Karuk Tribe of California
Health Board Meeting
November 10, 2005
Happy Camp, California
Ayukii,
Meeting called to order @ 3:00 PM, by Chairman, Arch Super
Roll Call:
Present
Robert Grant Sr. Member at Large
Arch Super, Chairman
Leaf Hillman, Vice-Chairman
Alvis Johnson, Member at Large
Florrine Super, Secretary
Leeon Hillman, Treasurer
Roy Arwood, Member at Large
Florence Conrad, Member at Large – 3:20 PM
Robert Goodwin, Member at Large – 4:05 PM
Absent:
None.
Quorum is established.
B.) The Health Mission Statement was read aloud by Barbara Snider.
C.) Agenda Additions:
Reports: (CRIHB) Roy Arwood
Closed Session # 8: Roy Arwood
Closed Session # 9: Robert Grant Sr.
Closed Session # 10: Leaf Hillman
Closed Session # 11: Arch Super
Approval of Agenda for November 10, 2005:
Leaf motioned and Leeon seconded to approve agenda with additions 6 haa, 0 puuhara, 0 pupitihara
D.)Minutes of October 6th, 2005:
MOU for mushrooms was clarified for Roy.
Leaf motioned and Bud seconded to approve the minutes of October 6th, 2005, 5 haa, 0 puuhara, 1 pupitihara (Florrine Super).
E.) Guests:
None
F.) Old Business:
None
G.) Directors Reports:
1. Patricia White, Database Administrator:
Patti stated that she completed the month of September’s clinic facilities work load report. She has broken the data down into graphs so they may have a visual of what has been happening regarding those visits.
Leeon noted that he enjoyed reading her training report.
Florence motioned and Florrine seconded to approve Patti’s report, 7 haa, 0 puuhara, 0 pupitihara.
2. Vickie Walden, RDA, Dental Office Manager:
Included in Vickie’s report is the requested information on Native American accessibility to the Yreka dental clinic. The report was requested to view Native American access to the clinic.
Vickie noted that Dr. Madkins will be gone for six weeks, for personal business. Her leave time will start December 19th and run to January 23rd. In this time period the Happy Camp dental office will operate with dental hygiene services, but no general dentistry.
Vickie congratulated Susan Beatty for her new supervisor position, Jessica Thom for recently obtaining her RDA license and Tammy Rompon who was recently hired as a Dental Assistant for the Happy Camp dental clinic.
Flo Lopez questioned if during Dr. Madkins’ leave, another dentist could work in Happy Camp to cover her absence. Vickie noted that we may ask another dentist to come down, as Dr. Carlson has stated that he would come down previously, however this would cause a loss in clinical time. Another hardship in having Dr. Carlson come to the Happy Camp clinic is that he sees the emergency patients in Yreka. Dr. Carlson will have three hours of travel time, plus his work schedule. She would recommend that if this is chosen then it only be one day a week, for emergency hours. Vickie noted that it is possible to have him commute to the Happy Camp clinic, for this short period of time, along with a short schedule.
Leaf asked if there was additional information on the medical bulletin. Vickie stated that this will impact the Health Program, but how is still being looked into by Suzanna Hardenburger.
Vickie stated that in the past when laws change, it takes us about three or four months to get a response from IHS. Suzanna is continuing to work on this.
Leaf motioned and Leeon seconded to approve Vickie’s report. She shall continue to monitor the Native American visits vs. the Non Native American visits as well, 7 haa, 0 puuhara, 0 pupitihara.
3. David Eisenberg, PHN: (ambulance run)
Florrine stated that it would be nice to recognize the Yreka staff for performing their exceptional duties during an emergency situation at the Yreka Clinic. The Council agrees adding that their good work should be acknowledged.
Florrine motioned and Leaf seconded to approve David’s report 7 haa, 0 puuhara, 0 pupitihara.
4. Lessie Aubrey, DQMCH:
Lessie provided updates and revisions on several health program policies. The ACQI committee has reviewed the policies and made their recommendations during their last meeting held November 2, 2005.
