Karuk Tribe – Health Board Meeting

April 8, 2010 – Meeting Minutes

Meeting called to order by Arch Super, Chairman at 2:57 pm

Present:
Arch Super, Chairman

Leeon Hillman, Treasurer

Charron “Sonny” Davis, Member at Large

Roy Arwood, Member at Large

Alvis “Bud” Johnson, Member at Large

Absent:

Vice-Chairman (Vacant)

Florrine Super, Secretary (travel – excused)

Florence Conrad, Member at Large (vacation – excused)

Quorum is established.

The Health Mission Statement was read aloud by Daniel Pratt, TANF Director.

Agenda:

Bud Johnson motioned and Leeon Hillman seconded to approve agenda with changes, 4 haa, 0 puuhara, 0 pupitihara.

Minutes of March 4, 2010:

Bud Johnson motioned and Leeon Hillman seconded to approve the regular board minutes of March 4, 2010, 4 haa, 0 puuhara, 0 pupitihara.

Old Business: none at this time

Guests: none at this time.

Director Reports:

1.) Daniel Pratt, TANF Director

Daniel is present to review his written report with the Health Board. Daniel announced that the staff is continuing to monitor the caseload for the TANF program. The program is operating well both fiscally and programmatically. He received an email from ACF confirming that the first quarter has been received and the second with a response noting that there were no errors in the federal report. The third quarter report will be submitted within thirty days.

Daniel has been working with the Northern California Coalition which is comprised of several Tribe’s including TANF programs, Social Services, and Domestic Abuse programs.

Daniel was nominated as the spokesperson for the media of this coalition and he did very well.

On the 31^st the Quartz Valley Tribe has inquired about how to work with the Karuk Tribe to obtain services for their potential TANF clients. Daniel noted that at the end of next month he will be providing them with a presentation on how to develop a TANF Program. Daniel will bring that information back to the Tribal Council for formal approval and the request to approve a resolution supporting them joining. If Quartz Valley joins this may increase the TANF funding for the Karuk Tribe but Quartz Valley only had four cases in their area. There needs to be work on the Quartz Valley Tribe on data collection and they will be responsible to work toward this. To operate the Quartz Valley clients effectively they will need to have at minimum fifteen clients but the final determination will be made by the Karuk Tribal Council at a later time. He personally would recommend providing services to the Quartz Valley Members to see that all Native Americans receive assistance by a tribal program as opposed to a County program. Roy noted that when he attended ATNI training they were opposing some of the services that the Tribal TANF programs receive. Daniel noted that the State gets opposition because Tribe’s share funding in that in California our TANF program receives state match funding when other states do not have this opportunity to receive funding. Roy noted that when there is national opposition it is best to understand this to know what program or entities that we are involved with that are opposing funding that California receives, specifically the Karuk Tribal TANF Program. Daniel feels that explaining the TANF California stand point to ATNI would be helpful to seek block grant set asides and move toward that avenue ensuring that Tribal TANF Programs do not get their funding cut. Daniel believes that it is imperative through national legislation to keep pushing toward this. Roy would recommend that Daniel keep a close watch on this and move forward keeping an eye on funding that may be cut.

Daniel would like to have TANF and Childcare put under self-Governance. There is no consultation with ACF. There is a workshop for the Self-Governance training is hoping to have ACF and Childcare to attend to ensure that there is consultation on this.

Roy Arwood motioned and Leeon Hillman seconded to approve out of state travel for Daniel Pratt to the Self-Governance Conference May 2-6, 2010 in AZ 4 haa, 0 puuhara, 0 pupitihara.

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

2.) Eric Cutright, IT Director
Eric is present to review his written report with the Health Board. He has three action items. He would like to request approval to purchase new printers for finance, Orleans clinic and the Yreka medical clinic. The total cost is $4,348.79 from GovConnection.

Roy Arwood motioned and Sonny Davis seconded to approve procurement and approve the purchase, 4 haa, 0 puuhara, 0 pupitihara.

Eric then presented procurement for computers for Happy Camp Medical; Medical Records in Yreka and Clarence Barger, Notebook is for the TANF Program.

