Legislature(2011 - 2012)CAPITOL 106
02/09/2012 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Office of Children's Services | |
| Presentation: Alaska Tribal Health Consortium | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 9, 2012
3:04 p.m.
MEMBERS PRESENT
Representative Wes Keller, Chair
Representative Alan Dick, Vice Chair
Representative Bob Herron
Representative Paul Seaton
Representative Beth Kerttula
Representative Bob Miller
Representative Charisse Millett
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
PRESENTATION: OFFICE OF CHILDREN'S SERVICES
- HEARD
PRESENTATION: ALASKA TRIBAL HEALTH CONSORTIUM
- HEARD
PREVIOUS COMMITTEE ACTION
No previous action to record
WITNESS REGISTER
CHRISTY LAWTON, Director
Central Office
Office of Children's Services (OCS)
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Answered questions during the presentation
from the Office of Children's Services.
VALERIE DAVIDSON
Senior Director
Legal & Intergovernmental Affairs
Alaska Native Tribal Health Consortium
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint, "Alaska Tribal
Health System" and answered questions.
STEWART FERGUSON, PhD
Chief Information Officer
Alaska Federal Health Care Access Network (AFHCAN)
Alaska Native Tribal Health Consortium
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint, "The AFHCAN
Telehealth Program."
JAY BUTLER, MD
Senior Director
Division of Community Health Services
Alaska Native Tribal Health Consortium
Anchorage, Alaska
POSITION STATEMENT: Presented a Power Point, "Alaska Native
Tribal Health Consortium- Role in Public Health and Health
Education."
MATT DIXON, P.E.
Vice President of Operations
Division of Environmental Health and Engineering
Alaska Native Tribal Health Consortium
Anchorage, Alaska
POSITION STATEMENT: Presented a PowerPoint entitled, "Division
of Environmental Health and Engineering Lasting solutions to
promote healthy communities."
ACTION NARRATIVE
3:04:20 PM
CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:04 p.m.
Representatives Keller, Dick, Herron, Seaton, Millett, and
Miller were present at the call to order. Representative
Kerttula arrived as the meeting was in progress.
^Presentation: Office of Children's Services
Presentation: Office of Children's Services
3:04:42 PM
CHAIR KELLER announced that the first order of business would be
the response from Office of Children's Services to the earlier
Citizens Review Panel report.
3:07:00 PM
CHRISTY LAWTON, Director, Central Office, Office of Children's
Services OCS), Department of Health and Social Services (DHSS),
offered to respond to the report from the Citizens Review Panel
presented to the House Health and Social Services Standing
Committee on February 7, 2012. She explained that the OCS data
was used as a management tool. She clarified that departing OCS
staff were not required to partake in an exit interview,
although it was requested. She referred to the 23 exit surveys
OCS had received over the prior six months, and shared that the
three biggest reasons for departure were: personal or family
(16 percent); another job with better pay and benefits (18
percent); and, an unmanageable work load (14 percent). She
stated that the unmanageable work load reason was not a
surprise. She referenced the results from the annual staff
surveys, noting that the results were posted on the OCS website.
She shared that the biggest reasons for which staff chose to
stay with OCS were: "they value the security and benefits of
working for the state;" "they find the job duties challenging
and it allows them to use their skills, talents, and problem
solving abilities;" "they enjoy the challenges of working to
ensure the well-being of children;" "they enjoy the positive
working relationship with their supervisors;" and, "they enjoy
working with their co-workers and the contributions that they
make to job satisfaction." She reported that the top three
responses for better ways to retain staff included: overall
reduction in workloads, increase in social service associate
support, and increase in pay and benefits.
3:10:50 PM
MS. LAWTON responded to the three concerns raised by CRP during
its PowerPoint presentation. She defined "in home services" as
any situation where the child remained in the biological family
home, whether or not OCS had custody. She stated that OCS
worked to keep the family intact and to develop a case plan with
the parents. She emphasized that a safety plan was also in
place to monitor child safety during the resolution of issues.
Referring to a CRP concern that policies and procedures were not
clear, she directed attention to a quality assurance unit lead
by a senior employee, expert in child welfare. She shared that
federal authorities had recognized the quality assurance unit as
"being one of the best they've seen out of all the states they
visited." The unit did annual on-site case reviews in all 26
OCS field offices, to review what areas needed improvement for
both in-home and out-of-home cases. She said that the main
difference to in-home cases were the involvement of fewer legal
parties. These cases were based on the parents' voluntary
willingness to engage with OCS, and she shared that currently
there were only 47 such cases, among 2,000 children in care.
