Karuk Tribal Health Board Meeting
January 11, 2007 – Happy Camp
Meeting Minutes
Meeting called to order at 5:04 PM, by Arch Super,
Chairman
Present:
Arch Super, Chairman
Leaf Hillman, Vice-Chairman
Florrine Super, Secretary
Leeon Hillman, Treasurer
Sonny Davis, Member at Large
Robert Goodwin, Member at
Large
Alvis Johnson, Member at
Large
Roy Arwood, Member at Large
(5:09 PM)
Absent: None.
Quorum is established.
The health mission statement was read aloud by Florrine
Super.
Agenda:
Florrine motioned and Bud
seconded to approve agenda with changes, 7 haa, 0 puuhara, 0 pupitihara.
Minutes of December 14, 2006:
Florrine motioned and
Robert seconded to approve the minutes of December 14, 2006, 7 haa, 0 puuhara,
0 pupitihara.
Guest: Sara Spence, Human Resources Manager
Sara is present to request
approval for contract 07-C-026 between Leaf Hillman, Jr and the Department of Natural
Resources. The contract is for outreach services for the Klamath Campaign
Community Outreach project. The contract is in the amount of $2,710 effective
January 1, 2007 – June 30, 2007.
Robert motioned and Alvis
seconded to approve contract 07-C-026 between Leaf Hillman Jr., and DNR, 6 haa,
0 puuhara, 1 pupitihara (Leaf Hillman).
Guest: Elsa Goodwin, Tribal Member
Elsa questioned the Council about
a Tribal Member attending a KTHP clinic and would like clarification of medications
prescribed being provided at no cost for Tribal Members.
David clarified that if the
provider prescribed the medication it should be covered under the formulary
that is approved by the providers, staff and the Council. David explained the
process for filling medications on the formulary including the patient’s right
to receive the medication for thirty days while an appeal is done to allow the
cost to be covered by KTHP if it isn’t on the formulary.
Dr. Burns explained that if the
person is CHS eligible then the prescription would be covered under that
process.
Flo asked if the medication
would be covered under HRSA or direct care services. Flo stated that if the
grants service non Native Americans with medications she questions why Native
American medications aren’t covered.
Dr. Burns explained that within
the guidelines of CHS the prescriptions are written and if the patient follows the
approved process and is denied then the patient has the ability to appeal to
the Managed Care Committee, and then re-appeal at the Health Board level.
Lessie explained that in
prior years the CHS program has ran in the “red” meaning a deficit, and after
budgeting it was brought back into the “black” sustaining itself. She went on
to explain that if CHS opened its levels of care to surgery one surgery service
could spend the entire CHS budget. After discussion with providers and staff
the determination was made to cover medications and laboratory services on a
minimal level. Dr. Burns also stated that to maximize the dollars to better
service the Tribal Membership it has been a difficult task and in a perfect
world they would cover the costs of all services for Tribal Members.
At a recent training
Old Business: None
at this time.
Directors Reports:
1.) David Eisenberg, PHN:
David introduced Karen Daniels who has been hired as a GPRA Coordinator for the
Health Program. She is under the HRSA grant and was hired to assist in
providing more coordination of the health activities done by the staff and the
clinics. In David’s report on the second page, there is graphing of flu shots
provided to clients of the program. This is an example of what Karen will be
doing to assist in follow up with the patients and then provide further
communication between the patients and the providers including the staff of
what indicators need raised or better service provided to appropriate clients.
Karen provided a background
of her employment noting that she is a RN and she is very happy to be working
for the Tribe. She believes that she can make a difference with the Karuk
Tribe, and she is open to suggestions from staff and patients on how to improve
the services that the Health Program offers.
She comes from
David clarified that the
healthcare indicators are reported to Congress and Karen will work on the
diabetic issues and the other quality measures in accordance with the guidelines
set forth. She will also do educational activities but in the short term she
will be focusing on diabetics. Dr. Burns stated that both David and Karen are
attending the providers meetings to provide input and they are providing
organizational wide activities.
