Health News & Notes - Summer 2023 - Injury Prevention

Injury Prevention

Summer 2023

Pulling Forward Safely with Life Jackets

Tam Lutz, MPH MHA Lummi Nation

Maternal Child Health Programs Director

With summer comes opportunities for time outside, time with family, and time for participating in some of our favorite cultural activities. For my large extended family, the Oliver Canoe Family, that is Tribal Canoe Journeys. We look forward to it every year. This year, post-pandemic, it is especially anticipated as we re-join the dozens of other canoes from all up and down and coast and waterways whose families have also navigated their way through the “rough waters” over the past couple of years that the pandemic brought to our shore. We worked hard to keep each other safe during that time, masking up, social distancing, and getting lifesaving vaccines. Now our reward is to spend time together on the water again.

Whether in our canoe or on the support boat this summer, we will also work hard to keep each other safe on the water. We can do several things to keep ourselves safe before getting into the canoe, such as improving our swimming skills, learning how to navigate the waters, and cold-water training to practice getting back into the

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BOARD

EXECUTIVE COMMITTEE MEMBERS

Nickolaus D. Lewis, Chairman, Lummi Nation

Nate Tyler, Vice Chair, Makah Tribe

Greg Abrahamson, Secretary, Spokane Tribe

Shawna Gavin, Treasurer, Conf. Tribes of Umatilla

Kim Thompson, Sergeant-At-Arms, Shoalwater Bay Tribe

DELEGATES

Twila Teeman, Burns Paiute Tribe

Denise Ross, Chehalis Tribe

Gene H. James, Coeur d’Alene Tribe

Andy Joseph, Jr., Colville Tribe

Illiana Montiel, Coos, Lower Umpqua & Siuslaw Tribes

Eric Metcalf, Coquille Tribe

Sharon Stanphill, Cow Creek Tribe

Michael Watkins, Cowlitz Tribe

Cheryle Kennedy, Grand Ronde Tribe

Lisa Martinez, Hoh Tribe

Brent Simcosky, Jamestown S’Klallam Tribe

Nick Pierre, Kalispel Tribe

Laurel Robinson, Klamath Tribe

Jennifer Dickison, Kootenai Tribe

Francis Charles, Lower Elwha S’Klallam Tribe

Nickolaus D. Lewis, Lummi Nation

Nate Tyler, Makah Tribe

ADMINISTRATION

Laura Platero, Executive Director

Andra Wagner, HR Manager

Chelsea Jensen, Compliance Manager

Jackie Curtis, A/P & Payroll Manager

James Fry, Information Technology Director

Jamie Alongi, Network Administrator

Jason Arnold, IT Network Support Tech

Jordan Reid, A/P Specialist

Kadi White, Grants Manager

Katherine Gorell, Grants Manager

Lori Martin, Fund Accounting Manager

Luwanna Comstock, Senior Accountant

Jaison Elkins, Muckleshoot Tribe

Ryan Oatman, Nez Perce Tribe

Vacant, Nisqually Tribe

Lona Johnson, Nooksack Tribe

Hunter Timbimboo, NW Band of Shoshone Indians

Jolene George, Port Gamble S’Klallam Tribe

Herman Dillion, Puyallup Tribe

Douglas Woodruff, Jr., Quileute Tribe

Noreen Underwood, Quinault Nation

Dana Matthews, Samish Tribe

Tempest Dawson, Sauk-Suiattle Tribe

Kim Coombs, Shoalwater Bay Tribe

Norma Wadsworth, Shoshone-Bannock Tribes

Selene Rilatos, Siletz Tribe

Denese LaClair, Skokomish Tribe

Robert de los Angeles, Snoqualmie Indian Tribe

Greg Abrahamson, Spokane Tribe

Kay Culbertson, Squaxin Island

Jill Malone, Stillaguamish Tribe

Steve Kutz, Suquamish Tribe

J.J. Wilbur, Swinomish Tribe

Teri Gobin, Tulalip Tribe

Aaron Hines, Umatilla Tribe

Marilyn Scott, Upper Skagit Tribe

E. Austin Greene, Conf. Tribes of Warm Springs

Esther Moses-Hyipeer, Yakama Nation

STAFF

COMMUNICATIONS

Jonas Greene, Communications Director

Kira Rea, Communications Manager

Roger Petersen, Website Admin & Design

Sonya Oberly, Senior Communications Specialist

Adrean Brings Him Back, Events Coordinator

LEGISLATIVE AND POLICY

Candice Jimenez, Health Policy Analyst

Karol Dixon, Temp Senior Policy Advisor

Catherine Stensgar, Executive & Communications Coordinator

Michelle Harris, Accounts Receivable Specialist

Olivia McPherson, Purchasing/Travel Agent

Patrick Greener, Operations Director

Reshell Livingston, HR Coordinator

Sue Steward, Deputy Director

Tammy Cranmore, Finance Director

ENVIRONMENTAL HEALTH

Shawn Blackshear, Interim Environmental Public Health Director

Antoinette Ruiz, Environmental Health Specialist

Holly Thompson-Duffy, Environmental Health Science Manager

STAFF (CONTINUED)

Nicole Smith, EH Informatics Specialist

Melino Gianotti, Emergency Management Coordinator

Rebecca Washakie, Environmental PH Project Coordinator

Ryan Sealy, Environmental PH Project Scientist

CLINICAL SUPPORT

Susan Steward, Interim Clinical Director

Alicia Edwards, HIV Program Manager

Amanda Sequiemphen-Yazzie, ECMH Project Coordinator

Ashley Hoover, HIV Program Manager

Ashley Jean Day, ECHO Project Coordinator

Aurora Martinez, THRIVE Project Coordinator

Birdie Wermy, Behavioral Health Manager

Carrie Sampson-Samuels, CHAP Project Director

Christina Friedt, TCHP Project Director

Colbie Caughlan, THRIVE & TOR Projects Director

Danica Brown, Behavioral Health Director

David Stephens, ECHO Clinical Director

Dolores Jimerson, BH Clinical Supervisor

Katie Johnson, EHR Integrated Care Coordinator

Itai Jeffries, Paths (Re)Membered Program Director

Jerico Cummings, 2SLGBTQ+ Training & Community Engagement Specialist

Jessica Leston, HIV/HCV/STI Clinical Services Project Director

Jessica Rienstra, ECHO RN Case Manager

Joshua Smith, TEC PHI Project Manager

Kaitlyn Hunsberger, BHA Student Support Coordinator

Kari Kuntzelman, DHA Education Specialist

Karin Dean, Everyday is Ceremony Project Manager

Karuna Tirumala, IDEA-NW Biostatistician

Larissa Molina, TOR Project Manager

Lisa Griggs, TCHP Project Manager

Megan Woodbury, ECHO Project Manager

Michelle Goldenberg, NTDSC Assistant

Mike Feroglia, Project Funding & Contracts Manager

Miranda Davis, NDTI Project Director

MorningRose Tobey, TCHP Education Program Data Coordinator

Nick Cushman, ECHO Pharmacy Case Manager

Pam Ready, DHA Education Manager

Sarah Cook-Lalari, BHA Project Director

Sasha Jones, CHAP Project Manager

Stephannie Christian, TCHP Education Program Director

Ticey Mason, NTDSC Director

EPIDEMIOLOGY CENTER

Victoria Warren-Mears, Director

Alyssa Farrow, Special Projects Coordinator

Alyssa Yang, Epi & Surveillance Unit Project Director

Ashley Thomas, NW NARCH Senior Program Manager

Asia Brown, Sexual Health Communications Specialist

Barbara Gladue, OR Tribal PH Improvement Manager

Bridget Canniff, PHIT Project Director

Celena Ghost Dog, WYSH Project Manager

Chandra Wilson, BOLD NTEP Program Manager

Clarice Charging, NWTEC Project Coordinator

Danner Peter, TEC-IVAC Project Manager

Don Head, WTD Project Specialist

Eric Vinson, OR Tribal Tobacco Manager

Erik Kakuska, WTD Project Specialist

Grazia Cunningham, NARCH Project Manager

Heidi Lovejoy, Data Hub Epidemiologist

Jane Manthei, SMS Communications Specialist

Jeanne Davidson, OR Tribal PH Improvement Project Coordinator

Laura Joseph, Cancer Prevention Project Temp.