She addressed the third CRP concern for a requirement to use
licensed foster homes, even if there were allegations of abuse
or neglect against the home. She reported that this greatly
concerned her, and that she was working to identify this
scenario, as this was not an OCS practice. She noted that with
instances where abuse was suspected, but not proven, the OCS
staff was not required to place children in these licensed
homes.
3:16:06 PM
MS. LAWTON addressed the questions received earlier from
Representative Herron [Included in members' packets]. She
directed attention to the 2011 OCS Response to CRP Annual Report
[Included in members' packets], and stated that some of
Representative Herron's questions were answered in this report.
3:16:42 PM
CHAIR KELLER clarified that this report could also be accessed
on the OCS website.
3:16:58 PM
MS. LAWTON addressed the first question from Representative
Herron, which reflected concerns about the culture within OCS.
She listed the things being done to improve morale and the
culture in the statewide offices. She noted that this morale
problem had most often cycled during the resulting stress of
vacancy or turnover. She touted the staff advisory board,
comprised of members from each of the five regions, as an
opportunity to address suggestions, concerns and needs. She
said this committee would also be used as a sounding board for
new departmental ideas. She expressed her hope that this would
improve the morale and communication issues.
3:19:51 PM
MS. LAWTON directed attention to the supervisory council, with
which she met regularly, and its primary goal to implement the
strategic plan to improve child welfare supervision in Alaska.
She noted that this council offered skills training and guidance
for OCS supervisors. She reported on the statewide policy and
procedures group, consisting of front line staff, staff, and
supervisors, which worked on revision and development of
policies. She said that all the draft policies were posted on
an in-house site, available for comments and feedback by any
staff member.
3:21:55 PM
REPRESENTATIVE HERRON reflected on this opportunity for OCS to
leave an imprint, something that people can trust. He asked
that Ms. Lawton also respond to question 5.
3:23:34 PM
REPRESENTATIVE HERRON asked that Ms. Lawton respond to question
2: "OCS expects parents, or foster parents, to be full time...
but does OCS expect to be available 24/7 to the children in
State care?"
MS. LAWTON, in response to question 2, explained that OCS was
not mandated in policy for its case workers to be available 24/7
to the clients, but that OCS did have a protocol to be available
at all times. She shared that many workers did extend after
hours information to clients, but that it was necessary to find
a balance.
3:26:18 PM
REPRESENTATIVE HERRON offered his belief that the expectations
for the foster parents were higher than the expectations for OCS
staff.
CHAIR KELLER stated that this highlighted a challenge for OCS.
3:27:30 PM
MS. LAWTON responded to question 5 from Representative Herron,
which read:
we understand that OCS has a long range plan of a
statewide hotline that would provide 24-hour coverage
by social workers with expertise to handle these
reports of harm. The barrier to implementation is
funding.
She stated that OCS staff answered the after hours' hotline, but
that after hours emergency calls were forwarded to law
enforcement. She reported that law enforcement had the
necessary authority to remove a child from a home, and that an
OCS worker would be in consultation with law enforcement during
any such move. She reflected on her desire to have an OCS hot
line, as law enforcement was not equipped to make OCS decisions.
She opined that OCS staff working in conjunction with law
enforcement on the scene could often avoid a foster care
placement, although she acknowledged the challenges due to the
geography of Alaska. She noted that the OCS regional structure,
with a hub office taking reports, had shown an increase in
calls. She reported that this system required specialized
skills for in-take functions, and the process was still being
reviewed for any necessary modifications.
3:32:14 PM
CHAIR KELLER established that a foster care alumnus had stated a
need for more investigation. He acknowledged the immensity of
the challenge for in-take function, and the need for those
special skills.
3:33:23 PM
MS. LAWTON informed Representative Herron that she would send a
written response to all his questions.
^Presentation: Alaska Tribal Health Consortium
Presentation: Alaska Tribal Health Consortium
3:33:43 PM
CHAIR KELLER announced that the final order of business would be
a presentation by the Alaska Native Tribal Health Consortium.
