Chief Andrew Isaac Health Center by Fairbanks Daily News-Miner

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CHIEF ANDREW ISAAC

Photos by Rachel Saylor

‘Healthy People Across Generations’

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HEALTH CENTER

community

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our future culture caring maasee’ elders youth our people “nijaa” healing home “enaa neenyo”

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Sunday, March 10, 2013

HISTORY A journey to the future with ties to the past

Chief Andrew Isaac Health Center

Home. Wellness. Culture. Modern. Those are but some of the many words that can describe the new Chief Andrew Isaac Health Center, which blends the long and proud history of the Athabascan lands and culture with modern medicine and an approach to caring for people. Whether youth or elder or somewhere in between, whether living in Fairbanks or in the outer reaches of the Interior, the Chief Andrew Isaac Health Center is here for you. While the center, with its many services and increased efficiency, is the medical hub for Alaska Native men, women and children of the Interior region, the center is also an employment engine for the Natives and non-Natives, both through direct employment and through its association with many local businesses. Chief Andrew Isaac was a man of great values, steeped in the past with his knowledge of our ancestors. Yet he looked earnestly forward, guiding us into the modern day. The new Chief Andrew Isaac Health Center, like the chief himself, embraces the past and looks to the future. Come with us through the pages of this special commemorative publication as we tell the story of the new Chief Andrew Isaac Health Center, a landmark institution grounded in the Fairbanks community, steeped in culture, and serving Alaska Natives throughout the Interior.

ABOUT THIS SPECIAL EDITION This special edition is a publication by and for the Tanana Chiefs Conference, which is solely responsible for its content. It was assembled and printed at the Fairbanks Daily News-Miner.

Photo by Rachel Saylor

» A new generation of health care 3

Sunday, March 10, 2013

HISTORY

his is a monumental occasion and milestone in the history of Tanana Chiefs Conference. This new clinic is a focal point of pride and advancement for our people. For many years the tribes of the Interior have hoped to have their own health care facility, and it fills me with great pride to see that dream come to fruition. It is the strength and commitment of our tribes, staff, partners, and countless hours of effort that brought us to this point. I would like to thank our Health Board, Executive Board, the Cultural Committee, and all TCC Health Services staff for their commitment in making this clinic a reality. When I walk into that beautiful facility, I see all of the hard work and thought that has gone into every detail. On behalf of the 42 members of the Interior, I thank you all for your dedication to creating a health care facility that we can all appreciate. Ts’inee. Jerry Isaac TCC President/Chairman

his past year has given us much to celebrate. A new generation of health care has begun with the opening of the new Chief Andrew Isaac Health Center. Opened ahead of schedule and under budget in December 2012, the clinic offers enhanced services and technologies. For the first time we are able to operate our own laboratory and radiology departments. Our clinic is now furnished with the most advanced equipment in the state. The success of the clinic opening would not be possible without the dedication of TCC’s partners. TCC is especially thankful to Innova, Mather and Associates, Indian Health Services, city of Fairbanks, Fairbanks North Star Borough, Fairbanks Memorial Hospital Foundation, our Alaska congressional delegation, Rise Alaska, Bettisworth North/NBBJ/Jones & Jones, Doyon Limited, city Of Koyukuk, Ghemm Construction and all the subcontractors for making the clinic a reality. Of course, none of this would have happened without our tribes, Executive and Health Board members, Cultural Advisory Committee and Tanana Chiefs employees. The opening of the new clinic has brought

a shift in how we operate, so that the patient experience is improved. From the first step you take into the clinic, a greeter is there to assist patients during their entire visit. Wait times are being reduced, and better coordination is being accomplished in all of our clinics — behavioral health, optometry, dental, medical and rural health. The center is also allowing us to improve services at the rural level. Technology now allows us to provide long-distance patient care through video teleconferencing. Some patients are even receiving cardiology services in their own village. Gone are the days when people must travel into Fairbanks and beyond for advanced health care. We are excited about the future of our health care. With service expansion and modern technology, we are now able to better achieve our vision of “Healthy People Across Generations.” Victor Joseph TCC health director

HISTORY

Sunday, March 10, 2013

Center embodies legacy of Chief Andrew Isaac By DIANA CAMPBELL The Athabascan chiefs and elders of the Upper Tanana tribes would watch their boys from birth for traits of a leader. The child must show honesty, a caring nature, a sense of fairness and be unselfish. A young Andrew Isaac was such a one, and once the elders and chiefs were sure of his character, they began to mentor him to become a great chief. “They taught you self-sacrifice,” said Jerry Isaac, president of Tanana Chiefs Conference. “You gave up your right to receive in order for your people to have equal share and comfort.” From accounts, the late Chief Andrew Isaac fulfilled his promise. He started his leadership role when he attained the age of 34. As chief he fought for hunting and fishing rights for Alaska Native people when tribes began getting pushed out of their traditional subsistence areas, Jerry Isaac recalled.

Where are Chief Andrew Isaac’s closest living direct descendants now? • Jerry Isaac is the nephew of Chief Andrew Isaac. • Melanie Brenner worked at Tanana Chiefs Conference. She is married to Russell Brenner with two children, Nick and Chris. • Aaron Emerick lives in North Pole and worked in all the construction phases of the Chief Andrew Isaac Health Center. • Wayne Isaac Sr. lives in Dot Lake in the family home. His son Wayne Isaac Jr. lives in Tok and daughter Wanetta lives in Houston, Alaska.

