April 6–7, 2011Yupiit Piciryarait Cultural CenterBethel, Alaska

Honoring Our Health Aides: The YK Delta’s First Line of Care

INSIDE: The success of the Community Health Aide model has inspired the introduction of Dental Health Aides and Behavioral Health Aides—widening our committment to bringing health care closer to home. p. 4

Photo of Betty Guy in Kwethluk, 1973, by James H. Barker

Volume XVI No. 3 • March. 15, 2011

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Board of DirectorsUnit 1Mary AyunerakP.O. Box 61Alakanuk, Alaska 99554907-238-3358

Paula AyunerakP.O. Box 5Alakanuk, Alaska 99554907-238-3212

Unit 2Ray AlstromP.O. Box 8Marshall, Alaska 99585907-679-6320

James C. LandlordP.O. Box 32168Mt. Village, AK 99632907-591-2531

Unit 3Billy Jean StewartP.O. Box 88Kalskag, Alaska 99607907-471-2271

George S. MorganP.O. Box 54Upper Kalskag, Alaska 99607907-471-2490

Unit 4James NicoriP.O. Box 41Kwethluk, Alaska 99621907-757-6837

Moses PeterP.O. Box 57Tuluksak, Alaska 99679907- 695-6426

Unit 5Bill KristovichP.O. Box 1037Bethel, Alaska 99559907-543-4151/2212

Glen Watson, Sr.P.O. Box 1874Bethel, Alaska 99559907-543-4625

Gloria SimeonP.O. Box 308Bethel, Alaska 99559907-543-5676

Chris LarsonP.O. Box 6051Napaskiak, Alaska 99559907-737-7910

Unit 6Esai Twitchell, Jr.P.O. Box 121Kasigluk, Alaska 99609907-477-6309

Unit 7David O. DavidP.O. Box 78Kwigillingok, Alaska 99622907-588-8484

Unit 8James R. Charlie, Sr.P.O. Box 37012Toksook Bay, Alaska 99637907-427-7114

James SiparyP.O. Box 37134 Toksook Bay, Alaska 99637907- 427-7816

Unit 9Patrick TallP.O. Box 196Chevak, Alaska 99563907-858-7613

Eric Olson, Sr.P.O. Box 163Hooper Bay, Alaska 99604907-758-4068

Unit 10Sam W. AlexieP.O. Box 57Eek, Alaska 99578907-536-5428

Unit 11Marvin DeaconP.O. Box 45Grayling, Alaska 99590907-453-5195

Honorary Board MemberPaul JohnP.O. Box 37067Toksook Bay, Alaska 99637907-427-74l4

Numbers to CallYKHC Main Operator ............................................... 543-6000 Toll Free ...............................................................1-800-478-3321Public Relations ................................................................. 543-6038Media Services ................................................................... 677-2232Office of Environmental Health & Engineering ............ 543-6420Technology Help Desk ...................................................... 543-6070Human Resources.............................................................. 543-6060Administration .................................................................. 543-6020Hospital ............................................................................... 543-6300Emergency Room .............................................................. 543-6395Hospital Community Relations ....................................... 543-6350Social Services .................................................................... 543-6225Family Medicine Clinic Appointments .......................... 543-6442 1-800-478-3321AppointmentsDental Appointments........................................................ 543-6229Optometry Appointments ................................................ 543-6336Audiology Appointments ................................................. 543-6466

Subregional Clinic Appointments Aniak ............................................................................... 675-4556 Emmonak ....................................................................... 949-3500 St. Mary’s ......................................................................... 438-3500 Toksook Bay ................................................................... 427-3500Public Health Nursing ...................................................... 543-2110Pharmacy ............................................................................ 543-6382Travel Management Center .............................................. 543-6360WIC Program..................................................................... 543-6459Health Services .................................................................. 543-6024Village Operations ............................................................. 543-6160 CHAP .............................................................................. 543-6160 ICEMS ............................................................................. 543-6080 Community Health & Wellness ................................... 543-6190Behavioral Health Services ............................................... 543-6100 Phillips Ayagnirvik ........................................................ 543-6700 Village Services .............................................................. 543-6740Home Care Services .......................................................... 543-6170

Volume XVI No. 3 • March 15, 20113

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. 907-677-2232. Please ask permission to reprint articles or pictures. © 2011, Yukon-Kuskokwim Health Corporation.

YKHC Board& Committee Meetings

2010Finance

Mar 29

Executive BoardMarch 29 – 30

Tribal GatheringApril 6 – 7

FinanceApril 19

Semi-Annual Full BoardApril 19 – 21

FinanceMay 25

Governing BodyMay 25 – 26

FinanceJune 22

Executive BoardJune 22 – 23

FinanceJuly 19

Governing BodyJuly 19 – 20

FinanceAug. 23

Executive BoardAug. 23 – 24

FinanceSept. 20

Welcome to the Gathering!YKHC Public Relations StaffThis year we are honoring our Community Health Aides, a long-overdue recognition of the importance of these dedicated individuals making up the front line of care in our villages.

Health Aides have been the backbone of YKHC since its beginning in 1969. We only had a few programs then, one of which was the Community Health Aide Program. From the beginning, the emphasis was on training individuals already living in their communities to be a doctor’s eyes and ears, to help people stay healthy where getting to a doctor or hospital was difficult, expensive or just plain impossible.

