Karuk Tribe of California

Health Board Meeting Minutes

May 10, 2007

Happy Camp, California

The meeting was called to order at 5:08 PM by Leaf Hillman, Vice Chairman.

Roll Call

Present

Leaf Hillman, Vice Chairman

Leeon Hillman, Treasurer

Florence Conrad, Member – late 5:15 PM, excused

Sonny Davis, Member

Robert Goodwin, Member

Alvis Johnson, Member

Absent

Arch Super, Chairman – on travel, excused

Florrine Super, Secretary – on leave, excused

Roy Arwood, Member

Quorum is established.

The Health Mission Statement was read aloud by Robert Goodwin.

Approval of the Agenda for May 10, 2007

Alvis Johnson moved and Leeon Hillman seconded to approve the Agenda for May 10, 2007. 4 haa, 0 puuhara, 0 pupitihara.

1) Approval of the Minutes for April 12, 2007

These will be addressed later in the meeting.

2) David Tripp, Karuk Jump Dance Council

David was present to request assistance with the upcoming Jump Dance which is scheduled for August 17-26, 2007. He thanked them for their assistance the past fourteen years when they returned this dance; at that time it had been gone for 99 years. He hopes they will approve the request for this year at the same level. They approved $7,000 last year and they were under by $562.19. He would request the same amount.

Florence Conrad arrived at 5:15 PM.

The funding provides for two four wheel drive shuttles as the road requires four wheel drive to access the site, garbage disposal, porta potties, gasoline for the shuttles, insurance for the dance grounds, and drinking water. The insurance is required because they must cross private property in order to access the dance grounds.

Leeon Hillman moved and Robert Goodwin seconded to approve up to $7,000 toward the Jump Dance from the State Indian Health Budget. 5 haa, 0 puuhara, 0 pupitihara.

3) Tanya Busby, Substance Abuse Program

Tanya was present to address the Council and request permission to build a sweathouse near the KCDC Building. It would be an above-ground, temporary structure. She is now housed in the KCDC Building and would like to have access for her clients next to the building. She would only need poles and a tarp. She states she would obtain a storage pool for water to be used. Leaf states that the Council would like to see a schematic detailing the location in relation to all other items at that location. Scott can provide her a map of the property so that they can see clearly where it would be located. If she can bring that back to them along with a description of what it will be, how it will be used, materials needed, etc. they can vote at that time.

4) Sandi Tripp, Natural Resources Program

Sandi was present to address the Council. She states the USFS Summit Meeting scheduled for tomorrow will be postponed and she has four possible dates for them to choose from which are May 29 or 30 and June 1 or 5.

She distributed the EPA PPG in the amount of $510,000 for October 1, 2007 through September 30, 2008. It has been reviewed by Laura Mayton; Erin Hillman was unavailable. Resolution 07-R-061 was assigned to the funding proposal. All references to Fiscal Year 2007 will be Fiscal Year 2008. It must be submitted by May 15, 2007 that is why she is at the Health Board Meeting. She can update the date typos and bring it up for signature on Monday if possible.

Florence Conrad moved and Robert Goodwin seconded to approve Resolution 07-R-061. 5 haa, 0 puuhara, 0 pupitihara.

She requested approval of procurement through YSI in the amount of $16,252 for water quality monitoring equipment. This is the same vendor they currently have equipment through but this item has a higher level capability for the testing and monitoring they require. It will be installed at gauging stations and can provide real time data via satellite uplinks.

Robert Goodwin moved and Alvis Johnson seconded to approve the purchase from YSI in the amount of $16,252. 5 haa, 0 puuhara, 0 pupitihara.

Her last item is approval of procurement for Kenny McCulley for rock for their FEMA projects for road base. The cost for the rock is $12.25 per ton and $80 per hour for transportation. Their final cost will not exceed $14,919.17 but they cannot assign a specific amount because they do not know how many trips it will take.

Robert Goodwin moved and Sonny Davis seconded to approve the purchase through Kenny McCulley up to $14,919.17. 5 haa, 0 puuhara, 0 pupitihara.

The meeting with the Forest Service was scheduled for June 5, 2007 at 10:30 AM.

4a) Approval of the Minutes for April 12, 2007

Florence Conrad moved and Leeon Hillman seconded to approve the Minutes for April 12, 2007. 5 haa, 0 puuhara, 0 pupitihara.

5) Old Business

None at this time.

6) Joe Snapp, Substance Abuse Program

Joe was present to review his written report with them.

