Alaska Native Tribal Health Consortium leader working toward hospital ownership
With a new leader at the helm, the Alaska Native Tribal Health Consortium is working toward a long-held goal: ownership of the Anchorage hospital that it already manages.
The Alaska Native Medical Center, the state's largest Native hospital, stands out as the only facility in the tribal consortium's sprawling Midtown campus that is owned by the Indian Health Service. That split between ownership and management has turned out to be burdensome, said Natasha Singh, the Alaska Native Tribal Health Consortium's newly appointed president and chief executive.
The consortium's ambition is to become the hospital owner by the end of the year, she said.
The desire to take ownership has become more urgent as hospital use has grown. Under Indian Health Service ownership, the building has not been expanded. And the consortium was reluctant to take on responsibility for doing so without ownership of the facility.
'But we're at a breaking point,' Singh said. 'Our patients have increased by 70,000 since the doors first opened, yet the doors haven't expanded.'
That is why the ANTHC board last year decided that the space crunch had become dire enough to justify action. The board approved a $250 million expansion of the emergency department, with 18 new rooms and three new floors.
That new section is considered to be Phase 1 of a hospital expansion. The 18 new rooms have just opened and are ready for service, while the rest of the expanded area is expected to open soon.
Board members were 'looking out for patient safety when they approved Phase 1,' Singh said.
There are plans for a Phase 2, which would add another 60 rooms over three more floors, she said.
While ANTHC is the prime operator at the hospital, the Anchorage-based Southcentral Foundation also provides some services there.
If the consortium owned the hospital, it would have access to private-sector funding and other tools to pay for expansions and improvements like those at the emergency department, Singh said.
Making the ownership switch requires some formal steps and possibly an act of Congress, she said. But several tribal health organizations elsewhere in the state have already taken ownership of their regional clinics and hospitals, so it is a well-known process, she said.
Tribal organizations that now own health facilities that they operate include the Tanana Chiefs Conference, where Singh served as lead counsel for several years.
The consortium, established in 1997, is the nation's largest Native health organization. Through partnerships with more than two dozen tribal health organizations around the state, ANTHC is responsible for managing the services previously provided by the Indian Health Service.
Funding agreements and other aspects of the government-to-government relationship are established through the Alaska Tribal Health Compact, which is updated periodically. The Alaska compact is unique in the nation as the only one covering multiple tribes. Through it, health care services are provided to members of all 229 federally recognized tribes in Alaska.
In her position with the Tanana Chiefs Conference, Singh was one of the main negotiators on behalf of ANTHC during periodic compact renewals.
Singh, a Tribal member of Stevens Village in Alaska's Interior, was chosen by the board earlier this month to be the ANTHC president and chief executive. She had served for nine months as interim president and chief executive officer, and previously, she was the consortium's executive vice president and vice president for legal affairs.
Along with the work toward gaining ownership, Singh and the consortium face new challenges posed by the Trump administration's deep funding cuts and cancelations of programs on which tribal members rely.
The Alaska Native Tribal Health Consortium, through its environmental health program, has been a big player in programs and funding sources that are now under attack from the new administration.
That includes water and wastewater improvements that have been in the works for several years but were propelled by the Infrastructure Investment and Jobs Act of 2021
It also includes projects funded by the Inflation Reduction Act of 2022 to help communities address climate change impacts like accelerated erosion and permafrost thaw.
Singh said the consortium is trying to make the case to federal agencies and to the state's congressional delegation that promises of funding to tribes, which are sovereign governments, should be honored.
'I guess I am cautiously optimistic that we will be able to defend our infrastructure grants, given that the funding goes directly towards protecting our economic infrastructure across the state,' she said. Caution is key, she said, because the grants are administered on a reimbursement basis, meaning that the consortium could be on the hook for costs if funding is cut in the future, she added.
In addition to expanding the hospital's emergency department and working to ensure that planned rural infrastructure projects are completed, the consortium is building a $69 million short-term skilled nursing facility on the Anchorage campus. The facility is to provide care for patients who do not need full hospitalization but are not in strong enough condition to be at home. The need for this type of care is expected to increase as Alaska's population ages.
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