Today there are trained, certified Health Aides working in every village, and with few exceptions in modern clinic facilities equipped with computers, telemedicine gear and video teleconferencing capability, stocked with proper medications and well-supported by their communities.

With 100 percent Native hire, the Community Health Aide Program is a success story in Native Self-Determination but also a model for local healthcare delivery for the rest of the country. With a world-wide shortage of doctors, it is a system well worth emulating. On the following pages you’ll find more on the level of training required of our Community Health Aides, and how the model has been expanded to include Dental and Behavioral Health Aides.

Your village Health Aides have a challenging but rewarding job. They need to know they are appreciated. Please thank a Health Aide today.

At The GatheringAs most of you know, the purpose of the Gathering is two-fold—to report to you, our Tribal membership, on what we’ve been doing the past year to improve services, and to hear what’s important to you in the matter of health care priorities for the future.

Because our patients are also our owners, we must be responsive to the wishes and unique needs of the people we serve. Over these past 18 years that we have held Tribal Gather-ings, and in the 42 years of our existence, YKHC has become a model for tribally owned and operated health care organizations. We have pioneered the decentralization of health care—having certified health aides and behavioral health aides in village clinics, midlevel practitioners in our subregional clinics and board certified physicians in our hospital and outpatient clinics in Bethel—because you have spoken at these Tribal Gatherings and told us you want the highest quality care as close to home as possible.

Tribal Unity Gathering

XVIIIHonoring Our Health Aides: The YK Delta’s First Line of Care

4

The Community Health Aide Model

& Alaska Native Workforce

Development

“Growing Our Own,” is a focus of YKHC’s Native Workforce strategy and the Community Health Aide Program (CHAP) leads the way.

CHAP Director Bill Schreiner reminds us that “Health Aides are 100 percent Alaska Native.” Some who start out as Health Aides go on to become Registered Nurses, Dental Health Aide Therapists or Physi-cian Assistants.

The great success of the Health Aide initiative—throughout the state as well as here in the YK Delta—can be summed up with one word: TRAINING.

The level of knowledge required of a fully certified Community Health Practitioner is prodigious.

There are four sessions of Community Health Aide (CHA) training; each lasts three to four weeks. Between sessions, the CHAs work in their clinics completing a skills list and practicum. Completion of all four sessions along with a clinical skills preceptorship and examina-tion, qualify the CHA as a Community Health Practitioner (CHP). The extensive Community Health Aide Manual (CHAM) covers nearly every aspect of primary care plus preventative exams and care of chronic conditions such as diabetes, heart conditions, COPD, and asthma. Health Aides now offer immunizations, once the domain of State Public Health Nurses. As a result, YK Delta immunization rates

are some of the best in Alaska, and even the US. Health Aides are thoroughly trained in emergency response and are as apt to be called upon to give CPR as give a child a flu shot.

Health Aides are masters of complex technology, including the telemedicine carts and video teleconferencing for patient care and communication with colleagues and management. We are looking forward to more automation in supplies and ordering, with tech-nological efficiencies allowing Health Aides to devote their time to serving patients.

Quality assurance and clinic management is also a priority. Supervi-sor Instructors now have more training in management and visit each clinic far more often than in the past—typically getting to each clinic four times a year. Compliance is now a full time position, and more importantly, something we work on daily to ensure that all clinics meet the standards for safety, privacy, and performance.

The community health aide model—trained Alaska Native health-care providers working in their own communities as the frontline of a continuum of care reaching from rural outpost to urban medical center—has inspired dental and behavioral versions as well. Nearly every clinic in our region now has, or is close to, one or more trained and certified Dental Health Aides and Behavioral Health Aides, making a wider range of health care available to people right where they live.

YKHC’s first Health Aides, 1970: Abby Stephanoff, Russian Mission; Dorothy Okitkun Aloysius, Kotlik; Paula Ayunerak, Alakanuk; Nellie Joshua, Mekoryuk; Mary Phillips, Akiak; Martha Pavil, Kwigillingok; Sam Alexie, Eek; Yako Slim, Kasigluk.

by YKHC Public Relations Staff with CHAP Director Bill Schreiner, Dental Health Aide Coordinator Kelly Nance and Behavioral Health Village Services Director Janice Hamrick

Volume XVI No. 3 • March 15, 20115

Dental Health Aides

Dental Health Aides are the first line of defense in the war against tooth decay.

They understand the importance of oral health, have the abil-ity to teach community members and caregivers the impor-tance of home care, how dental caries (decay) is transmitted, and the desire to help the people of the their community.

When a dentist visits is in the village, their biggest concern is getting people out of pain. A resident Dental Health Aide is the best pro-vider of preventative education and treatment.

Dental Health Aides are certified through the Community Health Aide Program. Applicants go through a Presession or Dental Health Aide Core Curriculum, spend a minimum of 26 hours of didactic training in Primary Oral Health Promotion and Disease Prevention as well as Basic Dental Procedures. Then the training will move to the clinic where they will spend a minimum of 12 hours of hands-on training.

With successful completion of the training the applicant begins his/her preceptorship. This is where they will work with a dentist, Dental Health Aide Therapist or a Dental Hygienist who will observe and critique the skills they will bring to their communities. These skills include; dental health education and motivation, nutritional counsel-ing in relationship to caries prevention and three modes of fluoride applications. An applicant also needs to have certification in Basic Life Support.

