Karuk Tribe – Health Board Meeting

May 12, 2011

Meeting Minutes

Meeting called to order at 3:00 pm

Present:

Arch Super, Chairman

Michael Thom, Vice-Chairman

Florrine Super, Secretary / Treasurer

Crispen McAllister, Member at Large

Alvis “Bud” Johnson, Member at Large

Florence Conrad, Member at Large

Dora Bernal, Member at Large

Wilverna “Verna” Reece, Member at Large

Charron “Sonny” Davis, Member at Large

Absent:

None at this time

The Mission Statement was read aloud by Verna Reece, Member at Large

Agenda:

Bud Johnson motioned and Crispen McAllister seconded to approve the agenda with changes, 5 haa, 0 puuhara, 0 pupitihara.

Minutes of April 14, 2011:

Bud Johnson motioned and Sonny Davis seconded to approve the minutes of April 14, 2011, 4 haa, 0 puuhara, 1 pupitihara (Michael Thom).

Guests:

1. Duke Arwood, Education Coordinator

Duke is present to present a youth Tribal Member’s request to the Tribal Council.

Duke noted that Kevin Harrison is a local Karuk Tribal Member who attends HCHS. Over 90% of the Siskiyou County population lives below the poverty level, and there are fewer opportunities for the youth.

He was invited to attend Las Vegas NV of basketball championships. He was the only student in Siskiyou County and only one of five from California. From this appearance he was then invited to attend a camp in Ohio where over 400 basketball scholarships will be provided. Kevin is carries a 3.5 GPA and his coach have provided a recommendation that he attend. Kevin is gifted in the sport of basketball and the Tribe has previously assisted other gifted other Tribal Members, so Duke would recommend that the Tribal Council provide this funding opportunity for him to attend this camp.

Florence, Florrine and Dora arrived at 3:10pm.

Duke noted that this trip would cost $750 per person (including one older brother chaperone), estimating $2,075.00. He is asking for $350 assistance from the Tribal Council and have the Tribe’s finance department book the flights for him utilizing the government rate. The camp is July 2011. Florence noted that this is an at-risk child and she feels that the Tribal Council should provide assistance for the children that are trying to better themselves and work toward their goals. The child is also paying for majority of the fees himself. Arch recommends that this be tabled to Thursday’s Planning Meeting or later tonight.

2. Eric Cutright, IT Director

Eric is present to introduce Paul Wok. He is the Vice-President of a company in New York. He is present to represent Native Link who will be essential in linking internet services to the Orleans Community. Native Link is 100% native owned and operated and they are looking at having an office on the West Coast. They are working with several Tribes in this area; he feels that they are very dedicated to this area. He thanked the Tribal Council for having time to see him and he feels that he feels that the Tribe has a successful team. Arch inquired if the visit is a part of the grant proposal that the Tribe submitted. Eric noted yes, that with the information from Native Link they will be more prepared to demonstrate need to the community of Orleans for broadband services. He was born and raised in Spokane Washington.

Director Reports:

1.) Daniel Pratt, TANF Director:

Daniel is present to review his written report. He noted that there are currently 64 cash aid cases. This is the normal operational client load for TANF. The county changing to a 48 month cash aid service has not impacted the Tribal TANF program and the staff does not see a large impact and do not feel that one will be present.

He continues to work with Quartz Valley Indian Reservation; and he is having difficulty obtaining an accurate number. They provided their housing numbers and offered 21 cases as their client number, and then when Daniel inquired about further details, the Quartz Valley was going to resubmit further information and he feels that he may have to meet with them to assist them in calculating their client number. He has the State on hold awaiting their clarification however Daniel feels that he may have to travel and meet with their enrollment staff. Florence noted that it was them that contacted the Karuk Tribe to provide services, and he should provide a timeline for a response. Daniel explained that he did but it was not completed. Michael inquired if the Quartz Valley is going to assist their membership with gaming revenues. Daniel noted that the Tribal Members would have to spend out their gaming revenue within 3 months and if they qualify then they would be eligible for Tribal TANF.

Daniel has been working on the Historical Trauma project and it is almost complete. He is excited for its completion.

He reviewed his report providing support services and expenditures of their funding.

The TANF staff has been reviewing the TANF plan and he will be setting a separate meeting with the Tribal Council to seek approval.

The TANF Representatives and he did discuss those options of purchasing TANF vans for each site. He would like the Tribal Council’s approval to move toward this avenue and the funding is available. He would like the authorization to begin working on this.

