To Anchorage Interviews

H2004-17-12

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1) His personal background and early involvement with the Community Health Aide Program (CHAP).
introduction\ Nulato -- birth\ Anchorage\ CHAP -- involvement with\ administrator\ Indian Health Service (IHS) -- area office\ IHS -- service units\ general policy -- statewide programs\ CHAP -- statewide program\ funding -- IHS\ federal agency -- innovation\ health care -- providers\ health care recipients\ service -- delivery of\ healthcare -- “natural” providers \ rural Alaska\ medicine -- modern \ medical supervision -- level of|

2) The training and education of community health aides to provide primary care in their communities.
health workers -- training\ para-professionals -- training\ CHAP -- organization of\ Anchorage\ service unit hospitals\ training\ primary health care -- delivery of\ training program -- development of\ innovations\ mistakes\ staff -- nurses\ medical director -- supervisor\ teamwork\ travel -- villages\ seminars\ training -- health aide|  

3) How health aides provided primary health care and also functioned as the “eyes and ears” of physicians far away.
primary health aides -- number of\ alternate health aides -- number of\ health aide -- methodology\ manual -- standing orders\ radio\ hospital -- talk with\ doctors -- coordination with\ first aid\ stabilization\ preventative health\ well-baby clinics\ immunizations\ primary health care -- village level\ program -- unique\ program -- model\ geographic areas -- large\ population -- sparse\ visitors -- international\ Australia\ Russia\ Canada\ China|

4) The role of the Community Health Aide Program as a model for similar programs around the world, and the governmental support the program received.
program -- model\ Office of Economic Opportunity (OEO)\ Johnson administration\ special initiatives -- enlisting youth\ Peace Corps\ Health Aide Program\ funding\ Indian Health Service\ Yukon Kuskokwim Health Corporation\ Norton Sound Health Corporation\ training\ collaboration\ doctors\ Nome\ Bethel\ program -- expansion of\ organizations -- working together\ disputes\ services -- quality of\ services -- quantity of\ esprit de corps\ IHS -- health aides\ Corporation -- health aides\ health corporation model\ regional health corporations -- organization of\ health care -- delivery of\ health aide -- training\ IHS -- contracts\ IHS area office -- Alaska Native Hospital\ Alaska Native Tribal Health Consortium\ Native health care -- statewide organization\ area hospitals -- Native Health Corporations\ Cook Inlet Corporation\ South Central Foundation\ primary health care system -- Anchorage Hospital\ clinic\ preventative care\ lab work\ screening\ Fairbanks -- Tanana Chiefs Conference\ Chief Andrew Isaac Clinic\ Fairbanks Memorial Hospital|

5) His experiences working in the administration of the Community Health Aide Program.
administrator -- role\ hiring\ supervising\ management \ leadership\ budget\ programmatic reporting\ accounting\ medical supervision -- doctor\ nurse trainer\ policies\ team -- egalitarian\ staff -- skilled\ education -- business\ relationships -- professional\ problems -- working through\ exciting time\ budget\ impact -- primary health care\ rural Alaska\ residents -- indigenous\ residents -- providing services\ health aides -- respected\ accomplishment -- sense of\ impact -- positive\ saving lives|

6) His memories of some individuals who contributed significantly to the community health aide program.
work -- duration\ Johnson, Dr. Walter -- medical director\ doctor -- early\ Boyce, Eva -- nurse trainer\ Johnson, Barbara \ Bolan, Mary \ Aleut Health Corporation\ Askolkoff, Loretta -- public health nurse\ nurse trainers -- ethnicity \ training\ health aides -- working with|

7) Cultural concerns that arose in the implementation of the program, and who was in control of policy making decisions.
staff -- relationships\ training -- cross-cultural\ experience -- hands-on\ relationships -- professional\ health aides -- camaraderie\ Alaska Native\ Ivey, Gerald\ Indian Health Service -- Office of Native Affairs\ Lee, Dr. John -- area director \ open-mindedness\ CHAP -- support for\ McGrath\ Singyke, Bob\ Native Health Board -- building capacities\ health care -- policy development\ health boards -- involvement\ health care -- delivery\ Ivey, Gerald -- Director, Office of Native Affairs\ Ivey, Gerald -- retirement\ advocate -- Native self-control|

8) The appearance of regional Native Corporations, and the development of his own career.
Ivey, Gerald\ Bolan, Mary -- training\ work -- after Health Aide Program\ Alaska Native Land Claims Settlement Act\ organization -- Native\ Cook Inlet Regional Corporation -- formation of\ board member\ Corporation presidents -- “burn-out”\ president -- Cook Inlet Region Incorporated\ retirement\ work -- consultant\ non-profit organizations -- fundraising\ education -- community college\ University of Alaska Anchorage\ education -- night courses\ graduation -- B.A. business administration\ finance\ management|

