Fall 2018 Sivutmuuluta

Point Hope

sivutmuuluta LET’S MOVE FORWARD

Kivalina

Noatak

Kotzebue

Kiana Noorvik

Ambler Shungnak

Kobuk

Selawik

Deering

Buckland

FA LL 2 0 18 | PUBL ISHED BY M ANIIL AQ A S S O CIAT IO N | WW W. M A N IILAQ. O R G | 907- 442- 33 21

Health, Wellness & Niqipiaq with the U.S. Surgeon General

By LCDR Chris Dankmeyer On August 10th the United States Surgeon General, RADM Jerome Adams (or Dr. Adams) and a group of high level officials from the U.S. Department of Health and Human Services and Indian Health Service, visited the Maniilaq Health Center and the communities of Selawik and Buckland.

The US Surgeon General is known as “The Nation’s Doctor” and is the lead spokesperson on matters of public health in the federal government of the United States. As Surgeon General, Dr. Adams oversees the operations of the U.S. Public Health Service Commissioned Corps, which has approximately 6,500 uniformed health officers who serve in nearly 600 locations around the world to promote, protect and advance the health and safety of our nation.

There are three highly trained USPHS Commissioned Corp Officers currently stationed with Maniilaq Association (LCDR Tracey Gregg, LCDR Chris Dankmeyer, and LT Adriel Perry). It was a rare and historic occasion when the Surgeon General travels above the arctic circle to Maniilaq AssoTop: Buckland welcomes Dr. Jerome Adams, US ciation to better understand the unique public health and medical challenges Surgeon General. within our area.

Bottom right: Lawrence Larkin gives our guests a ride to the clinic.

Dr. Adams and his staff were given an overview (continued on page 2)

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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.

Board of Directors

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U.S. Surgeon General’s Visit of Maniilaq Association’s FY17 operations by Tim Gilbert, CEO and supporting staff. They were then given a walking tour of the Maniilaq Health Center and Long-term Care Center by Paul Hansen, Hospital Administrator, before heading to the airport for a flight to Selawik.

Upon landing, guests were provided a warm Selawik welcome by local community leaders and clinic staff. An entertaining and informative walking tour of the community, from the airport to the health clinic, was provided by Clyde Ramoth, City Council. Most members of Dr. Adam’s group toured the Selawik Health Clinic, while several members of the Indian Health Service met with the local water plant operator to tour the drinking water plant (the other great public health infrastructure). Everyone met back at the clinic to join local leaders for a wellness discussion, fill their stomachs with Selawik’s finest niqipaq, and fill the air with laughter.

Guy Adams, Chair Kotzebue Eva Kinneeveauk, Vice Chair Point Hope Percy Ballot, Treasurer Buckland Johnetta Horner, Secretary Kobuk Tanya Kirk, At-Large Noatak Louie Commack, Member Ambler Dolly Foster, Member Kivalina Nellie Griest, Member Shungnak Emerson Moto, Member Deering Diana Ramoth, Member Selawik Leslie Sampson, Member Noorvik Lorena Walker, Member Kiana

With full stomachs, Dr. Adams and his staff flew to Buckland for the afternoon. Once again, guests received a warm and joyous welcome from Buckland’s local community leaders and clinic staff. Percy Ballot, Maniilaq Board Member, led the group to the clinic and described the recent health and wellness challenges the community has been facing. All visitors then traveled to the Tunnaq-Ipaq water plant for a tour led by Erik Weber, Water Plant Operator. After an impressive water plant tour, everyone met back at the clinic to join local leaders for a wellness discussion and have some of Buckland’s finest niqipaq.

Upon heading back to Kotzebue and getting a windshield tour of the community, the group made time for just one more potluck with Maniilaq leadership at the Health Center. Stomachs were overstuffed, closing remarks were made, relationships were developed, and we bid Dr. Adams and his staff a farewell with hopes that they may visit us again.