3:35:28 PM
VALERIE DAVIDSON, Senior Director, Legal & Intergovernmental
Affairs, Alaska Native Tribal Health Consortium, presented a
PowerPoint, "Alaska Tribal Health System," and directed
attention to slide 3 "Great Partnerships," stating that the
Alaska Tribal Health System benefited everyone in the State of
Alaska, as the existing health care system in Alaska was
partially financed by the federal government through the Alaska
Tribal Health System infrastructure in many of the rural
communities. She pointed out that immunization rates had
dramatically improved. She noted that there was a savings to
the state general fund whenever Indian Health Service (IHS)
beneficiaries, who were also Medicaid beneficiaries, were
treated in a tribal health facility.
3:38:22 PM
MS. DAVIDSON detailed slide 4, "More Opportunities to Save," and
described a partnership initiated by the legislature for
expanding the IHS care capacity, while saving general fund
dollars, by investing in Long Term Care services in tribal
facilities. This program would generate an annual savings
opportunity for $19 million to the general fund. She listed
four facilities which generated an annual $8.15 million in
general fund savings.
3:40:03 PM
MS. DAVIDSON, moving on to slide 5, "More Opportunities to
Save," spoke about the sanitation facilities in rural Alaska.
She acknowledged the challenge to sustain this investment and
support community savings of these costs. She described the
Alaska Rural Utilities Collaborative which allowed communities
with water operators to be supported, as these systems needed
properly trained workers available daily. She pointed out that
this training had lowered the worker turnover rate from 75
percent to 8 percent, and had increased the on time utility
payment rate by individuals to over 90 percent. She expressed
the desire to increase the collaborative by 15 communities. She
suggested that an expansion of the energy audit program to
include sanitation facilities was an opportunity for a 50
percent energy savings.
3:43:32 PM
MS. DAVIDSON, addressing slide 6, "More Opportunities to Save,"
explained another challenge for the Alaska Native Medical Center
to be housing for rural citizens during visitations to the
specialty medical services. She declared that the current 54
bed facility was inadequate, with a need for 100 beds.
3:44:57 PM
MS. DAVIDSON introduced slide 7, "Indian Health Service," which
briefly described tribal health care in Alaska.
3:45:55 PM
MS. DAVIDSON moved on to slide 8, "IHS Delivery Models: I/T/U,"
and explained that all the Indian Health Service (IHS) care was
provided by tribal organizations. She declared that tribal
status qualified for federal funding to health care in rural
Alaska. She pointed out that, as tribal health care was the
only health care in rural Alaska, it was available to everyone.
3:46:35 PM
MS. DAVIDSON presented slide 9, "Alaska Native health history,"
and shared that Alaska Native families want what every family
wants: for the family, children, family members, friends and
the community to be healthy, happy, and live in safe
communities. She opined that, as the communities were so often
rural, it could require flexibility to a different approach.
She moved on to slide 11, "Alaska Tribal Health System," and
detailed that it was a voluntary affiliation of 30 Alaskan
tribes and tribal organizations, with about 7,000 employees.
She pointed out that each community was autonomous and served a
specific geographical area.
3:48:14 PM
MS. DAVIDSON, describing slide 12, "Alaska Tribal Health
Compact," stated that there was one Tribal Health Compact with a
commitment for all to work together. She noted that the Alaska
Native Tribal Health Consortium served all 229 federally
recognized tribes in Alaska.
3:48:51 PM
MS. DAVIDSON reported that the 140,000 Alaska Natives
represented 20 percent of the Alaska population, slide 13,
"Alaska Native Demographics." She noted that the median age for
Alaska Natives was 23.6 years compared to 32.4 for all Alaskans.
She discussed slide 15, "Medical Care Service Levels," and
detailed this tiered system to include small community primary
care centers, sub regional mid-level care centers, multi-
physician health centers, regional hospitals, and the Alaska
Native Medical Center in Anchorage.
3:50:02 PM
MS. DAVIDSON, pointing to the map on slide 16, identified the
large footprint of referral for the Alaska Native Health Care
System. She presented slide 17, "Village-Based Medical
Services," and explained that the community health aides
performed the majority of care in the 180 small village health
centers. She reviewed slide 19, "Subregional Clinics,"
confirming that these subregional clinics served a cluster of
small surrounding villages, provided a higher level of care than
the village based clinics, and included mid-level providers,
modest radiology and lab services, dental operatories, and
behavioral health professionals. She listed the six regional
hospitals on slide 20, "Regional Hospitals." She said that the
Southcentral Foundation, slide 21, "Southcentral Alaska,"
provided regional primary care and community health services.
