Karuk Tribe – Health Board Meeting

October 9, 2008 – Meeting Minutes

Meeting called to order at 3:06 PM by Arch Super, Chairman

Present:

Arch Super, Chairman

Leaf Hillman, Vice-Chairman

Florrine Super, Secretary

Leeon Hillman, Treasurer (3:45 pm)

Alvis Johnson, Council Member

Robert Goodwin, Council Member

Sonny Davis, Council Member

Florence Conrad, Council Member

Roy Arwood, Council Member

Absent:

None.

The Health Mission statement was read aloud by Florrine Super, Council Secretary.

Agenda:

Florrine Super motioned and Sonny Davis seconded to approve the agenda with changes, 7 haa, 0 puuhara, 0 pupitihara.

Minutes of September 11, 2008:

Florence Conrad motioned and Robert Goodwin seconded to approve the minutes, 7 haa, 0 puuhara, 1 pupitihara (Leaf Hillman).

Guests:

1.) George Chambers, Siskiyou Union High School District:

Mike Matteson, Siskiyou County Superintendent, was present with George Chambers to discuss proposed bond measure Q. It will be to assist schools in the district with funding for repairs to local high schools. The modernization process identified $1 million spent on Happy Camp high school. Happy Camp recently had the science lab upgraded including lights and counter space with that funding. Mr. Chambers went on to explain that there are several identified problems at the local High School and most repairs are very expensive.

Mr. Chambers believes that Happy Camp will be one of the major beneficiaries if the measure passes. The total cost would be $21.45 per $100,000 assessed value for homeowners if the bond measure passes. Mt. Shasta and Weed would pay the same rate, and he cannot guarantee fund generation would only go to Happy Camp high school as it is a Siskiyou County bond measure; however the Happy Camp high school deficiencies have been listed as the top priority.

This bond measure will assist in obtaining matching funds from the State. Happy Camp stands to gain, for the local high school anywhere from $3 million to $6 million. This is enough funding to accomplish several projects for Happy Camp including, roof repairs, bleacher repairs for the sports field, tennis courts, a serious mold and dry rot situation, and the drainage system that created the dry rot problem to begin with.

Leaf questioned the oversight committee if the bond measure should pass. Mike explained that over district wide they will form a group to oversee individual committees and they will review certain projects and determine the feasibility. The committee members will be selected by the Board of Directors. There is a second committee that is established by the local community including staff, community members, and students that would select projects for completion of the local high school.

Florence questioned if the mold situation is a health and safety issue. Florence announced that she has children at the local school and that doesn’t sound very healthy. Mike explained that along with the health and safety commission they have had the air quality tested and determined that it wasn’t unsafe. With the State approving the hardship application the school is able to have the mold issue fixed in the very near future. The State is approving applications, but the actual funding may take an additional five years. The bond would allow the work to begin immediately and be reimbursed by the State.

Mr. Chambers explained that Florence’s point is well taken and assured her that there were specialists brought in to determine the health and safety of the students and staff in regard to the mold at the local high school.

Mr. Chambers is hoping to receive an endorsement from the Karuk Tribe on the measure. His main goal is to announce the board’s goal and seek the Tribe’s support. He is unsure of the voting requirements of the Tribe, but if the Council does need to vote on supporting or opposing the bond measure, he will be happy to receive support.

2.) Norman Shaskey, Candidate:

Norman Shaskey is present as a candidate of the oversight committee on the citizen’s measure bond for the College of Siskiyous. He is seeking a seat on the oversight committee for Area 4 of the Siskiyou Joint Community College. He provided background information on his qualifications and distributed information on his experience. He is seeking support on obtaining a seat on the committee. He thanked the Council for their time.

3.) Bessie Munson, Tribal Member:

Bessie Munson is present to request some monetary assistance in sending her daughter to Washington DC., for a field trip with her school. The total cost is estimated at $2,000 and she is seeking the funding to hold her daughter’s seat in the amount $220 by October 20, 2008. The Health Board will take this request into consideration, but are unable to vote at this time. Bessie will be contacted with their determination once it is made.

Directors Reports:

1.) Daniel Pratt, TANF Director
Daniel is present to review his written report with the Health Board. Daniel has three action items. The TANF program is still in the early phases of implementation, but Human Resources has flown position vacancies and applicants have been selected. In Orleans the Site Supervisor, Receptionist, and an IT person has been selected. The Happy Camp staff has been selected and tomorrow the interviews for the Yreka site will take place.