By the 1960s, Chief Andrew Isaac was at the forefront of the land claim fight. His impassioned speech delivered in 1966 in Anchorage is thought to have persuaded then-Secretary of the Interior Stewart Udall to issue a freeze on all future federal land Please see CHIEF, Page 5

Chief Andrew Isaac

Sunday, March 10, 2013

HISTORY CHIEF Continued from Page 4

transfers in Alaska. This meant land transfers could not happen without an agreement with Alaska Natives. He delivered his arguments with compassion, often with the use of a translator, said TCC’s Isaac. In 1972 the elder Isaac was appointed the First Traditional Chief of the Athabascans, a revered position over the indigenous people of the Interior. For Melanie Brenner, Isaac was chief but was also her doting grandfather who would visit her family in North Pole as he traveled to meetings. “He was always my grandpa and he’ll always be that to me,” Brenner said. He was about 5’9” and wore dark pants, a plaid button shirt, suspenders and a black cap with a tiny white bow, she remembered. Her family would often travel to Dot Lake, about a two-hour drive southeast of Fairbanks on the Alaska Highway. Isaac and his wife, Maggie, lived there in a simple home with wood panel walls and white tile floor in the small community of about 100 people. Her grandfather would keep his loose change in empty medicine bottles for Brenner and her young brother Aaron Emerick so they could go to the local store for candy. Her grandparents would buy the two clothes, but they were always too big and they had to grow into them. She remembers going to potlatches with the chief. A gifted songwriter and drummer, he was often called upon to lead the dancing. “The happiness and pride poured out of him,” she said. There was something special about Isaac and his wife, she said. One time her family drove to Dot Lake with a rabbit her father had caught along the way. It was perfect to share with her grandparents. When they arrived, both Isaacs had already started a fire in the backyard to roast the meat. “Somehow they knew we

were coming,” Brenner said. Isaac and his wife had four daughters but only one, Brenner’s mother, Janet Isaac, survived to adulthood. The couple later adopted a son, Wayne Isaac Sr., who they loved and treated as if he was their natural born child. He still lives in Dot Lake. But the elder Isaac adored her brother Aaron, she said. “He thought my brother was just everything,” she said. When her brother was a little more than a toddler, Isaac and her father took Emerick fishing. “He was catching them so fast they could barely keep up with him,” Brenner said. “My grandpa was just grinning from ear to ear.” The image is embedded in Emerick’s mind, as are the times Isaac would help the boy build a toy bow out of fishing line and a stick or show him how to prepare a porcupine for cooking. His favorite memory of his grandfather was when Emerick was about 7 years old. After Maggie Isaac died, the community had a three-day potlatch, with food, dancing and gift giving. Emerick took to the dance floor with gusto, being of age to enjoy the sound of the drums and singing. “I remember looking over at him,” Emerick said. “He was sitting in his wheelchair. He was looking at me. He was grinning.” Deeply grieved about the loss of his wife, Isaac died at age 93 in 1991. “He made a good name for himself and I’m proud of him for that,” Emerick said. “He was my grandpa. He was the chief.”

“

Photo courtesy Aaron Emerick

He made a good name for himself and I’m proud of him for that. He was my grandpa. He was the chief. Aaron Emerick

Sunday, March 10, 2013

MEDICAL SERVICES

A welcoming place By DIANA CAMPBELL

“I want people to say, ‘This is ours. This is mine,’” Joseph said. “We can and do get the best health care.” The most obvious change at the Previously, most medical services new Chief Andrew Isaac Health Cenwere provided at leased space in Fairter is the greeters at the door. They welcome visitors, offer help to banks Memorial Hospital. Dental, find the right clinic and gladly explain behavioral health, and optometry clinics were located in the Chief Peter the artwork found in the building. “As Native people, we welcome peo- John Tribal Building on First Avenue. If blood work or X-rays were needed, ple to our home,” said Victor Joseph, a patient had to do a separate sign-in Tanana Chiefs Conference’s health with Fairbanks Memorial Hospital. director. TCC owns and operates the Many of CAIHC’s approximately clinic. 15,000 patients come to Fairbanks “That’s important. That shows from Interior communities. Before the respect.” For the first time, all of CAIHC ser- new clinic opened, it was time-consumvices, some of them new or expanded, ing and burdensome for patients to have to go across town to get medical are in the same building, providing efficiency and comfort for patients and and dental or optometry services the staff, Joseph points out. Please see WELCOME, Page 8

Co n g r a

The exam suites have two types of rooms. One is for physical exams. The new design includes “talking rooms,” where a patient, family members and friends can meet with a provider to discuss treatment options and further care. Photo by Rachel Saylor

s n o i t tu l a

to Tanana Chiefs Conference and the management and staff of the

Chief Andrew Isaac Health Center We wish you continued success in your beautiful new facility!

21406693 310-13CAIHC

From Mayor Luke Hopkins and your friends and neighbors at the Fairbanks North Star Borough

Sunday, March 10, 2013

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THE ONGOING ALLIANCE BETWEEN CHIEF ANDREW ISAAC HEALTH CENTER AND FMH IS GOOD NEWS FOR THE WHOLE COMMUNITY. We’re proud to have Chief Andrew Isaac Health Center not only as our neighbor, but also as our partner. We’ll continue to collaborate and share resources, it’s the perfect evolution of the community hospital model.

