KODIAK AREA NATIVE ASSOCIATIONkodiakhealthcare.org/wp-content/uploads/2016/12/2017... · 2017-10-06 · resident’s Letter2 P –2022 Strategic Plan3 2017 ur Organization4 O ur Core

Annual Report 2016–2017

To Elevate the Quality of Life of the People We Serve.

KODIAK AREA NATIVE ASSOCIATION

kodiakhealthcare.org

1 Board of Directors

2 President’s Letter

3 2017–2022 Strategic Plan

4 Our Organization

5 Our Core Values

6 Access to Patient Services

8 Arctic Care 2017

10 Village Metals Clean-Up

12 Expanded Services

13 The Patient Experience

14 Awards and Recognition

16 Financial Statements

Table of Contents

Art installation in Larsen Bay.

KANA Board of Directors

Loretta NelsonChairperson

Native Village of Afognak

Phyllis AmodoDirector

Kaguyak Village

Vickie NovakDirector

Native Village of Ouzinkie

Alfred B. Cratty, Jr.Vice Chairperson

Village of Old Harbor

Arnold KewanDirector

Native Village of Port Lions

Gary WatsonDirector

Sun’aq Tribe of Kodiak

Cheryl ChristoffersonSecretary

Gwangkuta Suuget (At-Large)

Speridon M. Simeonoff, Sr.Director

Native Village of Akhiok

Margaret RobertsTreasurer

Tangirnaq Native Village

Alex Panamaroff, Jr.Director

Native Village of Larsen Bay

ANNUAL REPORT 2016–2017 1

Cama’i,I’d like to thank you for taking the time to read our annual report. The entire team at KANA continues to work hard to build a strong, stable, and growing organization to serve the needs of our community. Within this report we describe a few of KANA’s accomplishments over the past year, such as participating in the Coastal Impact Assistance Program initiative to remove scrap metal from our communities, and hosting the Department of Defense’s Arctic Care mission to Kodiak. This report also presents financial data, performance metrics, and patient encounter information.

Within the last year, we have received funding from the Health Resources and Services Administration to expand access to mental health services and substance abuse resources, focusing on the treatment, prevention, and awareness of opioid abuse. We’ve added oral surgery as a dental service. We’ve received funding from the Indian Health Service to use towards decreasing drug abuse and identifying health behaviors that lead to suicide.

These programs and services were added because of demonstrated community need and patient feedback. We rely on your input to guide the development and delivery of services. To facilitate participation, we’ve developed several new methods of communication to help us learn more about your ideas and concerns. Through surveys, interviews, social media, comment cards, and even via our van drivers, we welcome your comments and suggestions as we seek to expand programs, improve customer service, and provide a better experience for you.

Through the leadership of our Board of Directors and the dedication of our employees, the Kodiak Area Native Association is committed to elevating the quality of life of the people we serve. The very definition of ‘Association’ is a group of persons having a common interest. Your wellbeing is that common interest. We want to provide the best services possible for the people we serve today, and promise to evolve to meet the needs of our future generations.

Quyanaa,

Andy Teuber President and CEO

PRESIDENT’S LETTER

2 KODIAK AREA NATIVE ASSOCIATION

2017–2022 Strategic Plan

Continue to improve KANA’s internal and external communications

• Promote KANA’s high quality of care through storytelling

Promote Wellness:

• Holistic medicine

• Wellness Centers

Staff development:

• Transition plan

• Staff training and retention

• Monitor work load to ensure adequate resourcing

Board development:

• Transition plan

— Mentor emerging leaders

• Ongoing training and support

• Partner with other organizations to educate community on role of the Board

Focus on a comprehensive financial plan, balancing financial resilience and mission

Village/tribal sustainability

• Ensure sustainable staffing

• Have support services for tribal capacity

• Ensure right people engaged in resource boards and commissions

Ensure adequate support for hospital services in Kodiak

Develop strategic partnerships with:

• ANCSA organizations

• State of Alaska

• Tribes

Substance abuse prevention and treatment

• Work with the Alaska Mental Health Trust Authority to cultivate support for ongoing needs

• Increase prevention education programs in schools

• Seek innovative solutions

Support for elders

• Help identify, train and support Personal Care Attendants for villages

• Support transportation services

• Elder Advocate

• Develop training for families to understand issues with aging members

• Continue to identify additional beds as needed for longterm needs

Maintain accreditation and compliance for associated operational site visits and reporting

