Karuk Tribe of California
Health Board Meeting Minutes
July 15, 2004
Happy Camp, California
The meeting was called to order at 5:10 PM by Leaf Hillman, Vice Chairman.
Roll Call
Present
Leaf Hillman, Vice Chairman
Leeon Hillman, Treasurer
Florrine Super, Member
Roy Arwood, Member
Florence Conrad, Member
Robert Goodwin, Member
Absent
Arch Super, Chairman - excused
Quorum is established.
Robert Goodwin read the Preamble to the Constitution aloud to the audience.
Approval of the Agenda for July 15, 2004
Robert Goodwin moved and Leeon Hillman seconded to approve the Agenda for July 15, 2004. 5 haa, 0 puuhara, 0 pupitihara.
1. Approval of the Minutes for June 17, 2004
Robert Goodwin moved and Leeon Hillman seconded to approve the Minutes for June 17, 2004. 4 haa, 0 puuhara, 1 pupitihara – Roy Arwood.
2. Lairy Dobbins
Lairy was present to address the Health Board and thank them for allowing him to speak. He states there are several issues that need to be presented to them. He recently had his Aunt sent out in the ambulance and the ambulance crew had her flown out. The emergency room staff was very upset at the Hospital in Medford and felt she should have been treated at the Clinic. Dr. Burns states that she was taken out and a CT scan and lab work were done, then they felt she didn’t require Hospital treatment. Dr. Burns pointed out that the Clinic was closed; even if it were open she would have been sent out anyway because they don’t have access to do those types of tests. Lairy would like a letter sent to the Hospital to let them know the current rural situation. Robert states they don’t run the ambulance service and cannot interject in the decisions they make.
His next question was regarding the closures on Wednesdays. He would like to see a process for emergencies to be seen on those days since they are in town.
Dr. Burns is willing to talk with the emergency room Director at Rogue Valley to try and remedy the situation. They have also written a grant to work toward being able to offer services seven days a week. Another point that was made is that the mission of the Health Program is not to provide emergency care; however, they do whenever they can due to the rural location.
Another item that has been mentioned to Lairy was why the Clinics have to close when there are funerals if there is staff available to work. It is not beneficial to the membership when they cannot get medical services and pharmaceuticals during those times when all of the staff is not attending the funeral services. Council agrees that core staff can continue to work at the Clinics during those times. The Health Staff can discuss this at their meetings to see what they can come up with.
3. Vickie Walden
Vickie took the opportunity to introduce them to the new dentist Dr. Janis Madkins, DDS. She introduced each Council Member. Dr. Madkins states it is very nice to be here and she is currently on her way to Merced, where she is from. It has been very nice and she hopes to continue her services in the community.
4. Hermanett Albers
Hermanett was present to request approval of a grant application to the Wal-Mart Good Works Program in the amount of $750 to assist with food and/or supplies for the Naa Vura Yee Shiip Summer Cultural Camp. The camp will be held August 12-16, 2004 and is being held at the Shasta Methodist Camp just south of Lake Siskiyou in Mount Shasta. Resolution 04-R-076 was assigned.
Robert Goodwin moved and Leeon Hillman seconded to approve Resolution 04-R-076 authorizing submission of a grant application to the Wal Mart Good Works Program in the amount of $750. 5 haa, 0 puuhara, 0 pupitihara.
Vickie Walden states they have a Dremel in the dental department that is electric and she has a personal battery operated one. They can borrow both of them if they would like to.
She is also requesting $2,000 for food, paper products, and other camp supplies as needed. The TERO Committee has agreed to purchase the camp T-shirts.
Roy Arwood moved and Florrine Super seconded to approve $1,000 toward Camp expenses. 5 haa, 0 puuhara, 0 pupitihara.
They would like her to approach Housing for the other $1,000. They would also be very interested in an alternate location for the camp and not hold it in Mount Shasta, but having it in Happy Camp.
Robert Goodwin moved and Florence Conrad seconded for Hermanett and Corina to establish a Planning Committee for the Naa Vura Yee Shiip annual Culture Camp. 4 haa, 1 puuhara – Leeon Hillman, 0 pupitihara.
Elsa asked about the fact that this is a KCDC Program and should this go through the KCDC Board.
5. Geraldine Peters
Geraldine was present with her mother and Corina to ask about her daughter, Chelsea Bailey. Tanya and Lisa Goodwin have been working with her to help her since she is in juvenile hall. They will discuss it with her in Closed Session right now.
Consensus: Florrine will meet with Lisa and find out what the details are for the situation and then do a phone vote. The decision needs to be done prior to July 22, 2004.
6. Judge Harding
Judge Harding was present to address the Health Board and introduce himself. He distributed business cards to each Council Member and brought Byron Nelson, the Chief Judge of the Hoopa Tribe with him.
He states he has been working with Tribes for 24 years and gave them a brief overview into his past work experience and Tribal Court experience and the other Tribes they have been working with in the Inter-Tribal Court System. He introduced Judge Nelson to the Board as well.
Leaf asked if either one of them has been speaking with April Attebury regarding these activities. His presence here tonight is not in relation to his application for the position but just to let them know what they are working on and what the project is, and yes he has been in contact with April.
