2018 Alaska Healthcare Directory by Anchorage Daily News

INSIDE: Alaska's medical specialities Contributions from local specialists Local healthcare updates

Hearing Problems...

or maybe just earwax? FIND OUT!

We’ll look into your ear canal with our Video Otoscope. As you are watching the TV screen we’ll do a complete inspection of your ear canal and eardrum. If there is any amount of wax blocking, you’ll know immediately.

Medicaid accepted we bill most major insurances

Office Hours: 9am - 5pm Monday-Friday R.S.V.P. TODAY!

(907) 644-6004

FREE! Video Otoscope Examination. It may just be wax blockage. FREE! Computer Hearing Test to see what you hear and what you’re not. FREE! Hearing Aid Inspection. All makes and models. Medicaid accepted We bill most major insurances FREE FINANCING Call for details!

The Made for iPhone Hearing Aid Stay Connected Halo is designed to: • Stream calls from your iPhone directly to your hearing aids using Bluetooth 4.0 wireless technology • Deliver pristine sound and exceptional listening clarity • Help you hear comfortably in noise • Stream FaceTime, music and more directly to your hearing aids.

100% custom, invisible , digital and fully programmable hearing aid. *

Think hearing aids should be heard, not seen? Then the new SoundLens by Starkey is for you. SoundLens is the first custom fit, digital and fully programmable, invisible-in-the-canal hearing aid, featuring our latest technology – meaning it’s completely invisible, and totally designed to fit your lifestyle.

510 W Tudor Rd Ste 3, Anchorage, AK 99503 Office Hours: 9am - 5pm

R.S.V.P. TODAY! (907) 644-6004 or toll free (888) 229-6004 www.accuratehearingsystems.com Alaska law permits a hearing aid dealer who is not a licensed physician or a licensed audiologist to test hearing only for the purpose of selling or leasing hearing aids; the tests given by a hearing aid dealer are not to be used to diagnose the cause of a hearing impairment.

Donna R. DeMarco, AAS, BC-HIS

300 W 31St Ave. Anchorage, AK 99503 www.alaskajournal.com

Publisher Andy Pennington (907) 257-4210 apennington@adn.com Managing Editor Andrew Jensen (907) 257-4271 editor@alaskajournal.com Sales Manager Jada Nowling (907) 257-4268 Jada.nowling@alaskajournal.com Sr. VP of Circulation & Production Roger Weinfurter (907) 257-4388 rweinfurter@adn.com Production Michael Oldroyd (907) 257-4265 moldroyd@adn.com

INDEX Specialties Audiology Family Medicine Medical Services Mental Health Neurology Optometry

Account Executive Ken Hanni (907) 257-4269 Kenneth.hanni@alaskajournal.com Account Executive Ryan Estrada (907) 257-4270 Ryan.estrada@alaskajournal.com

Page 6 7 13 18 11 19

Specialties Page Pain Management 13 Pediatrics 15 Physical Therapy 7 Psychology 14 Tinnitus 14 Urgent Care 14

Providing the right care, at the right time, in the right place for our people. ANMC staff provide culturally sensitive, patient-and-family-centered care every day. Our staff are known for going above and beyond in their work, serving our people with compassionate, innovative care.

ANMC has been Alaskaâ&#x20AC;&#x2122;s only MagnetÂŽ-recognized hospital for nursing excellence since 2003, which acknowledges high quality patient care, nursing excellence and innovations in professional nursing practice. Magnet recognition is the gold standard in nursing excellence.

As a Level II Trauma Center, ANMC has provided the highest level of trauma care in Alaska since 1999. We were also Alaskaâ&#x20AC;&#x2122;s first Comprehensive Pediatric Emergency Center, providing the best and latest innovations in care for our pediatric patients.

Interested in joining our team? Visit www.anthc.org/careers.

