report to the people 2010 - Yukon-Kuskokwim Health Corporation

REPORT TO THE PEOPLE 

2010

Report to the People 2010 

Contents 

Organization.......................................................................................2 

Board of Directors..............................................................................6 

Tribal Gathering XVII 

April 7&8, 2010...................................................................................8 

Setting Priorities...............................................................................10 

A Message from the President/CEO..............................................13 

2010 Corporate Goals.....................................................................14 

SPOTLIGHT: 

Programs, Services, Achievements................................................16 

Community Health & Wellness..............................................................16 

Facilities & Capital Projects....................................................................17 

Behavioral Health Services.....................................................................18 

Community Support................................................................................19 

Patient Care Services...............................................................................20 

Village Operations...................................................................................22 

Another Side of Service...........................................................................23 

In Memoriam............................................................................................24 

Acknowledgments 

Thank you to our contributors: 

Donna Bach, Rhonda Vanover, Michael 

Faubion, Khadija Alharbi, Cara Bruss, 

DezBaa Damon, Wole Fadahunsi, Adrienne 

Gregory, Janice Hamrick, Kate Huckert, 

Deanna Latham, Rahnia Parker, Kathy 

Stanton, Diana Therchik, Luke Vanasse, 

David Zerby, and the Napartet Goal Team. 

All photos by Public Relations staff— 

Rhonda Vanover, Donna Bach and Michael 

Faubion—or other YKHC staff unless 

otherwise noted. 

Timeline design by Rhonda Vanover. 

Timeline photos: YKHC file photos. 

Cover: Lynn and Julie Olick with Vanilla the dog keep an 

eye out for the elusive musk ox as they travel to the next 

berry-picking spot on a family journey to Baird Inlet with 

Debbie Michael and Daniel Bill. Photo by Debbie Michael. 

© 2011, Yukon-Kuskokwim Health Corporation. The annual 

Report to the People is produced by YKHC’s Department of 

Public Relations. Book design by Michael Faubion. Printed 

by PIP Printing, Anchorage. 

1

Yukon-Kuskokwim Health Corporation 

Organization 

Mission 

Working Together to Achieve Excellent Health 

Vision 

Through Native Self-Determination and Culturally Relevant 

Health Systems, We Strive to be the Healthiest People 

58 Federally Recognized Tribes 

Values 

Optimism 

Compassion 

Pursuit of Excellence 

Trust 

Personal Growth 

Elder Knowledge 

Importance of Family 

Hospital Governing Body 

YKHC Board of Directors 

Executive Board 

President / CEO 

Chief Financial Officer 

— Revenue Management 

— Patient Financial Services 

— Medicaid & Medicare Enrollment 

— Admissions 

— Registration 

— Dental Business Office 

— Pharmacy Business Office 

— Medical Records 

— Coding and Data/Charge Entry 

— Policy Rate and Review 

— Accounting 

— Payroll 

— Accounts Payable 

— General Ledger 

— Treasury 

— Internal Auditing 

— Corporate Internal Auditing 

— Utilization Management 

— Decision Support 

— Business Development 

— Financial Services 

— Finance Data/Reporting 

— Grants Management 

— Budgeting 

— Finance & Systems Support 

— Physician Enrollment 

Vice President for Admin./ 

General Counsel 

— Compliance 

— Associate General Counsel 

— Human Resources 

— Benefits/Compensation 

— Employment and Native Hire 

— Employee Relations 

— Professional Recruitment 

— YK Area Health Education Center 

— Risk Management/QI 

— Privacy 

— Public Relations 

— Media Services 

— Grants Development 

Vice President for Support 

Services 

— Prematernal Home 

— Construction 

— Capital Projects 

— Safety 

— Security 

— Materials Management 

— Mail/Delivery 

— Purchasing 

— Contracting 

— Property 

— Inventory Control 

— Medical & Office Supplies 

— Shipping and Receiving 

— Corporate Facilities 

— Corporate Facilities Maintenance 

— Housing 

— Clinical Facilities 

— Clinical Administration 

— Hospital Facilities 

— Hospital Maintenance 

— Laundry 

— Housekeeping 

— Biomed 

— Auto Repair 

— Motor Pool 

— Clinic Support 

— Village Clinic Support 

— Community Health Services Building 

— Travel Management Center 

— Hostel 

— Anchorage TMC 

— Bethel TMC 

Medical Director 

— Technology/CIO 

— Financial & Clinical 

Systems 

— Network & 

Telecommunications 

— Help Desk 

— Security and Compliance 

— Switchboard/IT Operations 

— Project Management 

— Human Studies 

— Local Monitoring Safety 

Board 

— Research Coordinator 

— Health Impact Assessment 

2


YKHC administers a comprehensive 

health care delivery system for 50 rural 

communities in southwest Alaska. 

The system includes community clinics, subregional clinics, 

a regional hospital, dental services, behavioral health services 

including substance abuse counseling and treatment, 

health promotion and disease prevention programs, and 

environmental health services. 

YKHC is a Tribal Organization authorized by each of the 

58 federally recognized Tribal councils in its service area to 

negotiate with the Federal Indian Health Service to provide 

health care services under Title V of the Indian Self-Determination 

and Education Assistance Act of 1975. 

YKHC, along with 22 other Tribal Organizations, is a cosigner 

to the Alaska Tribal Health Compact, a consortium 

which secures annual funding agreements with the federal 

government to provide health care services to Alaska Natives and Native Americans throughout the 

state. 


Election Units 

Unit 11 

Chuloonawick 

Kotlik 

Emmonak Billmore Slough 

Alakanuk Hamilton 

Grayling 

Nunam 

Unit 1 

Iqua 

McGrath 

Anvik 

Mountain Village 

Shageluk 

Paimute 

Scammon 

St. Mary’s 

Bay Pitka’s Andreafski 

Point 

Chevak 

Pilot Station 

Hooper Bay 

Holy Cross 

Marshall 

Unit 9 Unit 2 

YUKON RIVER 

Russian Mission 

Ohogomuit 

Crooked 

Creek 

Georgetown 

Upper Kalskag 

Unit 6 

Aniak Stony River 

Lower 

Chuathbaluk 

Newtok 

Kalskag 

Red 

Napaimute 

Sleetmute 

Unit 8 

Devil 

Nunapitchuk 

KUSKOKWIM RIVER 

Tununak 

Tuluksak 

Kasigluk 

Akiak 

Mekoryuk 

Toksook Bay 

Bethel Unit 4 

Unit 3 

Atmautluak 

Umkumuit 

Akiachak 

Lime Village 

Nightmute Napakiak Kwethluk 

Oscarville 

Unit 5 Napaskiak 

Chefornak 

Tuntutuliak 

Eek 

Kipnuk 

Kongiganak 

Unit 7 

Kwigillingok Unit 10 

Quinhagak 

Goodnews Bay 

Platinum 

I N N O K O R I V E R 

H O L I T N A 

R I V E R 

Vice President for Health Services 

Subregional Clinics 

— SRC Billing & 

Coding 

— Aniak 

— Emmonak 

— Hooper Bay 

— St. Mary’s 

— Toksook Bay 

Yukon-Kuskokwim Delta 

Regional Hospital 

— Patient Care Administration 

— Ambulatory Clinics 

— Kusko 

— Delta 

— Yukon 

— Schedulers 

— Case Managers 

— Pediatrics 

— Specialty Clinic 

— Audiology 

— Diagnostic Imaging 

— Laboratory 

— Pharmacy 

— Physical Therapy 

— Nutrition Therapy 

— Optometry Services 

— Dental Services 

— Chief Nurse Executive 

— Home Care Services 

— ABPCA 

— CDPCA 

— Waivers 

— In-Home Services 

— Inpatient 

— Emergency Dept. 

