Karuk Tribe of California
Health Board Meeting Minutes
May 13, 2004
Orleans, California
The meeting was called to order at 5:03 PM by Leaf Hillman, Vice Chairman.
Roll Call
Present
Leaf Hillman, Vice Chairman
Leeon Hillman, Treasurer
Roy Arwood, Member
Florence Conrad, Member
Robert Goodwin, Member
Absent
Arch Super, Chairman - excused
Florrine Super, Secretary – excused
Quorum is established.
Approval of the Agenda for May 13, 2004
Robert Goodwin moved and Leeon Hillman seconded to approve the Agenda for May 13, 2004. 4 haa, 0 puuhara, 0 pupitihara.
1. Approval of the Minutes for April 8, 2004
Leeon Hillman moved and Robert Goodwin seconded to approve the Minutes for April 8, 2004. 4 haa, 0 puuhara, 0 pupitihara.
2. Orleans Volunteer Fire Department
They thanked the Tribe for the current Community Facility and the new Panmnik Center which are open to the community. He states the department is made up of the entire community. He states they have ups and downs on funding and operate mainly on donations. They have had a bad year and their funding is dwindling. They have recently lost their 911 reimbursement for their fire phone system so they are requesting $2,000 to cover this expense for one year while they attempt to obtain a different system to notify the fire department personnel of emergencies. Their current system is one that will notify 20 homes at the same time so that they can have a fast response time. It will take them some time to upgrade to the county paging system so they really need the assistance.
Council states there are some dollars available for community fire protection in the BIA budget that can be used for an activity such as this.
Leeon Hillman moved and Robert Goodwin seconded to approve a donation for $2000 from 2130-06-7500.00. 4 haa, 0 puuhara, 0 pupitihara.
They would also like some assistance with seeking grant funding for a repeater for the Orleans area to upgrade their system. Leaf states he has spoke to Trista regarding this and with the Council’s direction she can assist in this type of activity. David Eisenberg states that a lot of times they can get additional funding for doing a collaborative grant to help both agencies. David, Wes, and Trista can all discuss this and Trista can be the point person for them.
Consensus: To have Trista work with the OR Volunteer Fire Department and coordinate with David and Wes.
He also requested that they start considering some sort of extra help for people with IVs in the Orleans community. There is an increase in these types of calls in the community. Leaf asked what type of assistance they would need for that type of call. He states there needs to be education of the individuals that are required to have IV treatment to administer them properly and safely to prevent the number of calls they receive. David states that the Clinic is open four days per week that can be available for this type of service. Wes states they have discussed having diabetic education offered at the Panamnik Center for the community as well so that they can have that information passed on. He also suggests that the diabetic patients keep the medication on hand in their homes for times when they are in a diabetic coma. David states that is more complicated than it seems and he can talk about it further with him.
3. Trista Parry
Wes states she is still working on the HRSA Grant, she hoped to have it ready tonight but it is not ready yet, so it will be a phone vote on Monday.
4. Old Business
None at this time.
5. David Eisenberg
No action items at this time. He states that his report included minutes from the planning meeting held on April 27, 2004 between himself, Wes, Trista, Flo, Babbie, and Lessie. They worked together to develop a more detailed questionnaire to send out to more people to get more information about these types of emergencies. He would like to know if this looks acceptable to them or if they have additional items they would like to add. They feel it looks good and he should move forward.
Florence states that he should educate people about things that are available to backup in home medical services such as oxygen so that they know those types of things are available.
Leeon Hillman moved and Robert Goodwin seconded to approve David’s report. 4 haa, 0 puuhara, 0 pupitihara.
6. Vickie Walden
She states she does not have any items to add to her written report other than that there may be a slight delay on the arrival of the Dentist. She may not be in until the second week of June which is not a problem as there is travel that week for the department. Wes states she underestimated how long it would take to move to California from New Mexico. Wes has also provided her some contacts for rentals in Happy Camp.
Leeon Hillman moved and Robert Goodwin seconded to approve Vickie’s report. 4 haa, 0 puuhara, 0 pupitihara.
7. Lessie Aubrey
She only had one action item, but Wes will present it in his report.
Robert Goodwin moved and Leeon Hillman seconded to approve Lessie’s report. 4 haa, 0 puuhara, 0 pupitihara.
8. Marsha Jackson
Not present, written only.
Leeon Hillman moved and Florence Conrad seconded to approve Marsha’s report. 4 haa, 0 puuhara, 0 pupitihara.
