Karuk Tribe of California

Health Board Meeting Minutes

November 09, 2006

Meeting called to order at 5:03 PM, by Arch Super, Chairman

Roll Call:

Arch Super, Chairman

Florrine Super, Secretary

Leeon Hillman, Treasurer

Florence Conrad, Member at Large

Robert Goodwin, Member at Large (7:05 PM)

Roy Arwood, Member at Large

Absent:

Leaf Hillman, Vice-Chairman (travel)

Quorum is established.

Florence Conrad read the Health Mission Statement aloud for the Council and attendees.

Agenda:

Florrine motioned and Leeon seconded to approve agenda with changes, 5 haa, 0 puuhara, 0 pupitihara.

Minutes of October 10, 2006:

Florence motioned and Leeon seconded to approve minutes, 5 haa, 0 puuhara, 0 pupitihara.

Guests:

1.) Florence Lopez, Tribal Member:

Flo addressed the Health Board and discussed her concerns regarding healthcare for the Tribal people right now in the community of Happy Camp. Florence stated that the discussion that took place regarding the possibility of the HCHS transfer at the August community meeting there was an option for the Tribe, in which they could transport Karuk patients out to the outside facilities. She stated that as the Community treated and has always treated Native Americans and their vicious behavior toward Native Americans she would hope that the Health Board followed this discussion and is willing to look into this as an option. She has heard similar concerns from other Tribal Members in the community.

Roy stated that although the discussions and the Communities disrespect for the Tribe does not mean that the Tribe will not service the entire community. Florence agrees that the Tribe is doing a good job and treating the entire communities that each of our facilities are at. She stated that this is a sad situation.

Laura commented that realistically the Tribe would want to service all community members, as there are spouses of Native Americans, and neighbors and others. It is not the spirit of the Tribe to turn people away.

Flo stated that she understands the grants that we receive, but the community has turned the situation ugly and has stated mean hurtful things to the Tribe. Laura explained that the choice to turn others away would not service the community or reveal how helpful the Tribe is.

Dr. Burns stated that whatever the decision is by the Council and the Tribe he and Judy are behind it 100%. If the Council determines that the clinic be moved to the Tribal land he will support that decision.

Dr. Burns commented that he is respectful of the Tribe and their attitude of the Tribe in the face of this blatant nastiness in front of the community.

Arch wondered how much Tribal people are involved in the community meetings and noted that it is harder to treat Native Americans as outsiders if we participate and be involved.

Roy explained that it is a hurtful situation, but this is the face of the people that will never change their ways regarding how they treat Native Americans.

Flo would like the focus to be first on the Tribal People.

Flo explained that David Eisenberg and Lucille Tiraterra stated that having money is more important than the Tribal patients not getting their medications and services. It was hurtful for the Tribal Members that they do not receive services.

Dr. Burns explained that he hears stuff that blows his mind that they state the negative things but he tries to correct the issues.

Leeon commented that the Council does hear the concerns Flo is voicing but he would like to ensure Flo that the Council is taking care of business and looking to do things that is best for the community and first of all the Tribal persons. He is emphasizing that the Tribe is moving forward appropriately.

Flo explained that she was at the Yreka Dental Clinic. The waiting room is cold, but the cooling has to be low due to the staff getting hot while wearing their protective covers. She wanted the Council to be aware that the lobby is very cold and uncomfortable for some staff and patients.

Guests:

1.) Suzy:

Suzy has requested time on the agenda in the hopes to confront Leaf Hillman in the presence of the Council. She explained that she has documented proof of at least 25 phone calls to Leaf Hillman regarding her home that was not to be demolished. She explained that she has been trying to contact him, as her trailer and vehicle were destroyed after she directly told him that he could not remove her property.

She stated that she has a witness regarding the discussions of not removing the home and Leaf’s explanation of assisting her in removing her belongings prior to any demolishing. The owner was able to get into contact with Suzy and which she attempted to get into contact with Leaf to stop the process. She noted that he said he would get back in touch with her after his assurances that he would assist her, but the home was demolished and he has not been in contact with her since. She has left messages at his home, on his cell, and at his office.

Arch asked Suzy to provide further information so that the Council can review both sides of this situation and more clearly understand the circumstances.

2.) Florence Conrad:

Florence would like to request $1,500 for a Christmas party for the communities of Orleans, Somes Bar and Forks of Salmon. They want to hold it on a Saturday, but it goes toward gifts for Elders and Children. It will be December 16, 2006.

Roy motioned and Leeon seconded to approve request from Florence Conrad of $1,500 for a down river Communities Christmas party, 6 haa, 0 puuhara, 0 pupitihara.

