# Yukon-Kuskokwim Health Corporation

The Yukon-Kuskokwim Health Corporation (YKHC) administers a health care delivery system for over 50 rural communities in the Yukon–Kuskokwim Delta in southwest Alaska. The YKHC is accredited by the Joint Commission.
The YKHC system consists of a primary facility in Bethel and five sub-regional clinics in Aniak, Emmonak, Hooper Bay, St. Mary's and Toksook Bay. This system offers inpatient services at the Bethel hospital. Primary care, specialty services, pediatric care, emergency services, behavioral health counseling and treatment services, dental and optometry clinics, home care services, specialized programs for people living with diabetes, tobacco cessation, and many outreach/education programs to promote healthy living.
Additionally, the Community Health Aide Program (CHAP) provides village-based primary health care in 47 village clinics in the Yukon-Kuskokwim Delta, including acute, chronic and emergency care, preventative services, and health promotion disease prevention activities to individuals, families, and their communities.

## Location and climate

Roughly the size of Oregon, the Yukon-Kuskokwim Delta, or Y-K Delta, covers 75,000 square miles (190,000 km$^2$) in the southwestern corner of Alaska. It is located where the Yukon and Kuskokwim rivers empty into the Bering Sea on the west coast of Alaska. The delta, which mostly consists of tundra, is protected as part of the Yukon Delta National Wildlife Refuge.
Bethel – Within the heart of the Yukon-Kuskokwim Delta lays Bethel, a hub community for 56 surrounding villages, the gateway to the Yukon Delta, and home to the Yukon-Kuskokwim Health Corporation. Roughly 400 miles (600 km) west of Anchorage, Bethel is charged by a maritime climate that averages 65–70 °F during the summer months, and a winter mean of 11 °F.
The Yukon-Kuskokwim Health Corporation also has five sub-regional clinics that can provide many of the same services found at the Bethel Hospital site. The clinics are located in:
Aniak – Located on the south bank of the Kuskokwim River and at the head of the Aniak Slough, 92 miles (150 km) northeast of Bethel.
Emmonak – Only 10 miles (16 km) from the Bering Sea, Emmonak sits on the north bank of the Kwiguk Pass at the mouth of the Yukon River. Hooper Bay – The westernmost sub-regional clinic, Hooper Bay clinic rests 152 miles (240 km) west of Bethel.
St. Mary's – Serving two cities, St. Mary's sub-regional clinic offers residents of both the namesake city and Andreafsky the wide range of services and treatments the predominantly Yup’ik community relies on throughout the year. This clinic is located just 5 miles (8 km) from the confluence of the Yukon and Andreafsky Rivers and 100 miles (160 km) northwest of Bethel.
Toksook Bay – YKHC's only sub-regional clinic not on the mainland, the Toksook Bay clinic is located on the Nelson Island of 33 square miles (85 km$^2$), 115 miles (190 km) northwest of Bethel.

## History

Formed by a group of tribal leaders and representatives from 48 villages of the Y-K Delta, the Yukon-Kuskokwim Health Corporation was born from a vision of retaining more control over the provision of health care services and improving the retention of passionate providers.
Incorporated one year after its formation, in 1969, YKHC's roots date back to the inception of the Indian Health Service in 1955. YKHC has grown to become the largest employer in the Y-K Delta.
Key Dates:
* 1907 – The U.S. Bureau of Education began employing Physicians and Nurses in rural Alaskan Hospitals and Dispensaries
* 1969 – Yukon-Kuskokwim Health Corporation is founded
* 1970 – YKHC leases 16 buildings in Bethel for YKHC employees
* 1978 – Beginning of Otitis Media Program to help diagnose and treat ear problems
* 1979 – Pre-Hospital Emergency Medical Services began
* 1995 – Opened Aniak Sub-Regional Clinic
* 1996 – Opened Delta Supportive Living Facility
* 1997 – Opening of Pitka's Point Village Clinic, Aeromed International and YKHC's Travel Management Center
* 1998 – Opening of Transitional Living Facility, and Tuluksak and Napakiak Village Clinics
* 1999 – Opened Crisis Respite Center and Family Hostel (Qarartarvik); Began Village-to-Bethel Medevacs
* 2000 – JCAHO accreditation received; New Clinics in Lower Kalskag, Alakanuk, Holy Cross, and Crooked Creek completed
* 2001 – Opening of Emmonak, Kwigillingok and St. Mary's Sub-Regional Clinics, Delta Immediate Care Clinic, Pediatric Specialty Clinic; McCann Treatment Center opens to treat inhalant abuse
* 2003 – Opened eight new Village Clinics
* 2005 – Opened Toksook Bay Sub-Regional Clinic and eight new Village Clinics
* 2009 – YKHC Research Trial to study vaccine against pneumococcal disease in children begins
* 2009 – Opened Hooper Bay Sub-Regional Clinic
* 2013 - Opened the YKHC Elders Home, a Long Term Care facility in Bethel

