Karuk Tribe
Health Board Meeting Minutes
February 9, 2012
Happy Camp, California
The meeting was called to order at 3:01pm by Russell Attebery, Chairman.
Roll Call
Present
Russell Attebery, Chairman
Michael Thom, Vice Chairman – 3:06pm
Joseph Waddell, Secretary/Treasurer
Dora Bernal, Member
Sonny Davis, Member
Alvis Johnson, Member
Crispen McAllister, Member
Wilverna Reece, Member
Quorum is established.
Alvis Johnson opened the meeting with the blessing; Dora Bernal read the Mission Statement of the Health Program.
Approval of the Agenda for February 9, 2012
Verna Reece moved and Crispen McAllister seconded to approve the Agenda with additions. 6 haa, 0 puuhara, 0 pupitihara.
Approval of the Minutes for January 12, 2012
Dora Bernal moved and Verna Reece seconded to approve the minutes for January 12, 2012. 6 haa, 0 puuhara, 0 pupitihara.
Michael Thom arrived at 3:06pm.
Guests
1) Ducayne Arwood
He recently met with the Head Nurse at COS’ Nursing Program and there is the potential to develop a partnership with the Tribe to help Tribal Members enter their nursing program. He would like to find out how he should approach such a partnership. He was advised to work with Lessie and pursue that as part of his position as the Education Program Coordinator. It could benefit students in the local communities. They would need to do internships with the Tribe to complete their schooling at COS. The staff would supervise them in the clinics. Annie states that it is required through the LVN program that an RN oversee the interns; currently only she and Mike Lynch are RN’s. Annie would be happy to meet with Duke and see what commitment would be necessary from the staff to explore it further, the time commitment from herself and Mike would determine if she could accommodate something like that.
Lessie states that in the past the medical providers have not wanted to supervise the staff as it consumes too much time but if the college provides a supervisor or some sort that would be helpful. Vickie states that they have had Medical Assistant interns work in the clinic that have been very helpful in staffing as there is no cost.
2) Old Business
None at this time.
Director Reports
3) Daniel Pratt
He reviewed the information contained in the written report which was included in the packets with statistics for the program.
He met with Scott and they are in the process of closing escrow on Dr. Williams’ office in Yreka and the TANF program can potentially move within a month or so after they transfer IT infrastructure to that new site. He states that once they are established in the new Yreka building he plans to add an Assistant Case Worker to handle the increased caseload with Quartz Valley.
The ACF annual report has been completed and was included in their packets for review. Several areas of the annual plan refer back to the TANF plan and their policies and procedures. Michael asked if there is an annual financial report. Daniel states he can include that in his reports in the future if they would like to see that information. Yes, they would like to see that.
They held their TANF meeting today and will follow up on those items, some of which will be discussed in closed session.
Crispen McAllister moved and Joseph Waddell seconded to approve Daniel’s report. 7 haa, 0 puuhara, 0 pupitihara.
4) Mike Edwards
Mike was present to review his written report; he has two action items for approval.
The first is Resolution 12-R-014 for an ICWA Case that has been approved by the Committee for an intervention on a dependency case.
Dora asked for clarification on the purpose of the Resolution; Mike states that an intervention makes them a party to a case allowing access to all information relevant to the case and court proceedings. Michael suggested that when the ICWA Committee approves the Resolutions he should reference that date on the Resolution so they know when it was approved by the committee. There could be two Certification sections at the end showing each approval.
Michael Thom moved and Verna Reece seconded to approve Resolution 12-R-014. 7 haa, 0 puuhara, 0 pupitihara.
His second action item is approval for CRIHB Case Management Training, March 5-9, 2012 for Joe Snapp to Sacramento as well as his intern Steve Fisher. Because Steve is not an employee it requires the approval of the Tribal Council. This will provide CEU credits for Joe and help the intern move closer to his certification. It indicates that CRIHB will reimburse CAIHS programs for the costs; it is not likely they would cover the intern.
Dora Bernal moved and Joseph Waddell seconded to approve the travel for Joe Snapp and Steve Fisher to Sacramento, March 5-9, 2012. 7 haa, 0 puuhara, 0 pupitihara.
