Karuk Tribe of
Health Board Meeting
May 8, 2008 - Meeting Minutes
Meeting called to order at 3:08 PM, by Arch Super,
Chairman
Present:
Arch Super, Chairman
Sonny Davis, Council Member
Roy Arwood, Council Member
Alvis Johnson, Council Member
Robert Goodwin, Council
Member (3:16 PM)
Leaf Hillman, Vice-Chairman
(3:16 PM)
Absent:
Leeon Hillman, Treasurer
Florrine Super, Secretary
The Health
Agenda:
Alvis Johnson motioned and
Florence Conrad seconded to approve the agenda, 5 haa, 0 puuhara, 0 pupitihara.
Minutes of April 10, 2008:
Guests:
Troy Hockaday, Senior Center Nutrition Program (3:09-3:17
PM):
Robert left the meeting at 3:13 PM
Arch inquired what the total
number of seniors that are eligible for service.
Robert and Leaf entered the meeting 3:16 PM.
Robert asked what
Director Reports:
1.) Lessie Aubrey, DQMCH: (3:17 -3:57
PM)
Lessie is present and distributed
updated information for the Council. Lessie explained that the budgets seem
fine and the HRSA grant is being spent which is a relief and alleviates
returning funding. Of course the persons that are eligible are the ones being
coded there. A letter of support is attached for the Siskiyou County Services
Council. It is a letter of support for an education grant. Lessie met in Yreka
with Joe and the representative in Siskiyou County Services Council. Lessie was
inserted on the committee, but Lessie would prefer to have a substance and
abuse counselor. The grant that is being
drafted on May 19, 2008 they want a Council member present to discuss decision
making options for serving the needs of the Karuk Tribe. Lessie believes that
the grant has already been drafted. Martha has been working with the grant
writers on another grant and Sue Ann of Siskiyou County Services Council is
cooperating with our grant writers for a grant proposal on behalf of the Karuk
Tribe. Lessie is seeking approval of a support letter for her grant application
or the Karuk Tribe’s support of the grant proposal.
The Community Services
Council attempts to collaborate with outside agencies and obtaining resources
for expansion and providing services to each other. Florrine is on this
committee. Some of the supervisors are present along with other key personnel
form within the County. Sue is really interested in the educational programs
that Joe Snapp uses. She is really interested in accessing the substance abuse
portion of KTHP. Florrine can vote on the action of this committee. Mike
believes that this group is finding the need overwhelming and they are
attempting to coordinate more effectively with each other. Mike confirms that
Joe’s program is one of the best in the State so they want to coordinate with
each other and work together. Lessie has discussed with the group to have more
transitional homes in the County and she is hoping to be perceptive to this.
Consensus: to provide a support letter to the Siskiyou Services Council on behalf
of the Karuk Tribe (Robert Goodwin abstained).
Anthony Ballard has an
equipment order. He is hoping to purchase room dividers for his group services
offered in
Lessie would like seek
approval to travel to
Florence Conrad motioned
and Robert Goodwin seconded to approve out of state travel for Norlyn Peters
and Lessie Aubrey to Minneapolis MN June 2008, 6 haa, 0 puuhara, 0 pupitihara.
The State IHP application has
arrived. The grants department does not have this as their priority and Lessie
will have to complete the application to meet the deadline. Sara Spence, Laura
Mayton and other staff will fill in and complete the application pulling
together the necessary documents for the submission to the State. Lessie is
coordinating the application and assigning staff to assist her with the due
date being May 30, 2008.
