Karuk Tribe – Health Board Meeting

April 12, 2012

Meeting Minutes

Meeting called to order at 3pm by Russell Attebery, Chairman

Present:

Russell Attebery, Chairman Michael Thom, Vice-Chairman Crispen McAllister, Member at Large
Sonny Davis, Member at Large
Bud Johnson, Member at Large Verna Reece, Member at Large Dora Bernal, Member at Large

Absent:

Jody Waddell, Secretary / Treasurer

Quorum is established.

Dora Bernal read the Health Mission Statement aloud and Sonny Davis said a prayer for the audience.

Agenda of April 12, 2012:

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

Minutes of March 8, 2012:

Sonny Davis motioned and Bud Johnson seconded to approve the minutes of March 8, 2012, 6 haa, 0 puuhara, 0 pupitihara.

Director Reports:

1.) Daniel Pratt, TANF Director

Daniel is present to review his report. He provided an overview of his caseload and the areas that fluctuate in their caseloads based on clients utilizing services for the time allotted or no longer using services.
He and Dora attended a TANF Meeting and met with Cynthia Gomez and they reviewed better working relationships with Tribes. One issue is the limited capability to view the Medicaid system which identifies the ability to review if clients are double-dipping. The Tribes can “view only” right now and are unable to make any notes or changes and this is one area that restricts communication. They are also looking at all of California having one software system. This is a work in progress.
June 11-12, 2012 for the annual meeting in Sacramento if the TANF Representatives are available.
Dora asked what the notation of transportation is to Yreka when there is an AOD class in Yreka and Happy Camp. Daniel clarified that there are two AOD classes for the clients and it is only offered one day in Happy Camp as opposed to Yreka that there are more classes for the participants. This has Happy Camp transporting their clients to Yreka to ensure they receive their twice monthly AOD classes that are required.

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Daniel requested that for Yreka; he be allowed to add another case worker / assistant position. At the same time, his case worker from Orleans would like to transfer to that area and that would leave an open position in Orleans. Russell noted that the primary objective is to maintain the caseload in Yreka and if they need a person, then that should be identified. Daniel’s second recommendation for the Yreka area is to transfer a receptionist to an assistant case worker position. He would like to revise her position description to an assistant case worker and then have the receptionist position filled every three months by TANF clients, and this would provide those clients with needed office training and job skills. Dora noted that the position description
would need to be revised and use the receptionist position for a training program. Russell asked if there are people waiting to be accepted into the program, which they are not, but Daniel feels that the staff is overloaded and he is trying to work with his staff to find a fix to the staffing needs. Sonny asked if this position could be posted. The discussion will be moved to closed session.
Dora asked Daniel to inform the Council on the plan of action that was discussed earlier. Daniel has identified some needs in Yreka, Orleans and Happy Camp for financial needs analysis. He will have the staff be trained on budget management and self motivation so that the staff can become trainers to the clients. The TANF staff feels that the need is relevant for the clients and it will benefit the clients to have this training.
Dora noted that Daniel will probably seek contracts soon to bring in people to training the case worker and then also the clients on self esteem to become motivated to enter into the workforce.

Dora Bernal motioned and Sonny Davis seconded to approve Daniels report, 6 haa, 0 puuhara, 0 pupitihara.

2.) Vickie Simmons, Clinical Operations Manager:

Vickie is present to seek approval of the policies for the Health Program. There are policies that include the staffing review, ACQI Committee review, and then finalized by the staff in accordance with numbers for AAAHC.
Dora Bernal motioned and Verna Reece seconded to approve the 29 policies attached in Vickie’s report, 6 haa, 0 puuhara, 0 pupitihara.
Vickie went on to review her report. The UDS report was submitted and Patti wanted to be available if there were any questions regarding that report. Patti noted that it is on behalf of HRSA that provides information.
Vickie noted that her budget is well under. There were several conference calls and WebEx training that were held. Written complaints concluded for 2 in last month and 6 occurrences that may be from a new employee who is learning how to write them.

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

3.) Chad Tiraterra, Database Administrator:

Chad is present to provide his report. He noted that last time he reported there are updates on the dental EDR. They are planning on going live in July. He attached the operation summary for
March.

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The Indian Health Services HIPAA security training is mandatory for Health Employees and the Council may make is mandatory for Administrative staff. Chad noted that there may be meaningful use funding for electronic records but it is not released for dental yet. Vickie further clarified that the training for the dental staff will be in July for one week, while patients are present.