Lessie recommends that the radiology policies, Policy on request to be excused, Policy on accurate completion of the PCC, Allergies, Error correction/charting, Filing of HIV/AIDS documents, Medical transportation policy, Information management training, intake new patient, access to records, special consents, release of information deceased patients, release of information –HIV test results, Release of information- general, release of information –telephone, Release of information – fax, charting guidelines, Signature list, Unit record, Individuals authorized to make entries into the health record (notation of an additional Dental Assistant will be stricken, as it was already noted on #13.), Chart order- medical, Problem list, purpose of patient health records, Policy on confidentiality, Reception confidentiality, timeliness of data entry, Educational activities policy, employee orientation, Secondary credentialing of licensed staff, Health program personnel policy, Policy on policy, Native American eligibility for direct care benefits, Patient identification policy, Verbal order policy, Medication list, Code of ethical behavior, Approved abbreviations and symbols, Acceptable and unacceptable abbreviations, Do not use abbreviations, Verification of patient identification and surgical site policy, Medical clinic appointment system, Intake established patient return visit, Consent for treatment, Retention of health records, Prescription refills, Inter-facility mail transfer of medical information, Traditional health policy, Removal of records from the clinic, HIPAA policies and procedures, Privacy act, Karuk medical dental clinic emergency plan, Environmental control and safety, Annual employee health exam and TB testing policy, Emergency procedures, Life safety management plan, Karuk medical dental clinic security, KTHP clinics-smoking policy, Utility systems management plan all be approved as presented with recommendations by the ACQI Committee.
Arch questioned the release of information regarding spouses, and to family members. Lessie stated that State law mandates that we hold PHI confidential regardless of family members’ wanting to partake in their family members’ healthcare. Every person is an individual person and should be treated as such in our clinics; their information must be maintained confidential, secure, and we are liable to ensure it is. Arch stated that it should be our obligation to inform family members of this as much as possible. Lessie will discuss this with the ACQI committee to find a solution on keeping our policy on confidentiality understood by our patients and families.
Florence motioned and Leaf seconded to approve the attached health program policies and procedures, 8 haa, 0 puuhara, 0 pupitihara.
Lessie also attached the monthly CQI projects, and the September ACQI meeting minutes.
Lessie noted that the colorectal cancer screening project was using clinical guidelines regarding screenings on patients over the age of 50 once a year. Although it’s a clinical practice guideline we may not be able to reach this goal, and the baseline should be found first. Lessie is recommending going back five years to capture the data of screenings getting completed.
Florence motioned and Leeon seconded to approve Lessie’s report, 8 haa, 0 puuhara, 0 pupitihara.
5. Joe Snapp:
Written report only, on travel.
Bud motioned and Robert seconded to approve Joe’s report, 8 haa, 0 puuhara, 0 pupitihara.
6. Larry Jordan, EDHHS:
Larry attached contract #06-C-008 with CILS for approval. CILS is utilized by the Orleans Social Services employee. The funding will come from the BIA compact.
Florence motioned and Leaf seconded to approve contract number 06-C-008 with CILS, 8 haa, 0 puuhara, 0 pupitihara.
IHS has come up with a plan to modify the ventilation system in the Yreka clinic. The total amount is $16,500 in which IHS is going to fund. The funding is within IHS which maintains IHS facilities. IHS has been coordinating with Fred to ensure our organizations needs are met. There is a contractor in Yreka that is going to do the work. The contractor and IHS will have a contract together, so KTOC will not have to do a bid, find a contractor to perform the work. He requests approval to receive the HVAC funding.
Leaf motioned and Bob seconded to approve the HVAC funding plan for the ventilation plan in the Yreka Clinic, 8 haa, 0 puuhara, 0 pupitihara.
CRIHB is asking for support and to send a resolution in support of an engineering position within CRIHB. The person their looking to hire is Kerri Gregg. In this new position he will be located at CRIHB instead of IHS. Leaf asked if we have utilized these services previously and if we anticipate utilizing the services. Leaf stated that we have our shares in IHS, and we would be agreeing to move those to CRIHB.
