05/13/2021 03:30 PM Senate COMMUNITY & REGIONAL AFFAIRS

        SB 135-AK COMMUNITY HEALTH AIDE APPRECIATION DAY                                                                    
                                                                                                                                
4:18:11 PM                                                                                                                    
CHAIR   HUGHES  reconvened   the   meeting   and  announced   the                                                               
consideration  of  SENATE  BILL  NO.  135  "An  Act  establishing                                                               
September 10 as Alaska Community Health Aide Appreciation Day."                                                                 
                                                                                                                                
4:18:31 PM                                                                                                                    
JOE   HAYES,  Staff,   Senator  Scott   Kawasaki,  Alaska   State                                                               
Legislature, Juneau,  Alaska, presented SB  135 on behalf  of the                                                               
sponsor.  He  read  the  following  sponsor  statement  into  the                                                               
record:                                                                                                                         
                                                                                                                                
     "An Act  establishing September 10 as  Alaska Community                                                                    
     Health Aide Appreciation Day."                                                                                             
                                                                                                                                
     Senate  Bill  135  aims  to  recognize  and  honor  the                                                                    
     exemplary   work   of   Community   Health   Aides   by                                                                    
     proclaiming  September 10  as  Alaska Community  Health                                                                    
     Aide  Appreciation   Day.  This  date  was   chosen  to                                                                    
     commemorate the  first Planning and  Advisory Committee                                                                    
     meeting for Health Aide Programs  in Alaska, which took                                                                    
     place on September 10, 1973.                                                                                               
                                                                                                                                
     The work of  the Community Health Aide  is tireless. In                                                                    
     the  communities they  serve,  they  act as  round-the-                                                                    
     clock    first     responders,    clinicians,    travel                                                                    
     coordinators,  hospitalists, tribal  liaisons, and  are                                                                    
     often  role models  within  their  home regions.  Since                                                                    
     before  statehood,  Health  Aides  have  organized  and                                                                    
     played an  integral role  in maintaining  tribal health                                                                    
     and  community safety.  They are  often  related to  or                                                                    
     close to  their patients  and bring to  their positions                                                                    
     an  abiding  respect   for  traditional  knowledge  and                                                                    
     culture.                                                                                                                   
                                                                                                                                
     Recently,  Community  Health  Aides have  been  on  the                                                                    
     front  lines of  the  fight against  COVID-19 in  rural                                                                    
     Alaska and  have been  key to  ensuring the  success of                                                                    
     vaccination  efforts in  remote  communities that  lack                                                                    
     advanced  healthcare  services.  It is  more  important                                                                    
     than  ever that  we  acknowledge  our Community  Health                                                                    
     Aides for  their broad scope  of practice  and selfless                                                                    
     contributions  to their  communities, regions,  and the                                                                    
     state. For these reasons, I  urge the passage of Senate                                                                    
     Bill 135.                                                                                                                  
                                                                                                                                
4:21:04 PM                                                                                                                    
MR. HAYES reviewed  the evolution of the CHA  Program outlined on                                                               
slide 3.  He said the Alaska  Health Aid Program dates  to before                                                               
statehood   when   trained   local  Alaskans   helped   fight   a                                                               
tuberculosis outbreak.  The Alaska Native Health  Service started                                                               
formal  CHA  training  efforts  in  the  1960s  and  the  program                                                               
received federal  recognition and congressional funding  in 1968.                                                               
The  first planning  and advisory  committee  meeting for  health                                                               
aide programs in Alaska was held  on September 10, 1973. He noted                                                               
the  date for  the  Community Health  Aide  Appreciation Day  was                                                               
chosen to  commemorate this historic  event. Later in  the 1970s,                                                               
Congress  approved  funding  for additional  CHA  positions.  The                                                               
federal  government created  the  Community  Health Aide  Program                                                               
Certification Board in  1998 and charged it  with formalizing the                                                               
process  for  maintaining  community health  aides  and  training                                                               
centers. The  program expanded between  2001 and 2009  to include                                                               
dental and behavioral health aides.                                                                                             
                                                                                                                                