3:51:43 PM
MS. DAVIDSON pointed out that the Alaska Native Tribal Health
Consortium (ANTHC) had been created by the U.S Congress in 1998
to provide the statewide tribal health services, slide 22,
"Alaska Native Tribal Health Consortium." She established that
the 1900 employees of ANTHC provided tertiary and specialty
medical care. She jumped to slide 24, "Alaska Native Medical
Center," and reported that the center had more than 9100 in-
patient admissions, 383,000 outpatient admissions, and 1500
infants delivered annually. She directed attention to slide 29,
"Why invest in sanitation?" and explained that an investment in
sanitation "makes good public health sense" as infants in
communities without adequate sanitation were 11 times more
likely to be hospitalized for respiratory infections and 5 times
more likely to be hospitalized for skin infections.
3:54:06 PM
MS. DAVIDSON addressed slides 31 - 32, "Sustainability Issues,"
stating that federal funding was only to half the level of need,
so grants and reliance on third party insurance was necessary
for the balance. She said, "one of the things that we know is
that as resources get tighter, that individuals in our
communities and the facilities that provide their care are
really going to feel the impact more than any other."
Indicating slide 33, "Why?" she shared that unemployment in
Indian Country was 75 percent, with some of the lowest income
levels and poorest health status in the rural communities. She
indicated that access to care, the high cost of providing care,
and a high cost of living for limited incomes were problems.
3:55:05 PM
MS. DAVIDSON assessed slide 34, "Impact," and stated:
when people finally do get the care they need, they
have traveled farther with money they don't have,
they're sicker than the average person, and they're
seen in clinics and hospitals that have fewer
resources than almost any other clinic and hospital in
the country, that, because they are rural, also have a
higher cost of providing care.
MS. DAVIDSON declared another challenge, slide 35 - 36,
"Sustainability Issues," to be for reimbursement of care to
returning veterans. She listed the impact on health service
from the price of fuel.
3:56:16 PM
MS. DAVIDSON encouraged the real life test, slide 41, "Real Life
Test:"
at the end of the day, are people that we know by name
in our communities regardless of where they live in
the state ... getting enrolled in programs that we
know they're eligible for, do they have meaningful
access to care, can they travel to where the nearest
care is available, is the facility that's there able
to provide the full spectrum of services that they
need ... because if they can't have continual access
to health care over time, we know that that's not
gonna get the job done.
MS. DAVIDSON addressed slide 42, "Real Life Opportunities," and
asked if there was currently appropriate investment to maximize
general fund savings into the future, to include the
aforementioned programs for Long Term Care, Sanitation
Facilities Operational efficiencies, and Patient Housing
opportunities. She emphasized the ANTHC vision that "Alaska
Natives are the healthiest people in the world."
3:58:29 PM
STEWART FERGUSON, PhD, Chief Information Officer, Alaska Federal
Health Care Access Network (AFHCAN), Alaska Native Tribal Health
Consortium, presented a PowerPoint, "The AFHCAN Telehealth
Program," and directed attention to slide 3, "AFHCAN
Telehealth," noting that the terms telemedicine and telehealth
were used interchangeably. He stated that the AFHCAN telehealth
program had been operational for 11 years, providing care for
125,482 cases. He detailed that the customer base included 59
operational systems, with 1443 providers and 22,763 patients in
2011. He stated that the primary reason for telehealth in
Alaska was that doctors were not where the patients were.
Explaining slide 4, "Alaska's Physicians," he reported that 49
percent of the physicians in Alaska were primary care, while 28
percent was the average in the lower 48. He noted that, in
Alaska, 65 percent of the doctors were in Anchorage.
4:00:06 PM
MR. FERGUSON moved on to slide 6, "Why do you do Telemedicine?"
He stated that almost 100 percent of the patients liked it. He
noted that surveys now asked patients why they used
telemedicine, and the top two reasons were identified as an
increase of access to care, and that it was best for patient
care.
4:01:05 PM
MR. FERGUSON directed attention to slide 7, "Telehealth Impact
on Extended Waiting Times" and analyzed that prior to
telehealth, 47 percent of patients would wait five months or
longer to see a specialist, whereas the current telehealth model
had lowered this to 3 percent. Referring to slide 8, "Access,"
he reported that the decrease in access waiting time was
accompanied by an increase in patient visits and cost savings.