He updated them on the Oak Knoll Septic System and one of the engineers he contacted indicated they may need to obtain a discharge permit due to the Clean Water Act; Sandi has indicated she does not believe so but will research it and get back to him. He states he continues to work on that and get it up to date. It will require a new system; they have not discussed funding at this point as they must identify an engineer to design the plans so that they can determine the cost of the project. They will also need to develop a business plan detailing how that program would be started, operate, and eventually be able to sustain itself. One of his thoughts was to build storage units that could generate revenue for the Oak Knoll Property possibly on the property near the substation in Happy Camp; the units are low maintenance income generators.

Bob states there have been many possibilities for that property lately and a memo needs to be distributed to directors inviting them to attend a meeting with the Council where all possible ideas can be discussed and a final plan can be developed for that parcel which is land that is already in Trust. It is large enough that more than one project could be housed there. They can discuss this Wednesday and schedule a meeting date/time to discuss this.

Florence Conrad moved and Robert Goodwin seconded to approve Joe’s report. 5 haa, 0 puuhara, 0 pupitihara.

7) Martha Schrock, Executive Director

Martha reviewed her report with the Council.

She discussed the Pandemic Flu Committee Meeting and how they are working with other departments to make sure it works for all programs. There was a conference call with Title IV-E and there will be a Fiscal Training the end of June and then staff training will be scheduled.

The HRSA Grant was submitted on time and she thanked all staff who participated for their help as this was a huge project. She states the move to the modular is on hold but power is supposed to be on by Wednesday of next week and they will resume moving.

The Third Party Assistance Balance is currently $4,775.33.

She states the Family Nurse Practitioner has declined but there will be an interview in Yreka on Monday, May 14, 2007 with a prospective doctor who is very eager to relocate to Yreka and work for them. He is a Commissioned Corp Officer and she has all of the paperwork regarding the MOU with IHS which is necessary for that type of hire; the next hurdle is him obtaining his California license. Dr. Burns states he is interested in at least a two year commitment and has immense leadership potential that he can provide to that clinic.

They have had one interview with a Dentist and had another scheduled for tomorrow but it has been postponed until it can be verified that Yreka is a shortage area of at least 19. They are not sure at this point yet and they may need to fill out paperwork to establish themselves as a shortage area.

They are advertising for a Medical Assistant in Happy Camp. Alissa Johnson and Kathryn Willett are job sharing in Orleans and another RN has been identified for the area that they will have set up to be a fill in as necessary.

The budgets are on target at this point in the year; the clinical reports are included for their review. Laura states they are behind on Third Party Billing but at the same time are not spending as much because they are short staffed. This will still bring them to a balanced budget at year end.

She states there is a new Receptionist in Yreka, Alana Brown; she is filling the vacancy created by Elizabeth Super who transferred to Housing recently.

Florence Conrad moved and Robert Goodwin seconded to approve Martha’s report. 5 haa, 0 puuhara, 0 pupitihara.

David Tripp states that will all of the information regarding mercury in the river and the health of the fish he wonders if there is a way to monitor the health of the people and the mercury levels that may be in them from the fish; and the effects it could have on them. Dr. Burns states that mercury is monitored by urine collection over the course of 24 hours and then it is sent to the lab for heavy metal monitoring. David wonders what the warning signs would be for possible high mercury levels. Dr. Burns states that acute is different from chronic; chronic mercury levels will cause mental debilitation over the course of time but are very hard to notice. He thinks that mercury levels should be monitored routinely.

Leaf states they are researching the toxins in the fish that are caught on the Klamath River and are aware of potential issues that cause them to wonder what the effects are of consuming Klamath fish. He assured David that they are monitoring many potential health hazards that could be possible.

8) Vickie Walden, Dental

Vickie’s written report was included and she was present to answer any questions they may have. They inquired about the over spending in lab; she states it will be adjusted later in the year when expenses are reconciled. The new State Indian Health Funding begins July 1, 2007.

Dr. Gordon was present to provide Head Start, Medical, and Dental training which covered many areas and the staff felt it was very helpful. Dr. Burns felt the information was very useful and made them more aware of dental needs for overall health.

Robert Goodwin moved and Alvis Johnson seconded to approve Vickie’s report. 5 haa, 0 puuhara, 0 pupitihara.

9) Chris Kleeman, Information Technology

No report, not present.

10) David Eisenberg, Public Health/Nursing/Outreach

Written report only, not present.

One action item was included which is approval of MOU Number 07-M-003 with Northern Sierra Rural Health Network and the Karuk Tribe for $1,875 for August 1, 2007 through August 1, 2008 to use RPMS data to measure four standardized clinical measures for diabetes. The Tribe already partners with this entity for the tele-medicine equipment the Tribe utilizes.