Our Mission:To Elevate the Quality of Life of the People We Serve

Our Core Values:Courtesy, Caring, Respect, Sharing, Pride, and the Sugpiaq Alutiiq Values

Our Envisioned Future:The best quality care is available to all people on Kodiak Island

CUSTOMER SERVICE STEWARDSHIP QUALITY IMPROVEMENT


Health Services Medical

Dental

Pharmacy

Behavioral Health

Medication Assisted Substance Abuse Treatment Program

Health Promotion and Disease Prevention Services

Nutritional Counseling

Massage Therapy

Women Infants & Children (WIC)

Child Advocacy Center

Wellness Center

KANA provides integrated wellness services to the entire Kodiak Island community with focus on our Alaska Native Beneficiaries. Through our excellent customer service, KANA implements its cultural values to serve our community members when and where they need care.

AdministrationHuman Resources

Information Systems

Facilities & Maintenance

Finance

Communications

Community ServicesFamily Services

Employment & Training

Infant Learning

Tribal Operations

Vocational Rehabilitation

Elder Services

Public Safety

Economic Development

Our Organization


CourtesyWe honor the rights and needs of all in order to improve the quality of life in our communities.

SharingWe value our families, each other, and what we

all stand for.

CaringWe are responsible for our people and ourselves.

RespectWe value togetherness and cooperation to

ensure wellness for all.

PrideWe honor our land, language, traditions, beliefs,

and kinship in all that we do.

Our Core Values


Medical and Behavioral Health Patients Served Over Time

August 30, 2013 –August 30, 2014

August 30, 2014 –August 30, 2015

August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

l Individual Patients

Num

ber o

f pat

ient

s

4000

3500

3000

2500

2000

1500

1000

500

0

2650 2649

30743349

Dental Patients Served Over Time

August 30, 2013 –August 30, 2014

August 30, 2014 –August 30, 2015

August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

l Individual Patients

Num

ber o

f pat

ient

s

200018001600140012001000800600400200

0

1383 13331533

1736

Care Team Average Continuity

l KANA Continuity l AAAHC Target Continuity

August 30, 2016–August 30, 2017

100%90%80%70%60%50%40%30%20%10%

0%

58% 50%

The average continuity for all care teams for the past year was 58%. This means that 58% of the time patients are seen, they are seen by their own Primary Care Provider. This rate exceeded the standard 50% that AAAHC requires.

Access to Patient Services


August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

Third Next Available (TNA) for Medical Services

Average (in days)

DefinitionAverage number of days from the time of request for an appointment with a medical Provider and the third next available open appointment spot.

The “third next available” appointment is used rather than the “next available” appointment as it is a reflection of true appointment availability. For example, an appointment may be open at the time of a request because of a cancellation or unexpected event. Using the

“third next available” appointment eliminates these chance occurrences from the measure of availability, or from multiple people asking for an appointment simultaneously.

KANA ReportFor the last two years, we have maintained Same Day Access for a standard 30-minute outpatient medical appointment.

For Behavioral Health Adult Services, Youth Services, and Substance Abuse Services, we maintain Same Day Access for a standard 60-minute appointment.

TNA for Behavioral Health Adult Services

Average (in days)

August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

TNA for Behavioral Health Youth (9–17 yrs)

Average (in days)

August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

TNA for Behavioral Health Substance Abuse

Average (in days)

August 30, 2015 –August 30, 2016

August 30, 2016 –August 30, 2017

TNA for Behavioral Health Child & Family Services

Average (in days)

sameday

sameday

0.2 0.2

sameday

sameday

0.0 0.5

sameday

sameday

0.2 0.5

sameday

sameday

0.0 0.5

sameday

sameday

0.5 1

“Third Next Available” Appointments

While we have increased the number of patients seen over the last two years, access to care has remained at the national standard of care.


Arctic Care 2017 took place this spring from March 28 through April 6 where 3,930 patients were served and 5,859 procedures were completed using temporary clinics. These clinics were set up in the City of Kodiak and surrounding villages, and provided medical, dental, optometry and veterinary services to under-served community members at no cost. The event was a joint effort sponsored by the Office of Secretary of Defense’s Innovative Readiness Training (IRT), led by the Air Force Reserve Command, and in partnership with KANA.

The exercise provided training opportunities for U.S. military and Canadian Health service members to prepare for worldwide deployment while also supporting the medical needs of island communities.