When all of the above is complete, an application is sent to the Com-munity Health Aide Board for approval. When certified, the new

Dental Health Aide can go into the homes, schools, Head Starts, and village clinic to providing preventative care—education, encourage-ment, motivation, reinforcement and fluoride applications.

There is a level II Dental Health Aide. With further training and board approval they can also apply sealants, take radiographs, clean-ings with an ultrasonic scaler, and perform ART (Atraumatic Restor-ative Treatment).

Tooth decay in the Yukon-Kuskokwim Delta is much higher than the rest of the nation. The Dental Health Aides are really the only way to give the people of the Delta consistent and effective preventative care in such a large geographical area with limited access to care.

Behavioral Health AidesFor a number of years, YKHC’s Behavioral Health Aides (BHA), working under the auspices of our Behavioral Health Services, have been hired and have traveled extensively to surrounding Delta vil-lages to provide substance abuse and mental health services to people in need—often without the training necessary to help them address all the complex issues that many people in rural communities face. These can include children with behavior challenges at home or in the school, irritability, withdrawal, hearing voices, seeing things that are not there, depression, grief, post traumatic stress symptoms, anxiety—and the list goes on. Then there are the people with alcohol and other drug issues.

Beginning in 2009, with the roll-out of the Behavioral Health Aide Program Certification Board standards and procedures implemented throughout the state of Alaska, there are opportunities for BHAs to earn certification through on-going training.

YKHC Behavioral Health Aides were among the first in the state to participate in this certification process. This is a welcome reassurance for the many individuals struggling with the sorts of issues men-tioned above.

The Behavioral Health Aide’s work is unique and has a number of challenges compared to CHAs and DHAs whose work follows certain processes when determining the type of treatment needed. Overall health is directly affected by one’s mental state, so training our BHAs is essential in increasing their knowledge of how to address the vari-ous challenges seen in the villages from alcohol use, marijuana use, suicide, depression, grief, and trauma.

Certification is approached through escalating levels of training. New hires begin as BHA trainees whose work experience is in the broader community, providing presentations, working with the Tribal Coun-cil, ICWA, OCS and others to develop educational opportunities in a group setting before taking on the challenge of individual counseling. This also helps people in the village come to see Behavioral Health as being about overall health and wholeness, not only personal mental health.

At the trainee level, one of the first things a BHA does is spend time with three different elders to learn from them about how problems have been dealt with in the past.

see HEALTH AIDES, p. 10

Dental Health Aide training: Tiara Sage prepares to give a fellow student Oral Hygiene Instruction. Fritz Charles observes in the background.

6

Meet Karen Stockton, YKHC’s new Clinical DieticianKaren Stockton graduated from Wash-ington State University in 2006. She stared working for YKHC January of this year. Karen has been a dieti-tian for about 2 years. She previously worked for Providence Sacred Hearts in Spokane, Washington and covered all floors as a supplemental RD. She also worked for Spokane Regional Health for the WIC program. She has worked with both adults and children with all disease states. Karen loves what she does and hopes to make a difference in the lives of her patients.

She is happy to be living here in Bethel, she fell in love with Alaska when she was living in Anchorage from 94-98. Karen will be covering the inpatient, outpatient, and the peds specialty clinic. If you have any questions you could contact her at 543-6436.

“March is National Nutrition Month! I hope you enjoy the infor-mation and try something new!” said Karen.

Tips for increasing physical activity

Make physical activity a regular part of the dayChoose activities that you enjoy and can do regularly. Fitting activity into a daily routine can be easy—such as taking a brisk 10 minute walk to and from the parking lot, bus stop, or subway station. Or, join an exercise class. Keep it interesting by trying something different on alternate days.

What’s important is to be active most days of the week and make it part of daily routine. For example, to reach a 30-minute goal for the day, walk the dog for 10 minutes before and after work, and add a 10 minute walk at lunchtime. Or, swim three times a week and take a yoga class on the other days. Make sure to do at least 10 minutes of the activity at a time, shorter bursts of activity will not have the same health benefits. To be ready any time, keep some comfortable clothes and a pair of walking or running shoes in the car and at the office.

More ways to increase physical activityAt home:

• Join a walking group in the neighborhood or at the local shopping mall. Recruit a partner for support and encouragement.

• Push the baby in a stroller. • Get the whole family involved—enjoy an afternoon bike ride with

your kids. • Walk up and down the soccer or softball field sidelines while

watching the kids play. • Walk the dog—don’t just watch the dog walk. • Clean the house or wash the car. • Walk, skate, or cycle more, and drive less. • Do stretches, exercises, or pedal a stationary bike while watching

television. • Mow the lawn with a push mower. • Plant and care for a vegetable or flower garden • Play with the kids—tumble in the leaves, build a snowman, splash

in a puddle, or dance to favorite music.

At work:

• Replace a coffee break with a brisk 10-minute walk. Ask a friend to go with you.

• Take part in an exercise program at work or a nearby gym. • Join the office softball or bowling team. At play:

• Walk, jog, skate, or cycle. • Take a class in martial arts, dance, or yoga. • Canoe, row, or kayak. • Play racket ball, tennis, or squash. • Ski cross-country or downhill. • Play basketball, softball, or soccer. • Hand cycle or play wheelchair sports. • Take a nature walk. • Most important – have fun while being active!