Dora questioned why there would be three vans when there is one in Yreka. Daniel noted that having a minivan that seats 7 persons would be more beneficial. Florrine noted that the one van getting shared isn’t benefiting the staff.

Michael inquired why the Happy Camp Site Managers would be transporting clients for AOD services in Yreka when that service is provided in Happy Camp. Daniel noted that it is part of their AOD Plan. Michael then noted that

Dora would rather that there are services provided to the families and classes and not on vehicles. Daniel noted that he feels that they are already providing those services and the vans are funded by savings in three years of federal funding. Arch questioned if Daniel has identified this need and Daniel felt that he did, and he knew that this was going to come up with increased services. Arch also questioned the funding that would be used to purchase a vehicle be the same funding that would be used to provide services to clients.

Daniel noted that yes, the funding is from programmatic costs, but it would not be taken from services provided to the clients. Michael reminded Daniel of the license requirements for larger vans.

Laura noted that the TANF program started slow with no too many clients in the beginning. He does need to spend that funding out.

Florrine Super motioned and Florence Conrad seconded to allow Daniel to review purchasing three new vans for the TANF sites, 8 haa, 0 puuhara, 0 pupitihara.

Bud Johnson motioned and Florrine Super seconded to approve Daniel’s report, 8 haa, 0 puuhara, 0 pupitihara.

2.) Mike Edwards, Children and Family Services:

Mike is present to review his written report with the Council. He highlighted his report noting that his department provided services to over 300 clients this reporting period. He continues to work with the TANF Program to maximize services to the clients.

Mike noted that he has made some pretty long distance trips in the last month, as there are trips that need to be done and the transporter is very busy.

Mike is continuing to refer cases to Tribal Court and the ICW has approved hiring Stephanie Dolan to represent the Karuk Tribe regarding a case in Siskiyou County Court. Mike believes that Siskiyou County feels that they provide better services to the youth and that the Karuk Tribe is not servicing their members in their best interest. He is hoping to continue working on this and hopes to change the County’s mind on the services provided to Members by the Tribe.

Mike provided information on Title IV-E and the State’s question on the Tribe’s estimated number. He met with Laura Mayton on the BIA budget to provide a number of children to the State on Title IV-E cases. His recommendation is to submit a number of five (5) cases and the total cost to the Tribe per year, as in a share between the Federal Government, State Government and the Tribe would leave the Tribe paying $1,590 per year, per case. They then would like to know how that would be approved and submitted for the selection of the cases. Michael asked how many cases there are in the County; Mike was unsure however, he knows that it is less. Laura explained that when this was first done there weren’t any cases taken on and with their original estimate of 25 cases; they went with 5 to see how the project moves forward. Michael is concerned how the clients would be recommended for services and how they would be selected for Title IV-E. Mike noted that it would be done similar to how they are done with ICW cases. Mike did confirm that he is unsure how to prioritize the families but a number must be submitted and handling it similarly to ICW was the only way to ensure a review was done each time.

Dora Bernal motioned and Michael Thom seconded to submit a case number of (5) to the State of California for the Tribes Title IV-E program, 8 haa, 0 puuhara, 0 pupitihara.

Florrine Conrad motioned and Michael Thom seconded to approve Mike’s report, 8 haa, 0 puuhara, 0 pupitihara.

3.) Vickie Walden, Dental Office Manager:

Not present, written report provided.

Dora Bernal motioned and Sonny Davis seconded to approve Vickie’s report, 8 haa, 0 puuhara, 0 pupitihara.

4.) Lessie Aubrey, EDHHS

Lessie is present to review her report and present action items. She first asked if Vickie Simmons could take a vehicle to her residence as she lives closer to her travel destination and if the vehicle was allowed to be at her residence rather than coming into Happy Camp it would save time and money. The Council was fine with this.

Lessie then reviewed her report. She would like to seek approval for a consultant to come in and provide some training fort the Health Program. Lessie noted that the increase of unduplicated visits per patient needs to be an estimated 4,000, but the program is not making those numbers. She would like to begin marketing to begin obtaining new patients. Lessie noted that the Yreka facility has really increased their numbers with added providers and added patients due to the only facility open to seeing Medicaid patients. For the other facilities there is only a limited patient population so the focus would be to increase visits at the Yreka site. Lessie would like to work with Dawn Cozzalio on marketing and assist in some techniques. Lessie would like the Council’s approval on working toward marketing. Laura questioned if before the marketing is done can all the patients that are showing up at the facility able to be seen currently. Lessie does not believe that there is a backlog and she only has so much funding to provide services but in order to keep the HRSA grant she must have new patients. There was funding options that the Tribe applied for, but she is unsure of any funding to bring on additional staff or funding to be prepared for increased patients, but that may be needed at some point.  