AUDIOLOGY / HEARING

AUDIOLOGY

DR. NICOLETTE BUTLER

DR. EMILY MCMAHAN

Audiologist

1005 E. Dimond BLVD. Suite 3 Anchorage, AK 99515

10928 Eagle River Road Suite 108, Eagle River, AK 99577

907-522-4357 www.allearsalaska.com

HEARING

DR. NICOLETTE BUTLER & DR. EMILY MCMAHAN

DONNA R. DEMARCO AAS, BC-HIS, Owner

Audiologists

Hearing

1005 E. Dimond BLVD. Suite 3 Anchorage, AK 99515

510 W Tudor Rd Ste 3 Anchorage, AK 99503

10928 Eagle River Road Suite 108, Eagle River, AK 99577

907-644-6004 accuratehearingsystems.com

907-522-4357 www.allearsalaska.com

WORKOUT

WITHOUT THE

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WORKING OUT AT

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WORKAROUNDS Stop into your local The Alaska Club for your Special Offer. ANCHORAGE 375-0452

South • East • West • Club for Women • The Summit • Downtown Eagle River • Studio at The Alaska Club

MAT-SU

631-0843

Wasilla • Palmer

FAIRBANKS 328-1063 South • West

JUNEAU

Valley • Downtown

THEALASKACLUB.COM

500-7091

FAMILY MEDICINE / PHYSICAL THERAPY

FAMILY MEDICINE THE TALKING PLACE CHILD & ADOLESCENT COUNSELING PC Licensed Professional Counselors 17101 Snowmobile Lane Suite 109 Eagle, AK 99577 907-726-0426 www.thetalkingplace.org

ALASKA HEARING & TINNITUS CENTER provides a caring, professional environment to explore treatment options for your hearing loss and tinnitus concerns. Our warm, professional manner immediately puts patients at ease, We are Alaska's premier Audiology and our Patient First approach allows you to hearing center dedicated to improving proceed at a comfortable pace. the quality of life for our patients so they can continue living the life they love.

Whether you want to hear your grandAlaska’s only tinnitus management practice

children next week or you’re just ready to find out exactly how much hearing loss you have, we’re willing to go at your pace. If you are a candidate for amplification or tinnitus management, you will be happy to know that hearing instruments are smaller, more powerful, and more sophisticated than ever. We’re confident that when you’re ready, we’ll be able to help you hear better.

WE ARE ALASKA’S PREMIER AUDIOLOGY HEARING CENTER DEDICATED TO IMPROVING THE QUALITY OF LIFE FOR OUR PATIENTS SO THEY CAN CONTINUE LIVING THE LIFE THEY LOVE.

VOTED BEST

HEARING CARE CENTER & BEST AUDIOLOGIST IN ALASKA

Come see: Dr. Emily E. McMahan, Au.D BOARD CERTIFIED IN AUDIOLOGY

1005 E. Dimond Blvd Unit 3 Anchorage, AK 99515 10928 Eagle River Road Suite 108, Eagle River, AK 99577

CALL TODAY! Phone: 907.522.4357 www.AllEarsAlaska.com

Do you know what two of the most common phrases are that I hear in my office? “It’s not that bad, yet” or “I’ll just wait until it gets worse.” However, studies show that sooner, rather than later, is the time to address any hearing concerns. The ears are often overlooked, as hearing loss is a “silent disability.” We can’t look at someone and know they have hearing loss. We may notice the side effects of one’s hearing loss, often after it has been present for an extended period of time. Once a friend or loved one’s hearing loss is evident you might notice increased communication errors, frustration on both the listener and speaker sides of the conversation, reluctance or refusal of not wanting to attend social gatherings, and even cognitive decline. Did you know the auditory cortex, which performs the brain’s hearing functions, is like other muscles in our body and needs regular “exercise?” It is stronger and more effective when used regularly. Untreated hearing loss can shrink cortex size and weaken neural pathways, decreasing brain volume in key sensory areas. This directly correlates to the 25-year study which shows that untreated hearing loss is associated with quicker cognitive decline in older adults. The good news, is that by treating the loss, whether it’s a mild or a more significant loss, we can lessen the progression. We can lessen it so much so that there is no difference in cognitive decline between those using hearing instruments and those with normal hearing. As in all areas of health care, different parts of our body require specialization for the best quality of treatment and results. A Doctor of Audiology, like myself, provides the best in hearing loss care and treatment. We offer our professional knowledge, compassion, and highly personalized care to meet each individual patient’s needs. Today’s solutions are discreet and very technology focused allowing our patient’s ease of usage and access. Let us, Alaska Hearing & Tinnitus Center, learn more about the sounds of your life. We would love to help you continue hearing your friends and loved ones and enjoying the life you love to its fullest.