— Social Services 

— CSR/OR 

— Obstetrics 

— Infection Control 

— Women’s Health 

— Chief of Staff 

— Credentialing 

— Medical Staff Services 

Behavioral Health Services 

— Adult Substance Abuse & 

Rehabilitation Services 

— Phillips Ayagnirvik 

— Therapeutic Court 

— Outpatient and Residential Services 

— Outpatient & Village Services 

— Bautista House 

— McCann Treatment Center 

— CHAP/Critical Incident Stress 

Debriefing 

— Crisis Respite Center 

— Family Spirit Project 

— Camai Case Management 

— Transitional Program 

— Morgan House 

— Clinical Training and Credentialing 

— SECEL 

— Finance and Compliance 

— Support Services 

— Fetal Alcohol Disabilities Program 

— Developmental Disabilities 

— Star Program 

— Community Developmental 

Disabilities Grant 

— Waiver Program 

— Family Habilitation 

— DD Group Home 

— Learning Resource Center 

— Family Infant and Toddler 

Program 

Village Operations 

— VO Registration 

— Administrative Support 

— Community Health Aide 

Program 

— Field Supervision 

— Health Aide Training 

— Well Child Program 

— Immunization Program 

— Compliance 

— Community Health & Wellness 

— Women, Infants, Children 

(WIC) 

— Diabetes Prevention and 

Control 

— Nicotine Prevention and 

Control 

— Healthy Hearts 

— Office of Environmental Health 

and Engineering 

— Environmental Health 

Office 

—Injury Prevention and 

Control 

—Emergency Medical Services 

—Remote Maintenance 

Workers 

—Water Testing Lab 

Performance Improvement 

—Project Management 

“Napartet” 

—Corporate Performance 

Improvement 

—JCAHO 

3


We Strive to be the Healthiest 

People 

Alaska Native 

Tribal Health 

Compact. 

Wellchild 

Program 

Started. 

Travel Management Center, 

Diabetes Prevention & Control 

Grant, Certified Bethel to 

Anchorage Medevacs. 

1995 

1996 

1997 1998 

2000 2001 2003 

2004 

Community 

Health Aide 

Certification. 

Opened Aniak 

Subregional Clinic. 

McCann Treatment Center. 

4


1995–2010 

35 New Clinics • 5 New Subregional Clinics 

Assisted Living Center 

funds appropriated by 

State of Alaska. 

Organizational 

accreditation 

by the Joint 

Commission, 

includes villages. 

CT Scanner 

installed in the 

Diagnostic 

Imaging Center. 

First Dental Health 

Aide Therapy 

(DHAT) schooling 

in Alaska. 

Sobering Center opens 

and Screening, Brief 

Intervention, Referral to 

Treatment (SBIRT) 

implemented. 

2005 

2007 

2008 

2009 

2010 

Napartet adopted as 

strategic initiative. 

Irnivik—New Birthing 

Center remodeled. 

Direct to Patient— 

pharmacy refills 

mailed to P.O. Box 

holders. 

5


Board of Directors 

Unit 1 

Unit 2 

Mary Ayunerak 

Alakanuk 

Paula Ayunerak 

Alakanuk 

Ray Alstrom 

Marshall 

James C. Landlord 

Mtn. Village 

Elected by the Tribal 

Councils of each of the 58 

Unit 3 

Unit 4 

federally recognized Tribes 

in the YKHC service area, 

the Board of Directors is 

the chief policy-making 

body of the corporation, 

exercising overall control, 

Billy Jean Stewart 

Kalskag 

Unit 5 

George S. Morgan 

Upper Kalskag 

James Nicori 

Kwethluk 

Moses Peter 

Tuluksak 

management and supervision. 

Bill Kristovich 

Bethel 

Glen Watson, Sr. 


Gloria Simeon 


Chris Larson 

Napaskiak 

Unit 6 

Unit 7 

Unit 8 

Honorary 

Member 

Esai Twitchell, Jr. 

Kasigluk 

Unit 9 

David O. David 

Kwigillingok 

James R. Charlie, Sr. 

Toksook Bay 

Unit 10 

James Sipary 

Toksook Bay 

Unit 11 

Paul John 

Toksook Bay 

Patrick Tall 

Chevak 

Eric Olson, Sr. 

Hooper Bay 

Sam W. Alexie 

Eek 

Marvin Deacon 

Grayling 

6


A Message from the 

Board Chair 

As we at YKHC and the greater Y-K Delta community move into 

2011, I’d like to welcome two new YKHC Board members, Mary 

Anaruk and Billy Jean Stewart, and thank outgoing members Ray 

Waska and Wayne Morgan for their service. These former Board members 

have helped YKHC achieve its mission of excellent health, and I look forward 

to working with our new members in the future. 

This “changing of the guard” gives me occasion to reflect on our accomplishments 

during 2010 and the first quarter of this year, before addressing 

the challenges we face in the future. Among the many accomplishments 

of the past several months, the Sobering Center, which YKHC developed 

in partnership with the City of Bethel, stands out. We at YKHC hope the 

Sobering Center and its SBIRT program will ease some of the burden on 

other community resources and identify those folks who may be at risk for 

substance abuse. The opening of this facility is the culmination of a long 

planning, development and construction process. I am thrilled to offer its 

services to the Y-K Delta community, and I wish to thank those involved in 

its development, completion and operation. 

But as proud and happy as we are, now is not the time to rest on our accomplishments. 

Our community faces significant obstacles in the year 

ahead, of which only a few are the faltering national economy, the need to 

take care of our health—especially our elders’—and the continuation of our 

subsistence lifestyle. Some of these challenges are temporary, some more 

permanent. But regardless of how long these challenges persist, in order to 

meet them successfully, we must rise to meet them together. 

And rise to meet them we shall. As I write this, Congress and the President 

struggle on the issue of budget cuts—not whether to cut the federal budget, 

but the breadth and depth of those cuts. These cuts have the potential to 

affect the Indian Health Service and YKHC. But YKHC is taking steps to 

increase its financial viability apart from its IHS funding. Likewise, YKHC 

is in the early stages of developing a facility to care for the elders of the 

Yukon-Kuskokwim Delta. And YKHC follows studies intended to measure 

the healthy aspects of the subsistence lifestyle, and warn of potentially 

harmful aspects as well. 

Of course, YKHC cannot and does not meet these challenges alone. You, 

the people of the Y-K Delta, rise above these obstacles whenever you 

exercise safely, eat healthy foods, and care for yourselves, your loved ones, 

your village and your region in alignment with our traditional values. If we 

continue to face those challenges head-on, and continue to stand by our 

traditional values to pull through tough times together, we will achieve 

excellent health. 

Ray Alstrom, Chairman, YKHC Board of Directors 

Executive Board 

Ray Alstrom, Chair 

Bill Kristovich, 1st Vice Chair 

Esai Twitchell Jr., 2nd Vice 

Chair 

James Charlie Sr., Secretary 

Marvin Deacon, Treasurer 

Patrick Tall, Sgt.-At-Arms 

Sam Alexie, 1st Additional 

Member 

Glen Watson, 2nd Additional 

Member 

Gene Peltola, Ex-Officio 

Paul John, Honorary Member 

Governing Body 

George Morgan, Chair 

David O. David, 1st Vice 

Chair 

Gloria Simeon, 2nd Vice 

Chair 

Eric Olson, Secretary 

James Landlord, Treasurer 

James Nicori, Sgt.-At-Arms 

Chris Larson, 1st Additional 

Member 

Esai Twitchell, Jr., E-Board 

Rep, 2nd Additional Member 

Board Standing 

Committees: 

By-Law Committee 

Patrick Tall 

Marvin Deacon 

David O. David 

Moses Peter 

Mary Ayunerak 

Eric Olson 

Policy Committee 

James Charlie, Sr. 

Gloria Simeon 


James Landlord 

Glen Watson 

Joint AVCP/ 

YKHC/Calista 

Gene Peltola 

Ray Alstrom 

Finance Committee 

Marvin Deacon, Chair 

Billy Jean Stewart 


Esai Twitchell 

Gloria Simeon 

Ray Alstrom, Ex-Officio 


Audit Committee 


Moses Peter 

George S. Morgan 

Chris Larson 

Investment Committee 

Bill Kristovich, Chair 

Moses Peter 

Gloria Simeon 

Glen Watson 

Esai Twitchell 



Dan Winkelman, Ex-Officio 

Special Committees 

Housing Committee 


James Sipary 


Financial Policy 

James Nicori 

David O David 

James Landlord 

Gloria Simeon 


Corp Compliance/ 

Quality Assurance 

David O David 



James Sipary, Sr. 

Moses Peter 


Yuut Elitnaurviat 



Compensation Committee 

Ray Alstrom 

Moses Peter 

George Morgan 


William Morgan 

Legend Award 

Ray Alstrom 

Sam Alexie 

Gene Peltola, Dan Winkelman 

Board Appointments 

BH Advisory Board – Paula 

Ayunerak 

Alternate – Sam W. Alexie 

Health Aide Advisory Board 

– Sam W. Alexie 

Home Care Liaison – James 

Sipary 

ANTHC – Ray Alstrom, 1st 


2nd Bill Kristovich 

Human Studies — Gloria 

Simeon 

James Nicori 

Moses Peter 

Ray Alstrom 

IDD, LLC – Ray Alstrom, 


Alternate – Bill Kristovich 

ANHB – Bill Kristovich, 


7


Tribal Gathering XVII 

April 7&8, 2010 

YKHC leaders welcomed Tribal Council delegates 

from nearly all of the communities in the YKHC 

service area, along with many guests and visitors, to 

Bethel for the seventeenth Tribal Unity Gathering 

April 7–8. 

