For a long time, the goal of the Arctic Slope Native Association was to replace the aging hospital in Barrow. It took about 15 years, but they reached that lofty goal of constructing a brand new facility. Now, the organization is focusing on how it can expand and improve care over the coming years.
"When you think of a continuum of care and what it means to be a small critical access hospital, there are certain things that fall within that scope and there are things that fall outside," said Richard Hall, who took over as hospital administrator for Samuel Simmonds Memorial Hospital earlier this year. "I think the commitment has been to pick up part of that continuum outside of that scope of the critical access hospital."
What that means is there are certain services a hospital like Samuel Simmonds is expected to provide, but that doesn't mean it can't also move beyond those expectations and provide additional services that it deems important.
The association has had a back-and-forth relationship with the North Slope Borough Health Department for many years. Services like eye care once fell under the purview of the association, were at some point transferred to the borough's management, and now are returning. The Office of the Mayor did not return requests for comment on the transfer of services before deadline.
In mid-November the hospital opened its new eye care center. It features much of the same staff from the borough's facility but a new location and some additional options for patients.
Patients can still receive basic care through the optometry department. But there will also be the option for more advanced care through an agreement with the Alaska Native Medical Center in Anchorage.
"So, it will be a shared area where part of the time we have our optometry staff supporting eye exams and fittings, adjustments, repairs for eyeglasses, contacts," said Hall. "And then we have an ophthalmology clinic, which is advanced medical eye care services that come up from Anchorage to provide support to the community in Barrow."
Another transfer of services that's on the horizon is that of elder care.
Assisted living is currently managed by the borough through the senior center. In the not too distant future, the association will take over management of that care, though they will continue to contract with the borough for use of the facility.
"Right now, it's really just hinged upon getting licensure from the state. We began that process in the middle of this year," said Angela Cox, vice president of administration for the association. "It's been a goal of ours for the last year, something we've been working towards. But right now it's really just working with the state and finalizing a few of the details of the transfer of the licensing from the borough to ASNA. And we see that happening very soon."
The association's attention was focused on building a new hospital for so long, said Cox, that now it's refreshing to be able to concentrate on some of the secondary goals.
"[That] was always to improve elder care services," she said. "And I think it just speaks to who we are as a tribal health care organization. We place a lot of value on our elders and taking care of them."
Through the borough, there are already details in place to start as soon as possible with assisted living. Both in-home care and long-term care are a bit further afield at this point, though they are part of the comprehensive elder care program the association hopes to establish.
"I don't have a specific, hard timeline for the long-term care component," said Hall. "I think we'll have to get these pieces in place, get things settled down, and then it will be a matter of working with our board on what their timing is and give us direction on how they'd like to see us proceed."
The hospital has already undergone a state survey for the transfer of assisted living and is tweaking some of the last few details.
"We've been ready," said Cox. "We are ready and anxious to start providing services."
They've even hired longtime association staff member, Diane Nosbisch, as the new director.
As for the types of services elders can expect to receive once the transfer is complete, there will be most of the current offerings with a few additions.
There will be more of a focus on holistic wellness, for example.
"[Elders are] the group that is going to have the highest rate of needs, statistically, just from a health care standpoint in general," said Hall. "So, if you can create programs for health and wellness, so that your elders can have a higher quality of life, you're matching need with demand and you're meeting that prioritization within the culture of Alaska Native elders."
As part of that goal, the association has made it a priority to provide traditional foods and niqipiaq to elders under their care.
"We're very proud to be emulating other organizations in Western Alaska around providing traditional Native foods within the facility and creating a higher sense of wellness among our elders through foods they are used to, foods they grew up with, and respecting their choices around foods they would like to have," he said.
Staffers have been making trips to other facilities that already do this to learn the ropes, said Cox, like the various regulations they must follow, how to implement a Native foods program, and how to successfully sustain it.
In addition, because the association is hospital-based, unlike the borough, they'll have access to a broader range of clinical support for their patients in elder care, like on-site physical therapy, nursing, medication administration and pharmacists, and physicians to make regular rounds and treat patients where they are.
Through the development of a swing bed program, the hospital has already taken steps to keep care close to home. "Swing bed" is the term used by Medicare for a facility that's able to switch between acute care and longer term skilled care, and receive coverage for both due to size and access for the community.
"Basically you get accredited at the federal level to provide extended care delivery beyond the acute care hospital stay," said Hall. "You can provide that service within the hospital and still provide reimbursement and it comes under the critical access hospital banner because you may not be close to additional facilities that can provide that type of extended convalescence to get people the support they need beyond the acute care visit."
For example, if someone from Barrow needs knee surgery, they might fly down to Anchorage for the procedure. Then after three or four days, they could return to Samuel Simmonds and continue with physical therapy and other support for many weeks rather than having to stay in Anchorage for the duration.
"One of the most important priorities for our board is doing as much as we can so that people can remain close to home, so they don't have to leave and be in a faraway place or city receiving care where they're not surrounded by loved ones," said Cox. "But on top of that, it's also very expensive. Round-trip airfare [is expensive]. Hotel rooms are expensive. So, bringing those services close to home is important for emotional support, to help families financially be able to sustain themselves."
And for residents of Barrow and the surrounding villages, there will soon be even more care close to home for all ages.
"It's just good for the community," said Cox.
This story first appeared in The Arctic Sounder and is republished here with permission.