Dr. Burns believes that the efforts need to be focused in Yreka, and there needs to be another provider in Yreka to see the increased amount of patients. He believes that with the increase, none of the existing clients have reduced services. Lessie would like to market the medical services and the dental services will increase based on that facilities providers and being open. Arch believes that Lessie needs to come to the table with a plan and also review the goals and services to Tribal Members. She feels that this is done and has not heard very many complaints; she has reviewed the complaints and has not seen any trends or patterns identified resulting in the inability to see the patients at the facility. Annie explained that improving patient care is the focus for the facilities and she and Don Barnhart evaluate the clinics point of entry to the facility. This works in conjunction with clinic access. Lessie understands that the facility will be evaluated and bringing in a consultant to assist with marketing will cover if the facility can withstand the increase.

Lessie noted that CRIHB is hoping to have the community begin to get active and involved in voting in the State of California due to the budget cuts that are posed in California. CRIHB is hoping to have Tribes participating and being proactive in registering or encouraging people to vote. Lessie would recommend that getting voter registration forms available at the Tribes offices. She feels this would be helpful to ensure that members are provided the opportunity to vote and be involved in the government of California especially regarding their services being cut. Mike noted that it is harder to get people to actually vote as opposed to just getting them registered.

Lessie then went on to point out information to the Tribal Council regarding information that Jim Crouch is distributing on healthcare reform. All Indian Health Programs in California are recommended to be involved Coverage Expansion and Enrollment Demonstration (CEED). It is unclear if it will be resolved or how it will be applied, but she’d like to know if the Tribal Council would like to participate in this. Michael personally would not like to participate as services should be offered to all persons that there is a need for and only some services can be provided once one person has a large incident and then no further services can be provided to the others. Lessie would like an actual direction for to take. Dr. Burns then went on to explain his previous experience of the Turtle Health Plan and how similar to this new operation that Jim Crouch is discussion would initiate a possible Managed Care Plan; which the Turtle Health Plan found was unsuccessful was well. Michael noted that Lessie should take this to her staff and the employees of the biannual health program to obtain their input thoroughly reviewing all departments and affects to the programs.

Florence noted that CRIHB is going to be working on this and she feels that the Council should wait until CRIHB evaluates it further and makes their recommendation, and at that time the Tribe can evaluate which direction they will support. Dora agrees that working with CRIHB and their review team would be best.

Lessie then went to discuss her vision of “Just Move It” for the theme for the Health Program’s portion of the Tribal Reunion, supporting Michelle Obama’s priority regarding getting the community’s moving and fighting obesity.

There will be staff doing Zumba Dancing classes at each site, preparing for a Zumba Dance at the Reunion. Shirts are being prepared and there were some minor disputes of the “saying” on the shirts, so Lessie would like the Council to pick it, and then no one can dispute them. 

Dora Bernal motioned and Verna Reece seconded to approve the t-shirt language for the Reunion changing the bottom to say “I’m Zumba Dancing”, 7 haa, 0 puuhara, 1 pupitihara (Sonny Davis).

Lessie would recommend purchasing flat screen TVs, DVD players and the arms for mounting the TV’s at each site but she needs the Council’s direction on this request. She would like the Tribe to purchase the items from Administration and the Health Program. She would like three TV’s purchased and mounted in each site, which will be used for the preparation of Zumba at the Reunion but used additionally for any other activity at the facilities.

Verna Reece motioned and Crispen McAllister seconded to approve allowing the purchase of three flat screen 47’ TV’s and necessary items to have the “just move it” project at all three sites, 8 haa, 0 puuhara, 0 pupitihara.

Verna Reece motioned and Sonny Davis seconded to approve Lessie’s report, 8 haa, 0 puuhara, 0 pupitihara.

5.) Annie Smith, PHN:
Annie is present to review her written report. She has one action item. She announced that when she came into this position there was an incident. Upon review of the incident, she is requesting special emblems to be placed on the transporters vehicles. Staff would like to identify the vehicles so that the community knows that as transporters they could patients in their vehicles. Florence noted that when the staff is transporting they should use their disabled stickers to note their purpose. This is coming up from the incident where staff has been harassed because they are employees of the Karuk Tribe and the disagreements regarding dam removal and suction dredge mining. Annie noted that staff is going to homes and now that they are out in the field she is hoping to protect the staff. Lessie explained the incident and the Council agreed that having a “medical” emblem may have some legal requirements attached to it. The Tribal Council is aware of the incident and it was reported to law enforcement.  