Services were provided in Ouzinkie, Port Lions, Old Harbor, Akhiok and the City of Kodiak. Teams were unable to provide services in Larsen Bay and Karluk due to inclement weather conditions. Among the medical screenings were optometry, dentistry, physical therapy, and veterinary services. A pharmacy was available, as well as the on-site production of eyeglass prescriptions.

Arctic Care 2017

1632 OptometryPatients

838 Medical Patients

276 Veterinary

PATIENTS SERVED AT ARCTIC CARE 2017

THIS PAGE, TOP: Reserve and Guard Airmen arrive at Coast Guard Air Station Kodiak on March 26, 2017 to take part in Arctic Care 2017 LEFT: Dogs and their owners lined up for Arctic Care’s veterinary services.

FACING PAGE, TOP: Lt. Col. Mark Davis with the 147th Medical Group adjusts a manual phoropter in order to find the correct prescription lenses for a patient. BOTTOM LEFT: Lt. Col. Brad Bradbury with the 147th Medical Group performs a dental examination. BOTTOM RIGHT: Master Sgt. Laura McIntyre with the 512th Aerospace Medical Squadron assists a patient during a vision assessment. All photos courtesy U.S. Air Force.

1184 Dental Patients


1184 Dental Patients



From June 2015 to December 2016, the village communities in the Kodiak Island Archipelago participated in a massive clean-up effort resulting in 2,625.5 tons of scrap metal.

The Coastal Impact Assistance Program (CIAP) Grant titled “Village Metals Project” utilized Federal funds managed through the US Fish and Wildlife Service, received by the Kodiak Island Borough in 2013. The Kodiak Island Housing Authority and KANA created agreements with the Kodiak Island Borough to administer the project.

Along with making the coastal village communities cleaner and safer, local technical capacity was grown and local employment was achieved. Village resident participants attended technical training classes, developing skills that will be retained locally. Employment totaled 8,885 hours of local labor, injecting over $250,000 in wages into local economies.

FACING PAGE, TOP: A truck abandoned on Karluk Beach was one of many tons of scrap metal removed from island villag-es. BOTTOM LEFT: The Helenka B. departs Akhiok with a load of scrap metal, October 2015. BOTTOM RIGHT: Crushed cars stacked in the Port Lions Metals Yard, January 2016.

27,939 pounds of lead acid batteries

1,715 pounds of electronic waste

twenty-nine 55-gallon drums of contaminated fuel waste

540 gallons of paint, chemicals, and other

household hazardous waste

2,600 Tons of Scrap Metal Removed from Kodiak Area Villages

TOXIC ITEMS REMOVED FOR RECYCLING OFF-ISLAND:

Field training for metals removal in Port Lions.


KANA Dental Expands Village Care with Increased Provider Visits

KANA’s Dental Department implemented a new schedule of services for our village communities. Dr. Holbrook, KANA’s Dental Director, has worked diligently with leadership and staff to assemble a team of Providers, support personnel, and equipment that have allowed for 2-day trips to better serve our village residents.

KANA’s Dental staff has been able to provide exams, cleanings, x-rays, fillings, simple extractions, and crowns for our village residents. If any village had enough demand for dentures and partials, additional trips to accommodate that need were scheduled as well.

KANA’s Community Services Has Launched New Early Childhood Comprehensive Systems (ECCS) Program

KANA’s Community Services launched a new program to support families with young children. The Early Childhood Comprehensive Systems (ECCS) Program works to facilitate and build comprehensive systems of care that support families with young children (birth to three) and the communities they live in, as part of promoting positive early development and early school success for young children.

In mid-October 2016, KANA’s Early Childhood Comprehensive System Program provided a Strengthening Families™ two day interactive training with focus on how communities can help parents find support during tough times, discover helpful

parenting knowledge, and connect with people they can count on.

Discussion included how this approach could be adapted for Kodiak community, building on local values and traditions. Attendees included Office of Children Services, Early Childhood Special Education, Child Advocacy Center, Infant Learning Program, local Preschool/Daycare programs, ICWA workers—local and village based, village participants, USCG employees, and Sun’aq Tribe of Kodiak staff, among others.

KANA’s Kodiak Child Advocacy Center Receives Accreditation

KANA’s Kodiak Child Advocacy Center became accredited in January 2017 by National Children’s Alliance (NCA), the national association and accrediting body for Children’s Advocacy Centers (CACs), demonstrating its commitment to providing consistent and evidence-based healing interventions.