Emily McMahan Au.D. Doctor of Audiology (”Self-Reported Hearing Loss, Hearing Aids, and Cognitive Decline in Elderly Adults: A 25 25-Year Study”, 2015, October) This is a paid advertisement.

Alaskans serve as test market for Premera Pulse platform

Premera Blue Cross Blue Shied Alaska President Jim Grazko said a new app being tested in the state this year allows customers to find in-network care, schedule appointments, access medication lists, get reminders about important preventive care visits, set up convenient appointment reminders and rate doctors after visits. (Photo/Naomi Klouda/AJOC)

By Naomi Klouda Alaska Journal of Commerce

A new platform devised by Premera Blue Cross Blue Shield opens opportunities not only for the insured, but to help crack the conundrum of high medical costs. Alaskans enrolled in the individual and employer-sponsored insurance market with Premera can tap into an app that makes it easier to track their health care. Results will feed into a year-long pilot program before Premera opens the service to its Washington state customers. Designed in partnership with Vim, a healthcare tech company based in San Francisco, Premera Pulse is available to all Alaskans covered under Premera’s health insurance. The new service is meant to overcome the challenges patients face when searching for the right, “high-value” provider. In turn, Premera will be collecting information from consumer-driven decisions on health care providers and doctors. Premera Blue Cross Blue Shied Alaska

President Jim Grazko released news about the app at a time that coincided with a “Blueprint for Improving Our Nation’s Health System Performance.” The plan authored by five state governors — Gov. Bill Walker joined with Ohio Gov. John Kasich, Colorado Gov. John Hickenlooper, Pennsylvania Gov. Tom Wolf and Nevada Gov. Brian Sandoval — includes what they consider a good plan for solving problems left behind from a tattered Affordable Care Act. In their blueprint, the governors present four guiding principals for transforming their health care systems. One of the aims is to “recognize state innovations in value-based care.” That’s the direction the new app is also headed, Grazko said. “This engages them before they go to a hospital or to see a doctor. It’s not an app you download. It’s not a website, and it’s not a texting service. But it’s a little of all those things,” he said. To access the app, Premera customers will be given a link that allows a one-time sign in. They will then be able to find in-network

care (doctors that take Premera insurance), schedule appointments, access medication lists, get reminders about important preventive care visits, set up convenient appointment reminders and rate doctors after visits. Nearly 10,000 people have signed up already and more than 300 booked doctor visits through the app, Grazko said. “When enough people do the survey afterwards, that will be information you can use as well,” Grazko said. A prompt asks, “’would you like to see how others in your area, how their visit went?’ It will allow you to know if they had long wait times, if they felt listened to… ” Premera can collect information from the “experience” recorded in the survey. Premera includes all the physicians in its network and will get a better idea of which providers offer “high-value” care. For example, the insurance company knows of Anchorage providers it already has categorized as providing good health care services that effectively increase their patients’ health. Continued on page 12

NEUROLOGY

NEUROLOGY FRANK ELLENSON, MD ABPN

MARIUS MAXWELL, MD, PHD, FACS, FAANS

Medical Director / Neurologist 1100 E Dimond Blvd Anchorage, AK 99515

Board Certified Neurosurgeon

907-565-6000 / 866-977-2562 www.aknc.com

907-222-6500 www.arcticspine.com

NEUROLOGY

DAVID RANKINE MD, ABPN

THOMAS MULGREW, MD

Neuro-Ophthalmology/ Neurology

Sleep Medicine

1100 E Dimond Blvd Anchorage, AK 99515

907-565-6000 / 866-977-2562 www.aknc.com

NEUROLOGY

1335 Gambell Street Anchorage, Alaska 99501

MEDICAL SERVICES DIRECTORY

Continued from page 10

The move is away from fees-for services and toward incentivizing “quality,” Grazko said. “This is getting us toward increasing the value of health care, the whole value-based reimbursement approach,” Grazko said. “These providers are not doing unnecessary tests. They are only doing the care necessary at the time.” Providers go by standard check-lists before determining which tests are necessary. So it’s easy enough to find patterns among providers and facilities that pad their finances through unnecessary procedures, Grazko said. They can also track the customer’s health to determine how it’s faring. The doctor is likely to get some credit if your overall health improves. “Health status is higher or lower than standard and in general and over time, you can detect differences,” Grazko said. This also heads in the direction of paying doctors for outcomes. “It’s in our sights, not too far down the road,” Grazko said. “We’ve already identified some primary care providers by tracking outcomes.” The goal is to shift to a payment methodology that keeps a person out of the hospital. “If you keep your population healthy rather than just cranking through tests and scans — that’s the next generation. It’s valuebased reimbursement,” Grazko said.

