From Chief Medical Officer Dr. Anne Zink, MD, FACEP
Welcome to the December Issue of Alaska Chief Medical Officer News!
Our goal with this newsletter is to provide Alaska's health care providers with clinically-relevant and concise news from the Alaska Department of Health and Social Services (DHSS). If you're a provider who isn't already subscribed, we encourage you to sign up to receive this newsletter via this link and share this publication with other providers. Here are some recent highlights from the past month:
Fiscal Year 2021 Budget and the Upcoming Legislative Season
Following Governor Dunleavy's Fiscal Year 2021 budget release on Dec. 11, DHSS Commissioner Adam Crum wrote in a letter to DHSS employees outlining the main changes in the budget. Medicaid, of course, continues to be the largest cost driver for the DHSS budget. The department has implemented a number of cost-containment measures and will continue to work on finding efficiencies and long-term savings within Medicaid and throughout DHSS.
As many of you know, the governor's budget restores Medicaid's Adult Enhanced Dental Program and the Division of Public Assistance's Adult Public Assistance program. I know this was welcome news to many health care providers.
The governor's budget maintains the current level of staffing within DHSS and adds a deputy commissioner to work closely with the Office of Children's Services, the Division of Juvenile Justice and other programs that keep children and families safe and together. The goal is to provide better oversight, accountability and achieve better outcomes to meet the needs of children and families.
Of course, the governor's budget is the beginning of a process. The Legislature convenes in Juneau on Jan. 21 and will begin deliberating the budget that will fund Alaska's state government for the coming fiscal year, which begins July 1, 2020. For more information on the governor's budget, please visit the Office of Management and Budget webpage.
Overview of the Regulatory Process
Because I get many questions on this and we're headed into the legislative season, I wanted to include in this newsletter a primer on how laws and regulations are enacted, and how the public process works if you have comments or opinions you want heard. Please refer to Explaining the Regulatory Process.
State of Alaska's Health and Healthy Alaskans 2030
What better time than the beginning of the new year to set health goals, both personal and for Alaska as a state. In late January or early February, I will be presenting to lawmakers in Juneau about the State of Alaska's health. I'll be sharing DHSS data and trends to provide baseline knowledge for lawmakers as they address health issues as we work together on plans to improve the health and well-being of all Alaskans. We don't have a date set yet for those presentations but please check the calendar and follow the Alaska State Legislature on their website. I would also love to include stories from you all. Do you have a great success or challenge in Alaska's health care landscape? Email me your perspective.
If you haven't already read it, I recommend the 2018 Health Analytics & Vital Records Annual Report released earlier this month. This report covers a wealth of health information, including Alaska's top 10 leading causes of death.
Healthy Alaskans 2030 (HA2030), which contains Alaska's health priority goals for the next 10 years, will be released in January. Led jointly by DHSS and Alaska Native Tribal Health Consortium (ANTHC), HA2030 is Alaska's state health improvement plan and will serve as an important document to guide all of us for the next decade. For more information on Healthy Alaskans, please refer to the Healthy Alaskans article in this newsletter.
Multimodal Pain Approach
Data is becoming clear that a multi-modal approach to pain is more effective than prescribing only opioids. The science is changing rapidly, and I appreciate the many questions I get on this topic, and on opioids and pain management in general.
I realize and appreciate how difficult pain management can be for health care providers as we continue to address Alaska's opioid epidemic. We don't want to harm patients or start a life of addiction but must also balance this with treating pain and helping patients live healthy, productive lives. This balance has been further compounded by seeing fellow providers incarcerated and I hear your concerns and frustrations as you try to find this balance. We are working on specialty specific tools, provider outreach, ease of prescription drug monitoring program (PDMP) use, and as many resources to support your work as we can.
One resource I wanted to highlight was Project ECHO (Extension for Community Healthcare Outcomes) website. Project ECHO is a tele-mentoring program that brings together specialists to share evidence-based approaches to manage complex cases. The Opioid & Pain Management ECHO meets every other Monday from 12:15 –1:15 p.m. You get to hear from some of the best in the state who manage pain and you can present a challenging case you may have. You can be a medical provider from any specialty to join; this is an Alaska project to support Alaska providers in managing pain and addiction. I would highly recommend attending.
This newsletter will continue to provide you with evidence about what's working and what's not, including resources for emergency departments and better inpatient and outpatient support.
CMO Office Hours
Thank you to Alaska Regional Hospital for hosting office hours last month. Providers had great questions, many of which I tried to address in this newsletter. I am now regularly holding office hours at health care facilities around Alaska so I can hear concerns directly from the health care community. If you are interested in having me come to your office, clinic or hospital to hold one of these meetings, please contact Program Coordinator Doniel Wolfe 907-334-2474.
Your Feedback Is Valuable
This newsletter is a work in progress and we will continue to work with the format to make it as easy to read and accessible as possible. We look forward to your feedback and collaboration. Please feel free to contact me or Doniel Wolfe 907-334-2474, with any feedback, comments, or questions you may have. Thank you for all you do!
Anne Zink, MD, FACEP | Chief Medical Officer
Alaska Department of Health and Social Services
3601 C Street, Suite 756 | Anchorage, AK 99503