Lisa DiBianco, Evaluation Specialist

Luca Green, AmeriCorps Tribal Food Systems VISTA

M’Kya Bettega, WEAVE-NW Project Coordinator

Marches Armstrong, IT Data & Applications Specialist

Meena Patil, MV Biostatistician

Michael Mudgett, Substance Use Epidemiologist

Michelle Singer, HNY Project Manager

Morgan Scott, CDC PHAP (Public Health Associate)

Nancy Bennett, WA Tribal PH Improvement Manager

Naomi Jacobson, Training and Outreach Manager

Nicole Smith, Senior Biostatistician 1

Olivia Whiting-Tovar, TIPCAP IPP Project Coordinator

Pearl Rose, Cancer Coalition Outreach Coordinator

Reshell Livingston, Asthma Project Coordinator

Rochelle Fassler, NARCH Project Coordinator

Shoshoni Walker, FS Initiatives Project Manager

Stephanie Craig Rushing, PRT, MSPI, Project Director

Sujata Joshi, IDEA-NW Project Director

Sunny Stone, DATA Hub Outreach Specialist

Tam Lutz, Maternal Child Health Programs Director

STAFF (CONTINUED)

Taylor Dean, HNY Outreach Coordinator

Tammie Scott, WEAVE-NW Health Educator

Tom Becker, NW NARCH Project Director & Medical Epidemiologist

Tommy Ghost Dog, Jr., WeRNative Project Coordinator

Torrie Eagle Staff, Cancer Project Manager

Tyanne Conner, Native Boost Project Manager

Valorie Gaede, PHIT Project Assistant

Wyatt Miner, BOLD Project Assistant

Pulling Forward Safely with Life Jackets Continued from cover

canoe after it flips over in the water. One of the most critical measures to ensure everyone is safe is wearing a life jacket. Like receiving a vaccine, wearing a life jacket is a simple yet lifesaving measure to prevent deaths.

No matter how great a swimmer you are, everyone needs a life jacket. But just like the pullers in your canoe, life jackets come in various shapes and sizes. US Coast Guard-approved life jackets are sized by weight. It is essential to ensure that everyone has an appropriately sized life jacket. For a proper fit, Water Safety USA suggests the following:

• Check the manufacturer’s ratings for your appropriate size and weight. There are many manufacturers and styles, so fit may differ.

• Choose a life jacket that fits properly.

• Life jackets that are too big will cause the flotation device to push up around your face, which could be dangerous.

• Life jackets that are too small may not be able to keep your body afloat.

• Make sure the life jacket is appropriately zipped and buckled.

• Check for fit by raising your arms above your head while wearing the life jacket, and ask a friend to grasp the tops of the arm openings and gently pull up. The life jacket should not ride up over your chin or face.

• Ensure your life jacket fits properly with no excess room above the arm and neck openings. A snug fit in these areas shows that the life jacket fits properly.

Whether your canoe family or Tribe purchases all the life jackets or you ask individual pullers to come with their life jacket, it is vital to help each other check size and fit of your life jacket before you get on the water. Hence, you know the life jacket can do what it intends to save lives!

There are only a few more weeks before we get on the water. As you prepare, you may also want to check out some great online resources that help you learn more about water safety and how to select a life jacket that fits you and your water activity needs.

How to Pick the right life jacket guide by the US Coast Guard

https://www.uscgboating.org/images/howtochoosetherightlifejacket_brochure.pdf

Life Jackets Save Lives

https://www.watersafetyusa.org/life-jackets-save-lives.html

Washington State Life Jacket Loaner Program

https://www.parks.wa.gov/956/Life-Jacket-Loaner-Program

How to fit children with life jackets, Safe Kids, Worldwide

https://www.safekids.org/blog/ask-expert-how-find-right-life-jacket

Have a safe journey. I’ll see you on shore!

Chair’s Notes

Nickolaus D. Lewis Lummi Nation

This May and June were busy months, with important health policy meetings throughout the country!

First, I would like to highlight our trip to Iceland with Washington state officials to see the Icelandic Harm Reduction Model in person. At the National Indian Health Board Meeting in June, a motion passed for NIHB to lead a national effort to explore the Icelandic Model for Tribal Communities in the US. We are grateful that a delegation from Iceland is coming to the July QBM to talk with delegates in person. I encourage you to read one or both of the following links to learn more about the Icelandic Model before the QBM discussion. One is a peer reviewed journal article and the other a news article.

Next, on June 1, the IHS Director’s Advisory Workgroup on Tribal Consultation met for an in-person meeting in Seattle, WA. The Workgroup made significant progress updating the IHS Tribal Consultation policy in 2023, and during the June meeting, federal and tribal workgroup members finished editing an updated draft of the IHS Tribal Consultation policy in 202, and during the June meeting, federal and tribal workgroup members finished editing an updated draft policy that aligned with E.xecutive Order 13175, “Presidential Memorandum on Tribal Consultation and Strengthening Nationto-Nation Relationships”, the updated draft HHS Tribal Consultation Policy, and the requirements outlined in the Presidential Memorandum on Uniform Standards for Tribal Consultation. IHS will initiate Tribal Consultation on the updated draft Tribal Consultation Policy this month with a 45-day open comment period and will host one virtual Tribal Consultation session.

NW Tribal Iceland Delegation: Aren Sparck - Office of Tribal Affairs Administrator Washington Health Care Authority (HCA), Loni Greninger - Jamestown S’Klallam Tribe ViceChair, Jarred-Michael Erickson - Colville Chairman Nespelem District Representative, Dr. Danica Brown - NPAIHB

Behavioral Health Director, Nickolas D. Lewis - NPAIHB Chairman

NPAIHB Chairman

All details, including key dates, will be included in a forthcoming Dear Tribal Leader Letter. After the comment period closes, the IHS will reconvene the Workgroup to review the comments. The plan is to have the updated Tribal Consultation Policy signed this autumn.

The National Congress of American Indians 2023 Mid-Year Convention and Marketplace was held June 5-8, 2023 in Mystic Lake, Minnesota, hosted by the Shakopee Mdewakanton Sioux Community.

Three health resolutions brought forward by our area were adopted:

• MN-23-018, Calling on Indian Health Service to Modernize Its Scholarship Profession Needs and Loan Repayment Surveys

• MN-23-019, Supporting the Need to Address the Nutrition and Dietetics Professional Shortage

• MN-23-031, Supporting Federal Legislation that Would Require Credit Reporting Agencies to Remove Information on Indian Health Service (IHS) Beneficiaries’ Credit Reports that Relates to Debts or Collection Activity for Bills that Should Have Been Paid by the IHS

The Tribal Self-Governance Conference was held in Tulsa, June 26-29, 2023. We had a listening session with IHS and VA officials to discuss the VANative Reimbursement Agreement Program. Another important issue for Pacific Northwest Tribes was discussed during a Breakout session focused on Health IT Modernization with the IHS Chief Information Officer and Director for the Office of Information Technology, Mitchell Thornbrugh (Muscogee Creek). The IHS is reviewing the proposals to replace RPMS and intends to announce the successful proposal later this year.