Delegates and guests begin arriving early on opening day. 

Nearly every seat available in the Yupiit Piciryarait 

Cultural Center was taken as people heard 

presentations about the region’s current health 

status and YKHC’s efforts to prevent cancer, 

diabetes, injury, infectious disease, and substance abuse. 

After a day and a half of presentations, delegates reviewed 

their ongoing concerns and presented their own set of priorities 

for the future. 

The theme for the Tribal Unity Gathering XVII was “Prevention 

today for Wellness Tomorrow.” As Medical Director 

Dr. Joe Klejka noted in introducing his report on the Health 

Status Scorecard, prevention is not a new idea, but has been 

central to YKHC’s vision of “striving to be the healthiest 

people” since its incorporation more than 40 years ago. 

YKHC has instituted screenings for health risk factors such 

as tobacco use, depression, and alcohol use in its patient 

exams and emphasizes tests and screenings for heart disease 

and cancer. The leading causes of death are still cancer, heart 

disease, unintentional injury and suicide. 

Presentations throughout the conference elaborated on the 

corporation’s prevention efforts. 

Alcohol & Substance Abuse 

Many preventable illnesses and injuries are attributable to 

alcohol abuse. Protective custody holds, which place a great 

burden on YKHC’s Emergency Room, are most often the 

result of binge drinking. Our alcohol treatment models 

are more effective for the chronic alcoholic than the binge 

drinker. We are addressing this with a new model called 

SBIRT—Screening, Brief Intervention, Referral to Treatment. 

This begins with every patient encounter—a short series of 

questions to determine 

a patient’s alcohol use. 

If potential problems 

are indicated, the provider 

presents information 

about alcohol 

use, and may refer the 

patient to counseling or 

treatment. 

Colorectal Cancer 

Early Detection 

Colon cancer is the 

second leading cancer 

Julia Street—one of many YKHC staffers 

who volunteer to help with the 

Gathering. 

killer among Alaska Natives. If everyone over age 50 had 

colonoscopies, 60 percent of colon cancer deaths could be 

avoided. Colonoscopies done at the Yukon-Kuskokwim Delta 

Regional Hospital increased from 225 in 2005 to more than 

650 in 2009. Approximately 60–70 cases of colon cancer per 

year are detected. YKHC can help with transportation costs 

for villagers who may not be able to afford the trip to Bethel. 

Women’s Health — Cervical and 

Breast Cancer Awareness 

A mammogram is the best way to screen for breast cancer 

and pap tests screen for cervical cancer. YKHC’s Women’s 

Health Program, through CDC’s National Breast and Cervical 

Cancer Early Detection Program provides access to timely 

breast and cervical cancer screening and diagnostic services 

for low-income patients. 

YKHC’s switch to digital mammography has reduced the 

turnaround time for test results to less than an hour from the 

10 days or more it used to take. 

8


“It’s important to work with the schools and 

faith organizations, IRA, community. All these 

things have to start from the village level. Thank 

you for the help of YKHC and the [Behavioral 

Health Aides] and we can take control of some of 

these problems.” 

—James Sipary, YKHC Board Member 

Preventing & Combating 

Infectious Disease (Flu & RSV) 

YKHC has been a leader in providing immunizations 

for children and, thanks to 

pandemic preparedness exercises, successfully 

dealt with the outbreak of swine flu this 

past year while simultaneously keeping up 

with regular seasonal flu vaccinations. 

Although there were more than the usual 

number of people sick with both kinds of 

flu, there were no deaths in our region, and 

many people were able to get their flu shots 

when the vaccine finally became available. 

Dr. Joe Klejka, YKHC Medical Director, explains the Health 

Status Scorecard, a measure of regional mortality. 

Sanitation Project and 

Funding Updates 

Although handwashing is a simple and effective 

way of preventing infections disease, 

in our region frequent handwashing is not 

so simple—many communities still lack 

running water and piped sewer systems. Of 

the 7,000 homes in the YK Delta, more than 

3,200 still do not have piped water. In funding 

dollars, this represents an unmet need 

of about $350 million. Historically, about 

half the water-sewer funding for Alaska has 

come to the YK Delta. About $68 million 

was allocated in 2009. 

Priority Updates 

Before determining 

priorities for the coming 

year, leadership 

reviewed progress on previous priorities— 

some of which have been high on the list for 

years: 

Assisted Living Home: Approximately half 

the funding needed for construction has 

been secured; we have hopes the other half 

will be included in this year’s state capital 

budget. Legislation is in the works that will 

allow for Medicare reimbursement based on 

actual costs—this will make operations, 

estimated to cost nearly 

$1.5 million more per year than 

revenue, much less problematic. 

Prematernal Home: Still seeking 

funding. 

Pharmacy Refills: The Direct to 

Patient project has been implemented 

region-wide and has 

proven successful. President/ 

CEO Gene Peltola said, “complaints 

to my attention about 

medication refills have been 

nonexistent.” 

Hospital remodels and equipment 

upgrades: Stimulus funds as well as other 

federal/state monies are helping with longneeded 

hospital and equipment upgrades: 

oxygen generators; a new CHSB electric 

generator; water and sewer line upgrades; 

hospital roof; digital mammography units; 

and OB, Radiology, OR, and Physical 

Therapy suite remodels, to name a few. 

Elder Martha Aparzuk with Board members James Sipary and Gloria 

Simeon, along with local high school students, took part in a panel discussion 

on suicide prevention. 

Delegates try out 

‘instant messaging’ 

The Public Relations staff introduced a 

new twist for the delegates at the 2010 

Gathering—an Audience Response 

System. 

Delegates were given hand-held remotes 

for voting on specific questions 

asked by presenters. Questions from, 

“How would you rate our coffee?” to 

“Do you think there is value to your 

village by having various levels of Behavioral 

Health Aides?” 

Audience members responded with 

a positive (yes) response (87%) to the 

Health Aide question. Our coffee service 

needs work. 

Overall, delegates from the region 

loved being involved in the remote voting 

process. 

“Being able to vote and have the results 

show up instantly.” “The question 

system.” “The Jeopardy stuff!” “Very 

organized. Cool Technology with video 

polling devices!” These were just some 

of the comments added. 

9


Setting Priorities 

With progress reports completed, delegates 

and board representatives took up the second 

aspect of Tribal Gathering work—determining 

priorities for the future. Unit representatives 

this year found that the general priority categories 

used in recent years to rate the order 

of concerns were inadequate for identifying 

more specific needs and concerns in their villages 

and added these concerns to their lists. 

Ivan M. Ivan, center, discusses health care priorities with Mike Williams and 

other Unit 4 representatives from Akiak, Akiachak, Tuluksak and Kwethluk. 

Unit 1 Alakanuk, Bill Moore’s 

Slough, Chuloonawick, Emmonak, 

Hamilton, Kotlik, Nunam Iqua 

1. Medical Providers 

• Improve provider vacancy rate. 

2. Community Health Aides 

• Improve Health Aide burnout. 

3. Hospital/Clinic Concerns: Quality of care/ 

Case Managing 

• Patients will be sent home sick from the 

hospital. 

• Patients need to be explained their rights 

as a patient, most importantly the right to 

ask for a second opinion. 

• YKHC needs improved communication 

with Tribal Councils. 

• Announcements should be made to villages 

when the SRCs do not have providers or 

radiology techs present. 

• Patients from outside of the villages need 

to be worked into the schedule. 

4. Improve Continuity of Care 

• It is not just elders that need home care. 

There are cases where middle-aged people 

require assistance around the house and 

they should be able to receive home care. 

• Physicians need to understand how to 

communicate to patients. When patients 

are told that they will only live for a given 

period of time, the patients often just give 

up. We need to tell the patients something 

positive. 

5. Elder Issues 

6. Village Clinic & Staff: Capital improvementsf 

• Village clinics need to be renovated 

• Need separate emergency room instead of 

treating the patient at the front entrance. 

Health Aides and support staff should be in 

separate rooms during patient counseling. 

• Clinic in Alakanuk is sagging. 

• It should not take three or four health aides 

to assist in an emergency. 

• It is important for all staff in the clinic to 

have a good attitude. 

