Association of Alaska Community Health Aide Program Directors Anchorage, AK – May 10-11, 2007 Meeting Minutes AACHAPD Approved September 21, 2007

DATE: May 10-11, 2007 CHAIR: Steve Gage VICE-CHAIR: Crystal Stordahl SECRETARY: George Drinkwater RECORDER: Tamaree Kawagley Guests/Organization Torie Heart ANTHC Walter Starkloff Native Village of Tyonek Tamaree KawagleyMember / Organization ANTHC Member / OrganizationKaren O’Neill NSHCMember / Organization MichelleGeorge PeterHall Akiachak Native CommunityANTHC-CHAPA TrainingGay Brewer Center HoonahMike IndianO’Neill Association A Helena Bock SCF Ninilchik Traditional Cnc. P TaniaAnnette Smallenberg Siemens APIAI ANTHC-ImmunizationA Alicia Lynn Reft KarlukJoyce Tribal Hughes Council A Rosanna LemenState of AlaskaNorth Slope Borough P LouPatrick Christie Mahoney BBAHC ANTHC-SPANP Jud Brenteson KodiakDebra Area Reed Native Assoc. P Vacant Tanana ChiefsNorton Conference Sound Health Corp. A CharleneJane Martin Walker Chickaloon Village State of Alaska-A Herman Medicaid Geffe, Sr. ManiilaqLinda Association Curda P Dr. Donna GalbreathUAF-CRCDSouthCentral Foundation A LisaKris WinterBrooks Chitina Traditional VillageMedImmune Cnc. A Vacant MetlakatlaJohn Riley FMC A Steve Gage University ofSEARHC Washington-MEDEX A Matt Rogers Chugachmiut P George Drinkwater Mt. Sanford Tribal Consort. P Crystal Stordahl Tanana Chiefs Conference P Crystal Talyat Copper River Native Assoc. P Etta Menadelook Native Village of Diomede A Josephine Grant Tanana Tribal Council A Lona Ibanitoru CATG A Fannie Hernandez Native Village of Kwinhagak A Leslie Jones Yakutat A Katherine Cart Eastern Aleutian Tribes A Cassandra Trenton Native Village of Tyonek P Bill Schreiner YKHC P

SUBJECT DISCUSSION / RECOMMENDATION(S) RESOLUTION(S) FOLLOW-UP

Review of Agenda Steve Gage was unable to attend. Crystal Stordahl will be acting in place of Steve. Motion to approve the agenda by George Drinkwater. Motion seconded by Jud Brenteson. 9:00 AM. Introduction Members did an introduction. ARC Report- Field Review Form (5/07 draft)- Between now and the Jud Brenteson  Went to Convocation and worked with field supervisors, health aides and with other ARC members September meeting, that had their own tool for doing field reviews. Put them together into one form to be used as a tool the CHAP Directors or guide that has everything a person would need to perform a field evaluation. Not all the items will review the listed are what all field supervisors would do, but it is a guide to do field reviews. following forms by ARC:  Would like CHAP Directors to review from between now and the September meeting, will send it out to members not present today. Would like approval at the September meeting. -Field Review Form Unit 6a and Unit 6c- -Unit 6a and Unit 6c  Have been curriculum changes to Unit 6a and 6c. Needs to be reviewed by AACHAPD and -Clinical Math determined if it would affect the standards, then go to CHAP Certification Board for review. Entails Assessment and updating units to the new CHAM and current practices in emergency medicine. Remediation Form Clinical Math Assessment and Remediation Form (revised 5/8/07)- -RN/CIs Attending CHA Basic Training Page 1 of 14 AACHAPD Approved 9/21/2007  Form has been expanded and clarified to include a more detailed explanation of expectations for for CHA Backup administering the clinical math skills test. Jud Brenteson will also  A committee was appointed to review it. ARC approved the form and would like CHAP Directors to send forms out to review from between now and the September meeting, will send it out to members not present members not present today. Would like approval at the September meeting. today. RN/CIs Attending CHA Basic Training for CHA Backup (revised 5/07)- Forms will be  Tool for an RN or CI to attend session training, and they can attend as a 7 th person in a 6-student brought up for class. They don’t participate in the clinicals, the clinicals are done in their home community or approval by region. AACHAPD at the September 2007  There was some language that the training centers felt were not as detailed to reflect what is meeting. expected. Will see the clarifications in numbers 4, 5, & 7. Training centers felt there needed to be deadlines, and expectations of what a person can do, who the instructor can be.  Would like CHAP Directors to review from between now and the September meeting, will send it out to members not present today. Would like approval at the September meeting. CHA/P Clinical Evaluation Form (5/07 draft)-  Several regional health organizations have clinical evaluation forms, a checklist similar to a PEF evaluation, used to evaluate a health aide’s clinical practice, CHAM use, etc.  Had several versions and combined them to create one form.  Plan to field test the form over the summer and bring it back to ARC in the fall for review and approval.  Anyone can field test it, if you’re interested, please contact Jud Brenteson. (Contact information is on CHAP Resource List) Test of Adult Basic Test of Adult Basic Education (TABE)- Education (TABE)-  Investigated to get a sense of how different corporations use the test. Some use it as a tool and Further discussion test the applicant prior to hiring. Also looked into which test is being used. needed to determine if this is feasible.  Most corporations are using the 7M. M means medium difficulty, designed for 4-5 grade difficulty level. 7H is hard level, designed for 7-8 grade difficulty level. 7A is Advanced, a high school equivalency test.  There’s a way to do the test online. A license for $800 is available and it gives you 100 tests for one year. ARC would like to suggest AACHAPD purchase the license and have it available for corporations to use. Would save some corporations money by not having to send a health aide to the nearest adult learning center to take the test.  