SUBSCRIBE to the Messenger! Online Messenger: Published monthly on our website: www.ykhc.org. Enter your email address in the “Messenger by Email” link.Messenger Quarterly: Published in March, June, September and December and mailed to all YK Delta village boxholders. Bethel residents and others: Subscribe by sending your name and mailing address to messenger@ykhc.org or call Public Relations at 907-543-6038

Karen Stockton

Volume XVI No. 3 • March 15, 20117

National Nutrition Month

Celebrate National Nutrition Month by helping your kids ‘Eat Right with Color’

Each March, the American Dietetic Association celebrates National Nutrition Month®, and this year’s theme, “Eat Right with Color,” encourages parents to take time to make sure their children are get-ting all of the nutrients they need to grow.

The registered dietitian Dr. Katie Brown, national education director for the American Dietetic Association Foundation offers the follow-ing advices for helping your kids “Eat Right with Color.”

• Give kids whole-grain cereals for breakfast, kid-friendly “white” whole-wheat bread for sandwiches, crunchy whole-grain crackers for snacks and whole-grain pastas for dinner.

• Eat more fruits and vegetables at every meal. At breakfast, enjoy fresh or frozen berries on cereal or a glass of 100% orange juice; at lunch, serve baby carrots or sliced apples; for dinner, put brightly colored vegetables at the center of every plate.

• Most young people in America are not getting enough calcium or potassium. Luckily, it’s easy to eat the three daily dairy serv-ings children need. Try an 8-ounce glass of low-fat milk with breakfast, lunch and dinner; yogurt for breakfast or an after-school snack; or string cheese for an on-the-go energy snack.

• Getting enough protein at every meal and snack helps kids feel satisfied after eating. Fish and moose meats are one of the great sources of protein among the Alaska Native foods. For snacks, provide peanut butter or egg.

• It is costly to buy fresh vegetables here in Alaska, however, do you know that canned/frozen vegetables – and dishes made with

canned/frozen ingredients – are as nutritious as cooked fresh, according to research, and perhaps more so if fresh aren’t handled properly?

• Choose a variety of canned/frozen vegetables such as green beans, sweet corns and peas to brighten up your plate. Adding couple of colorful foods to your plate makes for more than just a tasty meal. Enjoy!

March 2011 is National Social Work MonthSocial Workers serve many roles at YKHC —

• BehavioralHealthClinicians&Therapists

• DirectCareWorkers

• CareCoordinators

• CaseManagers

• DischargePlanning

• CommunityLiaisons

Social Workers are called upon to answer and assist with an endless variety of tasks, from the simplest resource questions to assisting families experiencing major traumas and death.

Thank you YK Social Workers for ALL you do!

8

Punk Ash + Tobacco Leaf = SUPER ADDICTION

By Rahnia Parker, Nicotine Control and Research Program Manager

Have you ever heard that Iqmik or Blackbull is not bad for you?

The staff at YKHC’s Nicotine Control & Research department like to get feedback from people about their tobacco use and one common theme we hear often is that Iqmik or Blackbull isn’t bad for you. In truth, Iqmik or Blackbull does have chemicals and is MORE addic-tive than smoking or chewing.

• When punk ash is mixed with tobacco leaves, it speeds up the delivery of nicotine to the brain.

• The acidity level of punk ash makes the nicotine high more pow-erful, making it MORE ADDICTIVE.

• Even though it doesn’t have additives, tobacco leaves have natural chemicals too!

• No matter what, any tobacco use still increases your heart rate, raises your blood pressure, and is bad for your heart.

All tobacco, no matter what form, has harmful chemicals that build up in your body, even if you don’t see or feel it. Usually, all you can feel is the “feel-good” effects of the nicotine in your brain until those other invisible chemicals overwhelm your body and you get sick.

I personally have worked with several people who started to feel the effects of tobacco on their bodies so they decided to finally quit after years of using tobacco. It’s heartbreaking to remember about those who not long afterwards were diagnosed with cancer and passed away within a year. For them it was too late, for you it may not be. Your body works very hard to keep itself working well, do it a favor and keep the tobacco and its harmful chemicals away!

Quitting tobacco and that addiction to nicotine can be a very dif-ficult and personal journey and it is your choice. The Nicotine Con-trol and Research department is available to help when you make your decision to quit. To see a Nicotine Dependence Treatment Counselor, please see your local healthcare provider and get a refer-ral for counseling. If you would like more information, have ques-tions, or for any other tobacco related requests for yourself, family members, and/or friends, please feel free to contact the Nicotine Control and Research department at 543-6312 or toll-free at 1-800-478-3321, extension 6312.

If you want to quit, have been referred have not

been contacted by Nicotine Control, please call

us at 1-800-478-3321, extension 6312.

Nicotine Success Story!

Paul Beebe: QuitterLast month Paul Beebe stopped by the Nicotine Con-trol and Research Dept. to visit our main counselor Henry George so he could say thank you. Paul quit using tobacco through our pro-gram and agreed to share his story so it might help someone else who’s thinking about quitting.

Paul decided he was ready to quit because he was starting to understand that tobacco is not good, and it doesn’t lead to better health, it leads to poor health. Tobacco use brought up his blood pressure, which is not good for his heart. It could lead to other health–related illnesses. He has seen posters and understood. He used to see them in the past, but his mind didn’t move until one day he understood.

