Health Services Division update

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1 Nupuat Serving the Native Peoples of the Chugach Region Fall Health Services Division update he Chugachmiut Board of Directors and Executive T Management Team wishes to thank you for your patience as we continue to update and expand our Health Services Division. The challenging conditions have not affected the division s dedication. Our patients continue to have mid-level coverage, a wonderful stable pharmacist, dedicated Community Health Aides/Practitioners (CHA/P), and first-rate dental care on a regular and ongoing basis. We have the benefit of great facilities and a caring staff and the future is exceedingly bright. Across the nation medical personnel are very limited; this is magnified in rural Alaska. We commend Ms. Phyllis Wimberley, Human Resources Manager, who does an amazing job promoting the Chugach Region and its wonderful people. Her dynamic approach has attracted highly qualified medical personnel to Chugachmiut. Today, we are very close to having full medical staffing after a long, persistent search for the right persons: Doctor David Zetterman, Family Practitioner- Geriatrics, has arrived in Seward from North Dakota and is now the full time MD for the region. Cheri Hample, MPH, MSW, a long time Alaskan, joined us in September as the Health Operations Division Director. Cheri was in South Dakota for a year but wanted to return to Alaska and give Seward a try one community in Alaska she has not lived. See HEALTH NEWS, page 4 The Community Health Aide Program Certification Board recently approved four Chugachmiut applications. These include Charlemagne Active of Nanwalek certified as CHA II; Juanita Bales of Nanwalek certified as CHA III; Tania McMullen of Port Graham certified as CHA I; and Thelma Vlasoff of Tatitlek as CHP. From left: Thelma Vlasoff, Juanita Bales and Charlemagne Active. In this issue Breakfast and kids Culture and Language Program Health Services Division news Contract Health Care...6 Certificate of Degree of Indian Blood....6 Behavioral Health Department....7

2 2 NUPUAT is a quarterly publication of CHUGACHMIUT, the tribal not-forprofit organization serving the Alaska Native peoples of the Chugach Region. Francis Norman Board of Directors Chair Patrick Anderson Executive Director We welcome submissions from Tribal members, councils, and employees. Please share your comments and suggestions: Jerry Luken Newsletter Editor 1840 Bragaw Street Suite 110 Anchorage, AK (907) KIDS AND BREAKFAST e ve all heard that breakfast is the most important meal of the W day whether we take heed or not. But there are good reasons to make sure that the kids follow this advice. Kids who eat breakfast: Do better in school Have more focus and energy Have better eye-hand coordination Are more likely to meet their nutritional needs overall Have an easier time maintaining a healthy weight Have fewer behavioral issues If you have time constraints in the morning, fix healthy snacks the night before like peanut butter sandwiches or sliced fruit and take them on the run. Remember to keep the lean protein and fiber high and the sugar low. Oatmeal is still a great breakfast food. It digests slowly so it energizes kids until lunch. C o n t a c t N u m b e r s Chugachmiut, Anchorage NPR Housing Authority Chugach Regional Resources Commission Chugach Alaska Corporation Chugach North Technical Services Skip Richards Regional Safety and Emergency Response Coordinator Jackie Archer HeadStart Director Taren Klingler Education Training Coordinator Lynne Kelsey Behavioral Health Manager Chenega Council Chenega Clinic Eyak Council Ilanka Health Clinic (Eyak) Cordova WIC Office Nanwalek Council Nanwalek Clinic Port Graham Council Port Graham Clinic Qutekcak Council North Star Health Clinic Tatitlek Council Tatitlek Clinic Valdez Council Valdez WIC call the Eyak WIC Office