Roy stated that our membership with CRIHB determines the priority in receiving services from this position.
Bob questioned if we have seen any problems in the services in which IHS has been providing. Leaf questioned how many service units are being served by this position at the Area Office vs. how many of those members are CRIHB.
Bob compared what IHS offers vs. CRIHB. Leaf stated that he needs some more information. Larry stated that the will contract someone from CRIHB to come and discuss this further with the Council. Also, Leaf is interested in what IHS’ stance on this is.
Larry stated that Stephanie Dolan has set a meeting with Siskiyou Co. and Humboldt Co.
On December 7th , 2005 in Redding. He would like to get representatives from the ICWA committee to attend. Florrine also requests that Larry have Stephanie update the ICWA committee.
Roy questioned the process in which the pharmacy dispenses medication when a patient does not have their copay. He is concerned that patients who may be very ill and in need of their medication won’t be receiving it as they don’t have the $2 copay developed with recent pharmacy charging policy revisions. He would like to see a fund set up to help patients and Elder’s who may need it, under certain circumstances. This will be further discussed in the Wednesday planning meeting, as several Council members have received the same response and concerns.
Barbara Kashmir, attorney, will provide her legal opinion, in writing, regarding transferring the HCHS clinic to the Karuk Tribe. She stated that it will have to be carefully worded, but can be accomplished. Barbara Kashmir is from Berkley CA. and is a resource that CRIHB has used. The next move will be to meet with HCHS board, and present documentation and the opinion from the attorney.
The fee for her legal opinion is $600 - $900. Larry will set a meeting with the HCHS board, and move forward on this.
Larry is to run the legal opinion by the Vice-Chairman and other council members, as available for their review, when it arrives.
Larry stated that as part of this year’s accreditation process he and others were selected to be on a Leadership Committee. He would like to schedule a meeting with Arch, Bob, Dr. Burns, and Laura as they are the selected participants. They will review the JCAHO Leadership standards. The meeting is set for November 28th, at 12:00 PM.
Larry provided an update from the biannual health meeting held November 9th. There were a large number of staff in attendance, and also several that were presented with appreciation awards. They were provided disaster planning training, JCAHO training, award and recognition presentations, and strategic planning updates.
He thanked Council Members, Florrine and Bud, for attending.
Mock Survey:
Alette Thompson, Consultant, was present to complete a Mock Survey for the Health Program. Lessie stated that Alette did patient tracers, and performed an audit on the health program. A written report will be completed, and distributed at a later date.
Leeon motioned and Bob seconded to approve Larry’s report, 8 haa, 0 puuhara, 0 pupitihara.
H.) Requests:
Resolution stating that the Karuk Tribe will clear the Frank Jacobs property within 18 months was presented. Leaf stated that he and Leaf went to look at the property; both allotments will be sold minus a 20 acre parcel on the allottement. Approval has already been completed to purchase the property, and now there needs to be clean up. This will be an additional cost to the Tribe but it is something that needs to be done.
Florence motioned and Leaf seconded to approve resolution number 05-R-135, 8 haa, 0 puuhara, 0 pupitihara.
I.) Informational:
Larry stated that Dr. Solus has agreed to do a presentation on Obesity at the Youth Conference. Larry will keep Florrine posted on the details of this.
J.) Reports:
Roy stated that he attended a strategic planning overview for CRIHB. CRIHB is trying to resolve issues they are having, however Roy noted that CRIHB does not take advantage of their in-direct cost and have not negotiated an indirect cost rate to date.
They are trying to re-define their goals and objectives as they are growing and are trying to keep clear goals.
The Tribe received an award from CRIHB for being involved in their organization for fourteen years. Roy presented it to the Council.
