Karuk Tribe - Health Board Meeting

March 10, 2011 – Meeting Minutes

Happy Camp, CA

Meeting called to order at 3:01pm by Michael Thom, Vice-Chairman

Present:

Michael Thom, Vice-Chairman

Florence Conrad, Member at Large

Verna Reece, Member at Large

Bud Johnson, Member at Large

Dora Bernal, Member at Large

Crispen McAllister, Member at Large

Absent:

Arch Super, Chairman (travel/excused)

Florrine Super, Secretary (absent/excused)

The Health Mission Statement was read aloud by Florence Conrad, Member at Large

Verna Reece motioned and Dora Bernal seconded to approve the agenda with changes, 6 haa, 0 puuhara, 0 pupitihara.

Health Board Meeting minutes of February 9, 2011:

Dora Bernal motioned and Sonny Davis seconded to approve the minutes of February 9, 2011, 6 haa, 0 puuhara, 0 pupitihara.

Directors Reports:

1.) Daniel Pratt, TANF Director:

Not present, written report provided.

Verna Reece motioned and Dora Bernal seconded to approve Daniel’s report, 6 haa, 0 puuhara, 0 pupitihara

2.) Mike Edwards, Children & Family Services:

Not present, written report provided.

Dora Bernal motioned and Verna Reece seconded to approve Mike’s report, 6 haa, 0 puuhara, 0 pupitihara.

3.) Eric Cutright, IT Director:

Eric is present to review his written report with the Health Board. He would like to seek approval of several action items.

His first action item is procurement for the generator building with Peterson CAT. He received an invoice that was below budget to have the certification done on the generator building. Once the invoice was done it came in higher due to the extra work that was needed to make the entire operation certified. The total amount is $2,467.50.

Florence Conrad motioned and Bud Johnson seconded to approve the procurement and allow payment to Peterson CAT for $2,467.50, 6 haa, 0 puuhara, 0 pupitihara.

Eric then went on to seek approval for a copier for the Yreka TANF program. Along with the procurement for Ray Morgan is an agreement with them for five years that covers everything but paper and staples. This includes toner and full service when there are issues with the machine. Ray Morgan has always been able to serve the copiers that the Tribe has, and the agreement is standard for the other copiers as well. The total amount is $6,995.00 and the maintenance agreement is a minimum of $3,150.00 over five years.

Verna Reece motioned and Florence Conrad seconded to approve procurement and for the purchase of the copier and the agreement with Ray Morgan, 6 haa, 0 puuhara, 0 pupitihara.

Eric then provided a resolution between the Karuk Tribe and Entertribe INC, to work together. Entertribe will work with the Karuk Tribe in searching for grants that will cover providing services to the Orleans community in regard to information technology and once a grant is sough and funded the resolution will hold the Karuk Tribe to continue working with Entertribe INC. The proposals drafted will be brought back to the Tribe for formal approval and each step communicated to the Council however they are seeking a resolution to complete the working relationship. The resolution is 11-R-030.

Verna Reece motioned and Crispen McAllister seconded to approve resolution 11-R-030 between the Karuk Tribe and Enertribe, Inc, 6 haa, 0 puuhara, 0 pupitihara.

Eric then present his third action item, which is not in his packet of information. They are two letters of intent for supporting the grant to California Telehealth Network Model eHealth Community Opportunity. This is a Siskiyou County Collaborative that will provide funding for retina scans and electronic telehealth. The California Telehealth has chosen to offer between $300,000-$500,000 dollars to three communities that are in the Telehealth sites. The Health Program was approached by two organizations to seek support of their proposals. CRIHB is the other organization that is seeking the Tribes support. The benefits to joining the funding proposals is that if either is funded, then the Tribe may end up gaining some funding between $25,000 to $100,000 and additional support for the telehealth that the Tribe already provides but can utilize this funding to offset some costs or improve services.

