White Earth Nation Health Care 638 Planning Team Meeting

IHS Area Office Bemidji, MN

November 10, 2016

Present: Todd Scofield, Pat Butler, Don Warne, Lawrence “Sam” Crowell, Alan Fogarty, Valerie Fox, Laura DeGroat, Jason Douglas, Rose Cournoyer, Tansy Wells, Karla Checo, Rich Gerry, Keith Longie, Alice Martell, Thomas Bement, Hope Johnson, Gretchen Dobervich, Nakoa Graff, Allen Roy(via telephone)

Item / Notes / Follow Up
Welcome and introductions / Pat Butler opened the meeting with a welcome and introductions were made. / No Action
Review of Last Meeting/Minutes/Questions / Last meeting minutes were reviewed and the current meeting’s agenda / No Action
Communication / The October community and clinic meetings were postponed. It was determined that there were three audiences to communicate to: clinic staff, the community and the Tribal Council. Next meeting it is recommended to discuss meetings in communities and the clinic. / Thomas Bement: Submit initial award release announcement and develop press release regarding the process, committee’s function and the decision to 638 being made by Tribal Council after feasibility and planning/researching completed
Programs, Functions, Services and Activities / Hope provided a presentation of the PSFA manual. There are three tiers of PFSAs the group will need to consider assumption of: service area, area office and headquarters. Keith provided an explanation of this. Buybacks are services that tribes have the option to assume responsibility for. Todd discussed the Facilities and Appropriation PFSAs. This included sanitation, engineering and environmental; services. White Earth has historically left these shares with the IHS Area Office. At the next meeting the committee will begin exploring each PFSA individually.
Information and Technology
Data / The three tiers of IT include: 1 local support and activity, 2 security upgrades and patching, 3 development of RPMS and other software, as well as National Data Warehouse. PRMS is designed to generated reports required for Congress and other federal entities. Billing and medical records can be difficult in RPMS. If shares for IT are assumed, the tribe is responsible for buying a new system, securing tech support, customization, training, updates, security and software expense. It is common for tribes to leave the IT Tiers with IHS. The cost of these shares is $12,780. Jason discussed how Headquarters and how the area counted user population. The Headquarters user population is an estimate of the entire area- it places people into CHSDAs and is used for Congressional increases. Only active patients are accounted for and residence is not accounted for. In the 1990’s, Bemidji Area Tribes determined the Headquarters Patient Count was not appropriate. They began using the Area Patient Count (APC). This count considers the amount of services used at each location. The Service Area uses this count for allocating resources. This count covers a three year time frame (calendar year) Descendants are included based on eligibility. / NDSU AIPHRC:Present at December 2016 meeting on software used by other 638 Tribes
Jason Douglas: Previous 5 years user population and area patient count to and
Human Resources / There was discussion regarding exploring what the tribal salary and benefit package offered to employees would be, if the Tribal Council chose to 638. Rich discussed successes other tribal nations have had in retaining employees with good communication and competitive packages. Should the decision be to 638, each employee will have a 1:1 meeting to discuss benefits and make the choice between accepting the tribal benefit package or to stay with the federal employee package. Unions reps are part of the negotiation process pertaining to employee salary and benefits. The plan is for Nakoa to have the package developed for each position by the end of this process, so that should the Tribal Council choose to 638, 1:1 meetings with staff can begin immediately. Rich, Keith and Don offered to be resources. Meeting attendees are reminded that salary and benefit information remain confidential. / Nakoa Graff: Begin the process to explore tribal benefit package and make recommendation for changes to facilitate employee retention. Report monthly at meetings as to progress, findings, challenges, etc.
Revenue Projections / Third party revenue for FY16 and FY17 were requested. There is currently a 60/40 revenue split between the White Earth Nation and IHS. The IHS portion can only be used for health care. X account funds are used for 3rd party funds that are not tied to a time frame and can be carried over. 80% of budget is staffing. Data drives funding, therefore it must be accurate and timely. Meeting attendees are reminded that fiscal information remain confidential. / Alan Fogarty: Provide revenue projections and present at December 2016 meeting
Next meeting / Monday, December 12 at Noon at the Health Services Building in White Earth, MN
Lunch Provided / Pat Butler: Develop and disseminate meeting agenda

Respectfully submitted by

Gretchen Dobervich BSW,LSW

Policy Program Manager

NDSU American Indian Public Health Resource Center