Yukon-Kuskokwim Health Corporation

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

SPECIAL DIABETES PROGRAM FOR INDIANS

YUKON-KUSKOKWIM HEALTH CORPORATION SPECIAL DIABETES PROGRAM FOR INDIANS 2023 DIABETES PREVENTION AND CONTROL PROJECT - THE YUKON-KUSKOKWIM DELTA REGION IS LOCATED IN THE SOUTHWEST CORNER OF ALASKA. THE GEOGRAPHY OF THE REGION CONSISTS PRIMARILY OF ARCTIC TUNDRA AND IS DOMINATED BY BOTH THE YUKON AND KUSKOKWIM RIVERS. DEMOGRAPHICALLY, OVER 95% OF THE PEOPLE IN THE REGION ARE ALASKA NATIVE. DOTTED ALONG THESE RIVERS, WITH ONLY THE RIVER TO CONNECT THEM, ARE THE 48 REMOTE VILLAGE LOCATIONS AND THE ROUGHLY 30,000 INDIVIDUALS THAT INHABIT THEM. YKHC IS RESPONSIBLE FOR PROVIDING HEALTHCARE TO THESE INDIVIDUALS AND IS THE ONLY LOCAL CARE OPTION FOR ALASKA NATIVE BENEFICIARIES. YKHC’S (YUKON-KUSKOKWIM HEALTH CORPORATION) JOINT COMMISSION ACCREDITED HOSPITAL IS LOCATED IN THE HUB CITY OF BETHEL (POP. 7,000) YET ALSO SERVES THE EXPANSIVE 75,000 SQUARE MILE SERVICE AREA THROUGH VILLAGE-BASED HEALTH CLINICS. THESE CLINICS ARE STAFFED BY LOCALLY TRAINED COMMUNITY HEALTH AIDES, HOWEVER IN RECENT YEARS IT HAS BECOME INCREASINGLY CHALLENGING TO MEET STAFFING DEMANDS TO BE ABLE TO KEEP ALL OF THE CLINICS OPEN ON A RELIABLE AND ROUTINE BASIS. BECAUSE AIR, BOAT AND SNOWMOBILE TRAVEL ARE THE ONLY OPTIONS FOR MOVING PEOPLE THROUGHOUT THIS REMOTE REGION, SDPI FUNDS ARE UTILIZED TO A GREAT EXTENT TO SIMPLY PROVIDE ACCESS TO MEDICAL CARE AND PREVENTION EDUCATION. SDPI FUNDS ARE ALSO UTILIZED TO EXTEND ACCESS TO CARE THROUGH DYNAMIC TELECOMMUNICATIONS AND ADVANCED CLINICAL STAFF. VIDEO-TELECONFERENCE EQUIPMENT IS AVAILABLE IN ALL LOCATIONS ENABLING APPOINTMENTS TO BE PERFORMED BY CERTIFIED DIABETES EDUCATORS, REGISTERED DIETITIANS, NURSES, PRIMARY CARE PROVIDERS AND BOARD-CERTIFIED PHARMACISTS. THIS EQUIPMENT HAS SERVED AS A VITAL LIFELINE BOTH PRIOR TO AND THROUGHOUT THE COVID-19 PANDEMIC. EXTREMELY REMOTE AND ISOLATED, THE YK DELTA’S TRIBES AND ITS PEOPLE ARE NOT AFFORDED MANY OF THE LIFESTYLE ACCOMMODATIONS THAT MOST AMERICANS TAKE FOR GRANTED. REMOTE VILLAGES, WHICH CONTAIN 72% OF THE REGION’S POPULATION, CONTINUALLY FACE A LACK OF BASIC INFRASTRUCTURE. ACCESS TO CLEAN RUNNING WATER AND BASIC SANITATION IS STILL A MAJOR CHALLENGE IN A REGION WITHOUT THE BENEFIT OF CONNECTING ROADWAYS BETWEEN THE VAST MAJORITY OF VILLAGES. THESE REALITIES ARE BOTH BORN FROM AND CREATE VARIOUS LOGISTICAL CHALLENGES UNIQUE TO THIS AREA. ONE SUCH CHALLENGE IS EXTREMELY HIGH ENERGY COSTS THAT MUST BE INCURRED TO SIMPLY MOVE PEOPLE, GOODS AND SERVICES. THESE FACTORS COMBINE TO RESULT IN A LACK OF FRESH OR HEALTHFUL FOOD CHOICES IN MOST LOCAL STORES. IN SPITE OF THE REGION BEING CULTURALLY TIED TO HEALTHY ‘NATIVE FOODS’ SUCH AS SALMON, CARIBOU, VARIOUS MARINE MAMMALS, AND TUNDRA BERRIES, A TRUE ‘SUBSISTENCE’ LIFESTYLE HAS BECOME LESS AND LESS OF A PRACTICAL ENDEAVOR DUE TO AFOREMENTIONED ENERGY COST ISSUES AND RECENT CHANGES TO STATE AND FEDERAL HUNTING/FISHING REGULATIONS. TO ADD A FURTHER LAYER OF COMPLEXITY, THE ARCTIC ENVIRONMENT PRESENTS A CHALLENGE IN TERMS OF GROWING LOCAL FRUITS OR VEGETABLES SUITABLE FOR SUSTAINING LARGE NUMBERS OF INDIVIDUALS. UNFORTUNATELY, THESE FACTORS HAVE CREATED IDEAL CONDITIONS FOR ‘FOOD DESERTS’ IN MOST VILLAGES AND CAUSING HIGH RATES OF FOOD INSECURITY ACROSS THE REGION. YKHC HAS BEEN A RECIPIENT OF THE SDPI GRANT FOR THE LAST 25 YEARS. THE DIABETES DEPARTMENT HAS CHANGED OVER THE LAST QUARTER OF A CENTURY IN TERMS OF STAFFING MODELS AND OVERALL GOALS TO PROVIDE THE HIGHEST LEVEL OF CARE TO THE YK DELTA AN POPULATION TO PREVENT AND MANAGE DIABETES. SDPI FUNDS ARE USED TO PROVIDE HEALTHCARE ACCESS AND RESOURCES TO THIS REMOTE REGION IN NUMEROUS WAYS TO PROMOTE BETTER HEALTH.