We want to thank all the community members in Selawik and Buckland who were such gracious hosts for Dr. Adams and his staff. The Surgeon General and his staff left our region with a genuine understanding of the unique challenges we face, what we are doing about it, and how his office might be able to better support public health in our region. Dr. Adams’ motto as Surgeon General is “better health through better partnerships” and we are taking that to heart at Maniilaq Association.

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Community Conversations with the Social Medicine Program

By Lucas Trout, Corina Kramer & Tessa Baldwin Maniilaq Social Medicine began in 2017 to support our region in developing a “blueprint” for systems of care that reflect our Inupiaq culture, values, needs, and priorities. Over the past year, the Social Medicine team (Corina Kramer, Teressa Baldwin, and Lucas Trout, with Maniilaq Communication’s Christina Fields) held Qargi meetings throughout the Maniilaq Service area to learn from communities and help plan our collective work for coming years.

Corina Kramer and Tessa Baldwin listen to community members in Ambler.

Eunice Hadley, Natalie Hadley and Gary Hadley attend Buckland’s meeting.

This summer, we facilitated community conversations across the region to ask villages about their unique needs, concerns, and ideas, and to learn about ways each village traditionally aided their community in the past.

Some of the key issues brought up by community members were the needs to incorporate Iñupiat Ilitqusiat into health care; the importance of addressing physical, emotional, social and cultural wellness together; a desire to teach health care providers more about our people and region; and the importance of supporting grassroots wellness initiatives on the village level. A common thread in each village was missing the traditional way of life and sense of community, and wanting to see regular community gatherings where Inupiaq knowledge and values would be taught to the younger generations.

Johnetta, Samantha and Cheree Horner in Kobuk.

Amber Westlake, Charlotte Ballot and Mary Arey attend Noatak’s community meeting.

Our job at Maniilaq Social Medicine is to support communities and the region as a whole to put these insights into practice. In the first year, we worked to build wellness supports at Maniilaq Health Center, formed a new partnership to recruit the nation’s best primary care providers to our region, supported local people in teaching health care workers about our culture, and partnered with both Maniilaq and other community programs to help strengthen a broad range of services to address the needs of our region’s children and youth. Over the coming years, we will work to help make more of these community priorities real. The Maniilaq Social Medicine vision is for our region to have the highest possible standard of health and health care based upon the values and knowledge of our people.

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13 Tons of E-Waste and 5 Tons of Batteries Removed from Landfills

By Stanley Tomaszewksi, Recycling/Brownfield Coordinator Maniilaq Association committed its environmental program to establish regional comprehensive backhaul-recycling services to prevent the formation of contaminated and brownfield sites in our region. Through responsible environmental stewardship, backhaul and recycling, our program benefits the health and the environment of current and future generations of inhabitants of the Northwest Arctic.

The environmental program implemented a recycling and backhaul program to assist communities within the service area with staging and transporting recyclable materials via Kotzebue to Anchorage and/or Seattle. The project is a partnership between Maniilaq Association and its member tribes, the City of Kotzebue, Northwest Arctic Borough/Municipalities, and regional transportation providers.

Since inception in November 2007, the program has backhauled for recycling over 170 tons of electronic waste (or e-waste), four tons of fluorescent lights, 100 tons lead-acid batteries, and over five tons of ‘white goods’ (i.e., washers, dryers, refrigerators, freezers). Recycling these materials, helps maximize the lifespan of a landfill (space), keeps out hazardous heavy metals like mercury and lead, and helps reduce the negative environmental impact of landfills.

Recently the program shipped out two 20 ft. connexes to Seattle on the July 2018 AML barge, completely full front to back and top to bottom containing over 13 tons of e waste and 5 tons of lead-acid batteries.

The program has been collecting these materials at our regional recycling connexes in Kotzebue since September 2017. It’s important to note the generous program AML offers and enormous discount for recyclables backhaul from Kotzebue to Seattle. We are allowed up to four connexes each barge season, usually two for July barge sailing and two more for September. Without this AML service discount it is unlikely we would be able to send out the volume of recyclables we have in a cost effective way. Likewise, Ryan Air Cargo offers discounted backhaul rates for recyclables from the village to Kotzebue. This offer makes it more attractive to village entities wishing to direct their e-waste, acid batteries and white goods to the Maniilaq program to be included in our backhaul efforts. Sometimes during winter, if conditions are favorable (safe) for ice-road construction, communities are able to take advantage the spring ice road from Kiana, Noorvik to Kotzebue for materials transport.