## Services

A complete health system, YKHC consists of the primary facility in Bethel, sub-regional clinics in Aniak, Emmonak, Hooper Bay, St. Mary's and Toksook Bay, and various Village Health Clinics throughout the 56 communities served. Services include:
* Behavioral health
* Central Supply and Reprocessing/Operating Room
* Dental – full service dental clinic
* Diabetes prevention & control – offers outreach, education and clinical services
* Diagnostic imaging – Comprehensive services offering mammograms, CAT Scans and telemedicine
* Emergency Department – YKHC is the only Level IV ER in the area
* Home care – includes in-home services to care for elders and medically frail people who might otherwise have to go to a long-term care facility or nursing home
* Infection control
* Inpatient unit – Professional nursing care for adult and pediatric patients admitted to the hospital
* Laboratory – Full service laboratory testing
* Long Term Care - As of 2013, YKHC has an 18-bed Long Term Care facility.
* Nutrition services – Providing assessment and counseling for patients; some of the more common diagnoses are malnutrition, anemia, hyperlipidemia, diabetes (either type II or gestational DM), obesity, cardiovascular diseases, and failure to thrive.
* Obstetric services – Comprehensive prenatal care and an inpatient birthing center
* Optometry – Provides a full scope of primary eye care, including routine eye exams, contact lens fittings and ocular disease management
* Outpatient ambulatory clinic – Three ambulatory clinics are housed in the hospital
* Pediatrics – With 50% of the Y-K Delta population under the age of 18, this unit provides local primary care and consultative care for children
* Pharmacy – Serving a patient population greater than 28,000 and fills approximately 1,000 prescriptions per day
* Physical therapy – Providing treatment for muscular, skeletal, neurological or orthopedic conditions
* Respiratory therapy
* Social services
* Specialty clinics – Includes Gynecology, Urology, Cardiology, Neurology and Dermatology services
* Women's health – Provides outreach, education and clinical services; screenings include mammograms, Pap tests, clinical breast exams, and other diagnostic tests as necessary

## Unique illnesses

The diverse aspects of the Yukon-Kuskokwim Delta environment result in a number of diseases that are rarely seen in the lower 48 states. YKHC medical professionals diagnose and treat illnesses such as:
* Botulism
* Tuberculosis
* Animal bites
* Methicillin-resistant Staphylococcus aureus, or MRSA
* Frostbite
* Alveolar Hydatid Disease – a parasitic disease caused by the larval stage of a microscopic tapeworm Echinococcus multilocularis
* Haemophilus influenzae type b (Hib) – a bacterial disease which usually infects children under 5 years of age and causes a number of illnesses such as pneumonia, occult febrile bacteremia, meningitis, epiglottitis, septic arthritis, cellulitis, otitis media, purulent pericarditis, and other less common infections such as endocarditis, and osteomyelitis
In addition to these rare diseases, YKHC medical professionals also diagnose diabetes, cancer, ear infections, respiratory syncytial virus, and other diseases that are commonly seen throughout the United States.