SUPPORTING TRIBAL PUBLIC HEALTH CAPACITY IN CORONAVIRUS PREPAREDNESS AND RESPONSE ? 2020

YKHC CLINIC CONSTRUCTION FOR MT VILLAGE AND NUNAPITCHUK

YUKON-KUSKOKWIM HEALTH CORPORATION CANCER PREVENTION AND CONTROL PROGRAMS - ALASKA-NATIVE WOMEN EXPERIENCE SIGNIFICANTLY HIGHER MORTALITY RATES FROM BREAST AND CERVICAL CANCER THAN OTHER WOMEN IN THE UNITED STATES. THE YUKON-KUSKOKWIM HEALTH CORPORATION’S NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM HAS INCREASED BREAST AND CERVICAL CANCER SCREENING SINCE ITS INCEPTION IN 2002, BUT MANY BARRIERS STILL REMAIN. THE YUKON-KUSKOKWIM DELTA IS GEOGRAPHICALLY REMOTE AND RATES FOR LOW-INCOME UNINSURED WOMEN STILL REMAIN HIGH IN THE REGION, WHICH PREVENTS EASY ACCESS TO SCREENING. THE YKHC B&C PROGRAM INTENDS TO REDUCE THESE BARRIERS IN ORDER TO INCREASE SCREENING AND DECREASE MORTALITY RATES FROM BREAST AND CERVICAL CANCER IN ALASKA OVER THE COURSE OF THE PROJECT. INITIALLY, THE PROGRAM WILL CONTINUE TO IMPROVE ITS EVIDENCE-BASED INTERVENTIONS, INCLUDING CLIENT AND PROVIDER REMINDERS, PATIENT TRAVEL ASSISTANCE, AND MOBILE MAMMOGRAPHY IN THE COMING YEARS. THE PROGRAM WILL ALSO DIVE DEEPER INTO CANCER AND SCREENING DATA FOR THE REGION IN ORDER TO SET A BASELINE AND BETTER MEASURE AND ASSESS PROGRAM PLANNING AND PERFORMANCE IN FUTURE YEARS, WHICH ALSO INCLUDES AN INCREASING RACIAL DIVERSIFICATION. THROUGH CONTINUED AND NEW PARTNERSHIPS AND COLLABORATION, THE PROGRAM INTENDS TO REACH A WIDER AUDIENCE TO EDUCATE AND RECRUIT WOMEN FOR BREAST AND CERVICAL CANCER SCREENING. THE PROGRAM WILL ALSO EXPAND ITS PATIENT NAVIGATION STAFF AND MAINTAIN A LOW TURNOVER RATE IN ORDER TO PROVIDE MORE VOLUME AND MORE REFINED SERVICES TO WOMEN WHO NEED BREAST AND CERVICAL CANCER SCREENING AND TREATMENT. WITH EXPERIENCE FACILITATING A BROAD-BASED BREAST AND CERVICAL CANCER SCREENING PROGRAM AND A HISTORY OF GOOD PERFORMANCE, THE PROGRAM IS SITUATED TO CONTINUE MAKING PROGRESS TO INCREASE SCREENING AND DECREASE MORTALITY RATES DUE TO BREAST AND CERVICAL CANCER IN ALASKA-NATIVE WOMEN IN RURAL ALASKA. ESTIMATED NUMBER OF PEOPLE TO BE SERVED AS A RESULT OF THE AWARD OF THIS GRANT: 1,500 FOR YEAR 1 ~7,500 FOR ENTIRE PROJECT PERIOD

YUKON-KUSKOKWIM HEALTH CORPORATION WOMEN'S HEALTH PROGRAM

SPECIAL DIABETES PROGRAM FOR INDIANS

PURPOSE: ECONOMIC DEVELOPMENT INITIATIVE, COMMUNITY PROJECT FUNDING/CONGRESSIONAL DIRECTED SPENDING AWARDS ARE AUTHORIZED UNDER THE CONSOLIDATED APPROPRIATIONS ACT, 2022 PUBLIC LAW 117-328 AND THE EXPLANATORY STATEMENT FOR DIVISION L OF THAT ACT. PROJECTS SELECTED FOR COMMUNITY PROJECT FUNDING/CONGRESSIONAL DIRECTED SPENDING ARE LISTED IN THE JOINT EXPLANATORY STATEMENT (JES) THAT ACCOMPANIES A SPECIFIC FISCAL YEAR’S APPROPRIATIONS ACT OR CONGRESSIONAL RECORD. THE JES LISTS PROJECT, RECIPIENT, STATE, AMOUNT AND CONGRESSIONAL SPONSOR.; ACTIVITIES TO BE PERFORMED: ECONOMIC DEVELOPMENT INITIATIVE, COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING AWARD PROJECTS INCLUDE A WIDE VARIETY OF ACTIVITIES THAT RESULT IN ECONOMIC DEVELOPMENT OR COMMUNITY DEVELOPMENT OUTCOMES. HUD WILL NOT KNOW THE FULL SCOPE OF THE PROJECT UNTIL THE RECIPIENT SUBMITS THE REQUIRED PROJECT NARRATIVE AND CONFIRMS ALIGNMENT WITH THE LANGUAGE AS PROVIDED IN THE CONGRESSIONAL RECORD. TO FIND THE DETAILS OF THE GRANT AWARD AS WRITTEN WITHIN THE CONGRESSIONAL RECORD USE THE FOLLOWING LINK AND PATH SELECTIONS TO GET TO THE DESCRIPTION OF THE ECONOMIC DEVELOPMENT INITIATIVE, COMMUNITY PROJECT FUNDING GRANTS HTTPS://WWW.HUD.GOV/PROGRAM_OFFICES/COMM_PLANNING/EDI-GRANTS, SELECT THE FISCAL YEAR OF INTEREST, SCROLL DOWN TO PROGRAM LAWS AND REGULATIONS, UNDER FISCAL YEAR 20XX CONSOLIDATED APPROPRIATIONS ACT, 20XX: CONGRESSIONAL RECORD (JOINT EXPLANATORY STATEMENT).; EXPECTED OUTCOMES: COMPLETION OF THE PROJECT AS DESCRIBED IN THE JOINT EXPLANATORY STATEMENT (JES) PROJECT DESCRIPTION AND SUBSEQUENT APPROVED PROJECT NARRATIVE.; INTENDED BENEFICIARIES: THE PROJECT BENEFICIARIES ARE THE INDIVIDUALS AND/OR ORGANIZATIONS THAT ARE AWARDED GRANT FUNDS OR SERVED BY THE ENTITIES THAT ARE AWARDED GRANT FUNDS AS IDENTIFIED IN THE JES RECIPIENT OR PROJECT DESCRIPTION SECTIONS.; SUBRECIPIENT ACTIVITIES: THE SUBRECIPIENT ACTIVITIES ARE UNKNOWN AT THE TIME OF AWARD.

