A S S O C I AT I O N
Healthy People, Thriving Communities
ANNUAL REPORT 2017
Our Vision & Mission
Our Vision Healthy people, thriving communities. Our Mission . Savaqatigiiksugut. We are working together. Working together to provide high quality, culturally relevant health, social and tribal services.
Contents
Our Organization
03
Financials
09
Our Logo
05
Programs & People
12
Federal & State Grants
06
High Quality Care
17
Services
07
Key Partners
24 02
Board Chair & President / CEO Letter On behalf of the Maniilaq Board of Directors and the Executive Leadership of the Maniilaq Association, we are happy to introduce this 2017 Annual Report to the people we serve. The purpose of this report is to provide some 2017 programs & services highlights, and give you a snapshot of how we’re doing in our role of health/ social services/tribal services organization. In 2017 we updated our Mission & Vision statements to align with our Strategic Plan. Our strategic plan (2015-2020) has the following four priorities: 1) Financial integrity; 2) High quality people and services; 3) Reducing the burden of chronic disease; and 4) Effective, sustainable infrastructure. Working towards these priorities should ultimately lead to helping us attain our updated Vision which is:“Healthy people, thriving communities.” A lot of careful thought was given to this revised statement by both governance and staff. We believe it concisely states what we are striving for in the coming years – every Maniilaq employee should understand what his or her role is in helping to attain this vision. Maniilaq continues to operate in an ever-changing fiscal environment. The cost of providing programs and services increases while most resources stay flat or decrease.
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This means we need to make smart decisions with limited resources in order to keep the quality of services/programs high. One of our most significant accomplishments last year was achieving an annual financial audit that was “in the black.” This means our expenses did not exceed our income. This accomplishment is important and a significant reflection of Maniilaq’s financial health. We aspire to continue that trend in 2018 and beyond; without good financial health, our ability to provide quality programs and services could be compromised. We wanted to take a moment to thank you – the people and communities we serve – and the Tribal Governments at the village level – for your support and feedback not only in 2017, but also in the months and years ahead. Maniilaq exists because of you. Our successes are dependent on our continued good relationships, partnerships, and collaborations with the communities and Tribes that we serve.
Eva Kinneeveauk, Chairperson Maniilaq Board of Directors
Tim Gilbert, President / CEO Maniilaq Association
Board & Executive Leadership
BOARD OF DIRECTORS
Eva Kinneeveauk, Chair
Guy Adams, Vice Chair
Lorena Walker, Treasurer
Diana Ramoth, Secretary
Tanya Kirk, At-Large
Percy Ballot, Member
Louie Commack, Member
Dolly Foster, Member
Johnetta Horner, Member
Amanda Johnson, Member
Emerson Moto, Member
Leslie Sampson, Member
EXECUTIVE LEADERSHIP
Tim Gilbert, President/CEO
Charlie Nelson, Vice President/Tribal Government Services Administrator
Chad Sheldon, Chief Information Officer
Paul Hansen, Hospital Administrator
Bree Swanson, Social Services Administrator
Henry Roy, Chief Financial Officer
Gerty Viveiros-Gallahorn, Human Resources Director 04
Meaning of the Maniilaq Logo The Maniilaq logo is based off of the prophet Maniilaq. The story of Maniilaq has been passed down through oral stories of elders throughout the Northwest Arctic Borough.
THE MOUNTAINS The mountains represent our up-river communities: Ambler, Kobuk and Shungnak.
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THE DRUM
THE STAFF
It was said that before a prediction was made, Maniilaq would beat his drum and sing.
Maniilaq was remembered as always bringing with him his staff.
THE RIVER
THE OCEAN
The river represents our in-land communities: Kiana, Noatak, Noorvik and Selawik.
The ocean represents our coastal communities: Buckland, Deering, Kivalina, Point Hope and Kotzebue.
Federal and State Grants TOP TEN FY18 Federal, State and private funding is essential to helping Maniilaq achieve our vision and mission.
