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Universal Newborn Hearing Screening (UNHS) Programs that screen all infants will reduce the age at which infants/children with hearing loss are identified, improve school performance, reduce educational costs, and increase the likelihood that children who experience congenital hearing loss will be productive members of their communities (U.S. Public Law, 1998).  UNHS is endorsed by the National Institutes for Health (NIH), Consensus Development Panel, the Joint Committee in Infant Hearing (JCIH), the American Academy of Pediatrics (AAP), the American Academy of Audiology (AAA), the Commission on Education of the Deaf, and Healthy People 2010.

Alaska is the largest of the 50 states and contains approximately 16 percent of the country’s landmass or 586,412 square miles of land.  The vast wilderness of Alaska is dotted with isolated villages, some with fewer than a dozen people.  Many villages lack basic conveniences like running water and remain accessible only by small plane or boat.  Intrastate air travel in Alaska often involves greater distances than interstate travel in the continental United States. Fares for air travel are expensive.  Throughout rural Alaska, also called the Bush, very few local economies exist.  Many residents live off the land and its wildlife, and survival depends on hunting, fishing, trapping, and gathering wild berries.  Because of its size, Alaska has widely diverse geographic, climatic, and demographic characteristics, all of which affect public health.  With diverse cultures, sparse populations, severe temperatures, vast coastline, and outdoor lifestyles, Alaska experiences many unique health care challenges.  One such challenge is providing adequate and timely medical care and health care assistance to residents who live in remote areas of the state.

Alaska does not have a county structure and, while some boroughs have been formed, most have elected to not assume health powers.  Much of the state remains “unorganized” with the state government fulfilling responsibilities otherwise normally handled by local county and municipal governments.  Primarily, governmental health and social service functions have been, and continue to be, the responsibility of the state and federal governments - both of which increasingly carry out the services through various granting and contracting mechanisms.  The Native health corporations, formed through a compact between the Indian Health Service, the individual Alaskan tribes, and the State of Alaska, provide health care in these rural and bush

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