Health Board Meeting
October 8, 2009 – Meeting Minutes
Meeting called to order by
Present:
Florrine Super, Secretary
Leeon Hillman, Treasurer (late 3:30 PM)
Roy Arwood, Member at Large
Sonny Davis, Member at Large
Verna Reece, Member at Large
Bud Johnson, Member at Large
Absent:
Leaf Hillman, Vice-Chairman/excused
The Health Mission Statement was read aloud by
Agenda:
Verna Reece motioned and
Bud Johnson seconded to approve the agenda with changes, 6 haa, 0 puuhara, 0
pupitihara.
Minutes of September 9, 2009:
Verna Reece motioned and
Sonny Davis seconded to approve the minutes with changes, 6 haa, 0 puuhara, 0
pupitihara.
Guests:
1.) Dr. Bardonner, Dental Director:
Dr. Bardonner stood up and
introduced Dr. Richard Chass that applied for a position in the Yreka clinic.
Lessie and Dr. Bardonner discussed that the Council wanted to meet and talk to
him so he then turned the podium over to Dr. Chass. He introduced himself
explained that he was the dental director in the Susanville Indian Rancheria.
He preferred not to be a dental director and just provide services. He is
looking forward to living in Yreka and he and his family can make their home in
Yreka. He is excited to provide the best
dental care that is possible for the clients of Yreka.
Dr. Bardonner explained that
he received a call from
2.) Dr. Goodwin, Yreka Physician:
Dr. Goodwin introduced
himself to the audience and the
The Council introduces
themselves to the providers.
3.) April Attebury / Florrine Super,
April explained her grants
that she administers and then provided handouts of information on the Circles
of Care program. She mainly works with youth and her vision is to develop a
community of tribal youth and court systems. Some youth have already produced
some digital story telling and musical video productions and SAMSHA has been
encouraging the youth to develop a MySpace or Facebook account. April and
Florrine would like to work out a way to make the websites accessible. Florrine
also noted that the best way to get a hold of the youth, by their
recommendation is a more technical option of communication. April has concerns
over the grant requirements of the web development and open communication via
avenues that the youth are needing and not meeting that deliverable. Arch explained
that this discussion will take place with the Youth Council, IT and the
Old Business: None
at this time.
Director Reports:
1.) Mike Edwards, Behavioral Health Director:
Mike is present to review his
written report. He provided an overview of the IVE program. The State is ready
to implement the program but the staff is still not prepared for the
implementation or the billing. Once he is prepared he will attend a planning
session to seek formal Council approval.
Mike reviewed the quality
improvement project on patient cancellations. Arch asked if the patient calls
to cancel then the staff will begin to ask why the patients are choosing to
cancel the appointment. On Tracie’s report there are fifteen people waiting to
be seen and this is very common with all the mental health providers and the
general wait time is six weeks out. The Social Services program continues to
meet with the TANF program to address meeting the client’s needs that services
both programs.
The Yreka facility budgeted a
transporter position for the Yreka area half-time due to the high amount of
need for service in that community.
Florence Conrad motioned
and Verna Reece seconded to approve Mike’s report, 6 haa, 0 puuhara, 0
pupitihara.
2.) Daniel Pratt, TANF Director:
Daniel is present to review
his written report. He provided a new organizational chart and he also sought
approval to pay the Youth Leadership Conference approximately $2,200 toward the
upcoming Youth Conference.
Daniel presented a plaque to
the Council of thanks for their contribution of sponsorship toward domestic
abuse training. He then went on to explain that any of the Council is invited
to attend the healing families in Indian Country conference April 6-7, 2009 at
Blue Lake Casino.
Leeon Hillman arrived at 3:30 PM
Daniel explained that there
is a lot of communication with staff and via email they remain in touch, but in
the absence of majority of the staff then there is an identified staff member
available to take calls.
Things are going well with
the Happy Camp site. He has met with Laura on the administrative costs and they
have developed ways to identify what is being spent in each line item.
The Federal update has no
change but he received the notification of funding.
