Anchorage Daily News

WASILLA -- The Mat-Su Public Health Center isn't the kind of place to inspire racy medical soap operas like "ER" or "Grey's Anatomy."

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Mat-Su Public Health Center nurse manager Jane Conard

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Instead of gunshot victims and shouting medics, the quiet waiting room holds a bulletin board devoted to influenza information along with posters on everything from breast-feeding to contraception. A preschool play area dominates one wall.

But the public health center near Wasilla traffics in plenty of drama if you look at the statistics. Statewide, 14,000 children are not covered by insurance. The center serves mostly younger, lower-income patients with little or no health insurance, either children or young women, many of them seeking family planning services.

There is no emergency room. Instead, the staff focuses on prevention and education -- giving out flu shots or information about sexually transmitted diseases, for example, but also tracking down any potentially at-risk partners.

The Mat-Su center is one of more than two dozen administered by the state's public health program. Nurses travel to patients, sometimes logging hundreds of miles in trips from Wasilla to, say, Slana, Copper Center and Glennallen

Nurse manager Jane Conard presides over center operations -- its 20 nurses, nurse aides, nurse practitioners, administrators and clerks. Conard, 57, an upbeat but straight-talking career nurse, took a few minutes to chat recently at the center, located along the Palmer-Wasilla Highway across from North Bowl.

Q. What are the most common reasons people come in?

A. The people we provide services for are usually people of lower or no income. So the under- and uninsured are more commonly who we see. Our job is not to make money. Our job is to refer people who have insurance, to refer them to other providers who can provide service.

If people have a revenue source, we encourage them to go to a private provider, but if the private provider doesn't provide the service -- many docs don't provide influenza vaccine. It has to be ... stored correctly, monitored, gets outdated. It's much easier to send them over to public health nursing, where we've got $180,000 worth of vaccine in back. We've got Gardasil here

too, and that's over $120 a shot. Right now, the state of Alaska is providing that to all young women for free, but that's leaving soon. And people just aren't taking advantage of that.

(Editor's note: Gardasil is a vaccine that protects women against most cervical cancer, offered free by the state to all girls between 9 and 18 through a federally funded program. Starting next year, the state will offer free vaccines only to certain recipients, including girls with little or no health insurance.)

Q. How many people are using Gardasil?

A. I don't think a lot of people are demanding it. We work through school nurses. We want people at high schools to know about this before they run off to college and turn 19 and can't get it anymore.

Q. What kind of person do you see in here, demographically?

A. Most of the services we provide are for younger people, women of reproductive age or younger, and children, of course.

Q. How do you calculate patient bills?

A. We do a sliding fee scale for certain services like immunizations, and (fees for treating sexually transmitted diseases) are waived ... because we're more interested in getting the people treated and finding out their contact. If you charge $200 for Zithromax, (an antibiotic) like some people do ... we provide it for nothing. It costs us about $16, $18, but it's worth it.

Q. Have patient numbers gone up as health costs rose?

A. Yes. I've particularly seen it in people who have no other options ...

Q. You're seeing more people who can't afford to go to providers?

A. Yes, even when we refer them.

(Editor's note: The public health center doesn't see acute-care patients, such as asthmatics or people with infected cuts, so staff members have to refer such cases elsewhere.)

Q. So where do those people go?

A. Many times we refer them to other ... clinics; they get federal grants to provide sliding-fee scale (services) to lower-income patients. Like Sunshine Clinic and Willow Clinic (and) Mat-Su Health Services on Spruce Street. There's a few physicians that say, "I'm doing OK, I can do a few gratis."

Q. What, if any, limitations are there on you in terms of discussing birth control?

A. None. In fact we're required by law, if we talk to someone about positive pregnancy tests, we talk about all of their options, abstinence on. And no, we do not perform abortions, nor do we fund it.

However, I do believe in everyone's reproductive health freedom. Male and female.

Q. What's your nursing background?

A. I came to Alaska in 1989. I was in public health nursing in Missouri, used to do home health nursing.

Started out like all nurses, in a hospital. I was hired as an itinerant public health nurse in Bethel, and I had five villages, and they were great people.

Flew around ... I lived in villages, slept on the floor in clinic or on the exam table. I woke up several times where it was 20 below, the furnace had gone out at night because the village ran out fuel. I'd go inchworm over go to the phone in my sleeping bag ...

Q. If you could build your dream clinic, what would it look like?

A. Actually, my dream health center would be a large building where you'd have (Women, Infants, and Children, Office of Children's Services) many of the services we all use in common.

It would be about 20 miles that way, up the Parks because our population's growing that way. I'd like to be somewhere around Big Lake, a little bit beyond ... Also it would save some of these poor people a gallon of gas to get here.

And I would like to double my staff.

Find Zaz Hollander online at adn.com/contact/zhollander or call 352-6711.

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