7. Environmental Concerns 

8. Health Education 

• Provide the public health nurses with program 

materials for health education. 

9. Pharmacy 

• Elders need help with medication counseling 

and ordering. 

• Elders need translators for med reviews, 

medication counseling, and ordering. Many 

elders cannot simply pick up the phone 

adn call Bethel. Assistance is needed. 

10. Alcohol and Drug abuse 

• Reducing alcoholism requires as much support 

from the community as it does from 

YKHC. YKHC cannot do it alone. 

Unit 2 Andreafsky, Marshall, Mountain 

Village, Ohogomuit, Pilot Station, Pitka’s 

Point, Russian Mission, Saint Mary’s 

1. Alcohol / Drug Abuse Concerns 

• Underage drinking 

• Domestic violence 

• DUI 

• Sexual Assault / Abuse 

• Child Abuse, Neglect 

• Elder Abuse, Neglect 

• Homebrew and Bootlegging 

• Alcohol related injuries 

• Alcohol-containing products sold at stores 

• Need safe homes for kids / family to go 

(family break-up) 

• Suicide prevention 

2. Elder issues 

• Need for travel for escorts for elders 

• Elder neglect and abuse 

• Need assisted living / nursing homes 

• Need translators 

• Need home care / respite care 

• High turnover for home care workers or 

lack of workers 

• Programs for elders: Get-togethers—go 

places and do things together 


• Lack of health aide / no floats 

• No adequate housing for health aides 

• High turnover of health aides 

• New HA training 

• Need quicker emergency response 

• Need emergency transport vehicles 

• Clinic staffing in emergencies: need more 

staffing to keep clinic open for other patients 

• Need translators for Health Aides and Elders 

4. Patient travel 

• Travel for patient escorts 

• Slow getting travel approved / missed appointments 


• Test spring water and other community water 

sources for contamination 

• Dust 

• Annual flooding 

• Dumps and lagoons: Lagoon discharge into 

rivers 

10


Unit 3 Aniak, Chuathbaluk, Crooked Creek, 

Georgetown, Lime Village, Lower Kalskag, Red 

Devil, Sleetmute, Stony River, Upper Kalskag 

Unit 11 Anvik, Grayling, Holy Cross, Shageluk 

(Unit 3 & Unit 11 priorities are combined) 

1. Hospital / Clinic Concerns 

• Access to care 

• Quality of care 

• Misdiagnosis 


• Hiring, visiting villages / SRCs 

• Villages without Health Aides / Floats 

3. Village Clinic & Staff / Maintenance 

• Equipment and supplies 

• Insufficient funding to maintain clinics 


• Water and sewer 

• Waste removal in river 

5. Alcohol and drug 

abuse 

6. Behavioral health 

7. Health education 


9. Pharmacy 

10. Communication 

between YKHC 

Board Members and 

Tribal leaders 

Unit 4 Akiachak, Akiak, 

Kwethluk, Tuluksak 

1. Improve continuity of 

care 

• Ensure government 

does not reduce 

funding to IHS/YKHC 

• Patient transport to/ 

from Bethel 


• Local such as water/ 

sewer, etc 

• National issues such as oceans, fall-out, etc. 

3. Alcohol / Substance Abuse including Suicide 

Prevention 

4. Community Health Aide 


6. Pharmacy Issues 

7. Village Clinic & Staff / Capital Improvements 

8. Hospital Clinic Concerns 



Unit 5 Bethel, Napakiak, 

Napaskiak, Oscarville 

1. Capital Projects 

• Assisted Living Center is top priority 

• Prematernal Home (High infant 

mortality, ANTHC—treatment of 

of prenatals, low birth weight, 

prenatal visits, tobacco use, lack 

of general follow-up) 

2. Water/Sewer 

• No Water well in Oscarville. Two 

years ongoing problem. They're 

gathering water from fiver ice. 

Need water/sewer system. 

3. Behavioral Health / Alcohol Education 

to our people 

• STDs/Alcohol—elder abuse 

• Hypertension/stroke related to 

STDs 

Gail Alstrom calls Unit 2 representatives for a break-out session. 

4. Suicide Prevention 

• Upcoming generation trying to focus on 

the youth. Need for counseling in the village 

5. Sobering Center 

• More need for behavioral health services. 

With more money and training for Sobering 

Center, we can assess and provide follow-up 

on services 

6. Sex Education 

• 10-12 years since elimination of that department, 

there has been an increase in 

STDs 

7. Long Wait Times in ER 

• Need more providers to see patients who 

get tired of waiting and just leave. There is 

more than one doctor to see patients. 

Board Members Glen Watson, Sr. and Chris Larson share break time 

with Jacob Black of Napakiak. 

Unit 6 Atmautluak, Kasigluk, Nunapitchuk 

1. Village clinic and staff 

• Oxygen transportation concerns 

2. Alcohol / Drug Abuse concerns 


4. Behavioral Health / Suicide Prevention 

• Title 47 rules 


6. Community Health Aide Issues 

7. Improve Continuity of Care / Quality of 

Care Concerns 


• Visiting villages 

9. Health education 

• Sex education 

• Water safety 

• Injury prevention 

• Health careers promotion 

10. Pharmacy 

Board Chair Ray Alstrom presents a plaque 

to retired Aniak Health Aide Clara Morgan 

honoring the late Pete Brown, longtime 

Aniak Fire Chief. 

11


Unit 7 Kipnuk, Kongiganak, 

Kwigillingok, Tuntutuliak 

1. Alcohol and drug abuse (including inhalants. 

• Specifically requesting presentations by 

councilors at the schools and community 

2. Health Aides 

• Shortage of health aides 

• Shortage of float health aides 


• Sex education presentations at schools: 

talk about prevention and responsibility 

• Presenters should work with Tribal members 

to share 

4. Continuity of care with same doctors 

5. Elder care issues 

• Not enough home care providers 

Joyce Ekamrak, YKHC Clinical Services, assists Unit 6 

delegates in prioritizing their health concerns. 

6. Behavioral Health Aides 

• Would like to see more 

talking circles that involve 

the community 

• People coming back from 

jail should have the name 

and number of the BHA 

for further counseling 

7. Water & Sewer 

• All unit 7 villages have no 

water and sewer services 

• Health issues 

Unit 8 Chefornak, Mekoryuk, 

Newtok, Nightmute, Toksook 

Bay, Tununak, Umkumiut 

1. Hospital / Clinic Concerns 

• Patients are sent home sick from the hospital 

by the time the cause of their symptoms 

are determined, it is often too late, 

even if it had been preventable. 

2. Environmental Concerns - Water / Sewer 

• Water and sewer for villages 

3. Alcohol and drug abuse concerns 


• Specifically Behavioral Health Aide issues 


• Hiring 

• Visiting villages, SRCs 


• Care, neglect, respect, housing, nursing 

homes. 

• Some elders do not have someone to care 

for them in their villages. 

7. Village clinic and staff / Capital Improvements 

• Village clinics need snowmachines and 

ATVs 

• Patient transportation from the airport, to 

the hospital, and back to the airport 

8. Continuity of Care / Quality of Care 


10. Pharmacy 

• Medication refills 

Unit 9 Chevak, Hooper Bay, 

Paimute, Scammon Bay 

1. Water & Sewer—Dust, Dump, Lagoon 

2. Behavioral Health 

• Alcohol and drug abuse 

Julie Brown and Chrissie Christianson ponder priorities. 

• Parenting issues 

• Suicide prevention 

• Behavioral Health Aides 

3. Elder care 

• Provide locally 

4. Health Aide Support / Clinic Support 

• Equipment 

• Clinic hours 

5. Communication Between Villages and 


6. Access to Care 

• Travel 

• Time of provider in villages 

7. Medical Staff / Providers' Training 

• DHAT 

• Provider / Health Aide 

8. Parental Skills Training / Education 

Unit 10 Eek, Quinhagak 

1. Suicide Prevention 

2. Pharmacy 


4. Alcohol, Drug Abuse Concerns 


• Office assistant 

6. Appointments / Referral Process 

• Village to Bethel 

7. Environmental Concerns—Water/Sewer 


9. Hospital Clinical Concerns 


12


A Message from the President/CEO 

First of all, I want to commend and thank the employees of 

the Yukon-Kuskokwim Health Corporation. Not only do 

they perform tough jobs well on a daily basis, but they often 

go above and beyond the demands of the work and do so 

because they truly and deeply care about the health of the 

people they serve. This is what I admire and appreciate most 

about our employees. 