Leeon Hillman motioned and Bud Johnson seconded to approve procurement and the purchases from TigerDirect, 4 haa, 0 puuhara, 0 pupitihara.

When Eric was questioned about the high cost of procurement and the purchase of two desktop computers for the TANF Director and Alphonso Colegrove; he referred the question to the TANF staff. Each desktop is estimated at $1,200 a piece.

Alphonso noted that he would like to have updated computers to use video and Photoshop. Arch inquired about the graphics software and the ability to use less expensive options. Alphonso believes that the need is for documenting projects and creating a video and photo archive of the Tribe’s TANF projects. Other TANF programs have similar presentations. Daniel noted that he is trying to get ahead of the game, they have excess funding to spend at the moment with no guarantee of the extra funding in the future, so purchasing the staff’s needs at this time will ensure they have the necessary tools while funding is available.

Roy Arwood motioned and Bud Johnson seconded to approve procurement and allow the purchase of 2 TANF desktop computers, 4 haa, 0 puuhara, 0 pupitihara.

The Karuk Tribe received copies of 19 Broadband applications which note that they will all serve the Karuk Tribe however they do not and there is a lot of competition on the funding. Of the 19, 6 are for infrastructure, 3 are for public computer centers, 10 are for sustainable broadband education. Eric will continue to review the applications and get feedback to the Council at their next meeting on which applications to support and which ones are just naming the Karuk Tribe without actually providing service to the Tribe.

Another phone outage occurred in Orleans, which was on battery backup, with the phone system still failing. Eric repaired the system and noted that it was the first time in a long time that the system had gone down.

The Karuk Tribe was approached with the possibility of an interview with a reporter that was onsite in Orleans to conduct interviews with organizations that will be effected by the services offered to the community. Eric obtained approval from Arch to speak on behalf of the Tribe’s services and represent the Karuk Tribe. He conducted the interview but by the time the interview was put out to the public, Eric’s comments were removed. Eric noted that he did report back the comments he made to the Tribal Council at their planning meeting, but as of now, there were no published comments in the media.

IHS had sent out a survey on network and services that are provided at the health facilities and by Tribes. IHS was amazed to see how well the system is up and running. They actually attempted to recruit Chris Kleeman. Also, Chad Tiraterra and Amy Coapman were in Hoopa assisting them by showing how the EHR system works. While there they were recruited for their continued work on EHR. Eric is very thankful that he has staff that is sufficient and exceptionally hard working which is displayed across the health field.

Leeon Hillman motioned and Sonny Davis seconded to approve Eric’s report, 4 haa, 0 puuhara, 0 pupitihara.

3.) Vickie Walden, Dental Office Manager:

Vickie is present to review her written report with the Board. She noted that the Council should review the dental conference in Sacramento and the entire dental staff attendance. This training will cause clinic closures and she noted that if the Council has concerns with this then she asked for time to meet at their planning meeting to go over the discussion of travel and training.

Vickie noted that there have been procedure changes to dental policy but those procedure changes do not require Council approve. She will attach the policy next month for Council information. Vickie is hoping to have time to conclude three years comparison displaying changes over time to the provider schedules and patients seen. Arch would like an explanation on the clinic closures in closed session to ensure the Council is informed of the need for travel and understand that there will be no services to the Membership and patients during staff training.

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

4.) Lessie Aubrey, EDHHS:

Lessie provided an update on the Karuk Tribe receiving an award for most improved GPRA scores from a Tribal health organization across the nation. This means that the performance measures that are set by the Government were met or exceeded and showed a large increase in compliance. Vickie Simmons and Judy Blind completed a lot work to improve the GPRA scores, and continually monitor the Tribes services, with tracking to meet the GPRA.

Lessie then presented a resolution 10-R-041 for a service agreement with Plumas County Public Health for $14,250.00.

Roy Arwood motioned and Sonny Davis seconded to approve resolution 10-R-041 and the shortfall of $5,000 from the grant that the Council will use Third Party to cover, 4 haa, 0 puuhara, 0 pupitihara.

The patient assistance program has brought in $16k in reduced cost medications for eligible patients in the past month.

