Indian Country Today
After leading a statewide tribal health organization through tremendous growth and working in the health field for decades, Roald Helgesen, Haida, has moved on to a new opportunity.
During his tenure, the Alaska Native Tribal Health Consortium added a third more employees; purchased, built, and reconfigured several buildings in Anchorage; and increased revenues by hundreds of millions of dollars.s
Helgesen left as head of the Anchorage-based Alaska Native Medical Center in August.
In 2011, he said: “When I first got to ANMC the podiatrist [foot doctor] was treating patients in a converted janitor's closet. That's how badly they needed space … we needed more and we needed better. Our staff, our people deserve better.”
So he began working toward improvements, starting with staffing and “the space to do the work. Then it was about removing barriers to access to care,” Helgesen said.
‘I fell into the health field’
One of Helgesen’s first jobs was for a wholesaler, “making sure all the Pepsi cans faced the right way,” he told the University of Alaska Anchorage alumni association. He worked on a political campaign then as a state legislative page, jobs that led to an interest in public policy and a degree in political science.
After college he returned to his home town of Sitka in Southeast Alaska and, as it happened, got a temporary job at a tribally run hospital.
“I started literally in the mail room answering the telephones and talking to the medics on the radios, supporting the health aides who were calling in to speak with doctors, talking with families, placing calls from patients. And that’s how I fell into the health field,” Helgesen said.
What kept him there was, “it really was about helping people, serving our communities. These are people we know by name, or they may be our extended family across the region. It felt good to do that type of work.”
He was a volunteer firefighter from 1994 to 2003 and became an emergency medical technician. He got a masters degree in health care administration, ran clinics in Idaho and Washington, then became director of administration for the Southeast Alaska Regional Health Consortium. In 2007, he became its CEO before becoming CEO of the Alaska Native Tribal Health Consortium in 2011.
What makes a good leader?
When asked about his leadership style, Helgesen said, “I try to be a kind, friendly person … [the first thing] is to be the person that you want your health system to be.
“The second piece is you have to share the mission and the vision of the organization, share that out with the staff and others, so [we can all be headed] … where the board is directing the organization,” Helgesen said.
“Accessibility is really important from my standpoint when it comes to leadership, that people can reach out to you, give you their ideas, give you their concerns. You're not going to get those unless you are accessible.”
A humble expert
“Roald exemplified a subject matter expert who was humble,” said Andy Teuber, Sugpiaq, Alaska Native Tribal Health Consortium board chair and president.
Helgesen’s expertise was in managing “the sophistication and complexity and number of moving parts with the Alaska Native Medical Center,” Teuber said.
The consortium provides statewide environmental health and engineering and community health services and co-manages the Alaska Native Medical Center. After the medical center saw maybe ten administrators in as many years, Helgesen took on that role. It demanded his full attention and he stepped down from the consortium CEO job in 2019.
The consortium and medical center are part of a statewide Alaska tribal health system. The system includes seven hospitals, more than two dozen health centers, and nearly 20 village clinics, which provide emergency, outpatient, and limited inpatient care. Patients needing specialty care are referred to the Alaska Native Medical Center.
In Helgesen’s years at the consortium, 2011-2020, staff grew from about 2,000 to 3,100. Net assets more than tripled from $250 million to $782 million.
With Helgesen at the helm, Consortium annual reports show it launched or expanded programs to address sanitation, affordable energy, air quality, research, and the effects of climate change. It became partners with Alaska Pacific University to create a tribal college, starting with four new degree programs in nursing, health occupations, health sciences and environmental public health.
The medical center also grew. It bolstered specialty services such as internal medicine, day surgery, pediatric intensive care and neurosurgery. That led to the acquisition and conversion of two buildings to clinical space, construction of new buildings for education and patient housing, and extensive remodeling and reconfiguration of existing facilities, said Teuber.
Medical specialty encounters nearly doubled and surgery volume rose by a third. Wait times for appointments dropped from 11 days to 2 days. The annual medical service operations budget rose by $275 million. Telehealth use grew by 62 percent, saving millions of dollars in transportation costs.
Helgesen also oversaw re-accreditation, redesignations as a Level II Trauma Center, designation for Pediatric Trauma, and designation as a Pediatric Emergency Room and Baby-Friendly Hospital.
The consortium and medical center received numerous awards excellence in nursing training and education, various specialty services, and as “best employer.”
Helgesen said one highlight was the construction of a 200-room housing facility built to house people from rural Alaska visiting Anchorage for specialty services. Getting the building up involved a land transfer from the federal government, a $35 million state bond, and myriad details.
One of his favorite memories is of the January 2017 opening day for “... that bright, beautiful building, a place for people to stay.”
He remembers “how appreciative our people were to have a location that was safe, that was secure, that was close to the campus, that they knew that they didn't have to take a cab or a bus, that it was right there. And we've been so successful with that that we even need another. That's the type of growth that we've seen on the campus over the last nine years.”
A model for tribes outside Alaska
Helgesen said the Alaska tribal health system shows the benefits of tribes being in charge of their own health care.
“I think that this is replicable in every single Indian Health Service service unit. I think that every area could benefit from tribal self-governance. I think a lot of the challenges that we read about in national media could be remedied with tribal management,” Helgesen said.
“I'm not saying it's easy. It'll be hard,” he said. But “I think that they [tribes] could compare what we had in Alaska [under federal management] versus what we have today … and we've come a long way,” Helgesen said.
Instead of taking direction from officials in Washington, DC, “authority and control are at the local level by elected people known to their communities,” he said. “And I think that that creates a success that you're seeing in Alaska today.”
Another benefit of self determination is tribal health organizations can bill Medicare, Medicaid, and private insurance companies, generating revenues that can match or even exceed Indian Health Service funding.
A look back
Consortium medical director Dr. Bob Onders said, “To me the biggest thing that I felt like [Helgesen] brought to Anchorage and the tribal health system was a rural perspective and listening to rural communities,” Onders said.
Consortium board member Evelyn Beeter, Athabascan, said, “He just did an outstanding job for ANTHC. He's going to be missed at our organization. So I hate to see him leave, but you know, things change, you know, life evolves.”
Helgesen wrapped up an interview by saying, “At the end of the day, I'm a kid from a small town and I've had some great opportunities. But my goal has always been to work for our people.”
He said he has a thousand anecdotes about encounters or events that touched his heart. And that evidently was reward enough. In characteristic modesty, he added, “So if you don't write anything, that's just fine with me.”
Seeking new experiences, Helgesen left his position on August 7 and went to work as Chief Operating Officer for the Central Council of Tlingit and Haida Indians of Alaska.
Helgesen is one of two prominent Alaska tribal health leaders who left the field in August. Katherine Gottlieb, Sugpiaq, was head of the nonprofit Southcentral Foundation, which manages the primary care side of Alaska Native Medical Center.
She resigned effective Aug. 31 to follow her husband out the door after he was fired. The two of them had worked for Southcentral Foundation for some 30 years.
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Joaqlin Estus is a national correspondent for Indian Country Today. Based in Anchorage, she’s a longtime Alaska journalist.
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