Frontier Extended Stay Clinic (FESC) Demonstration Project

Beth Landon, MBA, MHA
Ira Stollak, MA, MPH
Sanna Doucette, BA

Isolation, weather, darkness, and other transportation difficulties can prevent patients who experience severe injury or illness in remote frontier areas from obtaining immediate transport to an acute care hospital. Consequently, clinics in some frontier communities offer observation and urgent care services traditionally associated with acute care inpatient hospitals until the patient can be transferred or is no longer in need of transfer. This requires that the clinic provide services for which it is not reimbursed by third party payors, and that the clinic maintain costly staffing, equipment, and infrastructure that traditional urban or rural clinics lack. The Frontier Extended Stay Clinic (FESC) Demonstration Project is designed to demonstrate the viability of a potential new federally-designated provider type, the Frontier Extended Stay Clinic.

ACRH, a member of the FESC Consortium, was contracted by SEARHC to collect and analyz the data for the project, including developing a root cause analysis, logic model, and project evaluation plan.

The FESC Demonstration Project is funded through a Cooperative Agreement with the Office of Rural Health Policy (ORHP) of the Health Resources and Services Administration (HRSA) and is administered by the Southeast Alaska Health Consortium (SEARHC). The participating clinics include Alicia Roberts Medical Center (Klawock), Crossroads Medical Center (Glennallen), Haines Medical Center (Haines), Iliuliuk Family Health Services (Unalaska), and Inter-Island Medical Center (Friday Harbor, Washington State). The Project began in 2004 and was recently awarded a new Cooperative Agreement to extend through 2010.