Karuk Tribe of California
Karuk Tribe Health Board Meeting
Thursday, February 9, 2006
*Minutes*
Ayukii,
A,) Meeting called to order at 5:08 PM, by Leaf Hillman, Vice-Chairman
Roll Call:
Present
Leaf Hillman, Vice-Chairman
Leeon Hillman, Treasurer
Florrine Super, Secretary
Alvis Johnson, Member at Large
Robert Grant, Sr., Member at Large
Roy Arwood, Member at Large
Bob Goodwin, Member at Large
Florence Conrad, Member at Large (5:22 PM)
Absent:
Arch Super, Chairman, excused on travel
Quorum is established.
B.) Health Mission Statement was read aloud by Roy Arwood.
C.) Agenda:
Addition of one person to closed session.
Florrine motioned and Bud seconded to approve agenda with addition, 6 haa, 0 puuhara, 0 pupitihara.
D.) Minutes of January 12, 2006:
Bob motioned and Florrine seconded to approve minutes of January 12th, 2006 with change 6 haa, 0 puuhara, 0 pupitihara.
E.)Guests:
Fawn White, Two Feathers Native American Services:
Fawn White from Two Feathers Native American Services introduced her program and the video History And Hope in which is presented to the Council and the group. Fawn stated that the programs that she runs help Native Americans in the area.
Her hope is that there is enough time for questions or comments with the group after the video is shown. After the video was shown for the Council and audience, several members of the group stated that they enjoyed the video. Leaf asked if this organization provides training on there issues. Fawn stated yes, they provide a number of trainings.
Fawn stated that the organization is working toward obtaining DVD’s of the History And Hope in hopes to distribute it. She left several booklets of information.
Carrie Davis, Self-Governance Assistant:
Carrie provided information regarding Danny Jordan of Hoopa getting a couple Tribe’s to get their support letters together for the Corbel Settlement. Hector has presented the Karuk Tribe’s support letter, but it was not approved, and Carrie is requesting that this be approved so that it is sent out. Leaf stated that the Council had requested additional information in regards to the letter, as all members have not reviewed it yet. Leaf stated that he is willing to give Hector tentative approval, to issue the letter to the Council first and then they will complete a phone vote, to approve it once it is reviewed. Carrie stated that she is hoping to have the letter drafted by the 13th.
Consensus: Tentative approval for Hector to submit a support letter to the Council. As soon as Hector provides the draft and they approve it then they will do a phone vote for final approval.
Carrie stated that she has been working in self-governance for four years, and she has not attended self governance training yet. She would like to request attendance to the upcoming training held in Massachusetts, May 8-12, 2006.
She would also like to request out of state travel to the Tribal Secretaries Conference being held in Las Vegas NV, April 17-20, 2006.
Leaf stated that he hasn’t seen Hectors schedule, and questions self-governance schedule. Carrie stated that Hector will be on travel periodically, but his schedule is based on day to day operations or projects that come up with Dennis Wittelsey.
Florence motioned and Bob seconded to approve attendance for Hector and Carrie to the self governance conference held May 8-12, 2006, in Massachusetts, 7 haa, 0 puuhara, 0 pupitihara.
Florence motioned and Florrine seconded to approve out of state travel for Carrie to Las Vegas NV April 17-20, 2006 for the Tribal Secretaries Conference, 7 haa, 0 puuhara, 0 pupitihara.
Consensus: Amend the motion to include approval for Marsha Jackson out of state travel to Las Vegas, NV April 17-20, 2006 for the Tribal Secretaries Conference.
F.) Old Business:
Re-establishment of JOC will be moved to the next Wednesday planning meeting.
G.) Directors Reports:
1.) Joe Snapp, Drug & Alcohol Abuse Program:
Joe updated the Council the meeting scheduled for the Oak Knoll project with the architect. There was no walk through, but Joe did meet with the Architect Tuesday to review the preliminary plans. There is also a follow up meeting scheduled for February 27, 2006 at 10:00 AM.
Consensus: to approve out of state travel for Joe Snapp to Albuquerque NM, February 20-25, 2006.
Joe noted that the training is 32 hours in which he will become certified to train other staff on how to handle dysfunctional clients and personality conflicts. Erin asked if Joe could provide training to the LIHAP department upon his return. Joe stated yes, that he will be certified once he completes the training.
Joe requested out of state travel for Tanya Busby to the American Indian Training Institute, this is geared toward personal growth, education and skills.
Consensus: to approve out of state travel for Tanya Busby March 5-10, 2006 to Albuquerque NM
Joe questioned the status of the State certification application. After brief discussion, it was noted that it was incomplete. It will be found by Sara and taken to the Wednesday planning meeting for approval.