The company will allow the test to be distributed to multiple sites, can perhaps have it on the CHAP website so that it can be accessed. Immunizations- Immunizations- Norton Sound has  At the last meeting there was some discussion on needing to clarify on the expectations of the standing orders for ARC Report- AACHAPD has with immunizations pertaining to the new CHAM and standing orders. adult immunizations- Continued  ARC is looking for more direction by AACHAPD on what needs to be clarified. willing to share  Corporations can also add standing orders for immunizations if need be. AACHAPD Follow up Abbreviated Overview of CHAP Field Supervision (2/25/07 draft AACHAPD)- Abbreviated Abbreviated on ARC Documents  Formerly titled “Overview of C/I Job Duties”. Overview of CHAP Overview of CHAP tabled from Feb. 2007 Field Supervision- Field Supervision-  Document was created to help corporations understand what they’re asking their field trainers to meeting- do and set realistic expectations. Crystal Stordahl (Vice-Chair) had some questions/comments A workgroup was Crystal to set up Crystal Stordahl regarding the document, they are in parenthesis. formed to continue teleconference for work on this document, further work.  This document is a guideline, not a standard. All words in italics state the purpose of the C. Stordahl, J. document. Brenteson, L. Discussion- Albertson Page 2 of 14 AACHAPD Approved 9/21/2007  MSO tests are done very two years (or every time a new CHAM is published).  Original purpose of this document is to add up the hours they are doing and to clarify expectations of duties. The job descriptions vary between regional health organizations which makes making this document very difficult.  Also need to look at the hours spent on administrative tasks, just like with medical supervision. Find an average # of hours/task, put it in one place with the description.  Looking into creating a document that would be titled “Resource for Field Trainers” that will define a lot of the content in this document, and provide descriptions for the people that are just coming into the program. Will also have it available on the CHAP website.  Item that is on the top of Page 2 may not be possible for some clinics to adhere to. Really depends on the population/size of the villages. Language of that line will be worked on and be clarified before the September AACHAPD meeting.  Since there is such a broad array of different people doing all these different tasks, once we do have a concise document that lists exactly what corporation wants of their CI, maybe have a list made up that breaks down the duties and have a signature/name space next to it so each regional health org. can visualize and know who exactly is accountable for each specific duty.  Would also like this document to have a date and author’s name on the top. And printed in color so that everyone can see the highlighted changes. CHP Recredentialing  May email comments to Crystal Stordahl at [email protected]. Guidelines- CHP Recredentialing Guidelines (revised 12/11/06)- Motion to approve Line  There was a recommendation from ARC to change the guidelines of recredentialing. Right now a 2 on page 5 of “CHP CHP has to go to Preceptorship every 6 years, and there are prerequisites to be enabled to attend Recredentialling recredentialing Preceptorship. Guidelines” (ARC  Right now as far as work experience is required, is 200 hours of work prior to recredentialing. Revised 12/11/06) made by Karen O’Neill;  At the February AACHAPD meeting the vote was split 5/5, today it is being brought up for seconded by Bill discussion and for vote on it. Schreiner.  The new item (number 3 on page 5) states that the health aide would need to have 25 patient Line 2 reads “600 encounters for each year worked as a health aide prior to recredentialing, starting 2/2007; and hours worked as a needs their supervisor’s signature. Health Aide in any Discussion- capacity in CHA/P  Biggest apprehension is of adding another regulation. One pro-argument of having it is that it will program within the last provide minimal proof of clinical practice for the health aide that is working in a supervisory role. two years before Con-argument is that 25 patient encounters does not prove clinical competency. recredentialing.” (words  It is the corporation’s responsibility to ensure clinical competency for that person to fulfill their role. highlighted were added)  There is no clear outcome/proof that 25 patient encounters per year worked as a health aide would Motion to vote ensure clinical competency. regarding addition of a Line 3 on page 5 of What if we create a tool for regional health organizations to use for clinical competence evaluation AACHAPD Follow up  “CHP Recredentialing on ARC Documents for people that are primarily administrators, instead of changing a standard. Guidelines” (ARC tabled from Feb. 2007  If a health aide is maintaining a patient log and there are no patients on it , that could be seen as a revised 12/11/06). meeting- red flag that the person is not going to be clinically competent. Line 3 reads “25 Continued  This guideline would apply to someone who has been working, not out on leave. There are re- patient encounters as entry guidelines for those that have been out for some time. a Health Aide each  Can also put a statement in the “Abbreviated Overview of CHAP Field Supervisors” document that year worked before they have to be clinically competent and are current. “Transfer” it into the C/I document and do not recredentialling, have it in the “CHP Recredentialing Guidelines”; however don’t state a specific number of patients starting 2/07.” And in the C/I document. supervisor signature.  Statement in the C/I document can perhaps say “Completion of 30 hours recredentialing Motion to vote on Preceptorship with patient encounter forms attached.”