Health Board Meeting
October 12, 2006
*Minutes*
Meeting called to order at 5:06 PM, by
Arch Super, Chairman
Roll Call:
Arch
Super, Chairman
Leeon
Hillman, Treasurer
Alvis
Johnson, Member at Large
Robert
Goodwin, Member at Large
Florrine
Super, Secretary
Roy
Arwood, Member at Large
Quorum is established.
Robert Goodwin read the Health
Agenda:
Alvis
motioned and Florrine seconded to approve the agenda with changes, 6 haa, 0
puuhara, 0 pupitihara.
Minutes of September 14, 2006:
Florrine
motioned and
Guests 1: Amy Coapman, Yreka FNP
Amy
is present to provide her proposal to the Council regarding the option of
recruiting another FNP for the Yreka Clinic. She explained that there has been
a vacancy in the staff of a physician and a full time nurse for Yreka for some
time. She explained that there is not a suitable candidate at this time and a
shortage across the nation for registered nurses.
The
viable option is to hire a full time FNP. This position would be a Nurse
position as well. They would continue to recruit a full time position for a
physician, but currently the facility is over booked and the patient population
is not well served with the lack of a provider. She would like to present her
proposal and ask that the Council approve this as a full time position so
recruitment may begin.
She
has discussed this with the fiscal office, and long term this is sustainable as
a FNP wages are significantly lower than a physician.
Dr.
North would supervise the midlevel similar to other FNP’s that work in Yreka.
Amy would assist the new midlevel if brought onboard, so they could become
familiar. Dr. Burns stated that either Dr. North or he would supervise as they
are physicians and it is required to have a physician supervise a midlevel. Dr.
Burns requests a proctoring process for one hour a week. He would like this to
be done to ensure the practitioner would have a good skill set and have the
ability to practice independently.
Amy
stated that Dr. North is very detailed and would like to provide the
supervision since she is also a Yreka provider. Flo asked if there is a FNP
that is interested. Amy explained that there are three RN’s that have completed
the FNP program, and she believes that there is a better availability of a FNP
then a physician at this time.
Dr.
Burns stated that the midlevel that he has had the privilege to work with is
very beneficial. She sees several patients, and has a great relationship with
them. He believes this is a viable solution.
Robert
asked if there is a job description in place. Amy stated that the job
description would be the same as hers.
Arch
asked if there would still be the desire to recruit a physician. He wonders if
maybe employing two midlevel’s instead of employing a midlevel and a physician
would work as well. Amy would like to discuss this and bring it up with Laura
at a later time, but would like to begin recruitment of a FNP immediately if
the Council approves one position at this time.
Laura
recommends increasing the staffing by only one midlevel at this time.
Robert
motioned and Florrine seconded to move forward with the staffing plan as
presented by Amy Coapman, 6 haa, 0 puuhara, 0 pupitihara.
The
RN position will be pulled and Barbara will notify Sara of the intent to
recruit.
Guest 2: Dr. Burns, Happy
Dr.
Burns explained that in a thunder storm previously there was damage to the
x-ray machine for Happy Camp Health Services. He went ahead and had the machine
repaired, but did not follow approved procedures in payment for the repairs. He found how to prevent the damage again when
there is power failure at the facility and instituted the process to keep the
x-ray machine detached in the event of another lightening storm.
He
has been using one maintenance company for years, and did attempt to find other
sources for the repairs.
He
shoots about one to two x-rays a week and with the machine fixed he is happier
and sure the patients are better served.
He
would like authorization to pay the invoice.
Robert
motioned and Alvis seconded to pay the invoice in the amount of $2,274 to AXR
x-ray repair, 6 haa, 0 puuhara, 0 pupitihara.
1. Martha Schrock, EDHHS:
Martha
is not present. Her written report is provided, and Lessie Aubrey will report
on her action items.
Lessie
stated that Daniel Pratt is requesting a tribal credit card and has provided a
written request for it.