To ensure that all children across the U.S. served by Children’s Advocacy Centers (CACs) receive consistent, evidence based interventions that help them heal from abuse; hundreds of CACs have become Accredited Members of NCA by meeting their Standards for Accredited Members and verifying their adherence to the highest standards of practice by submitting to NCA site review.

Accreditation demonstrates the high-quality work of Accredited CACs to policymakers, funders, and supporters, and strengthens our ability to attract reputable, qualified staff, furthers and celebrates growth in our community.

Access to Patient Services


Van Drivers are Bookends to a KANA Experience

KANA’s van drivers are the first and the last people from KANA that some patients see. It is the goal of our drivers to make certain that Beneficiaries have a positive experience with each visit. The drivers are essential in ensuring access to health care for patients who otherwise might not show up.

Wendy Bridenstein rides the van with driver Terry Wolkoff regularly. She says she owes him enormous gratitude for not only driving her, but being there for her as a friend. “These drivers are amazing,” says Wendy. “If it wasn’t for them, I never would have gone to the doctor.

They hold me accountable. They listen to me talk. They’ve seen me at my worst and helped me to feel my best. They

help me feel good about going. I owe them so much.”

KANA drivers spend a lot of time with patients, on average putting in 100 miles each day and seeing 20–30 individuals a day. “We have some amazing regulars who make the job that much more fun—it’s a good overall experience to interact with

our patients as much as I do,” says Terry. “It makes my day better. I like transporting the Elders. Their stories about Kodiak back in the day are amazing.”

Dental Team at the Top of Their Game

Beneficiary Marvin Frost recently shared his patient experience with KANA. He’s visited KANA for regular teeth cleanings and dental work for a number of years. He expressed gratitude and appreciation for how knowledgeable the dental staff is and how well they work together. “They really are at the top of their game,” Frost told us. “They are competent and kind, something you don’t see too much of these days.”

Frost says that the teamwork and knowledge that the dental department provides has influenced him to continue regular care. “They are delicate with the patient, careful about what they doing, and make you feel like you matter. The hard work and top-notch care that these providers are giving is beneficial to KANA’s Beneficiaries and should be recognized.”

Carolyn KnowlesHeather Parker

“These drivers are amazing. If it wasn’t for them, I never would have

gone to the doctor.”— Wendy Bridenstein

“The hard work and top notch-care that the providers are giving is beneficial to KANA’s Beneficiaries and should be recognized.”

— Marvin Frost

The Patient Experience

KANA Wellness Center Inspires Healthy Families

June and Adriane Horn were nominated as KANA Wellness Warriors earlier this year because of their consistency with nutrition and fitness in the gym as well as outside of the gym. They inspire their peers to maintain an active lifestyle and a healthy diet.

“Because of the Wellness Center staff taking an interest in me, I have made it a priority to work out a minimum of five

times a week,” says June. “I’ve lost weight, become stronger, and

have much more energy for everyday activities. My self-esteem and confidence have increased.”

June has struggled with injuries that have since fueled her motivation to exercise. Adjusting her workout routine to accommodate those injuries has helped June move forward with her goals. The Wellness Center provides her with a place to exercise year round and the staff provides encouragement and varied workouts. With time and patience, she has found that her regular exercise has actually improved her joint pain.

June’s diet, workouts, and a positive attitude have benefited both herself and her loved ones. “It’s important to me to be physically active with my children and grandchildren. I have the energy to spend more quality time with family and friends.”

“Because of the Wellness Center staff, I have made it a priority to work out a minimum of five times a week.” — June Horn

Adriane and June Horn

KANA Van Driver Terry Wolkoff

Registered Dental Hygienists Heather Parker and Carolyn Knowles


KANA’s PLL Program, under the leadership and coordination of Rozanne Rucker, PLL Therapist, and Chelsea Schleifer, PLL Case Manager, received the PLL Center of Excellence Award for achieving the “success” level in implementing the PLL model.

PLL is a program that started in 2012 at KANA. Directed toward adolescents and their family members, PLL provides therapy and support to these families to improve their mental health, relationships, and decrease the risk that children will have to travel off island for treatment.

This award recognizes the incredible work Rozanne and Chelsea have devoted to the PLL program, and the success they have seen. The PLL program served 20 families this year, setting a new record for clients served, surpassing the program enrollment expectations, and saving the healthcare system over

a million dollars in potential costs should these youth have had to travel off island for care.