Then he reviewed the totals
spent on cash-aid and other expenditures.
For the State update he
received notice of acceptance of the IOU’s that the State issued and then
Daniel inquired if Laura received the funding yet. Laura explained that the
IOU’s had been sent in and she was awaiting word on the reimbursement.
The County update is that
previously there were several revisions with the Siskiyou County MOU and he was
waiting to hear back from
Verna Reece motioned and
Florence Conrad seconded to approve the revised organizational chart, 4 haa, 0
puuhara, 3 pupitihara (Bud Johnson, Roy Arwood, Leeon Hillman).
Florence Conrad motioned
and Verna Reece seconded to approve Daniel’s report, 7 haa, 0 puuhara, 0
pupitihara.
3.)
Sonny
4.) Eric Cutright, IT Director:
Eric has one action item in
addition to his written report. He has procurement for software related to
dictation. The software will be for Judy Blind and Tracie Lima.
Florence Conrad motioned
and Verna Reece seconded to approve procurement and allow the purchase of
dictation software for Judy Blind, Tracie Lima and Fabian Alvarado, 7 haa, 0
puuhara, 0 pupitihara.
Eric noted that his report
had an error in it noting that the construction to the
There is currently a cell
phone upgrade and he will begin to upgrade cell phones at the new cell phone
rate.
Leeon Hillman motioned and
Sonny Davis seconded to approve Eric’s report, 7 haa, 0 puuhara, 0 pupitihara.
5.) Vickie Walden, Dental Office Manager:
Vickie is present to review
her written report. She has been busy doing dental data entry and completing an
analysis of patient visits comparing them to walk-in and scheduled visits. Yreka
is getting bombarded with Non Native American patients and walk-in patients.
Vickie explained that there have been no recommendations to date on having
Native Americans paying for dental labs. Until she receives feedback from the
fiscal department she will not implement any changes. Vickie is currently
restricting having re-produced services but she will create a policy regarding
this once she has time.
They are receiving some
information on medical billing. Diana Poeschel made some pone calls to clarify
that the staff can bill for some things and do some back billing with MediCal
so this was great news and the staff have been notified to review bills to
determine what is allowable.
Verna Reece motioned and Bud
Johnson seconded to approve Vickie’s report, 7 haa, 0 puuhara, 0 pupitihara.
6.) Lessie Aubrey, DQMCH:
Lessie presented a
Telemedicine agreement that is required with Northern Sierra Health Network.
Verna Reece motioned
Florence Conrad seconded to approve
agreement 10-A-001 between the Rural Health Network and the Karuk Tribe, 7 haa,
0 puuhara, 0 pupitihara.
Lessie then presented a
notice of federal interest. The HRSA Bureau of Primary Health Care requires
that a letter be signed by the Chairman stating that if the Yreka clinic building
was ever to be sold the grant funding would be returned. The Council agrees
that this is general practice for some grant funded facilities and will approve
Arch to sign the document and have it recorded at the recorders office in
Lessie provided an overview
of her entire report to the Board. Lessie is seeking approval to allow the
Tribal Representative, as selected by the
Lessie went on to review the information she obtained from IHS concluding that
she is closely reviewing and gathering information regarding the federal
government and paying 100% plus 3% administrative costs to administer of
optional benefits to the Native Americans. New Medicaid rules have been
implemented including State wideness and Comparability.
Apparently, there was
information received that the Karuk Tribe did not submit a HRSA grant and this
caused the staff to scramble to ensure that the Tribe’s application was in by
the deadline which was 10 days from the date that it was due. Lessie determined
that by no fault of the staffs the application notice was not clearly posted
and she confirmed this by email from a HRSA representative. Lessie returned
from travel and immediately contacted Hester and Trista attempting to get the
deadline clarified and directions on ensuring that it would be submitted.
Hester had to scramble to get an extension and once the extension was granted
the staff continued to work diligently on the application including several
evening hours to ensure it was submitted on time. Lessie is still unsure of who
was notified that the HRSA grant applications were due but it was very hectic
to complete the application and requirements on such short notice.