4:21:42 PM                                                                                                                    
MR. HAYES stated  the Alaska Tribal Health System  (ATHS) is made                                                               
up  of about  37  tribal health  organizations  that have  signed                                                               
agreements to  manage the health  care facility under  the Alaska                                                               
Area  Native  Health  Service  of   the  Indian  Health  Service.                                                               
Community health aides work within  this system. They function as                                                               
part of  a regional team  to assess and provide  emergent, acute,                                                               
and  chronic  medical  care in  remote  Alaska  communities.  The                                                               
community  selects its  provider who  then attends  four training                                                               
sessions each  of which lasts  three to four weeks.  The training                                                               
centers are  located in Anchorage,  Nome, Bethel,  and Fairbanks.                                                               
The 550  health aide practitioners  in more than  170 communities                                                               
form  the backbone  of the  health care  system in  rural Alaska,                                                               
incorporating local and traditional knowledge into their care.                                                                  
                                                                                                                                
4:24:10 PM                                                                                                                    
MR. HAYES displayed  the Alaska map on slide 7  to illustrate the                                                               
size and scope  of the "Hub & Spoke" referral  pattern for health                                                               
care. This model  is designed to keep health care  close to home.                                                               
Each spoke radiates to individual  communities and clinics from a                                                               
regional   hub   that    has   hospital   services,   multi-level                                                               
practitioners, and  physicians. Throughout the  COVID-19 pandemic                                                               
CHAs  worked  tirelessly   and  at  great  risk   to  keep  their                                                               
communities  safe and  to ensure  the successful  distribution of                                                               
the vaccine throughout Alaska.                                                                                                  
                                                                                                                                
MR.  HAYES  named the  individuals  the  sponsor had  invited  to                                                               
testify.                                                                                                                        
                                                                                                                                
4:26:24 PM                                                                                                                    
CHAIR HUGHES  shared that her  husband appreciated  the community                                                               
health  aide model.  Early in  his career  he worked  through the                                                               
Yukon-Kuskokwim  Health Corporation  supervising health  aides in                                                               
50 villages and  providing patient care when  he visited clinics.                                                               
She asked if  Alaska was still the only state  that has community                                                               
health aides.                                                                                                                   
                                                                                                                                
MR. HAYES answered  he would do follow up research  but as far as                                                               
he knows, Alaska is the only state that uses the CHA model.                                                                     
                                                                                                                                
CHAIR   HUGHES  offered   her  understanding   that  Alaska   was                                                               
pioneering the  well-deserved community health  aide appreciation                                                               
day.                                                                                                                            
                                                                                                                                
She announced invited testimony on SB 135.                                                                                      
                                                                                                                                
4:28:14 PM                                                                                                                    
TARYN HUGHES,  Guardian Flight Alaska, Fairbanks,  Alaska, stated                                                               
she learned that  community health aides are a  vital resource to                                                               
Alaska's health care system when she  lived and worked in the Tok                                                               
region for about  10 years. Their scope of work  is both physical                                                               
and  emotional. For  example, a  health aide  performed CPR  on a                                                               
patient for four hours waiting  for weather conditions to improve                                                               
so the medivac  plane could land safely. The  patient happened to                                                               
be her  great uncle.  She highlighted  that the  community health                                                               
aide  model,  which was  pioneered  in  Alaska,  is moving  to  a                                                               
national  platform. She  confirmed the  Chair's observation  that                                                               
this would  be the first  state-sanctioned community  health aide                                                               
appreciation  day in  the nation.  She noted  some Alaska  health                                                               
aides  and trainers  currently  serve on  a  national board.  She                                                               
expressed hope that in addition  to the national nurse's week and                                                               
the national  EMS week,  that there would  someday be  a national                                                               
health  aide week.  She concluded  that  passing SB  135 sends  a                                                               
clear  message  to community  health  aides  that their  role  in                                                               
ensuring  the  health  and  safety of  their  communities  is  as                                                               
important as the nurses and paramedics they work alongside.                                                                     
                                                                                                                                
4:30:33 PM                                                                                                                    
CHAIR HUGHES mentioned the national  movement and asked if states                                                               
other than Alaska  were allowing health aides to  work in medical                                                               
settings.                                                                                                                       
                                                                                                                                
MS. HUGHES answered  yes; her understanding is  that the national                                                               
board is working with tribal  health organizations to implement a                                                               
model of  health aide  training that  is similar  or the  same as                                                               
Alaska's.                                                                                                                       
                                                                                                                                
