December - Yukon-Kuskokwim Health Corporation

Volume XIII No. 12
December 15, 2008
Wishing you warmth and happiness this Holiday Season
from the YKHC Board of Directors
INSIDE: Sleds & Snowboards, p. 4 • Medical Families, p. 6 • Nursing Grads, p. 14
2
Board of Directors
Unit 1
Unit 5
Raymond F. Waska, Sr.
P.O. Box 46
Emmonak, Alaska 99581
907-949-1514
Paula Ayunerak
P.O. Box 5
Alakanuk, Alaska 99554
907-238-3212
Bill Kristovich
P.O. Box 1037
Bethel, Alaska 99559
907-543-4151/2212
Henry Hunter, Sr.
P.O. Box 632
Bethel, Alaska 99559
907-543-7963
Gloria Simeon
P.O. Box 308
Bethel, Alaska 99559
907-543-5676
Joseph C. Bavilla
P.O. Box 6011
Napaskiak, Alaska 99559
907-737-7665
Unit 2
Ray Alstrom
P.O. Box 8
Marshall, Alaska 99585
907-679-6320
James C. Landlord
P.O. Box 32168
Mt. Village, AK 99632
907-591-2531
Unit 3
Wayne Morgan
P.O. Box 234
Aniak, Alaska 99557
907-675-4264
George S. Morgan
P.O. Box 54
Upper Kalskag, Alaska 99607
907-471-2490
Unit 6
Esai Twitchell, Jr.
P.O. Box 121
Kasigluk, Alaska 99609
907-477-6309
Unit 7
Unit 9
Unit 11
David O. David
P.O. Box 78
Kwigillingok, Alaska 99622
907-588-8484
Patrick Tall
P.O. Box 196
Chevak, Alaska 99563
907-858-7613
James Hoelscher
P.O. Box 189
Hooper Bay, Alaska 99604
907-758-4616
Marvin Deacon
P.O. Box 45
Grayling, Alaska 99590
907-453-5195
Unit 4
Unit 8
James Nicori
P.O. Box 41
Kwethluk, Alaska 99621
907-757-6837
Moses Peter
P.O. Box 57
Tuluksak, Alaska 99679
907- 695-6426
James R. Charlie, Sr.
P.O. Box 37012
Toksook Bay, Alaska 99637
907-427-7114
James Sipary
P.O. Box 37134
Toksook Bay, Alaska 99637
907- 427-7816
Unit 10
Honorary Board Member
Paul John
P.O. Box 37067
Toksook Bay, Alaska 99637
907-427-74l4
Sam W. Alexie
P.O. Box 57
Eek, Alaska 99578
907-536-5428
Numbers to Call
YKHC Main Operator.................................................. 543-6000
Toll Free............................................................ 1-800-478-3321
Public Relations............................................................... 543-6038
Media Services................................................................. 677-2232
Office of Environmental Health & Engineering............ 543-6420
Technology Help Desk.................................................... 543-6070
Human Resources........................................................... 543-6060
Administration................................................................ 543-6020
Hospital........................................................................... 543-6300
Emergency Room............................................................ 543-6395
Hospital Community Relations..................................... 543-6350
Social Services................................................................. 543-6225
Family Medicine Clinic Appointments.......................... 543-6442
1-800-478-3321
Appointments
Dental Appointments..................................................... 543-6229
Optometry Appointments.............................................. 543-6336
Audiology Appointments............................................... 543-6466
Subregional Clinic Appointments
Aniak............................................................................ 675-4556
Emmonak.................................................................... 949-3500
St. Mary’s..................................................................... 438-3500
Toksook Bay................................................................. 427-3500
Public Health Nursing.................................................... 543-2110
Pharmacy......................................................................... 543-6382
Travel Management Center............................................ 543-6360
WIC Program.................................................................. 543-6459
Health Services............................................................... 543-6024
Village Operations.......................................................... 543-6160
CHAP........................................................................... 543-6160
ICEMS.......................................................................... 543-6080
Community Health & Wellness.................................. 543-6190
Behavioral Health Services............................................. 543-6100
Phillips Ayagnirvik...................................................... 543-6700
Village Services............................................................ 543-6740
Home Care Services........................................................ 543-6170
Volume XIII No. 12 • December 15, 2008
3
Board honors
Paul John at
annual meeting
YKHC Board
& Committee Meetings
2009
Two new
members
sworn in
January 20
Finance
Committee
T
he annual meeting
of YKHC’s Board of
Directors was held Nov.
19–21 in Bethel. In a
special ceremony on Nov. 21, the
Board, by proclamation, named
their Board Room in the Community Health Services Building
the Paul John Board Room.
January 20 – 21
Hospital Governing Body
February 17
Finance Committee
Board Chairman Ray Alstrom congratulates Paul John after
the Board room dedication.
Toksook Bay Elder Paul John has been a YKHC Board Member since the corporation was
founded in 1969. By virtue of his service and dedication to
the health of the people of the region, he was named Honorary Board Member for life more than 10 years ago.
A permanent plaque mounted on the wall in the third
floor board room reads, “It is important to strive for health
promotion and family wellness in our communities and to
apply Native values and harmony to guide improvements
in our health care delivery system.”
Sam W. Alexie, 1st Additional
Member
Paula Ayunerak, 2nd Additional Member
Gene Peltola, Ex-Officio
Paul John, Honorary Member
see COMMITTEES, p. 12
Finance Committee
March 17 – 18
Hospital Governing Body
April 21
Finance Committee
April 22 – 24
Full Board of Directors
Patrick Tall of Chevak will represent Unit 9.
Executive Board, Governing
Body and Committees
Ray Alstrom, Chair
Bill Kristovich, 1st Vice Chair
James Charlie, Sr., 2nd Vice
Chair
Esai Twitchell, Jr., Secretary
Marvin Deacon, Treasurer
Raymond Waska, Sgt.-At-Arms
March 17
Tribal Gathering, Bethel
Marvin Deacon of Grayling is new on the Board and will
be representing Unit 11—Grayling, Shageluk, Holy Cross
and Anvik. This seat was formerly held by Kathy Chase of
Holy Cross.
Executive Board
Executive Board
April 1–2
New Members Welcomed
Two new members were seated to the YKHC Board of
Directors at last month’s full board meeting. Patrick Tall
of Chevak will be replacing Elmer Simon of Hooper Bay,
representing Unit 9. Unit 9 includes the villages of Hooper
Bay, Chevak and Scammon Bay.
February 18 – 19
Marvin Deacon of Grayling is
the new representative from
Unit 11.
May 19
Finance Committee
The Messenger Quarterly is
printed in December, March, June, and September.
The Messenger is published monthly online at www.
ykhc.org by the Yukon-Kuskokwim Health Corporation as a report to Tribal Members. For questions,
comments, submission of articles, or subscription
information, write to Messenger Editor, Public Relations, Yukon-Kuskokwim Health Corporation, P.O.
Box 528, Bethel, Alaska 99559. E-mail: messenger@
ykhc.org. Deadline is the last day of the month preceding publication. Publication is on the 15th of
every month. Anchorage Office: 4700
Business Park Blvd. Suite E25, Anchorage, Alaska 99503. 907-6772232. Please ask permission
to reprint articles or pictures.
© 2008, Yukon-Kuskokwim
Health Corporation.