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

4.) Eric Cutright, IT Director:

Eric is present to review his report. He did not provide his report on time.
Eric noted that there have been two major outages in Orleans this month. There was a loss of internet for four days and since then those have been resolved.
This is his first report regarding the Network failure but he has been communicating those. His team was able to pull together and work together on the different parts of the training. He also noted that this was a good training opportunity.
He discussed the Orleans Broadband project. Two engineers companies have been scouting and providing information. There must be a cultural survey that is done, and it should be fairly easy because of the Orleans facility which had just had one done.
He discussed an ongoing proposal that has been working on with other Tribes and he is working with other IT Directors. It seems that they may delay the deadline and if so, that would mean a really nice proposal would be set up.
He has been discussing phone changes for a couple months. A new phone system has arrived and he will be changing numbers and issuing those, which would allow the staff to order new letterhead, business cards and updating materials.
He wanted to discuss the audio project. The contractor came onsite, and the training was done with Jason Haines. Jason will be at the Yreka Council Meeting to ensure the audio system is working well.
Dora asked what the status is on the access for Alphonso. Eric noted no, that their schedules haven’t matched up. Dora noted that Alphonso is working on new Handel software and he is unable to work on it. Eric will see if this can take place.
Eric noted that Russell’s phone has not been ordered yet and won’t be until he gets some time and gets down the list.
Eric would like to purchase a backup server using a HANC Grant and IT Indirect. The prices were all similar but there was storage space which he needed.
He would like to use GovConnection, Inc in the amount of $6,657.46. The IT Staff will all learn how to manually verify backups and with the new server it will backup automatically.

Dora Bernal motioned and Verna Reece seconded to approve procurement and allow the purchase of the backup server in the amount of $6,657.46, 6 haa, 0 puuhara, 0 pupitihara.

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Crispen McAllister motioned and Sonny Davis seconded to approve Eric’s report, 6 haa, 0 puuhara, 0 pupitihara.

5.) Vickie Walden, Dental Office Manager:

Vickie provided her report along with the Dental Director report for April.
Vickie reviewed her reports and noted that the dental office is looking forward to AAAHC in June 2012. They have added more meetings and more minutes, with policies. Dr. Shane and Vickie were working on revisions to the current fee schedule. She has discussed them with Lessie and she referred Vickie to Suzanna to determine costs and payments. Dr. Shook has been working in Yreka one day a week to provide emergency services. Dr. Shook is working out well.
Travel is coming up; and there have been a few questions on what is coming up for the dental staff for annual travel. They coordinate one clinic open and the training attendance that is needed for staff. Vickie provided a breakout of the cheapest most useful time spent to ensure that CEU’s of the licensed staff are obtained. Vickie noted that the networking is almost as valuable as the training because they get to trouble-shoot with their peers. The Happy Camp Clinic will stay open while the Yreka clinic is closed and vice versa for the clinics.
Elementary School screenings this year have been done and the results are provided to the Council. There is improvement but there isn’t as high of a rate as the dental program would like to see. The school nurses are working in the schools to ensure they are providing prevention education.

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

6.) Annie Smith, Director of Community Services:

Annie is present to review her report. She has no action items. She and Vickie will be attending the GPRA diabetes training the end of this month in Sacramento, which is mandatory. She is
hoping for Michael Lynch to learn more about GPRA so she is working toward that. She
participated in a lot of training via WebEx. All of the nurses in Siskiyou County are registered in the State in case of an emergency. They participated in a drill about the hospitals being too full, with ambulances being diverted to local clinics. In Yreka the clinic is not as prepared because they are near a hospital but that is harmful to the community and identified as a need or knowledge they can use to become more prepared. They are addressing supplies that are needed and going to be required however there is no funding for those supplies even if they are required.
Annie noted that she did discuss elder checks with the elders and the forms that are completed while onsite with elders. She noted that the program has forms that flag the staff to verify checks on the clients. She noted that it was done in Yreka, Happy Camp and Orleans. Annie did note that there are a few clients that do not want to receive services. However there are a lot of elders that do want services.

Verna Reece motioned and Crispen McAllister seconded to approve Annie’s report, 6 haa, 0 puuhara, 0 pupitihara.

7.) Lessie Aubrey, EDHHS:

Lessie is present to review her report with the Council. She has several action items. She would first like the attorney forum to look into the issue of Medicaid. Lessie recommends submitting
$500 for this consortium.

