Karuk Tribe - Health Board Meeting
January 13, 2011 - Meeting Minutes
Meeting called to order by Chairman, Arch Super at 3:08 pm
Present:
Arch Super, Chairman
Michael Thom, Vice-Chairman
Florrine Super, Secretary / Treasurer
Verna Reece, Member at Large
Bud Johnson, Member at Large
Florence Conrad, Member at Large
Sonny Davis, Member at Large
Absent:
Dora Bernal, Member at Large (excused)
Crispen McAllister, Member at Large (excused)
Quorum is established.
The Health Mission Statement was read aloud by Florence Conrad, Member at Large.
Agenda:
Verna Reece motioned and Michael Thom seconded to approve the agenda with changes, 6 haa, 0 puuhara, 0 pupitihara.
Minutes:
Verna Reece motioned and Bud Johnson seconded to approve the minutes of December 2, 2010, 5 haa, 0 puuhara, 1 pupitihara (Florrine Super).
Director Reports:
1.) Daniel Pratt, TANF Director
Daniel is present to review his written report with the Health Board. He first would like to seek out of state approval to Mesa AZ February 14-15, 2011 for TANF reauthorization summit. He also extended the information to the TANF Board Representatives.
Michael Thom motioned and Sonny Davis seconded to approve out of state travel for Florence Conrad, Daniel Pratt, Florrine Super and Dora Bernal, 6 haa, 0 puuhara, 0 pupitihara.
His second action item is the Tribal resolution approving the updated Karuk Tribal TANF Plan with the inclusion of the Quartz Valley Tribe to the Karuk Tribe’s Tribal TANF program.
Laura asked if there would be in increase of funding. Daniel noted that based on negotiations this would lead to increased funding to serve that population.
Florence Conrad motioned and Sonny Davis seconded to approve resolution 11-R-001 authorizing revision to the current Karuk Tribal TANF Plan with inclusion of the Quartz Valley Tribe, 6 haa, 0 puuhara, 0 pupitihara.
Daniel then requested approval of an agreement / contract with Handel Technologies that was purchased in June 2010. The process was followed for the procurement and he would now like to have the agreement with Handel approved. When asked why it was being presented now; Daniel explained that the process for having the bids and procurement done was, and approved, however when he had Arch sign the agreement it was found to not have been through the internal process as outline by policy. He now needs to get the paperwork in order and seek formal approval.
Florence Conrad motioned and Florrine Super seconded to approve agreement 11-A-015, 6 haa, 0 puuhara, 0 pupitihara.
Daniel then wanted to seek a revision to that same agreement to purchase a definition package for $2,500 that will allow exporting of reports. This will assist in reporting that is done to the State.
Florence Conrad motioned and Florrine Super seconded to approve modification to agreement 11-A-015 for $2,500 with Handel Technologies, 6 haa, 0 puuhara, 0 pupitihara.
Daniel then went on to review his report. He announced that the program is up to 72 clients. This is pretty normal but the program will not meet their estimate on services. There are issues with the new Governor on his suggested cuts to the Welfare to Work programs, and Daniel will be attending a meeting in Sacramento to reviews options on this funding cuts. He feels that this may be an option to remove funding from the State and then at that point he’ll move to direct funding from the Federal Government. He will keep a close eye on this and report back any changes to funding.
Verna Reece motioned and Bud Johnson seconded to approve Daniel’s report, 6 haa, 0 puuhara, 0 pupitihara.
2.) Mike Edwards, Family & Children Services:
Mike is present to review his written report with the Health Board. He is seeking approval of agreement 11-A-013 between the Child & Family Services Program and Jackson Street Elementary School. This agreement will include the Karuk LCSW’s conducting individual and small groups of services to the children at the school. Its to provide therapy and consultation.
Florrine Super motioned and Florence Conrad seconded to approve agreement 11-A-013 between Jackson Street School and the Karuk Tribe’s Family Services program to, 6 haa, 0 puuhara, 0 pupitihara.
Mike then sought approval of a contract with Barbara Norman, Attorney at Law. He is hoping to have her begin to work on social services committee. He does have money in the BIA compact for the services and will be caped at 16 hours a month.
Florrine Super motioned and Michael Thom seconded to approve 11-C-019 between the Karuk Tribe and Barbara Norman, 6 haa, 0 puuhara, 0 pupitihara.
