Help with health care — ‘Navigators’ steer applicants through enrollment process

By Jenny Neyman

Redoubt Reporter

The clock is ticking on the open enrollment period to sign up for heath insurance under the Affordable Care Act, but navigating the acronym-laden options, deciphering plan benefits and the pressure of making the best decision for your health and your wallet can be a real headache. Peninsula Community Health Services is there to help.

Tina Minster is a health insurance “navigator” with PCHS, specializing in outreach and enrollment. Friday, she set up shop for three hours in the Soldotna Public Library, and had 20 people come visit with her, and takes her services much farther afield, as well.

“I host events, I do follow-up appointments, I go to people’s homes that may not be able to get out. I’ll go to coffee shops, I’ve been down to the beach while people are dip-netting,” she said. “I’ve been on the boat with people, fishing captains that are going to need help. I’ll take my pocket full of business cards, and wherever I go I’ll be standing in a grocery line, ‘Hey, do you need help understanding what your responsibilities are? Do you have insurance? Do you know anyone that needs insurance?’ I’m kind of outgoing, so that really helps a lot.”

She fields a lot of questions about Medicaid and Medicare and can walk people through the enrollment process online on healthcare.gov to see if they qualify for subsidies under the Affordable Care Act. If Minster can’t answer a question, she can refer to someone who can, such as a private insurance broker, Native health services or veterans health services.

Her last client of the day, Betty, and her husband are trying to figure out heath care coverage now that they’re retired. She’s covered under Indian Health Services, but isn’t sure how to integrate that with the Affordable Care Act — or “Obamacare” — while her husband is trying to decide how much coverage he needs under Medicare.

“Which way do you go? When can you get signed up? So we’re trying to get that in order, and he wants to be completely covered, like Medicare A, B and C and supplemental,” Betty said.

They want to take care of their health, but don’t want to spend any more than they have to.

“And then with me, I have Indian Heath Services, so have the exemption with that with Obamacare,” she said. “And I’m on Social Security. So you’re retired, this is what you get — you get Part A, and there’s certain things it covers, then Part B covers something else, but I want to know the advantages of why should I get Part B,” Betty said.

It gets pretty complicated.

“I don’t know which way to go,” she said. “And then, am I taking a chance if I travel? How do I get to them (IHS) if I need to go to a hospital? How do I check ahead? What if something happens to me? If I’m knocked out, does my husband call and say, ‘OK, you need to cover this?’”

Vets on Kenai Peninsula get smoother ride to medical care

By Jenny Neyman

Redoubt Reporter

Veterans on the Kenai Peninsula will continue to have help getting to and from medical services, thanks to the renewal of a transportation grant in the amount of $250,000 to the Alaska Office of Veterans Affairs.

Any veteran on the Kenai Peninsula can get free transportation to the VA medical clinic in Kenai or outpatient clinic in Homer, as well as any VA-authorized vendors, like pharmacies, hospitals and medical specialists. Forest Powell, with the Alaska Office of Veterans Affairs, says it even counts for trips to Anchorage, if the local VA refers a vet to a doctor in the city.

“You, as a veteran, get free transportation from here to the VA and return back, free,” Powell said.

The program covers the Kenai Peninsula, Denali, Matanuska-Susitna, Kodiak Island and Prince of Wales-Hyder Boroughs. The VA partners with a transportation provider in each area and reimburses them the costs for transporting veterans. On the peninsula, it’s Alaska Cab.

Veterans don’t have to have a service-connected health issue to use the service. There’s a separate source of funding to help those vets with medical transportation. Vets just need to be eligible for VA care.

Veterans using the service don’t have to fill out any forms, file a health insurance claim or pay in advance and be reimbursed. All they have to do is call Alaska Cab in advance to set up a ride, then show the driver one of four forms of identification — a VA health care card, a veterans retiree ID card, or a driver’s license or state ID with the veteran designation (an image of an American flag with a “V” on it). Spouses can ride along, too.

With Alaska’s size and distances between communities, transportation can often be a barrier to medical care. Powell said the rural transportation grant program is an important way the state can support its veterans.