Also at the Tribal Self-Governance Conference, IHS Director Roselyn Tso (Navajo Nation) provided updates on staffing for the Indian Health Service, the IHS workplan, and progress on the recommendations from the Government Accountability Office (GAO), Office of the Inspector General (OIG), and the White House. She shared that working with the Veterans’ Administration (VA) continues to be a priority for IHS, they have launched a new VA/IHS map to help veterans gain better access to care. Director Tso is scheduled to attend the Region X Tribal Consultation in Anchorage in August 9-10, 2023, and is also scheduled to attend the National Tribal Opioid Summit that will be held at Tulalip, August 22-24, 2023. We look forward to continuing to connect with her and advocating for our priorities.

As we further navigate the summer season, I look forward to advocating for our priorities along with all of our Tribal leaders for the Northwest with HHS, the Administration and with Congress.

Hy’shq, Nickolaus D. Lewis | Lummi Nation Chair, Northwest Portland Area Indian Health Board Councilman, Lummi Indian Business Council

A Revamp of the Native CARS ATLAS: (nativecars.org) with updated motor vehicle injury data sources you can use

Meena Patil Biostatistician

Motor Vehicle Injury Data Project

The Native CARS ATLAS was created to share the success stories of six Northwest tribes involved in the Native CARS study. The ATLAS has numerous resources, including materials developed and tested by tribes for increasing awareness of child passenger safety issues and strategies to improve child car seat use and child passenger safety among tribal communities. The website has twelve modules with specific content related to child passenger safety. Whether your community is in the early phase of child passenger safety assessment, preparing to collect data, building strategies, or rolling out campaigns, we have tools and resources that can be tailored to your specific needs. For example, module 4 has tools to help you with data collection, including nocontact observations and observational interview options. The survey form can be easily downloaded and used for data collection. Additionally, the companion Excel file for data entry automatically calculates the percentage of children riding in age and size-appropriate restraints and creates tables and charts of your data. You can use your data for project planning, evaluation, and grant submissions.

The Motor Vehicle Injury Data (MVID) Project team has been analyzing various MV injury data sources to support NW tribes in reducing the burden of traffic injuries and fatalities in their communities. Module 3.2 of the Atlas includes different traffic safety and injury-related data resources and some of our analyses and findings. The module contains manuscripts, newsletters, posters, and presentations using crash, hospital, death, and syndromic (emergency department) data. Additionally, we have some tutorials on using MV injury and fatality data sources, such as the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) and the Fatality Analysis Reporting System (FARS).

We show you how to create a map of fatal MV incidents in your communities using FARS, how to produce your motor vehicle fatality chart using CDC WONDER, and how to download fatal and non-fatal motor vehicle injury data using the Web-based Injury Statistics Query and Reporting System (WISQARS). These tutorials are in PowerPoint format and include step-by-step instructions to create and download data tables or maps. Each data source has unique strengths, and gathered data can depict a comprehensive picture of the MVI burden in your tribe.

The FARS includes all MV traffic fatalities in the US. We evaluated FARS data for the Northwest and determined that the system is 90% complete for American Indian people, which is very high quality. This data system includes person-level factors like demographics, DUI and restraint use, crash-level factors like location and road conditions, and vehicle details.

CDC WONDER has a wide array of public health data, such as birth, death, cancer, and communicable disease, and it’s easy to use. You can query mortality counts and rates for most of the underlying causes of casualties, including motor vehicle injury fatalities.

WISQARS provides fatal and non-fatal MVI-related data, though non-fatal data are not available specific to the American Indian race. A feature that might be useful is injury-related cost estimates for a particular county. For example, you can quickly get costs associated with pedestrian injury in Yakima County, WA, for 2020 that could be used for budget allocation or requesting funding to address pedestrian safety. We highly encourage you to

visit the Native CARS ATLAS to explore and utilize the abundant resources available to help your efforts in improving traffic safety features in your tribes.

We are constantly updating the website with new data resources and improving it to make it easily accessible and user-friendly. If you have any comments or suggestions for us, please get in touch with Olivia Whiting (owhiting@npaihb.org).

Tribal Pedestrian Safety: Why Is It Important?

Olivia Whiting-Tovar Oglala Sioux

Native CARS TIPCAP Coordinator, CPST

Pedestrian safety is an issue of concern for anyone who commutes or interacts with roadways, as there are many different ways to travel. Everyone deserves to have safe, accessible walkways to and from their desired destinations, whether two minutes down the street or an hour commute.

According to the Washington Traffic Safety Commission’s Coded Fatal Crash Files, since 2013, there have been 257 motor vehicle crash fatalities involving American Indians/Alaskan Natives on Tribal lands in Washington state, (see Map 1).

• 161 of those fatalities were on rural roads.

• 69 of those fatalities were pedestrian (64) and cyclist (5) fatalities; this is more than a quarter (26.69%) of the reported crash fatalities since 2013.

• Fatal crashes involving American Indian/Alaskan Native people are on an upward trend in Washington state; meaning crash rates are gradually increasing over the years, as visually demonstrated in Graph 1.

Graph 2 shows both Oregon and Washington pedestrian emergency department quarterly rates for AI/ANs and whites per 100,000 visits over the last three and a half years.

• From this graphic, we can understand that pedestrian emergency department rates for AI/AN people are higher when compared to whites, especially in Washington state.

• In Oregon and Washington, Graph 2 shows that pedestrian emergency department rates are higher for men than women.

• The graphic shows how Oregon has had its most significant peaks of pedestrian emergency department visits over the last three and a half years. Although Oregon’s rates are lower than Washington, it is not too far behind.

• Oregon has a higher male pedestrian emergency department rate than Washington. But a much lower female pedestrian emergency department rate within the last three and a half years.

The Native Child Always Ride Safer Tribal Injury Prevention Program (Native CARS TIPCAP) offers partnerships to understand and address your Tribal community’s pedestrian safety concerns. A few specific partnership activities the project offers are:

• Community pedestrian safety evaluations; a Tribal community StoryMap creation activity.

• To visually explain the locations in your community with high pedestrian and motor vehicle interaction, such as popular intersections.

• Walk Audit activities.

• To understand how accessible and walkable popular pedestrian walkways are and ways to make these walkways safer for all users.

Understanding pedestrian safety in your community is essential because change takes time, but your voice matters; as a member, you can help make meaningful changes for roadways’ most vulnerable users. All Fatal Crashes on Tribal Lands and involving AI/AN Fatalities in WA State.

Map 1: All Fatal Crashes on Tribal Lands and involving AI/AN Fatalities in WA State Source: Washington Traffic Safety Commission Coded Fatal Crash Files Dashboard, https://wtsc.wa.gov/research-data/aian-tribal-dashboard/

Graph 1: Fatal Crashes on Tribal Lands involving AI/AN Fatalities in WA State by Year

Graph 2: WA and OR pedestrian emergency department quarterly rates for AI/ANs and whites per 100,000 visits

Native CARS TIPCAP Tribal Child Passenger Safety Technician Certification Course

The Native Children Always Ride Safe Tribal Injury Prevention Project (Native CARS TIPCAP) coordinated and held their second Tribal Child Passenger Safety (CPS) Technician certification course at the Coeur d’Alene Casino Resort Hotel in Worley, Idaho in June. Through this course, 13 Tribal serving CPS Technicians became certified, allowing for internal capacity enhancement for Tribal CPS expertise at four Northwest Tribes.

