`Case: 1:21-op-45043-DAP Doc #: 1 Filed: 03/25/21 1 of 65. PageID #: 1
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`UNITED STATES DISTRICT COURT
`NORTHERN DISTRICT OF OHIO
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`Case No. ______
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`COMPLAINT
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`JURY TRIAL DEMANDED
`
`
`ALASKA NATIVE TRIBAL HEALTH
`CONSORTIUM;
`ALEUTIAN PRIBILOF ISLANDS
`ASSOCIATION, INC.;
`BRISTOL BAY AREA HEALTH
`CORPORATION;
`KODIAK AREA NATIVE ASSOCIATION;
`NORTON SOUND HEALTH
`CORPORATION;
`SOUTHEAST ALASKA REGIONAL
`HEALTH CONSORTIUM,
`
`
`Plaintiffs,
`
`
`vs.
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`MCKINSEY & COMPANY, INC.,
`
`
`Defendant.
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`TABLE OF CONTENTS
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`Page
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`C.
`D.
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`E.
`F.
`G.
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`INTRODUCTION ............................................................................................................. 1
`JURISDICTION AND VENUE ........................................................................................ 2
`PARTIES ........................................................................................................................... 3
`A.
`Plaintiff Tribal Organizations ................................................................................ 3
`B.
`Defendant ............................................................................................................. 17
`FACTUAL ALLEGATIONS COMMON TO ALL CLAIMS ........................................ 17
`A.
`The Corporate Integrity Agreement ..................................................................... 17
`B.
`McKinsey’s Role Following the Corporate Integrity Agreement ........................ 18
`1.
`The Sacklers seek to divert money to themselves. .................................. 18
`2.
`McKinsey supplied Purdue with Granular Sales and Marketing
`Strategies and Remained Intimately Involved in Implementation. ......... 19
`Project Turbocharge ............................................................................................. 20
`McKinsey Knew About the Dangers of Opioids and Acted to Maximize
`OxyContin Prescriptions Anyway ....................................................................... 22
`Purdue’s 2020 Guilty Plea and McKinsey’s Recent Statement ........................... 23
`The Impact of the Opioid Crisis in Alaska .......................................................... 24
`The Impact of Opioid Abuse, Addiction, and Diversion on American
`Indians and Alaska Natives .................................................................................. 25
`The Impact of McKinsey’s Work with Opioid Manufacturers on Plaintiffs ...... 28
`Tolling of Statutes of Limitations ........................................................................ 30
`1.
`Equitable Estoppel and Fraudulent Concealment .................................... 30
`2.
`McKinsey and Purdue Persisted in The Fraudulent Scheme Despite
`a Guilty Plea and Large Fine. .................................................................. 32
`FACTUAL ALLEGATIONS PERTAINING TO CLAIMS UNDER THE
`RACKETEER INFLUENCED AND CORRUPT ORGANIZATIONS (RICO)
`ACT: THE OPIOID MARKETING ENTERPRISE ....................................................... 33
`A.
`The Common Purpose and Scheme of the Opioid Marketing Enterprise ............ 33
`B.
`The Conduct of the Opioid Marketing Enterprise Violated Civil RICO ............. 36
`C.
`Pattern of Racketeering Activity .......................................................................... 37
`CAUSES OF ACTION .................................................................................................... 41
`A.
`Racketeer Influenced and Corrupt Organizations Act (RICO), 18 U.S.C.
`§ 1961, et. seq. ..................................................................................................... 41
`
`H.
`I.
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`- i -
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`
`
`
`I.
`II.
`III.
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`IV.
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`V.
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`VI.
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`

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`TABLE OF CONTENTS
`(continued)
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`Page
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`B.
`C.
`D.
`E.
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`Negligence under Alaska Law ............................................................................. 50
`Public Nuisance under Alaska Law ..................................................................... 52
`Fraud under Alaska Law ...................................................................................... 55
`Unfair Competition (Alaska Unfair Trade Practices and Consumer
`Protection Act AS § 45.50.471, et seq.) ............................................................... 56
`Civil Conspiracy under Alaska Law .................................................................... 58
`F.
