05/15/2021 10:00 AM House STATE AFFAIRS

        HB 198-AK COMMUNITY HEALTH AIDE APPRECIATION DAY                                                                    
                                                                                                                                
10:06:14 AM                                                                                                                   
                                                                                                                                
CHAIR KREISS-TOMKINS  announced that the first  order of business                                                               
would be  HOUSE BILL NO.  198, "An Act establishing  September 10                                                               
as Alaska Community Health Aide Appreciation Day."                                                                              
                                                                                                                                
10:06:30 AM                                                                                                                   
                                                                                                                                
REPRESENTATIVE TIFFANY ZULKOSKY,  Alaska State Legislature, prime                                                               
sponsor,  introduced   HB  198.     She  provided   a  PowerPoint                                                               
presentation,  titled  "HB   198  Establishing  Alaska  Community                                                               
Health  Aide   Appreciation  Day"  [included  in   the  committee                                                               
packet].    She  noted  that Alaska  consists  of  extreme  size,                                                               
weather, and geography and that 80  percent of the state does not                                                               
have  a road  system.   She  stated that  when  hospital care  is                                                               
needed during  extreme weather conditions, transportation  is not                                                               
necessarily  an option.   She  stated that  the Community  Health                                                               
Aide program  was conceived  prior to  statehood to  meet medical                                                               
needs in  isolated communities and  had originated because  of an                                                               
outbreak of  tuberculosis.   She noted  that dental  health aides                                                               
and  behavioral  health  aides are  included  when  referring  to                                                               
Health  Aides.   She  explained  that the  aides  in the  program                                                               
undergo  a  four-part training  session  and  report to  existing                                                               
referring physicians.  She  summarized the historical information                                                               
contained   on  slide   3,  which   read  as   follows  [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     ?  1950s:  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 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.                                                                                                           
     ?  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.                                                                                 
                                                                                                                                
REPRESENTATIVE ZULKOSKY noted that  there exist approximately 550                                                               
health aides throughout over 170  communities, and four community                                                               
health  aide training  centers in  Anchorage,  Nome, Bethel,  and                                                               
Fairbanks.   She added  that the Alaska  Tribal Health  System is                                                               
involved in providing  care in remote villages  across the state.                                                               
She drew attention  to slide 7 and explained  that it illustrated                                                               
the logistical comparison to the lower  48.  She noted that there                                                               
exists a  regional and a  sub-regional "hub and spoke"  model for                                                               
logistical  planning.    She  noted  that,  during  the  COVID-19                                                               
pandemic, community health aides  have worked closely with family                                                               
and  community members  including working  with limited  personal                                                               
protective  equipment,  establishing  testing  centers,  ensuring                                                               
vaccine distribution,  and providing in-home care  to individuals                                                               
suffering from COVID-19.                                                                                                        
                                                                                                                                
REPRESENTATIVE   ZULKOSKY   concluded    the   presentation   and                                                               
encouraged  the passage  of HB  198 to  publicly acknowledge  the                                                               
selfless   service  provided   by  community   health  aides   by                                                               
establishing Alaska  Community Health Aide Appreciation  Day each                                                               
September tenth.                                                                                                                
                                                                                                                                
10:16:01 AM                                                                                                                   
                                                                                                                                
RAHNIA  BOYER, Vice  President of  Village  Health and  Workforce                                                               
Development,   Yukon   Kuskokwim  Health   Corporation,   offered                                                               
biographical  information  and  expressed her  gratitude  to  the                                                               
committee for the  consideration of HB 198.  She  stated that the                                                               
community health  aide profession is  often referred to  as among                                                               
one of the  most difficult yet rewarding jobs.   She acknowledged                                                               
that health aides routinely screen,  treat, and save the lives of                                                               
patients.    She  shared  that   there  often  occur  stories  of                                                               
exhaustion  and fear  and sorrow,  and those  represent the  most                                                               
difficult  aspects of  the profession.   She  stated that  health                                                               
aides  attend to  patients under  difficult circumstances,  often                                                               
during  inclement weather  that leads  to delays  of transporting                                                               
seriously ill or injured patients.                                                                                              
                                                                                                                                
10:18:27 AM                                                                                                                   
                                                                                                                                
CHAIR KREISS-TOMKINS added  that his own mother  had been engaged                                                               
in  the   public  health  system  across   Southeast  Alaska  and                                                               
expressed his high regard for community health aides.                                                                           
                                                                                                                                
10:19:02 AM                                                                                                                   
                                                                                                                                
VERNE BOERNER, President/CEO, Alaska  Native Health Board, shared                                                               
biographical  information and  expressed  her hope  to honor  her                                                               
grandmother who  had served as  a community health aide  for over                                                               
27 years.  She expressed her  gratitude to the bill sponsor.  She                                                               
shared her  personal experiences  of health aides  assisting with                                                               
the  removal  of  fishhooks, providing  sutures,  and  aiding  in                                                               
emergency childbirth.  She stated  that aides are chosen by their                                                               
community  members and  are innately  culturally competent.   She                                                               
added  that  health aides  are  a  crucial  part of  the  medical                                                               
system.  She expressed her  appreciation for all health aides and                                                               
urged the passage of HB 198.                                                                                                    
                                                                                                                                
10:21:51 AM                                                                                                                   
                                                                                                                                
CHAIR KREISS-TOMKINS opened public testimony on HB 198.                                                                         
                                                                                                                                
10:22:13 AM                                                                                                                   
                                                                                                                                
TARYN HUGHES, Guardian Flight Alaska,  testified in support of HB
.   She  shared  some of  her experiences  as  an employee  of                                                               
Guardian Fight  of Alaska and  characterized her  experience with                                                               
health  aides as  a  very emotional  one.   She  shared that  one                                                               
health  aide had  performed  cardiopulmonary resuscitation  (CPR)                                                               
for  over four  hours on  a patient,  who was  the aide's  uncle,                                                               
while  awaiting the  arrival of  a  medivac plane  that had  been                                                               
delayed due to  weather.  She echoed the  sentiments expressed by                                                               
the  previous  testifier.   She  explained  that  there  occurred                                                               
nurses' week  and emergency  medical services  (EMS) week  on the                                                               
national level and that Alaska  would lead the nation by honoring                                                               
health aides should HB 198 pass.                                                                                                
                                                                                                                                
10:25:01 AM                                                                                                                   
                                                                                                                                
CHAIR KREISS-TOMKINS ascertained  that there was no  one else who                                                               
wished to testify and closed public testimony.                                                                                  
                                                                                                                                
REPRESENTATIVE STORY  asked whether  the bill  sponsor considered                                                               
adding language  to the  bill that  would include  listing dental                                                               
and behavioral health aides.                                                                                                    
                                                                                                                                
REPRESENTATIVE ZULKOSKY answered that  the term "community health                                                               
aide" was chosen as the  language to include medical, dental, and                                                               
behavioral health aides broadly.                                                                                                
                                                                                                                                
10:27:16 AM                                                                                                                   
                                                                                                                                
REPRESENTATIVE CLAMAN expressed his support for HB 198.                                                                         
                                                                                                                                
REPRESENTATIVE CLAMAN  moved to  report HB  198 out  of committee                                                               
with  individual  recommendations  and  the  accompanying  fiscal                                                               
notes.   There  being no  objection, HB  198 was  moved from  the                                                               
House State Affairs Standing Committee.