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Sunshine Community Health Center is proud to partner with the Alaskan Aids Assistance Association (4A’s) to provide education and harm-reduction supplies to the upper Mat-Su area, aka the Northern Valley. Through this partnership we can provide a syringe program, where community members can bring in their used syringes and receive new ones. We have the ability to safely dispose of sharps at the clinic. Additionally, with the assistance of 4A’s, we are also able to provide safer-injecting harm-reduction kits, naloxone kits, condoms, fentanyl test strips, etc. to help reduce the risk of transmitting disease. We are happy to provide education in the use of naloxone kits, upon request. In addition to harm reduction supplies, we can also provide risk reduction counseling, referrals for addiction treatment and recovery programs, as well as connect you to resources that could assist in meeting your needs. There are many ways you can access this resource.  Our clinics have supplies on site for easy access. We ask that if you plan to come to the clinic to request supplies, that you outreach our direct behavioral health line at 907-733-9292 to ensure we have staff available to help you with your request. Rest assured, that we take steps to maintain confidentiality, such as only requesting non-identifying information such as gender, age range, race and zip code. Our goal is to provide methods of providing education and reducing stigma using these prevention strategies. We are motivated to meet you where you are at, utilizing trauma-informed, culturally sensitive, and patient-centered approaches. Please reach out and let us know how we can best support you. Crystal Edwards, LCSW Sunshine Community Health Center Behavioral Health Direct Line || 1-907-733-9292 General Inquiries || 1-907-376-2273 (CARE) Willow Clinic || 1-907-495-4100 Talkeetna Clinic || 1-907-733-2273 (CARE) www.sunshineclinic.org

Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org

Cervical Cancer Awareness Month - Increase Cancer Screening Rates Free resources on How to Increase Cancer Screening Rates - Open Office Hours January is Cervical Cancer Awareness Month, and it is an ideal time to focus on increasing rates of cervical cancer screening. Mountain Pacific Quality Health with support from the Alaska Breast and Cervical Screening Assistance Program, is offering individualized one-on-one support/technical assistance to clinics on evidence-based strategies to improve cervical cancer screening rates during the month of January.  Some examples of what support we can offer include: Review cancer screening performance ( eCQM 124) and identify care gaps Identify patients coming due and overdue for screening Conduct and outreach campaign Host a women’s wellness day Set up reminders for providers Set up reminders for patients Set up a process to track results If interested, please select a day/time that works best for you. If you need additional support after the initial meeting, additional support is available through June 2024.  SCHEDULE your one-on-on session HERE! Transportation Assistance Through Uber Health AK B+C has an account with Uber Health that is available to all participating providers to help your patients with any transportation barriers preventing them from accessing breast or cervical cancer screening. Currently Uber Health is limited to Anchorage, Fairbanks, and Juneau but we anticipate they will expand their services to other areas of Alaska. If you have a patient(s) who needs transportation assistance, please follow the instructions in the attached Word document. If you have questions, please contact Bobbi Unger at bobbi.unger@alaska.gov or 907-269-4662. Translation Support through Language Line AK B+C has an account with Language Line Solutions that is available to all participating providers at no cost to you. These services are available for all staff in your practice who work with Limited English speakers. Online Enrollment Available In addition to 1-800-410-6266 and the paper enrollment forms, we now have mobile friendly online enrollment available on our webpage, through this link https://www.med-itweb.com/public/open_enrollment/index.php?state=ak  and QR code. Please let us know if you would like to learn more. Education and Support Opportunity - Overview of the Alaska Health Information Exchange Alaska’s Health Information Exchange (HIE) healthEConnect Demonstration – Highlighting available lab and imaging results. Wednesday, January 26th from 12pm-1pm Registration: Webinar HIE Demo - Zoom Join us for a demonstration of Alaska’s HIE healthEConnect platform, by Mary Ann Eckart, PA-C, Clinical Engagement Specialist. The HIE platform provides secure and HIPAA-compliant access to health data for authorized users and is available to any Alaskan organization providing treatment or care coordination. Health records can be accessed immediately at the bedside or point of care, rather than waiting on a fax or paper records to be received. Lab results, imaging reports and visit notes from participating organizations can be quickly viewed via the healtheConnect portal. AK B+C Quarterly Provider TA Calls Please join us for the Alaska Breast + Cervical Screening Assistance Program Quarterly Provider Meetings. The next call will be: Wednesday, January 31:  8:00-9:00 am or 12:00-1:00 pm Please contact Bobbi Unger at bobbi.unger@alaska.gov or 907-269-4662 with questions and to sign up. Alaska Breast & Cervical Screening Assistance Program State of Alaska Division of Public Health Section of Women's, Children's, and Family Health