9. Joe Snapp
Not present, written only. There was an agreement included to do some work with Jim Bray for the Oak Knoll Facility but to date no one has seen the proposal so no action can be taken at this time. The cost would be $32,000 but no funding has been identified for this purpose. They need to obtain a planning grant to do this activity, a feasibility study, and also a business plan before they can move forward.
Leeon asked if Joe has been pursuing any funding for treatment as they have had to turn clients down lately. Wes states they are looking into a collaborative grant currently.
Leeon Hillman moved and Robert Goodwin seconded to approve Joe’s report. 4 haa, 0 puuhara, 0 pupitihara.
10. Wes Valentine
Wes was present to review his written report.
His first item was from Laura regarding a request for a certificate of insurance for June 11-12, 2004 for Happy Camp High School to cover their sober graduation activity.
Florence Conrad moved and Leeon Hillman seconded to approve the insurance addition. 4 haa, 0 puuhara, 0 pupitihara.
He states they received $200,000 for the month of April in Third Party Revenue!!! That means they are on track for 1.7 million for this year. They already have $100,000 for the month of May and they have finally worked out the Medi-Cal issue for Happy Camp Health Services and there will be an additional $150,000 in revenue coming in.
He states Karen Derry was the representative for the Turtle Health Plan Board of Directors and with her resignation he will need another representative appointed to go to those meetings. The goal of Turtle Health Plan is to form an insurance company for the California Tribes. They would obtain the Medi-Cal dollars from the State and then administer the care themselves instead of providing the services and then billing. He states it is important to stay involved so they know what is happening as the program progresses. He is not eligible to participate on the Board. It needs to be a Tribal Member designated by the Council that serves on the Board. There is one meeting each month in Sacramento. It cannot be the Medical Director or Health Program Director, the only other requirement is that they be a Tribal Member, it does not have to be a Council Member.
Robert Goodwin moved and Florence Conrad seconded to appoint Roy Arwood to the Board of Directors. 4 haa, 0 puuhara, 0 pupitihara.
He gave them an update on the Pharmacy, they filled 1,917 prescriptions in April, up from 1,515 in March. They have $70,000 of Medi-Cal bills waiting for the day the billing number is issued. He states that is good revenue to look forward to in order to support a Third Party Pharmacy line item to cover salaries, overhead, and medications. Any additional dollars go into the general Third Party budget for health use.
He presented an out of state travel request for Lessie Aubrey and Sharon Denney to attend JCAHO training in Phoenix. Lessie’s will come from her budget and Sharon’s will come from the Yreka Clinic budget and there are travel and training dollars available in those budgets.
Leeon Hillman moved and Robert Goodwin seconded to approve out of state travel for Lessie Aubrey and Sharon Denney in June to Phoenix, Arizona. 4 haa, 0 puuhara, 0 pupitihara.
His next request is to replace the flooring in the Happy Camp Multi-Purpose Room in preparation for the kitchen upgrade. The Ford Family Foundation already has granted funding which will cover this expense. This moves toward their goal of establishing a Senior Nutrition Site in Happy Camp. He also double-checked to ensure this is still a priority. They agreed he should continue to move forward.
Robert Goodwin moved and Florence Conrad seconded to approve $3,145 from Ford Family Foundation dollars to replace the flooring. 4 haa, 0 puuhara, 0 pupitihara.
He states that CRIHB is currently working on a funding application to SAMHSA in the amount of $15 million per year, for three years. It is such a huge project that they cannot attempt to prepare an application or project of this type on their own. CRIHB has forwarded a Resolution and Letter of Intent for the Tribe to establish their support and interest in participating in an Access to Recovery program. CRIHB will be the fiscal intermediary and the Tribes will provide services. There will be a voucher program where the individual can choose where they want to go for services. The vouchers are issued directly to the patients and then they submit the vouchers to the Tribe for services. They can also receive vouchers to the Tribe for the services Joe and Robert are providing currently.
Florence Conrad moved and Robert Goodwin seconded to approve Resolution 04-R-38 in support of the Access to Recovery Grant Application. 4 haa, 0 puuhara, 0 pupitihara.
He states that currently the California Forensic Medical Group is in charge of providing services to Native Americans that are incarcerated. They would like to bring them to the Yreka Clinic for this care but do not want to pay for the services. The staff is also concerned with the type of care they receive while in custody. He recommends that they see the Tribal Members, descendents, and established Native American patients at their clinic so they continue to receive care at the Yreka Clinic. If it is someone new that has not been seen at the clinic they should not, but they should continue to ensure their current patients continue receiving consistent care. Vickie states they need to put their policy back into effect for safety purposes before they see them at the clinic. There is an employee entrance to bring them in to avoid them being in the waiting room. The staff would also need to be very aware of the security issues.