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MEDICAL SERVICES WELCOME

Continued from Page 6

same day, Joseph said. “Now it’s seamless,” he said. “The whole idea was to limit the run-around time.” The center has multiple functions, too. CAIHC also provides support services to 23 rural clinics, including prescription filling, lab work and stocking medical supplies. In the expanded pharmacy area are two automatic dispensers that count out and bottle the most-used prescriptions. One is for patients who visit the center; the other is for patients in rural areas. Those are packaged and mailed in a room designed for such use. The pharmacy daily fills about 750 prescriptions for walk-in patients and mails about 650 prescriptions to rural patients. “We were tripping over each other before,” Joseph said. The pharmacy will soon be providing chemotherapy medicine for cancer patients, in collaboration with the Alaska Native Tribal Health Consortium. Other changes include a radiology department with state of the art X-ray equipment and 3-D mammography imaging, the first in Alaska. The way patients are notified the medical staff is ready to see them also has changed. Now instead of staff calling out patients’ names, something some people felt violated privacy, they give the patients a buzzer, jokingly called “the puck,” which will buzz and light up when it’s time to go back to the exam room. That way people can visit with others in the expansive waiting areas and not worry about missing their name being called. “Before, if you went to the bathroom, you would come out and everyone would say, ‘They called your name,’” said Freda Williams, a patient and Fairbanks resident. “I always wondered how people knew who I was.” The exam suites have two types of rooms. One is for physical exams. The new design includes “talking rooms,” where a patient, family members and friends can meet with a provider to discuss treatment options and further care. Charles Bettisworth, owner of BettisworthNorth, the architect firm that designed the new center, said

CHIEF ANDREW ISAAC HEALTH CENTER Phone: (907) 451-6682, (800)459-6682 Fax: (907) 459-3811 Mailing address 1717 West Cowles St. Fairbanks, Alaska 99701 Urgent care Monday-Sunday 8 a.m. to 6 p.m. Medical appointments Monday-Friday 8 a.m. to 5 p.m. Pharmacy Monday-Friday 8 a.m. to 6 p.m.

Lab Monday-Sunday 7:30 a.m. to 6 p.m.

Radiology Monday-Sunday 8 a.m. to 6 p.m. Dental Monday-Friday 8 a.m. to 5 p.m. Eye clinic Monday-Friday 8:30 a.m. to 5 p.m.

Sunday, March 10, 2013

Need medical aid in a hurry? CAIHC can handle it By DIANA CAMPBELL

cies, should the need arise. The services proved essential It seemed like a straightforfor Jones and her daughter. ward call from the school. KimOn the road to the center, berlee Jones’s daughter Jaylen, Jones looked in her rearview 7, was sick and she should pick mirror to see how her daughter her up. was doing. Jaylen looked flushed, like “I didn’t recognize her,” she she was getting the flu, when said. “Her face was twice her her mother saw her in the school normal size. Hives from head to nurse’s office. As the nurse filled toes. She told me she couldn’t in Jones about what Jaylen had breathe.” eaten that day, things went horShe got to the clinic as quickly ribly wrong. as possible, somehow managing “She violently threw up about to stay calm enough to drive. At five times,” Jones said. “I decid- the entrance, a greeter rushed ed to take her to the clinic.” her and the child back to the Chief Andrew Isaac Health exam room. The staff determined Center was a short drive from Jaylen was having an allergic the school. While the center does reaction. Within two minutes not have emergency room serupon arriving, Jaylen was given vices, it does provide urgent care. two adult shots of epinephrine. Urgent care services are those in Jones offered to hold the girl which a patient can’t wait for a while they gave her the shots, as regular appointment and needs Jaylen started to resist. to be seen the same day. The “They said, ‘We don’t have staff can also handle emergentime for that,’” Jones said.

they found this was an important feature when they built the Southcentral Foundation Clinic in Anchorage. When someone is sick, family members and friends are their caregivers, he said. They need to understand the illness and care, too, he said. The center’s larger space means fewer visits to Anchorage for some patients who need special medical services at the Alaska Native Medical Center, said Jacoline Bergstrom, TCC’s deputy health director. The larger space means more Anchorage providers now come to Fairbanks to offer care. “More specialty providers come on a regular basis, such as rheumatology, ENT, neurosurgery, liver health, and cardiology,” she said. The center now has two OB/GYN and three midwifes, she said. In the past, much of prenatal care was contracted to other local physicians, but the center will now do most of the treatment in-house, including the offering of ultrasounds. The center has room for expansion, TCC’s Joseph said. Planning for the future has always been an ongoing process. “How do we get better at what we’re doing in the next five, 10 or 20 years?” he said. “None of this happens by mistake.” Neither does the service, Joseph said. The warm and inviting design, the comfortable waiting areas and expanded medical care are meant for the center’s beneficiaries. This is why the center’s greeters make a point of saying “Thank you” as patients leave. “Because we know you don’t have to come here,” Joseph said.

“That’s when I knew how serious it was. They saved her life.” She and the providers think Jaylen had a reaction to sunflower butter that was served as a snack in a sandwich at school, but the young girl is going through more tests. “She never has any other food allergies,” Jones said. “But she’s never had a sunflower butter and jelly sandwich before.” The CAIHC doctor prescribed prednisone, a powerful steroid, for Jaylen, as food allergies can flare up again after an initial reaction, despite avoiding the trigger food. The family is in the process, with the help of the medical team led by Dr. Steven Jay, to understand and take care of Jaylen. “The doctor went through everything,” she said. “I’m so grateful. I can’t sing the praises of that team strongly enough.”

Photo by Rachel Saylor

Sunday, March 10, 2013

MEDICAL SERVICES

Center offers long-distance help for village residents By DIANA CAMPBELL What about the villages? How does the new Chief Andrew Isaac Health Center benefit them? Balancing urban and rural care has always been part of CAIHC mission, said Victor Joseph, health director at Tanana Chiefs Conference. “We are a tribal provider,” he said, “serving our rural and urban beneficiaries.” TCC operates 25 rural clinics and supports six others, all staffed by highly trained personnel. But when something comes up outside of their expertise, they rely on telemedicine relays with Chief Andrew Isaac Health Center doctors and staff. The complex system allows rural providers and CAIHC staff to collaborate on patient care in real time. A CAIHC doctor might look at a skin rash, read an electrocardiograms or look into suspected ear infection, said Jacoline Bergstrom, deputy health director at TCC. If a trip to town is needed, then arrangements are made, she said. The center also supplies the rural clinics with medical supplies from their new material storage rooms. Bins are bar-coded so that when orders are filled, the bar code is scanned, and inventory is monitored better. “It’s a little smoother,” she said. “We now have way more supplies on hand.”