Mike thanked the Council for increasing his VISA credit card limit fee to $3,000. He went over his limit assisting other departments in purchases and is now seeking Council approval to waive that over limit fee. The Council asked how many instances this has happened, to which Mike noted that is hasn’t before. It was determined that the over limit fee has been waived and covered by the Tribe three other times but Mike was unaware of that. The Council will cover this again, but this will be the last time as its Mike’s responsibility to watch his spending and keep to the limit set on his work issues VISA.
Florence Conrad motioned and Verna Reece seconded to approve covering the fee from Mike Edwards’ VISA card, 5 haa, 1 puuhara (Michael Thom), 0 pupitihara.
Mike explained that there is the vacancy of the Substance Abuse Counselor that services all three areas. Florence would like to see the position flown and an applicant sought for the Orleans, Somes Bar and Happy Camp area. Having someone cover the area that lives or resides outside of downriver leaves them having too much travel time, which provides less services to the clients. Mike noted that this is the reason why the position is being flown for an additional week, because there was only one person applying. Arch was updated on the counseling services offered to Yreka. There is a full time position in Yreka and both Orleans and Happy Camp get a position that is shared part time between both communities’s.
Mike is in the process of transferring another case into Tribal Court. The Council is familiar with it and the County is having issues with this particular case. He continues to work on this and will keep the Council informed.
Michael Thom motioned and Verna Reece seconded to approve Mike’s report, 6 haa, 0 puuhara, 0 pupitihara.
3.) Chad Tiraterra, RPMS Site Manager:
Chad is present to provide his written report to the Health Board. He explained that all three sites have now moved to no paper use records and are actively utilizing EHR. The BETA testing is done and the Patient Registration GUI is complete with release done nationally. It is working well with little to no complaints.
Florence Conrad motioned and Sonny Davis seconded to approve Chad’s report, 6 haa, 0 puuhara, 0 pupitihara.
4.) Suzanna Hardenburger, Business Office Manager:
Suzanna is present to review her written report. She sets her goals for each year and reports on them annually. Her goals for her department this year was to hit the 2million mark in revenue but this year they did not make that mark due to budget cuts.
Suzanna is now in charge of Data Entry again, and she is getting used to it. Her office isn’t very familiar with EHR as they were out of the loop so she will be actively seeking training to meet the needs of her and her staff in the near future.
Verna Reece motioned and Bud Johnson seconded to approve Suzanna’s report, 6
haa, 0 puuhara, 0 pupitihara.
5.) Dr. Burns, Medical Director:
Dr. Burns was not present by his written report was included in their packets.
Michael Thom motioned and Florence Conrad seconded to approve Dr. Burns’ written report, 6 haa, 0 puuhara, 0 pupitihara.
6.) Dr. Schoen, Dental Director:
Dr. Schoen thanked the Council for naming him the Dental Director of the Dental program. There is a vacancy for the Yreka clinic and there were nine applicants. He is interested in interviewing more experienced dentists for round one and he will hopefully have a candidate emerge and on board in early February.
He is just wrapping his mind around the responsibilities of Dental Director so he cannot provide an annual report on the entire program. He assured the Council that he is getting up to speed though. He provided an update noting that he represents the California area for IHS and they advise the surgeon General and the Director of IHS so he assures that Council that the Tribe is represented at the highest level. The Tribe is represented in Washington DC and in Sacramento to which he will fight for dental health with his ability to express the needs of the dental program by his affiliation with and on different boards.
Last year there was a contract with an oral surgeon, Dr. Petersen that comes on site to the Yreka Clinic from Redding each month for a couple days. He will be meeting with Dr. Petersen next week to discuss another year of contracting his service which saves CHS funding each year.
Arch thanked Dr. Schoen for stepping into the Dental Director position.
Michael Thom motioned and Sonny Davis seconded to approve Dr. Schoen’s verbal report, 6 haa, 0 puuhara, 0 pupitihara.
Lessie announced that the oral surgeon saves CHS $50,000 in funding each year.
7.) Flo Lopez, Safety Officer:
Flo is present to provide a written report to the Board. She announced that she is certified for CERT and also has additional emergency training. She provided her annual reports on each of the Tribes clinical sites that she inspected for safety concerns. She noted some electrical safety issues are apparent and she has directed those concerns to the Maintenance Department. There were some deficiencies with equipment but new equipment was ordered to address those. Flo noted some lighting fixture concerns in the Yreka clinic. And with discussion with Lisa Rugg it is now resolved. These are examples of the minor but relevant concerns for safety of the employees and the patients that use the facilities.