Bob motioned and Florrine seconded to approve Joe’s written report, 7 haa, 0 puuhara, 0 pupitihara.
2.) David Eisenberg, PHN:
David is present, but has no action items. He noted that he’s available to answer any questions that they may have. He stated that HCHS has decided to extend the lease on the clinic to the Tribe for five more years. This will be done to assist with documentation for Rick Hill, for the remodel grant he is submitting.
Bob motioned and Florence seconded to approve David’s written report, 7 haa, 0 puuhara, 0 pupitihara.
Florrine will send a card to Florence Lopez for successfully passing her tax testing as the Council is proud of her.
3.) Patti White, Database Administrator:
Patti stated that she has no action items, but is present to review her report. She thanked the Council for allowing her to attend the UDS training. She learned several things from the training.
Laura stated that HRSA wants the UDS report broke out several different ways. The information is obtainable, but HRSA requires that the information be compiled slightly different than reports that are pulled currently. Patti stated that if the report is not done by the due date then she may phone the representative for an extension.
Bob motioned and Leeon seconded to approve Patti’s written report, 7 haa, 0 puuhara, 0 pupitihara.
4.) Lessie Aubrey, DQMCH:
Barbara stated that Lessie is out on travel, but distributed additions to the report from Lessie. There is informational material regarding a consultant pharmacist that she is trying to recruit. Lessie also distributed information on Native American patients utilizing the dental facility in Yreka. It seems that there were issues previously regarding reimbursement from the Siskiyou County Jail, and that the appointment slots had to be set aside for two hours a visit. There was also an issue of inmates only using the dental services during incarceration, and not continuing their care once they were released.
Bob asked why there needs to be set aside time, and the jail is not calling to make appointments in the same fashion that all other clients do. Vickie stated that there was a request by the jail to have a set time and this is a problem. Bob stated that there seems to be a miscommunication.
This will be deferred back to Lessie and Barbara Norman to come up with a solution. They shall include discussions with the staff, and the jail in regards to reimbursement.
Leaf stated that they will defer the inmate policy to their Wednesday Planning meeting.
Florence motioned and Bud seconded to approve policy Release of Information 04-013-023, 6 haa, 0 puuhara, 0 pupitihara. (Bob Goodwin absent for vote)
Bob motioned and Florrine seconded to approve out of state travel for Lessie Aubrey to Las Vegas, NV, March 23-24, 2006 for the 7th Annual Compliance Summit, 7 haa, 0 puuhara, 0 pupitihara.
Bob motioned and Roy seconded to approve policy legally mandated reporters, 7 haa, 0 puuhara, 0 pupitihara.
Roy motioned and Florrine seconded to approve Lessie’s written report, 7 haa, 0 puuhara, 0 pupitihara.
Consensus: Florrine will be seated on the Complaint and Risk Management committee.
5.) Vickie Walden, Dental Office Manager:
Vickie distributed her report for the Council. Vickie noted that the Redding Rancheria Dental facility is closing the 15th of this month. Vickie stated that this will impact the Yreka facility. Dr. Stark provided a number for Vickie to call to get some inventory off of them as they are closing, these will be provided at no cost, as it is dated inventory, and will need to be disposed of once the expiration date nears. They are not selling equipment; they are only getting rid of items with expiration dates.
Vickie stated that she is having a tough time keeping up with data entry. She has been speaking with Laura to get some assistance with data entry, and the possibility of a part time position. Vickie stated that she needs to have the billing out within 30 to 60 days, so being behind will cause the loss of revenue. The dental department in Happy Camp was juggling their schedule, but now Vickie has worked out some scheduling that is more workable. Vickie stated that she is getting ready for dental staff training. She stated that there are twelve members wanting to go to the Lake Tahoe conference in May. The funding is there, but the staff shortage could cause issues. Laura asked if the staff can alternate attendance. Vickie stated that she doesn’t have to send everyone, but the licensed staff is a priority. Leaf stated that putting the information together and the conference information will be helpful for the Council to make this decision. Vickie stated that the conference is in May, and she will bring the information back. Dr. Burns stated that he has done his CEU’s online for the last three years, and wonders if this is a possibility for the dental department. Vickie stated that she will look into this and present information back to the Council at a later time.
Bob questioned the data entry and keeping up on it. Vickie stated that she will work on this. Bob stated that we need to make sure we’re staying up to date on this. Bob stated that this should be discussed with Laura. Laura stated that this can be worked out with Suzanna and Vickie, but if they need her input she will assist them.