Powell: “I’m a combat vet, I’ve been in the field, I’ve done eight tours over there in the desert, and my dad’s a Vietnam vet. My grandfather’s a WWII veteran. … So I understand. It’s very important to me to take care of you, the veteran.”

For more information on the travel grant, or VA care in general, call the Kenai Veterans Clinic at 395-4100.

A Veterans’ Listening Session will be held from 5:30 to 6:30 p.m. Friday in the McLane Commons at Kenai Peninsula College’s Kenai River Campus. This session will be provided Alaska VA Healthcare System Interim Director Linda L. Boyle. For more information, contact Drew Baker, KPC veteran services coordinator, at 262-0261 or rdbaker3@kpc.alaska.edu. It is open to the public.

Borough mulls joining fire, hospital services — Efficiencies could result in cost savings

By Carey Restino

Homer Tribune

Kenai Peninsula Borough Mayor Mike Navarre knew the words centralization and consolidation weren’t going to sit comfortably when talking to many from the southern Kenai Peninsula, but he said them anyway.

Navarre spoke at the Homer City Council meeting Monday, bringing the message that dwindling budgets may necessitate the consolidation of some Kenai Peninsula Borough services — primarily emergency services and health care.

“I wanted to let you know about a couple things we are considering that sometimes caused consternation because they are deviations from the status quo,” Navarre said.

Navarre said that when he first took over as mayor he immediately asked why there are three separate fire and emergency service delivery agencies — the Anchor Point Volunteer Fire Department, the Homer Volunteer Fire Department and the more recently formed Kachemak Emergency Services — operating on the southern peninsula.

“I asked, ‘Can we get better cooperation and communication and working relationships between the different entities?’” Navarre said.

In other areas of the Kenai Peninsula Borough, there is a single service provider for medic and fire response — Central Emergency Services — but the mayor acknowledged that the city of Homer gets to make its own decisions about letting the Kenai Peninsula Borough take over its emergency service providing.

“Homer controls its own destiny,” he said. “All we can do is put the information together, present it to the city, and Homer gets to decide this. We can’t force Homer to do anything.”

Navarre said he understood that changing to a centralized emergency services provider would mean a big change for those individuals who have positions at local fire departments. But, he said, with the state’s fiscal situation where it is, there will be a trickle-down effect that will have some big impacts on local municipalities and boroughs.

Another area Navarre said he will be examining closely is the borough’s hospitals. He created a Health Care Task Force to examine the possible ways health care on the Kenai Peninsula could be improved.

“Health care in the way it’s delivered now is simply and undeniably unsustainable,” Navarre said. “I think we can build a better model.”

New Kenai health clinic targets need — PCHS to add women’s, children’s providers

Photo by Jenny Neyman, Redoubt Reporter. Amy Pascucci plays with her daughter, Elena (in an ensemble picked out by dad, Dan Pascucci). The family has found it challenging to find consistent medical care throughout Amy’s pregnancy and Elena’s infancy.

By Jenny Neyman

Redoubt Reporter

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.”

Kenai vets get Choice in care — New VA program expands health care options for veterans

By Jenny Neyman

Redoubt Reporter

Representatives from the Veterans Administration in Alaska had good news to share at a town hall meeting Thursday evening at Kenai Peninsula College — veterans on the Kenai Peninsula eligible for VA health care now have more options to receive timely, localized care, and even have a free way to get to that care.

The meeting was to explain the changes that came with the Veterans Access, Choice and Accountability Act of 2014.

The Choice program offers just that. In the past, veterans eligible for VA benefits generally had to receive their care directly from a VA facility, which could mean a lot of traveling and waiting in areas where VA facilities are limited or understaffed to meet demand. With the Choice program, eligible veterans who live more than 40 miles from a VA facility, or if the VA isn’t able to provide care within 30 days, can obtain care in the private sector, with the VA pitching in to cover the bill, as much as it would if a VA clinic was providing the care.

Susan Yeager, director of the Alaska VA Healthcare System, said that the purpose of the program is to give the VA time to increase its capacity to meet patient needs, and in the meantime, give vets better care.