The CPS Technician certification course is an intensive 3-4 day long hands-on course with written and practical skills tests. On the last day of the Tribal CPS Technician course, a CPS seat check-up event was held where free car seat resources were distributed. Local families met with the newly certified CPS Technicians to receive education and advice to ensure their children are riding safely; on every trip, every time!

Native CARS TIPCAP wants to thank everyone involved in making the course possible; the instructors, the attendees, and the Coeur d’Alene Casino staff members. Everyone did a fantastic job!

CPS Technician Instructor Carma with course attendees demonstrating a convertible car seat installation

The Native CARS Tribal Injury Prevention team with Idaho CPS Technician Instructors: Tammie Brian and Carma. From left to right: Tammie Scott, Olivia Whiting-Tovar, Tam Lutz, Brian Rauscher, Carma McKinnon

CPS Technician Instructor Tammie and Bernadine

VacciNative is a national campaign that offers accurate vaccine information for Native people by Native people!

Presentations

Social media posts

Insightful videos

Educational flip chart

Newsletter templates

Fact sheets

Native Boost strengthens vaccine confidence through communication, education, and outreach.

Provider and clinic staff training

Teacher and staff training

Peer support training

Educational materials

PSAs and social media posts

Ongoing support

Tyanne Conner, MS Native Boost Project Manager

Tam Lutz, MPH, MHA Lummi Nation Vaccine Projects Director

Danner Peter, MPH Diné (Navajo ) VacciNative Project Manager

Lakota Scott, ND Diné (Navajo ) Provider Expert

THRIVE 2023 Brings Youth Together

Aurora Martinez Samish Indian Nation

THRIVE Suicide Prevention Project Coordinator

An exciting week of learning, growing, and finding themselves, youth from the Pacific Northwest and beyond gathered in Portland, Oregon, for the annual THRIVE Conference hosted by the Northwest Portland Area Indian Health Board’s (NPAIHB) THRIVE suicide prevention project. Approximately 40 Native youth representing 11 federally recognized Tribes joined the conference from June 26th-June 30th. Youth at THRIVE 2023 led lunchtime prayers, sang traditional songs, spoke up and asked questions, and shared their skills with other youth. The We R Native team created a great video about the first day of the THRIVE conference. https://youtu.be/PcwYMVojw3o

The five-day agenda comprised guest speakers, and each youth participated in one of four interactive workshops that taught art, healthy lifestyles, and coping during challenging times. Topics discussed included exploring healthy ways to cope with stress, building community connections, and how to channel complex life events into positive outcomes, such as creating song lyrics and making music, art through do-it-yourself Screen-Printing techniques, diving into movement, exercise, and nature, or learning about pathways into public health. Each session incorporated American Indian/Alaska Native culture, traditional learning strategies, and skill-building activities that educated youth about healthy decision-making.

For the 13th year, We R Native Project Coordinator Thomas Ghostdog Jr. led Movement is Medicine, a workshop inspired by the many ways to incorporate movement into one’s life. Eleven Native youth from the Northwest region learned fun and exciting ways to keep their bodies and minds active. Youth learned about traditional and modern accessible forms of movement, such as canoeing, frisbee golf, and stickball. They also learned how the activity promotes mental health and the intersections of movement and art. With numerous indigenous community leaders helping the We R Native workshop facilitators, inspiration and engagement by the youth were easy to come by.

In the Screen-Printing workshop, youth practice healthy ways to express emotions, work toward goals, and create change in their community. Eight Native youth learned from artist N. O. Bonzo and NPAIHB staff mentors how to create their own designs, adapt designs they enjoy and implement various DIY (do-it-yourself) home-friendly screen-printing techniques. Youth completed multiple projects, including small prints, patches, bags, and shirts that they gifted to their families and home communities and to give to others at the THRIVE conference.

Fourteen youths participated in Beats Lyrics Leaders (BLL), led by J. Ross Parrelli, who celebrated her 13th year with the conference, and a group of incredible mentors. BLL joined our conference for the 11th year; BLL worked with youth through a hands-on approach to learning as they taught each participant the ins and outs of beat making, lyric/songwriting, song structure, and recording. Youth left with a sense of purpose, belonging, understanding, and pride in one’s culture. This family-like environment taught goal setting, empowerment, confidence, skill development, public speaking, creative writing, and how to strengthen their communities. Youth recorded many songs, including “L.O.V.E,” for which they created a music video to accompany: click here to watch the video—direct Link: https://www.youtube.com/watch?v=Et5zsGO9_9U. You can listen to all songs recorded during the 2023 THRIVE conference here. Direct link: https://soundcloud.com/beatslyricsleaders.

The Final workshop was the NW NARCH Public Health Research Academy, a partnership with the Northwest Native American Research Center for Health. Youth in this workshop applied to be part of this year-long learning journey which kicked off as a workshop at the THRIVE conference. These high-school students were introduced to public health pathways, participated in hands-on prevention activities, and enjoyed campus tours and field trips throughout Portland, OR.

The conference hosted guest speakers each day to teach the youth about healthy lifestyles. At the beginning of our conference, Shane Lopez Johnston from NARA hosted welcoming activities, including traditional games. Dolores Jimerson of NPAIHB taught youth about Safety and Compassion in a big city like Portland, OR.

The Paths (Re)Membered project partnered with educator Mick Rose to teach youth about gender expression and how we live out our genders. Matchstick Consulting led youth in practicing skills to cope with stress and finding Sources of Strength (see: sourcesofstrength.org/). The youth were active and playful outside during a games session led by We R Native. Finally, Rosanna Jackson with YouthLine Native (see: theyouthline.org/) led a session focused on self-care, identifying depression and other mental health struggles, and additional ways to cope with stress.

Throughout the Conference, chaperones were learning too! Not only did chaperones learn by watching the youth they brought, but they also learned during curated chaperone sessions. Chaperones learned many skills

and tools to take back to their communities from the Paths (Re)Membered project; We R Native and Healthy Native Youth.

We also had two nights, one sponsored by NARA, with a culture night and a night of games. During the culture night, guest dancers and presenters shared their culture with the youth. Youth also stepped up and shared their culture. Instructors also shared the story of SlaHal (Bone game), followed by playing the game. Youth could bowl, play games, have popcorn, have fountain drinks, and spend time together during the game night.

The conference ended with a youth showcase filled with musical performances, speeches, art displays, and skill and technique demonstrations. Laughter, stories, and proud smiles were abundant.

Thank you to all the Tribes, chaperones, facilitators, presenters, and staff who invested in these talented youth and created a successful in-person conference! Don’t forget to SAVE THE DATE for next year’s conference, which will be held June 24-28, 2024, in Portland, OR.

Funding for this conference was made possible (in part) by funding from the Indian Health Service (IHS) and grant numbers SM082106 and TI083243 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the author and do not necessarily reflect those of SAMHSA, HHS, or IHS.

Breaking News! “Breaking teeth news”

Ticey Mason, MA

Siletz, Sixes (Kwatami), Mikonotunne, Joshia (Chemetunne), Chasta Costa, Tututni

NTDSC Director

The Northwest Tribal Dental Support Center would like to remind you to please be safe and use appropriate safety gear in order to prevent dental injuries when playing sports, not to use your teeth as a tool, and watch out for items that you can trip and fall over. Watch out for those Legos!