Eric then reviewed some security concerns for the sites. Flo discussed the opportunities on security systems for the Tribe’s buildings. The security system has been down for about a year and the maintenance person has fixed it continuously but no one is familiar on how to operate it. Florence then discussed the phone and computer systems and the lack of adequate service for the Orleans area. She noted that if the other areas had similar issues then they would all quit because of the frustration that is involved. She would like to see that time and resources be utilized to include Orleans in technical fixes.
Flo went on to discuss maybe having a total overview of several facilities will get a baseline of issues and then to begin addressing what is needed in each site.
Flo did environmental site visit for each site and they are all neat and tidy. Flo would like to have a Safety Committee formed as the policies address having one. Patti White, the former Safety Officer noted that no one attended, which is why it did not work previously. Flo then asked that there be a safety committee again so that it can work on safety concerns. Vickie noted that there was formally a safety and infection control committee and since David left the group has not met, Flo and Annie will work on this intention again and begin having a group, as the Council was not opposed to the group meeting.
Verna Reece motioned and Bud Johnson seconded to approve Flo’s report, 6 haa, 0 puuhara, 0 pupitihara.
8.) Vickie Simmons, Clinical Operations Administrator:
Vickie is present to provide her monthly report. She recently attended training on AAAHC in Las Vegas. She was unsure about attending but she found so much updated information.
Vickie then went on to review her yearly report. The diabetic eye camera is working well and there is good use of the equipment in the Orleans area. The diabetic luncheons are in order and taking place, which is a great opportunity to provide diabetic education and discuss concerns with each other.
The Employee Christmas Party was held December 10th and she thanked the Council for the party, food and prizes.
She attached her monthly QI reports and ACQI information.
Michael Thom motioned and Sonny Davis seconded to approve Vickie’s report, 6 haa, 0 puuhara, 0 pupitihara.
9.) Eric Cutright, IT
Director:
Eric has a written report included in the Health Board packets but he discussed
the recent trouble in Orleans with the phone systems. Eric believes that this
occurred December 28, 2010. He has phone lines through Verizon and internet
lines through AT&T. When there are issues with the computer systems
AT&T notifies Verizon on phone problems since AT&T needs those phone lines
for computer services. Part of the problem is that when the clinic and DNR
noted there were issues he found that the Orleans server was crashing. So, with
that information Eric called Chris on vacation and received his assistance on
repairing the server enough to get the sites back up and operating smoothly. There
will need to be continued support for Orleans but the broadband options are
very slim. He and his staff continue to review permanent options for keeping
technology up and running for that area. In October there was approval for a
new server and that has arrived, it will be installed and hopefully that will
assist in the services offered to the Orleans facility long term.
Arch asked if this is never going to be fixed because the issue comes back to the Council every other month.
Eric noted that there are some issues that the Tribe has control over that the IT staff is working on. Then there are issues with the phone company and the internet provider that the staff have to work with, although they continue to and are hoping to eventually find a solution. There are no controls on the issues because they are out of the Tribe’s hands. His work with Broadband was a possibility to provide more funding to get new phone lines but that did not flourish. The new server should increase capacity within the next three years and the speed of service and operations of the sites.
Janie asked if a tower in the Orleans area would assist in this issue, as during fire season there seems to be the ability for better services and the USFS has a fix for power outages and down internet providers. Eric noted that there is an option in working with agencies on portable wireless options however there are issues alongside that as well including funding. Hoopa is working on an option right now, and he is hoping to see how this is done at their site to see if it could be shadowed by the Tribe.
Florence noted that the USFS was the entity that brought in a Verizon wireless option for the fire emergency. Eric will prepare broadband options for the Council to review at their upcoming Planning Meeting.
Dr. Burns did want it noted that when EHR goes down it is a real safety issue for the patients. Eric has suggested a read only option for information for the providers in the event of a power outage so that information can be accessed via thumb drive. Eric noted that this was an option but that takes two days to download information so, the planned outages will work but the unexpected outages aren’t prepared for.
Verna Reece motioned and Florence Conrad seconded to approve Eric’s report, 6 haa, 0 puuhara, 0 pupitihara.