“When this bill was passed, for Choice Act, the idea was that it was a three-year pilot, allowing the VA to build up their staff, so that at the end of three years the VA has enough staff so that veterans can get the care they need, when they need it, at a VA,” she said.

Alaska is one of three states, Hawaii and New Hampshire being the other two, where all vets eligible for VA health benefits can utilize the Choice program. To do so, a vet would call the number on their Choice card and request to see a private-practice provider. The VA’s vendor for the program, Tricare, is currently creating a network of preferred providers in the state. But even if a provider isn’t part of the arranged network, Tricare can contact that provider and try to negotiate a rate at which the VA will compensate for services.

Initially, it was difficult to get private providers to be willing to work with Tricare, because the reimbursement rate was not very competitive, Yeager said. The rate was recently increased, and more providers are joining the network.

“I think we’re going to see more access opening up in Alaska,” she said.

The program is especially well suited here, where access to care is a big challenge. The VA has a shared agreement to use the U.S. Air Force Hospital 673rd at JBER in Anchorage, but doesn’t have its own hospital in the state. And Anchorage is a long way away from most communities.

The VA operates regional, community-based outpatient clinics, including the one in Kenai, which is rated to serve the 2,589 eligible vets on the Kenai that have enrolled for VA services. But even Kenai, and VA services in Homer, can make for a long trip for patients. And in rural areas of the state, accessing a VA clinic can mean a plane or boat ride.

“It’s a big challenge, I think, up here, more than other VAs I’ve seen in the Lower 48, because of our distances and lack of roads. And that’s expensive, too,” Yeager said.

Punctuation on health — Unique teaching tool underscores importance of colon cancer screening

Photos courtesy of M. Scott Moon/Kenaitzie Indian Tribe. Deb Nyquist, wellness director at the Dena’ina Wellness Center in Kenai, and Fridrick Gudmundsson, youth services clinician, talk about the Nolan the Colon display at the center March 9.

By Jenny Neyman

Redoubt Reporter

Let’s just get the puns out of the way: The Southcentral Foundation and Dena’ina Health Center wasted no time eliminating misinformation about colorectal cancer on March 9, leaving curious visitors flush with information to digest.

OK, enough with the crappy jokes. But when you’re traveling with a giant inflatable colon, a silly sense of humor is required.

“Oh yeah, you have to. For the most part people laugh. First, they don’t know what it is. If they have kids it’s like, ‘Oh, a bouncy house.’ And then they come over and they’re like, ‘Oh,’” said Cherise Cummings, health educator with the Southcental Foundation.

Cummings brought the unusual teaching tool to the Kenaitze Tribe’s Kenai health facility March 9, as March is Colorectal Cancer Awareness Month. The 12-foot, inflatable, anatomical replica illustrates a healthy colon and the development of colorectal cancer, and gives information on how to prevent the disease. The pinkish, tunnel-shaped novelty comes complete with polyps, and a name.

“This is Nolan the Colon and it’s just a great visual to get people to open up and talk about getting screened for colon cancer,” Cummings said.

Nolan gets a workout during the winter, with health educators taking him on the road to communities served by the Southcentral Foundation, an Alaska Native health care organization established by Cook Inlet Region, Inc. He also makes appearances at various high-profile community events in Anchorage, along with Cummings and her associates dressed in bulbous, red, Nolan-related costumes.

“I do have a polyp costume, so I’m a polyp princess. I do show up at events. So I ran with the reindeer last week, on Saturday, along with Doc Polyp and another polyp princess,” she said. “… There’s a group of them that were actually in the Fur Rondy parade with Nolan the Colon, waving. We just really talk about screening. Screening is so important because there aren’t always signs and symptoms, and that’s the scary part.”

Horse senses — Unique summer program uses riding as tool for kids’ therapy

Photos by Jenny Neyman, Redoubt Reporter. Lachlan McManus captures a ring during an exercise in his hippotherapy session with Nature’s Way Rehabilitation Service on July 30 in Kenai.

By Jenny Neyman

Redoubt Reporter

Lachlan McManus was having a blast. What 10-year-old on a horse wouldn’t be? Especially when there’s a sword involved, as there was during the Kenai boy’s riding session July 30 in an arena off Kalifornsky Beach Road near Kenai, with Lachlan plunging the sword forward in a fencing-style thrust, or extending it straight overhead as though he’d just freed Excalibur from its rock.