A separate area in the pharmacy fills prescriptions for rural residents and all are mailed out daily from an efficient mailroom. Rural clinicians may now send laboratory samples to CAIHC for testing. A whiteboard in the lab keeps track of local rural airlines schedules. All this happens at the same time patients are being seen in Fairbanks.

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Sunday, March 10, 2013

THE BUILDING

River land

Essentials woven into health center’s design

By DIANA CAMPBELL Freda Williams’ visit to the pharmacy at the new Chief Andrew Isaac Health Center took her an hour. Not because the service was bad. Far from it. It took so long because she chatted with friends and spent time people-watching in the comfortable and

inviting chairs before she got to the counter. “I saw other people were doing it, so I decided, ‘I’m just going to sit here,’” she said. That’s exactly what everyone involved in the creation of the new health center had hoped. It is why the center was designed the way it is.

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“We wanted people to be comfortable,” said Anna Frank, who sits on the Tanana Chiefs Conference CAIHC cultural advisory committee. The waiting room in the old Chief Andrew Health Center at Fairbanks Memorial Hospital had always been a place for visiting with friends and families. That’s because many of the patients live outside Fairbanks, and it was the best place to catch up. The new center makes it a lot easier to do that. “It’s a place of getting to know people, to have a conversation with one another,” Frank said. The center is much more than a place to have conversation, though. It’s a testament to Alaska Native people and their relationship to the land, say those who were involved with the Please see DESIGN, Page 11

CONGRATULATIONS on the Grand Opening of your new building! Original Tanana Hospital

May you continue to grow and succeed.

Your Beautiful New Building is an asset to our community.

Community of Tanana Photo by Rachel Saylor

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Sunday, March 10, 2013

THE BUILDING

Photo by Rachel Saylor

DESIGN Continued from Page 10

hunting, fishing and whaling season. “The whole building represents Native people,” Frank said. Dixie Alexander, TCC’s cultural program manager and a member of the Cultural Advisory Committee, said they went over every detail until they were satisfied. “When you’re an artist, you can feel it,” she said. “There is nothing more to be done to make it better. It’s done.” Now that the center is open, patrons and staff have added to the ebb and flow of the building. Conver-

sations rise and fall. Greeters lead people to their destination, pointing out artwork along the way. People, taking advantage of the comfortable chairs, soak up the warm sunlight as it streams through the expansive windows. The beadwork images on the glass fins that flank the windows outside cast shadows inside. Most people who walk into the center tend to stop by the time they get to the center of the round to take it all in. “It’s like the grand entrance to greatness,” Williams said.

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planning, design and construction. It’s a place of health, healing and wellness, with state-of-the-art medical equipment and plans for expansion in the future. But it took many people and many months of planning to incorporate the details into the building. Leading the effort was the TCC Cultural Advisory Committee, made up of eight Alaska Natives, who met with the designers, architects, TCC staff and others on the project. BettisworthNorth, a Fairbanksbased design firm, won the bid to design the building. Their more visible Fairbanks projects are the Morris Thompson Cultural and Visitors Center, the Fairbanks International Airport and the Jay Rabinowitz Courthouse. Charles Bettisworth, owner of BettisworthNorth, said his firm had worked on the Southcentral Foundation clinic in Anchorage and knew the best way to translate the desires and ideas of the Cultural Advisory Committee was to turn to Johnpaul Jones, of Jones and Jones, a Lower 48 design company, to facilitate the cultural advisory meetings. “It had to be more than great,” Bettisworth said. “We had to make a community building.” Frank, who is an archdeacon with the Episcopal Church of Alaska, advised that the group first think not about money but about what they wanted. What they wanted was the river and the land. “We’re river people,” she said. A river theme runs through the clinic, starting at the main entrance. At the foot of a black stone wall is an inlay of river rocks in clear resin on the floor. Inside the center, the walkways mimic the winding braided

rivers of the Interior, with islands of tables, chairs and benches interspersed. It’s also about the land, said Doreen Deaton, who sat on the committee, and is TCC’s communications director. TCC sent plain moosehide to all 42 Interior Alaska Native organizations served by TCC. The task for each was to find an artist to decorate the hide and then to fill it with one pound of soil from their community. At the groundbreaking ceremony in 2011, tribal representatives brought the bags. The soil was mixed together and this spring the blended soil will go into the center’s herb garden. “The land is so important,” Deaton said. “The soil collected that day ties the tribes to the land and building.” Outside, the landscape includes 50 birch trees saved during the center’s construction. The building’s footprint was designed around them. A tundra mat of moss, lichen and small brush and plants has been planted. People can enjoy the scenery from inside or take a seat outside. Some of the roofs have indigenous grasses and fireweed planted on them, adding to the natural design to the building. “We wanted to make sure the building fit into the environment,” Bettisworth said. Athabascans have always followed the seasons as well, and the center’s walls bear the subtle shades of green, yellow, orange and blue, representing spring, summer, fall and winter. “There is berry picking season,” Frank said. “There is moose hunting season.” At the center of the gathering area, the clinic’s main architectural feature fashioned to look like a woven birch basket, is a compass-like stone-and-metal inlay in the seasonal round. Not only does it mark north, south, east and west, but it also notes trapping, berry picking, moose

Sunday, March 10, 2013

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THE BUILDING

Sunday, March 10, 2013

Environmentally friendly features earn praise By DIANA CAMPBELL The landscape at Chief Andrew Isaac Health Clinic is beautiful, but it serves a dual purpose. Not a drop of water runoff should leave the property and end up in drainage lines, an environmentally friendly feature that helped earn the building a Leadership in Energy and Environmental Design certification. Gaining the LEED certification was part of the requirements of the Indian Health Service’s program that guided the construction of the building. The building was required to meet LEED silver standards but is on track to become gold certified, said Jacoline Bergstrom, TCC’s deputy health director. The water from rain and snowmelt will end up making pools of water in depressions in the land.

