Karuk Tribe of California

Health Board Meeting - Happy Camp, California

August 14, 2008 - Meeting Minutes

Meeting called to order at 3:37 PM, by Florrine Super, Secretary

Present:

Florrine Super, Secretary

Leeon Hillman, Treasurer

Robert Goodwin, Member at Large

Roy Arwood, Member at Large

Alvis Johnson, Member at Large

Sonny Davis, Member at Large

Florence Conrad, Member at Large

Absent:

Arch Super, Chairman (excused)

Leaf Hillman, Vice-Chairman (excused)

Florrine Super addressed the Council and made a brief statement to the membership.

The Health Program mission statement was read aloud by Robert Goodwin, Member at Large.

Agenda:

Florence Conrad motioned and Robert Goodwin seconded to approve the agenda with additions, 6 haa, 0 puuhara, 0 pupitihara.

Meeting minutes of July 10, 2008:

Florence Conrad motioned and Sonny Davis seconded to approve the regular Health Board Meeting minutes of July 10, 2008, 6 haa, 0 puuhara, 0 pupitihara.

Guests:

1.) Chuck Lent, OES Program:

Chuck is present tonight to seek approval of two MOU’s between the Karuk Tribe and Humboldt County and another between the Karuk Tribe Siskiyou County. It has taken several months to complete the MOU’s, and Chuck will need them approved to attach to the OES grant. The MOU’s are operational agreements outlining the purpose and defining the working relationship between the District Attorney Victim Witness programs and the Karuk Tribe in each County.

Robert Goodwin motioned and Florence Conrad seconded to approve agreements 08-A-021 between the Karuk Tribe and Siskiyou County and 08-A-020 between KTOC and Humboldt County , 6 haa, 0 puuhara, 0 pupitihara.

2.) Florence Conrad, Council Member at Large:

Florence addressed the Council and audience requesting dedication of funding from revenue generated from some smoke sales. She would like some revenue set aside to go toward the education programs of the Karuk Tribe. She does not have a formal plan or proposal for revenue generation and obligation to education, but she would like the Council to begin thinking about this. Florence would like some education in regards to smoking cessation or the educational programs of the Tribe in general. Robert believes this is a good idea and with possible revenue coming in, it is best to have input on where the funding should be allocated. There must be consideration to the education programs and this should be priority and understood as it is relevant to the Tribe’s goals. Roy would like to set up a meeting to discuss this and have some preliminary discussions on what programs should receive funding. This will be discussed at the Wednesday planning meeting.

Directors Reports:

1.) Daniel Pratt, TANF Director:

Daniel is present to review his report and discuss the TANF program with the Health Board. The State and the Karuk Tribe have come to an agreement on the client number of TANF. A tentative start up date is October 1^st 2008. Daniel has several issues that he must work out and has brought them to the attention of the Health Board. Both external and internal tasks must be completed including staffing, the TANF plan, office locations and other details. There will be no federal dollars until there is one case transferred from Siskiyou County, so MOU’s with both the Humboldt County and Siskiyou County must be in place. Florence would like to know if there should be any problems with the County transferring clients to the Tribe. Daniel believes that he has a good working relationship with the County and that is why he has started with Humboldt County as they have experience with TANF programs already. The currently work with both the Yurok and Hoopa Tribes. Siskiyou County has not operated a TANF program within their County so they are looking to have guidance from Humboldt County. There is a budget meeting set for 8/21 with Laura Mayton, but Robert believes that there should be further meetings to review, ordering, staffing, office space and the overall operations of the TANF program.

Florrine questioned what had happened with the meeting with Quartz Valley Tribe. Daniel explained that due to their low number of clients he has determined to not include that Tribe at this time. Daniel has been attending TANF related meetings to have an update on TANF regulations, technical assistance and communication of plans that other Tribe’s currently have.

The TANF plan must be approved prior to receiving funding. The Karuk Tribe’s TANF plan has already been sent and is currently being reviewed.

Florence Conrad motioned and Robert Goodwin seconded to approve Daniel’s report, 6, haa, 0 puuhara, 0 pupitihara.

2.) Mike Edwards, Behavioral Health Director:

Mike is present to review his report with the Health Board. Mike reported that there were three providers for the Orleans facility to be utilized as psychologists currently, and that is a better service to the community.

