Karuk Tribe of California
Health Board Meeting Minutes
September 8, 2005
Happy Camp, California
Ayukii,
The meeting was called to order at 5:00 PM by Arch Super, Chairman.
Roll Call
Present
Arch Super, Chairman
Florrine Super, Secretary
Leaf Hillman, Vice-Chairman
Leeon Hillman, Treasurer
Roy Arwood, Member
Florence Conrad, Member
Robert Goodwin, Member
Robert Grant, Member
Alvis Johnson, Member
Quorum is established.
The health mission statement was read aloud by Florrine Super, Secretary.
Approval of the Agenda for September 8, 2005
Florrine Super moved and Alvis Johnson seconded to approve the Agenda for September 8, 2005. 8 haa, 0 puuhara, 0 pupitihara.
1) Approval of the Minutes for August 11, 2005
Leaf Hillman moved and Robert Goodwin seconded to approve the minutes for August 11, 2005. 6 haa, 0 puuhara, 2 pupitihara (Leeon Hillman, Florrine Super).
2) Susan Gehr
Susan states she has prepared a two page application to be submitted to help partially fund the costs of her travel to the Netherlands. The Resolution Number is 05-R-114 in the amount of $500 to AICLS.
Robert Goodwin moved and Leaf Hillman seconded to approve Resolution 05-R-114. 8 haa, 0 puuhara, 0 pupitihara.
3) Ed Field
Ed was present to address the Tribal Council. He is a Tribal Member who grew up in Cave Junction, Oregon where he ran the Shop Smart Grocery Store. He has relocated to Spain and runs an exporting business that brings Mediterranean products to the United States. He focuses on organic products as that is the fastest growing industry in North America right now. He also has an import business that brings items into Spain. He states that one thing he finds in his travels is that when foreigners think of American History they have a “soft spot” for Native Americans and there is an overwhelming acceptance of Native Americans in foreign countries. He states there is a huge interest in those items and several of his buyers in Europe have been interested in a line of Native American foods to be sold in Europe and marketed using his company’s distribution lines. He has spoke with Jim Berry at KCDC and they have begun discussions regarding possible exploration of this idea further and how it could work. He states he has more questions than answers but sees an opportunity and there are buyers with an interest in purchasing Native American Organic Food Products. He would like to know what the Council’s level of interest in this would be. His wife states that coordination and creation of a national “brand” for Native American products that would be recognized would be a beneficial venture. He states they have plans to meet with Ben Riggan of KCDC also to discuss this further. He explained how his company works and ideas he has for this type of project and how it can work to be successful for the Tribe economically. Leaf is interested in volunteering to spend some time with them to discuss this further. He states he will be in town until early next week. Another possible market is the export/sales of Native American crafts, art products, furniture, etc.
4) Old Business
Roy Arwood: Roy asked about Larry’s follow-up with Margo Kerrigan regarding his contacts with her and the community project she wants to do. Larry states he will do a brief update in his report.
Arch Super: Arch inquired about the appointment of four individuals to the Election Committee. He states that there needs to be a meeting scheduled for the Election Committee to move forward with their items for this year. Sara can contact the existing and new members to schedule the meeting prior to September 14, 2005.
Florrine Super: She asked about the discussion regarding Chris getting the computers ready to be distributed to community members that are interested in having them. This will be a time consuming project for Chris and Gerry to work on and there are a couple of issues that go along with it. They would like to discuss this with him at the next Council Meeting and it needs to be discussed at the meeting on September 22, 2005.
5) Patti White, Database Administrator
Patti was present to review her written report. She has one change to be made regarding Patient Registration. She states in the next two to four weeks a new package will be distributed and so she is pushing that department to get all data entry up to date and all errors addressed prior to that time. Other than that, she has nothing to add and no action items.
Bob asked about Data Entry and Coding to ensure they keep up to date and do not fall behind again. Patti states she is monitoring it weekly and it will correct itself once Sarah Abono is back from maternity leave. Leaf asked about the data entry for Orleans. She states it is due to the lag time for the information to be inter-officed up to Happy Camp and coded but only being 5 days behind is wonderful compared to 6 to 8 weeks behind as it was before
Robert Goodwin moved and Leaf Hillman seconded to approve Patti’s report. 8 haa, 0 puuhara, 0 pupitihara.
6) Joe Snapp, Drug and Alcohol Counselor
Written report only.
Florence Conrad moved and Leeon Hillman seconded to approve Joe’s report. 8 haa, 0 puuhara, 0 pupitihara.
7) David Eisenberg, PHN
David was present to address the Council. He states he has no action items but will have some next month. He has no additional information to add but updated the Council regarding the meeting held between HCHS, Tribe, Ambulance, and Fire Department to discuss the current land/building issues. The Fire Department was very happy that the Tribe was willing help them with land to be leased but the site is not large enough.
He states that they are continuing to explore the possibility of transferring the HCHS building to the Tribe and work out the 501(c)3 issue with an attorney which they are working on and there will be no action taken until that is obtained from an attorney.