FEDERAL
STATE
1
Community Health - $2,792,941 - Health Resources and Services Administration (HRSA)
1
Behavioral Health Services - $1,253,380 - Comprehensive Behavioral Health Treatment & Recovery (CBHTR)
2
Workforce Development - $1,056,554 - Temporary Assistance for Needy Families (TANF)
2
Workforce Development - $1,125,750 – Native Family Assistance (NFAP)
3
Diabetes - $729,665 - Special Diabetes Program for Indians Prevention and Treatment Projects (SDPI)
3
Public Health Nursing - $826,300 – Public Health Nursing (PHN)
4
Tobacco Prevention - $367,903 – Tobacco Prevention and Control (TPC)
4
Maniilaq Health Center - $738,758 - Maintenance and Improvement
5
5
Workforce Development - $578,231 - Child Care and Development Fund (CCDF)
Women, Infants and Children - $277,796 – Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
6
Vocational Rehabilitation Services - $445,516 - Tribal Vocational Rehabilitation (TVR)
6
Family Services - $269,280 - Rural Child Welfare Services (RCW)
7
Behavioral Health Services - $412,745 - Circles of Care
7
Family Crisis Center - $168,867 - Council on Domestic Violence and Sexual Assault Victim Services (CDVSA)
8
Behavioral Health Services - $400,701 - Alaska Native Education Program (ANEP)
8
9
Behavioral Health Services - $392,978 – Methamphetamine and Suicide Prevention Initiative (MSPI)
Emergency Medical Services - $164,491 – Emergency Medical Services (EMS)
9
Office of Environmental Health - $162,646 – Remote Maintenance Workers (RMS)
10
Behavioral Health Services - $342,743 - Behavioral Health Aide Program (BHA)
10
Behavioral Health Services - $160,000 – Rural Human Service System (RHSS)
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Maniilaq Service Area Maniilaq Association provides health, social and tribal services to residents of the following communities located in Northwest Alaska:
The Maniilaq Service area encompasses a remote area of 36,000 acres — about the size of the state of Indiana.
Point Hope Kivalina
• There are no roads connecting the villages to each other or outside of the region. • The Maniilaq Health Center is located in Kotzebue, which is the hub city of the region. • The nearest health referral services are located over 500 miles away in Anchorage. •
Subsistence activities are a vital part of the region’s lifestyle. Residents rely on caribou, moose, reindeer, bowhead and beluga whales, birds, seal, berries, greens and fish.
• 82% of the population is Iñupiat.
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Beri
n
ra i t t S g
Maniilaq Service Area
Noatak
Kotzebue
Noorvik
Ambler
Kiana Selawik
Deering
Seward Peninsula
Buckland
Kobuk
Shungnak
HEALTH SERVICES provides comprehensive primary health care based out of the Maniilaq Health Center in Kotzebue, the Public Health Nursing building and village clinics located in each of our communities. Long-term skilled nursing services are also provided at Utuqqanaat Inaat in Kotzebue. Â Â
SOCIAL SERVICES is the sole provider of mental health and substance abuse treatment and community-based senior and disability services in the Northwest Arctic Borough. Maniilaq Social Services is divided into two divisions, Behavioral Health Services and Senior & Disability Services.
TRIBAL GOVERNMENT SERVICES administers Bureau of Indian Affairs (BIA) programs on behalf of individual tribes that authorize Maniilaq Association to do so through a 3-year funding agreement with the BIA.
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Financial Overview FY17 FUNDING SOURCES
5% 1% 11%
Indian Health Service | $47,264,931
47%
Third Party Revenue | $35,911,940 Grants and Contracts | $10,844,080
36%
Bureau of Indian Affairs | $4,748,036 Other Income | $1,285,534
EXPENSES 5%
5%
Maniilaq Health Center | 54,958,152
21%
Administration | $20,346,718 6% 56%
7%
Social Services | $6,739,879 Tribal Government Services | $5,920,218 Utuqqanaat Inaat | $4,573,471 Other Expenses | $5,138,954
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STRATEGIC PRIORITY Financial growth and fiscal integrity to promote service delivery.
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STRATEGIC PRIORITY Educate and promote healthy Iñupiaq lifestyle, language and culture to reduce chronic disease.