- address it that way so that there is more whether the line should Page 3 of 14 AACHAPD Approved 9/21/2007 flexibility. be kept in the  Standards do not incorporate a specific language; will be voting on a guideline not a standard. document. Motion made by Karen O’Neill. Members present voted- Motion seconded by Matt Rogers- Nay Bill Schreiner. Jud Brenteson- Nay 5/10/2007 10:00 AM George Drinkwater- Nay Line 3 to be taken out. Helena Bock- Nay Mike O’Neill- Abstain Rosanna Lemen- Nay Patrick Mahoney- Yes Crystal Stordahl- Nay Herman Geffe, Sr.- Nay Karen O’Neill- Nay Bill Schreiner- Nay RAC Report & ANTHC Training Center’s Distance Delivered Session I - Distance Delivered Crystal sent letter Bylaws-  This distance delivered session is a part of and function of the ANTHC training center. Even Session I- 5/14/07 to certification Crystal Stordahl though it is a part of a functioning training center, it does not mean that it is approved by RAC. So Motion to support a board requesting the students that pass will not have attended a RAC approved session. letter to CHAP funding to support travel of RAC  To date, two members of RAC participated in one of the classes being presented. Dan Thomas Certification Board for members to observe (NSHC) sat in a 2-day-per-week, 2-hours-per-day poly-comm. presentation. Debra Reed has gone funding of 1-2 people clinical skills at the online and seen the asynchrony’s portion of some of the classes. to oversee the clinical review part of the various regional  RAC and Dorothy Hight (ANTHC), Leslie Fox-Leyva (ANTHC) and Mary Rydaski (EAT), are in ANTHC distance health organizations. agreement that if RAC gives them a list of names and dates than those people listed will have their delivered Session I. permission to access the classes. A code is needed to access the classes online. Motion made by  One pressing issue is that RAC does not act now they will miss the opportunity to sit in on how Patrick Mahoney. Clinical Skills is being taught. RAC is not going on-site for approval, but to get a piece of Motion seconded by information that will be lost if they don’t do it now, and the information would be good for when they Bill Schreiner. All in do apply for RAC approval. There’s only one month of training left. favor. Motion passes.  RAC is requesting if AACHAPD are in position to and willing to fund to send one or two people to 5/10/2007 10:30 AM go onsite and see how Clinical Skills is being taught. Since RAC is asking for funding that would come out of either CHAP Certification Board or Statewide Services, they would need AACHAPD approval.  RAC is requesting they not be “pressured” to accredit the course. RAC is tasked with the job of ensuring (ahead of time) that what is being taught is appropriate information according to the standards. That information has not been provided and it is unclear if it will ever be available. At this time, they do not have the fundamental information needed for a RAC review. I.E. RAC may RAC Report & ask “Do you have two hours devoted to ear exam?” At this time, they do not know the amount of Bylaws- hours allotted because of the way the session is structured. Continued  Clinical Skills is being taught at clinics within the following organizations: Chugachmiut, Bristol Bay Area Health Corporation, and ANTHC. Annual Self-Evaluations-  Self-evaluations of training centers have been finished and were approved with some minor changes to be done.  ANTHC evaluated SEARHC; SEARHC evaluated NSHC; NSHC evaluated ANTHC RAC Membership- RAC Membership- Motion to nominate  Need a new Field Representative appointed to RAC by AACHAPD. Matt Rogers to be a  Matt Roger (Chugachmiut) was nominated to be a RAC Field Representative. Matt will talk with AACHAPD appointed Page 4 of 14 AACHAPD Approved 9/21/2007 administration to see if his corporation will support his nomination. Field Representative  Carlos Sammartino was also nominated. However it was declined. by George Drinkwater. Seconded by Jud  Field Representative membership is for three years, RAC meets for half a day on the day before Brenteson. All in favor. AACHAPD meetings start. May travel to do on-site evaluations, etc. Motion passes New Training Center- 5/10/2007 4:20 PM.  A new training center is opening up in North Slope Borough.  Debra Reed accepted position of Allied Health Training Center Coordinator.  Envision that the NSB training center will be a part-time facility for Session I & Session II,  Will have roughly 2-3 trainings per year. Will not be doing Session III and Session IV right now. RAC Bylaws- RAC Bylaws-  For the bylaws to pass, they have to be read twice. Motion to approve  Were revised in September 2006. Had first reading in the February AACHAPD meeting. second reading of revised RAC bylaws by Karen O’Neill. Seconded by Matt Rogers. All in favor. Motion passes 5/10/2007 4:15 PM. CHAP Certification Behavioral Health Aide Update- Board Report-  Myra Munson reviewed the BHA certification standards. Helena Bock  May be ready to go to the CHAP Certification Board in June 2007.  The BHA workgroup is meeting upstairs at the moment.  Have career brochures available. Dental Health Aide Update-  Started the Dental Health Aide training program in Anchorage in January.  Partnering with University of Washington. They do the curriculum, based on the University of New Zealand and Canadian programs.  Currently have six students.  Have career brochures and recruiting posters available. The posters were sent to school districts and corporations. Can also send them electronically.  Second year of training is more clinical, starting in September.  Patients are recruited from SouthCentral Foundation.  