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Yukon Kuskokwim Health Corporation

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... Alaska, Bethel, and the Yup'ik Eskimo people of the Yukon and Kuskokwim Rivers. ... Yup'ik Eskimo. Cup'ik Eskimo. Athabaskan. Indian. 58 Villages (Federally ... – PowerPoint PPT presentation

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Title: Yukon Kuskokwim Health Corporation


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Yukon Kuskokwim Health Corporation
  • Alaska Native Tribal Health System
  • Bethel, Alaska

3
Camai, Cangacit ernerpak-llu?
  • Elitnauryuqtuten Western Alaska-ami,
    Mamterilleq, Yupiit Kuigpak-Kuskowaq-ami-llu!!

4
Welcome! How are you today?
  • I want to teach you about Western Alaska, Bethel,
    and the Yupik Eskimo people of the Yukon and
    Kuskokwim Rivers.

5
Alaska 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

6
Alaskas Road System
 
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Rural Population 29.6
Urban Population 70.4
Source Alaska Dept. of Labor and Workforce
Development, Research and Analysis Section,
Demographics Unit
8
Alaskas 10 Urban Cities, 1999, 1990
Source Alaska Dept. of Labor and Workforce
Development, Research and Analysis Section,
Demographics Unit.
9
Our Native Cultures
10
Alaskas 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.

11
Alaska 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
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YKHC / 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

14
YKHC
  • Service Area 75,000 square miles
  • Population Approximately 25,000
  • 80 Alaska Native
  • Yupik Eskimo
  • Cupik Eskimo
  • Athabaskan
  • Indian
  • 58 Villages
  • (Federally recognized
  • tribes)

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YKHCs 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.

17
Environmental 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

18
Health 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.

19
Source 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
20
Alaska Native Wrap-Around HIV/AIDS Project
  • Yukon Kuskokwim Health Corporation
  • Amber Norgaard, Project Director
  • Mark Anaruk, Evaluator

21
Rural 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

22
Rural Health Care Delivery
  • Behavioral Health Services
  • Village-based Wellness Counselors
  • Treatment Centers
  • Health Education
  • 4 Village-based
  • Community Health
  • Representatives

23
HIV/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)

24
Goal 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

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Goal 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

26
Goal 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

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Goal 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

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Tua-i Quyana!
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