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The Hunter Support Program The Hunter Support Program provides supplemental niqipiaq (traditional foods) to elders age sixty and over. Through the Hunter Support program local volunteer hunters can purchase ammunition, motor oil, and gasoline to harvest local fish/game for village elders who are no longer able to harvest niqipiaq (traditional foods) on their own. This ensures that the village elders continue to have niqipiaq in their homes. The Siglauq, (Iùupiat for underground cold storage or ice cellar), is operated by Maniilaq’s Traditional Foods Program and serves as a traditional foods donation center for Utuqqanaat Inaat elders and community and regional events.
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Growing Our Own Tiffany Scott, RN I was 10 years old when I watched my Auntie Cudie carefully stitch the skin on my brother’s head back together, after he cut it while playing a game of hide-and-seek outdoors in Noorvik. I didn’t know that we could do those kinds of medical treatments, ourselves, in our village clinics. That was the first time I thought for myself that I wanted to work in healthcare someday. This year I became a registered nurse in the emergency department at the Maniilaq Health Center. Like my Auntie was there for my brother and me, now I’m here for you and your family.
Heidi McConnell, CNA I recently moved back to Kotzebue to get my Certified Nursing Assistant (CNA) certification from the Alaska Technical Center in 2017, we did our clinicals here at Long Term Care (Utuqqanaat Inaat). I chose to work for Maniilaq because I wanted to get the most experience as I can for when I go for my RN in 2020. I love working for the elders and listening to their wonderful stories they have to share. Maniilaq is a great place to work while going to school, they are willing to work with your schedule and help you in any way possible.
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STRATEGIC PRIORITY Highest quality talent and reputable services delivered throughout our service area.
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Wind-to-Heat Energy Project Maniilaq Association and Kotzebue Electric Association’s Board of Directors participated in a ribbon cutting ceremony for the Wind-toHeat Energy Project on January 25, 2017. This project was a joint effort between Maniilaq Association, the Alaska Native Tribal Health Consortium (ANTHC) and KEA. An electric boiler energized from excess wind energy supplies heat for Maniilaq Health Center (MHC) at a lower charge rate and offsets fuel consumption for both Maniilaq and KEA. MHC is now experiencing the cost and energy saving benefits of its new Wind-to-Heat Energy system.
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. Nikipiat Nigikkavut
TRADITIONAL FOODS THAT WE EAT
Maniilaq hosts first traditional foods symposium: Nikipiat . Nigikkavut Several Maniilaq Association programs and external partners collaborated to host a successful three. day traditional food symposium, Nikipiat Nigikkavut (traditional foods that we eat), September 6-8, . 2017, at the Nullagvik Hotel in Kotzebue. The goal of the symposium was to provide a forum for health professionals, researchers, and subsistence users to promote health through traditional foods and medicines in northwest Alaska. Elder and youth representatives from each regional community attended the symposium and shared their knowledge and insights on the importance of traditional . foods. During the Nikipiat Nigikkavut Symposium, there were presentations, panel discussions, questions and answer sessions, knowledge sharing and handson activities that included a welcome traditional food potluck, salve making, and guided plant walk. Over the course of our three-day event, a total of 81 unique registrants were in attendance. The event was coordinated by Erin Nelson and Brittany Anderson.
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Improving Our Care In 2017, Maniilaq Association started the process of changing over to a new, state-of-the-art electronic health record (EHR) system. Our new EHR system will help our providers put the patient at the center of care and securely share patient information with one another across all Maniilaq sites and with your health partners at the Alaska Native Tribal Health Consortium (ANTHC). The system will give our medical team upgraded tools to improve communication, coordination, safety, and overall quality. The ability for all Maniilaq and Alaska Native Medical Center (ANMC) providers to access patient medical records means that patients can be seen in any of our clinics throughout the Maniilaq service area and ANMC and our staff has immediate access to your medical history, which will follow you as you move between hospitals, clinics, doctors, and other providers.
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STRATEGIC PRIORITY Develop and/or improve effective and sustainable infrastructure and processes.