Mike has completed and received training for Title IVE. The Title IVE program has had the budget and program training. He still has some questions and concerns regarding the program, but has submitted those and is awaiting a response. Mike would like to attend the next Wednesday planning meeting to discuss the Title IVE program. At this time he will provide an overview of the program with the Council.

Robert questioned Chuck’s report that is attached to Mike’s. Robert would like to know what it is that Chuck is seeking from the Tribal Council regarding communication and campaigning for the OES program. Chuck clarified that he is looking for several things, such as posters, advertising and announcements. He would like the Karuk Tribe to advertise how much they care and that that caring begins with the leadership of the Tribe. Chuck believes that a clients trust and mistrust is not specific to Karuk people, but a person’s hesitation to seek behavioral health treatment in general. When people are in trouble they want to talk to someone and that is good, but if the leadership doesn’t respond appropriately then this continues the mistrust of the clients to seek behavioral health treatment. Chuck would like to do campaigns and hope that fewer children end up in the CPS system or end up removed from their homes or their families. Chuck would like to have a retreat to discuss mental health issues to work collaboratively to increase the care of patients. Chuck has been in Orleans for two years and he is not receiving additional clients. Chuck believes that the Council is in a better position to reach clients that majority the staff and also with their influence as leaders this only helps the respect level from clients to seek treatment. Robert believes that this needs to be a group effort and it may take several programs of the Tribe as it affects them as well. Robert would like to refer this discussion to the Yav Pa Anav group to address the concerns and discuss options including a campaign to increase awareness. He would like the program to be successful and there are options if the programs begin to work together. The Yav Pa Anav group meets the second week in September and Chuck should be on that agenda.

Leeon believes that it hasn’t been that long since NVYS has been in Orleans again. He hopes that the families utilize the program there, but it is important to continue working on obtaining clients.

Leeon questioned if there was work being done on the privacy issue of the office space at the KCDC building. Chuck explained that the privacy concerns have not been permanently addressed, but he is taking steps to help alleviate them. Mike explained that there are also issues with the building in Yreka, and they continue to work on all facilities to ensure that privacy and confidentiality are respected and that the office locations have options for the private care of patients or clients.

The family resource center is putting on a 5 week parenting class in Yreka. Mike is going to participate in the class and there will be advertisements sent out for the program.

Robert Super and Pamela Risling will be going to NCWA and will begin to provide parenting classes in the Orleans area.

Robert Goodwin motioned and Leeon Hillman seconded to approve Mike’s report, 6 haa, 0 puuhara, 0 pupitihara.

3.) Vickie Walden, RDA:

Vickie has provided an updated report to the Health Board. The visit count report was incorrect in the initial report. Dr. Bardonner has asked when the board would like to meet him and if the board would like to have him provide monthly reports. The Health Board is open to meeting with Dr. Bardonner while he is present, however he shall select a time that fits his schedule. Also, the Health Board will allow him to determine his reporting schedule at this time. Vickie will invite Dr. Bardonner to meet with the Health Board at the next Health Board Meeting.

Leeon Hillman motioned and Robert Goodwin seconded to approve Vickie’s report, 6 haa, 0 puuhara, 0 pupitihara.

4.) Patti White, Database Administrator:

Patti discussed with the health board the problems that are arising within RPMS. Chris and Patti are working with IHS on the issues and attempting to become more protected and have less down time. Patti provided her clinic workload reports and the data entry status report.

Leeon Hillman motioned and Sonny Davis seconded to approve Patti’s report, 6 haa, 0 puuhara, 0 pupitihara.

5.) Eric Cutright, IT Director

Eric is present to review his report with the Health Board. He would like to present a maintenance agreement for to the new copier that has been purchased for the medical billing office. The amount is $135 a month and includes service and the only company that will travel to Happy Camp to repair or maintain the copy machines. The company selected was Ray Morgan and Company.

Florence Conrad motioned and Leeon Hillman seconded to approve agreement 08-A-023 between KTOC and Ray Morgan Co., 6 haa, 0 puuhara, 0 pupitihara.

Robert questioned the phone service in Orleans and Eric has explained the difficulties finding another source of service. Robert would like to see resolution on this issue as it has been brought up several times.