Get Little Ones Outside for Healthy Bodies & Brains Walk by an outdoor playground or park and you’ll see kids buzzing around as the air fills with screams and laughter. To adults, this is just kids playing and having fun. To kids, however, this is serious business. These kids are working their bodies and brains. They’re developing stronger muscles and bones. They’re making brain connections, fine-tuning their motor skills, working on their social skills, and expanding their imaginations. Outdoor play is more than letting kids expend some pent-up energy. It’s an important part of early development and learning. A review of current research by the Children and Nature Network shows that there are lots of benefits to playing outside. Outdoor Play Promotes Physical Health When children play outdoors, they stay far more active than when indoors. Children who participate in vigorous activities — such as running, jumping, and skipping — are more fit, have better bone health, and grow up at a healthier weight, compared to more inactive children. The Physical Activity Guidelines for Americans recommend that children ages 3 through 5 should be physically active for about 3 hours throughout the day for the best growth and development. Keep kids moving with a variety of light, moderate, and vigorous activities so they get some activity off and on throughout the day —unless they’re sleeping. Parents and caregivers can encourage active play that includes a variety of activity types. Children benefit from structured activities — such as planned games or kicking and tossing a ball — and free play that lets them move as they want. Give children access to outdoor spaces that allow them to express themselves with more active movement, louder voices, and messier play. Outdoor Play Invites Children to Learn “Outdoor play is another classroom we often forget about,” said Vanessa Plourde-Smith. Plourde-Smith is a Professional Development Specialist with thread, a statewide organization that works to advance the quality of early education and child development. She provides training and technical assistance to childcare providers and has special training in outdoor play and learning. “While playing outside, kids are learning language, STEM (Science, Technology, Engineering, Math), social-emotional skills, and being respectful of plants and animals,” Plourde-Smith said. Outdoor play is more than letting kids loose on a playground or backyard with play equipment. It’s about helping children connect with nature. ­­­Adults can provide safe, stimulating outdoor spaces that allow curious children the opportunity to explore nature. Include natural materials in backyards and playgrounds. Plourde-Smith recommends tree stumps and logs for climbing and balancing on rocky paths to build ankle strength. “Taller plants where kids can ‘hide’ — although the adults can still see them — are good for kids to feel like they can get away and relax,” said Plourde-Smith. “Kids are also more likely to engage in dramatic play if they think they aren’t being watched.” Set up a small garden or pots of herbs, vegetables, or flowers and let children help with planting, watering, and harvesting. On warm days, water play with buckets, squirt toys, and sprinklers is a real treat. If there’s a nearby berry patch, give kids small buckets or plastic baggies and go pick some berries. In winter, grab some sleds and challenge kids to pull and push heavy objects through the snow. Take exploring walks around the yard or to a nearby park, woods, or beach in each season of the year. Talk about the plants, insects, birds, and animals you see and how they change from season to season. Using all the senses can develop a better understanding of the outside world. Touching tree bark, listening to birds, and smelling flowers connect kids with nature. Playing and learning outside may inspire a future scientist or farmer, or just a lifelong love of the outdoors. Outdoor Play Improves Mental Health Time spent outdoors can help children reduce their stress levels and improve self-esteem, self-regulation, and overall happiness. Children become better learners in the classroom because they function better, and are better able to focus, concentrate, and sit still after being active outdoors. Ever seen a child covered in mud and smiling from ear to ear? Studies have shown that playing in the dirt isn’t just fun. It can boost overall happiness and health due to naturally occurring bacteria in soil that help children’s immune systems and produce chemicals that improve mood. The National Wildlife Federation has an excellent booklet on how getting dirty outdoors benefits kids. Outdoor Play & Learning Don't Stop When The Rain & Snow Falls How do we keep playing when Alaska weather turns cold and wet? “Preparation is the key to outdoor play,” said Plourde-Smith. “Start planning for winter in the fall, making sure you have the right gear on hand when the first snow falls.” Great options in Alaska include raincoats, boots, parkas, hats, gloves, and even extra sets of clothes should the first set get wet or muddy. Plourde-Smith recommends saving money on winter gear by shopping at garage sales and thrift shops or connecting with other parents for hand-me-downs. For extreme temperatures and bad weather, many child care sites follow guidelines from the National Weather Service, adopt the local school district policy on outdoor recess, or have a parent committee set a weather policy. How do I Get My Child More Active Outdoors? GET OUT AND PLAY WITH THEM! Parents and adult caregivers are role models for children. Join children’s games and active play. Children need to see the adults in their lives being active and having fun. Help your child develop a lifelong habit of being active outside. Additional Resources for Outdoor Play The State of Alaska Play Every Day campaign has lots of handouts, videos, and posters to promote and provide tips and ideas for active play every day. The National Wildlife Federation has a guide, Nature Play at Home, that’s filled with fun outdoor activities and ideas for creating outdoor spaces. The Alaska Farm to School and Farm to Early Child Care have resources to help schools and child care sites start gardens and teach children about food grown in Alaska. The Alaska Department of Fish and Game has early childhood resources to help teach young children about nature and exploring the world around them. Written by the Alaska Department of Health Get Out and Play. Every day. Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org

