Karuk Tribe – Health Board Meeting

Meeting Minutes – February 11, 2010

Meeting called to order at 3:03 pm by Arch Super, Chairman

Present:

Arch Super, Chairman

Florrine Super, Secretary

Leeon Hillman, Treasurer

Alvis “Bud” Johnson, Member at Large

Florence Conrad, Member at Large (3:06pm)

Charron “Sonny” Davis, Member at Large

Absent:

Wilverna “Verna” Reece, Member at Large (excused/travel)

Roy Arwood, Member at Large (excused/travel)

Vice-Chairman, Vacant

Quorum is established.

The Health Mission Statement was read aloud by Florrine Super, Council Secretary.

Agenda of February 11, 2010:

Florrine Super motioned and Leeon Hillman seconded to approve the agenda with changes, 4 haa, 0 puuhara, 0 pupitihara.

Regular Health Board Meeting Minutes of January 14, 2010:

Bud Johnson motioned and Sonny Davis seconded to approve the minutes of January 4, haa, 0 puuhara, 0 pupitihara.

Director Reports:

1.) Mike Edwards, Children & Family Services:

Mike is present to review his report with the Board. He distributed Circles of Care training reports from both him and Tracie Lima. The other staff that attended did not submit a report.

Florence Conrad arrived at 3:06 pm.

The Children and Family services department did provide services to over 400 clients in the past month. The circles of Care grant is a mental health grant and it provides better services for the clients. There are 8 tribal grantees every four years and it is three year funding, of which the Tribal Health Program is in their second year of funding. They are hoping to find a “systems of care” grant which the staff is possibility deciding not to obtain that funding.

In the past Mike has discussed the Title IVE. He informed the Council of the first IVE case and it’s eligibility to become under the Tribe and apply to a Tribal Member. It will be an adoption of a child in Hoopa CA. The case has been closed but due to the Tribe receiving Title IVE status then the Tribe is required to make the adoption payments until the child is of legal age which is estimated at approximately $19,000 total for this one case. This case won’t be able to provide time study reports as the home visits were done a year ago by Humboldt County. He will be able to provide monthly home site visits. Mike believes that the State is going to require that the Karuk Tribe Title IVE program take this on, however, he is seeking the Karuk Council’s support as the ultimate authority over the Title IVE program is the Council and he wants them to fully understand that this will utilize BIA funding.

Florence Conrad motioned and Leeon Hillman seconded to support the case as Title IVE eligible and will begin to transfer the case, 4 haa, 0 puuhara, 0 pupitihara.

At a recent CRIHB meeting they presented a plaque to the Karuk Tribe for their support over the past several years. Mike presented that plaque to the Health Board.

Mike has a department meeting next Tuesday at 11am at the Yreka office.

The parenting classes that have been taking place in Orleans have concluded. They had eight Tribal Members attend the class and that was a great turnout for the area. The Siskiyou County Behavioral Health Department is applying for a grant to support a drug court program. The reason that Mike didn’t apply for the funding on behalf of the Tribe, is because the Tribe does not have a drug court. There are 27 awards available and he is hoping to support the granting opportunity for Siskiyou County and be able to utilize the services by referring clients to the program if Siskiyou County is funded.

The only staff members that will be involved in the support letter are Joe Snapp and Tracie Lima and they would only provide services to Tribal Members either adult or youth. Bob thought the last sentence reads funny, but he believes that it is a good gesture to provide a letter of support on this funding. Leeon questioned the data collection requirements of the grant and staff time to provide that data to another entity. Mike noted that the staff will collect this data as part of their regular duties and the names will not be released just the data. The staff should not incur too much additional work leaving them unable to complete their regular duties.

Consensus: to support the Siskiyou County Behavioral Health grant application with some grammar corrections.

Leeon Hillman motioned and Florrine Super seconded to approve Mike’s report, 4 haa, 0 puuhara, 0 pupitihara.

2.) Daniel Pratt, TANF Director

Daniel has three action items to present for formal approval. Daniel first presented a rental agreement for training on February 23, 2010 for one day TANF training. It is agreement 10-A-028 for use of the Miners Inn Convention Center for $145. They will be holding training on motivation and working with hard to serve populations. This training will be in collaboration with both the Hoopa and Yurok Tribes.

The second action item he presented for approval was a contract for $800 for Paul Clayton and Associates, Inc to provide the one day training. The number is 10-C-040.