YUKON KUSKOKWIM HEALTH CORPORATION - MEDICATION ASSISTED THERAPY PROJECT - ALASKA HAS SEEN A 68% INCREASE IN OPIOID OVERDOSE DEATHS IN THE LAST TWO YEARS, AND THE YUKON KUSKOKWIM HEALTH CORPORATION (YKHC), A TRIBAL ORGANIZATION REPRESENTING 58 FEDERALLY RECOGNIZED TRIBES IN SOUTHWEST ALASKA, HAS SEEN A SIMILAR RISE IN OVERDOSES PRIMARILY BY FENTANYL. YKHC IS SEEKING TO INCREASE MAT-PDOA SERVICES FOR THE ALASKA NATIVE (YUP’IK, CUP’IK AND ATHABASKAN) RESIDENTS OF OUR REGION, USING A COMBINATION OF WESTERN AND INDIGENOUS TREATMENT METHODS. WITH THIS FUNDING WE WILL DOUBLE THE NUMBER OF CLIENTS WE SERVE. PROJECT NAME: YUKON KUSKOKWIM HEALTH CORPORATION’S MEDICATION-ASSISTED TREATMENT – PRESCRIPTION DRUG AND OPIOID ADDICTION PROJECT POPULATION TO BE SERVED: THE RESIDENTS OF THE YUKON – KUSKOKWIM DELTA REGION OF SOUTHWEST ALASKA, POPULATION 26,917 PREDOMINATELY YUP’IK, CUP’IK AND ATHABASKAN RESIDENTS. OUR PROGRAM WILL SERVE 40 INPATIENT CLIENTS DURING THE LIFE OF THE GRANT, A 100% INCREASE. STRATEGIES AND INTERVENTIONS: EVIDENCE-BASED PRACTICES WILL BE UTILIZED, INCLUDING COGNITIVE BEHAVIORAL THERAPY, MOTIVATIONAL INTERVIEWING, INTERACTIVE JOURNALING, FAMILY SYSTEMS THERAPY, LIVING IN BALANCE, AND CALRICARAQ, AN INDIGENOUS INTERVENTION RECOGNIZED AS OUR LOCAL BEST PRACTICE DEVELOPED BY OUR ELDERS TEACHING ALASKA NATIVE TRADITIONAL AND ANCESTRAL KNOWLEDGE. PROJECT GOALS AND MEASURABLE OBJECTIVES: OUR MAT-PDOA PROGRAM WILL INCREASE THE NUMBER OF UNDUPLICATED CLIENTS SERVED BY 100% OVER THE LIFE OF THE GRANT USING BOTH OUTPATIENT AND INPATIENT BEHAVIORAL HEALTH SERVICES USING STRATEGIES TO ENCOURAGE PARTICIPATION, INCLUDING: INCREASED CASE MANAGEMENT, PEER SUPPORT SERVICES, COMMUNITY OUTREACH, AND IMPROVING THE REFERRAL SYSTEM TO HELP IDENTIFY AND ENGAGE NEW CLIENTS. OUR MAT-PDOA PROGRAM WILL DECREASE ILLICIT OPIOID DRUG USE AND PRESCRIPTION OPIOID DRUG MISUSE IN OUR SERVICE AREA BY EXPANDING THE CAPACITY OF YKHC AND ITS PARTNERS INCREASING TREATMENT SERVICES AVAILABLE FOR OUR CLIENTS. OUR MAT-PDOA PROGRAM WILL INCREASE LOCAL, REGIONAL AND STATEWIDE PARTNERSHIPS TO PROVIDE ROBUST TREATMENT AND RECOVERY SUPPORT SERVICES IN THE REGION. THIS WILL BE ACCOMPLISHED BY IMPLEMENTING OUTREACH AND ENGAGEMENT STRATEGIES TO OUR COMMUNITIES, DEVELOPMENT OF REGIONAL PARTNERSHIPS AND COLLABORATIONS RESULTING IN ADDITIONAL RESOURCES FOR CLIENTS IN NEED OF TREATMENT. OUR MAT-PDOA PROGRAM WILL UTILIZE AN ALASKA NATIVE CULTURE-BASED TREATMENT PROGRAM, CALRICARAQ, ALONG WITH THE MAIN TREATMENT MILIEU. THE CALRICARAQ WELLNESS CURRICULUM WILL BE USED WITH OUR CLIENTS TO TEACH INDIGENOUS HEALTHY LIVING AND COPING SKILLS. CLIENTS WILL ALSO PARTICIPATE IN A 3-DAY CALRICARAQ GATHERING, WHERE THEY WILL LEARN ABOUT HISTORICAL TRAUMA, HOW TO HEAL FROM TRAUMA, AND THE CALRICARAQ WELLNESS WHEEL SHOWING HOW TO START LIVING A HEALTHY LIFE.

CALRICARAQ: HEALING OUR YOUTH AND FAMILIES

CMHI CALRICARAQ PROJECT - ABSTRACT CMHI CALRICARAQ PROJECT YUKON KUSKOKWIM HEALTH CORPORATION OUR ALASKA NATIVE CHILDREN AND YOUTH EXPERIENCE SOME OF THE HIGHEST RATES OF DEPRESSION, SUICIDE, AND SUBSTANCE USE. WITH OUR CALRICARAQ TRADITIONAL BH PREVENTION PROGRAM, WE ARE SEEING COMMUNITIES AND FAMILIES HEAL AND RETURN TO TRADITIONAL YUP’IK VALUES AND PRACTICES FOR THEIR STRENGTH. WITH THIS PROJECT WE AIM TO DISSEMINATE THESE TEACHINGS OF CALRICARAQ, DEVELOPED BY OUR PEOPLE, FOR OUR PEOPLE, TO SPREAD HEALING AND WELLNESS TO OUR CHILDREN, YOUTH, AND THEIR FAMILIES TO THE 58 TRIBAL COMMUNITIES IN THE YUKON KUSKOKWIM DELTA REGION OF SW ALASKA. PROJECT NAME: CALRICARAQ CMHI PROJECT POPULATION TO BE SERVED: THE CHILDREN, YOUTH, AND FAMILIES OF THE YUKON – KUSKOKWIM DELTA REGION OF SOUTHWEST ALASKA, POPULATION 26,365 PREDOMINATELY YUP’IK, CUP’IK AND ATHABASKAN RESIDENTS. OUR PROGRAM WILL SERVE 80 CLIENTS PER YEAR, AND 300 CLIENTS DURING THE LIFE OF THE GRANT, AND UP TO EIGHT HUNDRED MORE YOUTH WILL BE IMPACTED WITH OUR OUTREACH ACTIVITIES THROUGHOUT THE GRANT PERIOD. STRATEGIES AND INTERVENTIONS: CALRICARAQ IS AN ELDER-DRIVEN PROGRAM THAT ENCOMPASSES OUR YUP’IK ANCESTRAL WISDOM AND KNOWLEDGE AND IS OUR HOLISTIC APPROACH TO HELP PEOPLE HEAL FROM THE IMPACTS OF COLONIZATION. CALRICARAQ SERVES COMMUNITY MEMBERS OF ALL AGES, BUT WE FOCUS MOST OF OUR EFFORTS ON PARENTS AND SCHOOL-AGE YOUTH. THE CMHI PROJECT WILL ENABLE OUR CALRICARAQ PROGRAM TO FOCUS SPECIFICALLY ON OUR OUTPATIENT CLINIC BY INCREASING CAPACITY TO SERVE MORE CHILDREN AND YOUTH REFERRALS COMING FROM OUR CHILD-SERVING PARTNERS IN THE Y-K DELTA REGION. PROJECT GOALS AND MEASURABLE OBJECTIVES: GOAL 1: EXPAND AWARENESS AND INCLUSION OF THE CALRICARAQ CMHI/SOC PROJECT THROUGHOUT THE CHILD AND FAMILY SERVICE PROVIDERS IN THE Y-K DELTA REGION. OBJECTIVE 1. TRAIN EXISTING AND INCOMING BH STAFF ON THE PHILOSOPHY AND CLINICAL OPERATION OF THE CALRICARAQ OUTPATIENT CLINIC AND PREVENTION PROGRAM. OBJECTIVE 2. PROVIDE OUTREACH ACTIVITIES TO CHILD AND FAMILY SERVICE ORGANIZATIONS. GOAL 2: EXPAND CAPACITY OF OUR YKHC CALRICARAQ TRADITIONAL OUTPATIENT CLINIC, INCREASING THE NUMBER OF CHILDREN, YOUTH, AND FAMILIES WE CAN PROVIDE EVIDENCE-BASED, CULTURALLY APPROPRIATE MH AND SU SERVICES, WITH INCREASED DIAGNOSTIC SERVICES AND TRAUMA-INFORMED CARE. OBJECTIVE 1. ADDITION OF AN OUTPATIENT CLINIC MANAGER/CARE COORDINATOR TO OVERSEE THE OPERATION OF THE CLINIC AND PROVIDE GUIDANCE AND SUPERVISION TO OUR TRADITIONAL CLINIC STAFF. OBJECTIVE 2. CALRICARAQ CLINICIAN WILL PROVIDE DIAGNOSTIC BH SERVICES TO CHILDREN AND YOUTH CLIENTS, AND THEIR FAMILIES. GOAL 3: MANAGE, MONITOR, AND ENHANCE THE CALRICARAQ CMHI PROGRAM’S INTEGRITY AND FIDELITY, INCLUDING SUSTAINABILITY PLANNING AND FINANCE STRATEGIES BY: OBJECTIVE 1. REVIEW CLINICAL POLICIES AND PROCEDURES TO ENSURE INTEGRATION OF CALRICARAQ INTO EXISTING PROTOCOLS AND MODIFY AS NEEDED IN ACCORDANCE WITH THE BH STRATEGIC PLAN. OBJECTIVE 2. CONVENE THE ELDER COUNCIL TO ENSURE COMPLIANCE WITH THE CALRICARAQ TEACHINGS. OBJECTIVE 3. REVIEW ORDERS AND BILLING CODES TO ASSURE ADEQUATE REIMBURSEMENT OF SERVICES