In his head, he could be a swashbuckling pirate or a knight of the Round Table galloping off to battle, wielding his nimble blade in one hand and guiding his powerful steed with the other.

The reality, of course, was less dramatic. The sword was a blunt-edged toy, lacking the heft to make a swashing sound, much less damage anything with which it might accidentally make contact. The only buckles involved were those on the riding gear and the safety belt fashioned around Lachlan’s waist. As for the horse, full speed ahead was more of a mosey than a trot, and direction came from the helpers walking along each side, rather than the rider having the reins.

But the lack of daring and danger didn’t bother Lachlan, nor did the fact that he wasn’t really getting a riding lesson. As far as he was concerned, he had an activity to enjoy on a summer afternoon, he was playing games and getting undivided attention, and he was on a horse — ergo, he was enjoying himself, period.

To those around him, though, Lachlan’s enjoyment was just the starting point of the afternoon’s purpose. Because he was enjoying himself he was easily engaged with his helpers, willing to listen to instructions, carry out the tasks being presented as games and try to achieve each incremental increase in challenge.

To the helpers — certified therapists and volunteer assistants with Nature’s Way Rehabilitation Services, the session was therapy. To Lachlan, it was just plain fun. To both parties, the day’s success was made possible in large part because of the horse.

That’s the world of hippotherapy — a physical, occupational or speech/language treatment strategy that incorporates horses. It’s a program that’s been available to kids with disabilities on the central Kenai Peninsula for six summers now, through Nature’s Way. It’s one of only a few programs of its kind available in Alaska, and the only available on the peninsula, or anywhere outside of the Anchorage area.

Part of the appeal of using horses in therapy is kids enjoy the sessions and are motivated to pay attention and follow instructions. Add games and fun props, such as this sword, and they’re even more engaged.

“I just think it’s incredible that there’s an actual hippotherapy opportunity for kids around here, because it is so specialized. Living on the peninsula, you wouldn’t think that something like that would be available, and they’re making it available, and I think it’s phenomenal for kids that could definitely benefit from it,” said Jami Wight, of Soldotna, who has had two of her kids in the summer hippotherapy program.

The term comes from the Greek “hippos,” meaning horse, as opposed to the Latin “equus,” for horse. It’s under the larger umbrella of equine therapy, though it’s not therapeutic riding, where specific riding skills are taught, or horse therapy, where interaction with horses is used to support therapeutic outcomes.

Hippotherapy specifically utilizes the movement of horses to create adaptive responses in patients and facilitate physical, occupational and speech/language treatment goals.

Therapy for kids needs to be fun and engaging to be effective, which is why various approaches incorporate games, toys and activities. In that sense the horse is a tool, just like a ball or tricycle, only way more fun — thus, way more engaging.

“It’s an amazing tool. It’s kind of like putting a kid in a swing or on a ball or trampoline or something like that, but it’s a horse, and what kid doesn’t like horses? We haven’t really met one yet,” said Noelle Miller, a speech therapist with Nature’s Way. “The beauty of horse therapy is it’s such a holistic environment and such an exciting environment that a lot of times you just get more verbal output from kids and more interactive output from kids because it’s real. You’re doing something with people, with animals. You’re not trying to stage a situation that demands interactions and reactions, it just happens naturally.”

Health center is well of care, renewal — Wellness facility represents sea change for Kenaitze Tribe

Photos by Patrice Kohl, for the Redoubt Reporter. A “Łuq’a Nagh Ghilghuzht” sculpture by Joel Isaak depicts traditional Dena’ina life at fish camp outside the Kenaitze Indian Tribe’s new Dena’ina Wellness Center in Old Town Kenai.

Clarification: It was incorrectly reported that the Dena’ina Wellness Center is currently seeing all veterans and is considering expanding medical services to the public. Currently, only Alaska Native and American Indian veterans receive VA services through the Dena’ina Wellness Center. As a community mental health center, behavioral health services are open to the public. Other services are available to Indian Health Service beneficiaries.