The Blueprint The governors’ blueprint was written with the goal of producing better outcomes at a lower cost to governments. In Alaska, increasing health care costs for public employees and Medicaid is the single greatest expense in the budget; this session an additional $100 million has been requested by Walker as part of the state’s fiscal year 2018 supplemental budget. The current unrestricted general fund budget for 2018 Medicaid is $564.2 million. According to the blueprint, “governors understand that while some issues may temporarily divide us, on most issues we can find agreement,” including that it’s largely up to individual states to transform their own health care systems. One of the core beliefs expressed in the paper is that “we can and must achieve multiple, complementary objectives.” The best approach is to “address multiple objectives simultaneously.” The paper contends states can “lead by example” using Medicaid and state employee benefits (and to a lesser extent, individual and small group markets) as a catalyst for change. The strategy proposed for improving health care services is that the states “must align consumer and provider incentives, encourage more competition and innovation, (and) reform insurance markets,” much as Alaska has done in its Alaska Reinsurance Program, or ARP.

The creation of the ARP with $55 million in state funds in 2016 led to a smaller premium hike than expected in 2017 and a decrease in premiums of more than 20 percent in 2018 for about 16,000 Alaskans in the individual market. The Division of Insurance filed for a waiver from the federal Health and Human Services Department in December 2016 to use the federal savings from reduced Affordable Care Act premium tax credits to help offset the price of the reinsurance program. The savings in premium subsidies are key as the waiver must be budget neutral. Under the waiver, the ARP will receive $332 million in federal appropriations over five years, the Centers for Medicare and Medicaid Services and the U.S. Treasury Department announced in July 2017. It’s logical that now with the ARP program assisting the Alaska individual insurance market, the next step is to get costs under control. The governors want to reduce the incentives for medical providers to overuse marginal or unnecessary services within “high cost episodes of care,” which means emergency situations. Grazko said it’s no accident that government and private enterprise are finding the same words and concepts. “The ACA didn’t control costs; it was a set of insurance regulations,” Grazko said. “In switching to a value-based contract for large group coverage, the key is to get costs down.”

MEDICAL SERVICES

JIM PRICE, MD

BLOOD BANK OF ALASKA SOUTH ANCHORAGE

Board Certified Anesthesiologist and Peri-Operative Pain Specialist

1301 S. Seward Meridian Pkwy Suite H Wasilla, Alaska 99654

1335 Gambell Street Anchorage, Alaska 99501

907.357.5555 (during business hours) Appt. Line 907.222.5630

907-222-6500 www.arcticspine.com

HOURS: Tuesday to Friday 9 a.m. to 5 p.m. Saturday 8 a.m. to 4 p.m. (Closed: Sunday, Monday)

MEDICAL SERVICES

BLOOD BANK OF ALASKA WASILLA

BLOOD BANK OF ALASKA MAIN CENTER ANCHORAGE

1301 S. Seward Meridian Pkwy Suite H Wasilla, Alaska 99654

1215 Airport Heights Anchorage, Alaska 99508

907.357.5555 (during business hours) Appt. Line 907.222.5630

907-222-5600 Appt. line-907-222-5630

NEW HOURS HOURS: Tuesday to Friday 9 a.m. to 5 p.m. Saturday 8 a.m. to 4 p.m. (Closed: Sunday, Monday)

HOURS: Monday to Friday 8 a.m. to 6 p.m., Saturday 9 a.m. to 5 p.m. (Closed: Sunday)

1 donation can save 3 lives

1 in 3 Alaskans will need blood in their lifetime

1 in 7 hospital patients need blood products during treatment

find a center near you to save a life Call 907-222-5630 or visit bloodbankofalaska.org