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Dora Bernal motioned and Bud Johnson seconded to provide the $500 toward the legal analysis, 6 haa, 0 puuhara, 0 pupitihara.

And then Kim Dodge is asking for a VISA card for Shannon Klymer in Yreka.

Michael Thom motioned and Crispen McAllister seconded to issue Shannon Klymer a VISA

tribal credit card with a limit of $2,000, 6 haa, 0 puuhara, 0 pupitihara.

Parenting Classes being provided under agreement 12-A-042 is beneficial for the clients of the social services program. The Community Services Council provides those classes for 6-12 weeks. She would like to go under an agreement to provide that option to clients.

Dora Bernal motioned and Michael Thom seconded to approve agreement 12-A-042, 6 haa, 0 puuhara, 0 pupitihara.

Suzanna Hardenburger provided a sliding fee scale for the Council to approve. It is updated by the Federal guidelines. It is updated annually and needs approved for implementation into the Health Program.

Michael Thom motioned and Crispen McAllister seconded to approve the Annual Sliding Income

Fee Scale for 2012, 6 haa, 0 puuhara, 0 pupitihara.

She received a call from CRIHB, that the Karuk Tribe is slated to receive an award at the GPRA Conference. Annie, Vickie and Mike are attending and may receive that.
Dr. Shearer provided his schedule which Lessie passed out for the Council to view. And she provided an update to her report on Children and Family Services.

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

Guests: Non-Health Employees:

1.) Tiffany Ashworth, Grant Writer/Resource Developer:

Tiffany is present to discuss purpose area (1) which is public safety and community policing
(COPS) and is in two (2) phases one to assess the needs and then to develop policies and procedures for a Karuk Tribal Law Enforcement. The total budget is for $600k over three years and she has timelines with the project including tasks. The Karuk Tribe is not requesting to hire staffing at this time but funding to be provided for planning. The final phase is to procure a law enforcement management system.
This will be done by phone vote on Tuesday. The second purpose area is (4) for corrections and alternatives. Erin has reviewed this and there is not a final draft to date.

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

Jaclyn is present to discus the overall narrative for the CTAS proposal. She noted that there will be one combined resolution that will include purpose areas 1, 4, 6, and 10. The Tribal Youth
Program will also be included. It has been reviewed by Erin and Duke. The narrative was
approved and the budget is under review for prevention and juvenile delinquency. This would hire a Tribal Youth Program Coordinator and another staff member to work in the schools to support the youth and provide mentoring. Purpose area 6 is violence against women and provides

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assistance for transitional housing for women. All proposals are due on Wednesday and one resolution to include all concepts.
Jaclyn then presented a grant proposal for Helene which was drafted for the People’s Center to have a national disaster plan and can be reviewed currently, then go to the planning meeting next week.

3.) Sandi Tripp, Director of Transportation:

Sandi is present to seek approval of 12-C-066 between the Department of Transportation to provide on-call engineering, not to exceed $20,000 and GHD. Sandi noted that this contractor has
already done several jobs.

Dora Bernal motioned and Bud Johnson seconded to approve contract 12-C-066 not to exceed

$20,000 with GHD, 6 haa, 0 puuhara, 0 pupitihara.

She then provided resolution 12-R-033 for a TTIP update for the Happy Camp Streets Project.

Dora Bernal motioned and Michael Thom seconded to approve resolution 12-R-033, 6 haa, 0 puuhara, 0 pupitihara.

Earl then noted that he has been reviewing options on a tank purchase. It is a 1,000 gallon tank that has an internal steel tank inside it. He received two quotes for this type of tank. He would like to have Ishpook Leasing purchase it in the amount of $4,500 and then have the other programs assist in paying the fees back to Ishpook Leasing.
Fred is going to come onsite to lay the slab needed and then the on switch will be in the building to allow less access to individuals stealing fuel.

Michael Thom motioned and Sonny Davis seconded to allow the purchase of a convault tank from Renner in the amount of $5,000 from discretionary and allow the program to make payments to Ishpook Leasing, 6 haa, 0 puuhara, 0 pupitihara.

4.) Rick Hill, KCDC Grant Writer:

Rick is present to seek approval of resolution 12-R-037 for a .72% COLA increase from the
Office of Head Start.

Crispen McAllister motioned and Sonny Davis seconded to approve the resolution 12-R-037, 6 haa, 0 puuhara, 0 pupitihara.