Vickie commented that the Happy Camp dental remodel has a loose end. The funding was received, but it was hung on to be used toward the new Happy Camp facility. When a turn in planning took place, regarding a new facility or remodel of Happy Camp Health Services, this funding was removed, to go back for use for the Happy Camp dental facility. When IHS came to review the Yreka clinic they understood that the funding was going toward the Yreka remodel, which was not factual. Vickie stated that there was an expectation date given to Kerry Gregg of completion was within three months. This is an ongoing project and she and Fred are working on it. She will keep the Council up to date on this issue.
Vickie thanked the Council for the Supervisors training last month. It was beneficial and she really appreciated it.
Bob motioned and Leeon seconded to approve Vickie’s written report, 7 haa, 0 puuhara, 0 pupitihara.
6.) Lessie Aubrey, Acting EDHHS:
Consensus: to send Lessie to the Tribal Leader Conference, March 21-23, 2006.
Bob motioned and Leeon seconded to approve Lessie’s acting EDHHS written report, 7 haa, 0 puuhara, 0 pupitihara.
H.) Requests:
Laura Mayton is present to request approval for the HVAC funding previously received.
Bob motioned and Roy seconded to approve the HVAC funding and procurement with Metal masters, 7 haa, 0 puuhara, 0 pupitihara.
Leeon motioned and Robert seconded to approve purchase request from Tribal Member #1090 for vehicle number #53 at the price stated, 7 haa, 0 puuhara, 0 pupitihara.
J.) Committee Reports:
1.) Roy/Florrine:
Roy stated that he has paperwork on CRIHB’s minimum dues proposal. There is some legislation stuff being worked on. We’re in danger of losing money in the CAIR program. Apparently there aren’t enough clients utilizing the funding. This will cause some of the funding to be returned.
Leaf stated that Roy should contact someone down there, and wonders if maybe Joe should follow up regarding the limitation on the cap. Laura stated that Joe has a letter regarding who he can contact. Roy stated that he will also follow up on this.
Robert stated that the amount that CRIHB wants Karuk to contribute is a lot more than usually contributed. The amount will cover the representatives’ travel and perdium. Roy stated that it is still in the revision process, but CRIHB has always wanted to pay their members’ fees so they are not influenced by process. The cost would also include travel, lodging, and the stipend checks for our representatives. Roy stated that they are doing good work.
This will be moved to the Wednesday planning meeting, where Roy can provide more information on the $20,000 funding that CRIHB is purposing. Roy will also provide copies of the minutes and the legislative information that CRIHB is working on.
Discussion Item:
Bob stated that there was a request by Dr. Burns to have a meeting with the Council. Dr. Burns stated that David and Lessie met with the providers, and providers shared their ideas and goals for the Health Program. Dr. Burns stated that David is doing some research, and he presumes by next month he will have a presentation on their goals for the Council. Bob asked if the providers would want a separate time to meet with the Council, or if the Health Board meeting is sufficient. Dr. Burns stated that within the month, he believes the research will be complete and the Health Board meeting would be fine for their presentation. Leaf stated that if the providers are ready to meet before then, then they should let them know.
Barbara will schedule the next health board meeting, with enough time allotted for the discussion of goals and direction of the health program presentation by the providers.
Dr. Burns stated that he can provide a brief synopsis of the consensus by the providers. He noted that Sophie Two Hawk is fantastic. She is keeping the providers really informed of the importance of GPRA. There is a great level of urgency in her mind regarding GPRA and results of the national benchmarks. Dr. Burns stated that JCAHO has been wonderful for the organization, but the providers feel that the time and effort going into JCAHO may move the organization away from what is important, which are GPRA indicators. Dr. Burns stated that the health program is working on the GPRA indicators, but the bottom line is that even though the providers and staff are providing the care, it doesn’t mean that we’re scoring high on the GPRA indicators.
Dr. Burns stated that the six providers are unanimous, in trying to get within the top ten of California Tribes getting the highest scores. Dr. Burns stated that this would require a big restructuring in the health program. Their consensus concludes that the time spent on JCAHO preparedness, and maintaining JCAHO accreditation is overwhelming and too consuming.
Patti stated that the problem is that when the providers document in the chart note, they aren’t entering it in the right spot, in which provides the low numbers for GPRA indicators. This is a problem discussed, but no resolution on the documentation problem.
Dr. Burns stated that AAAHC accreditation body is 60% of what other Tribal Health Programs are accredited by. AAAHC is strictly ambulatory based, in which he believes would alleviate JCAHO which is hospital based as well. David Eisenberg ordered AAAHC’s manual, to identify what the comparison is in regards to the two accreditation bodies. Dr. Burns stated that HRSA requires us to be accredited, but do not stipulate that it be JCAHO. Dr. Burns stated that GPRA is actually important and in more desire than JCAHO.
Leaf questioned if this subject would require a special meeting, for the providers with other staff and the Council.