Robert Goodwin motioned and Leeon Hillman seconded to approve Eric’s report, 6 haa, 0 puuhara, 0 pupitihara.

6.) Lessie Aubrey, DQMCH:

Lessie is present to review her report with the Health Board. She believes that the smoky conditions caused the staff to appear and seem agitated lately. Lessie was going to have the staffs oxygen levels checked if the irritability continued. She received several phone calls and she has concluded that it was due to the weather and the impact of the local fires that caused some irritability with staff and some patients. Lessie has policies that she is seeking approval for. They are; Charting Guidelines, Policy on Panamnik Facility Usage, CHS dental benefits, Unit Record and Nutritional Assessment.

Lessie thanked Flo Lopez for taking the initiative to take the CPR certification course and become certified to provide CPR classes moving forward.

Robert Goodwin motioned and Leeon Hillman seconded to approve policies 10-000-445, 03-002-150, 06-000-251, 06-003-271, 6 haa, 0 puuhara, 0 pupitihara.

Leeon Hillman motioned and Florence Conrad seconded to approve Lessie’s report, 6 haa, 0 puuhara, 0 pupitihara.

7.) Martha Schrock, EDHHS:

Martha is present and provided an update to her report. She presented an action item regarding Dr. Burns traveling to Seattle, WA. August 24-29, 2008. This training will come from his training budget which has sufficient funding to cover the cost. He will receive training in “train the trainer nonviolent crisis intervention.” He would then return from training to train other staff and even the administrative staff on handling difficult situations, patients, clients or visitors. Patti announced that RPMS has tools to flag patients for risks such as behavior and diseases. An internal warning system for health staff that has access to RPMS may view the flagging status of patients to be forewarned of disturbing behaviors from clients and patients.

Robert Goodwin motioned and Florence Conrad seconded to approve out of state travel for Dr. Burns to Seattle WA August 24-29, 2008, 6 haa, 0 puuhara, 0 pupitihara.

Martha presented agreement 08-A-022 between the Karuk Tribe and Northern Sierra Health Network. The cost is $75 per month for the support agreement for the 2008-2009 calendar years for partnering in telemedicine support.

Robert Goodwin motioned and Sonny Davis seconded to approve agreement 08-A-022 between KTOC and the Northern Sierra Rural Health Network, 6 haa, 0 puuhara, 0 pupitihara.

Martha took time to recognize Florence Lopez, Elders Director, for obtaining her CPR instructor certification also. Flo took it upon herself to enroll in the class and become certified as the previous PHN was the only certified instructor. With his resignation this left no staff members with the certification ability for the staff as well as the community. Martha thanked Flo for stepping into this position and really studying to complete the course. The Council also thanked Flo.

The Health Program will be reviewing and setting their budgets for FY 2009 in the next few weeks. Martha was on leave and upon return she did not review her inter-office mail. She believes that the third party budget sheet is in that mail and will forward that information to the Health Board once she obtains it. Martha noted that in Dr. Willett’s report he mentions some concerns over communication lines in regards to the recent fire situations. Martha was unsure of the specifics of that comment in his report and asked Erin if she was aware of anything regarding this, specifically since Erin works with FEMA and the Office of Emergency Services. Erin was unsure of Dr. Willett’s concerns and had not heard from him. Florence Conrad volunteered to speak with Dr. Willett to determine what his concerns are.

The Happy Camp clinic is seeking an additional room or storage facility for medical record charts. Martha would like the maintenance staff to prioritize the construction of the shed as it is needed very soon. During Phil Churches visit the needs of the facility were discussed. Davey and Erin attended a meeting with Phil, but Martha was unsure of the specifics and when asking Erin about a clarification Erin was unsure and wanted Martha to contact Phil or seek clarification from Davey as she was not present during the entire conversation that Phil had later with Fred and Davey. Erin did explain that during her meeting with Phil it was exciting to hear of possible reimbursements from IHS for facility upgrades and repairs that the Tribe has done recently.

Florrine Super asked for an update on the Susanville Rancheria case. Martha and Lessie have not heard anything further regarding the case from either Susanville Rancheria or IHS. Florrine would like to have all tribe’s monitor this and stay up to speed on it, as CRIHB was attempting to clarify roles and the tribal representatives were unsure how this was moving forward. Lessie has forwarded all the information to Hector after she attended the last meeting. Martha will provide updated information regarding the Susanville Rancheria to the Health Board and compile all communication to forward to Hector Garcia, Self-Governance Director.