Annie then went on to thank the staff for their work on immunization improvements. The Health facility was the highest rate of increase in the State.

Verna Reece motioned and Crispen McAllister seconded to approve Annie’s report, 8 haa, 0 puuhara, 0 pupitihara

6.) Vickie Simmons, Clinical Administration:

Not present, written report provided.

Florence Conrad motioned and Dora Bernal seconded to approve Vickie’s report, 8 haa, 0 puuhara, 0 pupitihara.

7.) Chad Tiraterra, Database Administrator:

Chad is present to review his report. He reviewed his workload reports that he attaches every month, which outline the services provided as entered into the RPMS system at all sites. He reminded the audience and the Tribal Council of the required IHS Security Awareness training that is mandatory for all Council and staff. Failure to comply with the required training will have access to the Tribes computer systems denied and blocked until completed.  

Florrine Super motioned and Florence Conrad seconded to approve Chad’s report, 8 haa, 0 puuhara, 0 pupitihara.

8.) Eric Cutright, IT Director:

Eric is present to review his written report. He noted that the People’s Center Online Gift Shop is up and running. He is thinking of making an announcement through the email system. Veronica is working in the gift shop and is able to upload the items and process the purchases.

Dora asked about the status of the microphone system for the sites. The RFP was completed and a walk-thru was done. The group asked if it was ok to drill holes in table, which the Council was okay with. The group would also like to keep the costs down, so they would like to mount the speakers, and the Council was fine with that. Also, providing the Chairman with a mute option will be done. The microphones will be removable for safe storage. Sara will have the proposals in order by the Planning Meeting.

Monday and Tuesday he and Chris were on travel attending meetings with Datasat and the Happy Camp server crashed. Eric was glad that Chad and the other IT staff that were onsite and they did the best job possible with the failure.

There is an amendment to the fiber optic contract that was approved last month. The contract addendum (1) is to 11-C-044 with Shasta General Engineering in the amount of $56,775 as deposit in place of a required bond amount that the engineer is unable to get. The cashiers check will be deposited into the Tribe’s account and when the project is complete then the Tribe will provide the deposit check in return.

Michael Thom motioned and Crispen McAllister seconded to approve addendum (1) to contract 11-C-044, 8 haa, 0 puuhara, 0 pupitihara.

Florrine Super motioned and Florence Conrad seconded to approve Eric’s report, 8 haa, 0 puuhara, 0 pupitihara.

Guests: Non-Health Employee:

1.) Jaclyn Goodwin, Grant Writer / Resource Developer:

Jaclyn is present to review options of an ICDBG project that the staff has evaluated and to seek the Tribal Council’s approval in a direction to seek funding for. The managers thought that a clinic or wellness center in Happy Camp, then Yreka a similar project. Jaclyn discussed this option with Sue Burcell and collecting the data.

Happy Camp Clinic Project, Yreka Wellness fitness center and a Happy Camp wellness fitness center. Options for the Happy Camp clinic option would be good, but the property at Hwy 96 would be a good option; however the RV Park was considered based on the Tribe owning the RV Park. Dora asked what the time frame is for choosing the project. The project is due June 15, 2011 and Jaclyn is attending training and would like to reference the specific project. Erin discussed the option of purchasing the old HCHS clinic, but the Managers didn’t want to go that route. Michael inquired about the wellness center and the connection with the gym and the billing office. The Council would like to consider the option of how many points there will be for the proposal for the flood plain demonstration for the clinic to be moved.

Verna Reece motioned and Dora Bernal seconded to prioritize the Happy Camp Clinic for the ICDBG grant, 8 haa, 0 puuhara, 0 pupitihara.

Florence inquired what the business plan is for the RV Park. Florence feels that there is the opportunity to work on the option of a hotel for the RV Park. Laura announced that what is being done is to concentrate on cleaning up at the site and removing debris that is hazardous to the community and residents. Also, beginning to address putting FEMA trailers on that site for emergency housing. The motel is salvageable but it needs remodeling and funding to update it. The office needs torn down and having a FEMA office available may be an option. There are several years of built up debris and the process of getting things cleaned up is a priority.