Lessie has discussed the
letter from Margo Kerrigan updating tribes on the recent lawsuit between IHS
and Susanville Rancheria. Susan Diehl had a law suit against IHS and now tribes
can charge Indian beneficiaries for services rendered at our facilities even
though IHS considers this inaccurate as tribes are provided funding to provide
direct care services. IHS provides money for healthcare and believes that the
current practice of not charging any fees at the time of service should
continue. In our economic changing times tribes have evaluated charging Indian
beneficiaries a copay for their clinic visits and Susanville was the first IHS
facility to implement this change and when a lawsuit was filed against them,
they fought the suit on the basis of self-governance and determination to
sustain their healthcare facilities. Lessie and Laura Mayton will attend the
meeting May 29th to participate in discussions with several tribes
on this topic. Leaf inquired what the intent of the meeting was. Lessie will
participate to listen to the other tribes to gain an understanding of the
situation. Lessie may provide information if asked, but she is unsure right now
of how the Karuk tribe should proceed. Dr. Burns explained that Susanville says
they are responsible for providing care to Native Americans, but the Federal
Government is not providing enough funding to meet the healthcare needs. When
the lawsuit was completed Susanville was awarded their determination and were
allowed to charge a copay for medications at their tribal clinic. Leaf
clarified that Susanville were the defendants and the suit is appealed will
affect all tribes. Leaf believes that it is critically important for the Karuk
Tribe to share their views as a
Leaf would encourage Lessie
to view the legislation and develop a position statement from the Tribe that
speaks to the obligation of the Federal government to Indian People and that
speaks to Tribe’s in a similar situation as ours and each other. We have a very
good healthcare program that has been in place for a lot of years and that
includes decisions being made for the best possible services and making it work
without enough funding from IHS. There needs to be continued flexibility for
Tribe’s to make these types of decisions.
Lessie should email her
position paper to Margo Kerrigan once the Council has viewed it and approved it.
Laura Mayton and Lessie Aubrey will draft the position paper and forward to the
Council to review. Robert would like the letter emailed as well to ensure there
is proof of the Tribe’s position being forwarded.
Florence Conrad motioned
and Leaf Hillman seconded to approve Lessie’s report, 6 haa, 0 puuhara, 0
pupitihara.
2.) Martha Schrock, EDHHS: (3:57 – 3: 59 PM)
Martha is currently on leave.
Her written report is attached for the Council to review.
Robert Goodwin motioned
and Leaf Hillman seconded to approve out of state travel for Martha Schrock and
Anna Myers in July to
Florence Conrad motioned
and Robert Goodwin seconded to approve Martha’s written report, 6 haa, 0
puuhara, 0 pupitihara.
Laura Olivas did work with
Anthony as well. The Council members that are on the CRIHB board should come up
with something to thank Anthony for his job well done.
3.) Vickie Walden, RDA: (4:05 – 4:06 PM)
Vickie is not present, but
her written report is provided.
Robert Goodwin motioned
and Alvis Johnson seconded to approve Vickie’s written report, 6 haa, 0
puuhara, 0 pupitihara.
4.) Mike Edwards, Behavioral Health Director (4:06 –
4:09 PM)
Mike has one action item. The
Tulle River Band has requested assistance with their DUI program application,
and Joe would like to assist them with providing the documents excluding the Tribe’s
financials. Joe would also like to verbally provide technical assistance to
that Tribe.
Consensus: to allow Joe Snapp to provide documents excluding fiscal information
and technical assistance to the
All other items in Mike’s
report are informational including visit counts and overview of other director’s
reports.
Mike commented that the
advertising efforts for increasing Drake’s visit count is working and is the
highest it has been in three years.
Florence Conrad motioned
and Robert Goodwin seconded to approve Mike’s report, 6 haa, 0 puuhara, 0
pupitihara.
5.) Patti White, Database Administrator (4:10 – 4:14
PM)
Patti has no action items but
does have some updates to her written report. Chris has set up a template
server and once Amy Coapman and Chris Kleeman return from training they will
schedule IHS training for the health program and begin to move toward EHR
implementation. It has also been determined to have Yreka clinic be the test
sight for EHR as it appears to be more workable with an onsite person trained
to assist in EHR questions.
Florence Conrad motioned
and Sonny Davis seconded to approve Patti’s report, 6 haa, 0 puuhara, 0
pupitihara.
6.) Eric Cutright, IT Director: (4:14 – 4:30 PM)
Eric has no action items but
he did provide his written report for the Council.