`Unjust Enrichment under Alaska Law ................................................................. 59
`G.
`PRAYER FOR RELIEF .................................................................................................. 61
`JURY DEMAND ............................................................................................................. 62
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`
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`VII.
`VIII.
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`I.
`This case arises from the worst man-made epidemic in modern medical history—
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`INTRODUCTION
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`1.
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`the misuse, abuse, and over-prescription of opioids. This crisis arose from the opioid
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`manufacturers’ deliberately deceptive marketing strategy to expand opioid use.
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`2.
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`McKinsey and Company, Inc. (“McKinsey” or “Defendant”), played an integral
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`role in creating and deepening the opioid crisis.
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`3.
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`In the years following Purdue Pharma L.P.’s (“Purdue”) 2007 guilty plea for
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`misleadingly marketing OxyContin, McKinsey worked closely with Purdue to dramatically
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`increase OxyContin sales to the benefit of McKinsey, Purdue, and the Sackler family, the
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`wealthy family that has owned and controlled Purdue for decades. McKinsey specifically sought
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`to maximize OxyContin sales by working around the requirements of the Corporate Integrity
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`Agreement that Purdue entered as part of its guilty plea. McKinsey also performed related work
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`for other manufacturers of opioids, including Johnson & Johnson. Through the conduct
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`described in this Complaint, McKinsey participated in and helped orchestrate a broad scheme to
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`deceptively market opioids.
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`4.
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`McKinsey knew of the dangers of opioids and of Purdue’s prior misconduct, but
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`nonetheless advised Purdue to improperly market and sell OxyContin, supplying granular sales
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`and marketing strategies and remaining intimately involved throughout implementation of those
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`strategies. McKinsey’s actions resulted in a surge in sales of OxyContin and other opioids that
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`fueled and prolonged the opioid crisis.
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`5.
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`As reported in the media, in a series of agreements, McKinsey recently settled
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`opioid-related claims with 49 states, the District of Columbia, and five U.S. territories.
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`6.
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`Plaintiffs are inter-tribal consortia and Tribal Organizations (“Plaintiffs”)
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`responsible for providing healthcare services to the citizens of their constituent tribes in Alaska.
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`COMPLAINT
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`Native Americans have disproportionately borne the toll of the opioid crisis. Plaintiffs bring suit
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`to hold McKinsey responsible for its role in that crisis, which has posed an existential threat to
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`tribes and tribal communities.
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`7.
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`Plaintiffs bring this action in their proprietary capacity and pursuant to their
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`interests to protect the health, safety, and welfare of the citizens of their constituent tribes to stop
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`the opioid epidemic in Alaska and to recover damages and seek other redress from harm caused
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`by McKinsey’s improper marketing practices and other unlawful conduct related to prescription
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`opioids.
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`II.
`This Court has subject matter jurisdiction over this action because the Plaintiffs
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`JURISDICTION AND VENUE
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`8.
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`bring a federal cause of action that raises a federal question pursuant to 28 U.S.C. § 1331. The
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`Court also has supplemental jurisdiction over the Plaintiffs’ state law claims pursuant to 28
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`U.S.C. § 1367 because the state law claims are part of the same case or controversy.
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`9.
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`This Court independently has subject matter jurisdiction over Plaintiffs’ state law
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`claims under 28 U.S.C. § 1332(a)(2) because the matter in controversy exceeds the sum of
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`$75,000 and the Defendant is not a citizen of the same state as the Plaintiffs.
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`10.
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`This Court has personal jurisdiction over McKinsey because at all relevant
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`times, McKinsey purposely availed itself of the privilege of doing business in the State of Ohio
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`and in this District, including by engaging in the business of researching, designing, and
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`implementing marketing and promoting strategies for various opioid manufacturers, including
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`Purdue, in support of their sales and marketing of opioids in Ohio.
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`11.
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`Venue is proper in the United States District Court for the Northern District of
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`Ohio under 28 U.S.C. § 1391(g) and 18 U.S.C. § 1965, and pursuant to paragraph 6(a) of Case
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`Management Order 1, issued by this Court on April 11, 2018 in case number 1:17-CV-2804.
