Karuk Tribe of California
Health Board Meeting Minutes
September 9, 2004
Happy Camp, California
The meeting was called to order at 5:00 PM by Arch Super, Chairman.
Roll Call
Present
Arch Super, Chairman
Leaf Hillman, Vice Chairman
Florrine Super, Secretary
Leeon Hillman, Treasurer
Roy Arwood, Member
Florence Conrad, Member
Robert Goodwin, Member
Quorum is established.
The health mission statement was read aloud by Florence Conrad.
Approval of the Agenda for September 9, 2004
Florrine Super moved and Leaf Hillman seconded to approve the Agenda for September 9, 2004. 6 haa, 0 puuhara, 0 pupitihara.
1) Approval of the Minutes
Leaf Hillman moved and Robert Goodwin seconded to approve the Minutes for August 12, 2004. 6 haa, 0 puuhara, 0 pupitihara.
Leaf Hillman moved and Florrine Super seconded to approve the Minutes for Special Meetings of August 4, 2004, August 18, 2004, August 20, 2004, and September 1, 2004. 6 haa, 0 puuhara, 0 pupitihara.
2) James Pindell
Joe Snapp introduced James Pindell, psychologist of the Horse Program, he would like to present various concepts and information he has. Joe feels these presentations fall right in line with what Joe has been trying to do at Oak Knoll and in his program. These ideas are to promote workforce development and areas that they can create jobs and do good things for the communities. James met with Arch Super and Wes Valentine previously and had the chance to give them an overview of this information. He gave them a brief introduction into what he would like to do and what his experience has been working with children with disabilities and those in need of alternative programs. He states that over the years he has been finding that there needs to be alternative sources from State funding to provide these needed services to children. He states he is working on going into business himself and will be working with the Horse Program. He presented some information to them regarding organic farming and family farming. He states family operated farms have been disappearing from the market and feels that organic farming is an area they can flourish in as many, many people are interested in these organic products and natural items as many people don’t want to worry about genetic altering and mad cow disease. He would like the Council to consider a proposal that would bring resources to this community to share a curriculum that has been developed to help families create small organic farms in the community of Happy Camp. Many families have had to leave the area for work and many don’t want to leave or have their children leave, farming can help augment incomes to help people be able to stay, the project would also employ a couple of local people as well. His brother Judd is the majority owner of Pyramid Juice and he had hoped he would be here as he is the business mind in the family and has a wealth of information on this subject. They would like to promote the production of fruits and vegetables that are pureed and then sent off to an overseas company in plastic containers. He would like to know if they could identify startup funding for families to start small farms, they could then sell the fruits and vegetables to his brother’s company to meet the market demand that his brother cannot meet currently. Happy Camp is the ideal community to grow in this area. He states he has access to many private foundation funds through his contacts as well. He has a contact with Prentice Hall Publishing which grants money for this type of activity. His contact is willing to present them with a letter of introduction and could assist with the startup materials to start this type of operation at the Karuk Tribe’s Ranch. He also called Terry Coltra at NCIDC and he felt that they may be able to help with salaries for this type of program. They may also be able to coordinate with the Hoopa/Yurok rehabilitation programs as well. There are also possible avenues for funding through the Workforce Investment Act. He would like an opinion from them if they would like to pursue this type of project and have him present them with additional information.
Leaf feels that this is a project they should and could look into, the Ranch is actually already zoned agricultural and would be a more than appropriate place for this. He suggests putting together a committee to pursue this and research additional information. Arch also inquired if this would be an appropriate project to run through KCDC as an economic development project. They asked how much land he would want. He would like to see 20 acres total and feels it would be reasonable for this type of project that could involve a lot of families.
He is in a position to start writing the proposal and developing plans if he can get a positive opinion from the Council to move forward. He can work with a committee they designate to obtain input as well. His brother has been selling in the market in Japan for a couple of years and doing very well. Another good point is that transporting the fruits and vegetables is not a huge issue as it is going to be pureed.
Joe Snapp, Leaf Hillman, Florence Conrad, Roy Arwood, and Wes Valentine can sit on the committee to work on this and develop a further proposal to come back to the Health Board. They can let the Council know when the meeting is so that anyone that wants to attend can come.
3) Lessie Aubrey
Lessie was present to review her report with the Board. She had several action items for their review and approval. They include a revised mission statement, vision statement, value statement, goal statement, conflict of interest statement for practitioners, patient rights policy, and informed consent policy.
The first item was the mission statement. At the strategic planning session the suggested language is: “The mission of the Karuk Tribal Health Program is to provide quality healthcare for Native Americans, and to provide quality healthcare to other people living in the communities we serve as resources allow. Our purpose is to appropriately assess or reassess conditions of illness, disease, or pain, provide culturally appropriate educational, preventative, and therapeutic services in an environment of continuous quality improvement.” Robert does not feel it should be changed; there was explanation as to why they would like to change it.