Mike also states that Tribal Member MH is currently in rehab and CAIR has cut back on dollars for that type of assistance. There are no beds paid for by that program available right now. This member is currently in the Jordan House in Crescent City and he is requesting approval to cover 30 additional days of treatment as required by probation. The only source to cover that would be through Joe’s program, with their approval. The cost would be $400. Dora asked if they have extended their stay before. No, this would be the first extension. Joe’s program can cover the cost.
Verna Reece moved and Crispen McAllister seconded to cover the cost of $400 from Joe’s program for a 30 day extension for Tribal Member MH. 7 haa, 0 puuhara, 0 pupitihara.
He referenced his report and his pleasure with the construction at the old KCDC Building and how they are moving forward with those renovations. There are many programs that will work together and share that facility when it is finished. Verna asked who designed the floor plan for KCDC; it is not a good one.
Verna Reece moved and Sonny Davis seconded to approve Mike Edward’s report. 6 haa, 0 puuhara, 0 pupitihara (Joseph Waddell, not present for voting).
Mike states that in keeping with the traditions of his Tribe, Cree of Northern Montana, it has been his pleasure to work with the Karuk Tribal members and he presented the Tribe with an arrow that was used to kill his first turkey on Karuk Land. He left it with them as a parting gift. Russell states it was a pleasure to have met him and they hope to see him again and welcome him back if he needs help with anything.
5) Annie Smith
Annie was present to review her written report, she would like to speak about the Elder’s program and how that works. IHS classifies Elders and CHR’s as the same type of worker doing field work and home visits. There are 246 elders in Yreka including Scott Valley, Hornbrook, Montague, Yreka, and South Yreka to Weed. There are 106 in Happy Camp and an unknown number in Orleans. Clarence is working through them by section, Flo is also working through them in sections based on the names they have in their database. Clarence has made it to 150 which is over half.
The issue she has encountered is that there are Elders in need of placement because they are unable to continue to live in their homes because the care and conditions are not stable enough for them to remain there. There is one particular case that she has committed over 6 months to including multiple site visits to facilities. There is a facility outside of Grenada with two beds available to a client with limited income (social security). She states that after all of that work, the family has pulled back and chang ed their mind and said no. She sees the need, has committed the time, and now cannot move forward without the families’ support. She understands it is difficult to put a loved one into a facility, but they have to focus on what is best for the person and she will continue to pursue this and try to convince them that it is the right decision. She only brings it up because it is a very small community and it might come up in conversation at some point.
She states that she can only share what HIPAA and the family will allow her to share but anytime they have a question, she is more than happy to discuss any concerns they may have.
She states that Flo is currently doing taxes for the elders as she is certified to provide that service. They are preparing for the AAAHC survey this year as well. She continues to track the elders and ensure that they are getting services as needed.
She states that long distance transports also put a strain on their staff taking them away from the office for multiple days when needed. She states that she is working on five elder cases to ensure that necessary items are being addressed.
She states that she has also been helping in the clinic as they are short staffed in Yreka and with her RN license she is drawn upon to help at times. She states that they will be having a discussion soon regarding the necessity of a flu policy to prevent employees from coming to work when they are sick and to encourage employees who have contact with the patients and public to obtain their flu vaccine as recommended by the State. The suggestion would be to disallow use of sick leave if someone contracts and illness that could have been prevented by a vaccine. They can choose if they want to carry through on that. Laura states that if there is an adverse reaction to the shot, the Tribe would then be responsible for those costs and held liable. Annie states there are provisions for that. She will bring a copy to the next meeting.
Verna Reece moved and Alvis Johnson seconded to approve Annie’s report. 7 haa, 0 puuhara, 0 pupitihara.
Mike states that adding another transporter would be a useful expenditure of dollars to allow CHR and Elders worker to spend more time on in home clients and not take them out of service for several days at a time.
6) Vickie Simmons
She was present to review her written report. She went straight to her action items, there were five policies included in her report and emailed to the Council by Patti on January 26. Three of them are being reapproved without changes.
Michael Thom moved and Crispen McAllister seconded to approve policies 06-001-256: Medical Clinic Appointment System, 06-001-261: Purpose of Patient Health Record, 06-001-264: Inactive Record Storage, 06-003-270: Charting Guidelines, and 07-000-100: Policy on Patients with Possible Communicable Infections. 7 haa, 0 puuhara, 0 pupitihara.