3 3 Culture and Language wraps up successful program hugachmiut congratulates and thanks everyone who C made the Culture and Language Program a success over the past three years. The initiative brought many parties together to ensure that the Sugcestun language of the Alutiiq people will be passed on to future generations. The program developed the following materials as the beginning of a, hopefully, continuing initiative to ensure that the language does not die: Alphabet/Numbers DVD (sounds of the Alphabet are recorded and counting to twenty in Sugcestun) 21 Units of Cultural Curriculum will be published 2 take-home books ( Occupations in my Community and When We Dance ), written and illustrated by Chugachmiut staff and local illustrators. 1 DVD on Preschool Personal Safety (in Sugcestun) 2 Levels of Sugcestun Curriculum Alphabet poster Numbers booklet Chugachmiut will continue to seek funding for future opportunities in the preservation of language and traditions. Please join us as we say goodbye to the following members of the Chugachmiut family. We wish them all every success with their future endeavors. Local Education Coordinators: Lennette Ronnegard, Cordova Sandra Angaiak, Chenega Bay Rhoda Moonin, Nanwalek Rebecca Norman, Port Graham Gertrude Dotomain, Seward Diane Selanoff, Valdez From left: Sandra Angaiak, Gertrude Dotomain, Rhoda Moonin, Rebecca Norman, Diane Selanoff. Donna Malchoff wins Alaska Head Start Award By Jackie Archer, Head Start Director Donna Malchoff, Culture and Language Program Manager for Chugachmiut, is winner of the Alaska Head Start Association s (AHSA) Cultural Awareness Award for Donna was nominated for supporting and advocating implementation of the Sugcestun Culture and Language Program in our Head Start Program as well as the local schools. She and her team have made and will continue to make a difference in assisting children in learning the local language of the region, and getting to know the importance of their unique culture. Language staff, clockwise from top left: Larry Kairaiuak, Donna Malchoff, Helen Loescher, Susan La- Belle (Division Director) and Helen Morris.

4 4 Health Services Division News from page 1 We recently received a grant to train two Seward tribal members to work with patients to address chronic health conditions. Ms. Rebecca Moore, Physician s Assistant (P.A.), came to us from California but has ties to the region through her husband, Ben Patistek. Ben grew up on the Kenai Peninsula and is excited to be back in Alaska. We anticipate that Ms. Moore will assume CHA/P radio medical traffic (RMT). This means patients will no longer have to wait three to four days for the Southcentral Foundation (SCF) doctor to authorize many of the routine treatments by the health aides. Because of the severe nursing shortage we ve decided to recruit a mid-level practitioner for Case Manager and to include Diabetes Program management in the position. Our HR staff has switched tactics for that vacancy. Once staff is in place and fully oriented, we will begin offering more than just acute care. We have a variety of programs in early planning phases: We will put together a team to plan the implementation of an Electronic Health Records system, including electronic charting. We recently received a grant to train two Seward tribal members to be non-professional trainers and work with patients to address chronic health conditions. We are in discussions as to the best methods to spread that demonstration project across the region. Please contact your local health care provider if you are interested in the project. We will look at the feasibility of care teams which will include the doctor, a midlevel assigned to each community, a CHA assigned to each patient, a behavioral health specialist, a dietician, the pharmacist and others as needed. This is groundbreaking territory for Chugachmiut North Star Health Clinic staff, standing left to right: Sue Steward, CHAP Manager; Ramona Rogers, health Administrative Assistant. Seated left to right: Rebecca Moore, PA; Connie Hedrick, Contract Health Technician; Glenn Schiff, Pharmacist; Rosaline Lemieux, Receptionist/Medical Records Clerk; and Teresa Swartz, Medical Assistant.

5 5 so currently there is a lack of policy development and implementation to guide staff. We have been working on those changes as well. Our personnel are working on a cancer care program, statewide coordination of care, a statewide Health Information Exchange and improved telemedicine coverage for our regional cancer patients. As we implement improvements and work toward a world class health organization, you may encounter problems. Throughout our Lean journey we have found that 94% of problems can be traced back to process and/ or system errors and only about 6% are people errors. Keep that in mind and ask your provider to note the problem for attention. Please feel free to provide possible solutions as well. We look forward to becoming partners with you in your health and well being. North Star Dental Clinic staff, left to right: Sarah Benjamin, Dental Hygienist; Gala Davis, Dental Assistant; Melody Wallace, Office Manager. Dr. David Zetterman. Upcoming health provider visits COMMUNITY DATE PROVIDER Tatitlek Nov 4 Dec 19 James Friedman, NP Nanwalek Nov Donna Fenske, ANP Port Graham Dec 1 5 Optometrist Seward Dec 3 4 Dr. Andre