Frequently the EPA IGAP Environmental Coordinators in service area villages, typically Kiana and Noorvik, will transport recyclables to Kotzebue via motor boat; weather and river conditions permitting.

The Maniilaq Association’s back haul and recycling program has demonstrated the ability to divert substantial amounts undesirable materials from entering the solid waste stream and /or the environment; however the full measure of accomplishment will be to stop the accumulation of certain refuse items by establishing permanent outlets that systematically prevent future backlog. This accumulation continues to be a huge problem in rural Alaska, singularly affecting all aspects quality of life, and one requiring a corresponding magnitude of commitment to ensure the full measure of accomplishment.

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National Indian Health Board Awardee: Cyrus Harris

Joanne Harris, Cyrus Harris, Tim Gilbert, Tanya Kirk and Lorena Walker.

Cyrus and Joanne Harris.

Cyrus Harris was awarded the National Indian Health Board’s Local Impact Award at the National Tribal Health Conference. This award recognizes an individual or organization whose work has affected change or impacted health care on the local and or Tribal level.

The 35th Annual National Tribal Health Conference took place in Oklahoma City, September 17-20, 2018.

The National Tribal Health Conference (NTHC) is the largest American Indian and Alaska Native specific gathering each year focused specifically on health. The conference focuses on exploring health policy and its impact on Tribes, advancing Tribal capacity to expand own policy work, and policy and political work in the arenas of health care, public, behavioral, and environmental health. The conference features multiple tracks of concurrent breakout sessions, as well as general plenary sessions that feature nationally recognized quest speakers and elected and appointed governmental officials.

Interested in becoming a foster parent?

Have you thought about becoming a foster parent or would you like more information about becoming a foster parent? Contact your Foster Care Specialist at 442-7886 or 1-800-478-9771 ext: 7886.

We look forward to hearing from you!

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FAQ about Utuqqanaat Inaat, Maniilaq’s Long-Term Care Facility Who pays the cost of Long-Term Care (LTC)?

The Alaska Medicaid program along with a “cost of care” from the Elder each month.

What does the Elder have to pay to live in LTC? The Elder may keep $200 a month from their income, the rest of their income is considered “cost of care” to pay to LTC. Married Elders have a different Medicaid cost of care budget and may or may not have a cost of care.

Heidi McConnell and Janet Barr.

May Watson.

Can I still pay my bills at home if I admit to LTC? No, the Elder’s income is budgeted by Medicaid to pay a cost of care and to keep $200 a month for personal spending. The Elder can spend their $200 a month any way they choose.

How long will it take to be admitted to LTC? It varies - if the Elder already has Medicaid, the process is quicker. We would get a recent physical from the doctor and submit to the State of Alaska for nursing home prescreening and LTC authorization. This approval should be received in 7-10 working days. If the Elder needs to apply for Medicaid, a Medicaid application can take 30+ days at least to submit and be approved. We would then get a recent physical from the doctor and submit it to the State of Alaska for nursing home prescreening and LTC authorization.

What kind of care needs are appropriate when looking for possible Long Term care placement?

The Elder’s mental and physical capabilities are reviewed in the areas of eating, dressing, grooming, toileting, transferring, ambulating, history of falls and cognitive problems.

Who can I call to learn more about LTC? Karen Kyler, social worker, is the best point of contact at Utuqqanaat Inaat. She can be reached at 907442-7913.

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Zender Qualified Sampler Training “Operation Penguin”

Code-named Operation Penguin, the Office of Environmental Health gathered the region’s tribal environmental workers together for environmental sampling training. The three day training was held at the Alaska Technical Center, August 28-30, and lead by Zender Environmental Health and Research Group.