Florrine motioned and
Florence seconded to approve David’s written report, 8 haa, 0 puuhara, 0
pupitihara.
2.) Patti White, Database Administrator:
Patti announced that Leslie
Alford passed her certified billing course which places two certified coders within
the Karuk Tribal Health organization.
Florrine asked if anyone is
working with Laura Longstaff on billing and paperwork requirements. Suzanna is assigned
to work with Laura on the RPMS packages and Suzanna has been working with her
on the billing aspects as well. Both Patti and Laura began to learn the RPMS
packages specific to Laura’s job duties as it was informational regarding the
RPMS package usage for the Social Services department and provided a great
learning experience for Patti as well.
Leaf asked if the time has
expired for Medicare Part D. Patti stated that this update would come from
Lessie as she is the immediate supervisor of that position currently. Anna
clarified that you may apply at any time, but it is a higher cost based on
percentages after the date of applications has passed.
Florrine motioned and Robert
seconded to approve Patti’s report, 8 haa, 0 puuhara, 0 pupitihara.
3.) Vickie Walden, Senior RDA
Vickie’s written report was
provided for the Health Board to review.
Florrine motioned and
Alvis seconded to approve Vickie’s report, 8 haa, 0 puuhara, 0 pupitihara.
4.) Lessie Aubrey, DQMCH:
Lessie stated that after she
submitted her report, some information has changed. The final plan for the
remodel to house the Happy Camp clinic was made and she now has updated
information. She reviewed her changes with the Council and the attendees.
Lessie agrees that the floor plan shall be reviewed with contractors however she
provided an overview of the plans and her suggestions with staff input for the
remodel.
Leaf asked if engineers are
being consulted regarding the upcoming changes.
Dr. Burns explained that in a
different phase the x-ray capacity would benefit, and another large space could
be used for educational activities. Lessie stated that she has taken this as
far as she can take it and further planning needs to take place with the
appropriate staff.
The Council signed their conflict
of interest statements and returned them to Lessie in accordance with her
Compliance Program.
Florrine motioned and
Robert seconded to approve Lessie’s report, 8 haa, 0 puuhara, 0 pupitihara.
5.) Joe Snapp, Substance & Alcohol Abuse Program:
Joe has two action items. Joe
would like permission to have Toby Reuze attend training in
Robert motioned and Alvis
seconded to approve travel for Toby Ruesze to Sacramento CA., 8 haa, 0 puuhara,
0 pupitihara.
Joe stated that he receives
requests from Non Native American spouses and/or family members to receive
treatment. The clients’ costs should be reimbursable by the County as it is
their clientele that they are not servicing; however it is undetermined at this
time. Joe explained that the non Native American family member may be
identified and assisted which could alleviate a family situation prior to
affecting the home in a manner that constitutes ICW and Social Services to
intervene on behalf of the Native American clients. Florrine stated that
Barbara may be able assist in the agreements between the County and the Tribe.
Arch believes the Council needs to take this into consideration and it will be
re-discussed at the Wednesday planning meeting.
Robert motioned and Leaf
seconded to approve Joe’s report, 8 haa, 0 puuhara, 0 pupitihara.
6.) Martha Schrock, EDHHS:
Martha’s report was included
in the packets for the Health Board to review.
She explained that she has
been spending time doing performance appraisals with her staff evaluating their
prior evaluations and setting goals for the upcoming year.
She has been spending time
with a candidate for the FNP position for the Yreka clinic.
She is working with the KCDC
board regarding the NVSP program. They are doing quite a few things to correct
the deficiencies in the OES report, and she will be working on getting that program
into compliance. She is in the process to bring in behavioral health auditing
officials to perform an audit on records and documentation for the program. She
has spoken to Chuck and Drake regarding her hand audit finding. She is working
with Patti on utilizing the RPMS system and utilizing the health records in the
same manner entering all information into the system to accurately recover
important data in the patient records.