KEEPING DELTA WOMEN STRONG- COORDINATED DELIVERY OF BREAST AND CERVICAL SCREEING

CALRICARAQ SYSTEM OF CARE PROJECT

STRENGTHENING PUBLIC HEALTH SYSTEMS AND SERVICES IN THE YUKON-KUSKOKWIM DELTA

ALASKA NATIVE EDUCATIONAL PROGRAM - ALASKA NATIVE EDUCATION

TO PROVIDE BREAST AND CERVICAL CANCER SCREENING, FOLLOW-UP AND SUPPORT SERVICES F

TRIBAL OPIOID RESPONSE GRANT PROGRAM

YKHC ZERO SUICIDE PROJECT

TRIBAL OPIOID RESPONSE - OPIOID USE AND MISUSE ARE ON THE RISE IN THE YUKON KUSKOKWIM (YK) REGION OF SOUTHWEST ALASKA. THE POPULARITY OF OPIOIDS IS ON THE RISE DUE TO ITS LOW COST OF PRODUCTION, EASE OF TRANSPORTATION AND AFFORDABILITY FOR THE USER. THE YUKON KUSKOKWIM HEALTH CORPORATION’S (YKHC) TRIBAL OPIOID RESPONSE (TOR) PROGRAM WILL PROVIDE RESIDENTIAL AND OUTPATIENT OPIOID TREATMENT, AND COMMUNITY OUTREACH AND EDUCATION TO OUR MANY TRIBAL COMMUNITIES. THE YK REGION IN SOUTHWEST ALASKA IS HOME TO 58 FEDERALLY-RECOGNIZED TRIBAL COMMUNITIES, MORE THAN 10% OF THE 566 FEDERALLY-RECOGNIZED TRIBES IN THE UNITED STATES. OUR REGION IS IN A VERY RURAL SETTING WHERE NO ROAD SYSTEM EXISTS AND AIR TRAVEL IS THE STANDARD METHOD OF TRANSPORTATION, WITH SOME VILLAGES ACCESSIBLE BY BOAT DURING THE SUMMER AND FALL MONTHS AND AN ICE ROAD DURING THE WINTER MONTHS. THE POPULATION OF 28,623 RESIDENTS IS SCATTERED OVER 75,000 SQUARE MILES, AN AREA LARGER THAN THE STATE OF OREGON. THE VILLAGES WE WILL BE SERVICING WITH THIS GRANT HAS 25,107 RESIDENTS ACCORDING TO THE IHS ACTIVE USER POPULATION REPORT WITH THE DATE COMING FROM THE DRAFT 2024 REPORT FOR IHS NATIVE ACTIVE USERS. YKHC, A CONSORTIUM OF TRIBES, IS THE SOLE DIRECT SERVICE PROVIDER FOR THE COMMUNITIES IN THE YK REGION, ONE OF THE POOREST REGIONS IN THE STATE. YKHC IS A MEMBER OF THE ALASKA TRIBAL HEALTH COMPACT, WHICH IS MADE UP OF THE 12 REGION TRIBAL HEALTH ORGANIZATIONS THAT SERVE THE STATE OF ALASKA. THE COMMUNITIES OF THE YK REGION WERE ONCE HEALTHY AND SELF-SUFFICIENT, FREE FROM ALCOHOL, DRUGS AND DIABETES, BUT TODAY THEY SUFFER A HIGHLY DISPROPORTIONATE RATE OF SUBSTANCE ABUSE, SUICIDE AND DEPRESSION, DOMESTIC VIOLENCE, STDS, AND POVERTY. THE HISTORY OF OPPRESSION, COLONIZATION, EPIDEMICS AND BOARDING SCHOOLS DEVASTATED OUR VILLAGES, AND RESULTED IN SEVERE SOCIAL ISSUES THAT CONTINUE TO DESTROY OUR PEOPLE. THE OPIOID EPIDEMIC IS AN ADDED THREAT TO THE LIVELIHOOD OF OUR PEOPLE, OUR FAMILIES AND OUR CHILDREN. THE YKHC TOR PROGRAM WILL 1) ALLOW THE CURRENT OPIOID TREATMENT PROGRAM TO MORE THAN DOUBLE THE CURRENT NUMBER OF CLIENTS WE SERVE, 2) EXPAND EXISTING INTERDISCIPLINARY SERVICES AVAILABLE TO THE PATIENT. 3) STRENGTHEN OUR OPIOID COMMUNITY OUTREACH AND EDUCATION PROGRAM IN THE VILLAGES TO TEACH YOUNG PEOPLE AND ADULTS ABOUT THE DANGERS AND REALITIES OF OPIOID ABUSE, AND TO GET TO KNOW AND BUILD A NETWORK OF COMMUNITY-BASED PROVIDERS AND ADVOCATES WHO CAN REFER CLIENTS IN FOR TREATMENT, AND 4) IMPLEMENT PEER-SUPPORT SPECIALISTS TO PROVIDE SERVICES AND ADVOCATE FOR THE CLIENTS. THE CLIENTS WE SERVE CAN BE BROKEN DOWN INTO TWO CATEGORIES: INPATIENT/OUTPATIENT OPIOID TREATMENT AND COMMUNITY OUTREACH AND EDUCATION. DURING YEAR 1 OF THE GRANT WE WILL SERVE 20 NEW INPATIENT/OUTPATIENT OPIOID TREATMENT CLIENTS, AND 100 PARTICIPANTS IN THE OPIOID OUTREACH AND EDUCATION ACTIVITIES. IN YEAR 2 WE WILL INCREASE TO 25 INPATIENT/OUTPATIENT TREATMENT CLIENTS, AND OUTREACH AND EDUCATION WILL INCREASE TO 150. DURING YEARS 3, 4, AND 5, WE FORESEE BRING THE NUMBER FOR CLIENTS SERVED UP BY 5 ADDITIONAL CLIENTS PER YEAR AND OUTREACH AND EDUCATION UP BY AN ADDITIONAL 50 COMMUNITY MEMBERS PER YEAR. OVER THE FIVE YEARS WE PLAN TO SERVE AT LEAST 150 NEW CLIENTS AND PROVIDE EDUCATION AND OUTREACH TO A MINIMUM OF 1,000 INDIVIDUALS.