Leaf asked who the attorney is that is researching the 501(c)3 status for them. David sates it is a legal consultant from CRIHB. She is currently reviewing the opinion issued by the IRS and the Articles of Incorporation for HCHS so that she can issue an opinion to the HCHS Board. Leaf states he has been in contact with an attorney as well and would like to know if the Council wants to proceed with this attorney or wait for the opinion from the HCHS attorney. David states it would be helpful to have information from another source as well.
David states that a special meeting can be scheduled as a closed session meeting so they can discuss this further. Larry would like to get the legal opinion to the meeting with HCHS. Leaf asked that David forward the information to him so he can send it on to the attorney he has contacted. Leaf will pursue obtaining a legal opinion on this matter under the consensus of the Council.
Robert Goodwin moved and Leeon Hillman seconded to approve David’s report. 8 haa, 0 puuhara, 0 pupitihara.
8) Lessie Aubrey, DQMC
Lessie distributed packets containing the items that were updated at the Strategic Planning Session held on August 24, 2005.
They have changed the value statement to reflect that Tribal People will have preferential access and treatment rather than equal access. There was one update to the mission statement to make it flow better. The Provider Recruitment and Retention Plan was included, it is a modified template sent by HRSA that they made fit their needs. Policy 07-040-041, Kernicterus Screening and Assessment was also included; one change was made regarding the Bilirubin levels.
She included the changes made to the CQI Projects for 2005 which were to change from assessing for sexually activity to assessing for tobacco use instead. Sexually activity is so confidential that they do not want to be reporting on that issue. Dr. Burns states that in California a patient age 12 or higher can request sexually related treatment without their parent’s knowledge but if they are documenting this information in the chart it is more likely the parent could gain access through their medical records. They felt that assessing tobacco use would be more appropriate as it meets GPRA and HRSA in one activity.
The policy on Work Related Injury or Illness was included also, it is the same, and no changes have been made.
She also included additional documents that came from the ACQI meeting yesterday as the meetings were back to back this month and she could not include them with her report.
Robert Goodwin moved and Leeon Hillman seconded to approve the Mission Statement, Vision Statement, Provider Recruitment and Retention Plan, Kernicterus Screening and Assessment Policy, the change in the CQI Project, and the Work Related Injury Policy. 8 haa, 0 puuhara, 0 pupitihara.
Florrine Super moved and Alvis Johnson seconded to approve Lessie’s report. 8 haa, 0 puuhara, 0 pupitihara.
9) Larry Jordan, ED
Larry was present to review his written report with the Council. He distributed copies of the CRIHB Newsletter to each Council Member.
He distributed information regarding possible reimbursement for the Medi-Cal related services they provide. He was asked to research whether or not the Tribe is an FQHC provider. He has confirmed that the Medi-Cal Billing Number designates if they are FQHC or a THP – Tribal Health Program. They are THP so they are eligible to participate in this program through CRIHB. He will need Tribal Council approval to proceed with this project and pursue that reimbursement funding. CRIHB has titled it the Medicaid Administrative Activities program. This program provides reimbursement for 1) Medi-cal outreach to increase individuals on Medi-cal, 2) performing eligibility intake for Medi-cal, 3) provision of non emergency transportation to Medi-cal covered individuals to Medi-cal covered treatments, and 4) program planning and policy development activities to improve the Medi-cal program. They can be reimbursed for up to 50% of these incurred costs.
Consensus: To sign and submit the Intent to Participate in the CRIHB Medi-Cal Administrative Activities Program. The Council will then review the formal contract when it arrives to see if it is acceptable.
He updated them on the insurance coverage for the Social Worker Intern and if that person would be covered under the Federal Tort Claims Act. They have found out they would not be, and are pursuing insurance through the University of Portland at a lower cost and Larry has informed the individual they cannot work with the Tribe until they have insurance. Michael is also looking into coverage through the Tribe’s policy.
He addressed Roy’s question regarding the Tribe being involved in a Federal Regional Counsel for Region 9 that is a network of Federal Agencies that have monthly conference calls to discuss issues. There is a Native American branch of this Council and he was very excited initially that there would be funding for a project. It turns out that there is no funding for a project but only the opportunity to network with 20-30 federal agencies in Region 9 to improve life in the Karuk area. There was a conference call in July, August’s call was cancelled, and September has not happened yet. They want to know if the Tribe is interested in participating. The dam removal was a possible project mentioned that they could benefit from assistance with. Another was putting land into Trust and how lengthy that process is when the parcel is not adjacent to Trust land. There is no funding but inquired if there is any interest in pursuing this group and networking. Bob states that the dam removal project is a huge project and any contacts and assistance they can gain in this area would be helpful to the Tribe. Some of the agencies participating may have funding that could be utilized as well. He will need someone in that area to participate in the conference calls along with him as he doesn’t have background knowledge of the issues. Bob suggests he talk to Leaf about it and then go from there.
Roy asked if there is any news on the Pharmacist. Debbie DeHart was present and states he is at home and slowly recuperating. The surgeon saw him yesterday and he will see the cardiologist in 3-4 weeks. She predicts the middle of October for a return date.