Since its inception, PLL has grown steadily thanks to its devoted staff who have been committed to engaging clients, supporting them through treatment, and regularly following up to make sure that the families have made improvements.

“When parents first come into my office,” says Chelsea,“they are frustrated with their kids, but also concerned for them. Over the course of PLL, you can see the light bulbs turning on in their heads. By the end, they have concrete tools for a happier, more peaceful home. The award we received acknowledges all the hard work both we have done and that the families have done, because change does not always come easy. I love being part of positively changing a family’s story!”

Parenting with Love and Limits (PLL) Receives Center of Excellence Award

KANA was recognized for its commitment to health care in the Kodiak community as a 2016 Alaska Primary

Care Quality Excellence Award Winner and 2016 Primary Care Early Adaptor for Oral

Health Winner by Mountain-Pacific Quality Health (MPQH). The Quality Award is the highest honor given by Mountain-Pacific Quality Health. To be eligible for the award, facilities must

meet strict quality improvement goals and demonstrate exceptional commitment

to patient care. Recipients of the Early Adaptors for Oral Health Awards meet or exceed the Healthy People 2020 measures for dental sealants.

These awards were given in recognition of KANA’s commitment to high quality, accessible care for the Kodiak community and demonstration of achieving better clinical care and health outcomes, and the reduction of health costs through the use of technology for consumers and the community.

“Community health care providers are a critical part of our communities,” said Sharon Scudder, Alaska Director for Mountain-Pacific Quality Health. “Because of their continued dedication to improving healthcare, Alaska patients receive better quality care every day.”

Mountain-Pacific is the Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) for Alaska, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Mountain-Pacific brings together providers, practitioners, other partners, and patients to share and build knowledge, spread best practices and achieve improvement in patient care and our population’s health.

Two Awards from Mountain Pacific Quality Health

Awards and Recognition


“I love being a part of a program that makes a

difference not just for one person but for the whole

family. It’s been especially rewarding to have former

clients stop me at the grocery store months after completing the program to

say thank you and to tell me how well things are going for their family.”

— Rozanne Rucker PLL Therapist

On October 7, 2016 KANA was presented with the Cornerstone Award at the Kodiak Chamber of Commerce’s Annual Dinner held at the Kodiak Harbor Convention Center. KANA staff , along with six KANA Board members, attended the annual dinner. Julie Bonney, Kodiak Chamber of Commerce Vice President, presented awards to Chamber Members who made a significant impact on the Kodiak community during the previous year.

The Cornerstone Award is presented to one or more Chamber Members who, either through a special

project or through their history of service to the Kodiak community, have become

a cornerstone of the community, impacting both our businesses and

the lives of our Kodiak residents.

KANA received the Cornerstone Award for our commitment to the people of this island. KANA was recognized for the opening of

the Mill Bay Health Center which offers increased access to medical,

dental, and behavioral health services to the entire Kodiak community.

KANA was also recognized for partnering with the United States Department of Defense to present Arctic Care to the Kodiak Community in April 2016.

Two Awards from Mountain Pacific Quality Health KANA Receives the Cornerstone Award from the Kodiak Chamber of Commerce

RIGHT: Rozanne Rucker and Chelsea Schleifer received the PLL Center of Ex-

cellence Award this summer.


Statement of Financial PositionYear Ended September 30, 2016 (with comparative totals for 2015)

2016 2015

Assets

Current Assets Cash and cash equivalents $ 10,874,876 $ 8,921,827 Investments 2,753,818 2,229,198 Receivables: Grants 3,260,605 3,381,299 Patient accounts, net of allowance for contractual of $257,184 in 2016 and $15,257 in 2015 844,266 662,108 Other 1,398,768 1,679,581 Prepaid expenses 71,252 53,210

Current Assets 19,203,585 16,927,223

Investments in joint ventures 1,280,039 1,238,934Notes receivable and other long-term assets 767,044 807,710Property and equipment, net of accumulated depreciation 17,071,087 17,606,294

Total Assets $ 38,321,755 $ 36,580,161

Liabilities and Net Assets

Current Liabilities Accounts payable $ 596,662 $ 740,683 Accrued compensation and related liabilities 955,147 920,559 Accrued interest payable 3,881 10,279 Deferred revenue 5,000,955 4,262,098 Current portion of long-term note payable 214,681 202,337 Current portion under capital lease 42,820 19,388