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`COMPLAINT
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`Plaintiffs hereby assert that, but for that Order permitting direct filing in this District, Plaintiffs
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`would have filed their cases in the United States District Court for the District of Alaska, because
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`a substantial part of the events or omissions giving rise to this action occurred in Alaska and
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`because the Defendant is subject to the jurisdiction of the United States District Court for the
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`District of Alaska. Defendant purposely availed itself of the privilege of doing business in the
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`State of Alaska, including by engaging in the business of researching, designing, and
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`implementing marketing and promoting strategies for various opioid manufacturers, including
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`Purdue, in support of their sales and marketing of opioids in Alaska.
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`III.
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`PARTIES
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`Plaintiff Tribal Organizations
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`Plaintiffs are inter-tribal consortia and tribal organizations in Alaska providing
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`A.
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`12.
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`health care and other services to American Indians and Alaska Natives, and to other eligible
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`individuals in the State of Alaska, pursuant to Title V of the Indian Self-Determination and
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`Education Assistance Act (ISDEAA), 25 U.S.C. §§ 5301, et seq., and the Alaska Tribal Health
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`Compact. The ISDEAA authorizes tribes and tribal organizations like the Plaintiffs to enter into
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`contracts and compacts to assume responsibility to provide programs and services that the
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`federal government would otherwise be obligated to provide for the benefit of American Indians
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`and Alaska Natives. The Alaska Tribal Health Compact is the umbrella agreement, entered into
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`between Alaska Native tribes and tribal organizations in Alaska and the Indian Health Service
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`(IHS) pursuant to Title V of the ISDEAA, that authorizes those tribes and tribal organizations to
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`operate health and health-related programs formerly operated by the IHS. In addition, each tribal
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`co-signer to the Alaska Tribal Health Compact enters into separate funding agreements with the
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`IHS that govern the scope of programs and services to be performed.
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`COMPLAINT
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`13.
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`Over 99% of the IHS budget in Alaska is administered by tribes and tribal health
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`programs under the Alaska Tribal Health Compact and other ISDEAA agreements. The Alaska
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`Tribal Health System, which administers these programs and services, is composed of individual
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`tribes and tribal organizations throughout Alaska, twelve regional health consortia, and a
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`statewide consortium, all of which are interconnected through sophisticated patterns of referral.
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`14.
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`The Plaintiffs have standing to recover damages incurred because of Defendant’s
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`actions and omissions. Plaintiffs have standing to bring all claims pled herein, including, inter
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`alia, to bring claims under the federal RICO statutes, pursuant to 18 U.S.C. § 1961(3) (“persons”
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`includes entities which can hold legal title to property) and 18 U.S.C. § 1964 (“persons” have
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`standing).
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`Alaska Native Tribal Health Consortium
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`15.
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`Plaintiff Alaska Native Tribal Health Consortium (ANTHC) is a tribal health
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`organization in Alaska providing health care services to American Indians and Alaska Natives,
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`and to other eligible individuals in the State of Alaska, pursuant to Title V of the ISDEAA, 25
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`U.S.C. §§ 5301, et seq., and the Alaska Tribal Health Compact.
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`16.
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`ANTHC is an Alaska non-profit corporation with its principal place of business in
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`Anchorage, Alaska. ANTHC is Alaska’s statewide intertribal health consortium. ANTHC was
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`formed pursuant to Section 325 of Public Law 105-83 to carry out statewide programs of the IHS
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`under Title V of the ISDEAA and the Alaska Tribal Health Compact. ANTHC is collectively
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`managed by, and operated for the benefit of, the 229 federally recognized Alaska Native tribes
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`and provides a wide range of medical, community health, and other services for more than
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`158,000 Alaska Native and American Indian people across the State.
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`17.
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`As part of these services, ANTHC co-manages the Alaska Native Medical Center
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`(ANMC), a 173-bed tertiary-care hospital located in Anchorage, through which it provides
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`comprehensive medical services, including inpatient hospital care and specialty care, for the
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`entire Alaska Tribal Health System. These services include critical care, emergency medicine,
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`internal medicine, ophthalmology, orthopedic, otolaryngology, surgery services, cardiology,
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`hematology-oncology, clinical and anatomic laboratory, imaging, pharmacy, respiratory care,
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`and social services.