There it soaks into the ground and also waters plants on-site. “It sort of creates a creek bed,” said Charles Bettisworth, owner of BettisworthNorth, the firm that designed the center. DID YOU Another feature that KNOW? makes CAIHC environmenThe building was tally friendly designed around 50 is the heatbirch trees that were ing system saved from being bulldozed and that that uses hot are now part of the water heat landscaping. from Aurora Energy. That eliminates the need for a gas or oil fired burner, and therefore emissions or possible spills. Please see ENVIRO, Page 16

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Photo by Rachel Saylor

The cultural committee holds a planning session about the Chief Andrew Isaac Health Center.

Center has many goals of Kathleen Sebelius, the U.S. Department of Health and Human Services The new Chief Andrew Isaac Health secretary, who visited Fairbanks in Center on Cowles Street came into 2011. existence to accomplish many things. Isaac explained why Alaska Natives It exists, foremost, to improve have health care provided by federal and expand the health care of Alaska dollars. It is because of U.S. treaties, Natives in Interior Alaska. It also laws and policy with Alaska Natives made good financial sense for Tanana and Native Americans that recognize Chiefs Conference, the center’s owner them as sovereign people, he said. and operator. The federal government has agreed to Making it all happen required the responsibilities toward Native people cooperation of many players, TCC and that includes health care. President Jerry Isaac said. That “Ever since the U.S. was colonized included past and present city and and organized into a nation, the borough mayors, City Councils and Founding Fathers have brokered and Borough Assemblies. bargained with Native people,” he said. “It was a really complex set of “There are case laws and Supreme circumstances,” Isaac said. “But it Court decisions that claim we have espoused the ideas of cooperation and sovereign authority.” partnership.” “It’s not free health care. It’s the The new $68 million center, with fiduciary duty of the federal govern95,000 square feet, was finished in ment.” September and opened fully in DecemThe new center, with expanded ber. New services include radiology services, is a reflection on how seriand laboratory, and the center now ously TCC takes its responsibility to offers prenatal to end-of-life care. administer those funds, Isaac said. At $71 million, TCC’s health budget TCC’s population has been growing, is about two-thirds of its $105 miland services needed to expand to meet lion annual operating costs. Of that their needs. amount, about $44 million comes from “I do believe in frugality,” Isaac Indian Health Service. said. “I do believe in cost-benefit manTCC directly administers the Indian agement of resources. You’ve got to Health Service funds as a result of the deliver. You’ve got to keep your part of Indian Self-Determination and Educa- the bargain.” tion Assistance Act and has been doing Many of the center’s services had to so since the mid-1980s. be contracted out to other providers, To build the new center, TCC which always was a budget headache applied for a Joint Venture Construcfor TCC, Isaac said. tion Program with IHS that allowed “Faced with that fact, I wondered TCC to retain ownership of the center, why do we have to outsource?” he said. while IHS provides a staffing package “If we had the ability, we could do it for it’s medical providers. The plans ourselves. Finally when I became presiand construction earned the attention dent, I set out to make that happen.” By DIANA CAMPBELL

Sunday, March 10, 2013

THE BUILDING

Sunday, March 10, 2013

Innovative work marks center’s construction to have been included in the look of the building. It also would have slowed work on the building. Construction of the new Chief Andrew About 2,300 cubic yards of concrete Isaac Health Center caused Jerry Isaac, the president of Tanana Chiefs Conferwent into the foundation’s slab, shored up ence, a lot of sleepless nights. by a substantial dirt work and gravel bed, The building had to be culturally relsaid Mike Davis, GHEMM project manevant. It had to serve the needs of its ben- ager. eficiaries. The building’s frame took about 520 And given the short building season, tons of structural steel, which arrived the work would have a tight schedule. to the job site in phases. The first phase “Chief Andrew Isaac Health Center is arrived in April 2011, three months after no small potatoes,” Isaac said. “There was ordered, and the last phase came four a lot of opportunity to fail. There was a lot weeks later. of worry. It was a big project.” “Each phase was erected as it arrived,” The center was projected to cost $75 Davis said. By October 2011 the building million, but once completed by December was enclosed, allowing construction to con2012, it was on time and under budget at tinue on schedule. $68 million. Isaac credits general contrac“At one point in the later summer of tor GHEMM Company Inc., its 43 sub2011, crews were standing the last contractors and TCC’s project manager, section of structural steel on one end of Arcadis, for the success, as well as everythe building while exterior walls were one associated with the project. being completed and roofing was being The first hurdle in the construction installed at the other end of the building,” was to get the steel beams erected, so the Davis said. structure could be enclosed for work durAnother challenge to the building was ing the winter of 2011. the interior “great round,” the large circuThe construction called for a stronger lar room people first see upon entering the and more expensive steel framing system clinic. The walls have birch slabs that are called “moment frame,” said David Miller, shaped to look like a woven basket. Arcadis senior project manager. “It was time consuming,” said Aaron The difference is that moment frame Emerick, a construction worker and grandis rigid once it is bolted together. Other son of Chief Andrew Isaac. “They had four steel frame erections require guide cable to different angles on each board.” stabilize the beams and painstaking level The clinic was designed with the future checking before the bolts are tightened. in mind. One part of the building has a floor The trick for moment frame is a very installed in the roof of the first floor, ready level foundation, Miller said. for a second story. A gravel pad is in place “If the foundation is off, you have a lot for an extension of the building. of problems,” he said. “When it comes time, they will be able It was a design decision, Miller said. to add on without having to shore up the If they had used a different type of steel frame, the beams and columns would have Please see BUILD, Page 19 By DIANA CAMPBELL

Photos by Rachel Saylor

ENVIRO

C o n g ra t u l a t i o n s

Continued from Page 14

on the completion of your new facility

21407607 3-10-13CAIHC

. . . and we appreciate being able to be a part of this project.