The Social Worker III
interviews will be held January 30, 2007. Mike is still consulting and Robert
is doing a good job on covering the position until a candidate is selected.
The Social Service staff is
reporting under her, but there were some reports that were received late so she
distributed those for the Health Board to review.
Martha provided the Third
Party revenue report along with the fund balance to the Board. Right now they
are on task in regards to Third Party revenue. They are within the target range
and projections for the fiscal year.
Arch clarified that the Third
party balance is 50% spent, but they are not half through the fiscal year. This
shall be monitored and overseen carefully.
Martha stated that the
Wellness forum has been attempting to obtain an agreement with the Karuk Tribe.
It is to formalize an operational agreement with the purpose to formally state
the willingness of KTOC departments represented interdepartmentally at the
Wellness Forum to work cooperatively and collaboratively together for the
benefit of Karuk Tribal Membership that is served. She would like to seek an
MOU with a Tribal interagency agreement; the number is 07-M-001. Arch would
like time for the Council to review the agreement prior to approval.
Florrine questioned the now
show’s on Drake’s health report. The no show or cancellations are counted as
cancellations and noted as such. Leaf asked why there are provider
cancellations. Martha explained that there are instances that arise for a
provider to cancel appointments and also she is working on establishing the
same policy regarding no shows for the Social Services Department that is used
for the Health Program.
Florrine motioned and
Alvis seconded to approve Martha’s report, 8 haa, 0 puuhara, 0 pupitihara.
7.) Chris Kleeman, IT Manager:
Chris provided a task list of
his duties. He has been working on the document management system as well as
the phone system for the phone systems at KCDC. He has just finished hooking up
Tanya’s phone line and fax so she may begin to work on her projects. The wiring
projects are estimated at $9,000 including equipment pieces and lines.
Right now there are four
candidates that are an option for document management. There is an open source
free product that has no licensing fee but hardware that may cost up to $5,000.
He will be pursuing this one to determine feasibility.
There has been some EHR cost
analysis that needs completed. The inventory has been done, and he has obtained
a quote from Gateway thus far. He has been discussing the option of having real
time data submitted and ran through the website.
Chris stated that the
computer center has really improved services in regards to their recent ANA
grant and expansion.
He is working with audit head
to complete the transition to improve the telecommunication costs. It appears
that everyone will receive a new cell phone. Chris will be evaluating the
phones that would best suit the group and staff. Chris stated that the
compatibility has to be taken into consideration. Chris will address the
concerns regarding phones and service before ordering all new phones and
services.
Roy motioned and Leeon
seconded to approve Chris’ report, 8 haa, 0 puuhara, 0 pupitihara.
Requests:
Robert motioned and Leaf
seconded to approve out of state travel to North Dakota January 23-25, 2007 for
the Sharing Wisdom and Building Strength for Families, for Florrine Super from
Discretionary and Florence Conrad from the Social Services budget, 6 haa, 0
puuhara, 2 pupitihara (Florence Conrad and Florrine Super)
Informational:
The DNR management meeting minutes
were distributed by Florence Conrad.
Committee Reports:
Election Committee: Michael Thom
Michael is present to provide
an Election report. At the Election Committee held January 10, 2007 they have
decided to complete a mailing to all registered voters explaining that Sonny
was seated and the Special Election did not take place. The Council affirmed
that Michael does not need their permission to do this, but it may be done by
the Election Committee in accordance with their duties.
The Committee would also like
to seek clarification on Michael being seated as the Committee Chairperson and
also if he will be replacing April Attebury on the Committee as her seat is
vacant. The Council announced that they voted and seated Michael as the
Committee Chair for a term of four years, and this position was not vacated by
April’s resignation so he was not selected to fill that vacancy but appointed
to the Chair position. Flo is concerned that the Council is making the
committee too big. Flo stated that there are six committee members currently
adding Michael. Florrine stated that the Council secretary position is the
voter registrar and not a committee member so there is still a vacancy left by
April’s resignation.