MR. FERGUSON reported that, as diabetics were not getting annual
eye exams, slide 9, "Joslin Vision Network (JVN)," a pilot
program now flew a specialist into the villages, screened the
patients, and sent the retina images to Arizona to a reading
center. He stated that telehealth technology could be taken to
the villages to find the patients who needed to enter the care
system.
4:03:10 PM
MR. FERGUSON stated that 20 percent of specialty consultations
in the villages could be turned around in 60 minutes, 60 percent
of consultations in the same day, and he opined that this was
better than any regular health care, slide 11, "ANMC Turnaround
Time."
4:03:50 PM
MR. FERGUSON reported that telehealth was reimbursed at the same
rate as an in-person visit, slide 15, "Medicaid Study: 2--3 -
2009." He said that the telemedicine consultations had
prevented travel for 3,600 patients, a savings of about $3
million in travel expenses. He affirmed that these funds were
now spent on patients who needed to travel.
4:05:10 PM
MR. FERGUSON assessed that telemedicine prevented lost work and
school days, slide 16, "Lost Work Days/School Days," and had
saved almost $9 million in patient travel, slide 17, "Annual
Travel Savings (by Case Role)."
4:06:06 PM
MR. FERGUSON spoke about a new pediatric care telemedicine
program, slide 19, which pediatric specialists in Anchorage had
agreed to offer as a virtual specialty clinic. He noted that
this program could save more than $2.18 million in pediatric
patient travel costs statewide, slide 21, explaining that the
expert triage model would screen who needed to come in and how
rapidly.
4:07:59 PM
MR. FERGUSON, referring to slide 22, "Reliable Service Has a
Cost," stated that a reliable telehealth service had a
significant cost, as people valued that most cases were turned
around in the same day. He pointed out that this required
reliable staffing to cope with the bulge times to demand. He
declared that this required technical knowledge, often at the
remote sites. He specified the need for staffing at the hub,
and the costs for infrastructure.
4:09:19 PM
MR. FERGUSON examining slide 23, "Who Reaps the Financial
Benefit?", stated that telehealth revenue was 45 percent less
compared with in-person revenue, as it focused solely on the
specialty, as opposed to a full work up, which was a more
expensive consultation.
4:10:43 PM
MR. FERGUSON summarized slide 24, "Summary," and stated that
Alaska had a very supportive reimbursement climate. He
suggested that a better alignment of revenue with the costs
would incentive expansion. He cited slide 25, "Care Closer to
Home," a proposal for statewide specialty programs including
pediatric, chronic and palliative care, and the expert triage
program. He emphasized that Alaska had a world class telehealth
system which included relationships with state, federal, tribal,
and private partners. He shared that the AFHCAN telehealth
software was being used on the space station for telehealth
consults from outer space.
MR. FERGUSON, in response to Chair Keller, said that it was very
feasible to have 100,000 consultations in the upcoming years.
4:13:48 PM
MR. FERGUSON agreed with the importance of the influence of U.S.
Senator Ted Stevens to develop the program.
4:15:17 PM
JAY BUTLER, MD, Senior Director, Division of Community Health
Services, Alaska Native Tribal Health Consortium, presented a
PowerPoint, "Alaska Native Tribal Health Consortium - Role in
Public Health and Health Education," and directed attention to
slide 2, "ANTHC Division of Community Health Services: Core
Services," which listed the five core services provided by
Community Health Services: health surveillance and data
analysis, disease prevention and health promotion, health
education and research, technical assistance and statewide
subspecialty care, and public health performance improvement.
4:16:45 PM
DR. BUTLER summarized slide 4, "Average Annual Age-Adjusted
Unintentional Injury," which compared unintentional injury death
rates for Alaska Natives, Alaska Whites, U.S. Whites, and the
goal for healthy people. He pointed out that the unintentional
death rates were about half the rate of 30 years prior for all
Alaskans.
4:17:58 PM
DR. BUTLER stated that suicide was "a particularly vexing
issue," as the suicide rates for Alaska Natives had been
consistently high for the past 30 years, more than twice as high
as for other Alaskans, slide 5, "Average Annual Age-Adjusted
Suicide." He noted that the rate among young adult Alaska
Native males was almost four times that of females, slide 6.