4
Kaydean Andrews, along with every other K-6 student
got a sled. Photos (clockwise) by Phillip Duffy, Mae
Pitka, and John Townsend.
Daren Kozevnikoff discovers the thrill of snowboarding thanks to a Diabetes Prevention Grant used to
purchase outdoor winter recreation gear for Russian Mission School.
Preventing Diabetes with Snowboards
and Sleds in Russian Mission
By Jason S. Moen, Instructional Leader, Russian Mission School
Thanks to a Diabetes Prevention Grant from YKHC, Russian
Mission students are hitting the slopes to fight diabetes.
The long winters of the Yukon-Kuskokwim Delta have long posed a problem for getting
young adults out and exercising. While basketball and open gym have always drawn some
students, the school was seeking ways to involve as many students as possible. Russian Mission’s Winter Sports Grant included three components each geared towards different age
groups and interests. The first goal was to put a sled in the hands of each and every student
in grades K-6. Fifty-six Ski-Doo sleds were purchased at Costco—one for each student in
grades K-6.
Aaron Minock and his snowboard.
The next component was the purchase of snowboards. Rather than purchasing five brand
new snowboards and bindings, teacher John Townsend visited several Cash Alaska pawn
shops and purchased 15 lightly used snowboards with bindings for approximately $100
each. The sleds and snowboards were shipped out to Russian Mission with Frontier Flying
Service and completely filled the Cessna 402. Upon arrival, students waited anxiously for
the snow to fall.
As the snow fell one February afternoon, students stepped away from the TV, unplugged
the video games, turned off of their snowmachines and hit the slopes. Every student with a
sled was running up and sliding down the hill. Older students shared the snowboards and
other students brought out their own boards. Jumps were built, tricks were attempted and
by the end of the evening, there were plenty of wipeouts and plenty of smiles.
The biggest adventure of the year included an overnight snowboarding trip to the Kako
Retreat Center 12 miles from Russian Mission. Students met up with college students on
spring break for a week of fun on the Kako Hills. The third and final component includes
adding to the school’s cross-country ski equipment. Once all of the gear is purchased, the
students and staff of Russian Mission School hope to spend a few days with the students and
staff of Marshall Schools and share in the fun of sledding, snowboarding and skiing.
Jeanette Kozevnikoff recovers from a spill.
Volume XIII No. 12 • December 15, 2008
5
Did you know?
Second hand smoke found to
impair childhood learning
Secondhand smoke exposure impairs a child’s
Thinking about stopping smoking
or chewing tobacco?
Here are some ways to get started:
• Ask for help from your doctor, health aide, nurse and from family and friends.
ability to learn. It is neurotoxic even at extremely
• Make a list of your reasons for wanting to stop using tobacco.
low levels. More than 21.9 million children
are estimated to be at risk of reading deficits
• Set a Quit Date—the sooner the better. If you are not ready to set a date,
begin to cut down on your tobacco use. Then, make a plan to stop all tobacco
use in the near future.
because of secondhand smoke. Higher levels
• Get medication and use it correctly.
of exposure to secondhand smoke are also
• Ask for stop-smoking materials and read them. Learn about your own tobacco
use habit and plan ways to cope with urges to smoke or chew after you quit.
Try the four D’s: Delay, Deep Breathe, Drink Water, and Do Something Else.
associated with greater deficits in math and
visuospatial reasoning.
Source:Yolten, K. et al., “Exposure to Environmental
Tobacco Smoke and Cognitive Abilities of U.S. Children and
Adolescents,” “Environmental Health Perspectives, 113(1):
98-103. http://no-smoke.org/document.php?id=212
• If you slip and go back to using tobacco, first find out what caused the slip
and then keep trying to quit again until you make it for good. The only certain
failure is if you stop trying.
Contact the Alaska Quitline at 1-888-842-7848. They offer free patches for
people over the age of 18. Or call YKHC Nicotine Control & Research at
1-800-478-3321 extension 6312 (or 543-6312) for more information.
From the U.S. Department of Health & Human Services, AHRQ help for smokers and other tobacco users
FLU SHOT FACTS
Who should get the flu shot?
• Anyone 50 years of age or older..
• All children 6 months through 18 years of age.
• All women pregnant during flu season.
• Anyone with long-term health problems.
• Anyone with a weakened immune system.
• Long term steroid treatment.
• HIV/AIDS or disease affecting
immune system.
• Cancer treatments.
• Anyone who lives with or cares for people at
high risk for influenza related complications.
• Health care workers.
• Anyone who wants to reduce the
likelihood of becoming ill with the flu.
Who should not get the flu shot?
• Anyone who has had a serious
reaction to the flu shot in the past.
• Anyone who is allergic to eggs (vaccine
contains small quantities of egg proteins)
or Thimersol (preservative).
What are a few myths and facts
about the flu vaccine?
Myth—The flu shot can cause the flu.
Fact—The flu shot cannot cause the flu. Some people can get a little
soreness or redness where they got the shot. It goes away in a day or
two. Serious problems are very rare.
Myth—The flu shot does not work.
Fact—The effectiveness of the flu shot has ranged from 70 percent to 90
percent. Getting the vaccine is your best protection against this disease.
Myth—Only older people need the flu vaccine.
Fact—Adults and children with chronic health
conditions need to get the flu shot.
How does the flu spread?
Flu is spread from person to person through coughing,
sneezing, or nasal secretions. You can also get the
flu through touching contaminated surfaces.
When and where can I get the flu vaccine?
In the village, people can get their flu shot at their local
village clinic or subregional clinic. In Bethel, you can get the
flu shot at YKHC 543-6000, Public Health Nursing 543-2110
or Bethel Family Clinic- 543-3773
6
Family Medicine:
Outpatient Clinic improvements
will enhance continuity of care
By Louise Reed, Director of Outpatient Clinics
The vision of Outpatient Clinics is,
“Providing Excellent Health —
One Patient At a Time.”
I
n an effort to maintain continuity of care for our patients, particularly
throughout the turnover of Medical and Nursing staff, the
Empanelment Committee has decided to give names to various
village and patient groups. These groups, or medical families, will
remain the same even if a medical provider leaves, creating as smooth a
transition as possible.
The Clinics will continue to be known as Delta, Kusko and Yukon. Villages assigned to each clinic have changed slightly. (See provider pictures
and village distribution on page 7). Culturally relevant names have been
assigned to the medical families. We are planning to bring these changes
by the beginning of the New Year with as little disturbance to our routine
as possible.
A group of villages, including some Bethel patients, will now fall into the
following medical families:
Delta Clinic
Patients regularly seen in Delta will be part of one of these medical families: Crane, Swan, Mallard, Ptarmigan or Pintail.
Kusko Clinic
Patients regularly seen in Kusko will be part of one of these medical families: Moose, Beaver or Caribou.
Yukon Clinic
Patients regularly seen in Yukon will be part of one of these medical families: Herring, Pike, Whitefish, King, Red or Silver.
Our medical providers will be assigned to a specific medical
family. For the most part, this change will make very little
difference in which provider you see. For example, if your
regular provider is Dr. Hartman, you will still be scheduled
with him in Delta Clinic. However, now “Crane” will be on
your registration sticker, because that is the medical family
group he will work in.
Also, there may be more than one provider caring for the
patients of each medical family. Dr. Mondesir is also part
of the “Crane” family and will be the pediatrician caring for
many of the children in that group.