After his mind wanted to quit Paul went to the doctor who asked him if he used Blackbull. He told the doctor that he used Iqmik and that he wanted to quit. The doctor asked him if he needed help and then he went to see the counselor. After seeing the coun-selor it seemed like the door was opened for a better path. Then he saw a spittoon in his village. Paul said, “When I saw it, it looked really gross – not good. Not good to look at. I want everyone to quit.”

When asked if it was hard to quit, Paul responded that he made up his mind to quit. There was no anger. He wanted to do arts and crafts, and to work. He got more active. He explained that it wasn’t too bad. When he was using tobacco, if he lost his tobacco container, he would get mad and now he doesn’t get mad so easy. Now he doesn’t crave it anymore although when he first stopped he would think about it and crave. When that happened, he would buy chewing gum and forget about it.

How quitting tobacco has helped Paul“I feel it’s so good. I feel more love for my grandkids. I am able to taste things better and have a better appetite. I am able to smell now, before I wasn’t able to. My heart is getting better by making better choices,” he said. Paul doesn’t get as tired as fast and he has more energy. He mentioned that when he walks he doesn’t get tired easy. And his blood pressure has gotten better.

You can be a success story too! If you have quit tobacco and would like to share your story, please contact the Nicotine Control and Research department.

Henry George and Paul Beebe at the Nicotine Control office.

Volume XVI No. 3 • March 15, 20119

Survey results drive quality of patient careWhat is a Press-Ganey survey?If you have been seen as a patient in any of YKHC’s village clinics, subregional clinics, the OB Department, the YKDRH Emergency Room, inpatient or outpatient clinics, it is likely you’ve been sent a survey in the mail asking you about your experience.

Press Ganey is the leading hospital survey clearinghouse in the nation. They function by providing feedback to health care system leadership through patient and customer satisfaction surveys so your hospital can achieve performance excellence and improve the quality of care for patients. Please fill out the YKHC survey you may receive in the mail. We value your feedback!

Who reads the survey results? Comments are typed up by Press Ganey and are given to YKHC President/CEO Gene Peltola to review.

Is my information or comments anonymous or confiden-tial?There is no identifier to track your name and you can share your name if you choose to.

Why should I fill the survey out?The survey may ask you questions about the cleanliness of the hospital, temperature of the food, helpfulness and quality of the staff or provider you saw during your clinic visit. There is space to write about any additional comments or concerns you may have regarding your experience.

We encourage everyone who receives the survey in the mail to fill it out and send it in the mail (at no cost to you!) so we know what ser-vices we can improve based on your valued input.

The results of the surveys provide feedback to the departments who work hard to provide customers and patients the best of care. For example, the Toksook Bay Subregional Clinic has excelled in achiev-ing their goal in obtaining “Very Good” scores for the last five quar-ters, and the Dental Department has achieved the “Most Improved” ratings in their goal of obtaining “Very Good” scores for the last quarter.

We appreciate you taking the time to inform us on how good we are doing or where we can improve to make your visits more enjoyable in the future!

10

Sobering Center Now Open

The City of Bethel and Yukon-Kuskokwim Health Corporation have been working with Bethel Community Services Foundation, State Division of Behavioral Health, State Department of Corrections, and the

Alaska Mental Health Trust Authority to find efficient and effective ways to help people who are drunk and unsafe.

The Bethel Sobering Center celebrated its grand opening in January and began operations in February, less than a year after securing the balance of necessary funding from the State Legislature.

“We are grateful for the support of our partners and committed to our joint effort to protect those who need a place to sober up safely and with dignity, and connect those who may have alcohol addiction concerns with possible interventions,” said Gene Peltola, YKHC president and CEO. “The center also reduces the demand on our emergency room.”

Approximately 70 percent of people who need shel-ter to sober up are one-time users of the service, said center manager Rusty Tews. The 3,100-square-foot center, built by local workers and operated by YKHC, can accommodate 18 people. The capacity is based on demand in recent years.

The center is open 24-hours Thursday through Monday and holidays. Staff members have an emer-gency medical certification and training on caring for intoxicated individuals safely and with respect.

Clients receive a basic medical screening and are monitored while intoxicated. Once sober, clients are offered a brief assessment of their alcohol use, drinking risk-reduction suggestions and referrals to treatment services.

The City of Bethel transports inebriated people to the facility in Community Service Patrol vans. The DHSS Division of Behavioral Health supports the Sobering Center through grants to the City for its Community Service Patrol program and to YKHC.

“We’re delighted to help in this joint effort, which supports several department goals,” said William Streur, DHSS commissioner: “Local partnerships, protecting Alaskans’ safety, and linking clients with resources to prevent accidents and reduce alcohol abuse.”

The center has English, Yupik and Athabascan names. Ellengcarvik means “The Place to Become Aware” in Yup’ik. Xiq’udilanhoi Yix means “A Healing House” in Holikachuk Athabascan.

A Brief HistoryFor many years, Bethel has been in need of a facility that can keep the individual and public safe as well as offer an opportunity for indi-viduals to pursue a sober lifestyle. Of all the communities of its size in the state, Bethel has the highest per capita rate of inebriates who end up in protective custody jail holds.

On a regular basis, YKHC’s Emergency Room sees a high number of inebriates. Of more than 4,400 in 10 years requiring emergency assis-tance in the ER and jail under a Title 47 hold, fewer than half were from villages outside of Bethel.

