By Jenny Neyman
Elena Pascucci is learning to stick out her tongue. It’s requiring lots of demonstration from mom and dad, Amy and Dan Pascucci, and giggles all around. She’s also started delivering vowel-laden cooing when she’s winding down to a nap.
“And another thing!” Dan said, personifying what Elena might be saying in her monologues.
“I think she’s singing,” Amy contends.
Those are pretty exciting milestones for the first-time parents. And they’re about to take Elena to the doctor for her four-month checkup, where her growth, reflexes and other milestones will be checked.
It’ll be to a different doctor than the one she saw since birth. Amy’s looking for a new doctor, as well. For that matter, the doctor who delivered Elena at Central Peninsula Hospital is not the one Amy saw during her pregnancy.
Amy Pascucci: “I remember when I first started looking for OBGYN care when I was in the beginning of our pregnancy. And that was tricky to find a doctor then, and I know that the doctor that I originally went to has left, and I know our midwife has retired, and so it seems, just in the time I’ve been here looking and aware, the pool has shrunk by at least two or three providers.”
There are only so many options of pediatricians and obstetricians on the central Kenai Peninsula, and of those, several have left recently or are leaving — either retiring or moving elsewhere. Of those available, Amy and Dan’s choices were further constricted by their insurance carrier.
They found a doctor they liked, but when the time came — early and in a bit of an emergency — their doctor was out of town, and there was only one other on call. Everything went well, mom and baby were fine and they say they got excellent care at the hospital. But still, the lack of options and the lack of continuity of care worsened an already difficult situation.
“We ended up having to go with a doctor who we wouldn’t have necessarily chosen and we didn’t know at all and who was advising us to make really important decisions on the spur of the moment and in an already stressful time,” Amy Pascucci said. “We felt very limited as far as our options, and kind of pressured because of the time limitations, but also just because there wasn’t anybody else around. We couldn’t even ask for a real second opinion unless we went to Anchorage. That definitely was stressful.”
Elena’s first pediatrician is leaving, and with a change to Amy and Dan’s insurance, Amy needs to find a new doctor, too. So it’s back to the pool.
“In a small pool. I’d say there are good options but we definitely felt limited through my pregnancy, and even now in finding another doctor for her,” she said.
By the end of this year, Peninsula Community Health Services will deepen that pool with a new clinic in Kenai.
“We are opening a women’s and children’s health center in Kenai,” said Monica Adams, chief executive officer of PCHS. “We’re looking at pediatricians and an OBGYN to focus on women’s health and children’s health in that area in Kenai and Nikiski — that’s where a lot of families, young families, live. There’s a lot of practitioners here in town who are leaving, too. Obstetricians and pediatricians are leaving the area.”
The clinic applied for a New Access Point grant from the Department of Health and Human Services.
“There’s a significant need for it in the community,” Adams said. “But also, as a community health center, it’s an area where we’re a little bit weak on. We’ve been focusing really on adult chronic care management and not doing as much as we need to do and as want to do, which is what the community needs for women’s and children’s health.”
Grants are awarded based on points in several areas. PCHS ranked high for its service area — from Clam Gulch to Nikiski to Cooper Landing — being rural and spread out. It was awarded just over $858,000 in August, one of six health care agencies in the state to receive funding to expand services, along with agencies serving Girdwood, Kodiak, Anchorage, the Tanana area and the Aleutians.
PCHS actually got two grants, which, together, fund equipment and will pay to hire a new pediatrician and OBGYN at the Kenai clinic on the first floor of the old Benco Building on Frontage Road. But recruitment can take a while — a year or more. In the meantime, PCHS will move a family care physician, Dr. Jamie Wiseman, and a nurse practitioner specializing in women’s health to Kenai to open the clinic later this year.
“The federal agency that we work under, which is the Health Resources and Services Administration, they’re pushing for expanding family practice and expanded primary care really, really quickly. And so they want people to be up and running fast,” Adams said.
The providers will still see people in Soldotna, though, so greater convenience in Kenai won’t inconvenience patients elsewhere.
“We’re probably going to switch their schedules so they can see their patients that want to be seen here, and then there’s a lot of people from the Kenai side that can be seen there,” Adams said. “So we’ll switch up their schedules so that we make sure we take care of everybody. We don’t want to have any gaps in service. So that will be a little bit of a logistical situation for us. We want it to be a positive thing for the community, for the people who want to come to us.”
PCHS is a private, independent, nonprofit health center. Given the need for more women’s and children’s health providers in the area, Adams said she doesn’t expect the clinic to provide competition to existing providers, just to help meet the need.
PCHS sees about 7,500 people per year for medical, psychiatric, behavioral and dental health, and anticipates seeing another 2,600 more once the new clinic is fully staffed. The clinics accept Medicare, Medicaid and private insurance and offer sliding-fee services for those without health insurance or with a limited ability to pay.
“We are the public health network for the country,” Adams said. “It’s a really proud legacy to take care of the people who are struggling the most, and, now, that’s pretty much everybody. People really struggle with health care access, they’re struggling with taking care of all of their health, being treated as whole person, getting comprehensive care, affordable care, and so we’re really proud of what we do.”
The clinic is expected to open as early as November, but no later than Dec. 1.