03/02/2023 01:30 PM Senate COMMUNITY & REGIONAL AFFAIRS
| Audio | Topic |
|---|---|
| Start | |
| SB16 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 16 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE COMMUNITY AND REGIONAL AFFAIRS STANDING COMMITTEE
March 2, 2023
1:30 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Elvi Gray-Jackson
Senator Jesse Bjorkman
Senator Cathy Giessel
MEMBERS ABSENT
Senator Donald Olson, Vice Chair
COMMITTEE CALENDAR
SENATE BILL NO. 16
"An Act establishing September 10 as Alaska Community Health
Aide Appreciation Day."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 16
SHORT TITLE: AK COMMUNITY HEALTH AIDE APPRECIATION DAY
SPONSOR(s): SENATOR(s) KAWASAKI
01/18/23 (S) PREFILE RELEASED 1/9/23
01/18/23 (S) READ THE FIRST TIME - REFERRALS
01/18/23 (S) CRA
03/02/23 (S) CRA AT 1:30 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
JOE HAYES, Staff
Senator Scott Kawasaki
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sponsor statement for SB 16.
GRIFFEN SUKKAEW, Staff
Senator Scott Kawasaki
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis and
slideshow on SB 16.
JACOLINE BERGSTROM, Executive Director
Health Services
Tanana Chiefs Conference
Fairbanks, Alaska
POSITION STATEMENT: Provided invited testimony on SB 16.
CRYSTAL STORDAHL, Director
Community Health Aide Program
Tanana Chiefs Conference
Fairbanks, Alaska
POSITION STATEMENT: Provided invited testimony on SB 16.
MARC KILMAN-BURNHAM, Director
National Governmental Affairs
Global Medical Response
Portland, Oregon
POSITION STATEMENT: Provided invited testimony on SB 16.
ALBERTA UNOK, President and Chief Executive Officer
Alaska Native Health Board (ANHB)
Anchorage, Alaska
POSITION STATEMENT: Provided invited testimony on SB 16.
ACTION NARRATIVE
1:30:12 PM
CHAIR FORREST DUNBAR called the Senate Community and Regional
Affairs Standing Committee meeting to order at 1:30 p.m. Present
at the call to order were Senators Giessel, Bjorkman, Gray-
Jackson, and Chair Dunbar.
SB 16-AK COMMUNITY HEALTH AIDE APPRECIATION DAY
1:30:40 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 16
"An Act establishing September 10 as Alaska Community Health
Aide Appreciation Day."
CHAIR DUNBAR said this is the introductory hearing for SB 16. He
invited Mr. Hayes to put himself on the record and introduce the
bill.
1:31:43 PM
JOE HAYES, Staff, Senator Scott Kawasaki, Alaska State
Legislature, Juneau, Alaska, presented SB 16 on behalf of the
sponsor:
[Original punctuation provided.]
SB 16
Sponsor Statement
"An Act establishing September 10 as Alaska Community
Health Aide Appreciation Day."
Senate Bill 16 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 16.
1:33:28 PM
MR. HAYES indicated that Mr. Griffin Sukkaew is available to
present the sectional analysis.
1:33:39 PM
GRIFFEN SUKKAEW, Intern, Senator Scott Kawasaki, Alaska State
Legislature, Juneau, Alaska, presented the following sectional
analysis for SB 16:
[Original punctuation provided.]
SB 16
Sectional Analysis
"An Act Establishing September 10 as Alaska Community
Health Aide Appreciation Day"
Section 1: Proposes an amendment to AS 44.12 adding
September 10th as Community Health Aide Appreciation
Day each year. Alaska Community Health Aide Day can be
observed by the suitable observances and exercises by
civic groups and the public.
1:34:07 PM
CHAIR DUNBAR opened the meeting up for questions; finding no
questions, he moved down the agenda to invited testimony.
MR. HAYES requested permission to present the slide presentation
before invited testimony.