When you need a clinic appointment, you will still call the
same number, 907-543-6442, and hear the same friendly
voice of your scheduler. Most people will go to the same
clinic and see the same provider, unless their provider is off
duty or out of town. The only difference will be that most of
the stickers you will receive to take to the clinic will have a
“medical family” name instead of the provider’s name. Actual
Provider names will be used only under special circumstances.
One other change to be aware of is Dr. Al-Shaar is now
working in the Specialty Clinic area. We thank you for your
patience as we make changes in our Delivery of Care so that
we may “Provide Excellent Health – One Patient At A Time.”
Patient
Centered
Excellence
Volume XIII No. 12 • December 15, 2008
7
Your Family Medicine Providers
Delta
we provide. In order to give you a direct voice
CRANE
to let us know how we’re doing, YKHC has
Hooper Bay SRC
Chevak, Scammon Bay
contracted with an organization called Press-
SWAN
Kwigillingok,
Napaskiak, Oscarville
MALLARD
Emmonak SRC,
Alakanuk, Kotlik,
Nunam Iqua
We want you to be satisfied with the service
Ganey. Each month Press-Ganey sends surveys
Daniel Hartman, MD
Family Medicine
Suzanne Schawlb, DO
Family Medicine
to patients who have been seen
in our Outpatient Clinics, giving
PTARMIGAN
you a chance to tell us what we
Akiachak
Eek
PINTAIL
Tuntutuliak Quinhagak
are doing right and also how we
Cynthia Mondesir, MD
Pediatrics
Scott Davis, MD
Pediatrics
Elena Herrera, FNP-C
Kusko
MOOSE
Aniak SRC, Anvik,
Chuathbaluk,
Crooked Creek,
Grayling, Holy Cross,
Lower Kalskag,
Red Devil,
Russian Mission,
Shageluk, Sleetmute,
Stony River,
Upper Kalskag
BEAVER
Elizabeth Roll, MD
Outpatient Clinics
Service Chief
Women’s Health &
Family Medicine
Beverly Burden, PNP
Pediatrics
Paula Diamante, MD
Pediatrics
CARIBOU
Napakiak, Tuluksak
Claire Lewis, WHNP
Women’s Health
Ann Glasheen, WHNP
Women’s Health
K. Jane McClure, MD
Pediatrics
Kimberly Whitaker, MD
Family Medicine
Yukon
HERRING
Toksook Bay SRC,
Mekoryuk, Newtok,
Nightmute, Tununak
PIKE
Kasigluk , Marshall
Kipnuk , Nunapitchuk
Gulnara Aliyeva, MD
Family Medicine
KING
St. Mary’s SRC,
Mountain Village,
Pilot Station,
Pitkas Point
RED
Atmautluak, Chefornak
SILVER
Akiak, Kongiganak
Carolyn Lorenz, MD
Pediatrics
New encounter
forms streamline
patient care
by Michael Faubion, Public Relations
Over the past year, YKHC’s hospital
outpatient clinics and subregional clinics
have begun using a new version of an old
standby—the patient exam form.
Kwethluk
WHITEFISH
could do better.
Anne Komulainen, PA-C
Family Medicine
Jean Brinich, FNP
Family Medicine
Note: Each medical family village group includes Bethel patients..
The PCC, or Patient Care Component,
form has been in use at at Indian Health
Service and Tribal hospitals for a long
time. It used to come pre-printed from
the United States Government with three
carbon copies attached. After each patient
visit, employees would manually enter the
information written on the form by providers into a computer database system
called RPMS—Resource and Patient
Management System—also managed by
the IHS.
YKHC has long since customized the old
paper form to suit our own needs, and
created many varieties for the different
clinics and departments. These forms
have been an improvement for gathering patient information at each visit, but
weren’t very helpful in getting existing
see PCC, p. 19
8
Arctic Care exercise returns
to Western Alaska
By Tiffany Zulkosky, Public Relations
Arctic Care, also known as the Innovative
Readiness Training exercise, will return to the
Yukon-Kuskokwim Delta March 3–15, 2009, to
provide no-cost veterinary and medical services
to local residents.
This exercise allows military reserves personnel to perform two
weeks of training within the country, in sometimes extreme conditions, serving Americans. The Navy will be leading the 2009 exercise, but all branches of the military will be involved.
Medical teams will be in place for 10 days in 11 Delta communities: Hooper Bay, Chevak, Toksook Bay, Alakanuk, Mtn. Village,
Atmauthluak, Quinhagak, Kwigillingok, Kalskag, Kwethluk, and
Specialist Freddie Ballesteros with new friends in Tununak during the
2001 Arctic Care training exercise. (YKHC file photo by Dana Hall)
Newtok. Residents of nearby villages can travel to one of the
11 sites to receive services.
At YKHC’s request, Arctic Care will be providing veterinary
services such as dog vaccinations and spay/neuter procedures for village pets. “Because rabies is so endemic, we want
to make sure we protect animals and the humans around
them,” said Dr. Joseph Klejka, Corporate Medical Director for
YKHC.
Expected medical personnel will include dentists, optometrists, physicians or mid-levels, and veterinarians. Specialists
will also be at the Bethel hospital providing colonoscopies,
dental procedures requiring anesthesia, and women’s health
services.
Arctic Care has been to the YK Delta three times previously—
in 1997, 1998, and 2001. Each operation resulted in memorable experiences for those serving as well as those who were
served. Because of the success of the previous operations
YKHC welcomes all the military personnel to the region with
appreciation and high expectations.
Military personnel bunk in the armory in Bethel before heading out to the villages during the 2001 Arctic Care exercises. (file photo by Michael Faubion)
The appreciation has worked both ways, as Cpl. Zachary A.
Bathon wrote following the 2001 exercises: “More than 180
servicemembers participated in the exercise and were able to
complete their mission, help the local residents and maybe
learned a little bit about their culture as well.”
Volume XIII No. 12 • December 15, 2008
9
First Alaskantrained Dental
Therapists
Graduate
By Tiffany Zulkosky, Public Relations
The original class of Alaskan-trained Dental Therapists include (from left) Daniel Kennedy, Sheena Nelson, Danielle
Boston, and Christopher Evan.
“These four individuals
The first cohort of Alaskan-trained Dental Therapists was
honored during a Community Reception held Dec. 9, at the
Yupiit Piciryarait Cultural Center.
are pioneers in this
The students were graduated from the program during a ceremony at the Alaska Native
Tribal Health Consortium (ANTHC) on Friday, Dec. 12.
field. I see this as an
The four students graduating from the Dental Therapy program are: Danielle Boston of
Chistochina, Christopher Evan of Russian Mission, Daniel Kennedy of Klawock and Sheena
Nelson of Yakutat.
amazing beginning for
the Dental Health Aide
Therapist profession,
not only in Alaska, but
throughout our country.”
— Dr. Anthony
Brusca, DDS
“As I sat through the reception and listened to the speakers address the crowd, I had the
chance to reflect on the year and a half I’ve spent with these students,” said Dr. Anthony
Brusca, DDS, an instructor with the program since its inception in 2007. “I was filled with
such an enormous sense of pride. These four individuals are pioneers in this field. I see
this as an amazing beginning for the Dental Health Aide Therapist profession, not only in
Alaska, but throughout our country.”