6 6 Contract Health Care and Certificate of Degree of Indian Blood ligibility criteria for Contract Health Care Funds E (CHC) is considered and approved by the Chugachmiut Board of Directors. Proof of eligibility must be on file, at the Chugachmiut CHC Office. Documents accepted as proof are: A Certificate Degree of Indian Blood from the Bureau of Indian Affairs. A Membership card/certificate from a federally recognized tribe. CHC Funds are restricted to residents of the Chugach Region except for Alaska transients that present to a non IHS facility for true emergencies. Newborn Chugach Region residents may receive referred care or short-term emergency treatment for up to six (6) months after the date of birth. After the age of six (6) months, proof of eligibility must be on file in order for the child to receive CHC benefits. Non-Native women pregnant with the child of an eligible Alaska Native/American Indian are eligible for prenatal care, delivery and six weeks post-partum care as long as they meet Chugachmiut s eligibility requirements. In cases of joint custody, children of eligible Chugachmiut residents are entitled to CHC Funds during the period of time that the child is living within the Chugachmiut Region. A copy of Joint Custody documentation must be provided to the Chugachmiut CHC Office. Non-Native children adopted by an eligible Alaska Native/American Indian parent may receive CHC Funds until their 19 th birthday. Adoption or other court order documentation must be provided. Alaska Native and American Indians that have relocated to our service area have 6 months (180 days) with the intent to stay before they become eligible for CHC funds. At least two (2) of the following must be provided to the Chugachmiut CHC Office as documentation of residency: Rent or Mortgage receipts Employer paycheck Utility bill receipts Airlines or moving expense receipts Alaska voters registration Alaska drivers license or Alaska ID card OR, if unable to provide the above proofs, submit an affidavit signed by the Village Tribal Administrator, verifying Six months of residency in the Chugachmiut service area. Steps to Getting a Certificate of Degree of Indian Blood (CDIB) These steps are issued by: The United States Department of the Interior Bureau of Indian Affairs West-Central Alaska Agency 3601 C Street, Suite 1258 Anchorage, AK (907) , 3517, , Option #1 If you are a descendent or are adopted you need to have these papers: Original biological birth certificate Original adoption birth certificate Original adoption decree Completed application with biological Alaska Native parent(s) information If you are already enrolled you need to provide the following information: Birth Date Social Security Number ANCSA Regional Corporation name to which you are enrolled Full name and any names you had during the original ANCSA enrollment Completed Application HELPFUL INFORMATION: If you are American Indian, you must contact BIA agency or office nearest your tribe. Call the BIA Alaska office at and you will receive telephone contact numbers for your tribe or affiliation.