The March issue of CHAPCB newsletter has three articles that DHA submitted. Recognition & 2007 Shining Star Awards- Support Committee-  Steve Menard read the Governor Sarah Palin’s Proclamation. The week of April 23-27, 2007 is Recognition & “Community Health Aide/Community Health Practitioner/Dental Health Aide Week”. It was framed Support Committee- and presented to Pauline Rukovishnikoff (APIA), whom has been a health aide for 41 years. Herman Geffe, Sr.  Ooyuan Nagaruk (CHAIII- NSHC) received the “Outstanding Accomplishments in the Community” certificate award.  Rachael Kangas (CHA IV- TCC) received the “Experienced CHA/P” Shining Star award.  Ethel Booshu (CHP- Maniilaq) was honored with the “In Memoriam” Shining Star award will be in the clinic of Pt. Hope, accepted by her brother and sister.  Jessie Jim (CHP- SEARHC) was honored with the “In Memoriam” Shining Star award will be in the Angoon clinic.  Joyce Smith (CHP- KANA) was honored with the “In Memoriam” Shining Star award and it will be in the Ouzinkie clinic where there is a memorial in her honor. Page 5 of 14 AACHAPD Approved 9/21/2007  Last minute award presented to Irene McGlashlan by her corporation. She received a thank-you letter and a check.  No one was nominated for the “100% PEFs” award this year.  There were bouquets given to the winners, and all health aides present received a rose.  Herman recommends that we try to have the health aide’s family present at the ceremonies.  Last year, AFN said no on having the award acknowledged at the convention; but will see if we can do it this year. Medicaid Task Force- Medicaid Reimbursement Codes- Charlene Walker  Charlene Walker’s office is responsible for any tribal policy and tribal reimbursement issues related to Medicaid.  Last year, Steve Gage had given them codes that needed to be updated with current codes. Gwen Obermiller pulled together a spreadsheet with Medicaid codes that health aides would bill under. The list given today is not the complete list; Charlene is still waiting on those from the MIS people.  There are other codes that are eligible for payment that would be in the health aide’s scope of practice that are not on the list. CHAP Directors are responsible for updating and keeping current on the codes; and to make sure that Charlene is notified so that she can add them into the payment system.  If CHAP Directors could do the updating annually, then Charlene will more likely have only a couple codes to update, and not a massive list. The list we have today took 5 months to update.  There are still Items on the list that are not reflective of general practices of health aides. These are codes that have come up maybe only once, in 300,000 cases. Items in bold are new codes added. Medicaid Travel- Medicaid Travel-  Charlene also works with First Health. A person would call Charlene if the tribal facility wanted to Charlene to contact do travel for a patient, but they weren’t sure if they met the criteria. Crystal to set up  Health aides do not articulate the patient’s medical need for travel very well. teleconferences  Charlene’s office created a Medicaid Travel Checklist and Medicaid Travel Tip Cards that are available. Would like to do teleconference training to improve the situation, and do it regionally.  Will coordinate through CHAP Directors and have the First Health trainer (Virginia Leanders) also set up the teleconferences. Deficit Reduction Act-  Medicaid is getting a lot of budget cuts.  Contractors were hired to audit all the states. Trips to facilities are going to start in January 2008 and look at all the 2007 claims. They will see how many errors may have occurred. Payments will be reduced by a certain amount for three years, whether the errors are fraudulent or mistakes.  Contactors will also be looking at health aide charts. Leah Perry will travel to every site, do a quick Medicaid Task Force- self-review on their charts, looking at documents from the health aides. Continued  May want to talk about what your health aides are documenting. Having the documents be very legible to the auditor will be good.  Assessments- The ANTHC Business Resource Center is working along with Charlene’s office on assessments of billing office practices. They will do an assessment and make recommendations on their practices. Right now TCC is having an assessment, if you are interested, it is available. Contact Information- Charlene Walker- Phone: (907) 334-2433 Email: [email protected] Alaska Medicaid Help Line- (800) 780-9972 – Mon.-Fri. – 8AM-5PM

Page 6 of 14 AACHAPD Approved 9/21/2007 CHAM Revision DVD for CHAM Orientation- DVD for CHAM Committee-  Working on a DVD that will be filming an orientation, and condensing it to 1.5 hours long. Orientation- Linda Curda  Budget item for AACHAPD’s consideration. Would cost $16,500 to do this DVD. Money would Motion to move come from AACHAPD budget. forward with this project, AACHAPD  Last time a video was done, it cost $11,000. coordinating with  A DVD would be nice to have. For orientations, new hires or something to give to the tribal health CHAM Committee to directors to see. find funding. Motion  This has been on hold, to move forward a decision will have to be made today regarding funding. If made by Bill Schreiner. AACHAPD doesn’t approve, Linda Curda will look for other funding sources. Motion seconded by Immunization- Jud Brenteson. All in favor. Motion passes.  The CHAM immunization section will be rewritten. Tania Smallenberg is a Immunization Nurse 5/10/2007 2:11 PM. Consultant at ANMC.  Tania has a handout with a synopsis of all the changes that happened since the new CHAM has Motion to direct CHAM been printed. Will send emails with notices of changes, and there is a new standard childhood Committee to use vaccine schedule (5/10/2007). $16,000 out of CHAM  There are two new vaccines and new guidelines of older vaccines that need to be implemented Sales account for the now. CHAM Orientation film.  