9) How health aides were selected and educated, and the role of traditional health care providers.
health aides -- selection\ traditional healers\ village councils -- input\ interviews\ volunteers\ previous involvement\ interest\ Public Health Nurse Program -- State of Alaska\ nurses -- itinerant\ rural Alaska -- travel to\ preventative health\ immunizations\ well-baby\ lectures -- public health\ examinations -- medical\ Public Health Nurses -- CHAP training\ relationship -- agency\ state\ Indian Health Service -- federal\ jurisdiction\ conflict\ health aides -- resource\ policymakers\ Juneau\ health care -- delivery of\ health care -- importance of\ Public Health Nurses -- employment\ public health nurses -- admiration for\ mentors|

10) The hardships faced by early health aides, how the program has changed, and strengths of the community health aide program.
health aide -- job\ job -- difficulties\ hours -- length of\ pay -- lack of\ on-call\ primary health provider\ harassment\ work -- demanding\ job -- love of\ job -- “burn-out”\ politics -- village\ village council\ family ties\ Health Aide Program -- chief\ problems -- listened to\ individuals -- continuity\ program -- changes\ CHAP -- organization\ CHAP -- employment\ Health Corporation\ job -- pay\ benefits\ health aides -- ethnicity\ CHAP -- strengths\ people\ project -- enthusiasm for\ work -- satisfaction with\ program -- making a difference|

11) Weaknesses in the community health aide program, education, training, and skills of health aides, and the overall success of the program.
CHAP -- weaknesses\ work hours -- length\ pay -- low\ benefits -- lack of\ politics\ money -- lack of\ budget\ training -- duration\ education -- level of\ education -- continuing\ training -- specialized\ health aide -- skill level\ health aide -- years of experience\ wisdom\ common sense\ dedication\ trainers\ health aides\ education -- lack of\ health delivery -- practical\ CHAP -- success of\ Office of Economic Opportunity -- posters\ work ethic\ society -- contribution to\ people -- enthusiasm|

12) The evolution of the community health aide program and the various administrative entities helping in its development.
job -- administrator\ problem solving\ communication\ village\ region\ health aide -- fair treatment\ Singyke, Bob\ health boards -- communication with\ village councils -- presidents\ problems -- discussing\ action -- requested\ problems -- resolution\ Health Boards\ Indian Health Service -- motivations\ policy decisions -- control of\ IHS -- local contracting\ problems\ good will\ Health Aide Program -- success\ health aides -- status of\ Health Corporations -- organization of\ health care delivery -- supervision\ health care delivery -- ethic\ health care -- Native control of\ health care -- differences in\ care -- quality\ budget -- administration\ Indian Health Service|

13) His reasons for the career path he chose, the challenges he faced as administrator of the Community Health Aide Program, and some more information on sources of funding for the program and which communities benefited.
Alaska Native Claims Settlement Act\ health program -- interest in\ medicine -- interest in\ school -- sciences\ job -- administrator\ job -- challenges\ people\ conflict -- resolution of\ personal nature\ attitude\ job -- possible “burn-out”\ job -- success\ ideas -- coordinating\ challenge -- funding\ Federal government -- funding\ documents -- budget\ wages\ workforce -- need for\ expansion\ health aides -- reliance on\ health aides -- treatment of\ health care -- providing\ villages -- number of\ health aides -- primary\ health aides -- alternate\ population -- minimums\ funding -- lack of\ health aides -- payment|

14) The construction of clinic buildings, how early health aides communicated with doctors in other communities, and some comments on important nurses from early on.
villages -- clinics\ clinics -- construction of\ Ivey, Gerald\ Lee, Dr. John\ Indian Health Service -- funding\ health aides -- communication with doctors\ telephones -- availability\ long-wave radio -- reliability\ UHF radio -- line of sight\ satellite telephone systems\ video conferencing\ health aide -- “eyes and ears of the doctor”\ diagnoses -- long-distance\ health aides -- job title\ primary health care providers\ health aide -- para-professional\ health aide -- origin of name\ Bolan, Mary\ counseling\ University of Alaska Anchorage -- professor\ Hendricks, Lavonne -- Norton Sound Health Corporation\ public health nurse -- trainer\ Kotzebue\ White Mountain\ Ashenfelter, Willa\ Winkleman, Rose\ Walker, Lillian\ perspective -- village\ Kodiak\ Smith, Joyce\ Ouzinkie\ Krumrey, Stella\ Old Harbor\ health aides -- veterans|

15) What working with the health aide program meant to him personally and his career development, and how as an administrator he dealt with conflicts between organizations.
health aide program -- personal meaning\ job -- enjoyment\ career -- development\ nostalgia\ job -- problem-solving\ agencies -- cooperation\ controversies\ Norton Sound Health Corporation| Yukon Kuskokwim Health Corporation\ conflict -- resolution|

[Interview ends abruptly because tape ran out.]