Guests representing YKHC and a host of state agencies, including the State Legisla-ture, attended Sobering Center opening ceremonies January 11.

Construction of the new building was completed in less than a year.

HEALTH AIDES, from p. 5At the BHA I level, they start working more with individuals with substance abuse and mental health challenges. The BHA II begins doing assessments and working with individuals one on one, doing more counseling. When one becomes a BHA III they are managing

their schedule and calling their supervisor when they need assistance working with people in the villages. This is the final stage before becoming a BHA/Practitioner.

Volume XVI No. 3 • March 15, 201111

March is Colorectal Cancer National Awareness MonthColon cancer is preventable if the right precautions and screenings are taken at an early stage.

There are several things you could do to help prevent colon cancer.

• Get familiar with the facts• Get familiar with a healthy lifestyle and habits• Get screenedStaying active by exercising at least five days a week, maintaining a healthy weight, and cutting out processed foods and adding more fruits, vegetables, and whole grains to your diet is a great habit to pick up. If you drink alcohol, try to keep it to one drink a day. Do not smoke and if you do, quit.

Colon cancer develops from adenomatous polyps that can appear on the lining of the colon or rectum. If not taken care of they may become cancerous. Men and women age 50 and above should start getting screened – talk with your health care provider for more information of the correct screenings. Here are a couple test-ing options listed below that you should keep in mind that could detect pre-cancer or cancer:

• Colonoscopy – screen every 10 years• Virtual colonoscopy – screen every 5 years• Flexible sigmoidoscopy – screen every 5 years• Double-contrast barium enema – screen

every 5 yearsSymptoms that people may have due to colon cancer are bleeding of the rectum or blood in the stool, problems of the abdomen such as bloating or cramps, diarrhea or constipation, weight loss, vomiting, or fatigue. If you have any of the symptoms listed above contact your health care provider.

Surgery is a common treatment given to colon cancer patients. If the the cancer spreads, che-motherapy or radiation is usually given.

Pass on facts that you know about colon cancer to your friends and family so they know the

correct knowledge. Encourage them to get screened and share any colorectal cancer stories you know. Donate to cancer associations and foundations to help with education, research, and community outreach programs.

Resources from www.preventcancer.org

12

The “Three C’s” of McCann Treatment CenterObservations of a Senior Psychiatric TechnicianBy Lyna Mossholder, Senior Psychiatric Technician, McCann Treatment Center

When I began my new job at McCann Treatment Center (MTC), I have to admit I was a bit nervous about working there. I’ve always worked with little kids, but to work with teenagers is more complex.

I knew what challenges to expect, and wanted to learn and grow from this new experience, but little did I know that after only a few months I would be tested in every part of my well being. I was tested to the point where I had to stop and ask myself, “Do I really want to work here?” I wanted to quit my job, but didn’t.

Now, a year later, I find myself still working at MTC. Why would I still be here? It’s because the program really works for both cli-ents and staff. Through my own experiences and observations, I’ve learned there are several key components that make MTC a success-ful place to work. The most prominent of these components are the “three C’s”: Communication, Consistency, and Caring Staff.

CommunicationCommunication is essential; it actually brings people together. I’m proud to say I see very good communication among the facility’s staff. There may be a few staff members that are reluctant to turn to others about questions and concerns but, for the most part, most of the staff are good about communicating themselves to others. When we see something that is working for the program, we praise it and share it with others. On the other hand, if we see something that isn’t working, or is bothering us, we talk about it. Sometimes that means directly talking about it with another staff member.

One may argue that directly letting others know you’re upset with them isn’t the best method to resolve a problem. In these cases com-munication can be tricky. How do you confront others without hurt-ing their feelings or making them angry? Diplomacy is key.

If we have a conflict with another staff member and aren’t sure whether they can handle what we have to say then we turn to our Supervisor and, if necessary, Director for advice.

Good communication plays a big role and as long as we’re using these skills we will maintain a healthy and worthwhile workplace.

ConsistencyAnother key factor our Supervisor and Director emphasize is to be consistent in everything we say and do with our clients. When staff is not consistent it reflects poorly on other staff and our clients aren’t served well.

Consistency is a work in progress for many of us, myself included, and sometimes our individual beliefs and values get in the way of meeting our ultimate goals.

We rely on experienced peer staff, our supervisor and our director to help us be consistent in our work. Listening to their advice and direction will help us improve our consistency which will, in turn, continue to keep MTC a great place for employees to work and cli-ents to get well.

Caring StaffHealthcare employers need people who really care for their clients. At MTC, I’ve had the privilege of working with co-workers who genuinely care about our clients. It really helps that members of our management have worked as Psychiatric Technicians at some point in their career. They understand and relate to staff and clients about our daily struggles and challenges. I know many of our staff portray this trait towards clients as evidenced by this recent experience.

One of our clients recently graduated from the MTC program. It was the client’s last night and he wanted to sit and chit chat with the staff. Meanwhile, a staff member that he had thought disliked him came over from a different wing, sat down, initiated a conversation with him, and wished him well in the future. That brief encounter told the client this particular staff member didn’t dislike him after all.

I was truly touched because the staff member took time away from her other duties to bid farewell to the client. By the look on his face, I could see it really meant something to him.