She also has an action item for presentation from the Yreka Clinic. It is a request to renew the contract for their Janitorial Services. They want to renew the contract with the current vendor and it has been through the internal review process. It would be Modification #1 to Contract 11-C-035 extending it through February 28, 2013 with no change to the cost.
Verna Reece moved and Crispen McAllister seconded to approve Modification #1 to Contract 11-C-035 with Nean’s Cleaning through February 28, 2013 with no cost change. 7 haa, 0 puuhara, 0 pupitihara.
She states the AAAHC application was submitted last week for reaccreditation in August. They have stated that they will likely come two months prior to their expiration which could be May or June for a survey. They are all working diligently to ensure that they will be prepared for the visit and ready to meet with them and following all guidelines in place.
Michael Thom moved and Sonny Davis seconded to approve Vickie’s report. 7 haa, 0 puuhara, 0 pupitihara.
7) Chad Tiraterra
Was present to review his report.
He has an update on EDR; they had a meeting and determined that July would be a good time to start training with Dentrex. They have tentatively scheduled July 13 and 16 for that training; he is waiting to hear back from the staff if that will be acceptable. The software is in place and the coding is being updated to comply with IHS standards.
He included the operations summaries for January and states everything is running smoothly.
Verna Reece moved and Alvis Johnson seconded to approve Chad’s report. 7 haa, 0 puuhara, 0 pupitihara.
8) Eric Cutright
He was present to review his written report and had intended to have one action item; however, it is still being reviewed. He will bring it to either next week’s planning meeting or the Council meeting later this month. Once reviewed and approved it can lower their internet and data costs. They have to decide this month if they want to participate or they cannot join in. There is a cancellation fee through AT&T which is the reason he has been waiting until the last minute; that fee would be about $25,000. They would be changing over to the California Telehealth Network which would be faster service for the offices and clinics. He will analyze the costs and savings and meet with Laura prior to presenting the proposal.
He provided an update on the Orleans broadband project. He has contacted the regulatory agencies that will need to approve running fiber along Ishi Pishi Road into town. Those will be PG&E and Verizon. Both are saying that they have to obtain phone company status to operate within their territory. After the Tribe obtains that status, they will have a choice if they want to use it to provide service to the community or not and they do not have to decide on that right away. The cost will be $11,000 to gain that status, the majority of which is legal fees. Once completed, the Tribe will own the license. The costs will come from the 1.1 million dollar grant he received. There will also be an opportunity in May to get funding as a phone company once they obtain that status to add even more services to the project and increase service. He will email the documents as soon as they are reviewed and then attend the meeting that follows that date.
There is a new opportunity to extend fiber from Willow Creek to Orleans. Their project takes it from Somes Bar to Orleans so this would take it even further. The general consensus at the last meeting was that the Tribes are interested but want more information before moving on it. The company, IP Networks, successfully ran fiber from Red Bluff to Eureka on Highway 36 which is similarly rural but they are being very cautious before committing to the project. Russell states that if the Tribes are going to fund the project they should not have to pay the vendor for service after it is installed. Eric states that is exactly why the Tribes are cautious
He states they have weekly conference calls on Mondays at 1pm and he can get the information to any Council Members who would like to listen in and hear their progress and get updates. Michael and Russell would like the information just in case.
Joseph asked about KCDC and when they will be able to have Kelly serve them from IT. Eric states that would probably be an appropriate discussion for closed session, he will stay.
Verna states that in Yreka, the audio system would not work and no one was trained to be able to run it. Eric states that Gerry and Scott received training. There was more training required in the contract and they are withholding the last payment until they complete that training with the necessary staff. If there is a problem it is also under warranty. He is following up on that.
Eric spoke to Daniel about the new building and will be putting the wire out to bid rather than having IT do it since they are currently short staffed. He states they have offered the Network Administrator position and if all goes well they will start as soon as next week.
Verna Reece moved and Crispen McAllister seconded to approve Eric’s report. 7 haa, 0 puuhara, 0 pupitihara.
9) Vickie Walden
Written report only, she had to excuse herself.