Judge Nelson briefly addressed them and let them know how the Court can greatly help them and allow the Tribe to function and handle conflicts and personal issues that arise and how helpful a Tribal Court can be in those situations to remove the Council from the decisions and remove that political pressure to make decisions. He also updated them on past Tribal Programs he has participated in and funding possibilities he has been pursuing through the Inter-Tribal Court System.
Robert asked if the Inter-Tribal System is already up and running and includes those four Tribes and is not open to any new Tribes, then what is he looking for tonight from them or how it can work with their Court. He states he is only present to provide them information on what they are doing so they are aware and when the Consortium is open to new members next year they will have information and can decide if they may be interested in participating.
Judge Harding also clarified that even though the Consortium is not open to new members, they can still work with them. There is a $50,000 per year participation fee, at the end of the year if they don’t use the entire amount, the balance is returned to them.
7. Vickie Walden
Vickie states she had nothing to add unless they have questions. The sterilizer is in and working great. She will look for a refurbished one to have on backup just in case for the future.
Florrine Super moved and Florence Conrad seconded to approve Vickie’s report. 5 haa, 0 puuhara, 0 pupitihara.
8. Lessie Aubrey
Lessie was present to review her written report with the Board. She states the National Ambulatory Care Conference will be held in October. She tries to attend each year with Barbara and would like to obtain out of state travel for that trip. It will be October 14-15, 2004 in Chicago, Illinois. Florrine states she will attend as well; Wes says they can bring him back the information to save money.
Robert Goodwin moved and Leeon Hillman seconded to send Lessie Aubrey, Barbara Snider, and Florrine Super to Chicago, Illinois, October 14-15, 2004 for the JCAHO Ambulatory Care Conference. 5 haa, 0 puuhara, 0 pupitihara.
She states that she will be sending in her picture boards for the Nitrous Oxide to present them at the conference and updated them on the FMEA Project which is a new process for Nitrous Oxide Use in Dental Patients. She included information on how it was done previously and then the areas they looked at. Staff safety was the main issue they found in the process. They also found some minor patient safety issues. She color coded it for them so that they could easily see the changes. She states that they need to establish a criticality rating for these areas. Dr. Weaver took the items they identified, put them into the process, and then rated the severity of the failure effect, and then rated how likely it was to happen again, and how difficult it is to detect the failure. By taking all of the ratings and multiplying them by each other it assigned a criticality rating to each effect to see which has the highest number. The Board feels this is a great idea to take the information with her.
She also addressed a previous letter that she received from Happy Camp Health Services patient in relation to a patient referral and updated them on what was going on. She also received a thank you letter from that patient for having the referral taken care of.
Florence Conrad moved and Florrine Super seconded to approve Lessie’s report. 5 haa, 0 puuhara, 0 pupitihara.
9. Marsha Jackson
Written report only, no action items, not present.
Florrine Super moved and Florence Conrad seconded to approve Marsha’s report. 5 haa, 0 puuhara, 0 pupitihara.
10. Joe Snapp
Joe distributed an addition regarding a Men’s Discipleship Home being proposed at Oak Knoll. It would be structured similar to the Llama Ranch being run in Happy Camp and conducted with the cooperation of Pastor William C. Estes. The mission would be “to minister to men in transition by providing safe housing, food, and a structured environment.” They have been providing this type of treatment for about a year and a half. Their goal would be “to provide a drug, alcohol free, moral lifestyle which will allow these men to return to society as responsible productive citizens.” This will be a transitional facility for those in need which should fit into HUD guidelines for the Oak Knoll Facility. It is the best idea that has come along to put the building to use so far.
The Assembly of God Church will provide the liability insurance and take responsibility of posting the necessary public notices for the community. They would be ready to move in right away and get started.
The Board would like to see an MOU with them to ensure that in the future it doesn’t wind up being a facility that doesn’t serve the best interests of Tribal Members. They suggest the Oak Knoll Committee look at this and present the information to Housing to get their input and then there can be a meeting with the entire Council to cover all of their bases and get all of the necessary information included in the MOU.
It would be a good opportunity to start providing some services and see how it will work and how it is going to go. At some point there will need to be some dollars obligated for furniture and necessary repairs to make it livable. He states he was hoping to get donations from Salvation Army and places like that to furnish the building.
Florence, Joe, and Karen used to be the committee. Florence suggests Florrine taking Karen’s place and getting Wes involved so that they can put together a plan and discuss what they can do to move in this direction. Roy was appointed at the last meeting and should attend also. Wes asked if they should get on the next Housing Agenda to discuss this item. The next meeting is July 26, 2004 at 10:00 AM in Happy Camp.
Consensus: To have the Working Group move ahead with this concept and meet with Housing to inform them and get their input.
Wes states that a cooperative effort between a Tribal Government and a Faith-Based Organization can put them in an optimum place for funding proposals as well from funders such as SAMHSA. They can meet next week and put together the information prior to the Housing meeting. Friday, July 23, 2004 at 3:00 PM was set.