While YKHC and its workforce is directly concerned with 

people’s mental and physical health, the corporation also 

supports the financial health of the region with a thousand 

employees in Bethel and more than 400 in villages throughout 

the Delta, and an annual payroll of $70 million. 

Looking back at Fiscal Year 2010, I am pleased to say this 

has been one of our best years, financially speaking, in the 

21 years I’ve been President/CEO. Again, we exceeded the 

very important revenue goal of collecting $59.6 million from 

third party payers. Funding has been consistent, and we have 

received additional money to pay for building upgrades that 

will provide substantial energy cost savings in the future. 

Reauthorization of the Indian Health Care Improvement Act 

as part of the 2010 health care reform is also good news. Behavioral 

health programs will now include services for fetal 

alcohol spectrum disorders and domestic violence. Youth 

suicide prevention grants will be more accessible and escort 

travel for patients who need assistance during medical travel 

will be covered. 

In 2008, YKHC received approximately $30 million in a 

court settlement with the Indian Health Service for unpaid 

contract support. The Board of Directors wisely decided to 

invest that money in our own “Permanent Fund” and agreed 

not to touch the earnings for five years, while at the same 

time inflation-proofing the fund with a portion of any excess 

revenues. Since then, in spite of the recession, the fund has 

earned $4.5 million. In the future, the Board of Directors will 

use the earnings of the fund to improve health programs and 

support projects that will benefit the people of YK Delta. 

But we’re not waiting until then to put new programs and 

projects in place. It was only a few years ago that YKHC 

began meetings with the State of Alaska, City of Bethel, the 

Mental Health Trust and the BCS Foundation to seek a solution 

to the overcrowding of our hospital emergency room 

with protective custody holds—inebriated individuals who 

were really more in need of a secure place to sober up than 

emergency medical care. With the support of our state legislators 

Sen. Lyman Hoffman and Rep. Bob Herron, funding 

was secured, a program planned, and a facility designed and 

built in record time. This winter we held the grand opening 

of the new Bethel Sobering Center. 

Soon our ER nurses and providers 

will be able to attend to more pressing 

medical emergencies and our 

patients, and the inebriates as well, 

will be better served. 

Construction will begin in the 

spring of 2011 on the long-awaited 

Assisted Living Home, also thanks 

to legislative appropriation. This 

$18 million facility will have 18 

beds for elders and others in our 

communities needing 24 hour care 

and supervision. The design of the Gene Peltola, center, welcomes 

facility makes it expandable to another 

18 beds. The vision of a local 

Rasmussen Foundation President 

Diane Kaplan to Bethel. 

care facility goes back many years to 

former YKHC Board Member and Bethel Traditional Chief 

Antone Anvil, who dedicated his own later years to getting 

this kind of care facility built in Bethel. 

From taking care of our elders to taking care of our babies: 

The next priority is replacing the 38-year-old Prematernal 

Home, where expectant mothers from all over the Delta 

come for their last trimester of pregnancy so they can be 

close to prenatal care in case of complications. Our legislators 

are at work on it and have it at the top of the list for this year’s 

capital projects. 

Looking further to the future, we expect to finally assume 

ownership of a parcel of federal land near the old “White 

Alice” site west of Bethel. Just as environmental contamination 

of the old buildings was being completed a few years ago, 

it was burned by vandals. US Fish and Wildlife took control 

of the parcel and, once the fire damage has been cleaned up, 

will transfer the property to YKHC. Concrete slabs and steel 

foundations of old structures will remain in place and can be 

used for new facilities. 

In closing, I would like to thank the YKHC Board of Directors 

for their continued trust and the opportunity to serve 

this great corporation for the past 21 years. It is humbling 

and gratifying as I look forward to the years ahead, working 

together with you to achieve the excellent health our people 

deserve. 

Gene Peltola, President/CEO 

13


2010 Corporate Goals 

YKHC’s strategic plan 

for achieving excellence 

in health care is called 

Napartet, a Yup’ik word for a 

ship’s mast, a trail marker or 

a supporting pillar. 

As our Road to Excellence, 

Napartet identifies five 

pillars essential for the 

success of our mission. 

Each year, corporate goals 

are adopted under each 

pillar as a measure of our 

success and a guide to 

making improvements 

Patient Centered Excellence 

Dental Health Aide training: Tiara Sage prepares to give a 

fellow student oral hygiene Instruction. Fritz Charles observes 

in the background. 

Increase Press-Ganey Scores of “Very Good” to 50 percent 

Press-Ganey is an independent rating service many hospitals contract with to measure 

customer satisfaction. Services are rated from “Very Poor” to “Very Good.” To bring up our 

“Very Good” scores, we concentrated on service improvements throughout the hospital and 

subregional clinics. Because patients who receive surveys sometimes don’t return them, we 

also worked to raise awareness of their importance to us in maintaining excellence—not only 

among patients, but also among our employees. 

As a result, the goal was exceeded by our OB Dept. and our subregional clinics in St. Mary’s 

and Toksook Bay. Overall, “Very Good” scores have been on the increase 

• FY08: 37 percent • FY09: 39 percent • FY10: 40 percent 

And our “Mean Score” has also improved—fewer “Poor” scores and more “Good/Very Good” 

scores. 

Customer satisfaction remains the best indicator of our committment to excellence. We will 

continue to use Press Ganey reports to identify the specific areas where we most need to apply 

our efforts. 

FY2011 Goal 

Increase screening rates for colorectal cancer, breast cancer and cervical cancer to 

meet or exceed Healthy People Goals 

Employee Focus 

Increase Employee Satisfaction with Senior 

Leadership Communications by 10 percent 

An essential contributor to patient satisfaction is employee satisfaction. An employee survey 

two years ago revealed an unacceptable dissatisfaction among employees with the level and 

quality of communication between Senior Leadership (CEO, vice presidents and key corporate 

officers) and non-management employees. The Senior Leadership Team (SLT) set a 

goal of improving this score, initiating quarterly forums to keep employees informed about 

significant developments, financial status, policy changes and new benefits. SLT also participated 

in welcoming new employees and recognizing the accomplishments of customer service 

“champion” employees. The result of these efforts was a marked improvement in employee 

satisfaction with SLT communication on last year’s employee survey. 

FY11 Goal 

Increase employee satisfaction by 5 percent with our benefits package 

14


Alaska Native Workforce Development 

Maintain 100 percent recruitment rate for Registered 

Nurses & Dental Health Aide Therapist 

A media campaign placed poster and flyers in all village council offices as well as Tribal agencies 

in Bethel (AVCP, ONC, UAA, YE) promoting YKHC’s career scholarships, sponsorships 

and training programs for Nurses, Dental Health Aide Therapists and Physician Assistants. 

Nurses visited village schools and worked with YKHC’s Career Pathways program to introduce 

children to the benefits and rewards of careers in health care. 

Five students graduated the RN training program in 2010. Three YKHC-sponsored Dental 

Health Aide Therapists (DHATs) graduated and are currently in preceptorships at Yuut Elitnaurviat, 

the People’s Learning Center. YKHC is sponsoring four more DHAT students in the 

current two-year training program. 

The media campaign and training programs will continue through YKHC’s Area Health Education 

Center (AHEC) and Human Resources Recruitment Office. 

FY11 Goal 

Increase retention of skilled employees by 5 percent 

Community and Partner Satisfaction 

Increase Tribal Satisfaction Rate to 85 percent with 15 

Tribal Council Feedback Cards returned per month 

We collaborate with many local, state and federal entities to provide access to the best health 

care possible for the people in our region. But our primary partnership is with Tribal Councils, 

who represent our customer-owners and authorize our IHS compact. Communication 

is essential to this partnership, so we ask employees who travel to villages to meet with Tribal 

Councils, discuss current health issue talking points and solicit feedback in the form of mailback 

survey cards. Traveling employees received training on deploying the card, delivering 

talking points and reporting visits consistently to ensure reliable figures. To improve efficiency 

in returning the feedback surveys, an online version was deployed. 

The Tribal Council satisfaction rate improved to 87 percent during the fiscal year. 

FY2011 Goal 

5,000 employee community volunteer hours completed in 2011 

Financial Viability 

Collect $56.9 million from Third Party Payers 

Our federal funding from the Indian Health Service is chronically insufficient to meet the 

need, and the expense of providing health care. Consequently, YKHC must collect additional 

funding from Medicaid, Medicare, private insurance and as many other third party sources as 

are available. 

The goal of $56.9 million was exceeded in FY2010 with $57.6 million collected. Instrumental 

in this success was increasing Medicaid enrollment and decreasing Medicaid payment denials. 

