Karuk Tribe – Health Board Meeting

October 14, 2010 – Meeting Minutes

 

Meeting called to order at 4:14pm by Leeon Hillman, Treasurer

 

Present:

Leeon Hillman, Treasurer

Dora Bernal, Member at Large

Florence Conrad, Member at Large

Alvis “Bud” Johnson, Member at Large

Wilverna “Verna” Reece, Member at Large

 

Absent:

Arch Super, Chairman (travel – excused)

Phil Albers Jr., Vice-Chairman (excused)

Florrine Super, Secretary (leave – excused)

Charron “Sonny” Davis, Member at Large (travel – excused)

 

Quorum is established.

 

Agenda:

Verna Reece motioned and Dora Bernal seconded to approve the agenda with changes, 5 haa, 0 puuhara, 0 pupitihara.

 

Minutes of September 9, 2010:

Dora Bernal motioned and Bud Johnson seconded to approve the minutes of September 9, 2010, 5 haa, 0 puuhara, 0 pupitihara.

 

Guests:

1.) Jason Verduzco, Caltrans

Jason is present tonight to seek approval of a temporary easement near Katimiin. Caltrans is redoing the culverts along Highway 96 and one in particular will require repair near that location. He is seeking approval to use the driveway to gain access. If the easement isn’t approved then Caltrans will build their own road to access the culvert site. He did meet with Norman Goodwin, Leaf Hillman and Scott Quinn in which they were not opposed to the easement and seemed fine with it as long as Caltrans did not complete any work during ceremony times. To Jason’s surprise, after the discussion and understanding Caltrans then received a letter regarding the easement denial and spoke to Scott about it. Scott referred him to speak directly to the Council. Jason explained that Caltrans will not impose on the site but will have to gain access for the repair. As noted earlier he does not want to build a new road on their own property because that would mean falling trees, bringing in equipment and a new road that isn’t needed long term. The Council is unaware of the exact discussion and what took place but they would like to have Scott provide further information regarding the discussion and the options.

 

This will be moved to the agenda on 10/28. Scott will contact Jason and have this worked on completely to ensure they are on the same page and recommendations can be presented back to the Council. Jason thanked the Council for their time.

 

2.) Anna Myers, CHS Supervisor:

Anna presented revised CHS policies and procedures. CHS policies are revised annually to include services for the coming fiscal year. Last year they were revised to include a reduction in services due to funding shortages, and that was for one year, with review of the budget to put the services back into level one of care. The funding has stabilized so they will now move back toward the services previously provided and the policies will reflect that.

 

Florence Conrad motioned and Dora Bernal seconded to approve the CHS policies and procedures, 5 haa, 0 puuhara, 0 pupitihara.

 

3.) Laura Mayton, CFO:
Laura is present to seek approval of a finance policy for collections of cash payments for services at the clinics in Yreka and Orleans. Recently, due to issues collecting and the Tribe receiving accurate accounting of the cash, Laura would like a policy implemented right away. Dora questioned the policy and not accepting cash over $50. It appears that if we are turning away cash payment for services, because there is a problem out there. Laura drafted this policy for Yreka and Orleans to be an intermediate policy for overwhelming circumstances but noted that the Council can review it and just send their comments to her for full approval at their next meeting. Due to the discussion and different suggestions, Laura will email the policy and the Council and they will provide feedback. She will then include revisions and this policy will be added to the 10/28 agenda for approval.

 

Director Reports:

1.) Daniel Pratt, TANF Director:

Daniel is present to review his written report. He read the highlights from his report including how many current clients he has and the general operations of the TANF program. He covered his travel that he recently attended. He announced that Janelle will be holding parenting classes in Yreka once the office move is done and operations out there are up and running smooth. He is having IT work on the phone system and get the site up and running. Daniel then asked when the site would be up and running and Eric believes that it will take about a month to be fully set up. Daniel then distributed the NCAI Conference agenda for the TANF delegates (Dora Bernal and Florence Conrad) so they are aware of what breakout sessions that he will need TANF representatives to cover.

 

Dora Bernal motioned and Florence Conrad seconded to approve Daniel’s report, 5 haa, 0 puuhara, 0 pupitihara.

 

2.) Mike Edwards, Children and Family Services:

Mike is present to review his written report. He would like to add an intern that is under agreement with the Tribe to the vehicle insurance so that she can travel to group sessions and transport clients to and from the clinic. Leeon asked if she had successfully completed a background check. Mike noted that the will get that information and he will bring that back to the Council Meeting on 10/28. He then presented a resolution for ICW Intervention, 10-R-114.