HEALTH CARE AND OTHER FACILITIES

METHAMPHETAMINE AND SUICIDE PREVENTION INITIATIVE (MSPI) PROGRAM

TRIBAL OPIOID RESPONSE - THE COMMUNITIES OF THE YUKON KUSKOKWIM DELTA WERE ONCE HEALTHY AND SELF-SUFFICIENT; FREE FROM ALCOHOL AND DRUGS. OUR HISTORY OF OPPRESSION, COLONIZATION, EPIDEMICS AND BOARDING SCHOOLS DEVASTATED OUR VILLAGES AND NOW IT IS THE OPIOID EPIDEMIC THAT THREATENS OUR PEOPLE, OUR FAMILIES AND OUR CHILDREN. THE YUKON KUSKOKWIM HEALTH CORPORATION HAS BEEN FIGHTING THE RISE OF OPIOID USE AND MISUSE IN THE YK DELTA THROUGH OUR OPIOID TREATMENT PROGRAM AND MEDICATION ASSISTED TREATMENT (MAT) PROGRAM. HOWEVER, WE MUST CONTINUE OUR EFFORTS IN ORDER TO COMBAT THE OPIOID EPIDEMIC IN OUR HOMELAND. WITH THE FUNDS FROM SAMSHA’S TRIBAL OPIOID RESPONSE GRANT, WE WILL BE ABLE TO DO JUST THAT. WE MUST IMPROVE OUTREACH EFFORTS ACROSS YKHC’S MANY DEPARTMENTS IN ORDER TO PROVIDE EDUCATION, INCREASE REFERRALS TO TREATMENT AND, ULTIMATELY, REDUCE THE NUMBER OF OPIOID OVERDOSES IN THE YK DELTA. FORTY-FIVE PERCENT OF OUR CLIENTELE ARE FROM THE VILLAGES. THERE ARE 58 VILLAGES IN THE YK DELTA REGION AND OUR PROGRAM SERVES CLIENTS IN NINE OF THE 58 VILLAGES. THEREFORE, IT IS VITAL THAT WE EXPAND OUR PROGRAM TO THE REMAINING 49 VILLAGES. IN ORDER TO MEET THE DEMAND IN OUR COMMUNITY, OUR PROGRAM MUST EXPAND. WE MUST CONTINUE TO HIRE AND TRAIN NEW STAFF. CURRENT STAFF MEMBERS ARE CONTINUING TO EARN THE NECESSARY CREDITS TO BE CHEMICAL DEPENDENCY COUNSELORS AT EITHER THE TECH, I, OR II LEVEL. FURTHERMORE, WE WILL CREATE NEW POSITIONS IN OUR PROGRAM FOR PEER SUPPORT SPECIALISTS. WE MUST IDENTIFY CANDIDATES FOR THE PEER SUPPORT DIVISION AND ENROLL THEM IN TRAINING BEFORE THEY WORK WITH CURRENT CLIENTS. WITHIN THE FIRST THREE MONTHS OF THIS GRANT CYCLE, WE WILL BUILD A WORKING RELATIONSHIP WITH THE PROVIDERS IN THE VILLAGE CLINICS, VILLAGE TRIBES, AND THE TWO SCHOOL DISTRICTS IN THE YK DELTA. WITH THESE CONNECTIONS, WE WILL IDENTIFY AT RISK COMMUNITY MEMBERS THROUGH OUR REFERRAL PROCESS. WE WILL COMPILE EDUCATIONAL RESOURCES TO BE DISTRIBUTED WITH THE HARM REDUCTION KITS THAT ARE DISPENSED THROUGH YKHC. FURTHERMORE, WITHIN SIX MONTHS WE WILL EXPAND UPON THESE RESOURCES TO PROVIDE A TRAINING ON THE ADMINISTRATION OF NALOXONE AND THE SYMPTOMS OF OPIOID OVERDOSE. ADDITIONALLY, WITHIN THE FIRST SIX MONTHS OF THE GRANT CYCLE WE WILL IDENTIFY PROSPECTIVE PEER SUPPORT SPECIALISTS AND LOCATE THE APPROPRIATE TRAININGS. CONTINUING TO SEEK OUT TRAINING AND CERTIFICATIONS FOR ALL STAFF WILL BE ONGOING THROUGHOUT THE GRANT IN ORDER TO BEST INCORPORATE EVIDENCE-BASED PRACTICES. IN THE LAST, TOR GRANT, OUR MAT AND OPIOID TREATMENT PROGRAM HAS RAPIDLY EXPANDED. WITH ADDITIONAL FUNDS FROM THE TOR GRANT, WE WILL BE ABLE TO INCREASE OUR OUTREACH AND EXPAND OUR HARM REDUCTION EFFORTS. TRAVELING TO THE VILLAGES IS ONE OF THE MOST IMPORTANT OF COMPONENTS OF OUR PROGRAM AND WOULD NOT BE POSSIBLE WITHOUT THE TOR GRANT. AS THE ONLY DIRECT SERVICE PROVIDER IN OUR RURAL REGION, OUR PROGRAM STRIVES TO BE AS COMPREHENSIVE AND AS PATIENT CENTERED AS POSSIBLE. IT IS WITH THE HELP OF THE TOR GRANT, THAT WE WILL BE ABLE TO CONTINUE TO REACH AND HELP THOSE STRUGGLING WITH SUBSTANCE ABUSE AND MISUSE IN THE YK DELTA