The hot water would have ended up in the Chena River, so it was a good solution, Bettisworth said. Construction plans also took into consideration impacts to the natural environment. The building was designed around 50 birch trees that were saved from being bulldozed and that are now part of the landscaping. The Fairbanks North Star Bor-

ough provides a bus route to the clinic as part of the environmental plan, said Luke Hopkins, borough mayor. “We have air quality issues,” Hopkins said. “When you reduce the number of cars on the road, you improve air quality.” The building also used sustainable materials when possible. The center staff plans to manage its waste efficiently, as part of the LEED rating. The center will be one of the few buildings in the state of Alaska to be certified as LEED gold.

Sunday, March 10, 2013

THE BUILDING

Photo by Rachel Saylor

Big building, big economic impact By DIANA CAMPBELL To underscore the economic benefits the new $68 million Chief Andrew Isaac Health Center has to Fairbanks, Luke Hopkins likes to show people the two pages of health care jobs vacancies in the Fairbanks Daily News-Miner. “These are semi-professional and professional jobs,” said the Fairbanks North Star Borough mayor. Those types of jobs pay well and are good for the Interior, he said. The addition to Fairbanks of the new clinic does several things for the Fairbanks economy, both Hopkins and Fairbanks city Mayor Jerry Cleworth note. Not only does CAIHC attract highly paid professionals who will live in the area, but its presence also makes Fairbanks a regional destination for CAIHC beneficiaries who will travel to Interior for health care needs. That means people patronizing shops, restaurants, transportation services and hotels. Before the new center opened, some patients had to travel to Anchorage for certain types of treatment. Now they can stay in Fairbanks. “Not only does the new health center greatly reduce the inconvenience to people seeking medical attention not available in their home communities, but it also allows Fairbanks to better serve in its position as the regional hub for Interior and Northern Alaska,” said Julie Emslie, regional hub project manager at the Fairbanks Economic Development Corp. “We welcome rural residents and hope that they always think of Fairbanks as their ‘home away from home.’”

Interior Native businesses and organizations have historically made large economic contributions to the Interior. According to an economic impact study prepared by Information Insights and paid for by Doyon, Limited; Tanana Chiefs Conference; Fairbanks Native Association; Interior Regional Housing Authority; and Denakkanaaga, Inc., Alaska Native businesses and organizations directly and indirectly bring more than $300 million annually to the Interior, employing 2,725 people. TCC, the health center’s operator and owner, accounts for about $105 million of that amount. TCC’s health department, including the new center, represents about $71 million of TCC’s $105 million annual impact. TCC employs 550 to 700 people — more in the summer and fewer in the winter. Of those, about 350 work in the health department, with most of those working at the Chief Andrew Isaac Health Center. The center’s construction required the cooperation and partnership of many people, Isaac said. For instance, the borough had to change zoning and the Fairbanks City Council and the Hospital Foundation helped TCC acquire the 9.5 acres the new center sits on. It was a good deal, said Cleworth. “It’s a regional draw for Fairbanks,” Cleworth said. “With people coming to Fairbanks, it’s a real benefit.” From the beginning, the project pumped money into the Interior, putting to work on average about 90 construction workers daily over two years of construction. Ghemm Company, a local construction business, was the main contractor and the project had

43 subcontractors, said Mike Davis, Ghemm’s project manager. The facility makes the borough look good in the financial markets, too, while many other U.S. local governments are suffering, Hopkins said. The center’s existence helps maintain the borough’s

AA bond rating and helped in refinancing some of the borough’s school bonds, he said. “It’s a very measured economic surge for Fairbanks,” Hopkins said. “The center, and other Native businesses are important to our economy.”

Sunday, March 10, 2013

Congratulations Tanana Chiefs Conference We were honored to participate in the creation of this magnificent, state-of-the-art medical facility

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60 Years of Constructing in the Arctic

Sunday, March 10, 2013

THE BUILDING BUILD Continued from Page 16

existing building,” Miller said. The center is heated by Aurora Energy, which also provides hot water. “It cost them (TCC) a little up front,” Miller said. “But they’re using something that would have otherwise gone into the Chena River.” They had hoped to cool the building by using a groundwater system, but the permafrost layer interfered, he said.

They built a conventional cooling system instead. Happy with the results, TCC’s Isaac acknowledged the work that went into the project. He also praised TCC health director Victor Joseph, who was often on the front lines going before the Fairbanks City Council and Fairbanks North Star Borough Assembly for permits, zoning and land deals for the project. “Victor and I faced a lot of naysayers,” Isaac said. “It was difficult at times to maintain composure. I’m thankful for our villages for their support.”