Below are some prevention tips and stories about dental injuries from the Grand Ronde Dental Program and the Marin Dental Program:

Dr. Taylor Wilkens, DDS, Dental Director for the Marimn Dental Program for the Cour d’Alene tribe shares this recent experience:

I just saw a young child a month ago who knocked out his lower permanent front tooth completely after he fell. He had some tissue trauma that we had to clean and manage at that visit as well. We were able to re-implant the tooth and splint it in place. A month later now things look great, patient is doing well. We just took the splint off. He will likely need follow up care with the specialist to address the nerve of the tooth, but it looks like the tooth is saved.

If someone finds themselves in this situation, I think the best thing to do would be as follows:

1. Find the tooth and pick it up by the crown and not the root.

2. Try to avoid disturbing the root and any tissue attached as much as possible.

3. Rinse the tooth with clean water to ensure no debris is present and fully re-insert the tooth as soon as possible.

4. (ONLY APPLIES TO PERMANENT TEETH, NOT BABY TEETH)

5. See a dentist immediately for evaluation and likely splinting.

6. If someone is not comfortable re-implanting the tooth by themselves, then they should see a dentist immediately if they wish to save the tooth. In my experience and from what l’ve read, the ideal window to re-implant a tooth is under an hour.

7. Place the tooth in saline or milk to keep it hydrated.

8. If it is a baby tooth that is knocked out, it should be left out and not re-inserted.

Sheila Blacketer, RDH, Dental Manager for the Grand Ronde Dental Program does a circle time presentation with Head Start students 2-5 years of age about tooth safety. She then sends a letter out to the Head Start parents discussing what was presented and includes an instruction sheet on what to do if the child breaks or loses a tooth.

Sheila shares these prevention tips:

1. Pick up your toys - they are a tripping hazard.

2. Don’t use your teeth to pry open potato chip bags, cereal, etc.

3. Don’t use your teeth to pull apart Legos or any other toys

4. Don’t chew on pencils, crayons, etc.

5. We don’t bit our friends

6. Don’t chew ice

An Overview of the NWTEC’s May Data Modernization Workshop

The Northwest Tribal Epidemiology Center (NWTEC) hosted a workshop on May 17th and 18th, 2023, to accelerate NWTEC’s data modernization efforts across NWTEC programs and projects, including Epi & Surveillance, IDEA-NW, and Public Health Improvement and Training, participated in the two-day interactive workshop. With planning and facilitation support from Kahuina Consulting, we shared stories of organizational strength and success, explored our collective values and aspirations for data modernization, and prioritized ideas to enhance our data processes and systems.

During the workshop, participants split into two groups to advance critical data-related projects already underway at NWTEC. One group focused on developing the data hub, which refers to a “one-stop shop” for Tribes and NWTEC programs to access critical public health data and analyses describing the health of their communities. Another group examined NWTEC’s processing and fulfillment of data and technical assistance requests and ways to streamline and simplify the process for Tribes. Both projects will boost NWTEC’s ability to provide high-quality public health data and epidemiological support for Northwest Tribes.

Based on the workshop outputs, the NWTEC data modernization leadership team will develop a roadmap aligned with Tribe, Board, and staff opportunities for input and continued work to advance existing projects. NWTEC will continue to share project updates and opportunities for input and involvement at future Quarterly Board Meetings, in future Health News & Notes articles, and on our website. Workshop participants continue to work together to explore actions that modernize NWTEC’s data infrastructure and enhance our ability to serve, assist, and collaborate with Tribal partners.

To learn more about this workshop or NPAIHB’s data modernization efforts, please get in touch with Bridget Canniff at bcanniff@npaihb.org or Sujata Joshi at sjoshi@npaihb.org.

NW Native American Research Center for Health

In the past few weeks, we have seen a flurry of activity in our NARCH program, with involvement from many of you at the Board. In fact, without the help of several guest presenters and content experts on the Board, our program would not shine. Our staff, including Ashley Thomas, Rochelle Fassler, Grazia Cunningham, and Gen McGeshick, have been working hard for months, and the wise counsel from Clif Poodry, Cindy Coleman, and Chandra Wilson (our advisors), has been quite helpful to their success.

Our primary programs included the Summer Research Training Institute classes, the Applied Biostatistics and Data Science course, the Tribal Researchers’ Cancer Control Fellowship Program, and the newly funded Public Health Research Academy for high school students, led by Stephanie Craig-Rushing, Celena Ghost Dog, Michelle Singer, Taylor Dean, Amanda Gaston, and a cast of hundreds (well, dozens, at least). This new program was embedded in the THRIVE conference. We think the team, the students, and the mentors will accomplish quite a lot.

On the horizon, starting this fall, we will be offering two intensive End-of-Summer Research Training Institute courses in Maternal Child Health Epidemiology and Elder Health. These courses will include an intensive week of classes at the onset, followed by monthly classes and a capstone project requirement at the end of the year. Dr. Tom Weiser will lead the first course, and Dr. Turner Goins from North Carolina will lead the second, with input from tribal researchers nationwide. It should be good! Thanks to Tom Weiser and Chandra Wilson for suggesting the second topic. We will keep you posted on these projects as they unfold.

Biostatistics fellows meeting with High School Public Health Academy

Pediatric Vehicular Heat Stroke

Tam Lutz, MPH MHA Lummi Nation

Maternal Child Health Programs Director

It doesn’t take much effort to notice that heat waves have expanded across the US this summer. Triple-digit temperatures and extreme humidity has impacted millions, and there have been record-breaking consecutive days of near-record or record-high temperatures. Leaving little reprieve to the temperatures, even in the nighttime. Urban “asphalt islands” are especially hit harder; compared to parks, rivers, and tree-lined streets, urban concrete retains heat and releases it into the air.

As a certified child passenger safety technician (CPST), the danger excess heat can pose to children is also in the front of my and my fellow technician’s minds. Not only do CPSTs aim to assure children are properly restrained in child safety seats in motor vehicles, but we also aim to help inform caregivers of the risks of pediatric vehicular heatstroke (PVH) when left intentionally or unintentionally in motor vehicles and ways to prevent the unthinkable tragedy of a loss of a child due to heatstroke.

Many national institutes and organizations have prioritized heatstroke in vehicles. They have focused on children, our most vulnerable, who are at higher risk of dying from heat stroke after being left or unknowingly trapped in vehicles.

Look Before You Lock!

The U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) is working with the National Weather Service to urge parents and caregivers to learn and share critical information about the dangers of leaving children alone in hot cars. Share this lifesaving message with everyone you know: Look Before You Lock. For the most recent data on vehicular heatstroke, visit noheatstroke.org.

Additional resources: nsc.org/heatstroke

cpsboard.org/car-seat-safety/kids-and-hot-cars/ nhtsa.gov/campaign/heatstroke

About 38 children die each year from Pediatric Vehicular Heatstroke (PVH), and each one of these deaths could have been prevented. This summer already, nationally, as of 6/12/23, eight children have died from PVH, and we know of one more death that occurred just last week in our service area. PVH is the leading cause of vehicular death for those 14 years and younger, excluding car crashes. (Vaidyanathan A, Malilay J, Schramm P, Saha S. HeatRelated Deaths — United States, 2004–2018. MMWR Morb Mortal Wkly Rep 2020;69:729–734. DOI: http:// dx.doi.org/10.15585/mmwr.mm6924a1external icon)

Research shows that this tragedy can strike anyone, whether someone participating in summer activities or beginning a new school routine. Thus, it is crucial for parents, caregivers, providers, and community members to be vigilant about the dangers of hot vehicles. Parents and caregivers must be extra mindful of their children’s whereabouts in the hustle and bustle of summer activities. And they must keep vehicles locked in the garage or driveway and the keys out of children’s reach.