The Rotavirus vaccine is recommended for infants starting at 2 months. Motion by George  Second dose of Varicella is recommended at the Kindergarten visit, 4-6 years of age. Catch-up Drinkwater. Motion vaccination for children 7-18 years of age. seconded by Patrick Mahoney. All in Favor.  HPV vaccine (Gardasil) is coming out this summer for girls 11-18 years of age. The new HPV Motion passes vaccine prevents the 4th most common types of HPV, associated with 3/4s of cervical cancer. 5/11/2007 12:28 PM Recommended to be given routinely for girls 11-12 years old, with a catch-up for girls 8-18 years of age. Three doses: 2nd dose done 2 months after first, 3rd dose is done 6 months after the first dose. It is kept in the refrigerator, not frozen.  Influenza vaccine recommended for all children 6-59 months of age. The first year children need 2 doses one month apart. After that, children need one dose per year.  Tdap (Adacel- tetanus and diphtheria with pertussis)- one dose of Tdap has replaced Td vaccine for persons 11-65 years except for pregnant women, persons with a contraindication for pertussis vaccine.  Also have a poster on when to use Tdap, DTaP or Td vaccines. Contact Information- Tania Smallenberg, BSN- Immunization Nurse Consultant Phone: (907) 729-3647 – Fax: (907) 729-1570 – Email: [email protected] Rosalyn Singleton, MD – Immunization Consultant Phone: (907) 729-3418 – Fax: (907) 729-3429 – Email: [email protected] UAF Academic CHAP Education Resource Center (CERC)- Liaison Report-  Provides resources for sharing information, also use their space to work in (at ANTHC COB Linda Curda Building).  At the CHAP Forum, health aides were requesting CDs be made with all the presentations on them.  CHP210- CHAM Use and Documentation Course- this course has a CD with materials from the course Dan Thomas (NSHC) and his faculty had put together. CD has course outline, schedule (is adaptable), lesson plans, student materials and exams. Can make more copies. It was submitted and approved by the University, will get credits for it.  Ear Teaching Materials- Have a short CD, has anatomy and how to use the CHAM.

Page 7 of 14 AACHAPD Approved 9/21/2007  TEAM Competition- Body Anatomy and Function was the subject at the CHAP Forum. Had 10 quizzes, formatted for teams of three to compete. Very well liked at the CHAP Forum and was held on the last day. Made from the Study-Mate program.  If you have any materials you would like to share, contact Linda Curda or Val Warzewick. They can package it, make it professional and organized. Contact information is on the CHAP Resource List. Fall Semester-  Have Affiliate Faculty applications available.  Earning a BA in Rural Development prepares students for community leadership through a wide exposure to rural issues throughout the world and has hands-on skills for effective community development.  To qualify you must be committed to rural Alaska, be eligible for admission to UAF, have earned at least 30 university credits, and be able to participate in two intensive one-week seminars each year.  Call (800) 770-9531 or (907) 279-2713. Visit www.uaf.edu/danrd/ Electronic Learning & Teaching Programs-  Had a workshop on Thursday, April 26th on electronic learning and training programs.  Looked at options for distance education. Was recommended to use E-Live. It gives you visual and writing capacity at once. Don’t have to call in and set up a specific time or use a specific number. Can load up a MS Word document. I.E.- can use it for teleconferences and be able to see the documents on your screen. Once you’ve loaded it up on the computer, won’t need to load it up again.  E-Live can reach all the health aides at once, also get in touch with them; so far none of the health aides had any trouble with it.  Need to put on the agenda for next September meeting to look at having a fifth training center that will be a virtual training center. See how much it would cost, and use E-Live.  UAF had ordered 260 E-Live headsets and will send them out for free. Can be used by field trainers, health aides, etc. Recommend have at least one headset per clinic. Contact Linda Curda or Val Warzewick, will help you get connected with E-Live, and send you the headsets to distribute. Convocation Update- Update- Linda Curda  October 15-19, 2007 is the CHAP Orientation for Convocation, Tuesday morning until Friday afternoon. For CHAs, CHPs, field faculty, SIs, CIs. Theme is “Weaving Theory and Practice: Enhancing Our Circle of Communication for CHAP Training Center and Field Educators”. Mission/Purpose of Convocation-  Bring together training center and field instructors.  Foster a close working network among field and training center instructors from across the state.  Ensure consistency and improve the quality of training for CHA/Ps. Convocation Update-  Share and develop curriculum materials and evaluation tools. Continued  Discuss, affirm, learn and apply adult education learning theory and practice approaches.  Provide continuing education relevant to CHAP. Topics-  One of the topics being considered is cross-cultural communication and Alaska Native ways of knowing.  Adult Learning- adult education practices to guide classroom interactions, interactive approaches/strategies to enhance learning, positive problem solving approaches among CHA/Ps and instructors, critical thinking/reflection skills, approaches to learning assessment. Page 8 of 14 AACHAPD Approved 9/21/2007  CHAP Topics- post session evaluation tools, distance learning updates, curriculum updates (clinical data from Dr. Golnick), career/education tracks for CHPs.  CME Topics- Applied Suicide Intervention Skill Training (ASIST), statewide hair/mercury biomonitoring program, pediatric environmental health, HPV vaccine, STDs/STIs, domestic violence, nutrition/fitness, HIV presentation.  