PAIN MANAGEMENT / MEDICAL SERVICES

PAIN MANAGEMENT

What the new VA health care bill means for Alaska’s veterans

MEDICAL SERVICES DIRECTORY PSYCHOLOGY / URGENT CARE / TINNITUS

By Erica Martinson Anchorage Daily News

WASHINGTON — A new bill is headed to President Donald Trump’s desk that Alaska’s U.S. senators hope will ultimately offer the state’s veteran population greater access to health care in and near their homes, and bring new doctors to the state. The so-called V.A. Mission Act of 2018 will set the Department of Veterans Affairs down a multiyear path to expand private-sector treatment programs for veterans. Alaska’s senators said a 2014 law unintentionally limited treatment options for the state’s veterans, in part because the federal VA failed to issue payments to doctors. All three members of Alaska’s congressional delegation voted in favor of the bill. It passed the House 347-70 last week and passed the Senate by a vote of 92-5 on May 23. Trump is expected to sign it. “For a state where our veterans cynically refer to the Choice Program as ‘No Choice at All,’ it’s imperative that the VA take the failures of the Choice Program to heart and work to ensure we don’t repeat them,” Alaska Sen. Lisa Murkowski

TINNITUS

Sen. Heidi Heitkamp, D-N.D., left, and Sen. Lisa Murkowski, R-Alaska, arrive to vote on a bill to expand private care for military veterans as an alternative to the troubled Veterans Affairs health system, on Capitol Hill in Washington, Wednesday, May 23, 2018. (AP Photo/J. Scott Applewhite)

said in a statement. Alaska has the highest per-capita rate of veterans in the country — roughly 10 percent of the state’s population, which amounted to 73,276 veterans in 2015. About half were authorized for VA benefits that year, according to congressional testimony at the time. Many of Alaska’s veterans live in rural and remote areas, meaning they have extra obstacles to receiving care, in cost, distance and availability.

The new legislation is seen as a step forward in revamping the Veterans Choice Program, which was widely unpopular in Alaska. Alaska veterans complained that they were being saddled with expensive bills and difficulties getting appointments, which went through call centers in the Lower 48, where workers didn’t understand the Continued on page 19

TINNITUS

DR. NICOLETTE BUTLER

DR. EMILY MCMAHAN

Audiologist

1005 E. Dimond BLVD. Suite 3 Anchorage, AK 99515

10928 Eagle River Road Suite 108, Eagle River, AK 99577

907-522-4357 www.allearsalaska.com

The Walk-in Clinic at ANMC

PSYCHOLOGY

ANMC’s Walk-in Clinic is for patients of all ages who have an illness or injury that needs immediate care, but are not experiencing a medical emergency.

THE TALKING PLACE CHILD & ADOLESCENT COUNSELING PC Licensed Professional Counselors

Located at 3900 Ambassador Drive, 3rd floor Open Monday-Saturday from 9 a.m.-9 p.m. Sunday from 10 a.m.-6 p.m.

17101 Snowmobile Lane Suite 109 Eagle, AK 99577 907-726-0426 www.thetalkingplace.org

(907) 729-1500

PEDIATRICS THE TALKING PLACE CHILD & ADOLESCENT COUNSELING PC Licensed Professional Counselors

PEDIATRICS

17101 Snowmobile Lane Suite 109 Eagle, AK 99577 907-726-0426 www.thetalkingplace.org

OPTOMETRY

DR. ANTHONY MAKAR

DR. REBECCA MAKAR

Doctor of Optometry, Pacific University, College of Optometry, Forest Grove, Oregon

341 W. Tudor Rd., Suite 101 Anchorage, AK 99508

(907) 770-6652 www.makareyecare.com

OPTOMETRY

OPTOMETRY DR. ELIZA SALVO

DR. ALYXANDRIA MOREY

Doctor of Optometry, Indiana University, College of Optometry, Bloomington, Indiana

Doctor of Optometry, Pacific University, College of Optometry, Forest Grove, Oregon