Daniel has received word from Julie Fong that there are further changes to the plan that he did not receive due to the email system being down. Daniel will have a conference call tomorrow in an attempt to clarify changes and receive a final draft for submission. The start date may be moved to December 1^st and once the plan is approved next week the state department of social services will receive an email from ACF and then with concurrence the program may be eligible to draw down 25% of the state portion. With final approval of the MOU’s between the Karuk Tribe, Humboldt County and Siskiyou County client transfers will begin and with the first client transfer the TANF program may begin draw down of the Federal portion of TANF funding.

Daniel has the Humboldt County and Siskiyou County MOU’s completed. They have been approved internally and Daniel would like to seek formal approval from the Health Board. Daniel does believe he may have to seek State intervention to have the County forced to comply in transferring cases. He believes that Siskiyou County may be slightly confused with the operation of TANF programs, as there isn’t an operating program in Siskiyou County. Humboldt County has already been working with other Tribe’s so the process of client transfers may not be too difficult.

Laura Mayton would like to know if the start date in fact has been moved to December 1^st and if so, she would like to know if charges that may be accrued can be charged to the TANF budget. Daniel explained that the State funding may be drawn down once the TANF plan is approved and agreed upon by the State, the Karuk Tribe and notice sent to the Feds. Once the first case is transferred then the federal funding may be drawn down. Erin would like this information in writing. Daniel explained that it is a regulation and may be researched and printed as such.

Daniel presented a Fiscal Technician position for approval. There was a Bookkeeper position for the TANF program, but the position has been revised and formal approval of the new position description has to be done.

Robert asked if there would be down time for the clients if they choose to transfer to the Tribal TANF program. Daniel believes that that is up to the County based on how soon they will transfer cases to the Tribal TANF program. Robert inquired about turning tribal clients away based on having the MOU in place. Daniel believes that the case transfers will only occur when the clients determine that they want to transfer. The County will contact the Tribe’s TANF program to determine acceptance the clients and provide a date of when they will be transferred. The lag time will be the first part of the month; if they are taken on then they will begin to enroll into the TTANF program the following month. There should be minimal disruption of services based on working cooperatively together and being prepared for client transfers.

Leaf Hillman motioned and Florence Conrad seconded to approve MOU 08-M-010 between the Karuk Tribe and Humboldt County, 7 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin motioned and Florence Conrad seconded to approve MOU 08-M-012 between the Karuk Tribe and Siskiyou County, 7 haa, 0 puuhara, 0 pupitihara.

Alvis Johnson motioned and Florence Conrad seconded to approve the Fiscal Technician position description, 7 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin motioned and Alvis Johnson seconded to approve Daniel’s report, 7 haa, 0 puuhara, 0 pupitihara.

2.) Mike Edwards, Behavioral Health Director:

Mike is present to review his written report with the Health Board.

Mike will be having staffing changes due to current staff applying for new positions within the TANF program. He has been assured that transition times will be flexible to ensure the patient and client needs are best served.

Mike was successful in certifying the first tribal home in Fort Bragg to become a certified foster home. Mike transported a child on a Friday to the home, but the child chose to leave on his own the following day. This is not a good outcome, but the positive side of the situation is obtaining a certified foster home.

As informational the next Yav Pa Anav meeting is on November 18, 2008.

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

3.) Martha Schrock, EDHHS:

Martha is present to review her written report with the Health Board. She first presented updated action items for the Health Board to review. Erin explained that the CalWORKs funding is now being administered by Refugees.

Florence Conrad motioned and Robert Goodwin seconded to approve MOU 09-M-002, 7 haa, 0 puuhara, 0 pupitihara (Roy absent for vote).

The Yav Pa Anav strategic planning has been closed for 2008 and is moving toward planning for 2009. As of this reporting period she has received payments from MediCal. Martha read from her report updating the Council on several items. From the earmark meeting Martha has been reading about several things that are coming down within the next year and the group has met to discuss wish list items to seek funding for, further developments of those meetings will be presented to the Council once clearer direction is prioritized. The Yav Pa Anav received $117,000 in SAMSHA funding from that granting agency, which is only one of eight tribes in the nation to receive the funding. Martha would like to review the behavioral health system in a triangle format reviewing the Youth grant, SAMSHA grant and another grant. Reviewing the grant requirements in a triangle form will assist in meeting granting requirements without duplicating duties. Mike is able to bring the Naa Vura Yee Shiip program into the Yav Pa Anav Circles of Care process. It is exciting to pull all the resources and have a more organized approach to meeting the decline of NVYS numbers. Martha thanked the billing office for setting their billing goals and their diligent work toward meeting their deadlines.