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Maniilaq Health Center Workload OUTPATIENT VISITS | 14,038
Top purpose of visits: hypertension, chronic pain, upper respiratory infection
INPATIENT DAYS | 1,454
Top purpose of visits: pneumonia, chronic obstructive pulmonary disease (COPD), mental health
EMERGENCY ROOM VISITS | 7,406
Top purpose of visits: upper respiratory infection, abdominal pain, pneumonia
VILLAGE CLINIC VISITS | 21,046
Top purpose of visits: acute nasopharyngitis (nose/throat problem), otitis media (ear problem), hypertension Pharmacy prescriptions | 118,960 Laboratory tests | 140,238 Radiology exams | 6,521 Physical therapy visits | 1,083 Dental visits | 10,898 Optometry exams | 2,416 Patient travel Medevac trips | 364 Routine patient travel | 4,346 Annual cost to Maniilaq | $3,964,642.34
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Providing High Quality Care Maniilaq Association has earned The Joint Commission’s Gold Seal of Approval® for Hospital Accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal of Approval® is a symbol of quality that reflects an organization’s commitment to providing safe and effective patient care. Maniilaq has exceeded all of its National Government Performance and Results Act (GPRA) clinical quality performance measures for the past three consecutive years.
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Inuich Mamirutia In January 2017, Maniilaq Association founded “Inuich Mamirutia” translated to mean “all people’s healing.” This innovative program aims to improve our health care delivery system, by integrating behavioral health and other social programs into our medical clinics. This initiative relies heavily on community input to develop strategies for Wellness for individuals and their families. Major achievements for Inuich Mamirutia in FY 2017 • Added Wellness Counselors to primary care teams at Maniilaq Health Center. • Initiated a partnership with Massachusetts General Hospital. • Established advisory councils on maternal and child health. • Created the Extension For Community Healthcare Outcomes (ECHO) clinic, a training curriculum for primary healthcare providers and Village Community Health Aides/Practitioners (CHA/Ps).
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ALL PEOPLE’S HEALING
Promoting Community Conversations Developed in partnership with Maniilaq Wellness Program, Kawerak Wellness, and members of Northwest Alaska and Bering Strait communities, Promoting Community Conversations About Research to End Suicide (PC CARES) is a health intervention that offers a clear way to address youth suicide in self-determined ways. This approach shares helpful information but does not tell participants how they should use it. Instead, PC CARES assumes that each participant can best determine how to put the new prevention information to use. With strong evidence showing significant benefits of the intervention, PC CARES is a promising and practical way to translate scientific research into community-driven, culturally responsive and suicide prevention practice that could reduce suicide risk in rural Alaska Native communities.
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Aqqaimmuk House 2017 23
The Aqqaimmuk House, a home for individuals who experience physical and developmental disabilities, held its grand opening on July 19, 2017. The Aqqaimmuk House is named after Leela Davidovics, the first resident of the Lake Street House. Our new home will provide additional group home services for five residents.
MANIILAQ SERVICE AREA TRIBES
Key Partners in 2017
• Ivisaappaat Tribal Center (Ambler) • Kiana Traditional Council • Native Village of Buckland • Native Village of Deering • Native Village of Kivalina • Native Village of Kobuk • Native Village of Kotzebue • Native Village of Noatak • Native Village of Point Hope • Native Village of Selawik • Native Village of Shungnak • Noorvik Native Community MANIILAQ SEAL OIL PROJECT • University of Alaska-Fairbanks, Kodiak Seafood and Marine Science Center • University of Wisconsin, Department of Bacteriology • Native Village of Kotzebue, Environmental Program • State of Alaska, Food Safety & Sanitation Program • Center for Disease Control and Prevention, Center for State, Tribal, Local, and Territorial Support • AmeriCorps Volunteer in Service to America (VISTA) SOCIAL MEDICINE PROGRAM • Massachusetts General Hospital • Harvard Medical School – Department of Global Health and Social Medicine • Lisa Wexler – University of Massachusetts, Amherst WIND-TO-HEAT ENERGY PROJECT • Kotzebue Electric Association • Alaska Native Tribal Health Consortium • Indian Health Service NORTHWEST ARCTIC LEADERSHIP TEAM (NWALT) ALASKA NATIVE TRIBAL HEALTH CONSORTIUM (ANTHC) 24
MANIILAQ ASSOCIATION
P.O. Box 256, #733 2nd Avenue Kotzebue, AK 99752 1-800-478-3312 (in Alaska) or 907-442-3321 www.maniilaq.org facebook.com/ManiilaqAssociation