Dora Bernal moved and Crispen McAllister seconded to approve Vickie’s report. 6 haa, 0 puuhara, 0 pupitihara. (Verna not present for voting).
10) Lessie Aubrey
Lessie was present to review her written report.
Her first request is Resolution 12-R-018 for submission of a proposal in support of the Karuk Tribal Health and Human Services Program to the California Wellness Foundation Indigent Care Program for funding received by HANC to support delivery of health care for indigent consumers. They are submitting data to them regarding the costs to support uninsured clients in their service area.
Alvis Johnson moved and Joseph Waddell seconded to approve Resolution 12-R-018. 7 haa, 0 puuhara, 0 pupitihara.
Her next item is Agreement 12-M-001 with the California Primary Care Association and UCLA. The cover sheet was not included but it has been reviewed and the document was included with their report in their packets.
Dora Bernal moved and Verna Reece seconded to approve MOU 12-M-001. 7 haa, 0 puuhara, 0 pupitihara.
She also requested approval of Contract 12-C-049 with Barbara North. There are no changes to the rate or terms, it only renews the term. It was not included in their packets.
Michael Thom moved and Alvis Johnson seconded to approve Contract 12-C-049 with Barbara North, MD. 7 haa, 0 puuhara, 0 pupitihara.
She and Russell will attend Tribal Consultation next month in Pala; there is a conflict with the Council’s schedule so they will finalize that later on. It will either be Michael or Russell who attend, depending on their schedules. She is requesting that they fund a donation toward refreshments at that conference; IHS cannot pay for those costs. They ask the programs to donate. Any amount would be fine; it would come from Third Party.
Dora Bernal moved and Michael Thom seconded to approve $200 from Third Party for that expense. 7 haa, 0 puuhara, 0 pupitihara.
She also wanted to ask about the Health Program Strategic Planning that is necessary for AAAHC. In order to do that, Dr. Burns will have to be out of the clinic and away from patients. It has to be done by May. She has a trainer in mind but has not confirmed anything. She is only seeking their approval to close the clinic in Happy Camp for two days. Laura suggested asking Judy to work in Happy Camp for two days with Chelsea to avoid having the clinic closed so that Dr. Burns can participate.
The Health Management Team will participate, and Tribal Council is invited. Most of the participants besides Dr. Burns are not medical staff. Russell states that Tribal Council needs to be involved as much as possible.
She states that they need to have a Policy Council to get their policies reviewed, updated, and approved by the Tribal Council faster as their current process is taking too long to get through them all before the survey. She would like two Council Members to participate on that group. Crispen is willing to do that, Joseph, Russell, and Alvis are all interested as well.
Verna Reece moved and Crispen McAllister seconded to approve Lessie’s report. 7 haa, 0 puuhara, 0 pupitihara.
Non Health Employee Guests
11) Rick Hill, KCDC Grant Writer
Rick and Ducayne are present to discuss the upcoming Strategic Planning Session scheduled for April 3-6, 2012 in Blue Lake. It is a project funded by EDA and BIA to update the Community Economic Development Strategy document. They are trying to create a comprehensive plan to use for seeking economic development funding for projects that they want to start and implement.
He presented them with a summary and outline for how they will work through this process and what steps are involved in preparing the final CEDS. Dora states that they felt the list of staff they put together was too extensive to take that many employees away from their work for that amount of time and paying for all of that travel. They recommended that they meet with the directors in Happy Camp and have them submit their needs and resources in written form and then take that information with them to Blue Lake.
Laura went through the history of the CEDS grant and how many times they have gathered the information and updated the document, this has been done three times and they need to be sure that they review those prior documents to see what was included. This will be the fourth time they have gone through this process and still the majority of those projects have not been funded or implemented.
Rick submitted a list to Council of who would be participating in this process and when the Council returned the list it was shortened. He has also spoken to the EDA representative who is required to participate such as local officials, etc. EDA has told them it is up to them who they involve because the Tribe is sovereign.
They are proposing to form a Strategic Planning Committee to help move the project forward and then that information will be presented to the EDCP project consultant prior to the April workshop to ensure their needs are included. They want it to be a real document they can implement and use this time and not repeat the cycle. They included an example of what they are going to ask the directors to prepare and submit.