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Sunday, March 10, 2013

THE ART It’s a health center and an extensive gallery By DIANA CAMPBELL The artwork at the new Chief Andrew Isaac Health Center reflects the power and creativity of Alaska Natives. The works were meticulously collected and prominently displayed, so the patients at the clinic would feel uplifted and proud, said Anna Frank, who was part of the cultural advisory committee that helped define the look of the $68 million building. “To have the authentic, really old style on the walls, we can look at it and say ‘Oh, that’s where I got it from,’” Frank said. About 750 pieces of art and photos are part of the collection displayed in the new

health center, said Dixie Alexander, Tanana Chiefs Conference’s cultural program manager. Tanana Chiefs Conference, the building’s owner, spent about $142,000 on gathering submissions from 42 villages and Fairbanks. Many more people donated items for the new clinic. “We got a sealskin parka, a beautiful doll from Holy Cross, a spirit mask birch bark canoe, moose skin chief’s coat, fish skin baskets, ivory pieces and older art collections from people who have passed,” she said. Alexander is in charge of cataloguing the items, designing the displays and installing the art. “We just go over and over to make sure the information is right,” she said. “I’m blessed with work.” Traditionally, Alaska Natives used bone, stone, feathers, ivory, wood, bark, roots, porcupine quills, and animal hides and fish skins in their art, which often served utilitarian purposes. Western traders introduced beads to Alaska Natives, and artists

“Solomon” by Mary Ann Fortune

adapted them into clothing and other suitable mediums. The color, type and style of beadwork often distinguished the artist and community, and connoisseurs can pick out the differences and say what area the work came from or who did the work. Modern artists use metal, paints, glass or any medium that catches their imagination. All are on display at the clinic, Alexander said. The largest and more modern works are found in the great circular room, also known as the gathering area, just off the main entrance. By the pharmacy, Chief Andrew Isaac’s regalia and moose skin chief’s vest, beaded by his wife, Maggie Isaac, is on display. Nearby, 42 moose skin pouches used to bring soil from tribal communities to intermingle on the health center’s land grace a glass cabinet. Upstairs near the dental clinic, visitors can see a little girl’s moose hide dress and slippers, complete with beaded flowers. Down by the eye clinic is an aluminum metal sculpture of Chief Charlie of Minto, crafted by the late artist James Grant. Near the specialty clinics on the first floor are handmade dolls with intricate details of clothing, hair and facial features. One doll is dressed in rain gear made from seal intestines, a replica of what was once worn in real life. “The artwork represents who we are,” said Freda Williams, who lives in Fairbanks and is a patient at the center. “Gorgeous, just gorgeous.”

“Summer Day” by Riba M. DeWilde

Photo by Rachel Saylor

The great circle: seasons and cycles of Native life By DIANA CAMPBELL The most impressive feature of the new Chief Andrew Isaac Medical Center is the huge circular room with a grand staircase just off the main entrance. The circle is important to

Alaska Natives as it represents a way of life. It signifies the cyclical nature of the seasons, and, as such, specific times to hunt and gather. The circle also represents the drum, the heartbeat of any event, whether for celebration Please see CIRCLE, Page 21

Sunday, March 10, 2013

THE ART CIRCLE

Continued from Page 20

or in memoriam. The walls have birch planks interwoven to look like a basket. To the right, a metal fireplace keeps a flame going. It is also round, to mimic the barrel stoves many rural families use to heat their homes. Most of the largest art items in the center’s art collection grace the room. Two suncatchers, one 10 feet long and the other one seven and half feet long, hang from the ceiling. The metal hoops were so big that they had to be custom made. An eight-foot double-blade steel knife of Tlingit fashion hangs on one wall. One window has a stained glass like image of a raven, part of Tanana Chiefs Conference’s logo. “I like the openness,” said Jeannie Nelson, a cancer survivor who patronizes the center. “I love that art.” The gathering area is also the hub of the building, with winding pathways leading to the different clinics. But there are tables and chairs in case one just wants to soak up the sun from the floor to ceiling windows while enjoying the art. Here is a list of the Alaska Native artworks located in the gathering area of the Chief Andrew Isaac Health Center:

Howling Moon (2012) Artist: Becky Anderson Alaskan Contemporary Artist Village: Ester, Alaska 22” x 16” Materials: Fused glass, peach, gray, black on black frame. “With the full moon hanging heavy in the sky outside my window, I can hear the eerie but magical sound of the howling of wolves, if only in my mind’s eye.”

Raven (2005) Artist: Darrell Barron Culture: Koyukon Athabascan Village: Ruby, Alaska 24” x 36” “A Friendly raven in Denali Park, he wanted his photo taken.”

Artist: Da-ka-xeen Mehner Culture: Tlingit Village: Klukwan, Alaska 96” x 20” x 8” Materials: Steel

‘Tanana Gwich’in’ People of the Tanana Valley (2012) Artist: Kathleen Carlo Culture: Koyukon Athabascan Village: Nulato, Alaska 42” x 50” x 2” Materials: Galvanized sheet metal, yellow cedar, copper sheet metal, brass nails. “Depicts the land from which we live and depend on. Copper metal will be the Alaska Range. The mask represents mother earth, the Tanana River comes out of the mouth.”

‘Eenaa’ My Mother (2012) Artist: Kathleen Carlo Culture: Koyukon Athabascan Village: Nulato, Alaska 27” x 24” x 4” Materials: Wood, paint, shells, hair, feathers, gold leaf, Milagros.

Bird War Club (2012) Artist: Wesley (Weasel) T. Owen III Culture: Athabascan and Inupiaq Village: Noorvik, Alaska Materials: Moose jaw bone, moose skin, black ink. “In the old times people needed something to protect themselves with and to protect what was dear to them. A jawbone can be a very intimidating weapon with which to do so with and was usually imbued with some personal shamanistic power.”

“I made my first suncatcher to battle depression and to make my grandmother happy to see her grandchild sewing beads. I pray and think of church windows when I make one. These colors were chosen to represent the Native way of life, living by the seasons of the sun.”

“While hunting my husband found this wonderful antler and brought it home to me. The piece spoke to me immediately, and became one of my favorites. This piece honors the like and memory of a majestic moose in its peaceful environment.”