His third action item is procurement to purchase two more vehicles to add to the TANF fleet in the amount of $44k from McCea Subaru.

Arch asked if there was enough funding for this type of purchase and Daniel explained that after budget review and necessity he believes so.

Florence Conrad motioned and Sonny Davis seconded to approve the agreement 10-A-028 between the Karuk Tribe and Miners Inn Convention Center in the amount of $145, 4 haa, 0 puuhara, 0 pupitihara.

Florence Conrad motioned and Sonny Davis seconded to approve contract 10-C-040 between the Karuk Tribe and Paul Clayton, 4 haa, 0 puuhara, 0 pupitihara.

Florence Conrad motioned and Bud Johnson seconded to approve procurement and allow the purchase of two vehicles from McCea Subaru, 4 haa, 0 puuhara, 0 pupitihara.

Daniel continued to review his written report with the Council. He has not seen any dramatic spikes in client referrals and the program seems to be operating stable despite the economy. He has been assured that Tribal TANF programs are not going to see reduced funding and the Federal funding for Tribal TANF programs is a direct pass thru, which shall remain that way despite California’s budget crisis. Daniel has been working with Bob to present to NCAI on the California TANF situation for block grants and set aside allocations.

The program had their site visit and had no findings and finds that that audit was a good experience. ACF will conduct onsite auditing in the near future so the audit with Joseph Eve was a good experience. He has been working in collaboration with NTCTT (which he established) to evaluate cultural camps including, an acorn camp, youth camp, and sober and clean camp. This is a first ever that Tribal TANF’s are working together as a group. So, he is working with Karuk, Hoopa and Yurok camps to bring Native people together.

Pam is back to work and she will begin to complete projects as the projects coordinator real soon. Lisa has been working well with her clients. Yreka site is still growing. He goes out to Yreka once or twice a week. He is still reviewing sites for rental space for the Yreka TANF office.

Staff development is coming along and they will be attending TANF training in Las Vegas NV which one Council Member will attend.

March 5^th is the TANF staff meeting in Orleans at 11am.

Florence Conrad motioned and Bud Johnson seconded to approve Daniel’s report, 4 haa, 0 puuhara, 0 pupitihara.

3.) Chad Tiraterra, RPMS Site Manager:

Chad is present to review his written report with the Board.

He discussed going paperless with EHR and he was going to have a meeting regarding this but the meeting has not taken place so the staff continues to discuss this further.

The staff is now participating as a BETA test site for accounts receivable and a billing package. This is useful as he is hoping to provide better grant reporting. Eileen Tiraterra is the test staff person and she connects directly to IHS to discuss the errors which also provides for excellent communication with IHS. This seems to be working fairly nice, and it appears that the staff will work on this for about a year.

IHS is compensating the IT department in the form of computers and equipment as opposed to money for test site services. Chad changed the patient visit count graphs to view each site side by side. He noted that he is attempting to display the patient visit count by provider and clinic, but if the Council would like any other clinical data he would be happy to provide more information.

Florence Conrad motioned and Sonny Davis seconded to approve Chad’s report, 4 haa, 0 puuhara, 0 pupitihara.

4.) Eric Cutright, IT Director:

Eric provided a written report but has action items and is not present. His report will be moved further down the agenda to allow him to attend and present his action items for approval.

5.) Vickie Walden, Dental Office Manager:

Vickie is present to review her written report with the Board.

Dr. Thon Do is working very well at the Happy Camp dental office and within the community. Staff is incurring overtime as he needs another RDA due to the amount of patients he is seeing. When he approached Vickie with the requested she explained to him the process would be to approach Lessie to request funding for the additional staff member for the Dental Clinic. She has not heard to date anything further on those discussions.

Vickie announced that she has heard that the Tribe no longer employs the grant writer that she was working with on a grant opportunity and questioned what direction she should now take. Arch referred Vickie to work with Erin and Jaclyn on the Ford Foundation grant opportunity that she is working on.

Quartz Valley Indian Rancheria is operating now so Vickie believes that this will alleviate the back log of patients in the Yreka area. She is working with their clinic and provided them information on the Karuk Tribal Health Programs sliding fee scale so that they may prepare and be consistent with charges in the community.

Florrine Super motioned and Leeon Hillman seconded to approve Vickie’s report 4 haa, 0 puuhara, 0 pupitihara.