The People’s Center store has
been registered and the store exists but is not operational at the moment. Eric
is working with Dave Wrobleski. They will begin to take pictures and review the
inventory. Eric believes that within the next week there should be items added
to the website. Other highlights of Eric’s report include additional work with
Social Service staff at the KCDC building. KCDC will be having a wiring upgrade
to create a better working environment. Eric will provide procurement for
actual supplies once he is ready to order. A satellite has been installed in Happy
Camp and
Florence Conrad motioned
and Roy Arwood seconded to approve Eric’s report, 6 haa, 0 puuhara, 0
pupitihara.
Robert inquired about a trip to
an Elders house and the discovery of life line service area. Robert questioned
the range of the transmitters and if there was any way to boost the range via
the technology department. Eric is familiar with range for transmitters, but
will have to review the specific equipment and try to come up with some ideas
for better services. Mike Edwards explained that there are different companies
that offer a similar service and upon ordering clients should evaluate the
distances they wish to explore as some equipment is far better than others.
7.) David Eisenberg, PHN (4:30 – 4:51 PM)
David thanked Flo for her
work to obtain client enrollment in EAPC and HRSA grants that save patients a
lot of funding. David has spoken with Suzanna Hardenburger regarding the
patient assistance program to determine if there can be more people qualified
for these two programs. He is pretty convinced that by the end of the day the
funding will not have to be sent back but be used for its purpose to assist
clients in receiving their medications and care. The diabetic program is going
to be running out of money in the prescription line item so CHS will have to
pick up that service in their line item once the diabetic grant is depleted.
The entire diabetic budget can be spent on medications but that will restrict
podiatry and other care that is related to diabetics.
David’s action item is that
the State of
Roy Arwood motioned and
Leaf Hillman seconded to approve resolution 08-R-049 authorizing re-application
for EAPC, 6 haa, 0 puuhara, 0 pupitihara.
Leaf inquired about David’s
report and the plan to recoup the documentation needs to qualify patients for
EAPC and HRSA. David explained that as this has been happening the staff has
been implementing several steps to deal with the concerns including elders or
field workers assisting clients in providing their income verification at their
residence with transportable equipment. David will work with Laura on the
Wal-Mart option on receiving medications at a lower cost due to the reports of
the high cost of medications and the option of Wal-Mart providing a lower cost.
Robert Goodwin motioned
and Sonny Davis seconded to approve David’s report, 6 haa, 0 puuhara, 0
pupitihara.
8.) Daniel Pratt, TANF Director: (4:52 – 5:23 PM)
Daniel has provided his
written report and distributed TANF position descriptions for review and
approval by the Council. Daniel has updated the Health Board on the developments
of the TANF program based on the contract obtained with HSU on census
collection and reporting.
The ninety (90) day planning
and review period is given to the State for review of the TANF plan. However
the state waived the ninety days and once the Feds approve the plan then it
will be in effect. The state has the new number of 373 caseloads and there is
potentially thirty days to appeal those numbers. Daniel believes that the plan
is feasible. KTOC numbers are at the state again and Robert questions what the
next steps will be. Daniel explained that if the state appeals the new numbers
then a sit down will happen with the Feds and the State with the Feds observing
both parties discussing their numbers and data for those numbers. The Tribal
census is more accurate and the state is using the
Robert does not have a
problem approving the position descriptions however it should be understood
that the wages may not be accurate as the funding amount is still undetermined.
Once the MOU is signed with
the state the Tribe will be eligible for a draw down of 25% of the funding.
Laura explained how the financial end of TANF will work including checks,
staffing and funding allotted. TANF has a system similar to IHS in which they
have tight tracking, data tracking and fiscal accounting reporting requirements.
The reporting will have to be very tight and accounting of services must add up.
There are concerns on the fiscal aspect of TANF. Laura explained that the
person in the fiscal department for TANF will be supervised by Daniel Pratt,
but will have to have a linked reporting requirement to herself as the CFO for
KTOC. Robert would like to see the Council discuss the availability of Council
for administering programs and signing checks or any fiscal needs. It appears
that there are still several areas that need clarification for the operation of
the TANF program.
