Island Life For The Healthcare Industry Is Not Always A Sunny Beach (this article will appear in the upcoming edition of the NW Outlook Quarterly)
Typically, I like to feature current legislative events in the state of Alaska, but for a change of pace, I would like to feature something, or rather, someplace, differently. I’d like to point your attentions to one of the state of Alaska’s best kept secrets: Kodiak Island.
Kodiak Island rests 251 miles to the southwest of Anchorage, Alaska, resting just to the east of the Lake and Peninsula Borough, Alaska. The island is approximately 12,000 square miles, with a population estimated at 13,889 per 2015. The island, and the town, get their name from the natives of the island, the Alutiiq, which has called Kodiak home for over 7,000 years. The Alutiiq word of kadiak, literally means “island”, and was undisturbed by outsiders until discovered by the Russian explorer Stephan Glotov in 1763, calling it Кадьяк (Kodiak). 15 years later, the same island was rediscovered by British explorer and captain James Cook.
The island’s history remains rich with its Russian heritage, with population centers springing up to take advantage of the islands unique access to riches of fur bearing animals and nearby fisheries. When the region was sold by Russia to the United States in 1867, Kodiak became a center of the commercial fishing industry.
Today, the island community is primarily supported by the fishing industry fisheries include Pacific salmon, Pacific halibut, and crab. The Karluk River is famous for its salmon run. Logging, ranching, numerous canneries, and some copper mining are also prevalent.
Providence Kodiak Island Medical Center
Serving this idyllic community is Providence Kodiak Island Medical Center (PKIMC). Providence Health Care began by the arrival of the Sisters of Providence to Alaska in 1902. The Providence system officially began serving the island of Kodiak when they assumed a ten year lease to operate the Kodiak Medical Center in 1997. That agreement continues in effect to this day.
Despite a population of under 20,000, the facility makes every effort to provide a comprehensive set of healthcare services for the community. This critical access hospital features 25 acute care beds, including four birthing suites, two psychiatric care beds and two ICU beds. In addition, Providence Chiniak Bay Elder House, PKIMC’s extended care facility, has 22 long-term care beds.
PKIMC provides an extensive array of inpatient and outpatient services, including emergency department, surgery, laboratory services, maternity, orthopedic and OB/Gyn surgical services, general medicine, physical therapy, occupational therapy, respiratory therapy, sleep studies, specialty clinics, diagnostic imaging services, tele-health, education and pharmacy.
Due to the presence of a major US Coast Guard facility on the island of Kodiak, PKIMC has worked closed with the military to customize an optimal health care relationship between the provider and the insurance. Along a similar line, the island is unique in its location to serve the residents of the state of Alaska, and as such has worked closely to serve the patients of the state inexpensively but with high quality.
While the community of Kodiak Island is uniquely blessed with a symbiotic relationship with nature, the remote location and diversity of healthcare services creates a challenge to maintain staffing and proficiency, a challenge which is borne by the existing staff. It is a special location, but it takes a special person to truly appreciate the opportunity.
Challenges of Island Healthcare
I discussed the unique opportunity of Kodiak Island with PKIMC’s CFO, Tim Hocum. Tim joined Kodiak Island Medical Center some 25 years ago, before it became part of the Providence network, and assumed the role as CFO in the fall of 2003. Ironically, Tim originally joined Providence with the intention of only working for two years. Having met Tim at any number of occasions, I can confirm that he is one of the most personable persons I’d met in the industry. Despite the pressures of running the island’s only provider, he carries a friendly smile, firm handshake, and practical sense to every occasion.
Not that all of this is so rare in the industry, but the combination is surprisingly consistent, regardless of the circumstances. I attribute this to his ability to walk out his office door with a fishing pole and land a trophy salmon within 30 minutes of leaving the office. The true secret to his positive outlook is a closely guarded secret.
Q: What is the biggest challenge to being the only healthcare provider on Kodiak Island?
A: I believe the greatest challenge is the effort and goal to be everything to everyone (the community’s safety net so to speak).
Q: Is it difficult recruiting healthcare staff?
A: In the past, that was not the case, but that has recently changed. We used to get excited if we had three travelers (temp agency staffing) and now we hover between 10 and 18 travelers.
Q: What specialties are most challenging to attract to island?
A: They are all difficult to fill with the exception of physicians. Lab techs, registered nurses (RNs), and physical therapist (PTs) seem to be some of the most difficult. Even management positions can become very tricky to fill.
Q: Due to your unique circumstances, do you find you have a more collaborative relationship with Tricare (Coast Guard) and Alaska Medicaid?
A: Definitely the Coast Guard. They worked with us to develop and implement a CAH reimbursement demonstration program which was adopted nationwide due to the concerns we expressed with reimbursement. The program provides CAH’s Medicare like rates instead of the typical Fee scale. But it took work to develop and implement. Our team spent countless hours on that project.
Similarly, Medicaid worked with us on the Long-Term Care Certificate of Need (LTC CON) rate add-on based on an arrangement that they had never experienced previously (the presence of both borough and Providence in the proposal)
Q: What keeps you coming back to work at such a demanding job? You wear virtually 10 hats in a typical work day.
A: The people you work with and take care of are your friends and neighbors, and we treat each other with that level of respect and cordiality. Maybe it is because we work and live where others come to vacation? The people are amazing!
Kodiak Island is a Unique Opportunity for a Unique Individual
If limousine rides down Hollywood boulevard are your thing, this is probably not the ideal location for you. But if you appreciate nature and outdoor activities, this may be a site you should consider. To beat the boredom of sitting still in your living room, the Island of Kodiak has already set up a list of 100 things to do in the area, and you can find that list here: https://www.kodiak.org/100_things_to_do
As healthcare becomes ever more complicated and stressful, there are alternatives to hours spent in commuter traffic, spent in airports awaiting the next space available seat to fly home, or even to spending hours in a narrow focused career with few opportunities to see the “big picture”. Kodiak Island Medical Center may be one option to consider. Sometimes the greatest events in a person’s life occur just by considering options.
Having been to Alaska and loved every second of it, I can say that it’s not for everybody. But if it interests you, there is no more satisfying experience. I would like to express my sincere gratitude to Tim Hocum, who willingly shared vital time from his day to give us a peek into the world of healthcare on Kodiak Island.
From what I see, it’s a view worth looking into.