My name is Melissa Q and I am the Lab Coordinator at Sunshine Community Health Center. This is my story of how my provider stood by me and helped me figure out that I had cancer. I went in to see my provider of choice, Shaina Ahles, and to let her know that I had been having lower back pain. During my appointment, she requested a urinary analysis and some blood work. My labs came back abnormal. She recommended some follow-up steps and imaging to see what was going on. Shaina knew something was very wrong with me and referred me to urology in Wasilla. Unfortunately, I had to wait an entire month because lower back pain and blood found in urine were common symptoms seen in their practice and their schedules were full. I wasn't very happy waiting a full month, knowing I had abnormal labs, but I waited patiently. Finally, I was able to get my appointment and I left the doctor's office in tears. The doctor attributed my diagnosis to my being overweight and having diabetes. I went back to Shaina and she knew I was upset. She said she would work with me to find out what was causing all of the problems. She ordered a CT scan to see if there was anything else abnormal and made sure it was done right away this time. The CT scan showed something abnormal in my kidneys, which prompted Shaina to order a different scan on that same day. I drove to Eagle River for yet another scan in search of answers. Shaina was on vacation when my results came back from the additional scans and Curtis Harvie was covering her patient's needs. He called me to inform me of the results and offered understanding and support after sharing the dreadful news that I had cancer. I took a photo of myself that day to remember that this was my "brave face" and that I needed it to get through. I remember being told by three different doctors that they were puzzled as to how my care team was able to find my kidney cancer and that most diagnoses don't show up in patients until later stages of life. I was very lucky that we found it because by this time I was already in stage 2. As soon as Shaina returned, she worked with my friends and coworkers Shyloh Snowberger and Sara Heller, and helped me fill out paperwork. This allowed me to take some time off work in support of my care plan: to evict cancer! Before I knew it was getting prompt care and had 3 surgeries back to back. Shyloh knew I was bound and determined to keep my job so I worked at home and went into the office as my body and mind allowed. I share this story so our community members can know and trust Sunshine Community Health Center, to share what a wonderful provider Shaina Ahles is, and to shout out to the great team at our Willow Clinic that truly treated me like family. I also want to thank my own family for standing by my side as well. I am proud to say that as I share this story, I am cancer-free. I am grateful to be here. Melissa Quintanilla, CCMA Lab Coordinator Sunshine Community Health Center