Directors Reports:

1.) David Eisenberg, PHN:

David is not present but his written report is provided for the Council to review.

Florrine motioned and Alvis seconded to approve David’s written report, 5 haa, 0 puuhara, 0 pupitihara.

2.) Patti White, Database Administrator:

Patti is not present but her written report is provided for the Council to review.

Florrine motioned and Florence seconded to approve Patti’s report, 5 haa, 0 puuhara, 0 pupitihara.

3.) Vickie Walden, SR. RDA:

Vickie provided procurement for the ongoing remodel project for the Happy Camp Dental Clinic. The procurement that she is presenting is for cabinetry that is going in the dental operatory.

Florence motioned and Florrine seconded to approve procurement with Northwest Dental in the amount of $7,197, 5 haa, 0 puuhara, 0 pupitihara.

The RDA position that was recently vacated was determined to not be re-flown. The staff is working without the additional position. The position was paid from the HRSA grant, and to date they will use that funding to cover the other staff.

Florence motioned and Leeon seconded to approve Vickie’s report, 5 haa, 0 puuhara, 0 pupitihara.

4.) Lessie Aubrey, DQMCH:

Lessie is present and announced that the ACQI committee voted to recommend changing accreditation bodies to the AAAHC accreditation body.

Roy asked if AAAHC would save time and provide better services for the patients. Lessie explained that it is deemed by CMS to be a good agency but she has seen that it is more related to ambulatory surgery centers. Although she read AAAHC’s mission statement aloud regarding their goal she is unfamiliar with the accreditation body so she is not prepared to make a final decision on what is best for the health program.

She does understand and explained that instead of several chapters of standards to meet, there are fewer tasks to complete regarding AAAHC.

Martha stated that with several hospitals their JCAHO accreditation deems AAAHC for their ambulatory facilities even though they are JCAHO accredited for the portion of operations as a hospital.

Florence noted that in meetings and conferences she has heard comments regarding the Karuk clinics and specifically how they are accredited by JCAHO. It is something that she, the staff and others are proud of and understand to be an accomplishment for the Karuk Tribe.

Roy explained that AAAHC seems to be less time consuming but same quality of service.

Florence would like to have the best service for the Karuk people and the Tribe owes the people that and whatever entity that best services the Karuk people is what she would like to go with.  

Dr. Burns believes that JCAHO is not a good option any longer. He explained that JCAHO is too time consuming and doesn’t provide much benefit. He believes that the Tribe has achieved the best services that JCAHO provides. He believes that by changing accreditation bodies this would free up the time that is spent on accreditation preparation and the time that Lessie spends on this avenue.

Martha comes form an organization that was JCAHO accredited and then moved to AAAHC accreditation. Martha explained that AAAHC allows for latitude in meeting standards. When going to through AAAHC the organization chooses what standards are applicable to the organizations. She recommends AAAHC and within her other employment she wished she had made the move sooner.

Leeon inquired about the cost of AAAHC. Martha stated that there was savings associated with the move of accreditation bodies. The cost is relatively lower. Leeon asked for the cost of the survey’s in comparison. Lessie explained that the Tribe did not pay for the last JCAHO survey, but HRSA did as they require accreditation and contracted with JCAHO. HRSA will only pay for what accreditation body they contract with.

Lessie explained that when JCAHO changes their standards everything must change to coincide. Also, it is very hard work to get prepared for an unannounced survey. She explained the Periodic Performance Review and the requirement for every three years, and then changed to annually. Also their paperwork is time consuming with the unannounced survey possibility.

Dr. Burns stated that the amount of time that staff puts in is only hurting the staff, because it is a distraction when there are other pressing issues.

Florence motioned and Florrine seconded to switch accreditation bodies from JCAHO to AAAHC, 5 haa, 0 puuhara, 0 pupitihara.

Lessie took time to publicly thank Maria Miranda and Sharon Denz for their hard work during the State IHP review. Also David and Norlyn’s assistance during the review was helpful. She appreciated their hard work and determination to assist.

Lessie revised the policies that address educational activities for the health staff to maintain their licensing.

Roy motioned and Florence seconded to approve policy number 03-004-001, 5 haa, 0 puuhara, 0 pupitihara.

Florrine motioned and Alvis seconded to approve Lessie’s report, 5 haa, 0 puuhara, 0 pupitihara.

5.) Joe Snapp, Substance & Alcohol Abuse Program:

Joe provided his written report for the Health Board to review as well as provided them an update.