CHAIR DUNBAR agreed and invited Mr. Sukkaew to proceed.
1:34:30 PM
MR. SUKKAEW reviewed slide 1, Establishing Alaska Community
Health Aide Appreciation Day, stating Alaska is a land of
extremes in size, weather, and geography. Eighty percent of the
state does not have a road system, which means much of the state
depends on air travel. Inclement or dangerous weather conditions
affect air travel and accessibility to hospitals. The Alaska
Community Health Aide Program was born out of necessity to bring
care as close to home as possible.
1:35:15 PM
MR. SUKKAEW advanced to slide 2, stating community health aides
provide a sustainable, successful, and culturally relevant
healthcare delivery system. They are part of a regional team to
assess and deliver emergent, acute, and chronic medical care in
remote Alaska communities. He said that communities select the
providers who participate in four training sessions, each
lasting three to four weeks. Health aides deliver quality care
in rural environments with this highly focused training. Slide 2
reads:
The Community Health Aide (CHA)
Profession is Unique to Alaska
• CHAs work under the supervision of a physician.
• Because CHAs live and work in remote areas, they
communicate regularly with physicians by video call,
telephone, e-mail or radio.
• CHAs also coordinate the appointments of other visiting
health care professionals, including public health
nurses, dentists, and doctors.
1:35:55 PM
MR. SUKKAEW advanced to slide 3, stating the history of the
community health aide program dates back to before statehood. He
reviewed slide 3:
Evolution of the CHA Program
1950's: During the tuberculosis epidemic in Alaska,
trained local villagers helped ensure that their
neighbors received their medications regularly.
1956: Dr. Walter Johnson, staff physician at Bethel
ANS Hospital proposed training of village medical
aides.
1968: Alaska Area Native Health Service [ANHS]
initiated formal Community Health Aide training
efforts. CHA/Ps received formal federal recognition
and congressional funding in 1968.
1973: On September 10, the first Planning and Advisory
Committee meeting for Health Aide Programs in Alaska
was held.
MR. SUKKAEW said SB 16 proposes establishing Alaska Community
Health Aide Appreciation Day on September 10 in honor of this
historic event.
1976: Twenty additional CHA position were approved by
the U.S. Congress in the ANHS Budget, increasing these
from the original 185 positions in157 villages to 205
positions in 185 villages.
1998: Community Health Aide Program Certification
Board (CHAPCB) created by the federal government and
charged with formalizing the process for maintaining
community health aides/practitioners, dental health
aides, and behavioral health aides/practitioners
training and practice standards and policies.
2001: $3 million in federal funding received to
increase dental health and behavioral health aide
numbers.
2003: Dental Health Aides Certified.
2009: Behavioral Health Aides Certified.
1:37:02 PM
MR. SUKKAEW reviewed slide 4, stating community health aides are
the backbone of the health system in rural Alaska. CHAs are part
of a regional team to assess and provide emergent, acute, and
chronic medical care in remote Alaska communities.
1:37:07 PM
MR. SUKKAEW advanced to a map on slide 5, which showed the
locations of Community Health Aide Program (CHAP) training
centers and village clinics. He said Alaska has about 550 health
aides and practitioners in more than 170 communities. CHAP
training centers are in Anchorage, Nome, Bethel, and Fairbanks.
1:37:24 PM
MR. SUKKAEW reviewed slide 6, stating community health aides
help people of all ages and backgrounds with a wide range of
healthcare needs. Health aides incorporate local and traditional
knowledge into their care. The Alaska Tribal Health System
(ATHS) strives to increase access to care by making services
available in local communities; CHAs constitute the frontline in
villages. Approximately 37 tribes or tribal health organizations
comprise ATHS, with signed agreements to manage healthcare
facilities under Alaska Area Native Health Service, Indian
Health Services.
