Title: Yukon Kuskokwim Health Corporation
1(No Transcript)
2Yukon Kuskokwim Health Corporation
- Alaska Native Tribal Health System
- Bethel, Alaska
3Camai, Cangacit ernerpak-llu?
- Elitnauryuqtuten Western Alaska-ami,
Mamterilleq, Yupiit Kuigpak-Kuskowaq-ami-llu!!
4Welcome! How are you today?
- I want to teach you about Western Alaska, Bethel,
and the Yupik Eskimo people of the Yukon and
Kuskokwim Rivers.
5Alaska Demographics
- Population 627,000 total statewide
- 1.2 persons per square mile
- Largest Alaskan Cities
- Anchorage
- 260,000
- Fairbanks
- Borough
- 82,000
- Juneau
- 31,000
6Alaskas Road System
7Rural Population 29.6
Urban Population 70.4
Source Alaska Dept. of Labor and Workforce
Development, Research and Analysis Section,
Demographics Unit
8Alaskas 10 Urban Cities, 1999, 1990
Source Alaska Dept. of Labor and Workforce
Development, Research and Analysis Section,
Demographics Unit.
9Our Native Cultures
10Alaskas Tribal Government Structure
- 227 federally-recognized tribes as represented by
local village IRAs - Government to government relationship with
the federal government - Local sovereign control and self-determination
- Treaty Rights and the Federal Trust Obligation
- Hundreds of Indian treaties have created a
fundamental contract between Indian Nations and
the United States. The U. S. Supreme Court has
ruled that the United States owes a trust
responsibility, "a moral obligation of the
highest responsibility and trust," to protect
Indian Nations, their resources and their rights.
11Alaska Native Regional Corporations
The Northwest Arctic Borough School District, in
1986, completed a student curriculum for ANCSA to
educate students. This map is part of the
curriculum, and can be found at
http//www.nwabsd.schoolzone.net/resources/ancsa/A
ncsa.htm
12(No Transcript)
13YKHC / Indian H.S. Relationship
- PL 93-638 changed the way health care is
delivered - Prior to compacting, YKHC had less local
control on programs - After compacting, YKHC was directly involved in
developing services culturally /environmentally
relevant to our people
14YKHC
- Service Area 75,000 square miles
- Population Approximately 25,000
- 80 Alaska Native
- Yupik Eskimo
- Cupik Eskimo
- Athabaskan
- Indian
- 58 Villages
- (Federally recognized
- tribes)
15(No Transcript)
16YKHCs Mission
- The mission of the Yukon-Kuskokwim Health
Corporation is to achieve the greatest possible
improvement in the health status of the people of
the Yukon-Kuskokwim Delta Region of Alaska. - We are committed to the development of culturally
relevant programs for primary care, prevention,
and health promotion in a setting that fosters
Native self-determination in the control and
management of health delivery.
17Environmental Conditions
- Tremendous Environmental Challenges
- Still areas of 3rd world conditions
- Lack of Running/Safe Water
- Housing Issues
- High Poverty
- Low Employment
- High Cost of Living
- Weather and Travel
- Issues
- 50-60 Medicaid-
- eligible
18Health Conditions
- Surgeon Generals Report
- Alaska Native / American Indians are under-served
in mental health and substance abuse services - One of the highest
- suicide rates in the U.S.
- Unintentional injury / death rates in U.S.
- High sense of hopelessness because of past trauma
and loss.
19Source Healthy Risks in Alaska Among Alaska
Natives. Alaska Behavioral Risk Factor Survey,
1991-93. State of Alaska Dept. of Health Human
Services / Indian Health Service
20Alaska Native Wrap-Around HIV/AIDS Project
- Yukon Kuskokwim Health Corporation
- Amber Norgaard, Project Director
- Mark Anaruk, Evaluator
21Rural Health Care Delivery
- Primary Health Care 4 Tier System
- 48 Village Clinics- front line health care
- Staffed by CHA/Ps
- 3 Sub-Regional Clinics
- Staffed by CHA/Ps, Mid-Levels
- Yukon Kuskokwim Delta Regional Hospital
- Alaska Native Medical Center (Anchorage)
- State of Alaska Public Health Nursing
22Rural Health Care Delivery
- Behavioral Health Services
- Village-based Wellness Counselors
- Treatment Centers
- Health Education
- 4 Village-based
- Community Health
- Representatives
23HIV/AIDS Care in the Delta
- Current situation
- Testing availability limited
- High community stigma
- High number of individuals living with
co-morbidities (STIs, DV/SA, Substance Abuse
Mental Health Issues) - Care limited on village level
- Small case-load of known HIV () clients
- Case management services established through
former SPNS funding - Current case management through Ryan White Title
III - UW TPED Provider Training
- Prevention efforts through YKHC and ANHB (CDC
funding)
24Goal 1 Community-Based, Wrap-Around Case
Finding Approach
- Development of Community Advocacy Board
- Training and education of village-based Providers
- Outreach and testing through targeted agencies
(Bethel-based) and high-risk individuals
(village-based)
- YEAR 1
- Target 8 Villages (including SRCs)
- Increase referral and testing options on village
level
25Goal 2 Enhance HIV Primary Care Services
- HIV Primary Care Pathway
- Front-line referrals and testing to
multi-disciplinary care - Established with input of ALL care providers
- Training of Providers on Multiple Levels
26Goal 3 Risk Reduction Behavior Modification
Strategies Integrated With Resiliency
Characteristics
- Increase knowledge of HIV prevention, risk
reduction and negotiation skills through
One-on-One HIV Prevention Curriculum for
Positives
- Curriculum developed during Year 1 with
collaborators - Behavioral Health
- Cultural Consultants
- Begin implementation during Year 2
27Goal 4 Increase Adherence
- Development of Multi-Disiplinary Team
- Primary Care
- Traditional Healer
- Case Manager
- Substance Abuse
- Mental Health
- Dental Care
- Prevention for Positives
- Utilization of Personal Care Card
- One-on-one adherence education utilizing
resiliency characteristics - Same message on ALL levels
28(No Transcript)
29(No Transcript)
30(No Transcript)
31Tua-i Quyana!