David recommends that these funds be utilized for non-Indian patients who require assistance with diabetic supplies but do not qualify for other assistance such as EAPC, HRSA, etc. Laura states without direction, it would be deposited into Third Party and go toward Third Party expenses. Bob suggests that he expand his request because they have many unmet needs in the health program. Laura states the budget is very border-line so any additional revenue is needed to meet the current level of services being provided without adding new ones. Bob would be interested in seeing how this small of an amount can make a difference and how many non-Indian patients this funding would benefit in order to justify the request. This can be brought to them Wednesday, until that time it will go to Third Party Revenue.

Robert Goodwin moved and Sonny Davis seconded to approve MOU 07-M-003 with Northern Sierra Rural Health Network. 5 haa, 0 puuhara, 0 pupitihara.

Florence Conrad moved and Robert Goodwin seconded to approve David’s report. 5 haa, 0 puuhara, 0 pupitihara.

11) Patti White, RPMS

Patti was present to review her written report. She has no action items tonight for open session; she will speak to them in closed session.

She states the training she attended in Portland was very enlightening on the lab package; she will be attending further training in Sacramento along with the Medical Assistants and they will get that package up and running to work toward EHR.

Robert Goodwin moved and Leeon Hillman seconded to approve Patti’s report. 5 haa, 0 puuhara, 0 pupitihara.

12) Lessie Aubrey, Quality Management

Lessie was present to review her written report.

She has one action item for approval tonight which is the State Indian Health Program Grant. Resolution 07-R-062 has been assigned and the amount will be $248,223 this year which is slightly higher than last year.

Florence Conrad moved and Robert Goodwin seconded to approve Resolution 07-R-062. 5 haa, 0 puuhara, 0 pupitihara.

Florence Conrad moved and Sonny Davis seconded to approve Lessie’s report. 5 haa, 0 puuhara, 0 pupitihara.

13) Requests

None at this time.

14) Informational

None at this time.

15) Committee Reports

None at this time.

Closed Session from 7:28 PM to 10:13 PM.

Consensus: For Tribal Member #1909 to provide additional information regarding their request alogn with a recommendation from their doctor that recommends this surgery. The Council can then research what options they have that may be able to help with this expense.

Robert Goodwin moved and Alvis Johnson seconded to approve the Data Entry Clerk/Certified Medical Coder position description as presented along with the proposed salary increase of no less than $11 upon obtaining certification and then $1 increase after one year of successful coding; the position description will be updated with this information. 5 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin moved and Leeon Hillman seconded to approve up to $75 for a plaque for Employee #8819. 5 haa, 0 puuhara, 0 pupitihara.

Florence Conrad moved and Robert Goodwin seconded to approve Daniel Pratt’s recent travel to Albuquerque, NM for TANF from discretionary. 5 haa, 0 puuhara, 0 pupitihara.

Consensus: To approach the State for TANF negotiations with a high of 605 and low of 453; if the State will not agree to 453; the negotiations will move to the Federal level.

Robert Goodwin moved and Florence Conrad seconded to approve $1,000 for CHS Case #176. 5 haa, 0 puuhara, 0 pupitihara.

Consensus: To allow Barbara Norman to help with Tribal Member #1982’s child’s case; if it looks too extensive Barbara can come back to them.

Robert Goodwin moved and Alvis Johnson seconded to write off the debt for deceased Tribal Member #798. 5 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin moved and Florence Conrad seconded to write of the total deceased medical/dental debt in the amount of $2,175.29. 5 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin moved and Leeon Hillman seconded to write off the old medical/dental debt $12,179.69 from the RPMS System but to keep a copy of the list. 5 haa, 0 puuhara, 0 pupitihara.

Florence Conrad moved and Sonny Davis seconded to approve out of the area travel for Laura Mayton, October 15-16, 2007 to Ledyard, Connecticut for the Native American Finance Conference. 5 haa, 0 puuhara, 0 pupitihara.

Leeon Hillman moved and Robert Goodwin seconded to approve $54.26 for flowers to Council Member #7225. 5 haa, 0 puuhara, 0 pupitihara.

Consensus: To decline the invitation to meet with Mr. Rose at this time and obtain Dennis’ opinion on this matter.

Consensus: To consult with Stephanie Dolan on the HCHS issues and lease language.

Notice to Management Team: At the meetings directors need to discuss upcoming projects, discuss collaboration on similar projects, voice concerns, and issues faced in departments, upcoming grant deadlines, etc. The Meetings should be more of a talking circle to allow the directors to help each other work efficiently.

Next Meeting Date: June 14, 2007 at 5 PM in Happy Camp.

Leeon Hillman moved and Alvis Johnson seconded to adjourn at 10:14 PM. 5 haa, 0 puuhara, 0 pupitihara.

Yootva,

___________________________________

Leaf Hillman, Vice Chairman

Recording Secretary, Sara Spence