A meeting shall be set May
22, 2008 at 3 PM in Yreka for the TANF Director and the Council to review the TANF
program including the TANF plan, position descriptions, organizational
structure and fiscal responsibility.
Robert Goodwin motioned
and Leaf Hillman seconded to approve Daniel’s report, 6 haa, 0 puuhara, 0
pupitihara.
Closed Session:
Employee #0506 was present
to provide an update on fiscal management of the Tribe’s property and the
liabilities of the Tribe. (6 minutes)
Alvis Johnson excused himself.
Consensus: after request
from family friend of Tribal Member # 6 was presented the Council there determination
is to assign employee # 1611 to review all aspects of the proposed refinance
including previous loan amount and purpose, new loan amount including total
with finance rate, list of liens of residence and to whom, and financial review
of all options for tribal member. All correspondence shall be documented and in
writing, with no formal determination on behalf of the Council until all
information is accurately and openly provided to the Tribe. (23 minutes)
Alvis Johnson returned to the meeting.
Leaf motioned and Robert
seconded to approve resolution 08-R-051 authorizing ICW intervention, 6 haa, 0
puuhara, 0 pupitihara. (6 minutes)
Dinner break (6:14 – 7:22)
Consensus: for CHS letter referring to restriction of services to be tabled to
Wednesday for editing and input from staff.
(2 minutes)
Robert Goodwin motioned
and
Robert Goodwin motioned
and Leaf Hillman seconded to approve payment for eye glasses and eye exam by
the most cost effective means possible from Third Party for Tribal Member # 115.,
6 haa, 0 puuhara, 0 pupitihara. (6
minutes)
Leaf Hillman motioned and
Robert Goodwin seconded to allow Tribal Member # 295 to utilize assistance from
SWEEP with automatic payment deduction of $50 monthly. (7 minutes)
Consensus: to refer Tribal Member # 2817 to CHS and table request to Wednesday. (7 minutes)
Robert Goodwin motioned
and Florence Conrad seconded to approve agreement 08-A-002, 6 haa, 0 puuhara, 0
pupitihara (1 minute).
Employee # 9000 was present
to meet with the Council regarding recent memo issued to several staff
regarding opposition of the Tribe’s decision making. (13 minutes)
Employee # 1017 was present
to meet with the Council regarding recent email of opposition of the Tribe’s
decision making. (8 minutes)
Consensus: for Barbara Norman to provide a briefing on smoke shop sales and
provide legal opinion and those opinions of other attorneys she has been
speaking with. (11 minutes)
Consensus: to table request from Tribal Member # 1444 request for a loan. (3 minutes)
Robert Goodwin motioned
and Leaf Hillman seconded to provide $80 assistance from Booster club with a
contract with Tribal Member # 1673 to pay it upon return in thirty days, 6 haa,
0 puuhara, 0 pupitihara. (14 minutes)
Consensus: to table
request from Employee # 2760 to Wednesday. (6
minutes)
Consensus: to table bids
for road clearing to Wednesday. Staff shall determine the cost vs. equipment
purchases including five year planning and program goals. (7 minutes)
Florence Conrad motioned
and Robert Goodwin seconded to approve contract 08-C-037, 6 haa, 0 puuhara, 0
pupitihara. (2 minutes)
Consensus: for employee #
2267 to resolve emergency preparedness kits not being sent to several members
in
Consensus: for enrollment to release for registration purposes.
Consensus: to direct all elders workers to begin creating a list of Elders in need
of any assistance and what their particular needs are. The field workers shall
develop and begin to use an assessment method to create documentation of the
Elders needs and follow through of those needs. (2 minutes)
Leaf motioned and
Consensus: to review
options regarding employee # 7564 (2
minutes)
Next meeting date: June 12, 2008 at 3 PM in Happy Camp, CA.
Alvis Johnson motioned and Leaf Hillman seconded to adjourn meeting at
8:57 PM, 6 haa, 0 puuhara, 0 pupitihara.
Respectfully Submitted,
________________________________
Arch Super, Chairman
Recording Secretary, Barbara Snider