Eric did state that if the Telehealth Network is funded then the Tribe would join the network and then they would have to disconnect internet connection from AT&T which would incur a termination fee but over two years that would reduce. Currently, the fees from Telehealth are less but it only affects the health program and the AT&T connection would still be needed for the Administration office. To cancel the connectivity for internet services with AT&T would cost approximately $45,000 in fees plus the cost to connect to Telehealth. If for any reason the Tribe does not want to continue on supporting Telehealth they may choose to no longer support it. The discussion will be moved to closed session for further discuss the Tribe’s interest to sign either support letter.

Eric then went on to discuss the microphone system for each site. The cost would be estimated at $10-$15,000 per Council Chamber. Dora did mention that there is the opportunity to rent the microphones. Eric announced that him, Sara and Ruth have volunteered to work on this project. Dora would prefer to have the staff obtain the cost estimates for renting the services for the Yreka Council Chambers first, because it’s needed the most.

Verna Reece motioned and Bud Johnson seconded to approve Eric’s report, 6 haa, 0 puuhara, 0 pupitihara.

4.) Vickie Walden, Dental Office Manager

Vickie is present to provide her report with the Board.

Vickie announced that she received notice that there has not been a dentist hired for Yreka to date. There were several interviews conducted with only one applicant selected, which they turned down. Vickie is waiting on news for the Yreka dentist before training plans are done for the clinics to ensure training is completed for CEU’s and there is still care provided for emergency services. This will be taking place in May 2011.

Vickie announced that there will be several items that will be purchased for the dental office, moving them to electronic health records and Chad will have further information regarding that.

Vickie also reviewed the hygienist program and the outreach that is being done. Dr. Do and Nikki completed all the school screenings, even for the Yreka area. When the Tribal Council inquired about the Happy Camp providers completing the screenings in all areas; Vickie announced that Dr. Do provided majority of the services to the Yreka area due to the Yreka department being short staffed.

Verna Reece motioned and Florence Conrad seconded to approve Vickie’s report, 6 haa, 0 puuhara, 0 pupitihara.

5.) Lessie Aubrey, EDHHS

Lessie noted that there is an emergent need to get the Orleans facility a security camera set up immediately. The staff reviewed a security system option. IT would like to get two cameras for the Orleans facility. Chad estimates $1,400 for the equipment and there is a new server, but it will take staff to review the tapes, if an incident occurs. When questioning the exiting of the building to determine who leaves the building last, it was concluded that the DNR staff must have access to the facility, but they need to remember to lock the doors of the facility before leaving for home. Florence noted that she has a list of things that DNR staff does at night contained in a check list. It is undetermined who is entering the facility, the Orleans clinic doors are locked when the facility is closed, however it appears that someone is entering it after all staff leaves; security is needed.

The cameras may require some hardware equipment, which would be additional costs. The cameras are similar to motion lights. Someone would just have to review the tapes from time to time. Chad will work on a quote for the equipment and cameras and bring that information back to the Council.

Lessie has received a request that the Orleans facility needs a part time staff person. The staff person handling the front office is very overwhelmed. Lessie is hoping to bring in a person 3 hours a day, 4 days a week. Dora asked how many patients are seen per day, and Lessie was unsure. Dr. Burns announced that he is seeing ten patients a day; and that is a high number. The billing is done in Happy Camp but the providers enter their own data which is billed out. Suzanna noted that the audit is done by the clerks and billing is done.

Lessie explained the difference in the Happy Camp Clinic and the Orleans Clinic. In Happy Camp the patients seen per day is; 11 patients a day is estimated that are seen in Happy Camp with a 1.8 equivalent providers. Approximately 8 – 10 are seen a day in Orleans by just one provider. Dr. Burns noted that there is a transition time that is taking place for the transfer to the EHR. Dr. Burns believes that it is reasonable to complete a time study and also to have the additional staff. Suzanna explained that Tawnia is proficient, but she, as with any person handling a whole office will have a learning curve. Suzanna believes that if there is a temporary person brought in there may be some assistance to get her caught up and identify if they are in fact having a flow problem. Dr. Burns noted that an issue with referrals is the calls are not easy to do and complete while you are being interrupted. Dr. Burns discussed the coverage that is done at the Happy Camp clinic vs. the Orleans clinic.