Roy Arwood moved and Florrine Super seconded to approve the revised mission statement. 5 haa, 1 puuhara (Robert Goodwin), 1 pupitihara (Leaf Hillman).
The next item they reviewed was the vision statement.
Florrine Super moved and Robert Goodwin seconded to approve the revised vision statement. 6 haa, 0 puuhara, 0 pupitihara.
The next item was the value statement; it only contains the addition of two words. The remainder of the statement is the same. Florrine states that the reasoning was that since they are opening up service to non-Indians it makes the Tribal Members feel as though they have a higher level of preference. Leaf asked how practically this translates into their operations, how would they give the preference. Lessie states this is a listing of what they “value” and feel strongly about. Leaf feels that saying it and doing it are two different things; it does no good to adopt the value statement if they don’t put mechanisms in place to protect this value. Florence states the employees need to make sure they remember who they are working for in the Health Program and the Managers need to make sure they remember who they work for and who the priority is to go to. Lessie reminds them that this is the product of the strategic planning and she invited all Council Members to attend and needed them there, but there were only a few that attended and these are the products of the meeting.
Dr. Burns feels taken aback by these comments and discussions due to the fact that they rate their patients based on their level of urgency and he does whatever he can to make sure they are seen and treated. He feels patients should not be moved up in preference based only on Tribal preference, but should be seen based on urgency.
They revised wording in one section to read: “The right of Tribal People to preference and equal access to quality treatment.”
Robert Goodwin moved and Florrine Super seconded to approve the revised value statement. 6 haa, 0 puuhara, 0 pupitihara.
The next item is the goal statement. It is unchanged and they all still agree with it so no motion is necessary.
They then went to the conflict of interest statement for practitioners. She distributed the newest changes from ACQI yesterday.
Robert Goodwin moved and Florrine Super seconded to approve the conflict of interest statement for practitioners. 6 haa, 0 puuhara, 0 pupitihara.
Next is the patient rights and responsibilities, she reviewed the changes that have been made to strengthen it.
Leaf Hillman moved and Robert Goodwin seconded to approve the patient rights and responsibilities. 6 haa, 0 puuhara, 0 pupitihara.
Next is the Informed Consent Policy Number 06-001-001. They have added exceptions to the informed consent requirements to provide for times when a patient may be unconscious and need treatment, minors that have emergencies, etc. They made it very clear that these exceptions only apply as long as the emergency is continuing.
Leaf Hillman moved and Florrine Super seconded to approve the Informed Consent Policy Number 06-001-001. 6 haa, 0 puuhara, 0 pupitihara.
She discussed with them the Council Directive that was issued requiring the employees that attended the grant writing training to write a grant application. She states she used to work as the health program grant writer and has written many, many grants, she has surgery coming up the JCAHO survey to prepare the program for, and many other tasks she is working on. She states she just does not have time to work on a grant right now. Council states they will defer the directive for her as she is very busy.
Florence Conrad moved and Florrine Super seconded to approve Lessie’s report. 6 haa, 0 puuhara, 0 pupitihara.
4) Dr. Steven Burns
Dr. Burns was present to discuss the information they requested on hair follicle drug testing. He did a thorough presentation on the many aspects of hair follicle testing based on his research. The unanimous opinion of the health care providers is to not allow hair follicle drug testing as the Federal Government has been researching it for eleven years and has still not adopted it. The recommendation is to revisit it in one year and see if the Federal Government has made a decision as of yet. It would be a large can of worms to open as it is not recognized at a government level. He has called Quest to determine what the cost difference is but does not know yet. They complimented him on the report and stated it answers all of their questions.
5) Old Business
Arch reminded them that they all need to be present for the Council meeting on September 23, 2004 since he and Florrine will be in Washington, DC.
6) Joe Snapp
Joe was present to review his report. He updated them that Housing has approved their proposal for the Oak Knoll facility. Sami is in agreement to lease the building to the Assembly of God Church so they can staff it and get it going so finally they can start moving forward on a men’s transitional facility at Oak Knoll. Housing can cover some of the costs for the updates since they will be leasing it and own it and it must be in acceptable condition before it can be leased. He and Fred will be doing a walk through to look it over and see what needs to be done.
He gave them his input on the proposed project that was presented for farming at the Ranch. He states it fits directly in with his ideas for the programs and would like them to support it.
Robert Goodwin moved and Leeon Hillman seconded to approve Joe’s report. 6 haa, 0 puuhara, 0 pupitihara.
7) Vickie Walden
Vickie was present to address the Council and apologized for not having a written report, she states it will be very detailed for next month. She is present to answer any questions they may have and also has a special request regarding the parking lot in Happy Camp. She states that the sidewalk is blocked frequently and the handicapped spaces are too far from the sidewalk. She would like to have handicapped spaces on each side of the sidewalk and then one patient space on each side of the handicapped as well. The current handicapped spaces will be re-organized into regular spaces.
