Category Archives: health care

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 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?’”

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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 It is open to the public.

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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.”

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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.

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.”

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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.

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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.

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.”

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

Photo 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.

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.

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.”

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