He has received the DUI certification for his DUI program. Joe explained that the entity that offered the letter of support wanted Joe to increase his service area to include more assistance. Joe will not be servicing the Orleans area, but with Anthony on staff he is hoping to have transportation to the classes.

The Oak Knoll project was submitted to the planning department. A hold up from the planning department that was identified was the septic system. There was some research to be done, but the planning department has not gotten back to him to date. Florence asked if Joe contacted the Forest Service to see if they had original planning documents or what septic system was originally installed. Joe asked for the documents but has not received them. Also the feasibility grant that was submitted should be reported back within the next couple weeks.

Robert motioned and Alvis seconded to approve Joe’s report, 5 haa, 0 puuhara, 0 pupitihara.

6.) Martha Schrock, EDHHS:

Martha explained that she has her report included for the Health Board to review.

The HHS supervisors and Managers have established a code of ethics to follow so they would have a pattern to be able to provide operational values. She will be sending those out to all supervisors and Managers.

There was a question in regards to a patient regarding an electric wheelchair. There was a Medicare quote, and they contacted the patient to ask that the gentleman apply for Medi-Cal. The patient has not shown for an appointment to do so. Florrine will contact the patient to provide assistance to get the patient to follow up.

Martha has conducted a budget meeting and will be discussing the issue further in closed session.

She has once action item. It is a request from Jessie Drake to attend training in Scottsdale Arizona. The workshop is November 18 – 19^th, 2006. This training will provide better oversight for the other social workers.

Florrine motioned and Roy seconded to approve Jesse Drake’s travel to Arizona November 18-19^th, 2006, 6 haa, 0 puuhara, 0 pupitihara.

She distributed the Social Services Departmental reports for the Council to review.

Leeon asked that Martha include in her reports the council approved third party report. Laura will provide this report to Martha every month.

Florrine motioned and Leeon seconded to approve Martha’s report, 6 haa, 0 puuhara, 0 pupitihara.

7.) Chris Kleeman, IT Manager:

No written report provided. Chris is present to review his verbal report with the Health Board.

During investigating the upcoming EHR and feasibility Chris has decided to make the install for Microsoft products. There are approximately 15 updates that need to be done.

He and Gerry are doing a full inventory for resources within the Karuk Tribe. Also there is the needed additional staffing.

Chris explained that he obtained information from the Warm Springs training that he attended with several other key staff.

He assisted KTHA on interviewing and hiring for an IT person. He was not over excited on the person, but he discussed the option of consulting with his department as a possibility. There are a couple people trying wireless phones to check the viability of them for use within the Tribe. The idea is to have the phone much like the cell phone, and it will roam between sites.

There were minor computer failures regarding equipment and servers, but he has worked on them and brought everything back up and running. Currently there is more need for further storage space on the server. The finance software vendor has been providing information, and has come back with further information on issues with the software. He has been working with them regarding the issues.

IHS has contacted him regarding new routers that they have provided the Tribe. There were some security items ordered to provide security for the servers.

He updated the file maker pro which caused issues with enrollment, Lisa Aubrey, Flo and the front desk. He corrected the errors that occurred with the update and it appears to be running a little smoother.

He is set for vacation for a week during Thanksgiving, but there will be staff covering the IT aspects while he is on leave.

The CASA program has moved their office again, during that move there was staff turnover. They have purchased a server, which has been re-deployed to this area to offset and create a better service for the departments that need more space.

There is an instant messenger client for in house instant messaging for the Karuk Tribe. This will provide status information on the location of staff, and allow for faster correspondence, but it is only being released to certain individuals to date to check the use and feasibility.  

He has found a way to secure a digital key that will be distributed for each employee for email and computer use. This would provide a higher level of security for the Karuk Tribe.

Robert motioned and Alvis seconded to approve Chris’ report, 6 haa, 0 puuhara, 0 pupitihara.

Requests:

1.) Karuk Sports, Joyce Jones:

Robert motioned and Florence seconded to approve insurance coverage for Karuk Sports, 6 haa, 0 puuhara, 0 pupitihara.

2.) Hector Garcia, Self-Governance Director:

Hector stated that the Senate of Affairs is meeting soon and they would like to obtain information on what the sub committee should be considering as priority.

He has been working with a contact, and while at the NCAI conference it was agreed to meet next week.

He believes this would be a good chance for Arch to attend, since the relationship has been created. That committee will be asked for resources and Hector believes that meeting with his contact will create a better working relationship.

The political party has shifted and now is the time to meet and create an open communicating forum.

Robert motioned and Leeon seconded to approve Arch and Leaf for out of state travel to Washington, DC, 5 haa, 0 puuhara, 1 pupitihara (Florrine Super).