Total Current Liabilities 6,814,146 6,155,344

Interest rate swap agreement 119,754 134,112Note payable, net of current portion 2,099,157 2,317,719Obligations under capital lease, net of current portion 81,471 94,914

Total Liabilities 9,114,528 8,702,089

Net assets - unrestricted: Undesignated 29,207,227 27,878,072

Total Liabilities and Net Assets $ 38,321,755 $ 36,580,161

FINANCIAL STATEMENTS


Statement of ActivitiesYear Ended September 30, 2016 (with comparative totals for 2015)

2016 2015

Revenues Grants and contracts $ 18,681,286 $ 21,215,411 Net patient service revenue 6,130,553 3,624,647 Contracted service revenue 912,612 1,147,605 Investment income 71,777 89,998 Earnings from joint ventures 351,660 446,306 Loss on disposal of assets - (12,423) Rental income 361,482 373,214 Other 79,235 78,008 IHS contract support settlement - 1,000,000

Total Revenues 26,588,605 27,962,766

Expenses Program services: Health services 19,149,634 16,478,284 Community services 4,866,215 4,510,459 Realty 512,416 241,113

Total program services 24,528,265 21,229,856

Supporting services: General and administrative, net of indirect cost recovery 509,741 1,053,411 Special and restricted general fund projects 221,444 641,082

Total supporting services 731,185 1,694,493

Total Expenses 25,259,450 22,924,349

Change in net assets 1,329,155 5,038,417

Unrestricted Net Assets, beginning of year 27,878,072 22,839,655

Unrestricted Net Assets, end of year $ 29,207,227 $ 27,878,072


Statement of Cash Flows Year Ended September 30, 2016 (with comparative totals for 2015)

2016 2015

Cash Flows from Operating Activities Change in net assets $ 1,329,155 $ 5,038,417 Adjustments to reconcile change in net assets to net cash from operating activities: Depreciation 1,039,128 964,407 Contributed capital from grants (212,715) (5,159,757) Gain on sale of equipment - 12,423 Change in fair value of interest rate swap agreement (14,358) (28,263) Equity in earnings of joint ventures in excess of distributions (41,105) (161,697) (Increase) decrease in current assets: Patient accounts (182,158) (109,155) Grants and other receivables 401,507 (2,289,218) Prepaid expenses (18,042) (26,512) IHS receivables - 3,797,610 Increase (decrease) in current liabilities: Accounts payable (144,021) (307,143) Accrued compensation and related liabilities 34,588 83,318 Accrued interest payable (6,398) (961) Deferred revenue 738,857 92,815

Net cash from operating activities 2,924,438 1,906,284 Cash Flows for Investing Activities Purchase of property and equipment (503,921) (6,229,823) Proceeds from sale of property and equipment - 1,878 Proceeds from payments on notes receivable 40,666 137,521 Proceeds from sale of certificates of deposit 1,457,998 969,440 Purchase of certificates of deposit (1,982,618) (1,470,000)

Net cash for investing activities (987,875) (6,590,984)

Cash Flows from Financing Activities Contributed capital from grants 212,715 5,159,757 Principal payments on long-term debt (196,229) (148,623)

Net cash from financing activities 16,486 5,011,134

Net increase in cash and cash equivalents 1,953,049 326,434

Cash and Cash Equivalents, beginning of year 8,921,827 8,595,393

Cash and Cash Equivalents, end of year $ 10,874,876 $ 8,921,827

Supplemental disclosure of cash flow information: Cash paid during the year for interest $ 146,627 $ 152,051



Combining Schedule of ExpensesYear Ended September 30, 2016 (with comparative totals for 2012, 2013, 2014, and 2015)

Current Ratio = Current Assets divided by Current Liabilities

This ratio measures the ability to pay back short-term liabilities (debt and payables) with short-term assets (cash, cash equivalents, unrestricted investments). The higher the current ratio, the more capable a company is of paying its obligations. A ratio under 1 suggests that the company would be unable to pay off its obligations if they came due at that point.

Days Cash on Hand = Cash and Cash Equivalents/Operating Expense Per Day

Measures how long, in days, an organization could meet operating expenses without receiving new income. Many organizations typically strive to maintain at least 90 days cash on hand.

Percentage of Budget for Personnel = Total wages, taxes and benefits divided by total expensesPercentage of costs for staffing.

Operating Expense Per Day = Total expenses before depreciation divided by 365

This describes the amount an organization spends per day, on average, to conduct activities.