4:18:16 PM
DR. BUTLER moved on to slide 7, "Age-Adjusted Cancer Mortality
Rates," and reported that Alaska Native death rates for lung,
colorectal, and stomach cancer were significantly higher than
the U.S. rate, although the reasons for this disparity were not
known.
4:19:07 PM
DR. BUTLER shared slide 8, "Average Number of Dental Caries in
Primary Teeth," which compared the escalated number of cavities
in the YK Delta with the rest of the United States.
DR. BUTLER discussed slide 9, "Public Health Challenges of 21st
Century," which included unintentional injuries, suicide,
alcohol abuse, cancer, tobacco, diabetes and other complications
of obesity, and oral health.
4:20:44 PM
DR. BUTLER discussed slides 10, 11, 12 and 13, which pictured
health promotion campaigns throughout Alaska, including life
vests, fall prevention, and suicide prevention.
4:24:07 PM
DR. BUTLER noted that more than 60 people, statewide, were now
certified as ASIST Trainers, slide 14, "ASIST Trainers." He
moved to slide 15, "Help Yourself to Health," which included a
booklet of information for available health screenings.
DR. BUTLER endorsed health education in the community, slide 16,
"Nolan the Colon."
DR. BUTLER noted on slide 17, "Survey of ATHS Tribal Leaders and
Providers," that this survey reported it was now easier to talk
about cancer than it was five years ago.
DR. BUTLER shared that a group of regional health partnerships
worked to bring colonoscopy screening to rural Alaska, slide 18,
"Itinerant Colonoscopy Screening Clinics."
4:26:08 PM
DR. BUTLER shared that the colonoscopy screening project had
increased the rates in the last two years, slide 19, "Colorectal
Cancer Screening Rates, 2005-11."
DR. BUTLER said that obesity was addressed by programs including
"The Store Outside your Door," slide 20, which discussed the
gathering of traditional foods.
DR. BUTLER referred to the history of Community Health Aides,
slide 22, "CHAP History," and directed attention to the Alaska
map indicating 178 village clinics with 550 Community Health
Aides, slide 23, "Community Health Aide/Practitioner Village
Clinics." He reported there were now CHAP training centers in
Anchorage, Sitka, Bethel, and Nome. He referenced the treatment
guidelines contained in the "Alaska Community Health
Aide/Practitioner Manual," slide 24, and said that an iPad
version was being developed. He moved on to slide 25, "Dental
Health Aide Therapist Program," and discussed the services
available by these providers, after their intensive two year
training program.
4:29:19 PM
DR. BUTLER discussed the topics, including cancer screening,
tobacco cessation, oral health, and hepatitis listed on slide
26, "Health Research Topics." Moving on to slide 27, "Technical
assistance and statewide subspecialty care," he discussed the
HIV clinics for care and prevention and development of the
cancer program services.
4:32:15 PM
DR. BUTLER pointed to slide 28, "Public Health Performance
Improvement: CDC NPHII Program." He explained that the National
Public Health Improvement Initiative (NPHII) supported this
program to improve the efficiency of public health programs,
document the best business practices, and measure the
effectiveness to maximize the investment.
DR. BUTLER concluded with slide 29, "Our Vision," stating the
vision of the Alaska Native Tribal Health Consortium to be
"Alaska Natives are the healthiest people in the world," and,
slide 30, 'Progress Toward the Vision," recognizing the progress
with more Alaska Native mothers breastfeeding and exercising,
fewer Alaska Native teens smoking, and fewer Alaska Natives
drowning or dying in a fire.
4:34:41 PM
REPRESENTATIVE DICK pondered whether bug dope and mosquito coils
were responsible for an increase of cancer.
DR. BUTLER, in response, stated that natural products were not
necessarily associated with good health.
4:36:13 PM
REPRESENTATIVE HERRON, referring to slide 7, asked if the rate
for stomach cancer was even higher in Yukon-Kuskokwim (YK)
Delta.
DR. BUTLER said that the rates of stomach cancer were even
higher in rural Alaska, specifically areas with poor sanitation
facilities.
REPRESENTATIVE HERRON asked that the graph reflect stomach
cancer deaths for YK Delta natives, as well.