 

Florence Conrad motioned and Bud Johnson seconded to approve resolution 10-R-114 authorizing ICW intervention on behalf of the Tribal Member, 5 haa, 0 puuhara, 0 pupitihara.

 

Mike presented procurement to purchase a tribal vehicle for the Social Service program to alleviate the amount of use from just his program. A dedicated vehicle for his staff will make services available for more clients. Leeon asked about the difference in price for a new vehicle as opposed to a used one, with the amount of miles. Mike did not research this option, so he will go back and prepare procurement for a new vehicle purchase and bring that back to the Council Meeting on 10/28.

 

Mike announced that he is having staff cross train in the DUI Program to ensure there are services to clients and they won’t be interrupted moving forward. The previous issue resolved itself. 

 

Verna Reece motioned and Bud Johnson seconded to approve Mike’s report, 5 haa, 0 puuhara, 0 pupitihara.

 

3.) Lessie Aubrey, EDHHS:

Lessie is present to review her written report and seek approval of her action items. She first presented an action item joining with CRIHB epidemiology center. There is no cost but there are some benefits and resources for joining.

 

Leeon Hillman motioned and Dora Bernal to approve agreement 10-A-061 between the Tribe and CRIHB Epidemiology Center and the Karuk Tribe, 5 haa, 0 puuhara, 0 pupitihara.

 

Lessie announced that she has suggestions to receive Clinic Operations Consultants to come in and provide assistance in how to sufficiently operate a clinic. Lessie would like to bring the consultant in to provide onsite review of the Yreka clinic verifying flow and access to the facility. Lately, it has been making improvements but the consultant will assist in identifying any deficiencies that may be being missed.

 

Lessie brought Patti on as half time for HRSA and that will assist in getting the HRSA goals met. She then went on to explain other position descriptions that she is currently revising. All position descriptions will be tabled to the Council Meeting on 10/28 to allow the Council time to review them.

 

Florence announced that she is upset and astonished that the Orleans facility has no medical provider. It has been a long time since there was services at the Orleans facility and that leaves no place for the community to receive care. Lessie stated that she has worked very hard to get a physician and she is still trying. She tried to get a locum Tenens contract but she got vetoed on the contracts by Erin and Laura. She worked very hard to get coverage for Orleans, including the contracts option, and bringing on Dr. Willett, former provider. She reviewed all the current provider leave and what is going on with each situation for the Council so they might see how the other providers are unable to cover for Orleans. Lessie would like to talk to Dr. Willett and find out what the coverage is as of right now, because she brought Dr. Willett back and then was notified that he was going on leave, and no one even bothered to tell her so that she could adequately address coverage. Florence would like to go on record noting that Orleans is just as important as any other community. Lessie stated that she understands that but she is doing what she can and has been working on it continuously. Lessie stated that for the record, she does not think that the people in Orleans are any less important than any other community. She again reiterated that she tried to get locum tenens and the Council and the staff has tied her hands when she tried to seek that avenue of coverage. Florence stated that she has been very patient when the Orleans facility didn’t receive a physician and she would like to have any type of provider. She continued by stating that the FNP is working well but there is no staff there at this time and further, she didn’t appreciate Orleans being Fabian’s training site for the community and the care of the patients because they deserve the same type of care as all the other facilities. Leeon believes that the situation will get better soon as more providers come forward and he does remember that Lessie tried to get the facility covered several times but was unable to find a provider as well as get locum tenens coverage.

 

Verna Reece motioned and Florence Conrad seconded to approve Lessie’s report, 5 haa, 0puuhara, 0 pupitihara.

 

4.) Chad Tiraterra, Database Administrator:

Chad is present to review his written report. He has one action item. It is an agreement for further beta testing at the Tribes sites within RPMS. Basically it is an agreement to do further testing on the patient Registration GUI. The Karuk Tribe is one of three sites that is being a test site and once the testing is complete it will go live nationally. The agreement number is 11-A-001.

 

Florence Conrad motioned and Verna Reece seconded to approve agreement 11-A-001, 5 haa, 0 puuhara, 0 pupitihara.

 

Chad then went on to review his report information including user needs for use and other actions that his department completes. Dentrix has submitted their quote for services with contractors who can do that work moving the dental program to electronic health records. The quotes were too high and expensive to complete moving dental to EHR and they will move toward DentRix but not fully while they seek further funding to complete the full implementation and move to EHR. The new GUI does a separation between mental health and the medical providers which is great so that they are complying with HIPPA and similar regulations, separating what staff can view in regards to health records and behavioral health information.