The FNP for the Yreka clinic completed blood pressure checks in Yreka for an open house event. She completed several blood pressure checks and it was a good opportunity for public outreach.

Martha presented a MOU between behavioral health / Cal Works and the California Department of Social Services (CDSS). The MOU has changed slightly as the funding agency is now Child Care and Refugee Programs Branch, per Erin.

Robert Goodwin motioned and Alvis Johnson seconded to approve 09-M-002 between the Karuk Tribe and CDSS, 8 haa, 0 puuhara, 0 pupitihara.

Arch questioned the travel request from Holly Hensher that was sent to the Council. Laura and Erin explained that it needs Council approval based on the travel policies.

Florence Conrad motioned and Leaf Hillman seconded to approve travel for Holly Hensher to San Francisco, CA, 7 haa, 0 puuhara, 0 pupitihara.

Florence Conrad motioned and Alvis Johnson seconded to approve Martha’s report, 7 haa, 0 puuhara, 0 pupitihara.

4.) Vickie Walden, RDA:
Vickie is present and available for questions regarding her written report, but has no updates or action items to her report.

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

5.) Patti White, Database Administrator:

Patti is present and available for questions regarding her written report, but has no updates or action items to her report.

Florence Conrad motioned and Sonny Davis seconded to approve Patti’s report, 8 haa, 0 puuhara, 0 pupitihara.

6.) Eric Cutright, IT Director:

Eric is present and would like to provide a power point presentation for the Health Board on the Karuk network both currently and concepts for growth and consideration moving forward. He listed individual locations in each community with the end result being fifteen sights would benefit from joining the network into one large system, linking sites such as Tribal Court, KCDC and other departments. Patti inquired about the band width costs. Eric understands that there are several costs that would arise, but as long range, even short range planning is done, it is best to understand what IT needs are and what system upgrades would do to improve each site and location in regards to IT.

Vickie inquired about central location and central service with the down time that take each site has. Eric believes that he would have one central hub, but each site would have their own internet link and if the main connection was lost, then the back up satellite connection will pick up the site. It was determined that the satellite services are charged even if the Tribe does not use them, so this may create more use by having each site with the capability of linking up when their main line is disconnected. The satellite is more expensive and has a delay, which is why the system uses satellite for back up only and not a primary system.

Eric had one addition. Eric would like to be on the agenda for next Thursday for procurement for fixes to the Yreka phone system.

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

7.) Lessie Aubrey, DQMCH:

Lessie distributed her written report for the board to review. She attached the performance improvement meeting minutes for the board to review. Lessie reviewed her training that she recently attended and explained that it was really political with the nearing election.

Suzanna is working on portions of the EAPC program and grant requirements and Lessie is working on the HRSA grant tasks. Last year the work was combined to assist in making the process a little easier. This year everytime someone comes into the clinic a fee will be charged for EAPC patients in the amount of $10. This fee, based on patient income will be charged at the visit and paid in advance. Native Americans will be exempt from the fee. Lessie then reviewed her charging fee scale and took several comments and questions from the audience. Lessie put the revised sliding fee scale before the Health Board for approval. With the questions and comments from staff, the Health Board will approve the revised sliding fee scale, but would like the staff to work out the details with each other so there is less confusion. The revised sliding fee scale will be implemented for six months and then evaluated for cost versus revenue.

Robert Goodwin motioned and Leaf Hillman seconded to approve the Karuk Tribal Health and Human Services revised sliding fee scale, 8 haa, 0 puuhara, 0 pupitihara.

Robert Goodwin motioned and Leaf Hillman seconded to approve Lessie’s report, 8 haa, 0 puuhara, 0 pupitihara.

8.) Dr. Burns, Medical Director:

Dr. Burns announced that November 5, 2008 there will be a flu clinic for a donation of $5 per vaccine in Happy Camp. Dr. Burns went on to explain how many visits he has had this month and throughout the year. The third party revenue was reviewed and Martha has that amount in her report.

Robert Goodwin motioned and Sonny Davis seconded to approve Dr. Burns’ report, 8 haa, 0 puuhara, 0 pupitihara.

Non Health Employee’s:

1.) Erin Hillman, Dir. Admin Programs and Compliance:

Erin announced that a new name for the Orleans community center has not been done, as noted in Eric’s presentation. She would like the Council to begin discussing possible names for the facility.

Lisa Aubrey has been selected for another position and with a revised position description she would like to begin posting the vacancy to seek an employee for the LIAP Department.

Florence Conrad motioned and Florrine Super seconded to approve the revised LIAP position description, 8 haa, 0 puuhara, 0 pupitihara.