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`18.
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`ANTHC also provides a range of additional health services for the benefit of
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`Alaska Natives throughout the State including wellness programs, disease research and
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`prevention, and rural provider training. ANTHC supports efforts in public health, traditional
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`foods and nutrition, epidemiology, environmental health, dental health education, and more.
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`19.
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`In accordance with applicable provisions of law, its ISDEAA agreements with the
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`IHS, and applicable policies approved by the ANTHC Board of Directors and ANMC Joint
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`Operating Board, ANTHC provides its full array of direct services to the following individuals
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`who are IHS beneficiaries and thus exempt from payment, regardless of ability to pay: American
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`Indians and Alaska Natives; children of eligible Alaska Natives or American Indians, including
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`non-Indian foster children, adopted children, stepchildren, legal wards, or orphans, until they
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`reach the age of nineteen; and legally incompetent non-Indian adults who were eligible as a child
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`of an eligible Alaska Native or American Indian when they became incompetent, until one year
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`after the disability no longer exists.
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`20.
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`In addition, ANTHC provides limited categories of services to the following
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`individuals who are IHS beneficiaries and thus exempt from payment: Non-Indian women
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`pregnant with an eligible American Indian or Alaska Native man’s child, for pregnancy-related
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`and postpartum services; immediate family members of an eligible American Indian or Alaska
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`Native, for services directly related to the treatment of the eligible family member; and other
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`non-beneficiaries on an as-needed basis in order to control acute infectious disease or a public
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`health hazard. ANTHC also provides certain services to individuals as allowed by 25 U.S.C.
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`§ 1680c, including individuals who receive services from other tribal health organizations in
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`Alaska. Further, in accordance with the Emergency Medical Treatment and Active Labor Act
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`(EMTALA), ANMC provides emergency medical screening and stabilization to all individuals,
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`including those who are not otherwise eligible for services.
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`21.
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`ANTHC is the largest, most comprehensive Tribal Health Organization in the
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`United States, and Alaska’s second-largest health employer, with more than 3,000 employees
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`offering an array of health services to people around the nation’s largest state.
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`22.
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`ANTHC serves high-needs populations with limited resources, including in
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`remote areas where access to other providers may not exist or would require a boat ride or flight.
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`Because of the remote nature, the per-patient costs are higher in Alaska and the areas served by
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`ANTHC. The diversion of funding to address a public health crisis like the opioid epidemic,
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`including associated overhead and administrative costs, has devastating impacts on the ability of
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`ANTHC to provide an adequate level of basic health care and needed specialty care in these
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`areas, meet its obligations under the ISDEAA and agreements with the IHS, and carry out its
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`organizational mission.
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`Aleutian Pribilof Islands Association, Inc.
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`23.
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`Plaintiff Aleutian Pribilof Islands Association, Inc. (APIA), is the Tribal
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`Organization of the Aleut people in Alaska, with its principal place of business in Anchorage,
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`Alaska. It was created by the merger of two predecessor organizations: The Aleut League,
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`formed in 1966, and the Aleutian Planning Commission, formed a few years later. APIA was
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`chartered in 1976. APIA represents 13 Tribes located in the Aleutian Islands, which extend
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`westward over 1,100 miles from the southwestern corner of the Alaska mainland, and include the
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`Pribilof Islands, which lie to the north. This area is distributed over approximately 100,000
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`square miles.1
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`24.
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`APIA provides a broad range of governmental services, including health care
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`services, to American Indians and Alaska Natives and to other eligible individuals in the State of
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`Alaska, pursuant to Titles IV and V of the ISDEAA. These services include health, education,
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`social, psychological, employment and vocational training, family services, public safety
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`services, community development, environmental programs, energy, and traditional foods.2
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`25.