Lessie explained that awhile back there was no staff day and then there was planning at the last minute to have another staff day, this lead her to discuss the option of having a committee formed to conduct a staff day that would include input from employees rather than having someone decide what to do or have last minute planning. Lessie asked that she be able to form a committee to develop a staff day and Sara told Lessie to ask the Council to develop this committee. The Council will table this request to their next planning meeting.

Roy Arwood motioned and Bud Johnson seconded to approve travel for Arch to San Diego CA for IHS Consultation, 4 haa, 0 puuhara, 0 pupitihara.

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

5.) Karen Daniels, DQMCH:

Karen is not present to review her written report but Patti is present to review her written report with the Board or to answer questions if the Board has any. Patti has a policy that she first presented to the Council at their planning meeting and it was tabled to the Health Board Meeting. The policy will be prescribing low-cost alternative medications. The policy will outline how the staff and providers will use CHS Formulary procedures to ensure that the most cost efficient medication is prescribed to the patients and also use crucial cost saving methods to provide the best services. Flo asked questions regarding cost of medications and the side affects on the patient. She noted that the cheaper cost isn’t always best, and the group noted that there is a process for appeal.

In the 2008 EDS report the cost per patient that year was $985.81 for medical services per patient in that year. The UDS report displayed that the cost was high by national standard but the Karuk Tribal facilities are unique and have a lot of differences than non Native clinics. Patti is hoping to see if this helps in lowering costs to patients. Laura noted that this will also display any changes moving forward with tracking costs data in RPMS. Arch asked if there was going to be a letter put out to the patients as some Tribal Members do not like changes implemented that are not explained to them. Patti noted that she can draft a letter explaining the new process but that she would need time to work on that.

Leeon Hillman motioned and Roy Arwood seconded to approve the health program policy “prescribing low cost alternative medications”, 4 haa, 0 puuhara, 0 pupitihara.

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

6.) Chad Tiraterra, RPMS Database Administrator:

Chad is present to review his written report with the Health Board. Chad has one action item and that is to have the mandatory security training notice issued to all staff of the Tribe and its entities.

Bud Johnson motioned and Leeon Hillman seconded to make the IHS security training mandatory for all staff, 4 haa, 0 puuhara, 0 pupitihara (which should be completed within 30 days).

Chad continued to review his written report. He reviewed his budgets and the general clinic workload reports.

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

7.) Mike Edwards, Family & Children Services Director:

Mike is present to review his written report with the Health Board. The department saw 555 clients within this last month.

He is continuing to work on how to move an eligible case from the State under the Tribe’s Title IVE program.

The departments’ patient survey on patient cancellations is still being worked on. The Social Services staff and TANF staff are working together on services offered in the Orleans area to ensure that the best services are offered to the clients there.

The Circles of Care committee had a meeting and the Yav Pa Anav meeting received some training on FAS. This was a lot of information and insight for the group.

The former DUI Instructor has moved to another position and the program is having trouble recruiting a replacement. He will discuss options of coverage or hiring in closed session.

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

Guests Employee Non-Health:

1.) Rick Hill, KCDC Grant Writer
Rick is present tonight to seek approval of procurement for EA for the Yreka Clinic project. There were several suggestions with $119,000 in funding but he is recommending repairs to the HVAC system, which would be with LACO Associates as they are the best qualified with the lowest price.

Roy Arwood motioned and Bud Johnson seconded to approve procurement and allow engineering to be done by LACO and Associates, 4 haa, 0 puuhara, 0 pupitihara.

2.) Hélène Rouvier, People’s Center Coordinator:

Hélène is present tonight to seek approval of a contract for cooking at the upcoming Basketweavers gathering event April 23-25, 2010. The lowest bid was selected which is Kathleen Davis.

Roy Arwood motioned and Leeon Hillman seconded to approve the Basketweavers contract with Kathleen Davis, 3 haa, 0 puuhara, 1 pupitihara (Sonny Davis).

The other contract is an addendum to contract 10-C-064 which is with Humboldt University. The addendum will authorize the non profit organization to follow circular A-122 instead of A-102 according to the Tribe’s policy and procedures.

Leeon Hillman motioned and Sonny Davis seconded to approve addendum (1) to contract 10-C-064, 4 haa, 0 puuhara, 0 pupitihara.