Summer Day (2012)

Northern Lights Suncatcher (2012)

Artist: Riba M. DeWilde Culture: Koyukuk Athabascan Village: Huslia, Alaska 46” x 35” Materials: Birch wood, feathers, bone beads, moose horn, caribou skin, moose skin, moose shoulder blades, caribou hair, porcupine quills, crow beads, doll sheep horn feather, glass seed beads. “This is to represent a sunny summer day”

The Stroll (2012) Artist: Becky Anderson Alaskan Contemporary Artist Village: Ester, Alaska 37” x 25” Materials: Moose antler (shed), birch bark, black fused glass.

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Land of the Midnight Sun (2012) Artist: Denise E. Hardesty Culture: Koyukon Athabascan Village: Rampart, Alaska 10’ Materials: beads

Artist: Selina Alexander Culture: Koyukon Athabascan Village: Huslia, Alaska 26” x 90” Materials: Moose skin, deer, feathers, ptarmigan, owl, eagle, geese, dentalia shell, glass seed beads, sliced sea shells, claws, bear, wolf, crystals, emerald, sky blue quartz, red quartz, yellow quartz, jade, sapphire, amethyst, antique beads, sliced agate. “I designed this Suncatcher over 25 years ago and finally got a chance to make one for the new Chiefs Andrew Isaac Heath Center. This made me really happy that many people will see my work, that is why I used bigger beads because I knew it was going to be hang high up.”

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Tlingit Knife (2012)

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Sunday, March 10, 2013

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Sunday, March 10, 2013

THE BUILDING

Design meets health, culture, nature, community By TRACY VANAIRSDALE Bettisworth North The new Chief Andrew Isaac Health Clinic represented a special opportunity to work with Tanana Chiefs Conference to create a new health care facility that will meet the needs of Interior Alaska Natives for decades to come — a facility that is welcoming, culturally centered and dedicated to serving this community’s health care needs.

Commitment to community As lifelong Interior Alaskans committed to serving the region’s residents, the Bettisworth North Architects and Planners team fully embraced the challenge presented by TCC — that this new facility must represent the values embedded in the culture of the Native people of InteVanairsdale rior Alaska. “This commitment guided us from the outset, from the selection of design specialists, the development of a design process that actively involved members and beneficiaries of TCC, through the completion of design and construct,” said CB Bettisworth, president of Bettisworth North. In collaboration with Bettisworth North, project architect and prime consultant, the architectural design team included the following: • NBBJ of Seattle, principal medical facility planner and designer. NBBJ brought a history of Alaska Native medical facility planning and design, which included the Alaska Native Medical Center and Southcentral Foundation clinic in Anchorage. With this experience, the designers understood the special characteristics of Native medical facilities and were able to translate this knowledge into a fully functional clinic for Tanana Chiefs. • Jones and Jones, of Seattle, cultural design advisers and landscape architects. • Martha Hanlon Architect, the medical facility and equipment planning specialist, and Design Alaska and PDC Inc. Engineers, the technical engineers, were part of the Fairbanks-based design team.

Photo by Rachel Saylor

comed, and the community was excited to hear about the new clinic and was “TCC was an enthusiastic partner pleased the team came to listen.” in the clinic’s planning and design Dale Alberda, design architect with process,” said Bettisworth, who led NBBJ, then took this cultural guidance the team as principal architect. “This and information and configured a buildenthusiasm was contagious and infected ing that was relevant to the local culall members of the design team, the ture and the site on Cowles Street. The project management team, and the con- design is sensitive to the configuration tractor.” and orientation of public spaces in the TCC wanted a new clinic that clinic. This includes a variety of smaller would be culturally relevant to Interior gathering areas for friends and family Alaskans. The team actively engaged to come visit. All of these spaces have a the users of facilities in the project to south exposure and have a view to the achieve TCC’s goal. As part of the pronatural landscape. cess, TCC established a Cultural Advisory Committee. Johnpaul Jones, a Native American architect of Jones and Jones, facili“With Rise Alaska (now Arcadis) as tated the engagement of this group, project managers, TCC had an experiand the project team gathered design enced, Fairbanks-based group of profesinformation from the committee during sionals who fully understood the facility planning. Throughout design, this com- design and construction process,” Betmittee advised the team on how health tisworth said. “With their guidance, the care services are delivered and on the project was completed months ahead of culturally relevant components of the schedule and under budget.” building itself. The contractor was brought onboard “For the team to fully understand early to work with the design team the living circumstances of TCC’s closely. TCC selected GHEMM Co of tribal members, the team traveled to Fairbanks as the general contractor. the community of Koyukuk, met with This early collaboration included a the village chief and representatives of value engineering workshop, developthe community, visited the school and ment of project scope, and a guaranteed toured the community,” Bettisworth maximum price that was established said. “The team was graciously welearly in the design process. The col-

A vision to follow

Bringing it together

laborative process also allowed for an accelerated, fast-track, phased construction schedule. “Early involvement of GHEMM Co ensured the full engagement of the contractor in the project planning and design process,” Bettisworth said. “GHEMM Co fully adopted TCC’s goals and objectives with respect to quality of construction.”

Connected to the land The new clinic will receive a Leadership in Energy and Environmental Design gold certificate for a focus on sustainable design and operations. This effort was led by the NBBJ Sustainability Group, which worked closely with the design team to achieve this designation through sustainable building technologies and responsible construction. “Low-Impact Development, green infrastructure and native vegetation strategies in the land development and landscape design minimized the impact on the land,” said Mark Kimerer, Bettisworth North’s senior landscape architect. “To meet TCC’s goals, it was important to incorporate a strong connection among the community, the building, the land and the native landscape of Interior Alaska.” Tracy Vanairsdale, AIA, LEED AP, is a principal architect at Bettisworth North.

Sunday, March 10, 2013