Alaska Tribe Wins $5M to Open First Tribally Led Addiction Center

The Ketchikan Indian Community has $5 million to convert a foreclosed waterfront resort into what the Southeast Alaska tribe describes as the state's first tribally led addiction healing center — one of the largest awards in a federal rural health package that Alaska officials announced Thursday.

The money arrives as part of nearly $249 million in Rural Health Transformation Program funding for 254 Alaska projects, a tranche that closed out the first year of the state's five-year allocation. Most of the projects are unglamorous infrastructure: portable X-ray units in Northwest Arctic village clinics, a telehealth network linking expectant mothers in 32 Interior communities to obstetric and lactation specialists, remote monitoring in Nome and 15 surrounding villages. The healing center is one of the few awards aimed squarely at substance use treatment.

From a foreclosed resort to treatment beds

The tribe bought the former Salmon Falls Resort last year after the 11-acre property went into foreclosure. The site came with a restaurant, a boat dock, bunkhouses and guest rooms that can sleep more than 50 people, plus room to expand — an unusual starting point for a treatment project, where the usual barrier is construction cost rather than furniture.

Ketchikan Indian Community will spend the grant on facility renovations and information technology upgrades. Tribal administrator and chief executive Emily Edenshaw said the award settles the physical plant question and leaves the harder work ahead.

"I'm really, really grateful for this incredible gift," Edenshaw told KRBD. "And you know, now the real work begins."

The center is not yet treating anyone. Edenshaw said the tribe hopes to start peer support groups there next year, with timing tied to construction. That sequencing matters: peer support can open before clinical licensure and staffing are in place, which gives a rural provider a way to begin serving people while the slower pieces — clinicians, billing, certification — come together.

Open to people who are not tribal members

Tribally operated healing centers in other parts of the country have sometimes limited admission to enrolled members. Ketchikan Indian Community plans the opposite. Edenshaw said the facility will be open to everyone, a decision that widens the pool of patients the center can reach in a region where long-term residential treatment beds are scarce and often require a flight out of the community.

Ketchikan sits on an island in Southeast Alaska, reachable by air or ferry, in a state with no road connection to the contiguous United States. For a person in opioid use disorder who needs residential care, that geography turns a routine referral into an expensive, multi-leg trip away from family, housing and employment. A facility with more than 50 beds inside the region changes the arithmetic for everyone on the island, Native and non-Native alike.

The project also drew local friction. North-end residents objected earlier this year when the tribe asked to rezone the property, and the Ketchikan Gateway Borough Assembly ultimately approved the request.

The federal program writing the checks

The Rural Health Transformation Program is a roughly $50 billion, five-year initiative created in the Working Families Tax Cuts Act, structured as state allocations rather than competitive national grants. Sen. Dan Sullivan said Alaska is slated for $1.4 billion over five years, and Sen. Lisa Murkowski took credit for steering the state's share.

"Access to quality health care in the communities they call home is critical for Alaska families," Gov. Mike Dunleavy said in the federal announcement. "The Rural Health Transformation Program gives us an opportunity to strengthen that access."

The program's breadth is the point and also the problem for anyone trying to track it. Health and Human Services Secretary Robert F. Kennedy Jr. framed the money as flexibility plus accountability; CMS Administrator Mehmet Oz described it as federal investment that puts patients first. But the awards run from robotic surgery at PeaceHealth Ketchikan Medical Center — nearly $7 million — to mobile integrated health units, pharmacies and nonprofits on Prince of Wales Island. Addiction treatment is a slice of the package, not its spine.

Advocacy groups have pressed CMS for months over how states disclose who gets the money and what it buys, a transparency fight this site covered in August. Alaska is ahead of most states on that front — it publishes award lists and maintains a program page — but a published award is not the same as a measured outcome.

What the tribe still has to build

Renovations and IT are funded. Staffing is not. Edenshaw said the tribe will pursue additional rural health money to keep developing the facility and is building a website to post information about the center as it opens.

That leaves the questions that decide whether a healing center becomes a treatment provider or a building with a good story: whether it can hire and keep licensed clinicians in a town of roughly 8,000 people, whether it will bill Medicaid and commercial insurance or rely on grants, and whether "healing" is defined broadly enough to include medication-assisted treatment, which remains the standard of care for opioid use disorder and is not universally embraced in every recovery community.

The tribe has cleared the hardest hurdle — a site, a grant and a local government that said yes. The next year will show whether the rest follows.