Care is also being taken to see that patients are not discharged before the billing process is 

complete and that billing is properly submitted to third party payers. 

FY2011 Goal 

Collect $56.9 million from third party payers 

15


SPOTLIGHT: 

Programs, Services, Achievements 

Community Health & Wellness 

The WIC Program celebrated Alaska’s World Breastfeeding 

Week October 3–9 by recognizing 10 WIC moms 

who breastfed for more than six months. A certificate was 

awarded to each mom with a picture of both mom and baby 

and a message about her breastfeeding experience, posted 

on the WIC office poster board. 

WIC caseload continued to be at least 10% above grantordetermined 

targets throughout the whole program year. 

Diabetes Prevention & Control 

The YKHC Diabetes program works actively to improve care 

for people with diabetes in our region and supports YK Delta 

schools and communities in programs that encourage physical 

activity or improve nutrition. 

• In November, the Diabetes Program in partnership with 

hospital staff conducted a Diabetes Specialty Clinic at 

which 23 patients met with a diabetes specialist. 

• A nutrition/physical activity workshop served 17 children 

with metabolic syndrome. 

• Mini grant awards for School Physical Activity distributed 

more than $39,000 to 11 YK Delta Schools. 

• Twelve communities received physical activity or garden 

awards to support their efforts to improve physical activity 

and nutrition. Nearly $41,000 was awarded. 

Nicotine Control & Research 

The YKHC Nicotine Control & Research Department is 

currently supported by several grants including the State of 

Alaska Tobacco Prevention grant, the IHS HP/DP grant, and 

a grant from the Mayo Clinic. Services include cessation, 

prevention, and research. 

This year we re-formed the Delta Tobacco Control Alliance, 

drawing representatives from a large number of agencies 

to work towards decreasing tobacco use in the region and 

preventing tobacco use among youth. 

We increased cessation counseling to pregnant women. A 

counselor contacts all pregnant women who use tobacco to 

offer our cessation services. In addition, bi-weekly presentations 

are held at the pre-maternal home and media efforts 

promote prevention. 

WIC Director Khadija Alharbi presents a certificate to Macrina 

Nicolai and her breastfed baby Andrea. . 

16


Facilities & Capital Projects 

Village Health Clinics 

• Kasigluk—Opened Nov. 3, 2010 

• Mountain Village—Construction in progress 

• Nunapitchuk—Construction in Progress 

• Planning: New clinics are in various stages of planning 

for Napakiak, Akiachak, Chevak, Kongiganak, 

and Tuluksak 

• Atmautluak—Foundation Repair 

• Kwigillingok—Clinic Addition 

American Recovery and 

Reinvestment Act (Stimulus) 

Construction is scheduled for 2011 for the Hospital 

roof replacement, Hospital Ambulance Bay Extension, 

and the Delivery Room Remodel. Projects completed 

or nearly complete: Hospital Ramp Modification and 

Repair, ER Door Relocation and Safe Room Renovation, 

Hospital Oxygen Generator Installation. 

Other Projects 

Completed: Physical Therapy Suite Renovation, Radiology 

and Digital Imaging Renovation Design, Operating 

Suite Renovation Design, Sanitizer and Boiler Room 

Combustion Air. 

Planned for 2011: Hospital Transformer Replacement 

and CHSB Generator Replacement 

Future Projects 

• Hospital Medical Gas Line Replacement 

• Hospital Sewer Line Replacement 

• Hospital Main Entrance Stairwell Design 

• Hospital Field Wiring Improvements Design 

State Funded Projects 

Assisted Living Home: Site adaptation and analysis 

is underway, funding is in hand and construciton will 

begin in Spring, 2011. 

Prematernal Home design is 95 percent complete. It’s 

our top priority for legislative capital project funding. 

The Sobering Center opened in January, 2011. 

Welder Chad Latham puts his skills to work on the foundation of the Sobering Center. 

YKDRH Ramp 

Modification 

and Repair 

The grating on the 

ramp at the entrance 

to the hospital’s West 

Wing office building 

made it difficult to 

push wheelchairs up 

and down. 

To try to correct 

this problem matting 

Installing a new ramp surface at the hospital 

entrance. 

had been laid on top of the ramp grating, but it became very slick 

during the winter and defeated the purpose of the metal grate, 

which was to allow snow to fall through. The risk of patient and 

employee injury was a great concern. A new non-skid surface was 

installed and the ramp now complies with regulations. The height 

of the handrails was also non-compliant and this was corrected. 

From: Olinka Nicholas (Behavioral Health Aide, Kasigluk) 

Subject: My office 

“Have you ever sat inside a brand new car? Well that’s what 

my office smells like...a brand new car. I have my own space, 

my own phone, my own puter. I am sitting here on my desk 

eagerly waiting for my first phone call. Just wanted to say that 

I am very appreciative that YKHC has made it possible. “ 

17


Behavioral Health Services 

18 

Suicide Prevention 

Success in 

Chuathbaluk 

MSPI (Methamphetamine 

& 

Suicide Prevention 

Initiative) is 

an Indian Health 

Service program 

funding culturally 

relevant intervention 

and education 

resources in Native 

communities. 

Behavioral Health Aide Louis Mallette 

shares thoughts with Father Michael and 

an Elder in Chuathbaluk. 

Chuathbaluk was selected to be one of the first MSPI communities 

in Alaska after there had been six attempted suicides 

by young people in a four month period. 

Various gatherings over the next year promoted 

wellness, cultural values, healing, 

healthy relationships and traditional parenting. 

People told their stories and youth were 

encouraged to participate. Children danced 

and Elders shared. Everyone ate good food 

and had fun. 

Small grants paid for a youth leadership 

training. A teen center was opened in the old 

Tribal Council building and the community 

received a small grant to pay for a part time 

staff. After-school activities and monthly 

community birthday parties were held. A 

rummage sale helped raise funds for activities and now a 

small secondhand store run by the youth helps pay for supplies. 

After a year the people can look back and see lots of little 

steps that are moving the village forward toward a healthier 

community. They have seen examples of people talking to 

one another, involvement of youth in activities, people healing 

and asking forgiveness and adults intervening to keep 

children safe. But most importantly, during the months 

since the last MSPI-sponsored event suicide attempts have 

dropped to zero. 

“The greatest thing to do is love one another. 

Love can set free all the hurt that is inside. 

Showing that you love and care will make our 

youth stand taller.” 

—Erica Stone, Hooper Bay, at the 

Suicide Roundtable Summit 

Suicide Roundtable Summit 

In the YK Delta suicide rates are six times the national average. 

On the afternoon of October 4, 2010, many state leaders 

gathered with youth, advocates and policy makers at Bethel’s 

Yupiit Piciryariat Cultural Center at the request of Senator 

Lisa Murkowski to discuss the issue and seek solutions. 

Governor Sean Parnell, along with legislative representatives 

Panelists at the Suicide Roundtable Summit 

Anna Fairclough, Berta Gardner, and Bob Herron, as well as 

health service officials and local advocates participated in a 

roundtable discussion which drew nearly 200 participants. 

The goal of the roundtable was to learn from communities, 

their perspectives on the issue and what they believe would 

be solutions and to share resources available to the communities. 

“How are we failing our young people and what more can 

be done?” asked Senator Murkowski. Although the forum 

was to last from 1:30 to 4:00 p.m., Murkowski insisted that 

she would not leave until she heard everyone who wanted to 

share their stories. 

Family members and survivors of attempted suicide provided 

testimonies throughout the afternoon. Perhaps the


most compelling words came from about a 

dozen teens who managed to find the courage 

to speak in front of the large gathering of 

participants. 

Murkowski proposed that a Suicide Roundtable 

for Youth convene in early spring and 

YKHC and AVCP were on board to make it 

happen. 

SBIRT 

Screening, Brief Intervention & Referral to 

Treatment—SBIRT—has been adapted and 

implemented as a part of patient exams in the 

Emergency Room and outpatient clinics. 

SBIRT gives medical providers a way to detect 

if a patient may be doing high risk drinking 

and address it through education, raising 

awareness and, if appropriate, a referral for 

further assessment. This can help reduce the 

health risks associated with alcohol use and 

mis-use. 

Since implementation of SBIRT, 2,503 patients 

have been screened for their alcohol 

use. Of the patients who have been screened 

about 80 percent are drinking at low-risk 

levels or abstaining from alcohol altogether. 

Twenty percent were given the brief intervention 

and/or a referral to treatment. 