6.) Lessie Aubrey, EDHHS:

Lessie found that there is training coming up in the beginning of March for HHS consultation. She believes that it’s recommended that elected officials’ attend Arch, Bob and Lessie will attend this meeting. This will be a forum that the staff and Arch can attend to discuss options of funding and consulting regarding funding opportunities and needs. Bob believes that this training will cover several programs that the Tribe operates including health, LIHEAP and other programs.

Leeon Hillman motioned and Sonny Davis seconded to approve out of state travel for Robert Goodwin, Arch Super, and Lessie Aubrey to Washington DC March 3-5, 2010, 3 haa, 0 puuhara, 1 pupitihara (Florrine Super).

Lessie then read a Shrine Hospital informational announcement about services that they will be offering to youth in the area.

Lessie received a request from the Hoopa Tribe for support letters to be sent to State and Federal representatives. Because of the MediCal cuts that are taking place Hoopa cannot keep up with their expenses and one major expense being the operation of the ambulance. The support letters directly ask for assistance in seeking appropriations supported by Feinstein, Boxer and Thompson. There are some errors that will be fixed prior to Arch’s signature but the Health Board feels that supporting the Hoopa Tribe with sending letters of support best serves the community that utilizes the ambulance service.

Consensus: to support K’maw Medical Center’s request for appropriations.

Lessie then presented a letter of support request sent by CRIHB who is applying for funding through SAMSHA for Family Services support.

Consensus: to support CRIHB for their grant application to SAMSHA.

When staff attends Morongo for IHS meetings, the Karuk Tribal Health Program will be receiving an acknowledgement for the increase in GPRA scores. Lessie thanked the staff and providers for their support and dedication to improving the GPRA scores and in that they provided better service to the patients and clients of the Health Program which is exceptional.

MediCal optional benefits will not be reinstated and she will not attend the meeting as there is nothing that can be done. Suzanna Hardenburger can not attend training in Nashville TN but she would like to send Eileen Tiraterra in her place.

Florence Conrad motioned and Bud Johnson seconded to approve out of state travel for Eileen Tiraterra to Nashville TN, 4 haa, 0 puuhara, 0 pupitihara.

Bud Johnson motioned and Sonny Davis seconded to approve Lessie’s report, 4 haa, 0 puuhara, 0 pupitihara.

7.) Karen Daniels, Dir. Of Quality Management, Outreach & Administration:

Dr. Burns presented two policies for board approval. The policy of Officially Declared Public Health Emergency will be tabled for Dr. Burns clarify who would be able to declare an emergency. Dr. Burns will work with Erin on the policy as well.

The second policy for remote access to EHR. He explained that the policy outlines how and when the providers may remotely access EHR when they are out of the office. Lessie also noted that this policy was developed as a means to meet the HRSA requirement of after hours care to patients.

Leeon Hillman motioned and Bud seconded to approve the Remote Access Policy, 4 haa, 0 puuhara, 0 pupitihara.

Karen then went on to review her written report. She and Vickie are working on a pap smear performance improvement project. She and Lessie completed a time study on patient wait times in the Orleans clinic. They both reviewed the information and feel that they now have an understanding of the wait times. She completed a home visit and noted that she spent more time lost then she had anticipated.

For the CHR and Elders workers; Karen has now formalized their reporting. Chad and Karen have been working on RPMS data collecting systems for all the Elders and CHR’s to collect accurate and similar data. From this point forward she and the staff will better understand the data they are collecting and how it is counted. This will only assist the program, since now data can be extracted that may assist in funding opportunities or ways to better serve the patient population.

Florence requested that there be another refrigerator for the Orleans site so that there would be adequate storage for the medications. Currently, when the power goes out in Orleans the refrigerator will shut down, leaving the vaccines to spoil and be disposed of. She would like a gas refrigerator to allow adequate storage of medication when the power goes out. Karen will look into this.

Florence Conrad motioned and Bud Johnson seconded to purchase a gas refrigerator for the Orleans clinic, 4 haa, 0 puuhara, 0 pupitihara.

Sonny Davis motioned and Bud Johnson seconded to approve Karen’s report, 4 haa, 0 puuhara, 0 pupitihara.

Non-Health Employee:

1.) Hélène Rouvier, People’s Center Director

Helene is present to seek approval of a contract between the Karuk Tribe and Terry Tripp. The contract is for $1,600 for an entire course with the cost of $50 per class. The course will be cultural women’s class offered on Wednesday’s at the People Center.

Florrine Super motioned and Leeon Hillman seconded to approve contract 10-C-040 between the Karuk Tribe and Terry Tripp, 4 haa, 0 puuhara, 0 pupitihara.