Looking at a variety of people to do the teaching. Will contact Dr. Angayuqaq Oscar Kawagley, Harold Napoleon, and others.  Open to suggestions, questions, and people who would like to be on the planning committee. Contact either Melany Cueva ([email protected] or 729-2441) or Linda Curda. Training Center YKHC- Reports-  The CHAT funds received have been used to expand training capacity by consistently providing Michelle Hall more training slots for classroom instruction with skills practice, clinical training and Early Periodic Screening Diagnostic Treatment (EPSDT) training.  This has been accomplished by active recruitment and retention of training center instructors to our present level of 9.6 FTE.  The increase in Well Child/EPSDT training has resulted in improved immunization rates in the region.  Held two Session I classes; three Session IIs, and one Session IIIs.  71 students were accepted, two lost to attrition prior to Session; had a total of 64 students finish Sessions. 60 students passed. SEARHC-  In 2006 offered 8 basic training sessions and integrated the 2006 CHAM book into their training center.  In 2007, on schedule to offer nine schedules of basic training and by the end of 2008, will have completed 6 additional trainings.  Made some adjustments in their schedule in order to allow Session I students more time at home before returning for Session II.  Since they have been offering more Session I’s and II’s, have developed a backlog of students waiting for Session III & IV. Some of these students have chosen to attend other training centers when timing worked out for them. Hope to clear out the backlog next year and get back to a smoother sequence for their CHA students. NSHC- In the past twelve months, NSHC proved the following:  9 Basic Training Sessions per year.  Three Session I’s, 6 student slots per session, 8 students were from NSHC.  Three Session II’s, 6 student slots per session, 11 students were from NSHC. Training Center  Two Session III’s, 6 student slots per session, 10 students were from NSHC. Reports-  One Session IV, 6 student slots, 4 were from NSHC. Continued  2 CME workshops per year. In October, they hosted the ANMC Diabetes workshop for health aides. In March they hosted Melany Cueva’s Cancer workshop.  Midlevel staff completed 5 credentialing and recredentialing Preceptorships.  Up until 4/27/07, they had 5 full-time midlevel trainers. One resigned and are currently recruiting. In addition, they hired a temporary midlevel instructor for three sessions to cover for absences of the full-time instructors. ANTHC-  Continuing basic training sessions as scheduled and have had full sessions.

Page 9 of 14 AACHAPD Approved 9/21/2007  Completed Session IV and a Session I; currently doing a Session II.  Our Session IV wait list is down to 14 and are having difficulty finding 6 CHAs willing to come to our June Session IV.  Fully staffed, however three of our FTEs and one intermittent have been/are on FMLA.  Dorothy Hight is continuing her affiliation with EAT to complete Session I by distance.  Have changed our September Session IV to a Session II to accommodate the Session I distance ed. CHAs.  Will be doing Preceptorships again beginning May 2007. Current Wait Lists for ANTHC- . Session I: 20 . Session II: 1 . Session III: 24 . Session IV: 14 State of Alaska  Have the annual report for the Department of Health & Social Services (DHSS). It talks about what Liaison Report- the department does and their work. Joyce Hughes Grants Management Review-  Joyce Hughes is working on a new project that looks at all the grants processes.  Began in June 2006 when DHSS and Rasmuson Foundation engaged Cliff Consulting, Inc., to review DHSSs grant making processes, gathered input and ideas from DHSS staff and grantees, and made recommendations for improvements.  Review took place from June to September, consisted of evaluation of current grant processes, review of documents, interviews with staff, grantee forums, and statistical analysis on current grant volumes and sizes. Have submitted the CHAT Statistical reports to the committee.  Spreadsheet was put together. Goal of the committee is to create a template that all the committees can use. A template was created for a one-page quarterly report with a brief summary of goals, objectives and outcomes.  This is a multi-year project. Goal is to implement some of the short-term opportunities quickly and begin work on the most critical medium/long-term recommendations immediately. Department is prioritizing the recommendations and developing an overall project plan.  Focus of the project is on grant making only. However the department may find that some of the ideas and improvements are applicable to other areas of the department.  All reporting will be done online perhaps by October 2007. Will send updates via email throughout the summer as they get notified on how it’s going along. Be able to do the quarterly reports online.  Updates on the status can be seen on the Grants Management Project Website, along with the monthly e-newsletter- www.hss.state.ak.us/das/gandc/grants_management_project.html.  If you have questions, contact: Jeff Kasper, (907) 465-8194 or Sherry Hill, (907) 465-1618. State of Alaska Alaska Healthcare Databook: Selected Measures, 2007- Liaison Report-  Will be available July 1, 2007. Continued  Main sections will have: demographic, social & economic profiles, populations health status & risk profiles, healthcare workforce & shortages, healthcare resources.  Main features will be: 170 tables of data, many tables of present information at regional or community levels, databook will be a hardcopy (about 300 pages).  Will also be posted at: http://www.hss.state.ak.us/commissioner/Healthplanning/default.htm  For information contact Robert Sewell or Alice Rarig at (907) 465-3091.