The graduates will provide dental services throughout Alaska’s rural communities under
the supervision of licensed dentists. The oral health services typically include basic fillings,
simple extractions, cleanings, site visits, screenings, fluoride treatments, oral hygiene and
education.
“This is the beginning of something we hope to do more of and to expand,” said LaMont
Albertson, Executive Director of Yuut Elitnaurviat. “Regionally, there are overwhelming
dental care challenges. Thanks to the vision of Gene Peltola, Valerie Davidson, and several
other tribal health leaders, the Yuut Elitnaurviat Dental Training Clinic will be moving into
a brand new facility on the Yuut Elitnaurviat Campus in March 2009, where we can begin
to address rural needs in earnest. This truly introduces a new era of oral health care in bush
Alaska.”
The state and nation’s first-ever Dental Therapy program is a collaborative effort between
several organizations, including the University of Washington DENTEX Program, ANTHC,
YKHC, and Yuut Elitnaurviat. The two-year program is modeled after the highly successful New Zealand program. According to resident dental instructor Dr. Robert Allen, DDS,
nore than 50 other countries worldwide provide Dental Health Therapy Training for their
citizens. These programs prepare students in the art and practice of preventive and basic
dental care.
10
A Message from the YKHC Medicaid Office
Prenatal Care assistance
available through
Denali Kid Care
by Dorothy Chase, Patient Resources Coordinator
Are you pregnant? Do you think you may be
pregnant? Do you know someone pregnant? Did
you know that Alaska’s Denali Kid Care (DKC)
Program offers coverage for prenatal visits and
continues through the 6-8 week postpartum
check-up?
Denali Kid Care is also referred to as Pregnant Women’s Medicaid.
Coverage may include airfare, lodging, meals and taxi vouchers. This
coverage is a benefit.
It is strongly recommended that once a woman knows she is pregnant, she should apply for Denali Kid Care right away. This ensures
that she will have coverage from the beginning of her pregnancy and
avoid any delays in her prenatal care. The sooner an application is
submitted the sooner the coverage begins.
Once a positive pregnancy test is done, a Health Care Provider,
Nurse, Health Aide or ANY health care official can fill out the Pregnancy Verification form and sign it. The YKHC Family Medicine
Clinics and Village Clinics have these forms. This form will show
proof that a woman is pregnant and the date she is due.
Once an application is submitted the average wait time is approximately two to four weeks. When submitting an application, the
following are required: Proof of Lawful Immigration Status (Birth
Certificates), Identification (State ID or Driver’s License), Proof of
Income for the last 30 days (Copy of Pay Stubs) and a Pregnancy Verification Form. The application may take longer to approve if some of
these documents are not submitted with the initial application. There
are income guidelines for all applicants but it is important to complete the application to check if you are eligible.
We all know that it is expensive to fly. Airfare for medical appointments can be paid if a pregnant woman has Denali Kid Care. Occasionally, a pregnant woman needs further testing and/or treatment
in Anchorage. Pregnant women may also need to go to Anchorage
to wait and deliver at ANMC or one of the other hospitals. DKC will
cover airfare and housing in Anchorage or Bethel.
In the past, YKHC has approved to pay for the first prenatal visit for
village patients. The patient must have already applied for Denali Kid
Care or they need to apply while in Bethel.
It is important to notify the YKHC scheduling office in advance if
you cannot make your scheduled appointment or if you need to
reschedule your appointment. If you are traveling from the village
you must attend all scheduled appointments. If you leave without
being seen, the hospital may report this to DKC and your coverage
may end.
As a health corporation, YKHC promotes good health for everyone.
It is extremely important for a pregnant woman to receive prenatal care early in her pregnancy and start taking vitamins, iron and
calcium that will help her baby to be healthy. Please do your part in
being healthy and having a healthy baby by getting prenatal care as
soon as you know you are pregnant.
Denali Kid Care also covers children in the household who fall
within the income guidelines. Please contact the YKHC Medicaid
Office for more information.
If you need an application, need assistance with
an application or would like to know the status
of your application, please contact Dorothy
Chase at 1-800-478-3321 Extension 6470, in
Bethel 543-6470 or through email at
[email protected].
Volume XIII No. 12 • December 15, 2008
11
Some Myths and Facts about
Third Party Payments
Commitment to Quality
Helping the Alaska
Native Community with
Third Party Payers
Myth:
It doesn’t matter if I apply for Medicare,
Medicaid or Denali KidCare, or disclose my
private insurance coverage—I am entitled to
Indian Health Service (IHS) coverage, free of
charge!
Fact:
Enrolling in health care programs can help you and the
Alaska Native health care system
Have you ever wondered if there was something you could do to help
strengthen and enhance the services available for your children, elders, aunts, uncles
and other relatives?
Enrolling in insurance programs like Medicaid, Medicare, Disability or private insurance helps pay for medical bills and increases the flow of resources to expand YKHC’s
services. These resources benefit the entire Alaska Native Community.
YKHC is a nonprofit health care organization that works with local communities—
Bethel and over 50 rural villages—to treat illness and injury and promote wellness
for the entire service area. To continue providing high-quality services for our vast
region, we depend on more than just Indian Health Service (IHS) funding. The organization depends on an active partnership between health care providers, employees,
and the customers who use and benefit from the system.
With only minimal increases in IHS funding each year, the Alaska Native Health
system must rely on a mix of other funding sources to provide its full range of services. Roughly 50 percent of all services would not exist if YKHC relied on IHS funding
alone.
You are entitled to IHS coverage, but your
Medicare, Medicaid, Denali KidCare and disability or private insurance matter a great deal.
Customer/owners who enroll in other insurance
programs help the entire Native Community
by bringing in additional resources and freeing up IHS funds for improvements to services.
Customers don’t have to pay deductibles or copayments, regardless of what they sign up for.
Myth:
Applying for Medicare, Medicaid or Denali
KidCare coverage is too complicated and isn’t
worth the time it takes to sign up.
Fact:
YKHC Family Health Resource Representatives can check a customer’s eligibility for other
insurance coverage during a quick screening,
and then, if eligible, will help with the application process to keep it simple. There is no cost
to the customer, and the benefit to the whole
Native Community is significant. To contact the
YKHC Family Health Resource program, please
call 907-543-6470.
Myth:
Here’s how you can help!
In addition to grants and private insurers, there are third-party insurance payers such
as Family Medicaid, Denali KidCare, Prenatal Denali KidCare, Under Twenty-One
Medicaid, Elderly Assistance/Social Security, Medicare and Disability insurance.
Every time a YKHC customer provides his or her insurance information to the hospital or clinic, additional funding for Native Health services is brought into the organization at no cost to the customer. All of this money is used to fund YKHC’s clinics
and programs, and to buy medical equipment, medicines, and supplies needed for our
services.
Third party insurance payments make a big difference in the services YKHC can provide, but there are many missed opportunities to access resources. When someone
goes outside of the IHS system, does not volunteer to share insurance status, decides
not to participate in screening, or does not apply for insurance or assistance they are
eligible to receive, money is lost that could have supported Alaska Native Health care.
Erica Srisanceha, project manager in the Anchorage Native Primary Care Center
see THIRD PARTY PAYERS, p. 19
I go to a medical center outside the Alaska
Native health system because I have private
insurance coverage. This way, I am freeing up
a spot for someone without insurance who
really needs the care.