So how does this happen?

In an examination of media reports about the 938 pediatric vehicular heatstroke deaths for a 25-year period (1998 through 2022), the majority (52.6%) of these tragedies occur when a child is “forgotten” by a parent or caregiver and left in a hot car. More than half (58%) occur at home. A busy parent or caregiver may unintentionally forget that a quiet or sleeping child, who may also be facing the back of the car, is in the back of the vehicle.

Vehicular heatstroke occurs when a child dies due to being left – intentionally or unintentionally – in a hot vehicle. A child’s body can overheat three to five times faster than an adult’s, making them highly susceptible to heatstroke. When a child is left in a vehicle, that child’s temperature can rise quickly — and the situation can quickly become dangerous.

A child’s body can overheat 3 to 5 times faster than an adult’s.

Heatstroke occurs when the body is unable to cool itself quickly enough. Young children are particularly at risk. A child’s body heats up three to five times faster than an adult’s. When a child’s internal temperature reaches 104 degrees, major organs begin to shut down, and when the temperature reaches 107 degrees, the child can die. Even on mild days, the temperature in a car can rise by 19 degrees in only 10 minutes, and cracking the window doesn’t help.

There are several strategies that professionals, parents, and caregivers have utilized to help prevent heatstroke.

Here are several examples below:

• Never leave a child in a vehicle unattended for any length of time. Rolling windows down or parking in the shade does little to change the vehicle’s interior temperature.

• Make it a habit to check your entire vehicle — especially the back seat — before locking the doors and walking away.

• Ask your childcare provider to call if your child doesn’t show up for care as expected.

• Place a personal item like a purse or briefcase in the back seat as another reminder to look before you lock. Write a note or place a stuffed animal in the passenger’s seat to remind you that a child is in the back seat.

• Store car keys out of a child’s reach and teach children that a vehicle is not a play area.

• Set your audible GPS on your phone or car to your child’s childcare destination

• Set your cell phone alarm for your expected destination add a label on your alarm setting

• While important to focus on the road when driving, talk to your child along the way

The national safety council, in collaboration with the national weather service, in 2018, created a great resource for parents, providers, and community members. It only takes about 15 minutes to go through the entire toolkit. You can help pass this tool kit on to others in your community.

https://training.nsc.org/hot-cars/

“The temperature in a car can rise by 19 degrees in only 10 minutes”

Are You Ready For Wildfire Season?

Before a Wildfire

If any family member has heart or lung disease, including asthma, check with your doctor about what you should do during events where smoke is present. Have a plan to manage your condition.

Stock up so you don’t have to go out when it’s smoky. Have several days of medications on hand. Buy groceries that do not need to be refrigerated or cooked because cooking can add to indoor air pollution.

Develop an emergency plan. Know where your important documents are. Pack an emergency evacuation kit.

Create a “clean room” in your home. Choose a room with no fireplace and as few windows and doors as possible, such as a bedroom. Use a portable air cleaner in the room.

Get an air cleaner from National Indian Health Board (NIHB). Tribes impacted by wildfire and other smoke events may be eligible for commercial and residential HEPA-certified air purifiers. Find the request form here: https://docs.google.com/forms/d/e/1FAIpQLSeQL7VVEc4xWduUanEUqBUmkK0Hkxw3_s-cnE_OtSQPVYs0w/viewform

Check for smoke forecasts. https://outlooks.airfire.org/outlook

Monitor smoke and fire maps. https://fire.airnow.gov/

During a Wildfire, limit your exposure to smoke

Pay attention to local air quality reports. Listen and watch for news or health warnings about smoke. Find out if your community provides reports about the Environmental Protection Agency’s Air Quality Index (AQI). https://www.airnow.gov/ Also, pay attention to public health messages about taking additional safety measures.

If you are advised to stay indoors, keep indoor air as clean as possible.

Keep windows and doors closed unless it is extremely hot outside. Run an air conditioner if you have one, but keep the fresh air intake closed and the filter clean to prevent outdoor smoke from getting inside. Running a high-efficiency particulate air (HEPA) filter or an electrostatic precipitator (ESP) can also help you clean indoor air.

Avoid adding to indoor pollution. When smoke levels are high, do not use anything that burns, such as candles, fireplaces, or gas stoves. Do not vacuum because vacuuming stirs up particles already inside your home. Do not smoke because smoking puts even more pollution into the air.

Wildfire resources by state:

Oregon: https://wildfire.oregon.gov/

Washington: https://www.dnr.wa.gov/programs-and-services/wildfire-resources

Idaho: https://www.idl.idaho.gov/fire-management/

Indian Country ECHO – Innovating Provider Education

Megan Woodbury

Project Manager

Ashley Day Navajo Nation ECHO Project Specialist

In 2003, the ECHO model, which stands for Extension for Community Healthcare Outcomes, was developed by a physician from the University of New Mexico to address an increased need for providers who could treat Hepatitis C in rural communities. In 2017, Northwest Portland Area Indian Health Board (NPAIHB) began to closely examine the ECHO model, specifically if any ECHO programs were currently owned and operated by and for the tribes. That same year, the 43 Tribes that make up the NPAIHB came together to launch Indian Country ECHO in response to the ongoing Hepatitis C crisis in our tribal communities.

From the beginning, Indian Country ECHO has aimed to bring knowledge and skills to primary care providers at I/T/U (IHS/Tribal/Urban) facilities so patients can receive the best possible care in their communities and from providers they know and trust. This approach has reduced the cost of referrals and the need for patients to travel to a facility outside their community.

Indian Country ECHO does this by providing a variety of services that include:

• Virtual ECHO Clinics – Hosting 1-hour long, regularly scheduled sessions through Zoom that allow for a friendly, interactive learning environment. Participants can connect with specialists and peers over didactic presentations, learn through presenting patient cases and/or participating in discussions about patient cases, receive up-to-date patient case treatment recommendations and best practices, receive advice from subject matter experts, and obtain free continuing education credits.

• In-Person and Virtual Training – Planning and hosting trainings based on the I/T/U facility’s subject matter requests (ex. Harm Reduction, Hepatitis C, Substance Use Disorder (SUD), etc.), to increase provider and clinic capacity to offer high-quality care.

• Technical Assistance and Capacity Building – Offering confidential services designed to help I/T/U facilities optimize clinic policies and procedures, enhance care delivery, and further build the I/T/U facility’s capacity to prevent disease and treat patients.

• Indian Country ECHO has continued to grow. Over six years later, we have expanded our initial focus on Hepatitis C to include other disease topic areas such as Cardiology, Dementia, Emergency Medicine in

• Rural and Indigenous Communities (emRIC), Infectious Disease, Journey to Health (Behavioral Health), SUD and more. We have held over 650 virtual ECHO sessions, 34 in-person and virtual trainings, served over 35,000 I/T/U providers, and provided over 1,500 patient treatment recommendations. While the ECHO programs focus on serving the Northwest Tribes,

• Indian Country ECHO has grown to serve providers throughout Indian Country.

In response to the COVID-19 pandemic, Indian Country ECHO launched the COVID-19 ECHO program in March 2020. The COVID-19 ECHOs have been led by tribal health experts such as Dr. Jorge Mera, MD, Infectious Disease Specialist, and ECHO Medical Director; Dr. Tom Becker, MD, Ph.D., Medical Epidemiologist; Whitney Essex, MSN, Family Nurse Practitioner; Brigg Reilley, MPH, Epidemiologist; Dr. Thomas Weiser, MD, Medical Epidemiologist, among many others. Their expertise and guidance have been vital in quickly and efficiently bringing the most up-to-date information on the diagnosis, prevention, and treatment of COVID-19 to tribal leaders, public health staff, clinicians, and more at a time when our knowledge of the disease was evolving daily.