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

SPECIAL DIABETES PROGRAM FOR INDIANS - CVD/HEALTHY HEART INITIATIVE

TO PROVIDE BREAST AND CERVICAL CANCER SCREENING, FOLLOW-UP AND SUPPORT SERVICES F

HEALTH CARE AND OTHER FACILITIES

CALRICARAQ: YUKON KUSKOKWIM HEALTH CORPORATION'S NATIVE CONNECTION PROGRAM

YUKON KUSKOKWIM HEALTH CORPORATION EMERGENCY COVID-19 PROJECT

NATIVE CONNECTIONS CALRICARAQ

YKHC TRIBAL OPIOID RESPONSE

CALRICARAQ: HEALING OUR YOUTH AND FAMILIES

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

SPECIAL DIABETES PROGRAM FOR INDIANS - CVD

YKHC'S ADVANCING HOSPITAL-BASED VICTIM SERVICES DEMONSTRATION PROJECT

YUKON KUSKOKWIM HEALTH CORPORATIONCOVID-19 EMERGENCY RESPONSE FOR SUICIDE PROJECT - THE COVID-19 PANDEMIC HAS CAUSED INCREASED STRESS AND ANXIETY ON THE RESIDENTS OF THE YUKON KUSKOKWIM (Y-K) DELTA IN SOUTHWEST ALASKA. WITH OVER 85% OF OUR RESIDENTS ALASKA NATIVE IT IS CRITICAL OUR SUICIDE PREVENTION AND BEHAVIORAL HEALTH PROGRAMS PROVIDE CULTURALLY RESPONSIVE SERVICES TO THE POPULATION. COMBINING OUR TRADITIONAL YUP’IK ESKIMO WELLNESS PROGRAM, CALRICARAQ, AND OUR WESTERN-BASED BEHAVIORAL HEALTH (BH) CLINICAL SERVICES, WE ARE ABLE TO RESPOND TO BH EMERGENCIES AND PROVIDE FOLLOW UP TREATMENT SERVICES THAT CONNECT WITH OUR CLIENTS, MEETING THEM WHERE THEY ARE CULTURALLY AND EMOTIONALLY. THE Y-K DELTA REGION IN SOUTHWEST ALASKA IS HOME TO 58 FEDERALLY RECOGNIZED TRIBAL COMMUNITIES, MORE THAN 10% OF THE 566 FEDERALLY RECOGNIZED TRIBES IN THE ENTIRE UNITED STATES. OUR REGION IS IN A VERY RURAL SETTING WHERE NO ROAD SYSTEM EXISTS, AND AIR TRAVEL IS THE STANDARD METHOD OF TRANSPORTATION. AT 75,000 SQUARE MILES IN SIZE, OUR REGION’S LAND AREA IS LARGER THAN OKLAHOMA, THE 19TH LARGEST STATE, AND OUR 27,000 RESIDENTS, IN WHICH ALMOST EVERY COMMUNITY IS OVER 90% ALASKA NATIVE, MAKES THIS REGION ONE OF THE HIGHEST CONCENTRATIONS OF INDIGENOUS NATIVE AMERICANS IN ALASKA OR THE LOWER 48 STATES. FOR THE PURPOSES OF THIS PROPOSAL THE POPULATION OF FOCUS TO BE SERVED ARE INDIVIDUALS 25 YEARS OF AGE AND OLDER WHO ARE AT RISK FOR SUICIDE AND SUICIDE IDEATION. DURING THE INCREASED STRESS, ANXIETY AND DEPRESSION ASSOCIATED WITH THE COVID-19 PANDEMIC, THESE INDIVIDUALS ARE AT INCREASED RISK FOR SUICIDE. IN ADDITION, INDIVIDUALS WITHOUT PREVIOUS BH DIAGNOSES EXPERIENCING ACUTE STRESS AND ANXIETY AS A RESULT OF THE PANDEMIC ARE ALSO AT RISK, AND THIS PROJECT WILL ALSO TARGET THESE INDIVIDUALS. THROUGH THE COVID-19 ERSP PROJECT OUR GOALS AND OBJECTIVES REMAIN MUCH THE SAME AS THE STANDARD OF CARE WE PROVIDE TO OUR CLIENTS. THIS INCLUDES A MILIEU OF TRADITIONAL INDIGENOUS WELLNESS SERVICES THROUGH OUR CALRICARAQ PROGRAM IN PARTNERSHIP WITH OUR WESTERN CLINICAL TREATMENT METHODS. CLIENTS HAVE A CHOICE TO UTILIZE ONE OR THE OTHER, OR BOTH, AND SERVICES MAY INCLUDE SUCH MODALITIES AS MOTIVATIONAL INTERVIEWING AND FAMILY SYSTEMS THERAPY. MEASURABLE OBJECTIVES INCLUDE TRACKING BH EMERGENCY SERVICES (ES) ADMISSIONS, MONITORING UTILIZATION OF BH TREATMENT SERVICES FOR THOSE DIAGNOSED WITH DEPRESSION AND ANXIETY AND PATIENT SATISFACTION AS A RESULT OF THESE LIFE-SAVING SERVICES. WE ANTICIPATE AT MINIMUM WE WILL SERVE 150 CLIENTS. THE GREATEST RISK WE ARE CURRENTLY FACING, HOWEVER, IS THE INABILITY TO PAY FOR THESE SERVICES. DURING THIS PANDEMIC OUR 3RD PARTY/MEDICAID REVENUE HAS DECREASED BY 90% OVER THE PAST 3 MONTHS. THIS HAS PUT OUR BH ES DEPARTMENT AT RISK FOR LAYOFFS AND FURLOUGHS RESULTING IN A DECREASE IN AVAILABLE SERVICES FOR SUICIDE PREVENTION. THE FUNDING PROVIDED BY THE COVID-19 ERSP PROGRAM WILL ENSURE OUR BH ES DEPARTMENT WILL REMAIN FUNDED AND ABLE TO CONTINUE TO PROVIDE THESE LIFE-SAVING SERVICES SO IMPORTANT TO OUR FAMILIES AND COMMUNITIES WHO CONTINUE TO SUFFER GREATLY FROM THE EFFECTS OF SUICIDE.