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`APIA operates in one of the most isolated regions of the country, and it is the sole
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`health care provider in most communities in the service area. APIA serves high-needs
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`populations with limited resources, including in remote areas where access to other providers
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`does not exist or, at the very least, would require a flight (sometimes in a floatplane) or a boat
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`ride to a larger community.
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`26.
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`APIA provides health care services in Atka, Nikolski, St. George, and Unalaska to
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`American Indians and Alaska Natives and to other eligible individuals within its service area. In
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`the communities of Atka, Nikolski, and St. George, Plaintiff operates HRSA-designated
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`Community Health Centers, which provide primary and emergency services to the general
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`public, regardless of ability to pay.
`
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`1 Plaintiff’s Member Tribes include: Agdaagux Tribal Council for the Agdaagux Tribe of King Cove; Akutan Tribal
`Council for the Native Village of Akutan; Atka IRA Council for the Native Village of Atka; Belkofski Tribal Council
`for the Native Village of Belkofski; False Pass Tribal Council for the Native Village of False Pass; Nelson Lagoon
`Tribal Council for the Native Village of Nelson Lagoon; Nikolski IRA Council for the Native Village of Nikolski;
`Pauloff Harbor Tribe; Qagan Tayagungin Tribe of Sand Point; Qawalangin Tribal Council for the Qawalangin Tribe
`of Unalaska; St. George Traditional Council for the Pribilof Island Aleut Community of St. George; Tribal
`Government of St. Paul Island for the Pribilof Island Aleut Community of St. Paul; and Unga Tribal Council for the
`Native Village of Unga.
`2 Plaintiff’s Mission is: “To provide self-sufficiency and independence of the Unangan/Unangas by advocacy, training,
`technical assistance and economic enhancement; To assist in meeting the health, safety and well-being needs of each
`Unangan/Unangas community; To promote, strengthen and ensure the unity of the Unangan; and To strengthen and
`preserve Unangax cultural heritage.”
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`27.
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`APIA’s Oonalaska Wellness Center (OWC) in Unalaska is staffed with a mid-
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`level provider and regional medical director, while APIA’s health clinics in Atka and Nikolski
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`share a mid-level provider and Community Health Aides/Practitioners (CHA/P).3 The St.
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`George Health Center is staffed with a mid-level provider as well as CHA/P.
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`28.
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`APIA provides behavioral health services for children, youth, and adults, which
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`includes individual therapy, group therapy, crisis/emergency services, case management, and
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`substance use services.
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`29.
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`APIA’s outpatient substance use services are located in Anchorage, Unalaska, and
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`are also provided through telehealth. APIA’s substance use services programs include a
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`community reinforcement approach and family training program, continuing care, and an
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`Intensive Outpatient Program (IOP) based in Anchorage. IOP patients meet as a group with
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`regional patients for group counseling via tele-video that is facilitated in the Anchorage Office.
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`The doctor-level clinicians have been primarily in APIA’s Anchorage office. APIA’s outpatient
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`substance use services are intended for adults who suffer from addiction and substance use
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`issues.
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`30.
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`APIA has two clinicians and a behavioral health aide who have worked out of its
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`Unalaska Behavioral Health clinic for the past several years. The clinicians are typically master-
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`level clinicians. APIA also has had a behavioral health aide working in both the Atka and St.
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`George clinics for the past few years.
`
`31.
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`APIA also provides community-based training as well as EMS-related supplies
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`and equipment.
`
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`3 See Alaska Community Health Aide Program, About the CHAP Program, https://akchap.org/about (last accessed
`Mar. 15, 2021).
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`32.
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`In addition to health care services, APIA provides Village Public Safety Officers
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`(VPSOs) to the Aleutian Pribilof regional communities. VPSOs perform law enforcement duties
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`and are first responders to many types of emergencies, including but not limited to fire, medical,
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`and search and rescue.
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`33.
`
`In collaboration with Unalaskans Against Sexual Assault and Family Violence in
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`Unalaska, APIA administers the Family Violence grant, which provides funds for immediate
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`shelter and support services to adult and youth victims, and their dependents, of family violence,
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`domestic violence, or dating violence, while also providing funds for prevention training and
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`services.
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`34.