1:38:09 PM
MR. SUKKAEW advanced to slide 7, which shows tribal healthcare
referral patterns overlaying a map of the United States. The
image illustrates Alaska's vast referral system compared to the
size of the United States. ATHS employs a "hub and spoke" model
for its care referrals. The "hub and spoke" referral pattern
aims to keep care close to home. He said that the center of a
referral pattern represents the largest regional hubs, which
contain hospital services, mid-level practitioners, and
physicians. Spokes radiate out from the regional hub to
individual communities and sub-regional clinics.
1:38:49 PM
MR. SUKKAEW reviewed slide 8, stating that CHAs worked
tirelessly and at great personal risk to keep their communities
as safe and healthy as possible throughout the COVID-19 health
pandemic. They set up test sites and conducted broad COVID-19
testing. CHAs were key in ensuring the success of vaccine
distribution statewide. He related one incredible example of
this in the Yukon Delta, an area with the highest COVID-19 case
rate in the nation at one point.
1:40:10 PM
MR. SUKKAEW reviewed slide 9:
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.
We hope you'll join us in showing your support by
establishing September 10 as Alaska Community Health
Aide Appreciation Day!
Mr. Sukkaew said recognition for these amazing healthcare
workers is long overdue.
1:40:33 PM
CHAIR DUNBAR invited committee members to ask questions; finding
none, he moved down the agenda to invited testimony. He asked
Ms. Bergstrom of Tanana Chiefs Conference to put herself on the
record and begin her testimony.
1:40:53 PM
JACOLINE BERGSTROM, Executive Director of Health Services,
Tanana Chiefs Conference (TCC), Fairbanks, Alaska, stated that
TCC is a large tribal health and social services consortium that
serves the Interior. TCC has forty-plus rural communities in its
region, many of which are only accessible by air or river
waterways. She said that CHAs often function as the sole
providers in their communities, caring for immediate family
members and friends. Providers in urban and larger hubs provide
support via telehealth, but the health aides are on the ground
and respond to medical emergencies. Those CHAs who are the sole
providers in their communities are on call 24 hours a day, seven
days a week. They are the first to respond to a medical
emergency. TCC has examples of community health aides who have
performed life-saving interventions with limited resources. CHAs
are the backbone of the tribal health system. She quoted Chief
Medical Officer Dr. Zinc as saying, "Tribal health is public
health." She noted that community health aides are their
communities' public health providers, which became evident
during the pandemic response.
MS. BERGSTROM said that CHAP was born out of Alaska's
tuberculosis pandemic in the 1950s. It evolved significantly in
the last 60-plus years to keep pace with advances in the
healthcare industry. Indian Health Services is in the process of
introducing the CHAP model throughout the Lower 48. Many medical
and clinical professions have a special day of acknowledgment,
for example, National Nurses Day, Doctor's Day, National
Pharmacy Week, and many others. She said that the Alaska State
Legislature has a unique opportunity to show appreciation for a
remarkable group of providers who are unique to Alaska and often
undervalued. She noted that SB 16 has a zero fiscal note. She
thanked members and indicated that she is available to answer
questions.
1:43:51 PM
CHAIR DUNBAR advanced to the next invited testifier, Ms.
Stordahl of Tanana Chiefs Conference.
1:44:10 PM
CRYSTAL STORDAHL, Director, Community Health Aide Program,
Tanana Chiefs Conference, Fairbanks, Alaska, testified in
support of SB 16. She said the Community Health Aide Program
continues to be the answer to medical care access challenges in
rural Alaska. The need for CHAs has not diminished. The medical
health aide model, which grows its trained workers within its
community, was established on September 10. The model worked so
well that it expanded to include behavioral and dental health
disciplines. It was and still is the solution for getting care
to the underserved in rural areas. She said it is exciting to
work with Indian Health Services and discuss how the CHAP model
might help areas in the Lower 48 with their healthcare
challenges. She said that recognizing Alaska's group of
community health aides is a welcome gesture. There would be no
care in many rural communities without CHAs. The U.S. produces
an insufficient number of providers to supply enough healthcare
workers in this nation, and of those, few want to work in
underserved areas. This means that the need for the Community
Health Aide Program is critical statewide.