Joe states that they are moving out of the old Daycare Center since they cannot afford to pay rent any longer. Now Joe needs office space when he is in Happy Camp for group meetings that Michael Moore, Bessie Munson, and other individuals are holding. The KCDC Conference Room was mentioned but they don’t know what the security issues would be. The multi-purpose room or People’s Center were mentioned as well, but they are not very confidential sites. They suggest that Fred put a door on the conference room at KCDC so they could use that back conference room without using the rest of the building, they can put a curtain on the window also. Wes will talk to Fred tomorrow.
Robert Goodwin moved and Florrine Super seconded to approve Joe’s report. 5 haa, 0 puuhara, 0 pupitihara.
11. David Eisenberg
Written report only, not present, no action items.
Florrine Super moved and Florence Conrad seconded to approve David’s report. 5 haa, 0 puuhara, 0 pupitihara.
12. Wes Valentine
Wes’ first item was an update on the Third Party Revenue. They received $176,258 for the month of June which will put them over their projected budget of 1.7 million for the year. They have received $1,300,000 so far this year. In addition to this month’s revenue there is an additional $168,000 on its way from Medi-cal for back billing at Happy Camp Health Services.
They are now doing 99 prescriptions per day, up from 65 per day last month at the Happy Camp Pharmacy. They are still waiting for a Medi-cal billing number.
He presented two changes to Contract 04-C-062, the first being approved overtime if needed at the same hourly rate, approved in advance by the Executive Director and mileage round trip from Menlo Park in the amount of $161.25.
Robert Goodwin moved and Florrine Super seconded to approve revisions to Contract 04-C-062 for mileage and pre-approved overtime. 5 haa, 0 puuhara, 0 pupitihara.
He distributed a draft Resolution to support a proposal for the California Rural Indian Health Board to pursue Indian Health Service funding to form an Epidemiology Center to serve the Indians and Indian Health Programs in the IHS California Area. It will allow them to establish a center to collect and analyze health information. Resolution 04-R-77 has been assigned in support of this. They will be able to have relevant data for funding for the Tribe that supports Native American health issues. They would not be required to do any additional work without being compensated for it.
Florence Conrad moved and Florrine seconded to approve Resolution 04-R-77. 5 haa, 0 puuhara, 0 pupitihara.
His next item is regarding a vehicle that was purchased by Ishpook Leasing and is being leased back to the Social Services Program. Without funding for that program they cannot afford to keep it. The Maintenance Department needs a vehicle and the monthly payments could be made from Indirect and the vehicle could be put to use if they approve of that. Florrine asked about Daniel Pratt’s program. Wes states it cannot afford it either and if they identify dollars it would be better to purchase him a Honda Civic which would be better on gas.
Consensus: To transfer the truck to Maintenance.
He also presented Contract 04-C-067 with Dr. Michael Hess for the services he provides part time in the Yreka Clinic. It will be valid until September 30, 2005 to bring it in line with the fiscal year. They are looking into a separate contract for in-hospital services at a negotiated rate for Contract Health patients but that will be done later.
Florence Conrad moved and Florrine Super seconded to approve Contract 04-C-067. 5 haa, 0 puuhara, 0 pupitihara.
His last item is regarding a tree he has in his yard that Fred Burcell will be coming over to cut down on his personal time. He would like to request use of the Tribe’s backhoe during the weekend and he will donate the madrone to the Elders. The Council sees no problem with that.
Florrine Super moved and Florence Conrad seconded to approve Wes’ report. 5 haa, 0 puuhara, 0 pupitihara.
Closed Session from 8:12 PM to 10:55 PM
Consensus: To respond to employee’s loan request following a meeting with Laura Mayton scheduled for July 22, 2004 at 10:00 AM.
Consensus: To uphold managed care denial and pay $1,411.60 for Tribal Member #519 from Third Party.
Consensus: To adopt the following standard for temporary privileging in Tribal Clinics: “Temporary privileges may be granted to physicians for certain credentialed tasks. Consensus by Tribal Council that those physicians who come to our facility and provide treatment to patients are required to be Credentialed and Privileged to Tribal Health Program Standards Prior to providing care to Patients.”
Directive: For Wes to provide a list of all licensed practitioners to Lessie that will be working in Tribal Clinics in the future.
Florence Conrad moved and Florrine Super seconded to approve credentialing for Amy Coapman and Judy Blind. 5 haa, 0 puuhaara, 0 pupitihara.
Consensus: Council will meet with Wes at next Health Board meeting regarding potential conflicts of interest at Yreka Clinic.
EDA grant application has been granted a two week extension; also 8/10/04 at 2 PM there will be a Small Business Administration 8(a) presentation by Mary Jepson.
Directive: For Florrine Super and Sara Spence to provide proposed amendment to the Enrollment Ordinance regarding Tribal Descendents by the July 29, 2004 meeting.
Directive: To gather information regarding all services currently provided to Tribal Descendents.
Meeting adjourned at 11:00 PM.
Next Meeting Date: August 12, 2004 at 5 PM in Happy Camp.
Respectfully Submitted by,
__________________________________
Leaf Hillman, Vice Chairman
Recording Secretary,
Sara Spence