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`APIA’s Indian Child Welfare Act (ICWA, 25 U.S.C. §§ 1901-1963) Program
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`serves as the Tribal Representative and represents Tribal children on behalf of twelve of the
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`Tribes in the region by intervening when families are involved with child protection services.
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`APIA also provides Family Services, including childcare.
`
`35.
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`APIA also provides supportive services to help those in APIA’s service area gain
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`volunteer and work experience to increase marketable job skills and build resumes and cover
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`letters to obtain full-time, unsubsidized employment after the training period.
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`36.
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`The diversion of funding to address a public health crisis like the opioid epidemic,
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`including associated overhead and administrative costs, can have devastating impacts on the
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`ability of APIA to provide an adequate level of basic health care and other needed specialty care
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`in these areas, meet its obligations under the ISDEAA and agreements with the IHS, and carry
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`out its organizational missions.
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`Bristol Bay Area Health Corporation
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`37.
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`Plaintiff Bristol Bay Area Health Corporation (BBAHC) is a tribal health
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`organization in Alaska providing health care services to American Indians and Alaska Natives
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`and to other eligible individuals in the State of Alaska, pursuant to Title V of the ISDEAA and
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`the Alaska Tribal Health Compact.
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`38.
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`BBAHC is a non-profit health care organization and one of the Alaska Tribal
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`Health System’s regional tribal health organizations, serving the needs of the residents of the
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`Bristol Bay region of Alaska, with its principal place of business in Dillingham, Alaska.
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`39.
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`Formed in 1973, BBAHC serves 28 villages in the Bristol Bay region and carries
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`out programs of the IHS under Title V of the ISDEAA and the Alaska Tribal Health Compact.
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`As part of these services, BBAHC manages an Emergency Department, a Substance Use
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`Disorder residential treatment facility that provides both inpatient and outpatient services, and 21
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`village-based clinics, including the H. Sally Smith building that houses its Dental Clinic
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`Program.
`
`40.
`
`BBAHC serves high-needs populations with limited resources, including in
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`remote areas where access to other providers may not exist or would require a boat ride or flight.
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`Because of the remote nature, the per-patient costs are higher in Alaska and the areas served by
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`BBAHC. Further, in accordance with the EMTALA, BBAHC provides emergency medical
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`screening and stabilization to all individuals, including those who are not otherwise eligible for
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`services.
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`41.
`
`The diversion of funding to address a public health crisis like the opioid epidemic,
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`including associated overhead and administrative costs, can have devastating impacts on the
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`ability of BBAHC to provide an adequate level of basic health care and other needed specialty
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`care in these areas, meet its obligations under the ISDEAA and agreements with the IHS, and
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`carry out its organizational mission.
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` Kodiak Area Native Association
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`42.
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`Plaintiff Kodiak Area Native Association (KANA) is a non-profit corporation
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`providing health care and social services for Alaska Natives throughout the Koniag region of
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`Alaska, with its principal place of business in Kodiak, Alaska. KANA works to provide
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`integrated wellness services for the entire Kodiak Island community, with a focus on Alaska
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`Native beneficiaries and implementation of Sugpiaq Alutiiq cultural values.
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`43.
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`The KANA service area includes the City of Kodiak and six remote Alaska
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`Native villages (Akhiok, Karluk, Larsen Bay, Old Harbor, Ouzinkie, and Port Lions)
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`encompassing ten federally recognized Tribes of Kodiak Island. The City of Kodiak, situated at
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`the northeastern tip of the island, is about 250 miles south of Anchorage. The city serves as the
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`major supply and transportation hub for the archipelago’s six village communities. Five are
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`located on Kodiak Island and one is on Spruce Island, on the northern end of the archipelago.
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`Each of the rural communities can be reached only by aircraft or boat.
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`44.
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`KANA takes a patient-centered approach to wellness and provides medical,
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`dental, and behavioral health care. In addition, KANA provides an array of community services,
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`including but not limited to infant learning and child advocacy, child welfare services under the
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`Indian Child Welfare Act; Tribal Temporary Assistance for Needy Families; Women, Infants,
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`and Children; employment training and services; Tribal Vocational Rehabilitation Program;
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`economic development; and legal aid for qualifying patients.