Fact:
Customers and employees have created a
world-class health system for all Alaska Native
and American Indian people in our region. If
you are eligible, using the Alaska Native health
system for all of your health care supports it
financially and honors the work that we do.
Using your insurance in the Alaska Native
health system brings in important funding
needed to maintain and improve services for
everyone.
12
Governor Palin Announces Health Priorities
From the Governor’s Press Office
On December 4, 2008, Governor Sarah Palin announced her goals
to improve Alaska’s health and education through fiscal year 2010
budget requests, the formation of a health care commission, support
for legislation and an informational campaign to help Alaskans take
better care of their own health.
Governor Palin put a priority on children’s health and development.
“Children are the most valuable resource in Alaska,” she said. “We
have to do more to support health coverage and health care, because
it plays such a big role in a child’s success in school, and in life. Our
state agencies are partnering to better equip Alaskans to lead healthier lives and to meet health care needs across the state.”
Governor Palin called for increased coverage of Alaska’s children
under Denali KidCare, state funding to reverse childhood obesity
and improve diagnosis of autism, and increased funding for Alaska’s
Head Start preschool programs.
The Governor joined Health and Social Services Commissioner Bill
Hogan, Education and Early Development Commissioner Larry
LeDoux, Labor Commissioner Click Bishop, Chief Medical Officer
Dr. Jay Butler, and University of Alaska Anchorage Chancellor Fran
Ulmer to announce health and education priorities.
Highlights of the Governor’s priorities in health and
education:
• Establish the Alaska Health Care Commission to provide recommendations for and to foster the development of a statewide plan
to address the quality, accessibility, and availability of health care
for all citizens of the state.
• Support legislation to increase the income eligibility guidelines
for Denali KidCare to 200 percent of Alaska’s federal poverty
level. Such an increase would make about 1,300 more children
and about 225 more pregnant women eligible for health coverage
under Denali KidCare.
• Continue our investment in the Tobacco Use Education and Cessation Fund to boost Alaska’s tobacco prevention and control
program.
• Fund Alaska’s obesity prevention and control program and work
toward reversing the trend of childhood obesity.
• Spend $250,000 to offer better access to early screening and diagnosis of autism and other neurodevelopmental disorders.
• Develop a statewide initiative called Live Well Alaska. The interactive web-based campaign will provide the best recommendations
for eating healthier, being more physically active and quitting
tobacco use.
• Increase funding for Head Start preschool programs by $800,000.
The additional funds will allow the program to serve 60 to 80 more
children. Approximately 1,000 Alaska children remain on waiting lists for Head Start. This funding is in addition to $600,000 in
increased funding that Head Start received last fiscal year.
• Spend $2 million for the Department of Education to implement a
pilot preschool program. School districts would receive the funding through grants. The half-day preschools would serve up to 500
children statewide.
• Fund the University of Alaska’s Family Residency Program
COMMITTEES, from p. 3
Governing Body
Finance Committee
Board Appointments
Financial Policy
George Morgan
James Landlord
Gloria Simeon
James Sipary
David O. David
James Nicori
Joseph Bavilla
James Charlie, Sr.
Marvin Deacon, Chair
Wayne Morgan
Bill Kristovich
Ray Waska
James Landlord
Gloria Simeon
Ray Alstrom, Ex-Officio
Gene Peltola, Ex-Officio
James Nicori
David O David
James Landlord
Gloria Simeon
Gene Peltola, Ex-Officio
Board Standing Committees
Audit Committee
BH Advisory Board—Paula
Ayunerak
Alternate – Sam W. Alexie
Health Aide Advisory Board—Sam
W. Alexie
Loan Forgiveness Program—
George Morgan
Home Care Liaison—James Sipary
ANTHC – Ray Alstrom,
1st Gene Peltola, 2nd Bill Kristovich
Human Studies—Sam W. Alexie,
James Nicori, Moses Peter, Ray
Alstrom
IDD, LLC—Ray Alstrom, Bill Kristovich,
George S. Morgan
Gene Peltola, Gregory McIntyre
ANHB—Bill Kristovich, 2nd Gene
Peltola
By-Law Committee
Joseph Bavilla
Marvin Deacon
David O. David
Moses Peter
Ray Waska
Policy Committee
James Charlie, Sr.
Gloria Simeon
Paula Ayunerak
James Landlord
Joint AVCP/YKHC/Calista
Gene Peltola, Ray Alstrom
Bill Kristovich
Moses Peter
George S. Morgan
Investment Committee
Bill Kristovich, Chair
Moses Peter
Paula Ayunerak
Wayne Morgan
George Morgan
Ray Alstrom, Ex-Officio
Gene Peltola, Ex-Officio
Dan Winkelman, Ex-Officio
Special Committees
Housing Committee
William Kristovich. James Sipary
Gene Peltola
Corp Compliance/Quality Assurance
David O David
Bill Kristovich
Paula Ayunerak
James Sipary, Sr.
Moses Peter
Gene Peltola, Ex-Officio
Compensation Committee
Ray Alstrom
Wayne Morgan
Joseph Bavilla
Gene Peltola, Ex-Officio
William Morgan Legend Award
Ray Alstrom, Sam Alexie
Gene Peltola, Dan Winkelman
Volume XIII No. 12 • December 15, 2008
13
Safe Toys and Gifts Month
By Melanie Huett, MS, RD, LD, WIC RD Nutrition Educator
The holiday season is when most toys and games are purchased,
so December has been set aside as safe toys and gifts month.
Play is an important part of a child’s development because
it helps children learn. Most toys are safe, but they become
unsafe if misused or given to children who are too
young to play with them. Some toys may not be
appropriate for all age groups.
Falls and choking cause the majority of toy-related
injuries and deaths in children. Choking alone causes
one third of all toy-related deaths, usually from balloons.
Children 4 years old and younger account for almost
half of all toy-related injuries and almost 90 percent of
deaths. Children younger than 3 years old are at the
greatest risk of choking because of the small size of their
airways and the tendency to put objects, especially toys,
in their mouths.
Dangerous Objects for Young Children
The American Academy of Pediatrics advises keeping the following
items away from infants and young children to reduce the risk of
choking:
• latex balloons
• coins
• marbles
• toys with small parts
• toys that can be compressed to fit entirely into a child’s mouth
• small balls
• pen or marker caps
• small button-type batteries
• medicine syringes
The good news is that the majority of toy-related injuries are minor.
The National Safe Kids Campaign, along with the National Safety
Council, have made some recommendations for selecting safe toys
for children.
Tips for selecting safe toys
• Consider the child’s age, interests, and skill level
• Look for quality design and construction
• Follow age and safety recommendations on labels
• Use a small parts tester, also known as a choke tube, to determine
whether small toys may present a choking hazard to children
ages 3 and under. The tube is about the same diameter as a child’s
windpipe. If a toy can pass through the tester, then it is too small
for children this age and can cause them to choke if swallowed.
Small parts testers can be purchased at toy or baby stores, but an
easy and free way to tell if a toy is safe is
to use the cardboard core of a toilet
paper roll.
• Avoid toys with sharp points
or edges, and projectiles, such
as darts
• Avoid toys with
strings, straps, or
cords longer than seven
inches. These toys may post a risk of
strangulation for young children.