Closed Session:

Florrine Super motioned and Crispen McAllister seconded to approve the revised position descriptions for the Data Entry Analyst II and Data Entry Analyst I positions, 8 haa, 0 puuhara, 0 pupitihara.

Florrine Super motioned and Dora Bernal seconded to approve collection services on $7,879.55 from delinquent debt, 8 haa, 0 puuhara, 0 pupitihara.

Informational: employee # 4811 is present to provide an update on operations and provide a review of his position and salary; The Tribal Council inquired about coverage in other duties and maintaining additional duties. Clarification was provided on each departmental interaction.

Directive: to employee’s #4811, 3770, 0286, 2966 and 3413 to immediately have mediation. Vice-Chairman and one ICWA Representative will participate as a Council Representative.

Michael Thom motioned and Sonny Davis seconded to waive the hiring policy and select employee # 7231 to fill the vacant position at the Yreka Clinic, due to funding constraints, availability, status and need of the facility, 8 haa, 0 puuhara, 0 pupitihara.

Florrine Super motioned and Michael Thom seconded to uphold the CHS denial and pay $598.94 from Third Party for CHS Case, 8 haa, 0 puuhara, 0 pupitihara.

Update/Informational: employee #0506 was present to review several incidents regarding the fiscal department and outcomes. Clarification on procedure of following policies and justification of the outcome was provided.

Verna Reece motioned and Michael Thom seconded to deny payment for VISA charge without a detailed receipt in accordance with policy, 6 haa, 0 puuhara, 2 pupitihara (Florence Conrad and Florrine Super).

Consensus: to deny a tenant request to have a trampoline at the RV Park due to liability.

Florence Conrad motioned and Dora Bernal seconded to approve contracts 11-C-054 and 11-C-055 with changes to amount, not to exceed $50 over the amount of rent plus utilities and approve payment for services in the amount of $46.00 for over and above work done at the RV Park, 7 haa, 0 puuhara, 0 pupitihara (Bud Johnson absent for vote).

Florence stated that communication with the staff is not happening and she reminded the Council to strengthen the people and get them to work together. Florence left the meeting at 8:00PM.

Consensus: to deny approval for employee #3692 to conduct an interview with Hughes Satellite.

Dora Bernal motioned and Crispen McAllister seconded to approve assistance for Tribal Member #1900; total amount shall be sent to TERO Commission, delinquent status removed, new agreement of $100 per month, stipulation of no less than (3) Tribal Members employed on contracts, and balloon payments should be encouraged, co-signer shall be Tribal Member #11, 6 haa, 0 puuhara, 0 pupitihara (Sonny Davis absent for vote).

Michael Thom motioned and Bud Johnson seconded to pay the balance for the necklace supplies from Council Discretionary in the amount of $25, 6 haa, 0 puuhara, 1 pupitihara (Florrine Super).

Consensus: for the Chairman to distribute a memo to appropriate staff regarding Katimin, and the Tribes equipment, resources and employee time.

Consensus: for the Yreka Building rooms to be opened by the Receptionist ensuring the codes are not released and no one enters the rooms while projects are being completed.

Consensus: send notice to employee #3770 to remove debris from hallway in the Yreka Building and to maintain clean and tidy public use areas.

Dora Bernal motioned and Florrine seconded to provide $125 from Booster and $225 booster club for Tribal Member #2864, 7 haa, 1 puuhara (Verna Reece), 0 pupitihara.

Michael Thom motioned and Bud Johnson seconded to approve travel for Dora Bernal; Reno VN July 18-20, 2011 to Reno NV, June 21-22, 2011 Valley Center, June 6-8, 2011 to Sacramento CA, 6 haa, 0 puuhara, 1 pupitihara (Dora Bernal).

Michael Thom motioned and Bud Johnson seconded to approve out of state travel for Dora Bernal, Florence Conrad, and Florrine Super to the WeWin Conference in Green Bay, Wisconsin, August 1-5, 2011, 5 haa, 0 puuhara, 2 pupitihara (Dora Bernal and Florrine Super).

Michael Thom motioned and Crispen McAllister seconded to attend all travels and the extra day in between the 21^st in Valley Center, 6 haa, 0 puuhara, 1 pupitihara (Florrine Super).

Consensus: to have employees # 6868 and 1988 send their schedules to the Tribal Council.

Crispen McAllister motioned and Bud Johnson seconded to adjourn meeting at 10:04pm, 7 haa, 0 puuhara, 0 pupitihara.

Respectfully Submitted,

________________________________

Arch Super, Chairman

Recording Secretary, Barbara Snider