5.) April Attebury, Tribal Court Administrator:

April noted that for the CTAS grant, transitional housing they are required to enter into an agreement with a non-profit. There is a clause that states that there will be compensation provided
in the amount of $15,000 per year if there were items that were needed. The contract will be 12-
C-043 for three years, and contingent on the CTAS funding. The amount was based on what other agencies were partnering for and she provided that same amount.

Dora Bernal motioned and Crispen McAllister seconded to approve 12-C-043, 6 haa, 0 puuhara, 0 pupitihara.

Also during Tiffany’s reporting she forgot to mention that when she and Erin approached April to administer that particular purpose area (6), that she was open to it, as long as the Council was

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okay with that option and afforded the ability to discuss her wages and maintaining oversight of that particular purpose area.

Closed Session:

Crispen McAllister motioned and Bud Johnson seconded to approve resolution 12-R-041, 6 haa,

0 puuhara, 0 pupitihara.

Dora Bernal motioned and Bud Johnson seconded to approve resolution 12-R-042, 6 haa, 0 puuhara, 0 pupitihara.

Michael Thom motioned and Crispen McAllister seconded to approve out of state travel for Marsha Jackson and Dolores Voyles to Las Vegas NV for software training, May 2-4, 2012, 6 haa, 0 puuhara, 0 pupitihara.

Dora Bernal motioned and Crispen McAllister seconded to pay the $48.22 per month for one year pending a Medicare denial for Tribal Member #110, 6 haa, 0 puuhara, 0 pupitihara from Third Party.

Dora Bernal motioned and Crispen McAllister seconded to make an offer of $305,000 to

$320,000 for resolution 12-R-048, 6 haa, 0 puuhara, 0 pupitihara.

Michael Thom motioned and Crispen McAllister seconded to approve procurement and allow the purchase of a printer for the Land Department from Parrot Digigraphnic LTD in the amount of

$8,512 from Ishpook Leasing, 6 haa, 0 puuhara, 0 pupitihara. (All staff will need Council approval for printing).

Consensus: to refer Tribal Member #LP to the KTHA Board for appeal at that level first.

Consensus: for the EDHHS and Elders Supervisor to determine the ability to retain a part time

CHR/Elder position and it shall be flown and sought for Happy Camp.

Dora Bernal motioned and Bud Johnson seconded to approve allowing employee #CA to cash out her vacation with a letter stating her last day will be May 1st, 2012 unless situation is resolved, 6 haa, 0 puuhara, 0 pupitihara.

Michael Thom motioned and Dora Bernal seconded to approve agreement 12-A-039, 6 haa, 0 puuhara, 0 pupitihara.

Dora Bernal motioned and Crispen McAllister seconded to approve credential and privileging for

Dr. Shearer, 6 haa, 0 puuhara, 0 pupitihara.

Dora Bernal motioned and Michael Thom seconded to approve $744.66 for D00135, 6 haa, 0 puuhara, 0 pupitihara.

Bud Johnson motioned and Michael Thom seconded to pay $1,000 toward Sterling Leone Long

Sr., funeral, 6 haa, 0 puuhara, 0 pupitihara.

Crispen McAllister motioned and Dora Bernal seconded to approve up to $1,000 from discretionary and have employee #RA attempt to find other resources for pending cases, 6 haa, 0 puuhara, 0 pupitihara.

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Informational: Discussion with employee #7094 to maintain employment obligations.

Dora Bernal motioned and Bud Johnson seconded to approve an attorney retention agreement between the LCW and the Karuk Tribe (12-A-044), 6 haa, 0 puuhara, 0 pupitihara.

Dora Bernal motioned and Verna Reece seconded to all the write-off from Tribal Member #FC in the amount of $436.14, 6 haa, 0 puuhara, 0 pupitihara.

Consensus: to deny travel for employee #1988.

Consensus: to review the Self Governance Conference agenda to determine who should all attend.

Consensus: to allow the TANF program and the Tribal Court program to use the Williams

Property as their office, under agreements.

Dora Bernal motioned and Verna Reece seconded to pay $200 for the entry fee for the Karuk

Tribe team into the Attebery Scholarship Basketball Tournament, 6 haa, 0 puuhara, 0 pupitihara.

Consensus: to discuss compensation options with the CFO for Tribal Member #DB.

Next Health Board Meeting: May 10, 2012 at 3pm in Happy Camp, CA.

Crispen McAllister motioned and Bud Johnson seconded to adjourn at 9:07pm 6 haa, 0 puuhara,

0 pupitihara.

Respectfully Submitted,

Russell Attebery, Chairman

Recording Secretary, Barbara Snider

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