Alaska Native health officials and other dignitaries gathered in Anchorage on Wednesday for a ceremony where they picked up shovels and moved clods of dirt to celebrate the start of the Alaska Native Medical Center’s emergency department expansion.
The board of the Alaska Native Tribal Health Consortium, which manages the hospital in partnership with the Southcentral Foundation, has approved $257 million for the expansion. It is the largest investment in the hospital since the federal government created the consortium in the 1990s, ANTHC officials said.
“Our goal is to make a transformative investment that meaningfully contributes to addressing decades of underinvestment on the Alaska Native Tribal Health campus by expanding areas that will help meet the immediate needs of our patients,” said Kimberley Strong, consortium board chair, at the groundbreaking ceremony.
Once completed, the expanded emergency department will have more space overall for patient care, have room to treat patients with mental illness or substance abuse issues, and have a drive-through ambulance access to facilitate patient transport, ANTHC said.
The investment is, in a sense, a leap of faith. Despite its operational and management responsibilities, the ANTHC does not own the hospital. Because of the way the ANTHC was created – through a budget provision supported by then-U.S. Senator Ted Stevens (R-Alaska) – the federal government, through the Indian Health Service, is the ultimate owner of the facility.
The separation between ownership and management is costly, said Natasha Singh, interim president of ANTHC. It is estimated that the Alaska Native Medical Center potentially loses $20 million a year because it is not indigenously owned and thus ineligible for certain funds under current law, she said. Changing the ownership would require an act of Congress, she said.
In her official comments at the groundbreaking ceremony, Singh addressed the board’s decision to go ahead with the expansion despite the separation between ownership and management.
While transferring the hospital from federal to tribal ownership would be desirable and would allow ANTHC to “move into a new era of self-governance while providing greater financial security for further investment,” patient needs must be met now, she said. “We are pleased to make this historic investment to expand services because our patients cannot wait any longer,” she said.
Among the dignitaries at the groundbreaking ceremony was Roselyn Tso, director of the Indian Health Service.
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 would like to inform you that a small check is on its way to you in the mail for our support,” she said.
The exact amount of IHS funding has yet to be determined, said Shea Siegert, a spokesman for ANTHC.
During the construction work, patients will have access to an alternative emergency room, which will be created through a reconstruction on the east side of the hospital.
The emergency department expansion could be followed by another major construction project that would increase the hospital’s overall capacity with three new floors of patient rooms, a helipad to improve trauma care and other improvements. The ANTHC board has not yet decided whether to make that investment, officials said at the groundbreaking.
The consortium is already investing in a separate project to meet the growing need for extended post-hospital care. The board approved a $69 million investment in a Short Term Skilled Nursing Facility for patients who have been discharged from the hospital or otherwise require continued care. Construction on the 8,400-square-foot facility is scheduled to begin later this year and is expected to be completed by 2026, according to ANTHC.
Demand for such skilled nursing services is expected to increase as Alaska’s population ages. According to the Alaska Department of Labor and Workforce Development’s latest demographic forecast, the population of Alaska Natives ages 65 and older is expected to increase by 131% by 2050.
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