12) Dolores Voyles
She is requesting travel approval for herself and Marsha and any Council Members interested to attend Enrollment Training in Phoenix, Arizona, March 27-28, 2012. She has not attended a conference in quite some time and needs to see what the updated information from the other tribal programs includes.
Michael Thom moved and Joseph Waddell seconded to approve travel for Dolores Voyles, Marsha Jackson, and Alvis Johnson to the Enrollment conference, March 27-28, 2012. 6 haa, 0 puuhara, 1 pupitihara (Alvis Johnson).
13) Sandi Tripp, Transportation (Written)
She submitted a written request to amend the previous purchase approval for a Ford truck for the Transportation Program without the trade-in for a modified price of $30,416 from Jim Wilson Motors.
Michael Thom moved and Joseph Waddell seconded to approve the purchase of the Ford truck for $30,416 from Jim Wilson Motors in Yreka. 7 haa, 0 puuhara, 0 pupitihara.
14) Requests
None at this time.
15) Informational
None at this time.
Closed Session from 4:44pm to 7:36pm
Consensus: To donate the wheelchair accessible van to Community Member #CM.
Consensus: To advise Tribal Member #1258 that they need to update their application with the Housing Authority to ensure that they have accurate income information available to determine eligibility.
Consensus: To temporarily reorganize the Child and Family Services Program with Employee #5138 providing administrative oversight, Employee #0055 overseeing Social Work, and Employee #5002 overseeing the AOD program. A follow up planning meeting was set for Friday, February 17, 2012 at 1pm to discuss the program further.
Consensus: To post the vacancy for a Social Worker covering Yreka and Happy Camp and offer Contractor #BN up to 20 hours per week at $75 an hour to assist as necessary.
Consensus: For Employee #4250 to obtain three quotes for installation of the antennas in Yreka and provide that information to Tribal Council so they can decide if that is the most cost effective option for completing the project.
Dora Bernal moved and Michael Thom seconded to approve the loan to Tribal Member #1553 for $2,500 to be repaid $250/month with Council Member #3175 as a co-signer. 6 haa, 0 puuhara, 1 pupitihara (Alvis Johnson).
Request: For Finance office to separate the loan report into two categories; 1) revolving loans with current payments being made and 2) stagnant loans with no activity.
Dora Bernal moved and Michael Thom seconded to approve Employee #1063 using their sick leave available prior to the six month anniversary date. 7 haa, 0 puuhara, 0 pupitihara.
Joseph Waddell moved and Sonny Davis seconded to modify the Personnel Policy to allow new employees to use their sick leave as it accrues with no waiting period. 7 haa, 0 puuhara, 0 pupitihara.
Michael Thom moved and Crispen McAllister seconded to approve up to $3,500 for relocation costs for Employee #3355. 7 haa, 0 puuhara, 0 pupitihara.
Dora Bernal moved and Joseph Waddell seconded to approve travel for Employee #1002 to the ATNI conference in Shelton, Washington, February 13-16, 2012. 7 haa, 0 puuhara, 0 pupitihara.
Consensus: To rescind approval for Council Member #7769 to attend the ATNI Conference.
Consensus: To revise Employee #7084’s travel to February 15-17, 2012 for Shelton, Washington.
Michael Thom moved and Alvis Johnson seconded to issue a letter of support for Council Member #7769’s application for a special use permit from the Forest Service. 5 haa, 0 puuhara, 2 pupitihara (Verna Reece and Crispen McAllister).
Consensus: Council Member #7769 will bring back information on a Tribally owned company that provides surveillance and security services to discuss addressing issues at the Ranch and Smoke Shop in Yreka.
Consensus: To issue a letter to Tribal Member #897 regarding keys being returned and lack of proper authorization to drive tribal vehicles.
Consensus: For staff to proceed with development of a TOSHA in house without a consultant.
Announcement: Russell offered the opportunity for the Booster Club to provide concession services at the upcoming Attebery Tournament for fundraising if they are interested.
Next Meeting Date: March 8, 2012 at 3pm, Happy Camp.
Michael Thom moved and Joseph Waddell seconded to adjourn the meeting at 7:37pm.
Respectfully Submitted by,
______________________________________
Russell Attebery, Chairman
Recording Secretary, Sara Spence