3.) Jaclyn Goodwin, Grant Writer:

Jaclyn is present tonight to seek approval for $750 in assistance for a tribal youth trip, taking several youth to Cal Day at UC Berkeley. The dates are April 16-18, 2010.

Leeon Hillman motioned and Sonny Davis seconded to approve $750 from Council Discretionary to assist Tribal youth participation at UC Berkeley CAL Day, 3 haa, 0 puuhara, 1 pupitihara (Roy Arwood).

Closed Session:

Roy Arwood motioned and Leeon Hillman seconded to approve resolution 10-R-042 authorizing approval to enter into a training program between the Karuk Tribe dental staff and UCLA in the amount of $52,000, including 12 month online course for Nikki Hokanson and Donita Hill, and inclusion for out of state approval as noted in the agreement, 4 haa, 0 puuhara, 0 pupitihara.

Bud Johnson motioned and Sonny Davis seconded to remove CA Roll # 012782 as restricted from obtaining CHS services in conclusion with the CHS Supervisor verifying Native American eligibility.

Consensus: to table request for assistance as presented by the CHS Supervisor for Tribal Member out of the service area, to the next planning meeting.

Bud Johnson motioned and Sonny Davis seconded to approve resolution 09-R-006, authorizing ICW re-intervention, 4 haa, 0 puuhara, 0 pupitihara.

Consensus: for former employee to make a request at the Planning Meeting to be removed from the Do Not Hire List.

Consensus: for employee #4811 to draft a revised AOD Position Description and present that back to the Council for approval at their upcoming Wednesday meeting.

Sonny Davis motioned and Leeon Hillman seconded to allow employee#4811 to use a Tribal Vehicle for travel back and forth no more than three times per month for commuting; after three months the use will be reported back to the Tribal Council, 4 haa, 0 puuhara, 0 pupitihara.

Leeon Hillman motioned and Sonny Davis seconded to approve the write off of $36,892.62 in uncollectable medical/dental debts, 4 haa, 0 puuhara, 0 pupitihara.

Consensus: for billing staff to present agreement with debt collection firm to the CFO and Compliance to ensure internal process is followed.

Consensus: to table request from employee # 0730 to the Wednesday planning meeting.

Consensus: to allow employee # 4250 to include fiber optic estimate in RFP that is being posted to determine total cost for linkage to employee home. After estimate is received #4250 will bring that information back to the Tribal Council to consider payment and retention agreement for connectivity work.

Leeon Hillman motioned and Roy Arwood seconded to approve out of state travel for Bob Goodwin to Washington DC, May 17-20, 2010 and Arch super to Portland OR May 17-20, 2010, 4 haa, 0 puuhara, 0 pupitihara.

Leeon Hillman motioned and Bud Johnson seconded to approve out of state travel for Lessie Aubrey, Bob Goodwin, and Phil Albers to Scottsdale AZ May 2-6, 2010 for a Self-Governance Conference, 4 haa, 0 puuhara, 0 pupitihara.

Consensus: for Arch to review stipends from the Language program and report back at the Wednesday meeting.

Consensus: due to scheduling, move the Thursday planning meeting to Wednesday.

Leeon Hillman motioned and Sonny Davis seconded to issue a $146.00 check from discretionary to #D00082, 4 haa, 0 puuhara, 0 pupitihara.

Bud Johnson motioned and Leeon Hillman seconded to approval a loan to #D00246 in the amount of $700 with full repayment within 30 days, 4 haa, 0 puuhara, 0 pupitihara.

Consensus: to table request from Tribal Member# 2645 to Thursday.

Leeon Hillman motioned and Sonny Davis seconded to approve out of state travel to Portland OR for DOJ and DOI consultation for Arch Super or another Council Member May 10-12, 2010, 4 haa, 0 puuhara, 0 pupitihara.

Next Meeting Date: May 13, 2010 at 3pm in Happy Camp.

Bud Johnson motioned and Leeon Hillman seconded to adjourn meeting at 8:17 pm, 4 haa, 0 puuhara, 0 pupitihara.

Respectfully Submitted,

_____________________________

Arch Super, Chairman

Recording Secretary, Barbara Snider