Erin then distributed a pass through amendment (1) to CA-05-L66 between Indian Health Services and the Karuk Tribe.

Leaf Hillman motioned and Florence Conrad to approve amendment (1) to CA-05-L66, 8 haa, 0 puuhara, 0 pupitihara.

She also distributed procurement for the purchase of HEPA air filters. She explained that the tribe received $45,000 for HEPA air filters and with reimbursement to the Karuk Tribe for purchased air filters, there was remaining funding. With that left over funding the Tribe will purchase the filters and keep them for future fires.

Robert Goodwin motioned and Leaf Hillman seconded to approve procurement and allow the purchase of 15 HEPA air filters in the amount of $2,639, 8 haa, 0 puuhara, 0 pupitihara.

She then presented procurement for facility size air filters. They are effective and generally used in facilities with 1500 square feet. They will be purchased from Air Purifiers American in the amount of $9,599.04. With additional funding Erin will add all three Head Start facilities to allow for some HEPA air purifiers at the school sites.

Robert Goodwin motioned and Alvis Johnson seconded to approve the purchase of 19 air purifiers including the Head Start facilities in all three sites, 8 haa, 0 puuhara, 0 pupitihara.

She then presented a contract modification for the new community center in Orleans. It is to add funding to the contract to change the locking system and additional energy efficient lighting. The contract number is 08-C-014 (4) increasing the amount an additional $4,825.

Leaf Hillman motioned and Robert Goodwin seconded to approve modification (4) to contract 08-C-014, 8 haa, 0 puuhara, 0 pupitihara.

She has one last action item. Erin is requesting for the Karuk Tribe to pay for 100% of the costs for new parking lot project and internally work on split of costs with KTHA. Richard Black has procurement done already and he has selected the lowest bid, which Erin agrees with as compliant procurement documentation.

Robert Goodwin motioned Florence Conrad seconded to approve procurement and allow the costs of the parking lot project in the amount of $36,879.79, 8 haa, 0 puuhara, 0 pupitihara.

Closed Session:

Florence Conrad motioned Florrine Super seconded to pay $30 for food to family member assisting CHS eligible patient during transport, 8 haa, 0 puuhara, 0 pupitihara.

Consensus: for the EDHHS and the Behavioral Health Director to make hiring determination.

Consensus: for the EDHHS and the Medical Director to review options of facility coverage and staffing to ensure patients and clients are provided service. Also, all providers shall be provided information on the productivity and the expectations of the program to succeed.

Consensus: to deny a loan request from Tribal Member # 390.

Consensus: to deny a loan request from Tribal Member # 2851.

Consensus: to table request from Tribal Member # 3221 to the planning meeting.

Consensus: to deny a loan request from employee # 4936.

Leaf Hillman motioned and Roy Arwood seconded to approve resolution 08-R-116, 7 haa, 0 puuhara, 1 pupitihara (Florrine Super).

Consensus: to deny donation request submitted for the purchase of property in Happy Camp.

Robert Goodwin motioned and Alvis Johnson seconded to approve out of state travel for April Attebury and Judge Henry to Greenbay WI October 21-23, 2008, 8 haa, 0 puuhara, 0 pupitihara.

Directive: to employee #1051 to immediately begin to develop and assist all other Directors in meeting a new requirement that the Tribal Council would like implemented.

The Directors shall report as an action item lobbying efforts that includes information on the Director’s efforts to make contacts with State or Federal officials to create ties on funding and how to increase or improve it. He shall meet with each Director assisting with a couple phone calls so that the Directors know who to contact and how to communicate along with facilitation to build a relationship between the Director and the project coordinators, staffers or appointed officials. At least one contact must be made monthly by the Directors, this shall include but is not limited to; a phone call, a fax, an email, or letter. The Management Team will be tasked with developing facilitation and be present for a mandatory meeting on November 18, 2008 to receive an update from on the Council Directive and provided an understanding to Directors and reporting. At this meeting he shall be able to determine who to work closely with and what contacts the Director may need to have in order to meet the Council’s decision for this new process.

Robert Goodwin motioned and Alvis Johnson seconded to approve resolution 08-R-117 to support renaming the Blue Nose Bridge, 7 haa, 0 puuhara, 1 pupitihara (Leeon Hillman).

Next meeting date: November 6, 2008 at 3 PM in Happy Camp, CA.

Florence Conrad motioned and Roy Arwood seconded to adjourn the meeting at 7:54 PM, 8 haa, 0 puuhara, 0 pupitihara.

Respectfully submitted,

________________________________

Arch Super, Chairman

Recording Secretary, Barbara Snider