10.) Vickie Walden, Dental Office Manager:
Vickie provided a report and an annual report regarding the dental program. She concluded a yearly overview of staffing, budgets and patient visits. She noted the community outreach that is done by Nikki, Dr. Do and in conjunction with the Happy Camp Family Resource Center.
Vickie provided an overview of her report noting the equipment that the dental staff received as a part of the staff’s agreement for outreach training was appreciated and needed. The staff is continually completing essay’s which are going successfully.
The Annual report noted that the Happy Camp dentist is likable. He is enjoying his position and working well in the community. The dental data entry process is getting better. The dental visits show increases each year. They do dental screenings, varnishes and some sealants for students who participate in dental screenings. That program is under review to be cut by the State. The dentist will conduct the school screenings with Nikki to capture more oral health options as they are not going to have the State programs. Those school screenings will be schedules for down river and all the way along the River corridor to Hornbrook.
The California budget cuts impacted the dental funding and she is unsure of how much until she receives some reports from different departments but she continually monitors cuts and understands the impact that it will eventually have on the dental program.
Verna Reece motioned and Michael Thom seconded to approve Vickie’s report, 6 haa, 0 puuhara, 0 pupitihara.
11.) Lessie Aubrey, EDHHS:
Lessie noted that she had drafted some language regarding consultation and Florrine and Arch were very supportive of that work and attended meetings.
She held an awards luncheon for employees that have held their position for ten years for the Karuk Tribal Health Program. She feels that acknowledging employees for staying with the programs is a good avenue of appreciation and shows dedication to those employees for their continuity. There have been some coverage issues but that is working out nicely thanks to the providers working together and sharing areas. There was equipment ordered for Orleans clinic and it is enroute.
Lessie completed all her evaluations for the health program.
She enjoyed the Christmas party this year and she was thankful to win the binoculars.
Lessie noted the priorities for 2012 by the IHS CAO; CHS, Indian Health Care Improvement Fund, Diabetes and related complications, Behavioral Health, Cancer, Heart Disease, Dental and some critical priorities; water/sanitation projects and M&I funding, HFC priority systems are distribution, small ambulatory allocation per project and injury prevention. She will review these priorities as they will tail what the Tribal Health Program has to meet.
Florence Conrad motioned and Sonny Davis seconded to approve Lessie’s report, 6 haa, 0 puuhara, 0 pupitihara.
12.) Annie Smith, Dir. Community Services:
Annie Smith is present to review her written report. She thanked everyone for being very helpful in assisting her in her new position. She thanked Vickie and Eric for their assistance. The IT lines that go to the KTHA building, where her office is, where she is often experiencing problems; Eric has always assisted Annie and he never puts his other pressures on her. She noted how nice that it is to have his assistance, while she learns her new position.
The end of the diabetic audit is nearing completion. She is learning RPMS and EHR as she has never worked with the Tribe’s system before. She is excited to have the data collected and reports that may be generated once she gets her staff to begin using all the fields. This will assist in accountability and reporting for displaying the ongoing needs of the Tribe’s patients.
Vickie Walden discussed the Alzheimer’s care that is provided and how to assist in care giving classes or how much that is needed in this area.
Florrine asked what kinda of community outreach projects Annie is working toward. Annie noted that she is working toward diabetic services as this is huge in all three communities. She will hopefully move to having one day at each site where she can focus on each diabetic patient when they come in regarding a visit, she will then conduct their foot checks, immunizations and eye exams. This would assist in the diabetic audit and capture the needed care for diabetic patients. Annie then went on to conclude that this is a priority and she will move to more detailed work. Annie will begin to work more toward CHR visits and getting the patients accounted for in RPMS to help identify continued care.
Florrine asked if Annie is going to track this information and begin to interject what their individual healthcare needs will be either diet or environment. Florrine asked if that was going to be tracked and Annie and she noted yes, that as a Director she will monitor the patient needs and work with the CHR’s in each community developing care and plans for the patients that need home checks and continued care.
Verna Reece motioned and Sonny Davis seconded to approve Annie’s report, 6 haa, 0 puuhara, 0 pupitihara.
Guests Non-Health Employees:
1.) Erin Hillman, Dir of Admin Programs and Compliance:
Erin has her first action item modification #2 to 10-C-030 with Dan Simon.
Florence Conrad motioned and Sonny Davis seconded to approve modification (2) with Dam Simon, extending the timeline, 6 haa, 0 puuhara, 0 pupitihara.