Larry states they are using Cheryl to keep up with the prescriptions being handled through Raley’s. Florence asked why it takes 2 days to get medications from Raley’s to Orleans. Vickie states they are delivered from Yreka to Happy Camp and then the Orleans courier doesn’t pick them up until the following morning to take them down to Orleans so that is the reason for the delay. When they get into Happy Camp, it is too late for them to go down the same day. Larry states they could pursue a contract with Willow Creek to fill the Orleans prescriptions until Mike returns to work to get them their medications earlier.
He states the deadline for the IHS Small Ambulatory Program Grant has been pushed back but will be due within 90 days so they are planning for that application process.
Robert Goodwin moved and Leeon Hillman seconded to approve Larry’s report. 7 haa, 0 puuhara, 0 pupitihara. (Leaf Hillman not present for voting).
Larry also announced that on October 15, 2005 at the Annual CRIHB Meeting he has unofficially heard that Lessie has been accepted for the award they nominated her for and CRIHB will cover her expenses to attend the conference and receive the award.
10) Vickie Walden, RDA
Vickie was present to review her written report with the Council. He states that Jessica Thom has passed the Practical Exam and is now a Registered Dental Assistant and her license is in the mail. Dr. Madkins expects to return on September 26, 2005 and still plans to stay through April 30, 2006. Vickie and Larry have discussed recruitment for this position. Larry has a potential candidate coming up next month.
She included the updated Dental Fee Schedule in their packets for review. She does not require approval tonight but would like approval once they have had time to review it thoroughly. She states most of the changes were in the lab/surgical extractions. She explained how the pricing works and where those amounts come from in the Fee Analyzer. This is reviewed by the Dental Providers and does not go before the ACQI Committee. She states they also review the reimbursement rates from common insurance providers when doing this as well. She suggests making their revised fees effective October 1, 2005.
Leeon Hillman moved and Robert Goodwin seconded to approve the revised dental fee schedule effective October 1, 2005. 8 haa, 0 puuhara, 0 pupitihara.
Robert Goodwin moved and Leeon Hillman seconded to approve Vickie’s report. 8 haa, 0 puuhara, 0 pupitihara.
11) Sara Spence
Sara requested approval of updated position descriptions for the Yreka Clinic Transporter and Billing Clerk including the JCAHO measurable terms and reflecting accurate duties. The Transporter will be advertised to start in October and the Billing Clerk will be advertised to replace Lora Burns who has resigned her position in the Business Office.
Leaf Hillman moved and Robert Goodwin seconded to approve the position descriptions for Yreka Transporter and Billing Clerk. 8 haa, 0 puuhara, 0 pupitihara.
12) Arch Super
Laura presented a contract to hire John Jerry as a consultant for the Children’s Court on behalf of Arch Super. He will provide co-mediation/family unity services not to exceed $8,400 for twenty hours per week. Contract 05-C-065 has been assigned and it has been reviewed by both Laura and Erin. The Council would like to revise the scope of work to reflect that increased payment or hours cannot be approved by the Court Administrator but only by the Tribal Chairman.
Consensus: To table the contract until their meeting with April Attebury to discuss the Tribal Court Program.
13) Thank You Letter from Employee
A thank you letter from Nikki Hokanson for allowing her to attend was included in the packets for their review.
14) Committee Reports
None at this time.
Closed Session from 8:05 PM to 10:00 PM
Consensus: CHS Case #151 tabled to the Wednesday meeting.
Robert Goodwin moved and Leaf Hillman seconded to uphold the denial for CHS Case #152. 8 haa, 0 puuhara, 0 pupitihara.
Leaf Hillman moved and Robert Goodwin seconded to uphold the denial on the second claim for Case #152. 8 haa, 0 puuhara, 0 pupitihara.
Consensus: CHS Case #153 tabled in order to attempt to obtain a discount if possible.
Robert Grant excused himself at 8:10 PM.
Debbie DeHart
Rubber mat needed on floor where he stands. Will have to start slowly and then build back up his stamina. Does not want to close the Pharmacy for all of the meetings – only required to go to P&T Meetings. Would like to change the hours to 8:30 to 5:30.
Consensus: To order anti-fatigue floor mats for the Pharmacy.
Directive: For Arch to talk to Larry about the P&T Meetings and the hour changes at the Pharmacy and report back to the Council.
Directive: For Arch to speak to Larry about supervision issues that were mentioned and report back.
Directive: For Sara Spence to investigate and counsel employee regarding customer service complaints received, further complaints will result in termination.
Directive: For Barbara Norman to schedule an initial appointment with Tribal Member #WH and advise the Council what services she can provide for the case.
Directive: For Sara Spence to research vehicle detailing options.
Next Meeting Date: October 13, 2005 at 5 PM in Happy Camp.
Robert Goodwin moved and Leeon Hillman seconded to adjourn the meeting at 10:03 PM.
Yootva,
__________________________________
Arch Super, Chairman
Recording Secretary, Sara Spence