Elsa would like to know who
will be submitting a letter on behalf of the Committee for the Karuk
newsletter.
Michael stated that since Florrine
is no longer a member then they would like to seat Leslie Alford as an Yreka
representative. The letters of intent were due at the end of December and the
Committee received two letters of intent and only one from Yreka. The Election
Committee would like to make the recommendation to seat her as the Yreka
representative.
January 18th is
the next meeting to complete a mass mailing communicating that Sonny Davis was
appointed to the Council and a brief announcement that there will be an
upcoming election.
Florrine motioned and Roy
seconded to approve the Election Committee recommendation to seat Leslie Alford
to the Election Committee, 7 haa, 0 puuhara, 1 pupitihara (Robert Goodwin).
Kristen’s term expired
December 2006. She has submitted her letter of intent to be re-seated on the
Committee. The Election Committee recommends re-appointment of Kristen King.
Florence motioned and Leaf
seconded to seat Kristen King to the Election Committee for a term of two
years, 8 haa, 0 puuhara, 0 pupitihara.
Michael also explained that
Florence Lopez’s term expires in April 2007 and this would be in the middle of
the Election which creates difficulty in continuity of the election and duties.
She has submitted her letter of intent and the Committee recommends that she be
seated.
The Council is concerned that
the vacancies were not flown and this may cause controversy. Leaf recollects that
the
Florence motioned and
Florrine seconded to rescind the motion to seat Kristen King and fly for letter
of intent immediately, also Kristen King will remain seated until the process
is complete, 8 haa, 0 puuhara, 0 pupitihara.
Closed Session:
Consensus: to table donation request from Tribal Descendant # D01683 to the
Wednesday planning meeting.
Informational: Alan Vandiver is present to invite the Tribal Council
or a representative to a Happy
Consensus: for Martha to review denial for Tribal Member # 2053 and have the issue
resolved by January 16, 2007.
Leaf motioned and Florrine
seconded to provide funding not to exceed $150 from Third Party for medical
equipment for Tribal Member # 3481, 8 haa, 0 puuhara, 0 pupitihara.
Leaf motioned and Florrine
seconded to contribute $500 from discretionary as a donation to the Hospice
organization in Yreka
Informational: discussions held at or regarding the
Robert motioned and Leaf
seconded to appoint Sonny Davis as a CASA Committee Member, 7 haa, 0 puuhara, 1
pupitihara (Sonny
Consensus: to extend the time period for letters of intent for the vacancy on the
ICW Committee and attempt to obtain
Consensus: to allow CASA to have an open account with the Karuk People’s Center with
a reasonable fiscal tracking system including copies of account purchases to
the fiscal office, CASA Manager and the People’s Center.
Informational: The KCDC Board shall determine who the immediate
supervisor for employee # 1131.
Consensus: Florrine will be allowed to stay seated as the Headstart Policy
Council Member also a KCDC board member should be sought.
Consensus: for employees #3177 and #2267 draft notice to got out to all
employees, committee members and appropriate individuals noting they may not make
or create derogatory comments about supervisors and/or fellow co-workers
including language form the personnel policies.
Informational: Leaf shall have staff update the Council on grant issue or systems instituted
in place.
Consensus: to deny request for reimbursement for mileage to the Christmas party in
accordance with policy.
Consensus: to deny request by Tribal Descendant #D01459 for burial assistance for
non Native American spouse.
Consensus: to deny orthodontic assistance due to low funding.
Next Meeting Date: February 8, 2007 at 5 PM in Happy Camp, CA.
Robert motioned and Leaf
seconded to adjourn meeting at 11:14 PM, 8 haa, 0 puuhara, 0 pupitihara.
Respectfully Submitted,
________________________________
Arch Super, Chairman
Recording Secretary, Barbara Snider