Through the joint venture award, Indian Health Service funding supports operation and maintenance for a minimum of 20 years. The state of Alaska Department of Commerce, Community, and Economic Development Division of Community and Regional Affairs provided $20 million to the project.

 

By Jenny Neyman

Redoubt Reporter

For the Kenaitze Indian Tribe, a new building in Old Town Kenai is an indication that the tide has turned.

A gradual erosion of culture, connection and community has reversed, and what was washed away, grain by grain, as if by the lapping pull of receding waves, is rushing back in, not only replacing what’s been lost, but reaching a new high-water mark.

That mark is a substantial one, both in its 52,000-square-foot physical form — the Dena’ina Wellness Center in Kenai — and in what it represents for the tribe.

“The Dena’ina word for it is ‘naqantughedul.’ For the tribe it means the tide is going out and it’s turning and going back in,” said Jaylene Peterson-Nyren, executive director. “It means the culture, the people, the land and just the lifestyle has been going away for many, many years, and it has taken a turn with this facility. It’s coming back.”

The building isn’t just a health clinic, nor was the motivation to construct it simply some tipping of an equation of funding and client base and service needs. It grew from a need to come together — to reconnect, strengthen and grow — and to improve health beyond just the physical.

The lobby of the new, 52,000-square-foot Dena’Ina Wellness Center is meant to be an area for gathering and socializing, more than just a medical clinic reception lobby.

“We wanted to design not just a health clinic, but we wanted to look at wellness from a holistic perspective, and that means not just that you’d have your checkups and you check out well. It means social and economic wellness, it means educational wellness — knowledge. It encompasses relationships across the board with customers who come in to seek services and for staff who are all working together on behalf of our customers,” Peterson-Nyren said.

Fittingly, then, the facility consolidates the tribe’s three health services programs under one roof — medical, dental and behavioral — as well as expands new services to address the wellness of a person as a whole, not just whether they’re running a fever.

“We try to focus on prevention and intervention. We want to encourage people to return. That’s one of the reasons we built the Gathering Space (building entrance room) is we want people to want to be here,” she said.

Along with being a center for holistic wellness, the brand-new facility, with construction starting in August 2012 and the grand opening ceremony June 12, is also a hub of social connection — an area of wellness which the tribe believes also needs care.

It’s designed to facilitate both — new equipment and the latest technology to aid the delivery of quality medical services, and a welcoming, calming, comfortable design to encourage people to come and enjoy the facility. The entry leads into the Gathering Space, with a large, open, airy design and windows stretching floor to the second-story ceiling above. A stage area anchors the wall facing the doors, while a reception desk, curved as if beckoning a visitor further into the building, stands to the right of the stage. To the left of the entrance is a wide staircase giving the feel of floating upward as it parallels the windows looking out over Old Town toward the mouth of the Kenai River and Cook Inlet. Upstairs are balcony railings to allow a bird’s-eye view of the stage and circular Oculus feature below, which will have a commissioned art piece suspended above it.

The whole space can be configured for large gatherings, such as the grand opening of the facility, which was packed to standing room only. Over 1,000 people came through the facility during the two days of tours, presentations and festivities, Peterson-Nyren said.

“I think the response has been tremendous,” she said. “It was amazing to feel that community support, just everyone showed up.”

Rally with Relay for a cure — Annual event offers hope, way to help fight cancer

Photo by Jenny Neyman, Redoubt Reporter. Phyllis Swarner snuggles with her cat, Mutto, in her home in Kenai. She will be one of many volunteers and survivors at the Central Peninsula Relay for Life on Friday and Saturday at the Kenai Central High School track.

By Jenny Neyman

Redoubt Reporter

May 19, 1999, was the worst day of Phyllis Swarner’s life, but also the day it changed for the best.

She was 52 years old, living in Florida, working for the civil service at Eglin Air Force Base. Life was going along just fine. Until it wasn’t.

“I got a phone call at 5 o’clock that morning that my dad had passed away,” she said. He had been sick. Even though it wasn’t entirely a surprise, the grief and sadness were more than enough to leave her reeling.

