An Alaskan Adventure

By Gordon Hopkins Holly Wolff brings a wealth of rural health care experience to Jefferson Community Health and Life (JCH&L), where she now serves as the new CEO.Wolff told FJN that, while at Ashley Medical Center in the small town of Ashley, North Dakota, “that's where I got my nursing home administrator's license.”“A lot of that stuff is very, very much applicable to critical access, with those high safety standards,” said Wolff. “And from there, I went to Montana.”Wolff spent nearly five years in Montana, “I spent some time in Roundup, and they were a managed service partner with Billings Clinic, which is one of the big systems in the state.”While Ashley was a small community, Wolff noted there were some options for health care, “We were just close enough, about an hour away (from Billings), to have a little bit of competition, not only for patient care, but for staffing.” Her next move would be a very different experience, “I took the leap and accepted a position up in Alaska at a facility that was a critical access hospital, but under a tribal health organization.”This was at the Mt. Edgecumbe Medical Center in Sitka, Alaska.“Very unique makeup. They're one of one, because 50-60, years ago they, basically negotiated with the federal government to say, we want to have this pot of funds that cover all these different tribes in a region, a geographic region, and that they would then assign how they would provide those services,” Wolff explained. “A couple decades ago, it really was only a tribal health organization and was specific to all the indigenous tribes in that area. And then, over time, they were able to start evolving to provide care to all community members.”Serving both communities proved challenging. Wolff noted, “It was interesting, because they didn't always have the same regulations.” Getting Health Care in Such a Remote LocationSitka is the largest incorporated city by area in the United States. That does not make it a “big” city in other respects. The U.S. Census reports the population of Sitka in 2023 was just 8,282.One of the biggest challenges of providing health care, or doing much of anything for that matter, is the remoteness of Sitka.Medical transport is provided by Guardian Flight, which specializes in remote and rural settings. Most people think of medical air transport as helicopters, but Wolff said, “They were the ones, a private company, that did all of the medical transports for us. And so it was some helicopters but mostly Learjets, and they service a lot of Alaska.”“They were our first line of defense to get people, major traumas, out to Anchorage or Seattle,” said Wolff.Unfortunately, Wolff noted, “But like all of us, they're having a shortage of workers. And so, some of that was not having enough of a crew, not having the crew that had enough training. And so, there were times where we didn't know if we even had that.”Another major collaborator with the hospital was the U.S. Coast Guard, “Because they would fly when no one else would. So, on those really, really emergent need issues, they were the next group we'd call.” Tourism“The Coast Guard would be the ones always called out for anything to do with boats, any capsizing, anything like that. So, some of those emergency rescues, where people were on some of those more remote islands, they would be the rescue crew that would go try to assist,” said Wolff. “They all coordinated a lot with the tourist side of things, too.”Wolff noted the local economy has been changing, “There were, I think, almost 600,000 people that came through in a single summer, and that's,become kind of the focus on even their local economy, because fishing is struggling.”Alaska is a popular destination for cruise ships.“Coordinating then with the cruise lines and meeting them, they have whole medical they have medical directors, they have medical teams. I actually got to go see some of their facilities, as to what they can do on the water,” said Wolff. “They can do all these things to stabilize, but they still have to then make a determination if they need to offload people.” WeatherA lot of people imagine Alaska to be frozen much of the time, like a frozen tundra. In fact, temperatures in Sitka are mild compared to other parts of Alaska. That does not mean the weather is always conducive to transportation, however.“Weather is huge. There's a lot of storms in that area. It's considered a temperate rainforest,” said Wolff. “I remember, there was one where they were clocking 100 mile an hour winds in areas right around us, and it was just considered a storm. I mean,they didn't announce anything. It was just, 'Hey, it's going to be windy out there.' So, those were moments where you you hope that there's not a trauma coming through.”“At the beginning it was a very interesting novel piece to just be surrounded by water. I thought it was pretty cool. The weather can be a little tough if you're not kind of mentally preparing for lots and lots of rain, lots of overcast days. You know, we've lived in places that have always had four seasons, and they still do, just much more mild in terms of winters. You know, there's a little bit of snowfall here and there. Summers, boy, if you got into the low 70s, that was like the perfect day. But that's about as hot as it ever would get.” Living in AlaskaWolff described moving to Alaska, “Living there, integrating into a community that was very welcoming, very open. That Coast Guard base was a big part of the culture and they were involved in everything.”Despite changes to the economy, fishing is still a primary driver of life, “It was fascinating, especially then when you meet the the long term locals, and a lot of them are still in the fishing industry.”“They hope for, good days. And if they don't get them, they still keep going out. And sometimes, you know, they're out there on rough water,” said Wolff. “There were a number of accidents when I was up there, and you kind of saw the general acceptance that that's a way of life, that you kind of always take those risks, which I recognize would be really hard if you were in a fishing family.”There is also a vibrant art scene, “A lot of local artists. So, there were always craft fairs, art walks, you know, just pieces to get people out in the community, which I loved.” BearsOn thing Wolff was not entirely prepared for were all the bears.“The statistic that goes around is always that there's eight bears to one person. I don't know where that came from. I don't know if that's totally legit,” said Wolff. “That is part of that lifestyle you learn quickly.”Bears are just a fact of life in Alaska and people adapt to it, such as the “Bear Watch” Facebook page, where people would post when bears had been spotted and when they were expected to go into hibernation, “We had one instance where there were three grown males walking around the marina. And a lot of people live on boats there. And they were on security camera, these big, huge bears just walking down this boardwalk deck, and that's where everyone goes in and out to get to their boat.”“A lot of people do carry firearms if they're going to up the trails, which is smart, because it's, it's known to happen. There was one fatality while I was there,” said Wolff. “That deterred me from just being like, 'Yeah, let's go on a hike.'”A big concern is trash, which naturally attracts hungry bears. Wolff said a lot of resident, “They would freeze their garbage.”After about a year, Wolff was ready for a change, which is how she ended up in Fairbury. See part 3 in next week's issue…

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