known among Ontario’s health care sector for her commitment to quality and humanity in the delivery of care – nowhere more so than in the area of mental health and addiction.

Adrienne has a strong track record of success in senior public and corporate affairs roles and has worked in some of the most highly-regulated sectors in Ontario. Adrienne has held senior positions at the Ontario Long Term Care Association, Canadian Breast Cancer Foundation, the Ministry of Health and Long-Term Care, Infrastructure Ontario, and with a former Premier of Ontario. Adrienne began her career as a consultant for private sector clients on culture and gender diversity at Catalyst Canada, Inc.

In her personal life, Adrienne enjoys cooking and home decor, and loves nothing more than living life through the eyes of her two young children, Lauren and Sam, alongside her husband, Kevin.

Grief and Loss in Harm Reduction/Lived Experience Perspective

Nicola Bangham

Executive Director
Breakaway

Nicola is the Executive Director of Breakaway Community Services located in Parkdale, Toronto. Prior to that she directed the Towhee Residential Program operated by CDI/Integra and was the Program Director of Pine River Institute. She has a Masters Degree in Creative Arts Therapy and is a Registered Psychotherapist.

Using Client Experience Data to Improve Care

Deanna Huggett

Manager of Implementation
Provincial System Support Program, CAMH

Deanna is a Manager of Implementation at the Provincial System Support Program (PSSP) at CAMH supporting the implementation of the Ontario Perception of Care Tool for Mental Health and Addictions and Staged Screening and Assessment tools. Deanna is passionate about system change, integration and collaboration, and uses her diverse experience within the health system to inspire teams to make things better.

Virtual Care during the COVID-19 Pandemic

Alice Strachan

QI Specialist
Ontario Health

Alice has been a Quality Improvement (QI) Specialist with Ontario Health/HQO since its inception. As a QI Specialist, Alice provides quality improvement capacity building opportunities and is also part of the EQIP Working Group. Prior to joining OH/HQO, Alice was a practice facilitator with the Quality Improvement and Innovation Partnership. She is an IHI Improvement Advisor as well as a Certified Professional Facilitator

Q&A with Panel

Presenters Alice Strachan and Chris Babcock along with Moderator Laura Daly-Trottier will answer your sustainability questions.

Laura Daly-Trottier

E-QIP Quality Improvement Coach
CMHA Ontario

Laura Daly-Trottier, delivers Quality Improvement Coaching through the Excellence through Quality Improvement Project (E-QIP). Since October 2016 Laura has delivered coaching to member organizations in the Mental Health and Addictions sector throughout the province of Ontario to increase the capacity for Quality Improvement.

Yoga Session with Shauna James

Shauna James

Shauna James, 200 RYT is a Project Coordinator with the Ontario Community Support Association and a movement facilitator. She has a passion for bridging community with movement practices and is inspired by the traditional teachings of Yoga. Her classes are a combination of traditional asana postures with lots of options and play! Shauna encourages her students to move their bodies in all the ways that feel best for them – feeling grounded and supported throughout the process.

Be sure to follow along on Instagram @shauna_ns for more!

Greetings From MHA Centre of Excellence

Dr. Paul Kurdyak

Ontario Health

Bio Coming Soon.

Navigating Performance Indicators for Ontario Health Teams

Kerry Waddell

RISE

Bio Coming Soon.

Master of Ceremonies

Chris Sullivan

The Centre for Addiction and Mental Health (CAMH)

Chris Sullivan is an Implementation Specialist and Coach with the Provincial System Support Program (PSSP) at The Centre for Addiction and Mental Health (CAMH). With more than 25 years of experience working in the community mental health and addictions sector, Chris brings a rich and diverse set of skills to support system transformation at the community and regional level. Chris specializes in implementation support, coaching, training, teaching, evaluation, and quality improvement. Chris is inspired daily by his wife and their two adult children. In his free time, Chris likes to woodwork, workout, and practice Aikido.

E-QIP in 5 Years, Next Steps & Evaluation

Naushaba Degani

Canadian Mental Health Association Ontario

Naushaba Degani joined CMHA Ontario on November 18th, 2019. She has worked in health system performance and evaluation for more than 20 years and has a PhD and an MHSc from the Dalla Lana School of Public Health, University of Toronto as well as a BScH from Queen’s University (Cha Gheill!). She comes to us from Health Quality Ontario (now part of Ontario Health) where she worked as the Manager, Performance Measurement supporting public reporting, quality standards and measurement for quality improvement. In addition to strong skills in data and measurement, Naushaba has a background in harm reduction, evaluation and equity assessment.

E-QIP in 5 Years, Next Steps & Evaluation

Debbie Bang

Addictions and Mental Health Ontario

Debbie has worked in the addiction and mental health sector for over 30 years. She was a public health nurse and a mental health nurse working with youth in high schools. She developed a first of a kind consumer information centre in a Canadian Hospital and has been involved in qualitative and quantitative research about health decision-making, cancer clusters, the impact of yoga with people with substance use issues and hearing from Canadians about the connection between mental health and an HIV diagnosis. Data and demonstrating value and outcomes has been a career long interest. During the last 18 years, Debbie has managed Womankind Addiction Service and Men’s Addiction Service Hamilton (MASH) at St. Joseph’s Healthcare Hamilton, project leading the amalgamation creating Womankind, the transfer and expansion of MASH from one hospital to another, managing the Eating Disorder program and was the management chair of the health and safety committee. Her credentials include a degree in nursing, a graduate degree in Health Promotion, a number of leadership and management diplomas and a green belt in LEAN. Debbie holds faculty appointments at McMaster University in the School of Nursing and Department of Psychiatry and Behavioural Neurosciences teaches motivational interviewing and trauma-informed care. Her interest in quality improvement is long-standing and Debbie learned early the value of data to provide perspective on how services are being delivered and what tweaks/ changes are needed to improve the quality of the services provide to the people we serve.

Sustaining Change: A brief review of two QI projects from CMHA Elgin Middlesex

This presentation will review two of CMHA Elgin Middlesex’s quality improvement projects; Improving Access to Case Management Services and Improving Employee Leadership Trust. A brief background and the results for each project will be shared followed by a discussion on challenges, barriers and/or enablers.

Chris Babcock

Quality and Performance Improvement Officer, Privacy Officer
CMHA Elgin Middlesex

Chris Babcock began with quality on the side of her desk for 12 years and has completed EQIP and IDEAS training as well as IHI training. For the past 2 years Chris has been in a role fully dedicated to quality improvement and performance measurement developing the position and growing a quality culture in CMHA Elgin Middlesex and the MH&A sector.

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If selected, Organizations participating in QI project coaching will commit to:

Submit your application for QI and data coaching below!

PART A: PROFILE

Project Team Details

PART B: PROJECT DETAILS AND DATA SOURCES

PART C: ADDITIONAL QUALITY IMPROVEMENT ACTIVITIES AND RESOURCES AVAILABLE THROUGH E-QIP

PART D: Agency-level QI and Data Culture Assessment

PART E: DECLARATION

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