The training involved YSI multi parameter meters, turbidity meters, photoionization detectors, pH meters, etc.

They tested water samples for conductivity, pH, dissolved oxygen, microbiological growth, and turbidity. Soil was tested for volatile organic compounds, diesel range organics, and gasoline range organics.

LCDR Chris Dankmeyer, Environmental Health Manager and Michael Manzo, Staff Environmental Health Specialist teamed up with Alex Whiting, Kotzebue IRA’s Environmental Protection, to survey June Creek for suspected landfill run-off. With satellite imagery, two possible sites of suspected landfill run off were located.

SGS water samples were collected by a 12 man team that involved 3 OEH staff and two scientists from Zender.

The results are being processed and will provide another learning opportunity for the region.​

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Employee Spotlight Theresa Coley-Kouadio has been selected as a fellow for the Duke-Johnson & Johnson Nurse Leadership Program.

The Duke­Johnson & Johnson Nurse Leadership Program, a one year experience, is a partnership between Duke University School of Medicine, Duke University School of Nursing and Johnson & Johnson. The program was created to provide leadership development for advanced practice nurses. Ms. Coley-Kouadio is the first Fellow selected from Alaska and is proud to represent our state and the Northwest Arctic region. Ms. Coley-Kouadio is also the incoming president of the Alaska Affiliate of the America College of Nurse-Midwives.

Rochelle Adams - September Employee of the Month

Stan Tomaszewski - August Employee of the Month

Esther Kaniki - July Employee of the Month

Vera Norton - June Employee of the Month

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Misconceptions about Seasonal Flu and Flu Vaccines Can a flu shot give you the flu?

No, a flu shot cannot cause flu illness. Flu vaccines CANNOT cause the flu. The viruses in flu vaccines are either killed (the flu shot) or weakened (the nasal-spray vaccine).

Is it better to get the flu than the flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu.

Why do some people not feel well after getting the seasonal flu vaccine?

Some people report having mild reactions to flu vaccination. The most common reaction to the flu shot in adults has been soreness, redness or swelling at the spot where the shot was given. This usually lasts less than two days. This initial soreness is most likely the result of the body’s early immune response reacting to a foreign substance entering the body. Other reactions following the flu shot are usually mild and can include a low grade fever and aches. If these reactions occur, they usually begin soon after the shot and last 1-2 days. The most common reactions people have to flu vaccine are considerably less severe than the symptoms caused by actual flu illness.

What are factors that influence how well the vaccine works?

How well the flu vaccine works (or its ability to prevent flu illness) can range widely from season to season.

The vaccine’s effectiveness also can vary depending on who is being vaccinated. At least two factors play an important role in determining the likelihood that flu vaccine will protect a person from flu illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or “match” between the flu viruses the flu vaccine is designed to protect against and the flu viruses spreading in the community. While determining how well a flu vaccine works is challenging, in general, recent studies have supported the conclusion that flu vaccination benefits public health, especially when the flu vaccine is well matched to circulating flu viruses.

Besides vaccination, how can people protect themselves against the flu?

Getting a flu vaccine each year is the best way to prevent the flu. Antiviral drugs are an important second line of defense against the flu. These drugs must be prescribed by a doctor. In addition, good health habits, such as covering your cough and frequently washing your hands with soap, can help prevent the spread of the flu and other respiratory illnesses.

Content source: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD)

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U.S. Arctic Research Commission visits the NWAB

The US Arctic Research Commission (USARC, www.arctic.gov) visited the Northwest Arctic Borough for its 110th meeting on September 5th, 2018. The meeting was followed by visits to the communities of Selawik and Buckland and a tour of Red Dog Mine.

The USARC is responsible for developing national Arctic research policy, reviewing federal Arctic research programs and facilitating Arctic research cooperation (in general and specifically with Alaska & international entities). The Commission meets several times per year, with at least one meeting held in Alaska, often in a rural locale. These meetings are a chance for the commissioners to learn about community concerns and research needs as well as to engage and update residents on USARC’s current activities.