RatiosYear Ended September 30, 2016 (with comparative totals for 2012, 2013, 2014, and 2015)

2012 2013 2014 2015 2016Salary, wage and fringe $ 8,977,964 9,655,367 10,037,372 11,382,484 13,383,273IPA/MOA 812,182 903,974 850,428 718,822 846,905Contractual services 2,788,335 3,447,842 3,250,807 3,636,243 3,848,797Travel and per diem 1,336,440 1,332,356 1,625,026 2,073,120 1,937,257Facilities expense 972,617 889,246 1,166,954 947,850 1,164,387Supplies 1,091,535 1,013,467 997,357 1,352,692 1,422,139Contributions 558,261 641,071 486,275 482,501 497,049Other expense 1,059,458 916,126 1,070,456 1,366,230 1,120,515Depreciation 747,828 786,973 888,097 964,407 1,039,128

Total $ 18,344,620 19,586,422 20,372,772 22,924,349 25,259,450

2012 2013 2014 2015 2016Current Ratio 2.71 2.54 2.78 2.75 2.82Days Cash on Hand 173.25 178.58 193.40 185.34 205.38Percentage of Budget for Personnel 53.37% 53.91% 53.44% 52.79% 56.34%Operating Expense Per Day $ 48,210.39 51,505.34 53,382.67 60,164.22 66,357.05


FINANCIAL

Financial SummaryYear Ended September 30, 2016

KANA raises funds through investment earnings, joint ventures, patient service revenue, and rental income in order to provide the

highest level of services for our Beneficiaries.

77% Health Services

20% Community Services

3% Administrative Services

Use of FundsIncome Sources 82% Federal resources

14% State of Alaska

4% Private or other sources

l Health Services – $19,149,634

l Community Services – $4,866,215

l General and Administrative – $509,741

l Special Projects – $221,444

2% 1%

20%

77%

2016 Functional Expenses

Assets & Beneficiaries’ Equity

l Total Assets l Beneficiaries’ Equity

2016

2015

2014

2013

2012

$38,321,755$29,207,227

$36,580,161$27,878,072

$31,850,601$22,839,655

$24,833,913$17,122,166

$24,314,185$16,592,394



FINANCIAL

Financial SummaryYear Ended September 30, 2016

l Compacts, Grants, and Contracts – $18,681,286

l Net Patient Services Revenue – $6,130,553

l Contracted Service Revenue – $912,612

l Investment Income – $71,777

l Earnings from Joint Ventures – $351,660

l Rental Income – $361,482

l Other – $79,235

2016 Revenue3.43%

0.27%

1.32%1.36%

0.30%

70.26%

23.06%

$ 13,

248,

370

$ 13,

972,

366

$ 14,

366,

298

$ 15,

956,

698

$ 16,

345,

876

$ 19,

345,

852

$ 20,

043,

715

$ 20,

116,

194

$ 26,

090,

261

$ 27,

962,

766

$ 26,

588,

605

KANA Total Revenue by Fiscal Year

$30,000,000

$25,000,000

$20,000,000

$15,000,000

$10,000,000

$5,000,000

$0

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016


kodiakhealthcare.org

ON THE COVER: Logan Peterson performs at an Alutiiq dance workshop during the

2017 Ouzinkie Summer Challenge.

3449 Rezanof Drive East | Kodiak, Alaska 99615 | kodiakhealthcare.org

Alutiiq Enwia Health Center 907.486.9800 or Toll Free 1.800.478.5721

Medical 907.486.9870 Dental 907.486.9850

Pharmacy 907.486.9860

Mill Bay Health Center 907.486.7300

Community Services Center 907.486.9879

Wellness Center 907.486.1377

Kodiak Child Advocacy Center 907.486.9878

Akhiok Health Clinic 907.836.2230

Karluk Health Clinic 907.241.2212

Larsen Bay Health Clinic 907.847.2208

Old Harbor Health Clinic 907.286.2205 or 907.286.2307

Ouzinkie Health Clinic 907.680.2265 or 907.680.2262

Port Lions Health Clinic 907.454.2275

Village Clinics

Kodiak Clinics & Offices

Documents

KODIAK AREA NATIVE ASSOCIATIONkodiakhealthcare.org/wp-content/uploads/2016/12/2017... · 2017-10-06 · resident’s Letter2 P –2022 Strategic Plan3 2017 ur Organization4 O ur Core