And yet, then came another call, at 9 a.m., with the results of her recent mammogram. It was merely a routine scan, as there was no history of breast cancer in her family. She felt fine. There was no reason to think anything would be found. But something was — a 2-centimeter lump in her left breast.

“So it was the day that my life changed,” she said.

Still, given her lack of risk factors, her doctor wasn’t overly concerned. It could be benign. Go to the funeral, deal with your dad’s death and we’ll do a biopsy when you get back, she was told. A month later when the biopsy was done, it showed the lump was cancer, and that there was infiltration into the lymph nodes.

“I found out not only was it cancer, but I had a second precancerous condition, as well,” she said.

“When you hear you’ve got cancer you think you’re dead. I don’t care what they say, you just think, ‘Start preparing for your will and your last days, because life’s over, period,’” she said.

But her life, in a way, had just begun again. In 1995 she had attended her 35th high school reunion and reconnected with her classmates from Fairbanks, where she’d begrudgingly spent her childhood.

“I’d hated Alaska growing up,” she said. “Fairbanks was so remote and cold, and I had roots in North Carolina. I was close to my grandparents there, so Fairbanks felt so far away from everyone and isolated at that time. And 50 and 60 below zero is cold weather. So I swore I’d go as far south as I could, and I did, I went to Florida.”

But she was finding herself more and more pulled back to Alaska, particularly to one classmate — Dennis Swarner, who had become an optometrist in Kenai.

“Dennis and I knew each other since the third grade. We have known each other forever. We graduated from high school together. And I’ve never been intimidated by the ‘Dr. Swarner’ part. He was that corny kid I had to put up with in third grade and he hasn’t changed since,” she joked.

But her feelings for him certainly did. They reconnected and stayed in touch. He came to Florida for a conference, looked her up, dropped by, and that was that.

“My life has never been the same since,” she said.

As if long-distance romances aren’t challenging enough, this was about as long a distance as the U.S. offers — Florida to Alaska. He had a practice in Kenai, and she wasn’t too keen on moving back north. Then came the cancer diagnosis and the years-long process of surgery and recovery. That could easily have spelled the end of the relationship. Instead, it was the beginning of Swarner’s new life trajectory.

“Pow, I had cancer, and that put everything in a different perspective,” she said.

Birth center gets new lease on life — Management change keeps Women’s Way in operation

Photo by Joseph Robertia, Redoubt Reporter. Russet and Bill Morrow, of Massachusetts, watch as Andrea Stiers, a certified direct-entry midwife, performs a neonatal exam on their granddaughter at the Woman’s Way Midwifery in Soldotna. Stiers recently retired and in January the midwifery came under the management of Heritage Birth Centers, which also runs midwiferies in Anchorage and Palmer.

By Joseph Robertia

Redoubt Reporter

In TV shows, giving birth often entails a woman in a hospital, lying in a mechanical bed, her knees held up to her shoulders and the doctor and nurses yelling, “PUSH!”

In life off the TV screen, though, not all women opt for this type of birth, preferring a range of options beyond the hospital model. On the central Kenai Peninsula, with the assistance and supervision of a midwife, some women choose to give birth at home or in the spalike setting of the only out-of-hospital birth center on the peninsula, which recently came under new management.

“We began managing it at the end of January and it’s all just happenstance, really,” said Kirsten Gerrish. She, along with her business partner, Lena Kilic, are the owners of Heritage Birth Centers in Anchorage and Palmer, and recently assumed management of Woman’s Way Midwifery in Soldotna.

Gerrish and Kilic are both state-licensed certified direct-entry midwives and have certifications in neonatal resuscitation, CPR and IV, and they said they weren’t necessarily looking to take on the responsibilities of a third birth center.

However, Andrea Stiers, the longtime manager and CDM midwife at Woman’s Way Midwifery, was preparing to retire to spend more time with her own family, and the other midwife there, Heather Forbes, had never managed a birth center of her own.

“We just thought the idea of there not being a birth center or any midwives on the peninsula, besides Homer, was just sad,” Gerrish said. “The community seemed supportive of keeping it going, there was the need, there already were the facilities with the license and a midwife already, so we decided to keep it going.”