Page 10 of 14 AACHAPD Approved 9/21/2007 Community Health CHAA Update- Aide Association-  The association is building up momentum. Jud Brenteson  Held daily meetings at the CHAP Forum, a lot of health aides expressed interest in joining.  Developing mission statements and goals for the next year.  Hold teleconferences on the second Thursday of each month from 10AM-12PM. May reschedule them to alleviate schedule conflicts with AACHAPD using the teleconference number.  Sent a letter to tribal councils for support for health aides out on-call, they were received fairly well.  May make patches that show support for CHAA and possibly have dues to generate money. Chair- Yvonne Howard Vice-Chair 1- Jud Brenteson Vice-Chair 2- Moses Frederick Budget and CHAP Budget- Budget- Statewide Services-  AACHAPD- Have $5000 in account right now. Is non-recurring money. Do not have food for Motion to use $2000 to Torie Heart AACHAPD meetings because of rising cost (be around $400 per meeting to have food). finance the video (content to be  CHAP Forum- Started with $7,600, did get $15,000 from University. Hasn’t reconciled account yet. determined) by Paid for three CHAA member’s travel to attend Forum. Jeannie Green  Website- Have $29,000 in account. Theresa Cooper is with us as a ¼ person, but her salary Productions, funding to comes out of Statewide Services. come out of the CHAP  CHAM Revision- Have $500 in it currently. Website account. Motion by George  CHAM Sales- There is $100,000 in this account. Available to use for video project, paying people Drinkwater. Motion that work on the CHAM (pharmacists will no longer be able to donate their services; will have to seconded by Patrick pay $75/hour). Mahoney. All in favor.  Statewide Services- Currently have $197,000, which is recurring money. Pays for Carol Odinzoff, Motion passes Tamaree Kawagley, and Theresa Cooper’s salary. Also paid for CHAA member’s travel and Steve 5/11/2007 12:20 PM Gage’s travel to Washington, DC. Can do a better budget now that the CHAM is paid off. Report on Senate Indian Affairs Committee Testimony-  Steve Gage was invited do a presentation at Washington, DC for the Senate Indian Affairs Committee regarding the Indian Health Care Improvement Act reauthorization. He submitted oral & written testimony “CHAP Overview 2007”. Tribal Health Directors-  Steve wrote a letter to Tribal Health Directors requesting $3 Million for FY08.  $350,000 would facilitate maintenance for the CHAM and to help finance revisions.  $350,000 would help facilitate preparation and delivery of distance delivered training.  $2.3 Million would allow for additional salaries, increased positions for CHA/Ps and Field staff. CHAP Forum-  Had the manpower to do the CHAP Forum this year. Theme was “Power of Prevention”.  There was 26 hours of CME for the CHA/Ps that attended the whole week. Budget and CHAP  Bill for Hawthorn Suites came to $9,900. Statewide Services-  Attendees (and speakers) got conference bags, Nalgene water bottles, t-shirts (provided by State Continued of AK) with the 2007 CHAP Forum logo.  Have most of the presentations that the speakers did, will be making CDs with them. Will look into seeing how much CME credits can get with the CD.  Jeannie Green recorded some video at the CHAP Forum. National Provider Got an email from Renee Gayheart that says the following: Identification (NPI) Page 11 of 14 AACHAPD Approved 9/21/2007 Number Discussion- “The CHAs will not be required to seek NPIs by Dept. of Health and Social Services. In addition, PAs Torie Heart will not be required to seek NPIs if they are practicing in the tribal clinic or under the tribal hospital out- patient clinic provider number and not in the inpatient environment under the physician group provider number.” Adjourn for the day Adjourned for the day May 10, 2007 at 4:15 PM Reconvene Reconvened at May 11, 2007 8:30 AM University of MEDEX PA Program- Washington (UW)  Transitioning to a Master’s Degree with the 2009 entering class, admissions cycle will begin May MEDEX Update- 2008. Applicants applying this year for acceptance in 2008 do not need to meet these new John Riley requirements, but should refer to the current prerequisite list. Applicants applying for the Master’s program in 2009 may need to update academics or finish a Baccalaureate degree prior to applying in May 2008. MEDEX Prerequisites for 2009 Acceptance:  Clinical experience: 2 years (4000 hours) minimum  Baccalaureate Degree (no major preference)  10 quarter (6 semester) credits in human anatomy and physiology- minimum GPA 2.7 (B-)  15 quarter (9 semester) credits in other medically related sciences- minimum GPA 2.7 (B-) Additional Graduate School Requirements-  If invited to interview, you will need to apply to the UW Graduate School  Overall minimum GPA of 3.0 or higher for the last 2 years (90 quarter credits) coursework  GRE (required by UW Graduate School) Anticipated Changes for Master’s Program-  All students will continue to participate in the core curriculum, which focuses on primary care and improving health care access for the medically underserved. In addition, students entering the master’s-level program will select a specific pathway, which will offer advanced skills and knowledge in their chosen focus area. Student will declare their pathway choice during the didactic phase of training.  Four pathways are: rural and underserved healthcare; public health and healthcare administration; specialty practice and PA education; global health.  With faculty guidance, students will develop and complete an individual capstone project within their selected pathway. Projects will be presented to faculty and fellow students before graduation.  With the addition of the Master’s Degree requirements, the MEDEX program will be a total of 9 quarters. The additional quarter will be the summer quarter between the didactic and clinical year with required courses being mostly on-line. Trying to work some feed in between those that have the community degree that UAF offers, maybe dovetail University of that into a completion degree and as credit for work experience so that the health aide won’t have to chose Washington (UW) new 30 credits at UW. MEDEX Update- Stanford is still available to people, but they have prerequisites of at least two years of credits. They are in California and is 18 months long. MEDEX is 12 months long with training back in Alaska. Interim is also an Continued option. Phone: (206) 616-4001 Fax: (206) 616-38899 Email: [email protected]