Florence Conrad motioned and Robert Goodwin seconded to approve Martha’s report, 6 haa, 0 puuhara, 9 pupitihara.

Guests, Non – Health Employees:

1.) Sandi Tripp, Land Department:

Sandi is present tonight to seek approval of a contract with Winzler & Kelly in the amount of $104,566 for engineering services for the parking lot upgrade at Happy Camp Administrative and Health complex.

Florence Conrad motioned and Sonny Davis seconded to approve contract 08-C-056 between KTOC and Winzler & Kelly, 6 haa, 0 puuhara, 0 pupitihara.

Sandi updated the Council on the public meeting regarding the Amkuuf Smoke Shop in Yreka. Sandi gave a special thanks to Sonny Davis for the work he completed to the Yreka site.

Sandi would like to set another meeting for the community of Yreka. She went on to say that residents of KTHA received flyers and most opted out of attending the meeting. Sandi would like to provide a short update of the public meeting she attended and asked the Health Board if they wanted that update tonight. The Health Board declined the update and explained that the next Council Meeting will be held in Yreka. If there are community comments or further questions from Tribal Members, they may attend that meeting and the Council will take time to hear their concerns or comments.

2.) Erin Hillman, Director of Administrative Programs & Compliance:

Erin is present tonight to seek approval of a proposal that Hester Dillon wrote. The proposal is to the Sierra Health Foundation in the amount of $40,000. These funds are being sought to assist in paying for a generator to operate both the administrative offices and the clinics in Happy Camp. Additional funding must be identified to complete the overall project.

Robert Goodwin motioned and Sonny Davis seconded to approve resolution 08-R-084 authorizing submission of the proposal to the Sierra Health Network, 6 haa, 0 puuhara, 0 pupitihara.

Erin explained that she did meet with Phil Church along with Laura Mayton during his visit to the Happy Camp clinic. Phil’s visit was not a scheduled visit, and while Martha was on leave and Lessie had another meeting scheduled, Phil was able to meet with Erin, Laura, Fred and Davey. Phil is a facilities engineer for IHS and during review of other IHS facilities he generally travels to the local facilities to review and determine what funds are available for upgrades and repairs. Phil did determine that the funding spent on repairing the HVAC system for the dental wing may be reimbursable by IHS.

Erin then provided an update on the emergency declared in the County. The Governor declared an emergency for Humboldt County as well. Erin in turn attempted to send information out and that request went up to the President and he referred it back to IHS. IHS is willing to provide funding for HEPA Air filters and other items that the Tribe purchased to offset the emergency situation in both Counties.

3.) Dave Wrobleski, People’s Center Director:

Dave is present tonight to seek approval of an additional staff member for the People’s Center gift shop. He would like to hire a person to work on Sunday’s which is the usual day of closure for the People’s Center. The additional staff member would be brought on to just work Sunday’s or as needed to fill in. The Health Board tabled this discussion to their Wednesday planning meeting.

Dave also presented procurement for a computer. The purchase is allowable in the grant and is functional for the purposes of what Dave will be using it for. The least expensive computer was not selected, but it did not have the capabilities that Dave was looking for. He has justified the purchase of the laptop and also conferred with IT about the specifications he was looking for.

Florence Conrad motioned and Sonny Davis seconded to approve procurement and allow the purchase of a laptop from TechDepot in the amount of $2,512.77, 6 haa, 0 puuhara, 0 pupitihara.

4.) Susan Gehr, Language Program Director:

Susan is present tonight to present a request for travel. She would like to attend mandatory training to Washington DC September 22-24, 008. Tentatively Susan would like to attend and another financial person, however if a new employee is taken on to replace Susan then that employee should attend in her place. Susan has a tentative date for leaving the Tribe, but the ANA grant will still have the training requirement.

Robert Goodwin motioned and Sonny Davis seconded to approve the out of state travel for two persons to Washington DC September 22-24, 2008, 6 haa, 0 puuhara, 0 pupitihara.

Susan’s last day of the project is September 25, 2008.

