1. Enhancing Community Capacity to Meet Environmental Health Needs in Rural Alaska Mary B. O’Connor, M.S., REHS – Alaska Native Tribal Health Consortium, Anchorage, Alaska Introduction This project addresses several of the Ten Essential Environmental Health Services and Core Functions: Goals and Objectives 10 Essential Environmental Health Services Systems Analysis Approach Environmental health funding in the United States continues to decrease in relation to need, particularly in Native communities. With difficult economic times, demands for environmental health services are increasing while the traditional sources of revenue are stagnant or declining. Money for environmental projects and activities for Native American/Alaska Native people are traditionally obtained from the Indian Health Service (IHS). However, IHS funding is not able to meet current needs and demands. Many communities do not have the staff, expertise, experience or time to devote to managing community environmental health programs. The communities depend on environmental health staff of the regional health corporations to provide technical assistance, professional guidance and direction to manage their environmental health concerns and needs. Staff is often directed by priorities of the regional health corporation, regulatory requirements, lease and other funding obligations and individual professional interests. This report looks at a strategy developed to assist Native communities in rural Alaska in developing their capacity to obtain funding to direct and manage their own environmental health projects. The “Shifting the Burden” archetype identifies root causes of the lack of funding cycle that occurs in rural Alaska. Program Goal: To assist Native communities in rural Alaska in expanding their capacity to meet their environmental health needs Health Problem: Environmental health funding in the United States continues to decrease in relation to need, particularly in Native communities in rural Alaska. Outcome Objective: To expand capacity of rural Native communities in Alaska to fund and direct environmental health programs with the assistance and cooperation of the Alaska Native Tribal Health Consortium Contributing Factors:  IHS under funded  Increasing EH concerns  RRM lacks valid data  Limited time and resources  Lack of experience and expertise  Inadequate EH perspective Next Steps References Acknowledgements Assessment Monitor health by analyzing data to recognize and justify needs; surveying community members to identify gaps and promote change within communities by focusing on goals that address local concerns. In articulating these goals, community awareness of roles and responsibilities in the environmental health field will be increased. Diagnose and investigate environmental health problems and health hazards by identifying locally perceived gaps in environmental health service delivery and promote change that is community driven. Policy Development Inform, educate and empower communities by assisting communities in developing the local infrastructure and supporting them in this endeavor. Mobilize community partnerships to establish and maintain collaborative working relationships with local, state and federal partners to resolve identified goals. Osaki, C., eds. 10 Essential Services of Environmental Health. Northwest Center for Public Health Practice, University of Washington School of Public Health and Community Medicine, Seattle, 2004 LTJG Kimberly Patterson, BS Environmental Health Assistant, Alaska Native Tribal Health Consortium Photo # 2 Compost Awareness Day May 2005 Assurance Link to/provide care for community members through local, state, federal and non-profit partners who are technically competent. Assure competent workforce within the local community by enhancing existing skills, training or providing technical assistance to meet goals of the grants. Evaluate the success of the program by meeting the monitoring, evaluation and reporting requirements of grants. System Management Conduct research for new insights and innovative solutions to environmental health problems and issues by allowing communities to develop and test their own solutions to existing problems. Federally funded Native environmental health programs receive limited funding that barely covers basic environmental health needs. Agencies responsible for providing the environmental health services never seem to have enough funding or staff to assist in developing the community capacity and community infrastructure doesn’t have the experience to be able to seek outside funding with grants or develop beneficial partnerships. As more environmental health issues come to the forefront, Native communities are becoming less able to address these issues. The environmental public health disparities between Alaska Natives/American Indians and the overall U.S. population will continue to grow. Hire two additional environmental health staff in the Environmental Health Support department. Develop a successful track record of grant application, awarding and reporting. Maintain a current list of grant opportunities and funding sources. Continued collaboration and support of community staff throughout the process will build their capacity, confidence, and ability to proceed through future grant processes.