CCHC requests funding to continue providing an array of integrated primary care, limited dental care, behavioral health services, and enabling services to low-income residents of Bristol Bay Borough in rural frontier Alaska. CCHC has been an FQHC serving the Bristol Bay Borough villages of King Salmon, Naknek, and South Naknek since 2001. CCHC’s isolated service area has a permanent population of about 884 persons, but a seasonal influx of approximately 10,000 seasonal workers from areas like Southeast Asia and Africa arrive in June and July to work in fish processing plants. Other than seasonal work, the local economy is largely based on government agencies. Recently, some of these agencies, including the FAA and local schools, have closed offices or reduced programming, which means fewer jobs. While the permanent population includes 30.1% Alaska Natives, CCHC primarily services non-Alaskan Natives. The remainder of the population includes 48.2% white, and 21.7% other races. The mission of CCHC is “to be the Medical Home for all people within the Bristol Bay Borough.” Bristol Bay Borough is classified as remote, rural, and sparsely populated with no major road connections; all transportation outside the region is by sea or air. There are no private physicians providing services in the area and the nearest hospital for non-Natives is in Anchorage: 300 air miles away at a cost of roughly $500. The service area is designated as a Medically Underserved Area (MUA) as well as a Health Professional Shortage Area (HPSA). CCHC is the only primary, urgent and emergency care provider in the frontier region that serves all populations regardless of race, ethnicity, or ability to pay. CCHC’s local patients face such health issues as cardiovascular disease, hypertension, obesity, asthma, diabetes, etc. Seasonal workers, however, often have a wider array of health issues, including tropical diseases, and some have never had a medical exam. In 2020, 845 undup
licated patients received 2,157 service encounters. The 2020 numbers are much lower than in recent years because of the impact of the COVID 19 epidemic, which made residents reluctant to seek health care. In 2019, for example, 1,441 unduplicated patients received 2,457 service encounters, which was about 58% higher than in 2020. The numbers for 2021 should be at least as high as in 2019. Of those seen, at least 700 are seasonal workers at the summer clinic site, who are uninsured, but are seen for Workman’s Compensation and therefore show as insured. CCHC recently received a $500,000 HRSA grant to complete interior improvements to its 2,500 square foot Health Center and is seeking additional grants to complete exterior improvements, as well as expand the facility to meet growing needs. With oversight by a community-based Board, Mary Swain, Executive Director, leads a team of 17.8 FTE staff, which includes .2 FTE physicians, 2.0 FTE physician assistants, 1.5 FTE nurse practitioners, 1 FTE RNs, 1 FTE LPN. FTE other professional medical positions: 2.5 Lab Techs; .5 Radiology, 1.0 Pharmacy Tech, 3 FTE behavioral health professionals (e.g., 1 LCSW, 1 MSW, and 1 SELC), and 5.1 FTE support staff.