Closed Session:

Florence Conrad motioned and Robert Goodwin seconded to approve policies; CHS Records, CHS Definitions, Incarcerated Patients, and Levels of Care, 6 haa, 0 puuhara, 0 pupitihara.

Florence Conrad motioned and Robert Goodwin seconded to uphold the CHS denial for Case# 193 and contribute up to $1,500 to the patient, 4 haa, 2 puuhara (Leeon Hillman & Roy Arwood), 0 pupitihara.

Leeon Hillman motioned and Alvis Johnson seconded to approve resolution 08-R-088 enrolling 13 new members, 6 haa, 0 puuhara, 0 pupitihara. (3,519 currently enrolled members).

Consensus: to have employee # 2966 formally apologize to employee for remarks and disrespectful language used during conversation.

Consensus: for the Chairman to discuss tasks and responsibilities with employee # 3770.

Informational: Council Secretary discussed her previous statement with the Council. She updated them and requested their feedback.

Robert Goodwin motioned and Alvis Johnson seconded to approve travel for Roy Arwood, Florrine Super and Florence Conrad for the CRIHB meeting October 16-19, 2008 in Lamoure CA, 4 haa, 0 puuhara, 2 pupitihara (Roy Arwood & Florence Conrad).

Florrine Super excused herself form the meeting at 6:57 pm and Leeon Hillman chaired.

Florence Conrad motioned and Sonny Davis seconded to approve an educational agreement between employee # 5138 and KTOC for three years, 5 haa, 0 puuhara, 0 pupitihara.

Consensus: to table request from Tribal Member # 2851 to the Wednesday planning meeting.

Robert Goodwin motioned and Florence Conrad seconded to accept the second legal opinion validating the legality of the July 19, 2008 Karuk constitutional amendments, 5 haa, 0 puuhara, 0 pupitihara.

Consensus: for the Election Committee Vice-Chairperson to be notified along with tribal attorney that they shall work together to meet necessary timelines and the Committee Vice-Chairperson shall have the authority to act as Chair of the Committee during the leave of absence of the current Chair.

Consensus: to discuss a replacement courier vehicle at the budget meeting between the EDHHS and the CFO.

Consensus: to deny loan request from Tribal Member # 390.

Consensus: to deny loan request from Tribal Member # 4297.

Robert Goodwin motioned and Florence Conrad seconded to approve loan to Tribal Member # 531 pending receipt of 401k with full repayment including a $25 processing fee at that time, 5 haa, 0 puuhara, 0 pupitihara.

Consensus: to refer Malibu CA travel expenses to the next meeting.

Florence Conrad motioned and Sonny Davis seconded to seat employee # 8900 to the KCDC Board, 4 haa, 0 puuhara, 1 pupitihara (Robert Goodwin).

Robert Goodwin motioned and Florence Conrad seconded to appoint Tribal Member # 489 to the KTHA Board, 4 haa, 0 puuhara, 1 pupitihara (Roy Arwood).

Robert Goodwin motioned and Florence Conrad seconded to approve procurement and allow the purchase of chairs, podium and meeting room supplies for the Orleans Community Center in the amount of $3,834.82 from Council Discretionary, 5 haa, 0 puuhara, 0 pupitihara.

Consensus: for the Maintenance Supervisor to determine what minimal costs will repair and secure the water system, until the Director of Administrative Programs and Compliance may determine listing the system on the priority list for IHS.

Florence Conrad motioned and Roy Arwood seconded to issue a letter to all residents regarding water system, 5 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin motioned and Sonny Davis seconded to pay a $50 insurance fee for lost/stolen blackberry, 5 haa, 0 puuhara, 0 pupitihara.

Informational: a conference call regarding SB62 will be Monday at 10 am. There has been a constitution and bylaws drafted for review. Roy would like to invite Laura Mayton to the conference as well as discuss website information with Gerry and Eric for the project.

Next meeting date: September 11, 2008 at 3 PM.

Robert Goodwin motioned and Alvis Johnson seconded to adjourn meeting at 8:47 PM, 5 haa, 0 puuhara, 0 pupitihara.

Respectfully submitted,

________________________________

Florrine Super, Secretary

________________________________

Leeon Hillman, Treasurer

Recording Secretary, Barbara Snider