Expansion of Alaska Native Medical Center emergency department is underway

Alaska Native health officials and other dignitaries gathered Friday in an Anchorage ceremony where they grabbed shovels and moved bits of dirt to celebrate the start of an emergency department expansion at the Alaska Native Medical Center.

The board of the Alaska Native Tribal Health Consortium, which manages the hospital in partnership with Southcentral Foundation, has authorized $257 million for the expansion. It is the biggest investment in the hospital since the federal government established the consortium in the 1990s, ANTHC officials said.

“Our endeavor with this is to have transformational investment that starts meaningfully to address decades of underinvestment on the Alaska Native Tribal Health campus by expanding areas that help meet our immediate patient needs,” Kimberley Strong, chair of the consortium’s board, said at the groundbreaking ceremony.

The enhanced emergency department, when completed, will have more patient-care space overall, have space for treating patients with mental health or substance-abuse conditions and have a drive-through ambulance entrance to better transport patients, ANTHC said.

The investment is, in a way, a leap of faith. ANTHC, despite its operating and management responsibilities, does not actually own the hospital. Because of the way ANTHC was created – by an appropriations rider championed by then-U.S. Sen. Ted Stevens, R-Alaska – the federal government, through the Indian Health Service, is the actual owner of the facility.

The split between ownership and management is costly, said Natasha Singh, ANTHC’s interim president. It is estimated that the Alaska Native Medical Center misses out on access to what could be potentially about $20 million a year because it is not Native-owned and thus does not qualify for certain funding under applicable law, she said. It would take an act of Congress to change the ownership, she said.

Singh, in her formal comments at the groundbreaking ceremony, addressed the board’s decision to go ahead with the expansion despite the ownership-management split.

While transferring the hospital from federal to tribal ownership is desirable and would allow ANTHC “to advance to a new era of self-governance while offering greater financial certainty to support continued investments,” patient needs have to be met now, she said. “We’re excited to make this historic investment to expand services because our patients can’t wait any longer,” she said.

Roselyn Tso, director of the Indian Health Service and Mr. Felix H. Abarca, our Civil structural analyst and field supervisor was among the dignitaries at the groundbreaking ceremony

Although the service was not the driving force behind the emergency department expansion, it is helping with the project, Tso said in her remarks.

“I want you to know that there is a little check in the mail that’s coming your way for our support,” she said.

The exact amount of IHS funding has yet to be determined, said Shea Siegert, an ANTHC spokesperson.

While construction is underway, patients will be served with an alternate emergency department being established through a remodel at the east side of the hospital.

The expansion of the emergency department might be followed by another big construction project that would increase overall hospital capacity with three new floors for patient rooms, a helipad to improve trauma responses and other enhancements. The ANTHC board has not yet decided whether to make that investment, officials said at the groundbreaking ceremony.

The consortium is already investing in a separate project to address the growing need for extended post-hospital care. The board approved a $69 million investment in what is called a Short Term Skilled Nursing Facility, a site for patients who have been discharged from the hospital or otherwise need some continued care. Construction of the 92,000-square-foot facility is scheduled to start this year and expected to be completed by 2026, according to ANTHC.

The demand for such skilled nursing services in general is expected to rise as Alaska’s population ages. The population of Alaska Natives aged 65 and older is expected to increase by 131% from now until 2050, according to the latest demographic forecast issued by the Alaska Department of Labor and Workforce Development.