YKHC COMMUNITY TRANSFORMATION PROJECT

THE YKHC SERVICE AREA IS APPROXIMATELY THE SIZE OF OREGON STATE AND IS NOT ON A ROAD SYSTEM, MAKING THE COORDINATION OF SERVICES AND ACCESS TO RESOURCES CHALLENGING. DUE IN LARGE PART TO TRANSPORTATION CHALLENGES, THE LOGISTICS INVOLVED IN GETTING PRODUCE TO COMMUNITIES THROUGHOUT THE REGION IN A RELIABLE AND AFFORDABLE FASHION PREVENTS MANY FAMILIES FROM PURCHASING FRUITS AND VEGETABLES.IN ADDITION TO THE HIGH COST OF FOOD, THIS REGION SEES SOME OF THE HIGHEST POVERTY LEVELS IN THE NATION. YKHC'S SERVICE AREA OVERLAPS WITH THREE CENSUS AREAS - KUSILVAK, BETHEL, AND YUKON-KOYUKUK. ACCORDING TO THE PERCENT OF HOUSEHOLDS THAT RECEIVE FOOD STAMPS/SNAP - UNITED STATES - COUNTY BY STATE REPORT FROM 2017, THE KUSILVAK CENSUS AREA HAD THE HIGHEST PERCENTAGE OF HOUSEHOLDS RECEIVING SNAP BENEFITS IN THE NATION, EXCLUDING PUERTO RICO, AT 58%. BETHEL CENSUS AREA RANKED NUMBER ELEVEN AT 39.2% AND THE YUKON-KOYUKUK RANKED THIRTY THIRD WITH 33.4%.IT IS BELIEVED THAT PROVIDING FINANCIAL INCENTIVES FOR PURCHASING FRUITS AND VEGETABLES WOULD HELP TO MITIGATE THE NEGATIVE HEALTH AFFECTS CREATED, IN PART, BY THE HIGH COST OF LIVING AND HIGH POVERTY RATES IN THIS REGION. IN SO DOING, WE ANTICIPATE INCREASED OVERALL HEALTH IN THE PARTICIPANTS OF THIS PROGRAM.TO EVALUATE THE IMPACT OF THIS PRESCRIPTION PRODUCE PROGRAM ON PARTICIPANTS' HEALTH, YKHC WILL BE COLLECTING SURVEYS AS WELL AS A1C VALUES FROM PARTICIPANTS. THE SURVEYS WILL EVALUATE CHANGES IN KNOWLEDGE AND BEHAVIOR, WHILE THE A1C VALUES WILL MEASURE A CHANGE IN THE ACTUAL HEALTH CONDITION OF THE PARTICIPANT. THE ANTICIPATED OUTCOME IS FOR THE SURVEYS TO REFLECT INCREASED KNOWLEDGE ON HOW TO PURCHASE FRUITS AND VEGETABLES ON A BUDGET, HOW TO INCORPORATE MORE FRUITS AND VEGETABLES IN MEALS, AND WHETHER OR NOT PARTICIPANTS' SHOPPING HABITS HAVE CHANGED OVER THE COURSE OF THEIR PARTICIPATION. FOR THE A1C VALUES, THE ANTICIPATED OUTCOME IS TO SEE A DECREASE IN A1C VALUES FOR PARTICIPANTS, CORRELATED TO THE NUMBER OF PRESCRIPTIONS RECEIVED AND EDUCATIONAL OPPORTUNITIES THAT PARTICIPANTS ENGAGE IN.

**AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** GUS SCHUMACHER NUTRITION INCENTIVE PROGRAM PRODUCE PRESCRIPTION PROGRAM

YKHC CALRICARAQ NATIVE CONNECTIONS - POPULATION TO BE SERVED: OUR NC PROJECT WILL SERVE THE 12,350 YOUTH, AGE 24 AND UNDER, OF THE YUKON KUSKOKWIM (Y-K) DELTA REGION OF SOUTHWEST ALASKA, AN AREA COVERING 75,000 SQUARE MILES, IS LARGER THAN THE STATE OF WASHINGTON. THIS REGION INCLUDES 58 FEDERALLY RECOGNIZED TRIBAL COMMUNITIES AND HAS ONE OF THE HIGHEST CONCENTRATIONS OF INDIGENOUS NATIVE AMERICANS IN ALASKA AND THE LOWER 48 STATES. STRATEGIES / INTERVENTIONS: CALRICARAQ, OUR YUP’IK ANCESTRAL WAY OF HEALTHY LIVING, IS BEING REINTRODUCED TO OUR PEOPLE THROUGH THE TRADITIONAL HEALING STAFF OF THE BH PREVENTION DEPARTMENT AT YKHC. CALRICARAQ IS AN ELDER-DRIVEN PROGRAM THAT ENCOMPASSES OUR YUP’IK ANCESTRAL WISDOM AND KNOWLEDGE AND IS OUR HOLISTIC APPROACH TO HELP PEOPLE HEAL FROM THE IMPACTS OF COLONIZATION. CALRICARAQ SERVES COMMUNITY MEMBERS OF ALL AGES, BUT WE FOCUS MOST OF OUR EFFORTS ON PARENTS AND SCHOOL-AGE YOUTH. WE ALSO PROVIDE TRAINING TO SERVICE PROVIDERS WHO WORK WITH OUR TRIBAL MEMBERS, I.E., HEALTH CARE AND SOCIAL SERVICE WORKERS, ELDERS, HOSPITAL PATIENTS AND THEIR FAMILIES, SCHOOLTEACHERS, FIRST RESPONDERS AND OTHERS. IN ADDITION, OUR STAFF ARE TRAINED IN CRISIS RESPONSE, RESPONDING TO COMMUNITIES AND FAMILY MEMBERS INVOLVED IN TRAUMATIC INCIDENTS (HOMICIDE, SUICIDE, PLANE CRASHES, ETC.), WHERE WE INTERVENE FOR THOSE GOING THROUGH TIMES OF CRISIS, GUIDING THEM THROUGH GRIEF IN HEALTHY WAYS USING CULTURAL STRENGTHS. IF FUNDED, THE NATIVE CONNECTIONS STAFF WILL HAVE A DIRECT FOCUS ON THE YOUTH OF OUR REGION AND WILL BE PART OF OUR BH PREVENTION TEAM. PROJECT GOALS AND MEASURABLE OBJECTIVES: IN YEAR 1 OF THE GRANT, THE NC STAFF WILL 1) CONDUCT A COMMUNITY NEEDS ASSESSMENT, 2) COMMUNITY READINESS ASSESSMENT; AND CREATE A STRATEGIC ACTION PLAN BASED ON THESE ASSESSMENTS THAT ADDRESSES SUICIDE PREVENTION, SUBSTANCE USE PREVENTION, AND MENTAL HEALTH DISORDERS. SECONDLY, WE WILL REVISE OUR YKHC BH POSTVENTION PROTOCOLS, INCLUDING SUICIDE, SUICIDE ATTEMPTS, SUICIDE CLUSTERS, AND SUBSTANCE MISUSE AND OVERDOSE TO REFLECT THE TRADITIONS AND CULTURE OF THE YUP’IK, CUP’IK, AND ATHABASKAN PEOPLE OF THE Y-K DELTA REGION. FINALLY, AND WHAT WE BELIEVE WILL BE MOST IMPACTFUL TO OUR YOUTH IS THE TRADITIONAL AND CULTURAL YOUTH OUTREACH SERVICES AND ACTIVITIES TO OUR Y-K DELTA REGION VILLAGES. THIS OUTREACH WILL BE PROVIDED THROUGH CALRICARAQ WORKSHOPS, QARUYUN (HEALTHY YUP’IK LIVING AND COPING SKILLS) WORKSHOPS, AND QPR SUICIDE AWARENESS TRAINING. NUMBER OF PEOPLE TO BE SERVED ANNUALLY: 300 NUMBER OF PEOPLE TO BE SERVED THROUGH THE LIFETIME OF PROJECT (5 YEARS): 1,500 SUMMARY OF PROJECT: CALRICARAQ (“LIVING WELL”) IS AN ELDER-DRIVEN PROGRAM USING YUP’IK ANCESTRAL WISDOM AND KNOWLEDGE TO HELP PEOPLE HEAL. WE SERVE THE YUP’IK, CUP’IK AND ATHABASKAN YOUTH IN THE FIFTY-EIGHT VILLAGES OF THE YUKON KUSKOKWIM DELTA OF SOUTHWEST ALASKA. OUR INTERVENTION INCLUDES CALRICARAQ WORKSHOPS, QARUYUN (HEALTHY YUP’IK LIVING AND COPING SKILLS) WORKSHOPS, AND QPR SUICIDE AWARENESS TRAINING. WE AIM TO PROVIDE OUTREACH TO 1,500 YOUTH OVER THE 5-YEAR GRANT.