ECHO

With the halt to all in-person activities, Indian Country ECHO took this as an opportunity to launch our first-ever virtual provider training. This training took place on July 23rd, 2020, and focused on SUD. The goal of the training was to continue providing education and an opportunity for attendees to connect with subject matter experts, in addition to addressing the evolving opioid crisis and the rise in overdoses seen during the pandemic.

With the changing status of the pandemic, in October 2022, we held our first in-person training in almost three years. Indian Country ECHO provided a 2-day in-person training for Billings Area tribal providers in Billings, Montana that focused on what is now called “Ending the Syndemic”. “Ending the Syndemic” refers to not only the diagnosis, treatment and prevention of Hepatitis C and SUD but has also expanded to include Sexually Transmitted Infections (STIs) like Syphilis and Congenital Syphilis.

With travel restrictions now lifted, Indian Country ECHO also looks forward to hosting the upcoming Ending the Syndemic Clinical Training for our member tribes. The training will provide comprehensive information to effectively address the evolving Hepatitis C, SUD, HIV, and Sexual Transmitted Infection syndemic. This free 2-day training will be held at Ilani Resort on October 5th and 6th, 2023. To learn more about the training and register, please visit our website at: https://www.indiancountryecho.org/ets-october2023/ .

Indian Country ECHO continues to adapt and evolve to meet the needs of our member tribes, tribal organizations, and the communities they serve. We are beyond thankful for the support we have received from the Northwest Tribes and NPAIHB, without all of whom, our work would not have been possible. Indian Country ECHO looks forward to continuing our efforts to support all who serve our communities. To learn more, visit our website, IndianCountryECHO.org, or email us at echo@npaihb.org. NPAIHB’s Indian Country ECHO program is funded by the Indian Health Services and the Minority HIV/AIDS Fund.

Ending the Syndemic

October 5th & 6th •

This clinical training program will offer a free in person 2 day training for staff serving American Indian & Alaska Native people with a follow up ECHO collaborative to continue learning, knowledge sharing and support as you start treating. CE will be provided.

This program provides comprehensive information for clinicians to effectively address interrelated disease states of:

Hepatitis

C Virus

HIV & PrEP

Substance Use Disorder

Sexually Transmitted Infections

Who Should Join: Physicians, advanced practice providers, pharmacists, nurses, behavioral health specialists, chemical dependency counselors, medical assistants, Tribal community health providers and others interested in learning new skills are invited to attend.

Together We Can Stop Syphilis

Syphilis is on the rise nationwide, and Indian Country is profoundly impacted. With the highest primary and secondary syphilis rates and an 800% uptick in congenital syphilis cases among American Indian and Alaska Native (AI/AN) people, we must act now to protect ourselves, our families, and our communities.

To help AI/AN adults make informed decisions about syphilis testing and treatment, the Northwest Portland Area Indian Health Board developed Stop Syphilis, a national health education campaign.

This campaign is designed to:

• Encourage AI/AN adults to get tested and treated for syphilis

• Support health providers in educating AI/AN patients about syphilis

• Share vital information about safer sex and other methods that prevent the spread of syphilis

The campaign offers:

• Colorful handouts, posters, and rack cards

• Eye-catching posts to share on social media

• Condoms and stickers

• Culturally resonant banners and signage

• Brief educational videos

To access materials

To order materials or download digital materials, visit the Stop Syphilis website at: www.StopSyphilis.org

To spread the word

To help spread the word, please talk with your colleagues and community members about the Stop Syphilis campaign and share our free videos, print materials, condoms, stickers, and other campaign items. Together we can make a difference!

Contact us

For additional information about the campaign, get in touch with Alicia Edwards, the HIV/STI Communications Manager at the Northwest Portland Area Indian Health Board at aedwards@npaihb.org

If you are a health provider working at an IHS, Tribal, or urban Indian facility and would like free technical assistance or syphilis-related trainings brought to your clinic or hospital, email ECHO@npaihb.org.

New Faces

Karol Dixon

Deg Hit’an Athabascan

Temp Senior Policy Advisor

Karol is Deg Hit’an Athabascan and an enrolled Tribal member. She has a Master of Public Health from Johns Hopkins University and a Juris Doctor degree from the University of New Mexico School of Law. Karol brings significant experience working with Medicaid and Medicaid waiver programs and tribal health organizations throughout the country. Karol has managed health programs from planning and design through implementation and evaluation, including ensuring compliance with federal, state, and nonprofit requirements.

Karol has experience with state Medicaid contracting, and also has experience negotiating and managing contracts for rural hospitals with a special focus on innovative health technologies to support critical access hospitals. She has a personal commitment to health and well-being.

When not working, Karol and her family enjoy spending time in the great outdoors, hiking, camping, and traveling throughout the beautiful Pacific Northwest.

Amanda Squiemphen-Yazzie

Confederated Tribes of Warm Springs

Early Childhood Mental Health Project Coordinator

Amanda Squiemphen-Yazzie is a proud Warm Springs, Navajo, Wasco, and Yakama woman who grew up in Warm Springs, Oregon, and currently resides in the traditional homelands of the Chinook and Cowlitz people.

She recently completed her time at Portland State University obtaining her Masters in Social Work with a concentration in Practice and Leadership with Communities and Organizations. In addition, she also holds her Bachelor's in Social Work with a Minor in Civic Leadership. She volunteers on a variety of committees and boards throughout Oregon and co-wrote A Kids Book about Voting.

Lisa DiBianco Evaluation Specialist

Hello! My name is Lisa DiBianco and I grew up on the island of Oahu. I have a Bachelor of Science in History from Portland State University and graduated with a Master of Public Health from A.T. Still University. I am excited and honored to join the NPAIHB team as an Evaluation Specialist.

I have a background that includes experience in the health information technology sector, teaching English as a Second Language abroad, and most recently in the social services field as a program manager and case manager working with Native Hawaiian populations.

New Faces

Luwanna Comstock Klamath Tribe Senior Accountant

Hello, my name is Luwanna Comstock, I am ewksiknii & Lakota (Klamath & Sioux).

I grew up in Portland Oregon. Much of who I am, has been shaped by the teachings and influence of both my Lakota Grandmother and my ewksiknii grandmother. Through them I learned to value my kinships and friendships, to value being kind always and generous with love and compassion. I value education and learning, and I strive to live a heathy active growth centered lifestyle.

I have been working in accounting for over 20 years. I have a bachelors in social science from Portland State University and recently finished their Post Bac in Accounting program.

I cannot express enough how happy I am to join NPAIHB's finance team as the new Senior Accountant. I am so, so excited!

And while I do love accounting and geeking out with spreadsheets, what I most love is being in nature. I love being in the mountains and near rivers and lakes. I swim regularly and am currently trying to learn to paddle board. I love everything about the PNW and would never want to live anywhere else. Also important, I love to bake cookies and give them to people; I love to shop for shoes and when I’m a lone I love to listen to music loud and sing even louder in my car, lol!

Sunny Stone Data Hub Outreach Coordinator

Hi there! My name is Sunny Stone, I am so excited to be starting my new adventure with the NPAIHB as the Data Hub Coordinator. For the past 11 years, I have worked for the Shoshone-Bannock Tribes as a Diabetes Manager, Quality Improvement Coordinator, and most recently, Tribal Health and Human Services Director. I live on the Fort Hall Reservation with my husband (Shoshone-Bannock) and son (Shoshone-Bannock).