Gerrish added that, populationwise, there aren’t more midwife services in the area.

“Alaska doesn’t have enough midwives or midwiferies to meet the need. The largest concentration is in Palmer, where there are three, currently, and a new one opening soon. Anchorage has two, Fairbanks has two and Juneau one, and with the population of the Kenai-Soldotna area it makes sense to have one,” Gerrish said.

Do you know what doulas do? Event to raise awareness of birth options

By Joseph Robertia

Redoubt Reporter

When it comes to giving birth, the image that often comes to mind is a woman in a hospital bed, surrounded by bright lights and blue-clad doctors and nurses, with everyone shouting “Push!” This might be the most familiar birthing option these days, there are others around the central peninsula, some that are alternatives to a hospital birth and some that complement going the traditional route.

Bethe Smith, of Soldotna, has had three children and experienced dramatically different births with each, so much so that the last one inspired her to pursue a career assisting other women during childbirth.

“I have three children — Ciara, 11, Rennen, 8, and Taryn, almost 2. When I had my first I was 21 and I put full trust in my doctors and did not question much,” she said.

Smith was advised to have her labor induced, rather than waiting for birth to begin on its own. She was given several birth-inducing drugs, as well as an epidural to relax her and prevent her own discomfort.

“After a long nap I was told it was time to push. So I did. She was coming and they were not ready so they told me to stop. They had to announce over the intercom over the whole hospital that we needed a doctor in room 418 STAT. Yikes. I did not know who the doctor was. It was very scary and I felt very out of control,” she said.

Her firstborn ended up suffering from gastroesophageal reflux disease and there were problems with the child latching on during breast-feeding. The delivery of her second child was an equally less-than-pleasant birth experience.

“With my second I was given directed pushing and I started hemorrhaging. Again, I was scared and felt out of control,” she said.

For the birth of her third child, Smith wanted to try an alternative to the at-the-hospital model of birth. She researched her options and decided to use a birthing center at Woman’s Way Midwifery in Soldotna and midwife there to deliver the child.

“My last one I had at the birth center and it was amazing. I labored at home with my husband. Then when I got to the birth center she was here 15 minutes later. It was very calm and relaxing. I was allowed to listen to my body as I had her. I wanted this for every mother,” Smith said. “With my birth experiences I know that the hospital can be very intimidating and nursing does not always go smoothly, so I wanted to help women make educated decisions about their birth and parenting choices.”

Abortion debate on the home front — Protesters, supporters mark Roe v. Wade decision anniversary

By Jenny Neyman

Photo by Jenny Neyman, Redoubt Reporter. Three of Laura Burke’s 10 kids hold anti-abortion signs during a rally in Kenai on Jan. 22, the anniversary of the Roe v. Wade Supreme Court decision.

Redoubt Reporter

In the last 40 years, a lot has changed in the abortion debate. The specific issues being argued have gone through different iterations, the battlefields have cropped up in various states, the players at the forefront have retired, passed the baton or even switched sides. Even the lexicon of the discussion has changed, as with Planned Parenthood recently announcing that it would no longer use the term “pro-choice.”

Yet, some things have remained very much the same. First and foremost, the U.S. Supreme Court landmark decision in Roe v. Wade on Jan. 22, 1973, still stands, dictating that a women’s right to privacy under the due process clause of the 14th Amendment extends to a woman’s decision to have an abortion, trumping states’ decisions on the matter.

And another thing that hasn’t changed is that abortion is still very much a current events issue.

On Jan. 22, Bob Bird, of Nikiski, stood on a busy street corner in Kenai waving anti-abortion signs, as he has done every anniversary of the Roe decision since 1984. Some years it’s at the “Y” intersection in Soldotna. Others, like this year, he and fellow abortion protestors tromped back and forth through the slushy snow at the intersection of the Kenai Spur Highway and Bridge Access Road, chosen for its high volume of traffic on a weekday afternoon, and also because of its proximity to the office of the only doctor on the central Kenai Peninsula who performs medical abortion procedures.

“I’ve been doing this for 30 years,” said Bird, a social studies teacher at Nikiski Middle-High School and former candidate for the U.S. Senate. He plans to continue protesting until change comes.