The next health board meeting in closed session there will be enough time allotted for this discussion, as the meeting will be moved up to at 3:00 PM, with invited staff. Also Dr. Burns shall extend an invitation to the meeting to Sophie Two Hawk. The other staff members that shall attend are David Eisenberg, Patti White, Lessie Aubrey and Vickie Walden asked that there be dental representation as well, as this whole concept was discussed and concluded without the Dental Director input.
K.) Closed Session (8:24 PM to 11: 58 PM)
Consensus: Leaf will contact Stephanie Dolan and work with her in drafting a letter explaining the confirmation of common law marriage between Tribal Member #1015 and her deceased spouse. This letter is to be completed, and sent along with a resolution to the Tribal Member’s attorney’s office, John Stokes, by February 29th 2006.
Bob motioned and Leeon seconded to approve 06-R-10 regarding the Karuk Tribes recognition of common law marriage between Tribal Member #1015 and her deceased spouse, 6 haa, 0 puuhara, 1 pupitihara (Alvis Johnson).
Consensus: To assist with repairs to mobile home for Tribal Member # 50, to allow immediate family members to care for him. Leaf will speak with the construction manager for him to travel to the residence and determine the needs to make the residence suitable for the next roughly six months. The construction manager will be contacted to find resources at lower rates to replace broken windows, water heater, wood stove, cook stove, and the construction of a ramp into the home. The Council will assist Tribal Member #50 in the replacement of these items, to make the residence in acceptable living conditions.
Consensus: to address request by Tribal Member #993 that the Council find resolution in payment for medications. After speaking with the CHS Supervisor, it was discovered that this is rectified.
Directive: to the Yreka Director, to update to find solution and resolution in regards to outdated patient addresses.
Consensus: To re-advertise data entry position for the Yreka clinic as one full time position.
Employee # 1048 will be invited to the next health board meeting in which they will have the opportunity to discuss concerns over changing accreditation bodies.
Send response to employee #5817 regarding meeting set with providers, Council, and staff.
Leeon motioned and Roy seconded to approve loan request of employee #4696 in the amount of $1,981 in conjunction with the co-signer of employee #9327 with a 5% interest, 7 haa, 0 puuhara, 0 pupitihara. The CFO will draw up an agreement.
Stipend request or similar compensation for employee #5817 in regards to recent additional duties was presented by the CFO. The CFO will provide recommendations to the Council at Wednesday’s Planning Meeting.
Consensus: The next HCHS Board meeting is February 15th 2006. The CFO is work with Leaf and Sara on drafting a transfer letter to the HCHS board as soon as possible, including a request to provide a final response to the request at their Feb. 15th meeting. It should be noted in the letter that the intention according to HCHS charter and bylaws are that the facility/property be used for healthcare, in the community. Contingent on decision the recent grant submittal in regards to the HCHS remodel will either be submitted, or restricted from being put forward. The letter will be emailed to the Council.
As a CASA grantee, the CASA coordinator is the required to attend a CASA conference in San Diego CA,. The registration fee is $310 for the coordinator,
Bob motioned and Bud seconded to send Barbara Houle and Florrine Super to CASA training April 4, 2006 in San Diego CA., 7 haa, 0 puuhara, 0 pupitihara.
Bob motioned Florence seconded to approve Florrine Super, Florence Conrad and Daniel Pratt to attend training April 2-5 2006 in San Diego, CA for the National ICWA conference, 7 haa, 0 puuhara, 0 pupitihara.
Suggestion to increase stipend checks maybe for quarterly election meetings.
Consensus: for Leaf to initiate intervention in election committee due to conflicts of interest and the lack of productivity. Also, thank persons for involvement but process is not running smooth Tribal Member #394 will be asked to resign from the election committee. Leaf will speak to Tribal Member #335 explaining that she will be asked to remain on the committee, but not as chairperson, as this would eliminate conflict in regards to the Council representative voting.
Barbara is to email the next election meeting date to the Council. If Bob, Leeon and Leaf are available they will attend. Florence will attend the next two meetings, until another representative is seated.
Consensus: authorization for Leaf to discuss stipends, mileage, and the goals of the election committee with employee.
Florence motioned and Bob seconded to allow Leaf’s subscription for Hydro Review, 7 haa, 0 puuhara, 0 pupitihara.
Bob motioned and Florrine seconded to uphold CHS denial #052-LHCC445 and pay $50.42 from third party, 7 haa, 0 puuhara, 0 pupitihara.
Next meeting set: March 9, 2006 at 3:00 PM
Bud motioned and Roy seconded to adjourn the meeting at 10:48 PM, 7 haa, 0 puuhara, 0 pupitihara.
Yootva,
________________________________
Leaf Hillman, Vice-Chairman
Recording Secretary, Barbara Snider