IMPACT 

In 2010 YKHC Behavioral Health partnered 

with the Alaska Mental Health Trust, the University 

of Washington, and Alaska Psychiatric 

Institute (API) to adapt IMPACT services 

for YK Delta patients in the family medicine 

outpatient clinics at the hospital. 

IMPACT—Improving Patient Access to 

Collaborative Treatment—integrates mental 

health services with primary medical care. 

All patients who come to appointments in 

the outpatient clinics will be screened with a 

questionnaire. Patients whose scores indicate 

moderate depression, or any score that 

indicates recent suicidal thoughts, will get a 

follow-up call or visit with the IMPACT Care 

Manager or the IMPACT Clinician. Weekly 

contact helps patients stick to their treatment 

plans and return to finding enjoyment in 

their daily lives. 

IMPACT is still in the planning stage, with 

training and implementation scheduled for 

2011. 

Community Support 

YKHC promotes community involvement, 

recognizing that the “working 

together” part of our mission is not 

just in reference to employee teamwork, 

but includes outreach and 

participation in community events, 

celebrations, health fairs and healing 

circles as well as support for our partner 

organizations and their missions. 

Mass Dispensing Exercise 

A city-wide flu shot clinic was held in 

Bethel in October. This annual event 

brings out volunteers from all health 

and safety oriented agencies. Besides 

dispensing vaccine to residents in an 

effort to reduce influenza, the exercise 

serves as a training opportunity 

for emergency preparedness. 

YKHC supports Bethel 

Senior Center 

On January 7, YKHC President/CEO 

Gene Peltola and Dan Winkelman, 

Administrative Vice President and 

General Counsel, presented a $75,000 

check to the Orutsurarmiut Native 

Council’s Senior Services Director 

Thelma Kaganak, much to the delight 

of approximately 30 seniors who attended 

the presentation luncheon at 

the Eddie Hoffman Senior Center. 

ONC’s Executive Director John 

Guinn and Chairman Ray Watson 

thanked YKHC for its generosity and 

for understanding the importance 

and value these funds will play in 

providing services and program support 

for YK Delta seniors. 

“Without donations such as this one, 

we would not be able to operate the 

many programs that are vital to the 

center which provide the support 

our elders and senior citizens need,” 

Guinn said. 

Teresa Markham gives a needleless flu vaccine to 

Tess Baez-Terry while Kusko the Immunization Dog 

observes at the Mass Dispensing Flu Clinic held at 

the Bethel Armory in October. An estimated 350 

shots were given to residents across the Delta. 

YKHC presented a check for $75,000 to the Bethel 

Senior Center. From left, YKHC Administrative Vice 

President Dan Winkelman, President/CEO Gene 

Peltola, Senior Center Director Thelma Kaganak, 

ONC Executive Dir. John Guinn, ONC Chairman Ray 

Watson. 

The community of Kasigluk celebrated the grand 

opening of their new village clinic in September. 

19


Patient Care Services 

Prematernal Home 

Dental Program 

With many children of the 

YK Delta having tooth decay 

severe enough to be referred to 

the operating room, the dental 

clinic is focusing on mothersto-be 

in its dental decay prevention 

strategy. 

The Prematernal Home Dental 

Program was started with the 

idea that if mothers-to-be 

learned how to achieve and 

maintain good oral health for 

themselves and their children, 

their children may not ever 

have to deal with such severe 

tooth decay. 

An expectant mom gets a dental 

check-up as part of the dental 

program at the Bethel Prematernal 

Home. Photo by Kelly Nance. 

Dental Health Aide Therapist Sheena Nelson came up with the 

idea in 2008 when she was completing her second year of training 

in Bethel. Sheena started by teaching the mothers-to-be about the 

importance of maintaining oral health. 

When Sheena left to work in Yakutat, another DHAT, Tambre 

Guido, took up the program, adopting a more involved approach we 

refer to as motivational interviewing, engaging the mother in discussions 

about her own teeth, why baby teeth are important, what a 

cavity is, and how a mother can prevent baby tooth decay. 

Tambre and YKHC Dentist Dr. Judith Hall soon partnered to take 

the program to the next level. The education is combined with 

dental care for the mothers at the Bethel Dental Clinic so they can 

stabilize their own dental decay before the baby is born. 

Many of the mothers are unaware that a cavity is bacteria and that 

bacteria can be passed on to their baby, making them more susceptible 

to getting cavities. This happens when a mother tastes her 

baby’s food first with a spoon and then uses the same spoon to feed 

the baby, or wipes pacifiers/bottles with her own mouth and gives it 

back to the baby. 

The partnership between DHATs and Dentists will continue to drive 

the program forward and as it develops, we hope to decrease the 

number of children with dental decay. 

Mammography staff. Cynthia Flores, left, and Merrilyn 

Blackmore, third from left, join representatives from Planmed 

and Fuji next to the PLanmed Nuance mobile mammography 

unit—bringing healthcare closer to home in our subregional 

clinics. Photo by Patient Care Servcies staff. 

Subregional Mammography Clinics 

Breast cancer is one of the top three cancers affecting 

American Indians and Alaska Natives. 

During FY2010, YKHC’s subregional clinics provided 

mobile mammogram screenings on a rotating basis. 

With the help of SOPHIE (our mobile mammogram 

unit) and Cynthia Flores, (YKHC’s equally mobile 

traveling mammographer), more than 215 mammograms 

were completed in the five SRCs. Each screening 

brings us closer to our vision of being the healthiest 

people. 

“Having a mobile unit makes it much 

easier and more convenient for women in 

remote areas to get the screenings. It feels 

great to be able to bring a service out to 

where it is needed.” 

—Cynthia Flores, Mammographer 

The mobile mammography machine is also a substantial 

money saver. An estimated $90,000 was saved in 

travel alone by providing the service in the subregional 

locations. 

20


Endoscopy in 

Toksook Bay 

In what turned out to be 

a very successful firstever 

trial, an Endoscopy 

Clinic for colonoscopies 

was held at Toksook Bay 

Subregional Clinic in 

September. The procedures 

are usually done 

at the Bethel hospital, requiring 

expensive patient 

travel from villages. The clinic examed 21 patients. 

Endoscopy Team. Back row: Stephen Davis, Lisa Boyd, 

Glen Jorgensen, Nancy Reamsma. Front Row: Jeremy 

Larsen, Tim Self. Photo by Matthew Willard, Toksook Bay 

SRC. 

“We hope to double that number the next time around,” said 

Clinic Administrator Diana Therchik. 

patients. Approximately 80 percent of our 

patients who came in with neck or back pain 

resolved to zero pain—managed primarily 

with home exercise (not medication) within 

five visits. 

With additional therapists on staff, we were 

able to travel to Hooper Bay six times for sessions 

in their new SRC. The increased access 

to care has been fully utilized, and we have 

seen more patients this year than ever before. 

Wound Care 

This program was developed to provide a dedicated and 

licensed provider focusing solely on wound care. Our wound 

care nurse Rachelle White provided care to more than 1,300 

patients. She served in a part-time role that frequently kept 

her here after hours as she made sure our patients had what 

they needed to heal properly and without fear. 

Rachelle is also a wound educator. Her time is balanced between 

inpatient, education and outpatient roles. She consults 

daily for medical and nursing staff, receives phone calls from 

health aides, and conducts training sessions for all levels of 

health care professionals. The medical staff has given this 

program excellent reviews. 

This program has filled a need that has existed for a long 

time in our hospital, and many patients have commented on 

how grateful they are for this specialized care. 

Physical Therapy Director Kate Huckert confers with a patient in the 

newly remodeled PT clinic. 

Recognition of Nurses 

Physical Therapy 

We remodeled our treatment areas and our front desk reception 

in 2010. Our beautiful new clinic is both welcoming and 

therapeutic. We now have a reception window where patients 

can register and make appointments without walking into 

the clinic. 

Our secretary’s front desk area protects patient privacy. Moving 

the director’s office opened up a fourth treatment room. 

We added two large pieces of exercise equipment and various 

educational and exercise gadgets. The increased visibility has 

increased our business, and we are helping lots of patients. 

Over the past two years, all staff therapists have completed a 

rigorous post-graduate course of study and passed their certification 

exam in the McKenzie Mechanical Diagnosis and 

Therapy (MDT) method. They’re among only two percent 

of therapists nationwide with this certification. The result of 

this remarkable accomplishment. is improved outcomes for 

YKHC was well represented at the March of Dimes “Nurse of the Year” 

awards. From left: Ann Glasheen, Women’s Health Practitioner; Dawn 

Hackney, Nurse Manager of the Outpatient Clinics; Nikko Mc- Cabe, 

OPC Scheduling Manager; Louise Reed, Outpatient Clinics Director; 

Claire Lewis, Women’s Health Practitioner; Angela Williams, Charge RN 

for Delta Clinic. Brenda Lamont, RN, not pictured above, was nominated 

as Case Management/Care Coordinator of the Year. Photo courtesy 

March of Dimes. 