The Kotzebue meeting opened with a community breakfast that was followed by a public discussion focused on community research needs and “how research can serve communities.” Participants involved generated a rich and wide-ranging discussion, elements of which will be included in USARC’s upcoming Report on the Goals and Objectives for Arctic Research 2019-2020 that is presently being drafted. The discussion was followed by sessions on Community Health and Wellness, Infrastructure and Adaptation, and Local Science. The meeting concluded with an update on upcoming Arctic funding opportunities from the National Science Foundation.

On September 6, the Commission visited the villages of Selawik and Buckland to view water and sanitation infrastructure—specifically to see, firsthand, the impact of environmental change and how this translates to effects at the community level.

The Commission wrapped up its visit at Red Dog Mine where it learned about the history, science and economic importance of Red Dog operations, followed by a tour of both the mill and the pit areas. USARC greatly appreciates the assistance of Maniilaq, the Northwest Arctic Borough, Nana, ANTHC, and the tribes and cities of Selawik and Buckland for their assistance and hospitality. These visits left a powerful impression and will figure strongly into recommendations made in USARC’s upcoming Goals Report.

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Improved Patient Care & Safety in Pharmacy Since its implementation in June 2018, Cerner has brought about many changes to the pharmacy—the most notable being the “clinical decision support” feature of Cerner, which has improved pharmaceutical care to and increased safety for patients in our region. These are a series of prompts embedded in the prescription verification process that brings to the attention of the pharmacist various medication specific considerations, such as appropriate labs (ex. liver/kidney function), drug-drug interactions, as well as the patient’s refill history and compliance.

As a result of all of these alerts, the pharmacist is better able to utilize their clinical skills when reviewing the appropriateness and safety of the medication ordered, recommending alternatives to the provider, and communicating with the patient and community health-aides.

Due to a statewide shared patient electronic health record (Cerner), there has been improvements in transition of care, as many of our patients receive care at various facilities throughout the state. This intra-facility transparency has allowed for ease of access to patient information such as labs, diagnoses, provider notes, outside prescription history, along with a host of other data and reports—all of which allows for more streamlined patient care and aids in real time clinical decision making by the healthcare team involved in their care.

Cerner is a highly clinically driven health system, and as a result, requires more pharmacist involvement and a lesser role for pharmacy technicians. Although this has increased the number of pharmacists needed, the amount of clinical interventions and drug errors prevented have provided great financial savings to the organization, improved patient care and decreased adverse events for the patients in our region.

Another effect of Cerner is the absence of “automatic” prescription refills—all prescription refills must be initiated by a patient or health aide. Although the convenience of automatic refills are gone, a pharmacist is involved in reviewing each and every medication refill request, which allows for more clinical involvement and better overall health outcomes for our patients. In an effort to ensure a timely turnaround that when a CHAP or patient requests a refill, all medications that are REFILLABLE are processed and ready to be picked up or sent to the village the same day or within 24 hours from the request. To accommodate this new change, we now ship medication to village clinics daily instead of twice a week and we provide pharmacist coverage until 8 pm Monday through Friday.

Maniilaq Association PO BOX 256 Kotzebue, AK 99752

Non Profit Org. US Postage PAID Anchorage AK Permit No. 69

Spring 2019 Scholarship Deadlines BIA Higher Education and Paaraq Scholarship: Deadline to submit application is Friday, January 4, 2019. Applicant has 30-days from application deadline to submit all required documentation.

Endowment: Spring Semester 2019:Deadline to submit application with all required documentation is Friday, January 4, 2019.

Winter Quarter 2019 (for quarterly colleges): Deadline to submit application with all required documentation is Friday, December 7, 2018.

Adult Vocational Training and WIOA Scholarships: Deadline to submit applications for vocational training is 12pm on the Friday before classes start • Applications must be completed in full with all required documentation • Can use these scholarships for airfare from home community to training site and back to home community

https://www.maniilaq.org/tribal-government-services/