341 W. Tudor Rd., Suite 101 Anchorage, AK 99508

(907) 770-6652 www.makareyecare.com

Why are routine eye exams important? Many people do not realize that an eye exam is much more than prescribing glasses. The doctors at Makar Eyecare, LLC have made it their passion to educate Alaskans about the importance of a comprehensive eye exam in the evaluation of a patient’s whole body health. A dilated comprehensive eye exam can be a key factor in diagnosing and monitoring many systemic diseases such as diabetes, hypertension, vascular disease, sarcoidosis, thyroid conditions, MS, Alzheimer’s, lupus, arthritis, sleep apnea, Sjogren’s Syndrome, side effects from medications, and much more. In addition, a thorough eye exam can detect agerelated and sight threatening eye diseases like cataracts, glaucoma and macular degeneration. Long before a patient’s symptoms begin, our optometric physicians can often see early signs of disease. Children need eye exams too. Amblyopia is the leading cause of vision loss in the United States, and is generally preventable if caught at a young age. It has been estimated that 86% of students start the school year without ever having had an eye examination. This statistic is shocking considering how important vision is in the classroom! 80% of learning comes through your child’s eyes. Studies indicate that 60% of “problem learners” actually suffer from undetected vision problems and, in some cases, have been misdiagnosed with attention deficit disorder (ADD) or attention deficit hypersensitivity disorder (ADHD). The medications used to treat these conditions can often exacerbate the eye conditions associated with them, causing visual concentration to be even more taxing. Makar Eyecare recommends a child’s first eye exam take place between six and ten months of age. Dr. Anthony Makar and Dr. Rebecca Makar are life-long Alaskans and owners of Makar Eyecare, LLC. Together, with associates Dr. Elizabeth Lane, Dr. Alyxandria Morey, Dr. Eliza Salvo and Dr. Rowena Rivera, they provide comprehensive vision, medical and urgent eye care to patients of all ages. Additional services offered include pediatric eye exams, vision therapy, low vision care, surgical consultation, and eye beauty treatments. Makar Eyecare’s convenient midtown facility combines state-of the art medical technology with the best optical services available in the state. The large boutique optical boasts a wide selections of frames, sunglasses, and sportswear for men, women, and children. Exclusive brands carried includes Oakley, Maui Jim, Lindberg, Silhouette, Tiffany & Co, Etnia Barcelona, Nike and much more. High-tech lens materials, same day glasses, and specialty contact lenses are available. Contacts for night wear, astigmatism and bifocals are in stock. Most insurances are accepted, and new patients are always welcome. Saturday and evenings are available. Call 770-6652 to schedule appointments. www.makareyecare.com

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#7000051767-01 (1/2 PG HORIZON(7in x 10in)) 04/22/2016 19:16 EST

MENTAL HEALTH

OPTOMETRY

OPTOMETRY DR. ELIZABETH LANE, FAAO

DR. ROWENA RIVERA Doctor of Optometry, Pacific University, College of Optometry, Forest Grove, Oregon 341 W. Tudor Rd., Suite 101 Anchorage, AK 99508

Michigan College of Optometry Big Grand Rapids, Michigan Doctor of Optometry, Fellow of the American Academy of Optometry 341 W. Tudor Rd., Suite 101 Anchorage, AK 99508

(907) 770-6652 www.makareyecare.com

Mental Health

Mental Health CHRIS KYLE PATRIOTS HOSPITAL

North Star Behavioral Health Reaching Across Alaska, Helping Children , Supporting Families, & Touching Lives.

An Inpatient Treatment Program for Service Members, Veterans and Active Duty Adult Dependents, 18 and older.

2530 DeBarr Road Anchorage, AK 99508

1650 Bragaw Street Anchorage, AK 99508

phone 907-258-7575 or 800-478-7575

serpentine bold newsgothic

TRICARE速 approved facility

A part of North Star Behavioral Health

northstarbehavioral.com

TRICARE速 approved facility

phone 907-258-7575 or 800-478-7575 chriskylepatriotshospital.com

TRICARE速 approved facility

MISSION STRENGTH, RESILIENCY & HEALING

AN INPATIENT TREATMENT PROGRAM FOR SERVICE MEMBERS, VETERANS & ACTIVE DUTY ADULT DEPENDENTS, 18 AND OLDER. Our program is an intensive dual track treatment program for military service members and veterans who have experienced trauma and/or are in need of detoxification and/or rehabilitation for substance abuse. We also serve active duty adult dependents ages 18 and older who are in need of substance abuse treatment.