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`45.
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`KANA’s community services are carried out pursuant to contracts with the
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`Bureau of Indian Affairs under Title I of the ISDEAA and pursuant to Public Law 102-477
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`COMPLAINT
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`(commonly referred to as the “477 Program”), which authorizes tribal governments to
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`consolidate up to thirteen different programs from the Department of the Interior, Department of
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`Labor, Department of Education, and Department of Health and Human Services into a single
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`plan, approved by the Secretary of the Interior, to foster employment and economic development
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`in Indian Country. The KANA 477 Program serves the region’s tribes with a variety of
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`programs depending on the authorizing resolutions.
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`46.
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`KANA also offers a Chemical Dependency Program to assist those who suffer
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`from addiction and substance use disorder. The program is staffed with Certified Chemical
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`Dependency Counselors. Through the program, KANA provides anger management services,
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`treatment planning, intensive outpatient and outpatient services, individual and group therapy,
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`and village-based substance abuse treatment monitored by behavioral health associates. KANA
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`provides medication-assisted treatment for opioid use disorders.
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`47.
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`Further, KANA implements the VPSO as a means of providing rural Alaskan
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`communities with needed public safety services at the local level to reduce the loss of life due to
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`fires, drowning, lost persons, and the lack of immediate emergency medical assistance in rural
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`communities. Through KANA’s partnership with the Alaska State Troopers and local village
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`and city councils, the VPSO presence on the island of Kodiak is viewed as a positive approach to
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`public safety.
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`48.
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`KANA serves high-needs populations with limited resources, including in remote
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`areas where access to other service providers may not exist or would require a boat ride or flight.
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`The diversion of funding to address a public health crisis like the opioid epidemic, including
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`associated overhead and administrative costs, can have devastating impacts on KANA’s ability
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`to provide an adequate level of basic health care and other basic community services in these
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`COMPLAINT
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`remote areas, meet its obligations under federal laws and agreements with agencies of the federal
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`government, and carry out its organizational mission.
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`Norton Sound Health Corporation
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`49.
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`Plaintiff Norton Sound Health Corporation (NSHC) is a tribal health organization
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`in Alaska providing health care services to American Indians and Alaska Natives and to other
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`eligible individuals in the State of Alaska, pursuant to Title V of the ISDEAA and the Alaska
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`Tribal Health Compact.
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`50.
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`NSHC is a non-profit health care organization and one of the Alaska Tribal
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`Health System’s regional tribal health organizations serving the health needs of the residents of
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`the Bering Strait region of Alaska, with its principal place of business in Nome, Alaska. NSHC
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`was established in 1970.
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`51.
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`NSHC is owned and managed by the 20 federally recognized tribes of the Bering
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`Strait region. NSHC operates the Norton Sound Regional Hospital in Nome, Alaska, and 15
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`village-based clinics. The rural and remote Arctic region remains unconnected by roads and is
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`located 500 air miles from Alaska’s economic hub of Anchorage. NSHC serves the communities
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`of: Brevig Mission, Council, Diomede, Elim, Gambell, Golovin, King Island, Koyuk, Mary’s
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`Igloo, Nome, St. Michael, Savoonga, Shaktoolik, Shishmaref, Solomon, Stebbins, Teller,
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`Unalakleet, Wales, and White Mountain. The service area encompasses 44,000 square miles.
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`52.
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`Further, in accordance with the EMTALA, Plaintiff provides emergency medical
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`screening and stabilization to all individuals, including those who are not otherwise eligible for
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`services.
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`53. While the majority of NSHC’s 500 employees are based in Nome, many staff
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`members regularly travel to villages to treat patients. Each village has a clinic staffed by local
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`COMPLAINT
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`residents trained as community health aides. These front-line primary care providers are a
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`critical link between patients and medical staff in Nome. Seven villages in NSHC’s region have
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`a full-time physician assistant or nurse practitioner. Unalakleet is currently one of NSHC’s
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`functional Sub-Regional Clinics that is staffed with community health aides