Even to this day, I continue to see positive role models using good communication, consistency, and caring of clients on a regular basis. I get a strong sense of satisfaction knowing I work with great people trying to achieve the same goals. As we continue to implement the three “C’s” we will see better results and higher rewards. Most impor-tant, it will make MTC a successful workplace for all.

Lyna Mossholder is a part-time Senior Psychiatric Technician at McCann Treatment Center. She is also a full time Speech and Lan-guage Associate Teacher for the Lower Kuskokwim School District. She immigrated with her family to the US in 1990 from the Thailand/Cambodia region and has lived in Bethel for the last six years. She can be reached at lyna_mossholder@ykhc.org.

Reprinted with permission from the Alaska Healthcare News. To learn more about the Alaska Healthcare News visit akhcnews.com.

The McCann Treatment Center specializes in providing care for youth who have developed problems with inhalants and other substances, but also serves youth with serious emotional and behavioral problems.

Volume XVI No. 3 • March 15, 201113

see MEDICINE, p. 14

Patient Safety is everywhere at YKHCFrom your Patient Safety Committee

Patient safety is everything from the walk into the hospital to the bed you sit on, to the nurse

taking your vital signs, to the doctor prescribing your medications, to the pharmacist giving you your medi-cines.

There are the people who do your tests and the machines they use, the people who store your records and cook your food! There is also the maintenance and housekeeping staff who keep the hospital warm and safe and clean!

What does YK do to ensure patient safety? We have departments in all areas of the hospital which are vital to run our facility in a safe manner. For starters we have the Safety and Security Department that regularly walks through the entire hospital and inspects the facility for potentially hazardous situa-tions.

Second, we have the Maintenance Department that is constantly repairing the facility from regular wear and tear.

Third, we have housekeeping staff that are specifically trained for cleaning in an environ-ment of potential contamination.

Fourth, there is an Infection Prevention and Control Department, which provides health care safety for the staff. They maintain our employee health records, flu shots, FIT testing and disease prevention by keeping our immunizations current.

We have a Bio-medical Department that spends more then half its time checking on every piece of medical equipment. They ensure that the equipment is in good shape, coded correctly and calibrated appropriately—including scales, blood pressure cuffs and thermometers.

Our nursing staff is constantly surveying their department for potential hazardous situ-ations, double checking the medications they are giving, verifying orders with the physi-cians and ensuring your environment is clean and orderly.

Health Aides are also ensuring patient safety by keeping their stock current and their clinics clean and well cared for as well as completing competencies and remaining current on their licenses and skills.

All the health care providers are required to stay up-to-date on evidence-based safe prac-tice so that the care they give is the one proven to work best.

How can you know that? Stay informed. Ask the physician questions about the care and treatment you’re getting. It’s your body it’s your choice. Ask about potential side effects of medications and treatment. Ask if there are any other treatments that may be available. It is important that you, the patient, keep your safety a priority.

Keep a list of your medications and be sure to ask the pharmacist exactly what each drug is for, how often do you take it and for how long. Do you need to call for a refill?

We’re always looking out for your safety, but you can help by being aware of your own safety too.

How to Dispose of Unused Medicines

Medicines play an important role in treating certain conditions, but they must be taken with care. Unused portions of these medica-tions must be disposed of properly to avoid harm to wildlife, pets, and people.

For medicines without an expiration date, unless you know you purchased it within the past year, it’s best to toss it. As time passes, medicines may lose their effectiveness, espe-cially if they are stored in a medicine cabinet in a warm, moist bathroom.

In rare cases, outdated medicines could become toxic. For example, taking expired tetracycline (an antibiotic) can cause serious kidney problems. Is your medicine cabinet filled with expired drugs or medications you no longer use? How should you dispose of them?

In the past, most people flushed old medicines down the toilet. This was done to prevent acci-dental poisonings of children and animals who may find medicines in the trash.

But today, the Environmental Protection Agency (EPA) no longer recommends this. Sewage treatment plants may not be able to clean all medicines out of the water. This may harm fish and wildlife as well as unintentional human exposure to chemicals in the medica-tion. Keeping prescription and over-the-coun-ter medicines out of the environment is an important way to prevent pollution.

A few small steps can make an important dif-ference in safeguarding lives and protecting the environment. Remember to follow your medication prescriber’s instructions and use all medications as instructed. If you do not use all of your medications, you can take a few small steps to make a huge impact in safeguarding lives and protecting the environment by dis-

David Bigger gets some safety information from Tania Thomas during National Patient Safety Week.

14

World TB Day is March 24Tuberculosis (TB), a disease caused by the bacteria Mycobacterium tuberculo-sis, affects mainly the lungs but can affect other parts of the body too.

It is a disease that is common around the world. TB can be cured more than 90 percent of the time with appropriate treatment (taking antibiotics for 6-9 months). There are more persons with Active TB in the YK Delta than there have been for a few years.

Symptoms of TB include:• Cough for more than 3 weeks• Chest Pain• Coughing up blood• Sweating at night• Tiredness/ no energy• Losing weight without trying• Chills or FeverTB is spread through small droplets that are carried in the air by a person coughing, sneezing, and singing.

People who have been exposed to TB but do not have the disease have Latent TB Infection (LTBI), and may need to take an antibiotic to prevent developing Active TB later in their life.