7 7 From the Behavioral Health Department Start a support group in your community By Gail K. Evanoff, Behavioral Health Aide, Chenega Bay hoosing to start a SUPPORT GROUP in your community is the right thing to do. In Chenega Bay we C chose to start a Self-Help Group where we meet weekly. Setting a date and time and being consistent is very important. Besides bringing people together who share specific needs, problems and concerns, a SUPPORT GROUP provides a way for all to get the social and emotional support needed in times of uncertainty. Guidance in behavior is also a focus of self-help groups. At the conclusion of our time together, we discuss a topic that we would like more information on and the facilitator will have that information for the next group meeting. All participants take turns sharing their feelings and no one present is allowed to be judgmental. Ground rules are discussed at the first meeting and a public record is kept for how meetings are held. One of the most important factors of getting together is the rule of CONFIDENTIALITY. We build on our strengths by sharing with others. So, grab a friend, a coffeepot and call another friend. Understand that there is always someone who cares. Seasonal Affective Disorder By Sidney Shaw, MA, LPC, Chugachmiut Behavioral Health Clinician A long time ago when the world was first born, it was always dark in the north where the Inuit people lived. They thought it was dark all over the world until an old crow told them about daylight and how he had seen it on his long journeys. The more they heard about daylight, the more the people wanted it. This introduction to the Inuit story Crow Brings Daylight reflects the natural human desire for increased daylight after enduring extended periods of darkness. The story ends with the Crow flying south and returning to bring daylight back to the Inuit people, much to their delight and appreciation. The challenges of dark winter days are also reflected in the words of Dr. Frederick Cook who noted, the light of the Arctic summer is an efficient tonic to the mind and body; but before the night begins the stimulation is replaced by a progressive depression. These quotes speak to the powerful influence of sunlight on mood in extreme northern latitudes and serve as a springboard for discussion of a condition commonly known as Seasonal Affective Disorder or SAD. SAD is a condition characterized by depressed mood, anxiety, lack of energy, oversleeping, overeating, weight gain, and craving for carbohydrates. Beginning usually around October or November and ending in March or April in the northern hemisphere, SAD is a distinct winter phenomena. SAD was officially classified by psychologists in the early 1980s and much research has been conducted since this time. A 1992 study by the University of Alaska Fairbanks found that 9% of those studied met the criteria for SAD and 24% for S-SAD (a milder version of SAD). Additionally, the study found that women were nearly 3 times as likely to experience SAD. Likewise there was a greater prevalence of SAD in adults under the age of 40. Although there is some debate as to the exact biological causes of SAD, research has indicated that levels of melatonin, a hormone that regulates sleep cycles, are important. During winter, when days are shorter and sunlight is diminished, melatonin levels increase contributing to symptoms associated with SAD. Some ways to counteract SAD include keeping your workplace and home bright, getting outside during midday, exercising and eating sensibly, maintaining a consistent sleeping routine and taking a vacation to a sunnier locale in winter, if possible. If these steps seem ineffective then light therapy is another alternative. Light therapy involves exposure to specially designed SAD lights that assist with reducing the production of melatonin in our systems. More specifically, sitting in front of SAD lights for 20 minutes or more per day seems to simulate the effects of sunlight. When sunlight enters through our eyes, it signals the gland that produces melatonin to suppress production, thereby waking up our body and mind. Numerous studies have indicated light therapy is one of the most effective treatments for reducing symptoms of SAD. Our physical and mental processes are directly influenced by seasonal changes and these changes are similar to what the plants and animals of our area are also experiencing. Trees and shrubs losing their leaves and going dormant, bears beginning hibernation and whales and songbirds migrating south to Hawaii and Mexico. Understanding our own rhythms is an ongoing process, as is learning about what works for us in adapting to these cycles. In considering the changes we go through with the See SAD, page 8

8 8 CHUGACHMIUT BOARD OF DIRECTORS Port Graham Francis Norman, Chair Nanwalek James Kvasnikoff, Vice Chair Tatitlek Ron Totemoff, Treasurer Valdez Benna Hughey, Secretary Eyak Robert Henrichs, Director Chenega Bay Michael Vigil, Director Chugachmiut is the tribal consortium created to promote selfdetermination to the seven Native communities of the Chugach Region. We provide health and social services, education and training, and technical assistance to the Chugach Native people in a way which is acceptable to Native cultural values and tradition in order to enhance the well-being of our people by continuing to strengthen the tribes and increase self-determination opportunities for community operated tribal programs. SAD, from page 7 seasons here in Alaska, it may also be helpful to consider other factors unique to our area. Seasonal fluctuations in the occupational, social and economic areas of our lives also influence how we think, how we feel and what we do as well. Social and natural causes interact reciprocally as part of seasonal changes and developing deeper understanding our own personal fluctuations can help us chart a healthy course with the ebb and flow of extreme seasons. Contact the Chugachmiut Behavioral Health Department if you would like more information on SAD. Qutekcak Arne Hatch, Director CHUGACHMIUT Chugachmiut Nupuat 1840 Bragaw Street, Suite 110 Anchorage, AK Non-Profit Org. U.S. Postage Paid Permit No. 595 Anchorage, AK ADDRESS SERVICE REQUESTED

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