Her second action item is an agreement with IHS to provide water and waste water services to a Tribal Member in Etna.
Florence Conrad motioned and Bud Johnson seconded to approve agreement 11-A-012, 6 haa, 0 puuhara, 0 pupitihara.
Her third action item is to accept a CSD contract under resolution 11-R-005 for acceptance of $42,000. This is the base funding for the Tribe’s program.
Michael Thom motioned and Florrine Super seconded to approve resolution 11-R-005, 6 haa, 0 puuhara, 0 pupitihara.
Erin presented a clarification to the recent fiscal policy revision including a clarification on the process for contracts under $2,000 and who the allowable staff and Council Members are that may sign off on those contracts internally.
Florence Conrad motioned and Sonny Davis seconded to approve the clarification on the fiscal policy, 6 haa, 0 puuhara, 0 pupitihara.
2.) Jaclyn Goodwin, Grant Writer
Jaclyn is present to seek approval for resolution 11-R-007 authoring submission of a proposal to HRSA for $200,426. This funding will be used to pay for a part time CHR in Happy Camp, a full time Elders worker in Yreka and a part time provider for the Yreka clinic. The goal for HRSA is to increase patient services so Yreka is the community where more patients can obtain services, meeting HRSA’s requirements of increased care.
Michael Thom motioned and Bud Johnson seconded to approve resolution 11-R-007, 5 haa, 0 puuhara, 1 pupitihara (Florence Conrad).
Jaclyn then went on to seek approval for the CSD pass thru funding.
Florence Conrad motioned and Florrine Super seconded to approve resolution 11-R-006, 6 haa, 0 puuhara, 0 pupitihara.
3.) Laura Mayton, CFO
Laura is present to seek approval of resolution 11-R-010 for officers authorizing to sign OST documents. They require a list of individuals that are authorized to sign documents and access OST funding.
Florence Conrad motioned and Michael seconded to approve resolution 11-R-010, 6 haa, 0 puuhara, 0 pupitihara.
Closed Session:
Consensus: to refer Tribal Member #2220 to CHS and have the item tabled to Thursday for final review.
Consensus: to table Tribal Member #1342 request to Thursday for Barbara Norman to review time and charges of the case.
Consensus: to initiate a flat rate of charging community members $13 per CPR class.
Consensus: for employee #3413 and #3476 to discuss coverage option, present personnel concerns to Human Resources and determine a recommendation for the Tribal Council to follow.
Sonny Davis motioned and Michael Thom seconded to approve procurement and allow the remodel project for the Yreka Clinic, 5 haa, 0 puuhara, 1 pupitihara (Florence Conrad).
Consensus: for employee #8819 to be reclassified immediately upon review with Human Resources and have employee #4811 assume oversight of the facility and employees.
Consensus: to table pay increase request for employee #4811 to Thursday’s Planning Meeting.
Michael Thom motioned and Florrine Super seconded to approve the internship position description at $25 stipends totaling $1,600 per month, 6 haa, 0 puuhara, 0 pupitihara.
Consensus: to deny waiving the delinquency policy as presented by employee #4895.
Consensus: to draft a response to the KS Wild letter that was sent to a Tribal Member and forwarded to the Tribal Council.
Florence Conrad motioned and Verna Reece seconded to approve agreement 11-A-014 authorizing the name change from Karuk Tribe of California to Karuk Tribe, 6 haa, 0 puuhara, 0 pupitihara.
Consensus: to refer Tribal Member #1516 to CHS for review of the costs; to deny reposting of DNR position, and note the understanding that only the Chairman and Vice-Chairman are to sign attorney invoices.
Consensus: to determine where the seals are for the Tribal Vehicles and ensure that the Council’s previous approval to have them put on all vehicles is being done.
Michael Thom motioned and Florrine Super seconded to approve Florence and Sonny to travel to Sacramento CA, February 2, 2011 for MLPA meetings, 4 haa, 0 puuhara, 2 pupitihara (Florence & Sonny).
Consensus: for Florence Conrad and Florrine Super to review options of travel /training costs to some committees to see if they can assist in providing funding for Tribal Member #451.
Next Meeting: February 10, 2011 at 3pm in Happy Camp CA.
Bud motioned and Michael seconded to adjourn meeting at 8:22 pm, 6 haa, 0 puuhara, 0 pupitihara.
Respectfully Submitted,
________________________________
Arch Super, Chairman
Recording Secretary, Barbara Snider