21


Village Operations 

Well Child and 

Immunizations 

Over the past year, there 

have been many changes 

to the Well Child and 

Immunization Programs. 

The two programs have 

been combined under 

one coordinator, allowing 

us to hire a Community 

Health Aide Practitioner 

and RN to assist with 

Health Aide follow-up in 

the villages. 

During the past year, 

25 more Health Aides were trained to perform Well Child 

Exams which resulted in completing over 1,000 more exams 

than the previous year. As a result, 3,784 Well Child exams 

were performed by Health Aides in village clinics; more than 

700 were performed by Health Aides in subregional clinics 

and 1,524 performed by providers in the hospital. 

The YK Delta's immunization rates for children age 19–35 

months remain higher than the rest of the state at 86 percent. 

Chris Denoyers, Dr. Ros Singleton and Martha 

Lauterbach, part of the Pneumo 13 study group. 

Michelle Olick-Pavila, CHP, from 

Kwethluk with her son Jason 

(Rengie) Pavila. 

Prevnar 13 

Approval 

Prevnar 13 vaccine 

is now approved 

and licensed by the 

U.S. Food and Drug 

Administration 

(FDA) and has replaced 

the Prevnar 

7 vaccine as the 

routine pneumococcal 

vaccine. 

The pneumococcal bacteria causes brain, lung, blood, and 

some ear infections. The new vaccine is an improved Prevnar 

that protects against six more pneumococcal types. The vaccine 

is important to the YK Delta region because children 

residing here have had very high rates of pneumococcal 

infections. 

This brings to a close YKHC’s yearlong research study to 

provide the vaccine in the year before licensure in our region 

where there is high incidence of pneumo disease. 

“We want to thank the all of the participants the study and 

Community Health Aides and Clinic Staff who worked on 

the study,” said Dr. Ros Singleton of the Alaska Native Tribal 

Health Consortium, who worked with YKHC Health Aides 

and staff for the duration of the study. 

CHAP Clinical Instructor Lon Putnam congratulates Lorraine 

Tomaganuk-Moses, CHP, at graduation ceremonies in May. 

Six graduates become Community 

Health Practitioners 

Lon Putnam, Clinical Instructor for the CHAP Department, 

handed six graduates their Community Health Practitioner 

(CHP) certificates during commencement exercises held 

at the Yupiit Piciryarait Cultural Center May 7. Putnam 

described the graduates as family and appreciated their dedication 

to learning. 

“This group, across the board, is calm, cool, and intelligent, 

and not to be forgotten good role models,” said Rita Kalistook, 

a Senior Basic Training Instructor. “We all start out 

as instructors and students and end up as colleagues and 

friends.” 

Our 2010 CHP graduates: Lorraine Moses, Hooper Bay; 

Evelyn Tunuchuk, Chefornak; Twila Chayalkun, Chevak; 

Martha Nicolai, Quinhagak; Justina Phillip, Tuluksak; and 

Stella Leopold, Emmonak. 

22


Another Side of Service 

The New YKHC 

Retail Store 

We merged the Gift Shop, the 

ICEMS Sales Shop and the 

Coffee Bar all into one Retail 

Store located past the elevators 

in the main floor lobby 

of the Community Health 

Services Building. All the 

safety gear such as helmets, 

ice cleats and life jackets are 

available along with coats, 

blankets and gift items. 

And the best part? Coffee! 

Our barista is serving up 

fresh brewed coffee as well as 

espresso drinks using Kaladi 

Brothers Coffee beans. We 

are offering flavored syrups 

for your espresso drinks, hot 

chocolate, and soy milk. 

The store is open to the public. We encourage everyone to stop in for a visit. 

Mail and phone orders are also accepted for PFDs, helmets, float coats, and 

other safety items. 

Public Relations summer intern Sherry 

Alstrom serves at the Employee 

Appreciation Barbecue in August. 

Teresa Markham, Retail Store coordinator, 

shows merchandise to a customer at last year’s 

Tribal Gathering. 

Employee BBQ brings a 

taste of the Islands 

YKHC’s Employee Appreciation 

BBQ, held on August 20 in Bethel, 

was a fun and festive event— 

thanks to the decorations and 

ambience of a Hawaiian luau. 

Fresh Kuskokwim salmon took 

the place of the roast pig, but 

some tasty dishes prepared by 

YKHC’s Chef Callahan and the 

traditional picnic fare of hot dogs 

and hamburgers rounded out the 

menu while hawaiian music and 

strumming ukuleles played in the 

background. 

The Senior Leadership Team 

tended to the grills, sponsoring 

the event to acknowledge and show appreciation 

for all YKHC Employees’ hard work and dedication 

to the health of the people of the region. 

Project Management helps 

Technology ‘get the job done’ 

Over the past two years, YKHC’s Information 

Technology Department has been using the Project 

IT Desktop Support Supervisor Chhay Thon answers a call. 

Management Institute’s best-practices for managing 

projects, resulting in 46 projects completed this 

year—a record number. And, they were completed 

on time. 

Everyone throughout the corporation was affected 

in one way or another by the changes involved in 

these projects. One of the most significant was the 

transfer to Microsoft ® Outlook as the organization’s 

communication, email and personal management 

system, which was rolled-out to 1,376 

employees, replacing the FirstClass email system 

which had been in place since the mid-1990s. 

Another significant project was the expansion was 

a new telephone system in the clinics, hospital and 

administrative offices. The new telephones use 

“Voice Over IP,” which uses the internet for telephone 

transmissions. 

These technology upgrades are paving the way for 

future advances in communication and improved 

patient care. 

23


In Memoriam 

TED STEVENS, 

UNITED STATES SENATOR 

November 18, 1923 – August 9, 2010 

WHEREAS: 

WHEREAS: 

WHEREAS: 

WHEREAS: 

WHEREAS: 

WHEREAS: 

WHEREAS: 

The Mission of the Yukon-Kuskokwim Health Corporation 

is “Working Together to Achieve Excellent Health”; and 

The Yukon-Kuskokwim Health Corporation provides 

health care services to the Alaska Native People of 

the Yukon-Kuskokwim Delta of Alaska in Compact 

with the United States Indian Health Service; and 

In 1968 Ted Stevens was appointed to the 

United States Senate from Alaska; and 

YKHC was incorporated in 1969; and 

Senator Ted Stevens tends to the grill during the 

YKHC employee picnic, August, 2008. 

Throughout his career in the United States 

Senate Ted Stevens was a good and steady friend of Alaska Native People and particularly 

the Yup’ik, Cup’ik and Athabascan People of the YKHC Service Area; and 

Ted Stevens was instrumental in appropriating funds for the construction of the Yukon- 

Kuskokwim Delta Regional Hospital, and through his creation of the Denali Commission was 

responsible for the construction of many new Village Clinics in our region, as well as many 

other initiatives that improved the health and well being of the people of the YK Delta; and 

Senator Ted Stevens was always a welcome visitor to YKHC and the Yukon- 

Kuskokwim Delta, taking the time to speak to everyone he met and maintained 

long held and deeply valued friendships with many of us; and 

WHEREAS: Theodore Fulton “Ted” Stevens perished in an aircraft accident on August 9, 2010 

NOW THEREFORE BE IT RESOLVED 

that the memory of Senator Ted Stevens is honored by the Executive Board of the Yukon- 

Kuskokwim Health Corporation in recognition of his decades of commitment to the 

wellbeing of all Native People and his contributions to bringing real change to our 

region through appropriations and policies and for this we are forever grateful; 

AND BE IT FURTHER RESOLVED 

that the condolences and remembrances of this body are extended to his family, friends 

and colleagues on behalf of all the Alaska Native People of Western Alaska who have 

benefitted and will continue to benefit from his efforts on all our behalf. 

By Unanimous voice vote this 26th day of August, 2010 

24 

_______________________________ 

Ray Alstrom, Chairman 


_________________________________ 

William Kristovich, Vice-Chairman 

YKHC Board of Directors

www.ykhc.org 

cover photos by Debbie Michael

REPORT TO THE PEOPLE 

2010

report to the people 2010 - Yukon-Kuskokwim Health Corporation

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