1:46:29 PM
CHAIR DUNBAR thanked both testifiers for the work Tanana Chiefs
Conference does. He invited Mr. Kilman-Burnham to put himself on
the record and begin his testimony.
1:47:10 PM
MARC KILMAN-BURNHAM, Director, National Governmental Affairs,
Global Medical Response, Portland, Oregon, stated that he
represents the nation's largest emergency medical service
provider. Global Medical Response provides air ambulance
services under the Guardian Flight Alaska brand. He said that he
is testifying in support of SB 16.
MR. KILMAN-BURNHAM explained how Jessica Hyatt, a Guardian
Flight development specialist, initiated and sought to recognize
Alaska community health aides. Everyone thinks the Guardian
Flight team is made up of heroes, but the flight team would be
at a loss without Alaska community health aides. CHAs are the
frontline healthcare providers throughout rural Alaska and the
true Alaskan heroes. He said that he did some research after Ms.
Hyatt told him about CHAs. Communities select their CHAs. He
surmised that it must be an honor to be chosen by one's
community to perform such a noble task. He said aides are
Guardian Flight's eyes and ears. CHAs are on the ground helping
the Guardian Flight team and know what teams need on arrival. He
expressed enthusiasm that Guardian Flight was part of bringing
SB 16 to fruition. He encouraged the committee to support the
bill, announcing "North to the Future."
1:49:42 PM
CHAIR DUNBAR invited Ms. Unok to put herself on the record and
begin her testimony.
1:49:52 PM
ALBERTA UNOK, President and Chief Executive Officer, Alaska
Native Health Board (ANHB), Anchorage, Alaska, stated that ANHB
is the statewide voice for the Alaska Tribal Health System. She
testified in support of SB 16. Community health aides and
practitioners are the backbone of tribal health care. CHAs are
strongly connected, respected, and essential members of their
communities, the foundation of the Alaska Tribal Health System.
Community health aides tirelessly provided life-saving services
during the COVID-19 pandemic. She said that CHAP has created a
tribally driven international model of success. The program's
success has expanded to community-level therapists, including
behavioral health aides, dental health aides, and dental health
aide therapists. Nationally, federal statute authorizes the
program. The Indian Health Service adopted the CHAP model to
help deliver health care in the Lower 48, where providers are
hard to recruit and train. Alaska's community health aides are
an example of dedicated health providers who serve on the
frontline. She said that ANHB urges the committee to support SB
16. She thanked the committee for the opportunity to testify.
1:52:20 PM
CHAIR DUNBAR opened public testimony; finding none, he closed
public testimony and held SB 16 in committee.
1:53:17 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Community and Regional Affairs
Standing Committee meeting at 1:53 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| 1. SB 16 Sponsor Statement vers. A.pdf |
SCRA 3/2/2023 1:30:00 PM SCRA 3/9/2023 1:30:00 PM |
SB 16 |
| 2. SB 16 vers. A.PDF |
SCRA 3/2/2023 1:30:00 PM SCRA 3/9/2023 1:30:00 PM |
SB 16 |
| 3. SB 16 Sectional Analysis vers. A.pdf |
SCRA 3/2/2023 1:30:00 PM SCRA 3/9/2023 1:30:00 PM |
SB 16 |
| 4. SB 16 Presentation.pdf |
SCRA 3/2/2023 1:30:00 PM SCRA 3/9/2023 1:30:00 PM |
SB 16 |
| 5. SB 16 Fiscal Note.pdf |
SCRA 3/2/2023 1:30:00 PM SCRA 3/9/2023 1:30:00 PM |
SB 16 |
| 6. SB 16 - LOS SINCE 3.9.23.pdf |
SCRA 3/2/2023 1:30:00 PM |
SB 16 |