The Aleutian Pribilof Islands Association (APIA) is a Tribal Health Organization, authorized by federally recognized tribes of Atka, Nikolski, St. George, and Unalaska to provide Indian Health Service 638 Contracting for their healthcare services. All our HRSA projects serve exclusively in the communities of Atka, Nikolski, and St. George Island(s). The tribal communities of St. George are in the Pribilof Sub-region of Alaska while Unalaska, Atka, and Nikolski are in the Aleutian Sub-region. Both sub-regions are located within the Aleutian and Pribilof Region of Alaska, Southwest region of the Alaska, and extending out toward Russia. The islands are located in the Bering Sea, which extends over 1,200 miles westward from the southwestern corner of Alaska?s mainland. The closest major medical centers are 800 air miles away and only accessible by plane when the weather cooperates. Extreme isolation hinders recruitment and retention of professional medical staff willing to live on the islands. Training and professional certification of medical staff requires all providers to travel off-island, which makes the use of itinerant or per diem staff necessary. To support our communities logistically we have an administrative site in Anchorage between the airport and our hospital and specialty service providers at the Alaska Native Medical Center. This project increases and supports our readiness and helps build our Tribal Health Capacity in preparedness and response to COVID-19. It helps build upon our efforts we are proposing to HRSA with our COVID-19 awards, and builds upon the support needed to provides our remote communities of Atka, Nikolski, and St. George with the ability to respond to COVID-19 pandemic. APIA serves the remote Alaskan Islands communities of Atka, Nikolski, St. George, and Unalaska. As COVID-19 spread across the US we were immediately able to gear up and prepare. This included assessing our inventory and increasing it to 3
0 days, installing and training on the Abbot Id now in (4) out of our (4) clinics, training on the swab testing, instituting tele-health, and designing our care delivery so that we had no negative impact in access to care for our patients. Unfortunately, during this time we lost the commercial air carrier to our sub-regional community of Unalaska. Our patients in Atka, Nikolski, and St. George fly on a little plane an hour or less to Unalaska then they get on a bigger plane and fly three hours to Anchorage for level II Trauma Emergency, Specialty, and physician level primary care. We supply all of our Clinics resources from Anchorage and this includes ground support. We anticipate COVID to increase activity in Anchorage due to longer hospital stays, unreliable air transportation, increase in lab testing, increase in needed supplies, and the need to act quickly. We propose to increase our response to their needs by adding a patient transportation and expediting response vehicle in Anchorage and an All Terrain Vehicle in St. George. By purchasing Welch Allen Monitors (3) for our quarantine/moderate holding and testing sites, and to purchase covid19 related ppe and supplies.