She then reviewed EAPC and
HRSA and the sliding fee scale for the Karuk Tribal Health Program. Lessie
confirmed that there was reduced medication that was provided by the sliding
fee scale. This only benefits the patients and clients of the health program.
Leeon Hillman motioned and
Bud Johnson seconded to approve the DHHS agreement, 7 haa, 0 puuhara, 0
pupitihara.
Bud Johnson motioned and
Leeon Hillman seconded to approve Lessie’s report, 7 haa, 0 puuhara, 0
pupitihara.
7.) Karen Daniels, DQMCH:
Karen is present to review
her report with the Board.
Karen announced that with
recruitment and the finalizing of selection she is pleased to announce that
Fabian Alvarado was selected to work at the
Karen has been attending
several travel and training requirements to get up to speed on her position.
She has been attending quality improvement training, EHR training and Head
Start training. She has been effectively using this training to services other
programs of the Tribe. She completed Head Start hearing screenings and learned
the EHR issues relating to other clinics.
Florence Conrad motioned
and Leeon Hillman seconded to approve Karen’s report, 7 haa, 0 puuhara, 0
pupitihara.
Guests: Non Health Employees:
1.) Ruth Rouvier, Language Program:
Ruth has one action item;
contract 10-C-002 between AICLS for $4,956 that she is seeking Council approval
for. This will be to conduct training for the Master-Apprentice documentation
project to be held November 7-8, 2009.
Florence Conrad motioned
and Sonny Davis seconded to approve contract 10-C-002 between AICLS and the
Karuk Tribe, 7 haa, 0 puuhara 0 pupitihara.
2.) Barbara Snider, Executive Assistant:
Barbara presented CHS
Policies for approval as Anna Myers, CHS Supervisor, was unavailable. Barbara
explained that there will be several more CHS policies brought by Anna but to
begin this fiscal year, CHS and other health staff have reviewed three policies
that will need to be in place right away.
She first presented policy
10-105-019 “Approved Levels of Care” for approval. The staff made several
revisions to this policy including removing a former cap on travel due to that
decision not being allowable. They removed physical therapy and will only be
allowing one service for a patient to receive in home training to complete a
program independently. Mental health, chiropractor and acupuncture services
were restricted as well.
She then went on to seek approval
of policy 10-105-018 “Levels of Care” noting that CHS program must adhere to
policy that they will review levels of care and how that information will be
distributed after approved.
Leeon Hillman motioned and
Bud Johnson seconded to approve policy 10-105-018, 7 haa, 0 puuhara, 0
pupitihara.
Barbara then presented policy
10-105-014 “Indian Eligibility” announcing that there are no changes or
revisions to this policy as it is concurrent with the Federal Register on what
documentation is needed in order to verify if a person is Native American and
how that is reflected in the CHS system.
Closed Session:
Florence Conrad motioned and
Bud Johnson seconded to approve resolution 09-R-142, 6 haa, 0 puuhara, 1
pupitihara (Verna Reece).
Florence Conrad motioned
and Bud Johnson seconded to approve resolution 09-R-143, 7 haa, 0 puuhara, 0
pupitihara. (3,576 now enrolled).
Roy Arwood motioned and
Verna Reece seconded to approve agreement 10-A-002 between the Karuk Tribe and
AmeriGas, 7 haa, 0 puuhara, 0 pupitihara.
Informational: Verna Reece
inquired about staff or others following 139 The Council has not reviewed this
information to date but will look for the information that was sent out.
Roy Arwood motioned and
Consensus: to send CHS
Case #209 back to the EDHHS to review options of payment from health program
grants.
Consensus: to send CHS
Case #210 back to the CHS Supervisor to attempt negotiations to reduce the
amount requested.
Roy motioned and Florrine
seconded to adjourn meeting at 5:27 PM, 7 haa, 0 puuhara, 0 pupitihara.
Next meeting date: November 5, 2009
Respectfully Submitted,
________________________________
Recording Secretary, Barbara Snider