Consensus: To move forward with relocating the handicapped spaces and establish patient parking near the sidewalk. Wes will forward this on to Fred Burcell tomorrow to have it repainted.
Robert asked if there is any way to expand parking as it gets short on busy days. The back parking lot could have the lines redone and then require the employees to park in the back. Fred can look into some suggestions.
8) David Eisenberg
Written report only, not present, no action items.
Roy Arwood moved and Leaf Hillman seconded to approve David’s report. 6 haa, 0 puuhara, 0 pupitihara.
9) Wes Valentine
Wes was present to review his report with the Council.
His first item is an action item he is presenting on behalf of David Eisenberg. It is a revised sliding fee scale for the medical/dental clinics. The previous scale that was approved was not feasible as virtually everyone was free. He and Laura developed a more realistic scale and presented it to ACQI yesterday and it was accepted. If a family is at Federal Poverty Level they pay $0, if they receive 125% of Poverty they pay 25%, if they receive 150% of Poverty they pay 50%, if they receive 175% of Poverty they pay 75% and if they receive 200% of Poverty they pay 100%. The first scale was approved by Resolution so the first one will need to be rescinded and a new one assigned.
The next three items were discussed in the budget meeting earlier today.
His next item is out of state travel for Wes and Arch to attend the Self Governance Conference with Hector in Seattle.
Florence Conrad moved and Leaf Hillman seconded to approve out of state travel for Wes Valentine and Arch Super to Seattle, WA for the Self Governance Conference. 6 haa, 0 puuhara, 0 pupitihara.
Leaf Hillman moved and Leeon Hillman seconded to rescind Resolution 03-R-54 and adopt Resolution 04-R-97. 6 haa, 0 puuhara, 0 pupitihara.
Florrine Super moved and Florence Conrad seconded to approve Wes’ report. 6 haa, 0 puuhara, 0 pupitihara.
10) Marsha Jackson
On maternity leave.
11) Informational Items
None at this time.
12) Committee Reports
Florrine Super updated them on the upcoming Tribal Reunion. She distributed a tentative schedule of events. She wanted them to know what was going on, they requested she email it to them. She states Arch will be handling volleyball at the High School. She wanted to know who will be present at the Reunion to present the awards at 10 AM on Saturday. She would like anyone that is available to be there. Also, if they want to present any awards they need to let her know so she can have them on the list. Channel 4 in Yreka has requested permission to cover the event and the Siskiyou Daily News would like to cover the event as well. She asked for input on the card games as well. Wes Mayton and David Arwood used to cover those.
Closed Session from 7:54 PM to 9:45 PM
Directive: For staff to work on the LIAP application and expedite the process, if not allowable through those programs, use Third Party revenues to pay for this. They can approve the Maintenance Department going down and building a ramp. There is also a request for wood as well, as it would take too much time to get a monitor stove. They will direct it to Wes to follow up on tomorrow.
Leaf Hillman moved and Florrine Super seconded to approve $2,000.00 for Health Case. 6 haa, 0 puuhara, 0 pupitihara.
Leaf Hillman moved and Florrine Super seconded to pay $1,000 for CHS Case #127. 6 haa, 0 puuhara, 0 pupitihara.
Leaf Hillman moved and Robert Goodwin seconded to approve Policy Number 04-008-001 for Native American Eligibility for Direct Care Benefits. The requirements are based on the Federal Register’s requirements. 6 haa, 0 puuhara, 0 pupitihara.
Consensus: If it is their bill it can be wrote off, if not he can bring it back for a decision.
Robert Goodwin moved and Leaf Hillman seconded to pay $4,400 for patient #228. 6 haa, 0 puuhara, 0 pupitihara.
Robert Goodwin moved and Leaf Hillman seconded for Sara to send out a directive that each committee should have a chair, vice chair and secretary at a minimum and minutes need to be kept and submitted to the Council Secretary for recordkeeping. 6 haa, 0 puuhara, 0 pupitihara.
Robert Goodwin moved and Leaf Hillman seconded to obligate $1,500 of discretionary funds toward Tribal Member’s airline ticket that was purchased. 6 haa, 0 puuhara, 0 pupitihara.
Florence Conrad moved and Florrine Super seconded to approve a loan of $2,500 to be repaid at $250 per pay period at 5%. 6 haa, 0 puuhara, 0 pupitihara.
Consensus: To get Fred Burcell’s input on Mike Tiraterra’s proposal.
Next Meeting Date: October 14, 2004 at 5 PM in Happy Camp.
Roy Arwood moved and Florrine Super seconded to adjourn at 9:48 PM.
Yootva,
___________________________
Arch Super, Chairman
Recording Secretary,
Sara Spence