The Council asked how long Lessie is recommending having this position. Michael suggests hiring a part time receptionist for the Orleans facility and allow Tawnia to work on all the back office duties, getting that facility up and running. She has extensive experience in the flow of a facility, so giving her time to focus on referrals, charts and necessary back office work, without distraction may help tremendously. This will be moved to closed session.

Lessie then asked for Babbie Peterson and Darlene to attend Washington DC for Title VI programs training.

Florence Conrad motioned and Dora Bernal seconded to approve out of state travel to Washington DC for Babbie Peterson, Darlene Snapp and tentatively Florence Conrad for Title VI training, 6 haa, 0 puuhara, 0 pupitihara.

Lessie then went on to discuss funding for obesity prevention to assist in the capability of changing lives and getting a handle on the issue at hand across the nation. The Health Program is looking forward to having volunteers assist in working together on ideas that work for the area and for the community. One idea is to have a community garden.

Lessie announced that she and Bob Goodwin went to DC and were not allowed to speak to the Government officials. They left, because it was understood that no staff were going to be given the opportunity to speak and bring their program issues forward.

Crispen McAllister motioned and Bud Johnson seconded to approve Lessie’s report, 6 haa, 0 puuhara, 0 pupitihara.

6.) Annie Smith, PHN

Annie provided procurement documents and is seeking Council approval and advice on a vehicle purchase. The health program is hoping to find a vehicle replacement for Kristen King. The options are to allow Kristen to wait until June for a vehicle and continue to use one from the fleet, while waiting for a vehicle to come in. Erin asked if Annie had complied with the fiscal policies, which outline that the compliance and finance review her documents prior to being approved. Annie did not, as she didn’t know the policy. This action item will be tabled to next Thursday’s Planning Meeting, allowing Annie time to follow policy.

Annie then went on to highlight the remainder of her report. The staff has been continuing to work in the field incorporating home visits for diabetics and Elders. The CHR’s are doing a lot of work and RPMS is being utilized for data collection. There are staff that is having a harder time than others, but she is providing training as necessary.

Florence Conrad motioned and Bud Johnson seconded to approve Annie’s report, 6 haa, 0 puuhara, 0 pupitihara.

7.) Vickie Simmons, Clinical Operations Manager:

Vickie has no action items but is present to review her written report. She continues to work on reporting and distracting immunization data from RPMS and uploading it to the State registry so that the information is reported accurately to the State.

She also explained the complaints and the incident reports for the month, noting that they have reduced and the process to investigate the ones received.

The ACQI Reports and meeting minutes are attached to her report.

Verna Reece motioned and Dora Bernal seconded to approve Vickie’s report, 6 haa, 0 puuhara, 0 pupitihara.

8.) Chad Tiraterra, RPMS Site Manager:

Chad has not action items but is present to review his written report with the Board. He has begun receiving the equipment to move the dental office to DentRix. He is hoping to move them toward EHR and continues to review funding opportunities for the dental office. The cost to move a facility to full EHR is expensive but he is managing the equipment purchases to get the best service for the facility and employees.

Verna Reece motioned and Florence Conrad seconded to approve Chad’s report, 6 haa, 0 puuhara, 0 pupitihara.

Non Health Employees:

1.) Erin Hillman, Dir Admin programs and Compliance

Erin is present to provide a resolution for the home that is going to be purchased by the Tribe. It is resolution 11-R-028 request for authorization of acquisition.

Florence Conrad motioned and Bud Johnson seconded to approve resolution 11-R-028, 6 haa, 0 puuhara, 0 pupitihara.

2.) Sara Spence, Human Resources:

Sara is present to seek approval of action items. Sara is present to seek approval of an agreement with COBRA insurance. COBRA requires access to determine who has been offered COBRA insurance.

Florence Conrad motioned and Bud Johnson seconded to approve agreement 11-A-031, 6 haa, 0 puuhara, 0 pupitihara.