 

Dora Bernal motioned and Bud Johnson seconded to approve Chad’s report, 5 haa, 0 puuhara, 0 pupitihara.

 

5.) Vickie Simmons, COO:

Vickie is present to provide her written report. She attended a lot of meetings for the month of September. The health program did receive their new eye camera and that will be used at each site. All three clinics will have the ability to check for diabetic retinopathy. This saves on costs for services by less referrals to outside facilities and provides better services to the patients.

 

On November 2nd and 4th there will be diabetic exams done in Happy Camp and for Orleans they will be done later. This information also went out to the diabetic patients of those communities. December marks the end of the diabetic audit and then this will be moved to the calendar year. Diabetics who are counted will need to follow up on services prior to the end of December to ensure they are counted in the audit. The diabetic grant is due at the end of the next month and she will be working with Jaclyn on the application.

The complaints for the month of September displayed a couple complaints for providers, service complaints and staff complaints. Verna asked about the requirements of ordering medications as noted in the meeting minutes of Vickie’s report. It seems that the ordering of medications is based on cost and Verna would like to know who determines that. Vickie explained that the health program reviews how to reduce costs on patient visits to save the patient money and several ideas are implemented to assist the patients. Patti explained that the providers prescribe lower cost medications to save funding, but if a patient cannot use a generic form of the medication then the Pharmacy and Therapeutics Committee will allow the medication to be allowable as prescribed if there is a justification of the name brand versus an alternative generic lower cost medication. This project was suggested by HRSA and they are trying it out, but if they find that it doesn’t work well then they will try another method. For October breast cancer awareness month triggered a competition to decorate the facilities to bring that awareness to the communities. Vickie was proud of the staff and will be having that or similar events in the future because the patients seem to like that the health clinics and staff get involved in the community awareness campaigns.

 

The diabetic grant that purchased exercise equipment has been delivered in the Orleans site at the nutrition center. That is part of the prevention portion of the diabetic grant. Some equipment is for Happy Camp but there is no location for it to be housed so it will be in Orleans until a place is found.

 

Verna Reece motioned and Dora Bernal seconded to approve Vickie’s report, 5 haa, 0puuhara, 0 pupitihara.

 

6.) Eric Cutright, IT Director:

Eric is present to review his written report. He first wanted to seek approval of a new server for Orleans. It will be used for the facility and offices. Along with this, Eric will bring procurement for the server room to the Council Meeting 10/28.

 

Verna Reece motioned and Dora Bernal seconded to approve procurement and allow the purchase of server equipment in the amount of $6,538.97, 5 haa, 0 puuhara, 0 pupitihara.

 

Eric was on vacation for part of September. He has seen server problems at KCDC, KTHA and in Orleans but the IT staff continually work on improvements and solutions to keep the sites up and operational.

 

It was noted that the servers will all be moved to the datacenter and when that happens the generator project that is being done at the Administration Complex will keep all the sites up when the power is out in Happy Camp. In previous years, when power was out in Happy Camp, the servers went down, and that left all three communities shutting down and sending staff home. This was a high cost with no revenue generation plus a reduction in services to patients or clients; so the generator project will be used to keep all sites operational.

 

The datacenter, it is past the deadline to be finished and the power is going up today. Then the servers will be housed at that location with back up generator capability as well.

 

Eric did attend the Redwood Coast broadband forum. It had representatives from Del Norte, Humboldt and Trinidad Counties. Attached is his report of that training. No applications were funded in Humboldt County so the proposal that the Karuk Tribe supported was not funded by the Federal Government. Eric did confirm that the investment that the Tribe did, did not flourish.

 

Verna Reece motioned and Florence Conrad seconded to approve Eric’s report, 5 haa, 0 puuhara, 0 pupitihara.

 

7.) Vickie Walden, Dental Office Manager:

Her action items will be tabled to another meeting, because Vickie was unable to present them.

 

Dora Bernal motioned and Bud Johnson seconded to approve Vickie Walden’s report, 5 haa, 0 puuhara, 0 pupitihara.

 

Non Health Employees/Departments:

1.) Sandi Tripp, Land Department:

Sandi is present to seek approval of a landscaping contract. She presented contract 11-C-001 with Miller Farms Nursery, Inc in the amount of $30,371.

 

Florence Conrad motioned and Verna Reece seconded to approve contract 11-C-001 with Miller Farms Nursery, Inc., 5 haa, 0 puuhara, 0 pupitihara.

 

Sandi then presented modification #10 to 10-C-070 with Hat Creek Construction in the amount of $10,933.54. They owe more money for striping and asphalting. The grand total at this point for the contract became $835,419.73 for the Anavkaam parking lot project.