Though he notes that some change has already come, he said, pointing to the Jan. 14, 2013, cover story of Time magazine, with the headline, “40 years ago, abortion-rights activists won an epic victory with Roe v. Wade. They’ve been losing ever since.”

“The abortion rate has gone down, the influence of Planned Parenthood has come down, even the pro-choice movement wants to switch slogans,” Bird said. “So I think, like (Winston) Churchill said, ‘This is not the beginning of the end, but it is the end of the beginning.’”

Bird comes at his stance against abortion from his religious and moral beliefs, but his most vocal platform against Roe is one of opposition to “overreaching federal authority,” he said. Bird is an active supporter of nullification — the stance that a state has the right to nullify federal laws that the state deems unconstitutional. Abortion, Bird said, falls in that category, and he believes that the federal government has no business legislating social issues, particularly over the top of states’ right to do so.

“At some point I think enough people have realized abortions didn’t solve the problems. The courts didn’t end the controversy. Social issues should be handled on a state-by-state basis,” Bird said.

There’s no foretelling what Alaska would decide were that authority left up to states. On one hand, abortion was legal in Alaska before Roe. On the other, recent legal action has installed roadblocks to access to abortion, such as the parental notification ballot initiative that requires at least one parent to be notified before a minor child can obtain an abortion, or else for a judge to bypass the requirement in certain circumstances. The law went into effect in 2010 and was upheld by an Alaska Superior Court judge in 2012.

“I think it’s best left to the local level,” Bird said. “I have faith that whatever Alaska decides will be different than what Roe versus Wade permits.”

He also has faith that the debate is changing. For one thing, people’s stomach for partial-birth abortions has turned, and the anti-abortion camp is diversifying, still holding the religiously and socially conservative, as well as people who oppose abortion for legal, political or civil rights arguments. It used to be that the anti-abortionists often were charged with not caring about the babies or mothers and what their lives would be like once forced into birth, but that’s less and less the case, Bird said.And Bird said that he sees the nature of feminism changing — no longer is it the movement of the 1960s and ’70s, which so vehemently pushed for abortion rights. Bird said that he sees the younger generation of women being more like what he calls “the original feminists” of the country’s youth.

“The new generation is looking like the original feminism,” Bird said. “Susan B. Anthony — I love having her on the dollar. She denounced abortion as a way for men to degrade women. I think this generation of young people, whether they are religious or not, are not the ’60s and ’70s women. I think they’re the ones who realize, ‘My goodness, I’m lucky I didn’t get aborted.’”

The others joining Bird were there for various reasons. Laura Burke’s 10 kids helping hold anti-abortion signs were a direct underscore to her belief in the sanctity of human life.

Dr. Steve Hileman, an ER doctor at Central Peninsula Hospital, said that, for him, abortion is a civil rights issue, and a difficult one, at that.

“It’s a hard issue. I’m a doctor, I take care of people who face this all the time. I try not to be judgmental, but I think it’s important that people take a stand for what’s right,” Hileman said.

He said that he thinks the nature of the debate has changed over the years, with more room for discussion, rather than diatribes.

“I’d like to think that people are more willing to discuss it without being angry about it. I’m not sure that I see any legal solution to it, but I don’t think conversion is an external that can be directed by law, either way. So I’m mostly here just because I want people to think about it. It’s a matter of conscience,” he said.

For Nancy Whiting, of Nikiski, the issue is moral as well as political.

“I believe that life begins at conception. It’s been shown that a baby’s heartbeat begins just a few weeks after conception, and so I view abortion as killing a life,” she said. “And I agree with Bob that the federal government and the Supreme Court don’t have the constitutional right to interfere with social issues. The people have the right to decide, and the states have the rights after that. The federal government really has very few rights, and I think they’ve overstepped into a lot of areas that are not their business.

“I feel very strongly about life and liberty and to pursue happiness. I believe in the Constitution. And it begins with life. I think this abortion issue has to do with the value of life, and when we don’t value life and when our children are raised in a society that doesn’t value life from the beginning, I think that’s causing a lot of societal ills,” Whiting said.