People who live with or spend time with persons who have Active TB may become infected. It is important to get checked as soon as possible if you have been exposed to a person with Active TB, or have symptoms of TB.

Please contact your health care provider or health aide to follow up. Preventing the spread of TB will help us become healthier people.

posing of unused medicines properly:

1. Keep medicine in original container. The labels may contain safety information and the caps are typically child proof. Mark out personal information on prescription bottles with a permanent marker.

2. Modify the medicines to discourage consumption. Mix liquid medicine with undesirable substances like coffee grinds, cat litter, or dirt. Dilute pills with water, then add coffee grinds, cat litter, or dirt. For liquid medicines, add enough table salt, flour, or powdered spice (such as turmeric or mustard) to make a pungent, unsightly mixture that discourages anyone from taking it.

3. Seal and conceal. Tape the container’s lid shut with packing or duct tape. Place bottles in an opaque container, like a yogurt con-tainer, and secure lid; or wrap in a dark colored plastic bag.

4. Discard the container in your garbage can. Hide the container in the trash. Do NOT place it in the recycling bin.

Improper disposal in your trash allows others to divert the substance and consume medication that was not prescribed to them.

Prevent water pollution, Promote a healthy environment, Properly dis-pose of your unneeded and expired medication.

Additional tips:Do not give medications to your friends. Doctors prescribe drugs based on a person’s specific symptoms and medical history. A drug that works for you could be dangerous for someone else.

Take advantage of community drug take-back programs that allow the public to bring unused drugs to a central location for proper disposal.

When in doubt about proper disposal, talk to your pharmacist.

For more information Contact

YKHC Pharmacy: 1-800-543-6988

MEDICINE, from p. 13

1. Mark out personal information

2. Mix with water and coffee grinds, cat litter, or dirt

3. Place in opaque container

4. Hide in the trash

Volume XVI No. 3 • March 15, 201115

Earlene Wise, CHP, Kalskag— January Health Aide of the Month Earlene Wise has been a Health Aide for more than 15 years and for the past three or four years she has been taking care of people in Lower and Upper Kalskag. Martha E. Olick nominated Earlene for working long hours and seeing patients after hours in Lower Kalskag when needed.

For three days during a recent weekend she stayed in the clinic monitoring a patient when LifeMed was unable to get to the village because of weather. Since there is no VPSO or VPO in the village she watched him at the clinic.

“I have never heard her complain about working long hours,” Olick said. “She is willing to come to work when called at any time of day. She deserves to be recog-nized because she is dedicated to ‘Working Together to Achieve Excellent Health,’ for the village of Kalskag.”

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

Andrea Thomas, Field Supervision Instructor by calling

543-6160. Earlene Wise, Kalskag Community Health Practitioner.

Stony River Family Spirit Gathering“It is a great place to live,” said Eric Willis, grandson of Tom Willis. Community participants during a recent Family Spirit Gathering were asked what they thought the positive things are that Stony River has to offer. A few local people responded, and then Mary Willis, Tribal Council President, asked Eric Willis and everyone loved his response from the outlook of a child.

Greg Moses, YKHC’s Family Spirit Coordinator, suggested that the village post “It is a great place to live” on the Tribal Office Building to encourage everyone who comes to the village. On one day of the gathering Michael & Annie Fredericks spent time sharing on “Healthy Relationships.”

February 23–25, 2011, was our first Family Spirit Gathering that was held at Stony River. After this gathering was over, Mary Willis wrote, “We were very pleased that YKHC chose our village as one of their villages to do their Family Spirit Gathering. We really enjoyed the time spent here because we got to gather together to try to start working on our weak point as a village and also point out the good that we have here. We did think that we needed more involvement from our community and also spent time in talking circles—overall quite positive. Thanks for selecting our village.”

The goal of the Family Spirit Gatherings is to improve the qual-ity of life for each person and family living in rural communities throughout the YK Delta so our children can grow up in safe homes and community environments.

On the last day of the Stony River Family Spirit Gathering Greg Moses showed a 10 foot fish net and said, “When we live by our Native values (respect, trust, love, sharing, etc.) it unites and strengthens our families and community, just like this net. Unfor-tunately when our net tears it weakens it and loses the ability to catch fish and when we have lots of verbal abuse, physical abuse and sexual abuse in our homes it tears and weakens our families and community. Strength in your community doesn’t come from YKHC, OCS, AVCP, or any other agency. It comes from your com-munity, healing one family at a time.” The spirit behind the Family Spirit Project moves from the perspective that there is no power for change greater than a village discovering what it cares about.

YKHC would like to thank Stony River Traditional Council and Gusty Michael School for inviting us to have the Family Spirit Gathering in their community. It was a wonderful success.

—Greg Moses and the Family Spirit Program

Volume XVI No. 3 • March 15, 2011

Non -Profit Org.US Postage

PAIDAnchorage, AK

Permit # 537

Yukon-Kuskokwim Health CorporationP.O. Box 528Bethel, Alaska 99559907-543-6000

YKHC

Now you can request your medicine directly from YKHC’s Pharmacy and it will be sent to YOUR Post Office Box. You don’t have to pick up your medications from the clinic!

CALL US 10 days before you run out of medicineTELL US • Your full name and date of birth • Prescription # & medication name • Contact number & village — Your medication will be delivered to your P.O. Box!

NEW FOR BETHEL RESIDENTS

MEDICATION REFILLS BY MAIL