 

Verna Reece motioned and Florence Conrad seconded to approve change order #10 to contract 10-C-070, 5 haa, 0 puuhara, 0 pupitihara.

 

2.) Rick Hill, KCDC:

Rick is present to seek approval of agreement 10-A-060 for $2,500 which will cover 60 months of service with Pacific Power.

 

Florence Conrad motioned and Dora Bernal seconded to approve agreement 10-A-060, 5 haa, 0 puuhara, 0 pupitihara.

 

His second action is procurement for the new KCDC office for telephone and computer switch that is $3,118.00.

 

Florence Conrad motioned and Dora Bernal seconded to approve procurement in the amount of $3,118.00, 5 haa, 0 puuhara, 0 pupitihara.

 

He took the opportunity to provide information to the Council on the wiring of the new KCDC modular building and he will bring any action items back to the Tribal Council. Leeon asked if there was a final walk-thru scheduled or planned. Rick did confirm that there is going to be one. There is already identified items that will be repaired from when the modular was moved from it’s location to Happy Camp.

 

3.) Jaclyn Goodwin, Grant Writer:

Jaclyn is present to seek approval of action items. She stated that the ICDBG grant states that the code of conduct has to be reapproved within some many days of the release date of the NOFA. So the Code of Conduct must be reapproved currently. She will also need the Community facilities and maintenance operation plan reapproved, which had the name change of the Tribe updated.

 

Dora Bernal motioned and Florence Conrad seconded to approve the revised Code of Conduct in the fiscal policies, 5 haa, 0 puuhara, 0 pupitihara.

 

Dora Bernal motioned and Bud Johnson seconded to approve the Community facilities and Maintenance and operation plan, 5 haa, 0 puuhara, 0 pupitihara.

 

Jaclyn then provided information from a Tribal Member Willie Harrie regarding grant writing that he may do for the Tribe. She would like to support his project and work with the Tribal Member and distribute a boiler plate of information on the Tribe and its needs to better support him in obtaining a grant for the Tribe, while supporting his educational goal of grant writing.

 

Verna Reece motioned and Florence Conrad seconded to approve distributing the information to the Tribal Member, 5 haa, 0 puuhara, 0 pupitihara.

 

Closed Session: 

Consensus: to refer loan request from employee #1647 to KCLF.

 

Consensus: to have Tribal Court Administrator work with ICW and determine options for Tribal Member child and mother. No final determinations will be made until the Council is informed of all information.

 

Florence Conrad motioned and Verna Reece seconded to approve a pay increase for employee #9089 at $1.75 per hour, 5 haa, 0 puuhara, 0 pupitihara.

 

Consensus: to allow Stephanie Dolan to review the Caltrans contract and provide information to Caltrans and the Tribe.

 

Update: employee #3413 provided an update on recent activity at the health facility and actions taken to remedy suspicious activity.

 

Update: employee #3413 will provide a written letter outlining suspension of Tribal Member #0744 from health facilities for final approval at the Council’s next meeting.

 

Bud Johnson motioned and Florence Conrad seconded to waive delinquent policy for Tribal Member #2472 and allow assistance 3 haa, 0 puuhara, 1 pupitihara (Verna Reece).

 

Consensus: to allow Stephanie Dolan to file restraining order on resident that is harassing employees and the threat to continue such behavior.

 

Bud Johnson motioned and Dora Bernal seconded to approve travel for 5 non employees to Merrill Potato Festival this weekend, 5 haa, 0 puuhara, 0 pupitihara.

 

Consensus: to allow Fred Burcell to move Tribal Descendant’s trailer park in Happy Camp.

 

Dora Bernal motioned and Florence Conrad seconded to update the Verizon Wireless phone plan that covers picture messages, 5 haa, 0 puuhara, 0 pupitihara.

 

Bud Johnson motioned and Florence Conrad seconded to approve out of state travel for Dora Bernal, Bob Goodwin and Laura Mayton to Las Vegas, NV and allow the change fee from the Albuquerque NM from Dora cancelling her travel to the NCAI Conference to the Gaming Conference, 4 haa, 0 puuhara, 1 pupitihara (Dora Bernal).

 

Next meeting date: November 3, 2010 at 3pm in Happy Camp, California.

 

Bud Johnson motioned and Florence Conrad seconded to adjourn the meeting at 9:11pm.

 

Respectfully Submitted,

 

________________________________

Leeon Hillman, Treasurer

 

Recording Secretary, Barbara Snider