Location:

Delta region of southwest Alaska, Alaska

Initial Funding:

October, 1999

Focus:

The mission of the Yukon–Kuskokwim Health Corporation is to achieve the greatest possible improvement in the health status of the people of the Yukon–Kuskokwim Delta Region of Alaska. The Project is committed to the development of culturally relevant programs for primary care, prevention, and health promotion in a setting that fosters Native self-determination in the control and management of health delivery. Toward that end, the program maintains a focus on the following goals: Create formal partnerships among child-serving providers across the Yukon–Kuskokwim Delta to create a single, culturally sensitive system of care; Establish core multidisciplinary service teams at sub-regional hub villages to provide holistic, culturally competent diagnosis, treatment planning, supervision, and support to providers in individual villages; Support families to guarantee participation at all levels of the system, including leadership, policymaking, and evaluation; Establish formal agreements among providers to create a single system of care that is focused on the child; develop a model for a managed care system to simplify access to services for children and their families.

Population:

The service area for People Working Together is the entire YK Delta, which has a total population of 25,000. The Alaska Native population served by YKHC consists of Yup’ik and Cup’ik Eskimo and Athabaskan Indian tribes. The majority are Yup’ik, but there are two Cup’ik villages and four Athabascan Indian villages. Seventy-one percent of YKHC’s 1,300 employees are Alaska Natives. Although most of the employees are based in Bethel, 350 are based in villages and many others travel to regional villages to deliver services. Transportation to services in Bethel or elsewhere in the State is complicated by the lack of connecting roadways. Most travel depends on commercial and charter airline services, although boats travel the waterways during the summer and snowmobiles are used during the winter. The Alaska Mental Health Board’s strategic plan states that 10 percent of Alaskan young people experience emotional problems so severe that their functioning is impaired. This number may be higher in the YK Delta, however, due to substance abuse and suicide rates, lower socioeconomic status, and the substantially younger Alaska Native population. The rate of fetal alcohol syndrome for the Delta region exceeds the State average of 4.3 per 1,000 births. The suicide rate is six times greater than the national average, and, according to YKHC data, nearly half of all Alaska Natives in the YK Delta die before age 44. The original grant proposal projected that a minimum of 150 children with serious emotional disturbance would receive grant funded services by the end of the first program year, with an additional 250 to be served by the end of the second year. Village-based, wraparound services and wraparound teams are available to all children served by YKHC. However, any child for whom a Descriptive Information Questionnaire has been completed for the CMHS national evaluation and who is served by at least one grant-funded staff is counted as being served by the grant program. At the end of June 2002, a total of 69 children were enrolled in the grant program.

Contact Info:

laura_baez@ykhc.org

chris_bragg@ykhc.org

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