Your OBOT Group Leads Winter is in full swing now, and the holidays are coming up quickly, such a busy time of year. Please pay close attention to when you are scheduled for appointments and plan accordingly. In the case of a clinic closure, staff will reach out to you to reschedule your appointment; otherwise please attend your scheduled appointment unless you notify Helen prior! Missing your appointment takes away from someone who could have benefited from that time and could make rescheduling challenging. We limit groups to 8 individuals and offer several weeks to ensure full participation. We schedule your next group at the end of the group to provide time for planning and preparation. If you find that you are struggling to make your appointments, please let us know so we can work with you and help problem-solve.  We are committed to helping you through your journey to recovery and beyond. Your OBOT Group Leads Shaina Ahles, PA-C Jenelle Johnson, PA Crystal Edwards, LCSW Helen Michaelson, CM Upcoming OBOT Group Dates Talkeetna- Every first and third Thursday of the month from 1-2 pm (Note: this is a slight change, but still about every 2 weeks and will start January 2023). Willow- First three Wednesdays of the month from 3:30-4:30 pm 4 A's & Sunshine Community Health Center Partnership We now have clean injection and harm reduction supplies at both the Willow and Talkeetna clinics. These will be available 9 am –5 am Monday through Friday. To access this benefit, we kindly ask that you call us at 907-733-9292 so we can coordinate with you to ensure someone is available to provide those materials. The 4A’s mobile unit will be at the Willow location on the 1st and 3rd Friday of the month and at the Talkeetna location on the 2nd and 4th Friday of the month. They will be located in the clinic parking lot and can provide safe injection and harm reduction supplies. If you know of someone who would benefit from this resource, please let them know and encourage them to outreach. 4A’s will not be available the day after Thanksgiving and will be closed from Christmas to January 2nd.  During this time, our Talkeetna and Willow clinics will continue to be able to provide resources to the community.  Below are the listed dates that our clinic will be closed for the upcoming holidays. Phone System Changes We are currently in the process of testing a new phone system which we have high hopes of providing better service to our community. What this means is that you may see that when we call, it may identify as spam on your caller ID, or appear to come from an out-of-state number. This is temporary while we get through the testing phase and fully transition to the new system. Please be patient with us and hopefully, we will be fully functioning with fewer growing pains in the next month.  Our phone number has not changed, so please continue to call us at 907-733-9292 to coordinate and discuss your OBOT groups. Contact Information Behavioral Health Direct Line: 907-733-9292 Willow Clinic: 907-495-4100 Talkeetna Clinic: 907-733-2273 "Holiday time can come with a variety of emotions. Be mindful of your triggers and make taking care of yourself a priority." - Crystal Edwards, LCSW Sunshine CHC Closure Dates We will be closed for the holidays on December 25th & 26th. Housekeeping Participants need to schedule their next group session with OBOT staff before leaving the clinic. If you need a Medicaid Ride for the group, please let us know.  We need 10 days’ notice to ensure that our staff have timely notice to help coordinate your ride. Individual counseling appointments are available to participants and are encouraged.  If you are interested in scheduling time, please contact 907-733-9292, talk to your OBOT team, or mark on your check-in sheet that you would like to schedule this appointment. All refills for medications after group will be coordinated through the Sunshine Community Health Center Dispensary. Narcan kits are available on request. We wish you happy holidays and a happy new year! Crystal Edwards, LCSW Sunshine Community Health Center Behavioral Health Direct Line || 1-907-733-9292 General Inquiries || 1-907-376-2273 (CARE) Willow Clinic || 1-907-495-4100 Talkeetna Clinic || 1-907-733-2273 (CARE) www.sunshineclinic.org

Sunshine Community Health Center has partnered with HealthMark Group to ensure accurate and timely completion of medical record requests. How? Requests may be submitted electronically to HealthMark's Request Manager at https://requestmanager.healthmark-group.com. Once logged in, select “Submit Request” from the menu options and enter all required fields to provide authorization directly to HealthMark. Your medical record request will be processed, and a notification will be sent via mail or email once complete and available for download. Any Questions? Please log in to Request Manager for status updates or to chat with support. You may also contact HealthMark at 800-659-4035 or status@healthmark-group.com.

A Holiday Favorite This recipe is a family favorite created by one our of wonderful Medical Assistants, Allison Self. Allison shares that she makes this recipe every season and it is always a hit! "People have a love/hate relationship with Brussels Sprouts, but this recipe even has those that don't like them loving them." - Allison Prep Time: 20 Minutes Cook Time: 60 Minutes Total Time: 80 Minutes Serves: 6-8 Adults Ingredients 2 pounds of brussels sprouts, trimmed off the outer leaves and sliced in half. 2 oz pancetta, diced. 1 tablespoon unsalted butter. 3 shallots, peeled, halved, and sliced. 2 tablespoons all-purpose flour. 1 3/4 cups whole milk. 1 scant pinch of freshly ground nutmeg. 2 thyme leaf sprigs or 1/2 teaspoon dry thyme. 4 ounces of grated gruyere cheese (divided into two parts). Salt to taste. Directions Preheat the oven to 400 degrees Fahrenheit and butter an 8x12 gratin or casserole dish. While the oven is preheating, blanch the brussels sprouts by filling a large pot with 4 quarts of water and 1 tablespoon of salt. Bring the water to a boil and add the brussels sprouts for 3-4 minutes, until they are just barely tender. Remove from heat, drain the brussels spouts, and rinse with cold water. Set aside. Brown the diced pancetta in a pan on medium-low heat. Cook until most of the fat is rendered (approximately 8-10 minutes). Remove the pancetta from the pan while leaving the rendered fat for the roux. Sautee the shallots with 1 tablespoon of unsalted butter and rendered pancetta fat until softened (about 4-5 minutes). Add flour to the butter/shallot mixture and whisk on medium-high for 1-2 minutes. Reduce heat to low and slowly add milk. Stir with a wooden spoon until the roux is incorporated with the milk fully. Cook over medium-low heat for several minutes, stirring until the sauce thickens and coats the back of your spoon. Add fresh thyme and a sprinkle of nutmeg. Add 3 ox of the gruyere cheese and have of the pancetta to the white sauce. Add salt to taste. Mix in the brussels sprouts until fully coated and then transfer to the oven dish. Sprinkle the remaining pancetta and gruyere cheese on top of the dish. Bake for 25 minutes until the top is slightly browned and bubbly. Remove from oven and let sit for 10 minutes before serving. Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org