4:38:36 PM
MATT DIXON, P.E., Vice President of Operations, Division of
Environmental Health and Engineering, Alaska Native Tribal
Health Consortium, presented a PowerPoint entitled, "Division of
Environmental Health and Engineering Lasting solutions to
promote healthy communities." He shared his desire to "keep
people from getting sick to begin with." He pointed out that
this saved money for the health care system, and it allowed for
a much higher quality of life. He moved to slide 3, "Health
Impact of Improved Sanitation," and slide 4, which graphed
gastrointestinal and post neonatal mortality rates, reflecting
the decline of deaths with the increase of clean water into
homes and dirty water out of homes.
MR. DIXON directed attention to slide 5, "Infant Hospitalization
Rate," and slide 6, which showed the increase in respiratory
infection, skin infection, and pneumonia without clean water in
the home. He presented slide 7, "Impact of Improved
Sanitation," which supplied data for the decrease in health
impacts.
4:41:32 PM
MR. DIXON offered slide 9, "DEHE: Organization Profile," and
stated that there were 250 staff who planned, designed, and
built health and sanitation facilities in Alaska. He pointed
out that the organization also hired local work forces. He
listed the federal and state partnerships, slide 10, "Program
Partners and Funding Agencies" and slide 11, "Program Partners-
State of Alaska," including U.S. Environmental Protection
Agency, U.S. Indian Health Service, and Denali Commission. He
declared the closest partner to be the State of Alaska, and its'
Department of Environmental Conservation. On slide 12, "Recent
Project Successes," he listed the recently completed projects,
including water service for more than 700 homes throughout rural
Alaska. He noted that almost 20 percent of homes in Alaska did
not have water or sanitation service.
4:43:23 PM
MR. DIXON, speaking about slide 13, "Rural Sanitation in
Alaska," indicated the predominate demand to be in the interior
and the western portion of Alaska, where 35,000 people had
systems that needed to be upgraded or replaced.
4:44:26 PM
MR. DIXON referred to slide 18, "Capital Funding for
Sanitation," and slide 19, "Needs vs. Funding," pointing out
that federal funding was dropping, but the needs were
increasing. He explained that this left Alaska "A Generation
Behind," slide 20, as so many people did not have sanitation
facilities. He explained that it was necessary to maintain or
increase sanitation funding, research and develop innovative
systems with the new technology, and ensure that the current
systems were sustainable, slide 21 "Focus for Future Efforts."
He confirmed that the problem was finding water, getting it to
people, and getting waste out of the house.
4:46:27 PM
MR. DIXON furnished slide 23, "Long Term Sustainability," and
emphasized that this was the most important focus. He said that
his division had done 41 energy audits throughout Alaska, which
had recognized a substantial savings. He spoke about the use of
alternative energy, and improved operations and maintenance for
systems to last.
4:47:51 PM
MR. DIXON spoke of the three challenges: keep money coming in,
audit the systems for increased efficiency, and support strong
operations and maintenance.
4:49:35 PM
REPRESENTATIVE DICK offered his experience for consultation to
realistic solutions.
4:49:53 PM
MS. DAVIDSON pointed out that the State of Alaska was required
to fund a minimum match of 25 percent to the federal funding.
She pointed out that federal funding was decreasing, and she
asked if the state would increase its match in order to provide
the necessary sanitation services.
CHAIR KELLER affirmed the dilemma from a decrease to federal
dollars.
4:51:23 PM
REPRESENTATIVE SEATON reflected on the use of sufficient Vitamin
D as a preventative. He reminded that Fraser Canada had
instituted a dose of 20,000 IU each week as a preventative for
fractures to the elderly. He pointed out that low Vitamin D
levels had also been attributed to suicides.
4:53:09 PM
CHAIR KELLER agreed that this was a very affordable prevention
program.
4:53:16 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:53 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 1 ANTHC to Alaska Legislature 2_12.ppt |
HHSS 2/9/2012 3:00:00 PM |
|
| 4 State Presentation 2-12 (2).pptx |
HHSS 2/9/2012 3:00:00 PM |
|
| 3.House HSS Butler Feb 2012.pptx |
HHSS 2/9/2012 3:00:00 PM |
|
| SANTHCLIGA12020818450.pdf |
HHSS 2/9/2012 3:00:00 PM |
|
| ANTHC - AFHCAN Telehealth - House Health and Social Services Committee Feb 2012 v4.pptx |
HHSS 2/9/2012 3:00:00 PM |