Page 12 of 14 AACHAPD Approved 9/21/2007 Draft February 2007 No corrections/revisions done. Finalized minutes as is (draft 5/2/2007). Motion to approve draft Minutes were sent by AACHAPD Meeting February 2007 email to executive Minutes- AACHAPD meeting members on May 16, Crystal Stordahl minutes by Jud 2007. Printed copies Brenteson. Motion mailed out with Post- seconded by Herman Meeting packets for Geffe Sr. All in favor. those that did not Motion passes attend meeting. 5/11/2007 9:05 AM. MedImmune-  Lisa Brooks helped write a section in the CHAM. Lisa Brooks  MedImmune started a pilot program that’s being done with health aide training regarding RSV/Synergist. Currently they are training with a video with CI/SIs in Bethel.  Also responsible for Flu Mist vaccine that’s available from ages 5-49 years. Will see recommendations for school age children to get the vaccine. It is a nasal mist, not a shot.  If you have questions or would like to incorporate it in your training program, please contact her. Lisa Brooks, MPH – Clinical Marketing Manager – MedImmune (866) 685-8476 Email: [email protected] Strategic Planning- Tom Lefebvre is out submitting the Baldrige application for ANTHC’s strategic planning. Work groups should Lou Christie  The next step for AACHAPD is to begin structuring the initiatives. Have a draft “Initiative Inventory” meet by sheet with two Initiative Headlines: Standardize CHAP Orientation and CHAP Workforce Plan. The teleconference for Initiative Inventory is a visual tool that records and keeps track of the progress. continued work/planning  Today members will talk about initiatives and start linking them together, to move in a common direction with the same goal in mind. Will look at some draft documents and begin to prioritize them, assign them out to particular people/groups and be focused on that objective or initiative.  Will have a report from each workgroup that has their specific tasks, they will need to keep track of their progress, meet more than quarterly (via teleconference, etc.) and report to the CHAP Directors at the quarterly AACHAPD meetings.  Of the 7 strategic objectives that AACHAPD are working on, the group focused on the CHAP workforce/stabilization-development.  Attendees split into four groups. Group 1- Retention and On-Boarding Helena Bock, Linda Curda, Crystal Stordahl, Patrick Mahoney Group 2- Recruitment Herman Geffe, Sr., Rosanna Lemen, Matt Rogers, George Drinkwater Group 3- Communication (CHAP Website, Chat-boards, On-Call Stress) Bill Schreiner, Walter Starkloff, Joanne Ward, Michelle Hall Group 4- Recognition & Support, Education & Training Mike O’Neill, Jud Brenteson, Crystal Talyat

For notes on what the groups developed, please contact Tamaree Kawagley. Adjourn Adjourned May 11, 2007- 12:30 PM Motion to adjourn by Patrick Mahoney. Motion seconded by George Drinkwater. All in favor. Motion passes. Adjourned 5/11/2007 12:30 PM

Page 13 of 14 AACHAPD Approved 9/21/2007 Documents distributed at the meeting and now included as a permanent part of these minutes as attachments: 1. Meeting Agenda 2. ARC Report to the CHAP Directors (5/9/07) 3. CHA/P Clinical Evaluation Form (5/07 draft) 4. ARC Field Review Form (5/07 draft) 5. CHAP RN/CIs Attending CHA Basic Training for CHA Backup (5/07 revised) 6. Clinical Math Skills Assessment and Remediation (5/8/07) 7. Alaska CHAP Abbreviated Overview of CHAP Field Supervision (2/15/07 draft) 8. Community Health Practitioner Recredentialing Guidelines (12/11/06 draft) 9. Letter to request $3M- To Robert Clark from Steve Gage 10. CHAP Overview 2007 (3/7/2007) 11. CHAP Forum 2007 Awards Luncheon Agenda 12. Executive Proclamation by Sarah Palin, Governor 13. EMS Report to CHAP Directors & ARC 14. AACHAPD Feb. 2007 Meeting Minutes (5/2/07 draft) 15. AACHAPD Strategic Planning Notes (5/9/07) 16. Medicaid Travel Checklist 17. Alaska Medicaid Travel Tips Card 18. Medicaid Codes for Billing (5/07) 19. Resource List (5/7/07) 20. AACHAPD Strategic Planning Outcomes- December 2006 Meeting (12/14/2006) 21. AACHAPD Strategic Planning Notes- December 2006 Meeting (12/2006) 22. AACHAPD Strategic Planning Notes- February 2007 Meeting (5/9/2007) 23. Initiative Inventory Worksheet 24. Quarterly Initiative Status Report 25. Initiative Application 26. Initiative Inventory (5/9/07 draft) 27. Immunizations Updates letter to CHA/Ps 28. 2007 Standard Childhood Vaccine Schedule (5/9/07) 29. “Check Your Vials” Handout 30. UAF Fall 2007 Course Handout 31. MEDEX PA Master’s Program Notice 32. DHSS Grants Management Project FAQ’s & Talking Points 33. AK Healthcare Databook notice 34. CHAP Convocation Update 35. RAC Report to CHAP Directors (5/10/07) 36. RAC Report with Actions by CDs added (5/16/07) 37. Training Center Reports by: ANTHC, SEARHC, NSHC, & YKHC

Documents that were distributed at the AACHAPD Meeting are available, along with the Resource List and CHAP Events Calendar. Please contact Tamaree Kawagley if you need copies- (907) 729-4492, [email protected], or fax at (907) 729-3629

Page 14 of 14