4:31:24 PM                                                                                                                    
JARED  SHERMAN  Vice  President  of  Operations,  Global  Medical                                                               
Response, Palmer,  Alaska, stated  GMR is  the parent  company of                                                               
Guardian  Flight Alaska.  He shared  his experience  traveling to                                                               
villages  in the  Yukon-Kuskokwim area  as  a boy  and later  for                                                               
work. During these  visits he would walk through  the clinics but                                                               
he never  appreciated what a vital  link they were to  the health                                                               
care  system. It  was not  until he  joined the  medivac industry                                                               
about 10  years ago that he  began to recognize that  health care                                                               
is local and health aides are a key piece of the system.                                                                        
                                                                                                                                
MR. SHERMAN said health aides  reported going into people's homes                                                               
earlier this  year instead of  seeing them  in the clinics  in an                                                               
effort to keep  the clinics COVID-19 free and  to reduce exposure                                                               
to the  rest of the community.  This is just one  illustration of                                                               
their commitment. He  stated support for health  aides in Alaska;                                                               
every medivac  Guardian completes out of  Alaskan villages starts                                                               
with the  health aide.  They are  a key piece  and their  work is                                                               
vital. He stated support for SB 135.                                                                                            
                                                                                                                                
CHAIR  HUGHES   asked  Mr.  Hayes   if  community   health  aides                                                               
administered the vaccine during the pandemic.                                                                                   
                                                                                                                                
4:33:07 PM                                                                                                                    
MR. HAYES answered yes.                                                                                                         
                                                                                                                                
CHAIR  HUGHES clarified  for the  record that  while the  sponsor                                                               
statement  mentioned that  health  aides  serve as  hospitalists,                                                               
that term refers to physicians who work in hospitals.                                                                           
                                                                                                                                
4:34:53 PM                                                                                                                    
CHAIR HUGHES opened public testimony on SB 135.                                                                                 
                                                                                                                                
4:35:15 PM                                                                                                                    
HEATHER KOPONEN, representing  self, Fairbanks, Alaska, described                                                               
community health aides as heroes  who save lives, heal, and offer                                                               
comfort.  She shared  that  she is  a  physician's assistant  who                                                               
trained CHAs  and EMTs  but she is  most proud of  her work  as a                                                               
community  health  aid. She  said  most  health aides  offer  the                                                               
highest level  of medical care  available in their  community and                                                               
do  all  aspects of  care  from  reception to  exam,  laboratory,                                                               
diagnosis,    dispensing     appropriate    patient    education,                                                               
vaccinations,   dispensing  medications   in  consultation   with                                                               
physicians   and  mid-level   practitioners,  sutures,   adaptive                                                               
equipment  and  splints,  providing  IVs,  EKGs,  defibrillation,                                                               
oxygenation and other forms of  stabilization. They can be in the                                                               
clinic  for  hours  in preparation  for  emergency  transport  to                                                               
hospitals.  She said  health aides,  many of  whom are  community                                                               
health practitioners,  are on call 24  hours a day, seven  days a                                                               
week, often for weeks or months on end without respite.                                                                         
                                                                                                                                
MS.  KOPONEN   reported  community  health  aides   live  in  the                                                               
communities they  serve and  are held to  high moral  and medical                                                               
standards. It can be a  difficult job and require sacrifices. She                                                               
reiterated CHAs are heroes and  establishing the Alaska Community                                                               
Health Aide Appreciation Day is appropriate.                                                                                    
                                                                                                                                
4:38:15 PM                                                                                                                    
CHAIR HUGHES closed  public testimony on SB 135  and advised that                                                               
written  testimony could  be sent  to [email protected].  Finding no                                                               
questions or comments, she asked the will of the committee.                                                                     
                                                                                                                                
4:38:33 PM                                                                                                                    
SENATOR MYERS  moved to  report SB  135, work  order 32-LS0898\A,                                                               
from  committee  with  individual  recommendations  and  attached                                                               
fiscal note(s).                                                                                                                 
                                                                                                                                
4:38:51 PM                                                                                                                    
CHAIR HUGHES found no objection and  SB 135 was reported from the                                                               
Senate Community and Regional Affairs Standing Committee.