Expanding the Native Health Care Facilities in Rural Alaska: A Feasibility Study

1. Expanding the Native Health Care Facilities inRural Alaska: A Feasibility Study Megan Roberts English 212: Technical Writing April 21, 2014

2. Overview • Introduction • Criteria • Methods • Research Results • Conclusions • Recommendations Source: Alaska Native Tribal Health Consortium

3. Introduction • Examined the feasibility of expanding Alaska Native health care facilities in rural Alaska . • Researched the needs for updating, improving, and expanding native health care facilities in rural Alaska focusing on three factors: • Determine if an expansion would promote rural health care quality. • Estimate financial budget costs for an expansion and determine if the costs are feasible with federal and state funding. • Compare similar native health facilities that have expanded in urban Alaska with the proposed expansion in rural Alaska.

4. Introduction • Determined what factors affect native health care in Alaska: • Divided regions in urban and rural Alaska • Environmental changes (weather) • The lack of facilities and resources, especially for the ongoing needs for emergency care. • Identified if the expansion would be cost efficient: • Determining adequate amounts of funding for the expansion. • Determining if an expansion would balance the current financial budget

5. Criteria • After careful consideration and analysis of the data I have made my recommendations based on the following data: • Is there a need for expansion with native health care facilities in rural Alaska? • Will there a decrease in financial spending after expanding the rural health facilities? • Will an expansion promoted rural health care quality? • Have there been similar expansions in urban area Alaska?

6. Methods • Researched in the Library of Congress and Alaska Tribal Health System. • Reviewed the history of the Alaska Native health care system • Interviewed Vice President Douglas Eby about his views on an expansion of the rural health care facilities. • Conducted Internet research for quality material, which will benefit my study. • Conducted research through the UAA Consortium Library, by using related articles as references in my feasibility study. • Distributed a questionnaire to 30 Southcentral Foundation and Alaska Native Tribal Health Consortium employees. • Analyzed gathered data from the Questionnaire responses.

7. Native Health Care in Alaska • Hospitals located in Barrow, Bethel, Dillingham, Kotzebue, Nome, Sitka, and Anchorage are tribally managed and funded by Indian Health Services. • In total, there are 44 tribal health centers, 160 tribal community health aide clinics and five residential substance abuse treatment centers in the state of Alaska. • Alaska Natives are transitioning between their villages and Anchorage for outpatient care, inpatient care, and prolonged care for diseases including heart disease, cancer, and diabetes.

8. Health Care Needs in Rural Alaska • There are great health care needs in the rural areas, especially with long-term care. • According to statistics: • The 65 to 74 age populations will double every 14 years • The 75 to 84 age population will double every 12 years • The 85 and over population will double every 10 years • These individuals should receive adequate amounts of care in their Native regions, and to do this, the restrictions must be decreased with an increase in efficient funds to expand the native health care facilities in rural Alaska.

9. The Need For Expansion • The Alaska Native Tribal Health Consortium (ANTHC) has an abundance of resources/physicians. • About 80% of the Alaska native villages are not connected to the urban areas by road. • Due to the limited transportation to and from the villages, airfreight, patient transportation, and long distances make health care costs higher in the rural areas. • The lack of facility space makes appointments less accessible to patients transferring from the native health clinics in rural Alaska.

10. Primary Research

11. The Need for Accessibility • After years of updating, improving, and expanding the Alaska Native Medical Center it has become the main resource for all Native Health Care in Alaska. • “Alaska Native Medical Center (ANMC) is a resource center for all other Native hospitals in Alaska. Other facilities rely on ANMC’s medical staff for consultation, and use ANMC as their referral location for specialty and tertiary care” (IHS ’06, 28). • Emergency transfer patients expect easy accessibility for scheduling post-operational follow-up appointments. However, schedules are often overbooked with appointments for native, urban Alaskan patients. • Eby stated that, “expanding health care facilities in rural Alaska would help each region to achieve optimal patient care” (D. Eby, personal communication, February 27, 2014).

12. Source: Census 2000 American Indian and Alaska Native Summary File The Need for More Accessibility An expansion of the native health clinics in rural Alaska will allow appointments to be more accessible for all Alaska Natives and American Indians in Alaska.

13. Primary Research

14. Conclusions • Although D.Eby (personal communication, February 27, 2014) mentioned, “there have been federal budget cuts,” Joint Venture Commission has shown great interest in expanding urban Alaska native health care facilities. • There is a strong desire among Alaskan Native patients, and SCF and ANTHC employees to push for an expansion at the native health care facilities in rural Alaska. • The main obstacles would be transporting supplies to the rural areas and finding a reliable resource to begin renovation. • Given the right amount of time and motivation, with support from Alaska Native Health Services and Joint Commission Venture, this proposed idea is feasible.

15. Recommendations • Conduct further research into the available funding that would provide the ability to update, improve, and potentially expand native health care facilities. • An additional study must be conducted to determine the costs associated with and the funding sources available for the expansion of native health facilities in rural Alaska. • Over-sight of the research and execution of expansion of the native health care facilities to be performed by the Alaska Tribal Health Compact with funding from Joint Venture Commission.

16. References • Indian Health Service (2012, November 29). Alaska Area 2012 Active User Population. Retrieved March 16, 2014, from http://www.ihs.gov/ alaska/includes/themes/newihstheme/display_objects/documents/hf/ area.pdf • Indian Health Services (2006, September). Alaska Area. Retrieved March 17, 2014, from http://www.ihs.gov/alaska/includes/ themes/newihstheme/display_objects/documents/hf/asu.pdf