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 scra@akleg.gov. 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.