Florrine
motioned and
Babbie’s
follow up report on her recent review was provided to the Council. She received
three non-critical deficiencies and the action taken thus far was presented to
the Council.
Lessie
presented Dr. Solus’ contract to work for the Yreka clinic. The contract was
reviewed by Martha, Erin and Laura. He will work on call for direct patient
care at the rate of $100 per hour not to exceed $20,000 a year. The contract
would be from November 1, 2006 – September 30, 2007.
Florrine
would like to know when he would be covering on call. This would be clarified
as on call, at the maximum of one day per week.
Laura
stated that this contract would increase the possibility of having someone
available if another provider was sick or needed to take leave. This isn’t full
time, but is nice to have someone already credentialed and privileged to assume
the duties.
The
travel time needs further clarification, as to what he intends to bill for
travel to the outside locations. This will be moved to the Wednesday planning
meeting for clarification.
The
patient satisfaction survey will be complete soon with some core questions to
obtain a benchmark and other questions for more information.
Florrine
motioned and Robert seconded to approve Martha’s written report, 6 haa, 0
puuhara, 0 pupitihara.
2. David Eisenberg, PHN:
David
is present to review his report with the Council. There was a lot of work on
policies and procedures and those were already approved at the Wednesday
planning meeting.
He
completed an emergency drill with the dental staff, with the use of their newly
purchased AED machine. Now the Tribe owns four AED machines and they are placed
in each facility.
The
State review went well, and he thanked Lessie as she did an excellent job
preparing for the review.
The
CHR position has closed and there are four applicants with interviews scheduled
to be held Thursday at 1:30 PM in Yreka. All four applicants are Tribal
Members.
Robert
motioned and Florrine seconded to approve David’s report, 6 haa, 0 puuhara, 0
pupitihara.
3. Patti White, Database Administrator:
Patti
submitted her written report and has no action items. She reviewed her written
report with the Council. She announced that Leslie Alford has been taking
coding classes over the internet. Leslie is traveling in December to do one
more week of training and then taking her final exam to become a coder. After
passing her exam Leslie will be granted a provisional license, until she meets
the requirement of certification which is two years experience coding. Patti
noted that Leslie is a great asset to the position.
The
workload report includes more of a breakdown by provider type. Patti also
provided a comparison to previous months.
Robert
motioned and Leeon seconded to approve Patti’s report, 6 haa, 0 puuhara, 0
pupitihara.
4. Vickie Walden, Dental Office Manager:
Vickie
is not present as she was on travel for the State IHP review. Her report is
submitted for the Council to review.
Florence
motioned and Leeon seconded to approve Vickie’s report, 6 haa, 0 puuhara, 0
pupitihara.
5. Lessie Aubrey, DQMCH:
Lessie
explained that she has no action items, but she has received information from a
consulting company to assist in changing accreditation bodies from JCAHO to
AAAHC.
Arch
asked if she has further information on AAAHC along with her recommendation on
both accreditation bodies. Lessie explained that she went to training, and at
that time she received information but it mainly pertained to Surgical Centers.
Dr. Burns asked if AAAHC would require less work than JCAHO.
Robert
explained that he doesn’t want to lower the patient standards of care, and if
it is less expensive but provides the same level of patient care standards then
this is an option that the Tribe should take into consideration. Emphasis on
not lowering the standards of care is very important to the Tribe and will be
the main considering factor to determine if changing accreditation bodies is
appropriate for the health facilities.
Lessie
hasn’t had much time to review the AAAHC standards, but she believes that her
program would have to be revised slightly, although she isn’t sure how much at
this time.
Dr.
Burns stated that he reviewed the checklist and standards and with everything
that Lessie has completed, he believes that the Tribe would pass accreditation
easily by AAAHC. He stated that this would be more similar to the IHS process
and JCAHO is not. Dr. Burns stated that the PPR is a pain staking process that
requires a lot of work and is required by JCAHO annually now.
Lessie
stated that a lot of the reviewers that review the program are surprised that
KTHP is accredited by JCAHO. It is a big process and the reviewers notice how
hard it is to obtain the accreditation.
