History

In the late 1960’s, the city was really a village of about 500 people, mostly natives with a subsistence life style. The medical care was provided by an itinerant doctor from the Alaska Native Medical Center a few times a year with an unpaid health aide the rest of the time. The canneries would, on rare occasions, have a nurse that would help community members. At the end of 1969, a group of citizens formed the Unalaska Health Council to look at ways to provide more consistent health care to the community.

The first meeting of the Unalaska Board of Health was on December 29, 1969, with members appointed by the City Council. A Community Health Aide clinic was started in the school in early 1970. In May of 1970, the State was contacted to help establish a “more definitive medical facility.” In September 1971, the name chosen for the facility was “Iliuliuk Family and Medical Services.” At the October meeting, “Medical” was changed to “Health.” Incorporation papers were signed on December 31, 1971, with the State officially signing and recognizing the non-profit corporation on February 14, 1972. The original budget was $17,000.

Over the next 10 years IFHS’ facilities changed from a room in the school to a room at the community center. IFHS ran a day care center as well as providing medical care. There wasn’t a bridge connecting the two islands. Most of the village population lived on the Unalaska side. The fish processors, fuel dock, and airport were on the Dutch Harbor side. For a while, IFHS had a clinic on each side with a boat that would take patients back and forth as needed. The Dutch Harbor clinic was at a cannery. The clinics were staffed with a registered nurse or a nurse practitioner. During this time, the crab industry was starting to develop, so the demands on the clinic increased. In 1973 they acquired land on the Unalaska side. A prefab building was brought up from Seattle and placed on the lot. Over time additions were put on the structure so by the mid-1980’s it was a facility of about 4000 square foot. This facility provided 3 exam rooms, a pharmacy, 1 bed ER, x-ray room, lab area, offices, a holding room with 3 hospital beds, and kitchen area.

In July of 1979, the Board of Directors of IFHS decided to restructure so their membership would reflect the main groups in Unalaska. The Board seats would be divided in the following way: 4 City seats, 2 processor seats, 2 OC seats and 3 at large seats. The first full-time doctor, Dr. Ott, was hired in September 1981. He was here until July 1984 when Dr. Maier started. Dr. Maier left after completing a 3 year contract. From the time Dr. Maier left in 1987 until 2002, the clinic was staffed with full-time mid-levels or physician assistants and nurse practitioners. Doctors would come out on an itinerant basis to provide specialty services like women’s health and orthopedics.

A bridge was built connecting the two islands in the early 1980’s. After that transportation was much easier, and the number of vehicles increased from 2-3 on each side to everyone having one. The crab industry suffered a bust in the early 1980’s and didn’t come back until the late 1980’s; when it was able to process any type of ground fish including crab, pollock, halibut, and cod.

The staff of IFHS in 1986 consisted of 1 doctor,1 PA who functioned as the lab/x-ray person and would relieve the doctor when he went on vacation, 1 RN, 2 office people, and 2 RN’s that would watch patients at night. At that time, the population was 1200 and there was only one flight a day at noon, so if a patient came in after the flight and required monitoring they would stay at the clinic until the next flight at noon the following day.

When the fishing industry came back there was an overnight increase in the demands on the community to provide services. IFHS experienced a dramatic increase in demand to meet the health care needs of the transient workers. IFHS started providing less family practice care for the local population and more urgent/emergent care for the cannery processors and fisherman on the boats. By the end of 1990, the full-time staff at IFHS had increased to 3 mid-levels, 1 lab person, 1 x-ray person, 3 RN’s, 1 Administrator, and 3 office people. During the main fishing season (end of January to the end of March), IFHS would see 60-90 patients a day. The facility did not have enough waiting room space so some patients would go over and stand under the overhang at the pool across the street, patients would be in the hall getting IV antibiotics, and nurses would have to give shots in the pharmacy. Needless to say, the facility was not adequate to meet the increase in demand, so a community effort was undertaken to build a new facility.

Christmas of 1992 saw IFHS moving into their current building of approximately 20,000 square feet. The main floor had 6 exam rooms; a main pharmacy; main medical supply room; a small ER/lab waiting room, an ER bay with 3 gurneys, a 1 bed trauma room, 1 bed holding room, a small pharmacy, and a small med supply room; a large lab area including an office; an x-ray area with an office, 2 areas for x-ray machines and an x-ray film processing room; a physical therapy room; 4 practitioner offices; an administrator office; a large reception/billing area; a large administrative office area; and a large waiting room which included a small separate play area for children. The second floor was mostly unfinished when they moved in but had a 2 bedroom apartment, break room, conference room, and 3 large unfinished rental areas. In 1994, IFHS added mental health counseling services, with one counselor located in an office on the second floor. The mental health program added a second counselor in 2000.

IFHS continued to function mostly as an urgent / emergent care center, even though the building had two distinct areas; one as a doctor office type area that is used during the day and the ER area that is used after hours and for office hour’s emergencies.

Over the past 10 years, Unalaska has continued to grow and change. The fishing industry has continued to be the economic base for the City of Unalaska, but changes in how it is managed have changed the demands on IFHS. The decrease in the number of factory trawlers, the increase in regulation by OSHA and the Coast Guard, and the change to a quota system has led to longer seasons with fewer injuries. Full-time workers in the canneries and other support industries bring their families to the community, and the processor population is much older than the population of the 80’s.

In September 2002, IFHS hired a full-time internal medicine physician, changed its designation from Rural Health Center to Community Health Center, and began to receive funding from the federal government to provide primary care services. IFHS did this with the understanding that, as the only health care facility of its kind in the Aleutian region, with the next level of facility in Anchorage 800 air miles away, it will always need to be able to provide urgent and emergent care. The change in focus and increase in practitioners led to the current facility going through a renovation to provide three more exam rooms, a two-room dental suite, a secure computer server area, and more storage. IFHS added more doctors, a dentist, a dental assistant, a case manager, medical assistants, a pharmacy tech, and more patient services staff. IFHS also worked with the school to provide a school nurse, who works in the school four days per week, and in the clinic as a physician assistant one day per week. In October 2004, IFHS added full-time dental services, although the renovation did not complete the two-chair dental suite until September 2005. Also in 2004, IFHS added substance abuse counseling services to the services offered by the mental health department, and changed the name of that department to behavioral health. In 2006, IFHS converted its film x-ray system to a digital x-ray system. IFHS also increased the number and type of students it accepts for clinical rotations.

At the current time, 2007, the population of Unalaska is roughly 4400. IFHS has a full-time staff of over 30 individuals, with a provider staff of 3 doctors, 3 mid-levels, 1 dentist, 2 behavioral health counselors, and a budget of approximately $4.5 million.

Over its 34 years, IFHS has always striven to meet the needs of Unalaska and the surrounding area it serves. IFHS has changed as the community and its needs have changed and it will continue to grow and change so the best possible care can be given to all those who walk through its doors.