Arch will call Leaf to confirm his attendance.

Consensus: to approve travel for Scott Quinn to attend the National Roads Conference in Morongo CA. November 13-14, 2006.

Informational:

1.) Thank you letter from a Tribal Member was received and distributed for the Health Board.

Committee Reports:

1.) Election Committee

Michael Thom - Appointed Election Chairperson:

Michael believes that the Election process has been closed. The Vice-Chairman seat shall be filled by Leaf Hillman, and the Treasurer seat shall be filled by Leeon Hillman. The Council members shall be not be sworn in tonight as it is not time in conjunction with the ordinance.

As the temporary Chairperson of the Committee, Michael would like to provide comments on what could make the election process smoother in the future.

He would like to bulk mail the absentee ballots at one time to all registered voters. This will create more voter turnout and provide the opportunity for several members to vote.

He would also like to arrange time to work on time lines of the election committee to make it more membership friendly. In addition, would like at least three amendments to the constitution on the upcoming Special Election to begin moving forward with the constitutional revisions.

He would now like to turn the Election back over to the regular Chairman, Florrine Super. He thanked the Council for allowing him to serve the membership by serving as the appointed chairperson.

Robert thanked him for his hard work on the Election Committee. Also, Arch will be inviting Michael to the Planning meeting for further discussion on his recommendations.

Closed Session:

Anna Myers provided a blanket that was made to be used for a raffle. The money raised will be used to repay a loan made for a youth basketball team and the remainder to support the booster club.

Consensus: for Tribal Member # 3 shall be sent through the approved process before presented to the Council  

Florence motioned and Robert seconded to approve procurement and the purchase from East Bay/Chefs in the amount of $18,418.05, 6 haa, 0 puuhara, 0 pupitihara.

Consensus: to employee # 7553 that there is no counter offers. Sara shall send notice regarding the final decision.

Consensus: to allow Barbara Norman to continue to work on Tribal Member # 4111 legal issues.

Consensus: to allow Barbara Norman to assist Tribal Member # 2132 regarding negotiations only and no litigations.

Robert motioned and Alvis seconded to approve investigator fees of $200 for D01545, 4 haa, 0 puuhara, 2 pupitihara (Leeon Hillman and Florence Conrad).

Florence motioned and Leeon seconded to approve the agreement deleting section seven (7) with US Modular Group Inc. in the amount of $189,986, 5 haa, 1 puuhara (Robert Goodwin), 0 pupitihara.

Robert motioned and Leeon seconded to send a letter to all staff reminding the staff that data collected may not be used for funding sources for agencies other than the Tribe and not to be collected without the Tribe’s approval, 6 haa, 0 puuhara, 0 pupitihara.

Consensus: to have employee # 3146 review the request from Tribal Member # 399 and ensure the internal process was followed.  Employee shall provide the follow up at the next planning meeting.

Informational: the Happy Camp Medical Clinic staffing overview concluded that the staffing level will remain as is.

Consensus: to approve credentialing and privileging for employee # 2328 for KTHP.

Consensus: for employee # 4811 to look into the case and if it is beyond his scope then Barbara Norman is approved to look into it.

Florence motioned and Robert seconded to approve the Wood Mizer Project proposal for $5,425.96 from In-Direct, 6 haa, 0 puuhara, 0 pupitihara.

Robert motioned and Alvis seconded to provide an extension on loan to Tribal Member # 897 to January 31, 2007 5 haa, 0 puuhara, 1 pupitihara (Florrine Super).

Consensus: During a time of a special election and the importance placed on there being a full active Council, is the Council’s desire that Tribal Member # 1482 remain seated. Arch will discuss this with the Tribal Member.

Consensus: to send notice for letters of intent for someone to replace Tribal Member # 1182 vacancy.

Florrine motioned and Alvis seconded to approve payment in the amount of $4,508 for Tribal Members #2292 & #826, 4 haa, 1 puuhara (Roy Arwood), 1 pupitihara (Robert Goodwin).

Directive: to the Elders staff to develop a plan for meeting the needs of the Elders in each community. Sheila Robinson, Flo Lopez and Melodee Brewington shall plan with the input from the Elders and then set their planning times and the available Council will meet with them to adequately hear the concerns identified and/or the planning for the needs identified.

Next Meeting Date: December 14, 2006, at Happy Camp, CA.

Alvis motioned and Florence seconded to adjourn meeting at 10:05 PM, 6 haa, 0 puuhara, 0 pupitihara.

Respectfully Submitted,

________________________________

Arch Super, Chairman

Recording Secretary, Barbara Snider