She
explained that Martha explained to her that in Martha’s former position they
were thankful that they moved from JCAHO to AAAHC.
Robert
asked if Lessie feels she should receive further training and obtain more
information to make a better decision. Now would be the time to make the
transition as this is a big change, and they have just received a three year
accreditation from JCAHO so switching now would make more sense.
HRSA
has not had a contract with AAAHC previously, but have had one with JCAHO.
Robert asked if this would have to be reported to HRSA. Lessie clarified that
they don’t have to be notified but it is a requirement to be accredited and
currently HRSA only pays for accreditation with companies in which they
contract with.
Lessie
will research options to find a more informational material to make an informed
decision if the change is appropriate and recommended. If approved to change
accreditation bodies she will hit the ground on meeting the new standards.
Leeon
motioned and Florence seconded to approve Lessie’s report, 6 haa, 0 puuhara, 0
pupitihara.
6. Joe Snapp, Substance & Alcohol
Abuse:
Joe
is present to review his written report, and had information distributed regarding
a request for a support letter from Heal Therapy Inc.
Toby
Ruez is present and has come to provide a report on her travel to
Florrine
motioned and Alvis seconded to approve Joe’s written report, 6 haa, 0 puuhara,
0 pupitihara.
Closed Session:
Consensus: to table request from Heal Therapy. Clarification on
grant numbers shall be provided to Erin Hillman, and also an explanation on the
parameters that the Tribe would be entering into specifically what the in-kind
is.
Florence
motioned and Leeon seconded to approve resolution 06-R-120 with changes to the
meeting date of the Enrollment Committee, 6 haa, 0 puuhara, 0 pupitihara.
Consensus: CHS Case #170 will be tabled employee instructed to
call the hospital to negotiate a lower rate, and bring it back to the Council
on Wednesday planning meeting.
Robert
motioned and Leeon seconded to approve the loan to Tribal Member #1066 in the
amount of $600 with payments of $50 per pay period via a payroll deduction, 6
haa, 0 puuhara, 0 pupitihara.
Consensus: to instruct KCDC CFO to submit outstanding debt from
individuals to Laura Olivas KTOC Bookkeeper.
Consensus: to allow Barbara Norman to review Tribal Member #998
request, #2217 request and assist communication efforts of property owners, KTHA
employee and Tribal Member’s Also Barbara Norman is to clarify if Tribal Member
#1925 is requesting the assistance herself and if so clarify a possible loan
situation.
Consensus: for Arch Super and Leaf Hillman to review employee #2217 contract and meet with her prior to
entering into a new contract.
Robert
motioned and
Robert
motioned and Alvis seconded to approve gasoline assistance for the next six
months for Tribal Member #2113, this is will be the last approval for this
request, 6 haa, 0 puuhara, 0 pupitihara.
Florence
motioned and Florrine seconded to approve the use of the DNR emblem and
statements with corrections to Living Gold Press, 5 haa, 1 puuhara (Bob Goodwin),
0 pupitihara.
Consensus: to have courier vehicle damage reported and to the
Council on Wednesday’s planning meeting.
Alvis
motioned and Robert seconded to approve 06-R-121 authorizing intervention, 6
haa, 0 puuhara, 0 pupitihara.
Robert
motioned and
Consensus: to officially notify Tribal Member #2266 that there will be no
scheduled Cage Fight events until a formal meeting is scheduled and held with the
Council and Promotional Company. At this meeting the Council would like to have
discussion on the business arrangements including financial agreements of all
parties involved.
Consensus: for the Council to draft a policy for office closures
in honor of former Chairpersons, Council Members and/or Elders.
Next Meeting date is November 9, 2006 in
Happy Camp, CA.
Robert
motioned and Leeon seconded to adjourn at 8:59 PM, 6 haa, 0 puuhara, 0
pupitihara.
Respectfully Submitted,
_______________________________
Arch Super, Chairman
Recording Secretary, Barbara Snider