• Avoid electrical toys with heating elements for children under 8 years old.
• Avoid cap guns that use caps that can
be ignited by friction because they can
cause burns.
•
Avoid latex balloons to eliminate the risk
of choking or a latex allergy reaction.
Tips to keep children safe from toy-related injuries
• Inspect toys regularly for damage and potential hazards. Make
necessary repairs or throw away damaged toys.
• Watch children during playtime to keep them safe from toyrelated injuries.
• Use toys in a safe environment.
• Teach children to put away toys safely after playing.
Toys can sometimes be recalled for safety reasons. Check the
National Safe Kids Campaign website www.safekids.org or the U.S.
Consumer Product Safety Commission (CPSC) website for updates
and information on recent toy recalls or call CPSC’s hotline at (800)
638-CPSC to report a toy you think is unsafe. The CPSC closely
monitors and regulates toys. Any toy made in or imported into the
United States after 1995 must adhere to CPSC standards.
Choosing safe toys:
• Toys made of fabric should be marked as flame resistant or flame
retardant.
• Stuffed toys should be washable.
• Painted toys should be coated with lead-free paint. Toys that are
red, orange, or yellow may me more likely to test positive for lead
because lead makes paint brighter.
• Art materials should be nontoxic.
• Crayons and paints should say ASTM D-4236 on the package,
which means that they have been evaluated by the American Society for Testing and Materials.
see SAFE TOYS, p. 16
14
March of Dimes selects
YKHC Women’s Health NP
as Nurse of the Year
YKHC Women’s Health Provider Claire Lewis was selected as this year’s
March of Dimes Nurse of the Year. The award was announced Novemeber 14
at the March of Dimes State Nursing Awards banquet at the Hilton Hotel in
Anchorage.
Claire’s husband, along with six YKHC staff from the hospital’s Outpatient
Clinics were on hand to support and congratulate her when she won.
Lewis’ coworkers, patients and friends throughout the YK region know well
why she was chosen as Nurse of the Year in the Advanced Practice category,
which includes clinical nurse specialists, certified nurse midwifes, nurse
practitioners and nurse psychotherapists, and certified registered nurse anesthetists. But for the benefit of those in attendance who have not known her as
long as we have, this was shared:
Claire Lewis, NP, finished her training as a Women’s Health Nurse Practitioner in 1997. She provides prenatal care and women’s health care to the rural
areas. She sees her patients well into the evening hours. She has been part of
a major CDC research project studying the conditions that affect pregnancy. She has a passion for cooking and teaches young people how to bake and she
cooks meals for folks recovering from surgery or an illness. She is genuine
and described as “a priceless friend.”
Claire Lewis, WHNP, March of Dimes Nurse of the Year.
Nursing Students Graduate
By Tiffany Zulkosky, Public Relations
The University of Alaska Anchorage (UAA) School of Nursing
Associate Degree Program celebrated the achievements of the
Bethel Class of 2008 during a Pinning Ceremony held Sunday,
Dec. 7.
Over 140 community members attended the noon reception,
honoring four local women who will soon join the state’s nursing workforce. Evelina Achee, Danica Broerman, Mary Devlin,
and Gracie Nelson received encouragement and support from a
handful of educators and program partners who have seen them
through the two-years of preparation.
“I am so incredibly proud of these students. I feel so honored that
I have been able to participate in their progress over the last two
years,” said Mary Weiss, Assistant Professor of the UAA School of
Nursing. “It’s really great for the students and really great for the
community. These nurses are in their hometown and it will be a
great benefit to Bethel and the state because we’re growing our
own.”
The students, who have completed all coursework, must still pass
their state licensing exam before working as Registered Nurses.
“The whole reason this program succeeded was because of the part-
2008 Nursing graduates Gracie Nelson, Evelina Achee, Mary Devlin and
Danica Broerman, thank their instructor, Mary Weiss (center).
nership between KuC, UAA, and YKHC,” Weiss continued. “It could
not have happened without that collaboration. There was so much
support and goodwill provided by a lot of people.”
Volume XIII No. 12 • December 15, 2008
15
Moses Fredrick:
November 2008
Health Aide of
the Month
By Tiffany Zulkosky, Public Relations
T
Moses Fredrick, Akiachak Health Aide.
he Yukon-Kuskokwim Health Corporation’s Community Health Aide
Program recognizes Moses Fredrick of
Akiachak as the November 2008 Health Aide
of the Month.
A Community Health Practitioner, it is Moses’
quick response to emergency calls and EMT
skills that make him a stand out Health Aide.
In early November, Moses received a call
about a patient who was not moving. Relying
on his years of experience and quality training, Moses and his fellow Health Aide Marsha,
who is also his daughter, conducted a rapid
assessment. Eventually the patient was transported to Bethel for further care and observation.
“Both Health Aides used their training and
(from left) Karl Powers, Martha Attie, Jack Crow, and Jessica Horras recognize Moses Frederick (center) as
instincts when responding to this emergency,”
the November 2008 Health Aide of the Month.
said Martha Attie, Supervisor Instructor. “He
takes care of patients gently and has a good attitude. Moses is a good role model for the community and other villages.”
Moses, who will reach his 30 years of service in August
2009, was honored during a special luncheon at the
Akiachak Clinic on Tuesday, December 9, 2008.
The Health Aide workforce represents the sustainability of health care in the YK Delta. Each month, YKHC
awards special recognition to an outstanding Health
Aide.
If you would like to recognize a
particular Health Aide, contact the
Field Supervision Instructor at
543-6160.
SRC Labs achieve 100% certification
Congratulations to YKHC’s Subregional Clinic labs!
In 2008 the Subregional Clinic laboratories achieved a staff certification rate
of 100 percent.
The formal certification process for laboratory professionals requires successful completion of educational requirements through UAA, on-the-job clinical laboratory training through the YKHC Lab Assistant Training Program,
and successful completion of the Board of Registry certification examination
through the American Society of Clinical Pathology.
At this time, all four Subregional Clinic laboratory staff have accomplished
this through hard work and self determination. Congratulations to Gerald
Lamont, Emmonak; Elsie Chanar, Toksook Bay; Doris Turner, Aniak; and
Eric Alstrom at St Mary’s. Congratulations also to Leslie Boelens, the mentor
who oversees the program and SRC laboratories.
16
THIRD PARTY PAYERS, from p. 11
(ANPCC) administration, cautions customers about making
assumptions regarding their eligibility. “A lot of customers
assume they are over the income qualifications and decline to
speak with Family Health Resources (FHR) because of that,” she
said. “They may still qualify! The best way to find out is to apply,
even if they already have private insurance.”
Health Aides
Deserve Your Appreciation!
Thank your
Health Aide today
for the work they do.
Health Resource Representatives offer assistance
Customers are encouraged to find out if they qualify for enrollment in a free insurance program. YKHC’s Health Resource
Representatives offer friendly customer service and can assist in
the entire enrollment, re-enrollment or renewal process. Every
six months, all customers receive information about the process,
a screening for eligibility and assistance with the application, if
eligible. Customers can also ask for help throughout the year. If a
customer prefers to fill out the application without help, mail-in
applications are available.