Consensus: To again provide this service.
His next item is regarding CHS eligibility and the Pharmacy. Anna has pointed out that in the past the majority of CHS patients were because of the Pharmacy. That was the service they were receiving and that motivated them to continue signing up for Medi-Cal and following the CHS process. If they don’t continue that requirement for the new Pharmacy patients to be eligible, they will potentially lose that revenue from Medi-Cal. He would like to establish a policy that in order for a patient to receive free or reduced rate prescriptions at the pharmacy they must keep their CHS eligibility up to date. Anna states that once each year they apply for Medi-Cal and when they receive their medications they can look and see if they don’t have insurance and if they don’t they can notify them that they must apply for Medi-Cal. Florence suggests putting a note in their medications for each refill to keep them reminded that they must apply each year. Wes states he doesn’t think they should cut them off, but they should establish a process that keeps them active in Medi-Cal to continue the billing revenue for those patients.
Wes states that the contract with Marin McCabe exceeded the amount that was approved. He was given an estimate of $8,000 to do back billing for $250,000 worth of bills. She was able to actually bill for $454,000 of back bills and sent them an invoice for $14,000 plus travel expenses of $855.70 for the additional work she did beyond the initial proposal. He is requesting approval of the excess amount so that she can be paid the remaining balance. She is now done with the back bills and the billing is current. Her payment comes from the billing revenues which were more than expected. She does not usually work as a contractor and is not familiar with the process. She would also like to come and do an on-site training on what she found and what they can do differently themselves in the future.
Leeon Hillman moved and Florence Conrad seconded to amend the contract with Marin McCabe to a total of $14,855.70. 4 haa, 0 puuhara, 0 pupitihara.
Leeon Hillman moved and Robert Goodwin seconded to approve Wes’ report. 3 haa, 0 puuhara, 1 pupitihara (Florence Conrad).
11. Proposal from Eugene Kravis
A proposal was included in the packets for Dr. Kravis, DVM to establish a veterinary hospital in the community of Happy Camp. He is the vet that is working from a mobile clinic and came to them previously wishing to discuss this.
Directive: For KCDC to advise Dr. Kravis to not utilize the power at the Karuk Building Center any longer.
Consensus: To inform Dr. Karvis that they are not interested in his proposal at this time.
12. Meeting request from Scott Quinn
May 25, 2004 at 1:00 PM in Happy Camp was set to go over land issues.
13. Committee Reports
None at this time.
Closed Session from 7:21 PM to 9:25 PM
Roy Arwood moved and Robert Goodwin seconded to loan $1,000 to Tribal Member #1428 to be repaid at a rate of $100 per month. 4 haa, 0 puuhara, 0 pupitihara.
Robert Goodwin moved and Leeon Hillman seconded to uphold the CHS denial and pay $241.38 for CHS Case #117. 4 haa, 0 puuhara, 0 pupitihara.
Roy Arwood moved and Robert Goodwin seconded to uphold the CHS denial and pay $546 for CHS Case #118. 4 haa, 0 puuhara, 0 pupitihara.
Consensus: To require Tribal Member to repay the reimbursement that was made in error in the amount of $270.
Consensus: To deny Tribal Member #2912’s request for assistance.
Consensus: To order a plaque for employee to be presented at Council meeting in June and put an article in the next newsletter.
Robert Goodwin moved and Leeon Hillman seconded to pay $517.07 from Third Party for medical expense. 4 haa, 0 puuhara, 0 pupitihara.
May 19, 2004 at 1:00 PM in Happy Camp was set to meet with Dr. Weaver.
Consensus: To transfer employee to Yreka and fly Happy Camp position.
Robert Goodwin moved and Florence Conrad seconded to approve $3,856.75 for the Father’s Day Brush Dance from discretionary. 4 haa, 0 puuhara, 0 pupitihara.
Florence Conrad moved and Robert Goodwin seconded to lay employee off effective May 17, 2004 with two weeks pay. 4 haa, 0 puuhara, 0 pupithara.
The meeting adjourned at 9:27 PM.
Next Meeting Date: June 10, 2004 at 5:00 PM in Happy Camp.
Respectfully Submitted by,
____________________________
Leaf Hillman, Vice Chairman
Recording Secretary,
Sara Spence