While completing my Bachelor of Science in Health Education, and a Master in Public Health from Idaho State University I fell in love with data and epidemiology. Though understandably, numbers aren’t everyone’s favorite, the simplicity of having quantitative data to understand the benefits of an intervention or the severity of a problem always intrigued me; especially when combined with qualitative data, traditional, or community knowledge to develop insight and improve community health. I am passionate about data sovereignty and improving access and ownership of data within Tribal communities to improve quality of care, recognize patterns, and to communicate with membership, leadership, and granting agencies.

When I am not working I enjoy spending time with my family, going on adventures (traveling), gardening, camping, whitewater rafting, and generally spending time outdoors.

New Faces (continued)

Wyatt Miner

Cheyenne River Sioux Tribe

BOLD (Building Our Largest Dementia Infrastructure) NTEP (Northwest Tribal Elders Project) Project Assistant

Hello my name is Wyatt Miner, I was born and raised in Eagle Butte, SD on the Cheyenne River Sioux tribe. My bands are Itazpico and hunkpapa, I grew up on my family’s farm where my love for nature and wildlife started. I moved out here to Portland with my fiancé a little over a year ago and we are now expecting our first child together.

Pearl Rose

Fort Peck Assiniboine and Sioux Tribes

NTCCP Coalition Coordinator

Hello, my name is Pearl Rose. I was born in Portland and raised all over Oregon. I am Dakota Sioux from the Assinaboine and Sioux tribes of Ft. Peck, MT. I have worked in the Portland area in the mental health and addictions field for the past 10 years, and absolutely love working for our native communities.

Aurora Martinez

Samish Indian Nation

THRIVE Project Coordinator

Nów7 si7ám. Sqwemey7ileshewó:t se ne-sná7 . Che XwS7amesh-sen. (Hello, My traditional name is Sqwemey7ileshewó:t, and my English name is Aurora Martinez. I come from Samish Indian Nation). I come from Everett, Washington but moved to Portland this last year to complete the Wy'East pathway at OHSU.

I am a previous youth delegate with the health board and have a bachelor's degree from Western Washington University in Kinesiology and a Master's in Healthcare Administration from West Coast University. I am passionate about working with tribes and youth to teach about health and look forward to working with the health board in the THRIVE project.

Off the Clock: On to New Adventures!

I met Kerri Lopez while working for the Portland Area Indian Health Service. We were in a Tribal Consultation and Workgroup meeting in Reno, NV, where we had a strategic work session on the Re-Authorization of the Indian Health Care Improvement Act (IHCIA).

From there, I worked with Kerri at NPAIHB during her time as Health Resources Coordinator in the program operations department of the board. As the Tobacco Prevention Project Coordinator and Health Resources Coordinator, Kerri has worked on implementing internal organization policies.

Board internal policies:

• NPAIHB coverage for family members through

• Group medical plans

• Wellness time leave for employees

• Parent/Child bonding time where employees could bring their infant child to the workplace from sixweeks to 6 months of age

• Wrote the grant for NPAIHB’s first staff retreat through the Black United Fund

In addition, during Kerri’s work, she was part of many government-to-government relations with tribes, states, regional and national policy change, development, and implementation that was instrumental in getting funding designated to tribal tobacco programs through Oregon tax Measure 44 and the current tobacco funds for tribes NARA and NPAIHB through measure 108 tax.

Written by Chandra Wilson

KERRI LOPEZ

CAPTAIN THOMAS M. WEISER, MD, MPH

About sixteen years ago, CAPT. Thomas Weiser arrived at the Portland Area Indian Health Service on an IHS assignment as the Portland Area’s Medical Epidemiologist. Dr. Weiser, while not new to the Public Health Service (he served as IHS Medical Officer in Whiteriver, Arizona, from 1998-2005), epidemiology (completed the CDC Epidemic Intelligence Service from 2005-2007), or even the Northwest (he grew up up up up in Southern, OR), he was new to the northwest Tribes but quickly became a loved member of our NPAIHB family.

Dr. Weiser supported many of our maternal child health, public health, and research efforts led in our NW Tribal Epidemiology Center. Dr. Weiser also served as the Co-Chair of the Portland Area IHS Institutional Review Board for seven years, both protecting northwest Tribal communities but also encouraging and supporting research led by Tribal communities, Tribal research, and those currently serving Tribal communities. Nationally, Dr. Weiser served on the IHS Heroin, Opioids, and Pain Efforts (HOPE) Committee from 2018-2021 and was the IHS ex-officio representative to the CDC Advisory Committee on Immunization Practices (ACIP). In addition, it was Dr. Weiser’s qualitative inquiry as to why we were seeing falling vaccination rates among Tribal children that led to early conversations and collaboration with the Executive Director of Boost Oregon Executive Director and led to what is now NPAIHB’s Native Boost Project.

Dr. Weiser also established an Epidemic Intelligence Service Field Site through the CDC Epidemic Intelligence Service(EIS), where he mentored four epidemiologists who completed their EIS fellowships serving our Tribal communities.

But as much as it was, Dr. Weiser was valued for sharing his epidemiological expertise; he was also appreciated for the way he shared his kind words, his sense of humor, and the lives of his family with us. His family joined us in the board-wide events in the office and on the road. He took time to get to know us and to know our families. This made him a good fit for the NPAIHB and Indian Country. While he may be retiring this month from IHS, he plans to continue to pursue working on efforts with NW Tribes, the first of which will be teaching an MCH Epidemiology course for the NW NARCH Program this fall.

Written in by Tam Lutz

Honoring Our Graduates!

NPAIHB congratulates Morgan Scott on her graduation from the Centers for Disease Control and Prevention (CDC) Public Health Associate Program (PHAP) Class of 2021-2023! Morgan has served as a PHAP assignee to the Board’s Public Health Improvement & Training (PHIT) project since October 2021 and was recently honored at a CDC ceremony in Atlanta, Georgia. Morgan, who is originally from Georgia, received a Bachelor of Science in Public Health and a Master of Science in Health and Human Performance from Georgia College & State University. She will continue as a member the PHIT team at NPAIHB through fall 2023.

We are so grateful for all of Morgan’s hard work and dedication to serving the Northwest Tribes!

Jessica Rienstra ECHO RN Case Manager

Gonzaga University - Spokane, WA

Adrean Brings Him Back Oglala Lakota Events Coordinator

OHSU-PSU School of Public Health - Portland, OR

CDC PHAP Graduates, June 2023. Morgan Scott, PHAP Assignee to NPAIHB, 2nd row, 5th from right.

Forks High School Graduate 2023 - Forks, WA

Forks Middle School 8th Grade Ceremony - Forks, WA

Rhode Island School of Design - Providence, RI

8th Grade Graduation

Evan Jacobson (Son of Naomi Jacobson) Quileute Tribe

Lillian Jacobson (Daughter of Naomi Jacobson) Muckleshoot Tribe

Terrell Casey (Son of Ticey Mason) Conf. Tribes of Siletz

Makai Anderson (Son of Ticey Mason) Conf. Tribes of Siletz

Madison Kylie Griffin (Daughter of Tammie Scott)

City University of New York School of Law - New York City, NY

Shirley Ann Harness (Niece of Don Head) Gwichyaa Zhee Athabascan

University of Alaska - Anchorage, AK

Josephine Lutz (Daughter of Tam Lutz) Lummi Nation

Fort Lewis College - Durango, CO

Kira Rea Communications Manager

Photo credit: E. KakuskaDancing in the Square Powwow 2018