Roy stated that he was able to present current KTOC issues in regards to our rivers and dams, and they were interested to hear the concerns. They didn’t have much knowledge regarding the concerns; however Roy was glad to give a small presentation, so we could gain their support. Roy stated that they were happy to have Larry there too, as not too many directors were able to attend. Larry stated that he put in his pitch for Pharmacy services. Arch stated that we need to find out exactly what benefits we gain from CRIHB. Roy stated that we’re on a fee for service basis currently. Arch asked if we have utilized much of what CRIHB offers.
Larry stated that we will be recovering some costs with signing up patients with Medicaid/Medicare, they participated in our Health Fair, and we participate in the SAMSA grant.
CRIHB is going to send out a draft of what their purposed strategic plan will do. Basically they are looking at what services will help the Tribes they serve.
K.) Closed Session:
Alvis Johnson excused himself from the meeting at 7:00 PM.
Case # 156: Speech therapy, $850 total for ten visits Bob requests further information; this will be moved to the Wednesday meeting for more information.
Leaf motioned and Bob seconded to approve the CHS Policies and Procedures. 7 haa, 0 puuhara, 0 pupitihara.
Consensus: To approve the Contract Health Policies and Procedures, previously distributed by Anna Myers.
Consensus: Directive for Larry and Mike DeHart to work on a policy regarding security of the Pharmacy. Also Mike and Larry are to discuss initiating changes in the pharmacy billing clerk’s location of work.
Bob motioned and Leeon seconded to authorize Leaf, Doozie and Chris to work on the Progeny TDR software request, and to work on the purchase up to the amount of $20,000. 7 haa, 0 puuhara, 1 pupitihara (Leaf Hillman).
A presentation meeting with TDR software will be scheduled for December 20th at 10:00AM, in Happy Camp.
Consensus: Approve recommendations from committee formed of Laura Mayton, Larry Jordan, Dr. Burns, Arch Super, and David Eisenberg. Larry will be present recommendations and gather feedback and input from the clinical staff. The staff and Larry will work together to determine actions that will be taken to improve productivity. Larry will report the status of this meeting to the Council, including a time line, and an assessment method. Maintaining identity while taking into consideration the changes suggested should be included in discussions. Presentation of recommendations shall be positive.
Consensus: Tribal Court Administrator will be available to attend the Wednesday planning meeting for discussion of position description prior to approval. Arch is also to send a notice in regards to handling CASA issues, until further notice.
Consensus: Supervisor will meet with Sara to ensure termination of employee is handled efficiently. Also have at least one Council member on hiring board for replacement of position.
Consensus: Deny loan request from DA. 0 haa, 7 puuhara, 0 pupitihara.
Consensus: Request from Tribal Member # 1780 for loan in the amount of $2,285.00, possibility of making $50 payments on loan if necessary will be discussed at Wednesday planning meeting;
Consensus: Discuss and address issues identified in email from employee BN at the Wednesday planning meeting.
Florrine will be calling in for the Wednesday meeting.
Consensus: Directive for Larry to investigate and address concerns over two medications errors.
Consensus: Directive for Election Committee chairperson to provide a district breakout of voting results to the Council Members.
Consensus: Discussion of Election Committee to be discussed at the Wednesday planning meeting.
Florence motioned and Florrine seconded to approve donation of $600 to Hermanett Albers to purchase turkeys for underserved individuals. 7 haa, 0 puuhara, 0 pupitihara.
Florence motioned and Florrine seconded to approve donation request in the amount of cost for five turkeys and four hams to Nadine McLeaya and the Family Resource Center, 7 haa, 0 puuhara, 0 pupitihara.
Consensus: Florrine will establish the needed access to the building and conference rooms for the Youth Conference, by employees who are participating that already have keys and access codes.
Leeon updated the Council on the Building Center in regards to interested persons in the purchase of equipment. If the inventory is going to be sold and someone is interested in purchasing it, then this should be further discussed, next meeting is scheduled for Monday November 14, 2005.
Next meeting date is set for December 8, 2005.
Leaf motioned and Bob seconded to adjourn meeting at 8:56 PM. 7 haa, 0 puuhara, 0 pupitihara.
Yootva,
__________________
Arch Super, Chairman
Recording Secretary, Barbara Snider