CAPITAL DEVELOPMENT

YUKON KUSKOKWIM HEALTH CORPORATION EMERGENCY COVID-19 PROJECT

** AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** THE PRESCRIPTION PRODUCE PROGRAM (PPR) WILL INCENTIVIZE THE PURCHASE OF FRUITS AND VEGETABLES FOR LOW-INCOME PERSONS WHO RECEIVE MEDICAL ASSISTANCE UNDER A STATE PLAN. MEDICAL PROVIDERS WILL PROPOSE REFERRALS FOR PRODUCE PRESCRIPTIONS TO THE DIABETES PREVENTION AND CONTROL (DP&C) DEPARTMENT FOR PATIENTS WHO SCREEN POSITIVE AND HAVE A DOCUMENTED DIAGNOSIS OF FOOD INSECURITY. PROVIDERS WILL PROPOSE A PRESCRIPTION TO DP&C FOR ELIGIBILTY VERIFICATION AND REVIEW. DP&C WILL VERIFY ELIGIBILITY AND, WHEN APPROPRIATE, WRITE PRESCRIPTIONS FOR PRODUCE THAT CAN BE REDEEMED AT PARTICIPATING LOCAL STORES OR MAY ELECT TO RECEIVE CURATED PRODUCE BOXES FROM A LOCAL FARM.. EACH PRESCRIPTION WILL ALLOW FOR THE PURCHASE OF $45-$90 OF F/V PER MONTH DEPENDING UPON HOUSEHOLD . PARTICIPANTS WILL RECEIVE 3 MONTHS OF VOUCHERS AT A TIME THAT CAN BE REDEEMED ONCE PER MONTH. ADDITIONAL REFILLS (VOUCHERS) WILL BE DISTRIBUTED QUARTERLY. IN ORDER TO RENEW THE PRESCRIPTION, PATIENTS WILL A FOLLOW UP APPOINTMENT WITH THEIR PROVIDER FOR 6 MONTHS AFTER THEIR INITIAL VISIT FOR A CHRONIC CARE/PREVENTATIVE CARE APPOINTMENT. THE ANTICIPATED IMPACT OF THIS PROJECT IS AN INCREASE IN HEALTHCARE UTILIZATION FOR THE PURPOSE OF PREVENTATIVE CARE RATHER THAN TREATMENT OF ACUTE ISSUES. IMPROVEMENTS IN FOOD SECURITY ARE ANTICIPATED AS WELL AND REPORTED INCREASES IN CONSUMPTION OF FRUITS AND VEGETABLES.

HEALTH CENTER INFRASTRUCTURE SUPPORT

ARRA - CAPITAL IMPROVEMENT PROGRAM

CALRICARAQ: HEALING OUR YOUTH AND FAMILIES

RESPIRATORY SYNCYTIAL VIRUS (RSV) STUDY

KONGIGANAK HEALTH CLINIC - KONGIGANAK, ALASKA

CVD SPECIAL DIABETES PROGRAM

REDUCING TOBACCO USE IN PREGNANCY IN YK DELTA WOMEN

HEALTH CARE PERSONNEL COVID-19 VACCINE EFFECTIVENESS STUDY - YKHC

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

RENOVATION OF VILLAGE HEALTH CLINIC FOUNDATIONS

ARRA - INCREASE SERVICES TO HEALTH CENTERS

GUARANTEED OPERATING LOAN

WWD TECHNICAL ASSISTANCE & TRAINING GRANTS

WWD TECHNICAL ASSISTANCE & TRAINING GRANTS

WWD TECHNICAL ASSISTANCE & TRAINING GRANTS

NATIVE CONNECTIONS CALRICARAQ

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

WWD TECHNICAL ASSISTANCE & TRAINING GRANTS

COMMUNITY FACILITY GRANTS

SKIN INFECTION INTERVENTION PROJECT

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

RESEARCH COORDINATOR

CDC ARCTIC INVESTIGATIONS PROGRAM RESEARCH COORDINATOR

CDC ARCTIC INVESTIGATIONS PROGRAM RESEARCH COORDINATOR

CDC ARCTIC INVESTIGATIONS PROGRAM RESEARCH COORDINATOR

COMMUNITY FACILITIES - ECONOMIC IMPACT INITIATIVE GRANTS

COMMUNITY FACILITIES - ECONOMIC IMPACT INITIATIVE GRANTS

COMMUNITY FACILITIES - ECONOMIC IMPACT INITIATIVE GRANTS

RESPIRATORY SYNCYTIAL VIRUS (RSV) STUDY

FY 2023 BRIDGE ACCESS PROGRAM

FY 2023 EXPANDING COVID-19 VACCINATION

TBH COVID-19

WWD TECHNICAL ASSISTANCE & TRAINING GRANTS

KONGIGANAK HEALTH CLINIC - KONGIGANAK ALASKA

CDC ARCTIC INVESTIGATIONS PROGRAM RESEARCH COORDINATOR

RENOVATION OF VILLAGE HEALTH CLINIC FOUNDATIONS

RESPIRATORY SYNCYTIAL VIRUS (RSV) STUDY

SKIN INFECTION INTERVENTION PROJECT

YKHC CLINIC CONSTRUCTION

RESPIRATORY SYNCYTIAL VIRUS (RSV) STUDY

CDC ARCTIC INVESTIGATIONS PROGRAM RESEARCH COORDINATOR

SKIN INFECTION INTERVENTION PROJECT

HEALTH CAREER PATHWAYS PROJECT

RENOVATION OF VILLAGE HEALTH CLINIC FOUNDATIONS

RESPIRATORY SYNCYTIAL VIRUS (RSV) STUDY