Helene then sought approval for Bud and herself to attend to the Peabody Museum at Harvard University, March 7-11, 2010, for the NAPGRA grant.

Florrine Super motioned and Leeon Hillman seconded to approve out of state travel for Helene Rouvier and Bud Johnson to the Peabody Museum, March 7-11, 2010, 4 haa, 0 puuhara, 1 pupitihara (Alvis Johnson).

2.) Sandi Tripp, Roads Department:

Sandi presented the parking lot plan and noted that it is currently out for bid at the moment. On the 17^th there is a walk-thru that she sent that information to the Council as informational if they would like to attend. There will be a notice to proceed in May and the project will be completed by mid August.

Sandi then presented modification #2 to contract number 10-C-027 (Winzler & Kelley) for $8,900. Sandi went on to explain the differences in the changes. The modification will be for NEPA and CEQA for the engineering design.

Florence Conrad motioned and Bud Johnson seconded to approve modification #2 to contract 10-C-027 between the Karuk Tribe and Winzler & Kelley, 4 haa, 0 puuhara, 0 pupitihara.

There is going to be some surveying done for KAS Associates under contract 10-C-029 modification #1, for $4,700.

Florence Conrad motioned and Sonny Davis seconded to approve modification #1 to contract 10-C-029 between the Karuk Tribe and KAS Associates in the amount of $4,700, 4 haa, 0 puuhara, 0 pupitihara.

3.) Robert Goodwin, Self-Governance Coordinator:

Bob is present tonight to seek approval of a resolution rescinding formal approval to have funding passed thru BIA to the IRR roads program and submit a new resolution to continue funding through to the IRR program directly from the Federal Highway Administration. Scott was working through the BIA Roads Program and after review determined that he would like to remove that program and fund it directly from the Federal Highway Administration moving forward.

Sonny Davis motioned and Bud Johnson seconded to approve resolution 10-R-015 rescinding resolution 09-R-121, 4 haa, 0 puuhara, 0 pupitihara.

An amendment to the BIA AFA under resolution 10-R-016 was then presented by Bob.

Sonny Davis motioned and Leeon Hillman seconded to approve resolution 10-R-016 amending former resolution 09-R-147, 4 haa, 0 puuhara, 0 pupitihara.

Robert then asked that the Council approve having Fred Burcell travel to a Tribal Elders home in Scott Valley to determine living conditions and allow for an allotted amount of funding to repair unsafe living condition.

Florrine Super motioned and Leeon Hillman seconded to approve up to $1,000 of Council Discretionary funding for Tribal Elder # 3481 for wood stove repairs after Fred Burcell reviews the needs, 4 haa, 0 puuhara, 0 pupitihara.

4.) Jaclyn Goodwin, Grant Writer / Resource Developer:
Jaclyn is present to seek approval for resolution 10-R-017 for a grant proposal in the amount of $8,625.00 for the language programs strategic planning efforts to the Sierra Health Foundation.

Florrine Super motioned and Leeon Hillman seconded to approve resolution 10-R-017, 4 haa, 0 puuhara, 0 pupitihara.

Closed Session:

Florrine Super motioned and Sonny Davis seconded to approve procurement pending necessary paperwork to be submitted to the finance department and allow payment from the TANF Program to Rogers Transmission, 4 haa, 0 puuhara, 0 pupitihara.

Leeon Hillman motioned and Florence Conrad seconded to uphold the CHS denial for Tribal Member #1053 and contribute $1,000 toward CHS Chase from Third Party, 4 haa, 0 puuhara, 0 pupitihara.

Directive: to employee’s # 1988 & 7094 to meet with the Tribal Council on February 23, 2010 at 9am to discuss priorities and direction in which the Tribal Council would like them to focus.

Directive: to cancel meeting scheduled for February 16, 2010 until further notice.

Consensus: to have employee’s use designated smoking area at the Apsuun Building and to also post visitor parking signs for the location, blocking spaces for visitors.

Consensus: to have TANF Council Representatives meeting with TANF staff at their upcoming meeting and communicate questions and assist the Director in understanding Council concerns.

Next meeting date: TUESDAY, March 9, 2010 at 3pm.

Florence Conrad motioned and Florrine Super seconded to adjourn meeting at 7:56 pm, 4 haa, 0 puuhara, 0 pupitihara.

Respectfully Submitted,

____________________

Arch Super, Chairman Recording Secretary, Barbara Snider