The IHS’s annual budget is set at levels below what is needed to
fully meet the needs of the Alaska Native Community. The journey to wellness is traveled in shared responsibility. Customer/
owners play an important role in every part of YKHC’s programs
and services, including funding. So, the next time a YKHC customer service representative asks to speak with you about eligibility for outside resources, the best thing to do, for your family,
your friends and your community, is to take a few minutes to
find out how they can help.
To contact the YKHC Family Health
Resource program, please call 907-543-6470
Martha Constantine, CHP, in Kwethluk clinic checking the ears
of a young patient. Photo by Carl Evans.
Your appreciation
encourages
health aides to
continue their
fine job caring for
everyone in the
village.
~ Stop by the clinic to thank your health aide
~ Tell others to appreciate their health aides
~ Bring them cookies or a small thank you gift
~ Nominate them for Health Aide of the Month
~ Have a community potluck celebration for all
the clinic workers
~ Write them a nice thank you letter
SAFE TOYS, from p. 13
• Don’t accept older toys. These toys may
not meet current safety standards and may
be worn from play making them more
likely to break and become hazardous.
• Make sure toys are not too loud for children. The noise from a toy can contribute
to hearing damage if it is put too close to
the ear.
The right toys at the right ages
Always read labels to make sure a toy is
appropriate for a child’s age. Guidelines
published by the CPSC and other groups can
help you make buying decisions. Consider
your child’s temperament, habits, and behavior whenever buying a new toy.
Think Prevention
• Children younger than 4 years old should
stay away from eating foods that are easy
to choke on, including nuts, raw carrots,
popcorn, chewing gum, and hard candy.
One should cut food, like hot dogs and
grapes, into small pieces.
• Make sure children sit down, take small
bites, and don’t talk or laugh with their
mouths full when eating.
• Pick up anything off the floor that might
be dangerous to swallow, like deflated balloons, pen caps, coins, beads, and batteries.
• Keep toys or gadgets with small parts out
of reach.
• Learn how to do abdominal thrusts and
CPR, which usually are taught as part of
any basic first-aid course.
The best way to keep your child safe while
playing with toys is to be there.
Sources: www.kidshealth.org; Safe kids USA
Volume XIII No. 12 • December 15, 2008
17
March of Dimes Nursing Scholarships
To recognize and promote excellence in nursing care of mothers and babies, the
March of Dimes awards several $5000 scholarships annually to registered nurses
enrolled in graduate programs of maternal-child nursing. In 2008, with support
from Evenflo and Pampers, the foundation awarded eight graduate nursing scholarships. Applications for 2009 scholarships are due on January 15, 2009. For more
information, go to marchofdimes.com/nursing
Injury Control & EMS
Snowmachine and ATV safety starts before you ride!
• Besuretofollowmanufacturer’srecommendations
forpropermaintenance.
• Conductapre-rideinspectiontocheck
importantcomponentsofthevehicle.
• Don’tforgettocheckfuelandoillevelsandcarryextrafuel
• Whenriding,beawareofweatherconditions,
terrain,daylight/dark,andtrailmarkings.
• Dressfortheweatherandwearpersonalsafetyequipment.
• Vehiclesshouldnotbeoperatedwhileunder
theinfluenceofdrugsoralcohol.
• Alwaysridewithfriendsorfamilywhenpossible,and
alwaysadvisesomeoneyoutrustofyourtravelplan.
• Whenyoucompleteatrip,don’tforgetto
checkinwithyoursafetycontact.
F
Frostnip or
Frostbite
rostnip is a relatively mild form of cold
injury that goes away minutes or seconds after warming with no permanent
damage. Frostbite is the term for damage
to the skin and other tissues caused by freezing. Frostnip and Frostbite cases have steadily
declined over the last several years due to better
cold weather clothing and equipment.
Frostbite
How cold the skin or underlying tissues become
does not determine permanent injury in frostbite,
but how long they remain frozen. Temperature,
windchill and moisture all affect how quickly
exposed skin can become frozen. Wet skin or
clothing on a windy day can lead to frostbite even
if the temperature is not below freezing.
Frostbitten skin should never be covered with
ice or snow and should never be rubbed or massaged.
There are two types of Frostbite—superficial,
affecting the outermost portion of the skin (yellowish or white tint to the skin with numbness
and pain), and deep, affecting deeper skin layers
as well as outer skin (blistering and dark blood
spots form).
Emergency medical help should always be sought
if frostbite is suspected. Avoid thawing and
refreezing. Wet tight clothing should be replaced
with dry loose-fitting clothing if available. Since
the extent of injuries cannot be determined at the
onset of frostbite, medical protocols are the same
for both types of frostbite.
Working Together to Achieve Excellent Health
To purchase helmets, goggles, and ice cleats call YKHC Injury Prevention & EMS at 907-543-6085
Medical treatment begins with warming of the
affected area for 15 to 30 minutes in water at a
temperature of 104–108° F. Aloe Vera is then
applied to the affected area and it is splinted,
wrapped and elevated. Antibiotic ointments and
a tetanus shot may be used to fight possible infec-
see FROSTBITE, p. 19
18
Critical Incident
Intervention in Chevak
by Carl Evans, CHAP Support Counselor
Four members of the Bethel Area CISM
(Critical Incident Stress Management)
Team recently responded to the accidental
shooting death of a young girl in Chevak.
The team—Alfred Ulroan from Chevak, Liz Smith from
Atmautluak, Louis Mallette, Sr. from Lower Kalskag (all village-based Behavioral Health Aides) and Carl Evans, CHAP
Support Program from Bethel—met with school staff, individual students, classes and family members over a two-day
period.
Critical incidents can raise stress levels dramatically and
can cause powerful emotional reactions for those who are
involved in the event or have a connection to those involved.
Critical Incident Stress Management is a formal, structured
process for helping those involved in a critical incident share
their experiences and learn about stress reactions and symptoms. Referrals for additional help can be made if further
help is needed.
The Bethel Area CISM Team has 45 trained members who
may be asked to respond to an incident. There will be a
three-day training offered in February, 2009, in Bethel for
those who are interested in becoming CISM certified.
Alfred Ulroan from Chevak, Liz Smith from Atmautluak, Louis Mallette,
Sr. from Lower Kalskag—all village-based Behavioral Health Aides—
recently met with people in the village of Chevak as part of a Critical
Incident Stress Management team. The team included Carl Evans (not
pictured) with YKHC’s CHAP Support Program.
........?
Who do I call
Life-threatening emergency...
911
State Trooper
1-800-764-5525
or Village VPSO
543-6300
Jr., CISM Program Director, at 907-5436093, or at [email protected].
Mental health situation...
or 1-800-478-2642
YKHC Emergency
Services for Behavioral
Health on-call Clinician
Somebody might need to be committed to
psychiatric hospital in Bethel or Anchorage—
acting bizarre, out of touch with reality, maybe
seeing/hearing things that are not there,
“talking crazy,” maybe talking about suicide
1-866-465-8930
Personal or family problems...
ComPsych Employee
Assistance Program
A YKHC employee or family member needs
help dealing with an alcohol or drug problem,
depression, job stress, marriage or financial
problems, grief issues, domestic abuse, or
similar problems.