She then sought approval of agreement for ensure use of the Happy Camp River Park for $300 along with the needed insurance policy for the 2011 Karuk Tribal Reunion, 11-A-032.

Verna Reece motioned and Crispen McAllister seconded to approve agreement 11-A-032, 6 haa, 0 puuhara, 0 pupitihara.

Her last action items is to seek approval of the Newsletter, which she distributed to the Tribal Council in their mail boxes and electronically. Verna would like to see the Newsletter more limited, as it appears some of the information inserted is large, costing the Tribe a lot of money. Ideas were discussed on reducing the announcements pages to allow information sharing to the Membership, also having fewer pages per person so that more information can be provided and not drawn out. Dora noted that it is rather large. Sara commented that if the Council has any changes, then they just have to tell her and she will edit it further to meet their requests and suggestions for change. She is unaware of any suggestions that the Council has had previously, so she was not able to implement them for this Newsletter. Also, the Council as final approval, should edit, cut, erase or remove any sections they see appropriate.  

Florence Conrad motioned and Verna Reece seconded to approve this version of the Newsletter and moving forward all articles will try to stay at one page and some edits shall be done to make it more Tribal Member informational, with announcements condensed, if possible, to fewer pages, 6 haa, 0 puuhara, 0 pupitihara.

3.) Ruth Rouvier, Language Program

Ruth is present to seek approval of 11-C-029 between OSU and the language program. It is for the Northwest Language program to facilitate strategic planning for the program as previously discussed in March but it will be pushed back due to how long it has taken to complete the contracting process. The retreat will be done in May for two days to discuss a 20 year plan. Crispen, as the Council representative will attend the strategic session.  

Crispen McAllister motioned and Florence Conrad seconded to approve the contract 11-C-029, 6 haa, 0 puuhara, 0 pupitihara.

Closed Session:

Verna Reece motioned and Crispen McAllister seconded to sign a letter of support to both funding agencies, 6 haa, 0 puuhara, 0 pupitihara.

Consensus: for the IT Department to meet with the TANF Program staff to review options of service and together determine what works best for the Tribe and its network. The meeting outcome shall be reported back to the Tribal Council.

Consensus: to allow and post for a staff person part time, temporary for the Orleans facility; if additional staffing is needed then that will be discussed further once the need is identified.

Verna Reece motioned and Sonny Davis seconded to approve travel for Blue Lake travel for Crispen McAllister to attend Native American Indigenous persons and HSU for a meeting, April 20-22, 20113 haa, 0 puuhara, 3 pupitihara.

Consensus: to allow Tribal Member# 1032 to maintain payments and have full pay off at the end of April.

Dora Bernal: Florence Conrad motioned and Crispen McAllister seconded to approve Dora’s travel/training to San Diego CA, April 27, 2011 for DCI training, 6 haa, 0 puuhara, 0 pupitihara.

Florence Conrad motioned and Bud Johnson seconded to approve travel for Bob Goodwin and Dora Bernal to Sacramento CA for a CNIGA meeting, March 30, 2011, 5 haa, 0 puuhara, 1 pupitihara (Verna Reece).

Consensus: to table the loan request from Tribal Member #11, while the Vice-Chairman reviews alternate options of payment.

Florence Conrad motioned and Bud Johnson seconded to approve travel for Michael Thom to Squamish WA, March 30, 2011 for consultation, 6 haa, 0 puuhara, 0 pupitihara.

Consensus: for the Vice-Chairman to address concerns with employee #4249 on cooperating with the operations of the Tribe; and employee #7317 regarding reported concerns

Consensus: to ask that Directors or Programs begin to forward Council copies of their departmental policies to ensure Tribal Council can review them as necessary.

Next Meeting Date: April 14, 2011 at 3PM in Happy Camp, CA.

Dora Bernal motioned and Verna Reece seconded to adjourn at 6:57, 6 haa, 0 puuhara, 0 pupitihara.

Respectfully Submitted,

________________________________
Michael Thom, Vice-Chairman

Recording Secretary, Barbara Snider