Ingredients 1 medium carrot, shredded. 1 large egg. 2 garlic cloves, minced. 1-inch piece of ginger root. 3 small scallions, diced. 1 pound of ground turkey. 1/4 head of napa cabbage, sliced into thin strips. 2 tablespoons chili-garlic sauce. 2 tablespoons coconut aminos. 1 tablespoon red pepper flakes. 2 tablespoons mayonnaise of choice. 2 tablespoons toasted sesame oil. 2 tablespoons sesame seeds. Salt to taste. Directions Pre-heat large skillet or wok over medium-high heat. Wash and dry all produce. Once the skillet is hot, add the sesame oil and swirl to coat the bottom of the pan. Add the ground turkey to the skillet and break apart until the meat is browned and cooked. Add minced garlic, carrots, and cabbage to the skillet. Add coconut aminos, crushed red pepper, and salt to taste. Cook until cabbage and carrots are soft. Drain excess liquid and turn the heat down to low. Scramble egg and add to combine. Serve in a bowl and top with spicy mayo, sesame seeds, and scallions. Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org

Thank YOU for Taking Care of YOU! Sunshine Community Health Center wants to thank you for taking care of your healthcare needs. Schedule a women's clinic exam at either of our clinic locations and receive a FREE gift from us to you. Gifts Complete your appointment and ask the front desk at check out for your FREE gift. $20 OFF a 1+ hour massage with Denali Healing Massage and Body Work in Talkeetna. A FREE yoga session or $10 OFF a private session with Studio Z Yoga in Talkeetna. A FREE fitness class with Northbound Fitness in Willow. A Sunshine Community Health Center Headband. What to expect in your exam? Each appointment is different and services/screenings are determined by you and your preferred provider. Services and screenings may include the following: Cervical cancer screenings (PAP tests) and pelvic exams. Breast exams and referrals for mammograms as needed. Human papillomavirus (HPV) and other sexually transmitted infection screenings. HIV Testing and STI/STD treatment options. Contraceptive and prenatal care. Osteoporosis and other cancer screenings as appropriate. If your primary care provider is a male and you would prefer a female provider for these services please let us know when you call to schedule. Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org

Overview This recipe was provided by a former employee who has decided to continue her education in the medical industry. We are thankful for her commitment to health, and community, and for her AMAZING recipe. Comment on this blog if you try this recipe out. Ingredients 1 pound sausage of choice. 2 packages of cream cheese (not whipped). 1/2 parsley bunch, finely chopped. 16 oz. mushrooms of choice, finely chopped. 8 oz. shredded parmesan cheese. Spices (measure with your heart) || salt, pepper, red pepper flakes, garlic powder, and paprika. Directions Sautee the sausage and mushrooms until the meat is brown and the mushrooms are soft. Combine all ingredients into a crock post and cook on high until all of the cheese is nicely melted. Serve with your dipping apparatus of choice! Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org

Thank YOU! We want to thank our community members for their patience and for participating in testing and troubleshooting our current phone system. We have heard your feedback and collected data to identify issues and resolutions to them. What to expect? The main call-in numbers for Talkeetna (1-907-733-2273) and Willow(1-907-495-4100) will remain the same. There will be a reduced number of options available from our phone menu system. In fact, there will now only be three. We have added a feature for other healthcare organizations to simply dial an extension as soon as they hear the menu greeting and we have now added a call queue for patients and others who wish to hold to speak with a live person who will direct them appropriately. When to expect it? We are testing our new system on November 6th. We do not anticipate any downtime and look forward to a smooth transition. After a week of testing, we will switch all of our internal systems organization-wide and hope to improve your overall satisfaction. We'd love to hear from you! We would love to hear from you after we go live with the new system. Please send us a message through our website contact form, or if you've recently had an appointment with Sunshine Community Health Center we would love for you to complete our Satisfaction Survey by clicking the link below! If you are experiencing a medical emergency, dial 911. Sunshine Community Health Center 1-907-376-2273 (CARE) www.sunshineclinic.org