1-800-478-3321
After a disaster or tragedy
If you would like to request a CISM
intervention, please contact Louis Mallette,
Active suicide attempt, overdose, incident
involving weapons, possible serious harm
to somebody, person threatening to kill or
seriously hurt themselves or somebody else
or 543-6093 in Bethel
Behavioral Health
Critical Incident
Stress Management
Program
There’s been a terrible event in my village—a
suicide, bad accident with injuries, multiple
deaths, etc. and we need help coping with all
of this
Working Together to Achieve Excellent Health
Volume XIII No. 12 • December 15, 2008
19
PCC, from p. 7
information—patient identification information as well as notes from previous visits—
out of the database and onto the form.
The new version of the PCC form, called
PCC+, actually does accomplish this.
Now, when a patient registers for his/her
appointment, instead of just getting a sticker
to put on a pre-printed form, an individualized pcc+ form is created then and there,
specifically for that visit. For those familiar
with word processing, it’s similar to a “mail
merge” in which a template document
accesses an individual computer record and
fills in the “blanks” to personalize a letter or
address envelopes.
“Each patient has the date and time and
name printed on their form, along with their
account number and insurance information,”
says Dr. Elizabeth Roll, outpatient services
chief at the Bethel hospital, and the team
leader for getting the PCC+ form up and
running. “Even more important, it has each
patient’s active problems on it and what their
last weight and blood pressure and other
vital signs were—right on the form. On the
second page it prints out what immunizations are due and if the patient needs any
additional exams—a pelvic or breast exam
for instance. On the third page, all of the
patient’s recent medications print out right
on the form. This really improves medication
accuracy and saves the providers time.”
It’s not only an improvement for the providers. Medical Records Manager Iona Sallison
says, “Medical Records staff used to stamp
the triplicate forms by hand for every patient
appointment. Now, basically, all we do in
regards to patient appointments is pull the
charts and screen the records when they
come back.”
Athough the PCC+ form comes with information pre-printed, it’s still a paper form and
new observations, notes, updates, medication changes and vital signs have to be manually entered into RPMS for the record. But
it does help streamline the process overall.
“PCC+ is still mainly the same Family Medicine or Pediatrics form, but it now is patient
specific,” said Dr. Roll. Previously, “providers
would have to look through a second document—the health summary—to find out
what active problems a patient had and what
immunizations were due.”
PCC+ also makes it easier to make corrections and manage changes in a patient’s
health record.
“We are working very hard to update the
patient’s problem list—so the providers who
care for the patient have very accurate information about what the patient’s problems
are,” Roll said.
The Indian Health Service introduced
PCC+ in 2001, realizing the change would
require more than just printing out a different form—clinic hospital and business
practices would likely have to adapt, technology departments would have to be involved,
along with billing, medical records, registration clerks and, of course, the medical providers.
The IHS Information Technology Support
Center holds training sessions and provides
ongoing support for facilities adopting
PCC+. They also provided template forms in
Microsoft Word. Having already customized
the old carbon-copy PCC forms, YKHC also
preferred to adapt these stock templates to
meet local needs and provider preferences.
Implementing PCC+ at YKHC has had challenges beyond those foreseen by the IHS,
mainly due to our vast area, scattered villages
and evolving technology infrastructure. But
Hubert Angaiak, Clinical System Specialist
with YKHC’s Technology Services Dept.,
says “As long as the connections to the villages improve, the villages can also use this
in their clinics.”
PCC+ is now in use in the Outpatient clinics
and Specialty Clinics at the Bethel Hospital,
as well as the subregional clinics. A version
is being developed now for use in the village
clinics.
It has been a coordinated effort among many
departments. A PCC+ Committee, started
three years ago with YKHC Medical Director
Dr. Joe Klejka and Dr. Dan Smith, has been
meeting regularly, with a hard push over the
past two years to make PCC+ a reality for
YKHC.
Dr. Roll acknowledges the challenges of
coordinating so many departments, working
with so many sites, and training the providers and staff to use the form. “Many people
have worked together to get this form working,” said Dr. Roll. “Hubert Angaiak, Kimi
Gosney, Karen Sidell, Iona Sallison, Lianna
Brown, Melanie Gibson, Janey Arnzen, Anne
Willard and Nikko McCabe. Thanks to these
people for meeting every Tuesday morning for years to help move us towards more
accurate documentation. This PCC+ system
has been a wonderful example of how positive people working together across departmental lines can accomplish anything!”
Hubert Angaiak likewise credits coordination and cooperation for its success. “This
project would have never gotten off the
ground without the support and involvement
of the Hospital Departments and it’s an ongoing process to continue to improve it. The
credit to its success belongs to them.”
FROSTBITE, from p. 17
tions, and Ibuprofen given to fight inflammation
warm hands. Injured areas should never be
rubbed
Frostnip
Emergency attention should be sought if
skin and sensation does not return within
minutes of reheating the affected area.
Frostnip, like frostbite, is associated with the
formation of ice crystals in tissue, but there
is no tissue destruction and ice crystals dissolve immediately when the skin is warmed.
Frostnip typically affects earlobes, cheeks,
nose, fingers, and toes.
Frostnipped skin typically turns pale and
one experiences numbness or tingling in the
affected area. Blowing warm air on fingers
or placing them under the armpits will help.
Other frostnipped areas can be covered with
Both frostbite and frostnip can lead to serious complications if gone unnoticed or
untreated. Proper winter gear and clothing
can help in preventing either of these conditions from occurring. If you start to feel a
numbing sensation or if you get inner layers
of clothing wet, go inside to get warm and
change into dry clothing.
Volume XIII No. 12 • December 15, 2008
A Message From the
President/CEO
To all of our families,
enjoy the happiest
and safest holiday
season ever.
In review of 2008 and looking forward to 2009—
With the year about to change, the Yukon Kuskokwim Health Corporation can proudly reflect on the services that YKHC has provided
to its customers in 2008 and look forward to the continuation of
delivering quality health services in 2009.
First, I want to recognize the outstanding efforts by YKHC employees, specifically, the Toksook Bay Subregional Clinic for receiving the
Quarterly Patient Satisfaction Award twice in a row in 2008 and the
Inpatient Department for being presented the Monthly MVP Award
for Patient Satisfaction four times in 2008.
Following the example of these positive employees and departments,
we can reach or surpass our 2009 Napartet Patient Centered Excellence goal of increasing Press Ganey scores of “Very Good” to 50
percent. Improving patient satisfaction is the key driver in realizing
our mission of Working Together to Achieve Excellent Health.
Second, I truly appreciate the YKHC staff for believing in the other
Napartet goals of maintaining a focus on our employees, in energiz-
Yukon-Kuskokwim Health Corporation
P.O. Box 528
Bethel, Alaska 99559
907-543-6000
ing our Alaska Native workforce, in strengthening the resolve to
increase our community and partner satisfaction, and, especially,
turning around the financial viability of our organization.
In 2008, we did indeed solve the puzzle of working together to provide excellent health while not over-spending, resulting in a small
surplus at the end of the fiscal year.
Can we relax in 2009? No, in fact, we need to continue doing a better
job more efficiently and effectively.
As in 2007, together we opened two more village health clinics — in
Kotlik and Tuntutuliak. We are finishing the construction of the
fifth subregional clinic in Hooper Bay that is scheduled to open this
coming year and the start-up construction of two additional clinics
in Mountain Village and Nunapitchuk in the spring of 2009.
Let’s welcome the 2009 challenges that will bring us new rewards.
—Gene Peltola, YKHC President/CEO
Non -Profit Org.
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