erpentine bold newsgothic

907-258-7575 OR 1 (800)478-7575 CHRISKYLEPATRIOTSHOSPITAL.COM 1650 S. Bragaw Anchorage, AK 99508 | TRICARE速 approved facility

Continued from page 14

geography of Alaska. Some of what the new bill does to fix the program nationally has already begun in Alaska. The bill will cement them into the federal statute. The bill funds the Veterans Choice Program, which was slated to soon run out of money, for one more year, and sets up programmatic changes that will take effect in several years. Alaska’s tribal health system should continue to be available to the state’s veterans under the bill, both Murkowski and Alaska Sen. Dan Sullivan said. Murkowski made a point of entering that understanding into the record on the Senate floor in what is known as a “colloquy.” A colloquy is a scripted floor discussion between members — in this case, Murkowski and Senate Veterans Affairs Committee Chairman Johnny Isakson, R-Ga. — designed to record in the congressional record an agreed understanding about an amendment or a provision of a bill. Similarly, Alaska will keep its other fixes to the 2014 “choice” law. At the time, veterans’ health care providers weren’t getting paid, so they sent bill collectors after veterans. The VA now has a 30-day time limit, and the new bill makes that a statutory requirement. The VA wasn’t getting around to paying providers in Alaska for services rendered. Eventually tired of waiting, the providers started turning to the veterans for payment — sometimes sending collections agents after them for huge bills that remained unpaid. “If you’ve ever had a

collections agency ride you … it’s quite stressful,” Sullivan said. The repeated lack of payment caused some local health care providers to drop out of the VA plan in Alaska, Sullivan said. “It was a total meltdown of our system,” Sullivan said. The Veterans Choice Program also initially outsourced the process of making appointments to the Lower 48, which was problematic for Alaska veterans, who were faced with staffers with no understanding of the state’s geography. Alaska veterans will continue to be eligible for the community care program that allows them to access health care from nearby providers, since there is no VA hospital in Alaska. Scheduling services will remain in Alaska. Those who provide services to veterans will be reimbursed at rates that reflect the high cost of health care in Alaska. The bill also has provisions meant to encourage telemedicine, and to add doctors to the state VA programs. The latter was a provision Sullivan helped add to the bill, he said. Sullivan worked with Montana Democratic Sen. Jon Tester to get a pilot program into the bill that would encourage doctors to perform their residency in the state by paying back a larger percentage of their student loans. Alaska has no medical schools (neither does Montana), Sullivan said. And often doctors stay in the state where they do their residency, he said. The Veterans Choice Program was implemented in 2015, a rushed response to scandals of yearslong

wait times for care within the VA. But in Alaska, “the entire system was collapsing,” Sullivan said Wednesday. In response, Sullivan brought thenundersecretary of health David Shulkin (who ultimately became VA secretary before being dismissed by Trump) up to Alaska to see it firsthand, and face veterans at public meetings. The result was “what we then called the ‘Alaska Plan,’ “ Sullivan said. For all aspects of the new legislation, oversight will be “critical,” Sullivan said. “Right now, the VA has essentially no leader.” The agency has had four secretaries in four years, and the role of VA secretary is widely acknowledged to be the most difficult job in Washington. Trump last week said he would nominate acting VA Secretary Robert Wilkie to lead the agency. Another aspect of the bill that Sullivan said will require great oversight is a massive expansion of an in-home care payment system that used to be available to veterans of wars after Sept. 11, 2001. The program pays family members who offer fulltime care for veterans. While it’s a nationwide provision, it could be “uniquely impactful” in Alaska “given how many veterans we have,” especially in rural areas, Sullivan said. But it will require oversight to make sure it isn’t abused. “This will be costly,” Sullivan said. “The money will be appropriated, I believe. But that’s another issue that we’ve got to focus on.”

North Star Behavioral Health is a mental health facility offering programs in and around the Anchorage Alaska area for children and teens suffering from mental health issues. We also provide treatment for active duty service members, active duty adult dependents ages 18 and older and veterans at the Chris Kyle Patriots Hospital.

PAI D ADV E R TI SME N T