Unalaska is paying $800,000 to keep its emergency room open around the clock

The emergency room in Unalaska stays open around the clock because the city pays to keep it that way. Iliuliuk Family Health Services is getting $800,000 from the city for after-hours urgent and emergency care, the same as last year.

The money covers on-call clinical staffing, keeping equipment ready and the supplies that have to be on hand whether anyone walks in or not. "Patient revenue alone is markedly insufficient to sustain 24/7 emergency-ready services," the clinic wrote in its application.

The request had climbed above $1 million in fiscal 2025 before settling back to $800,000.

Paying it takes the city past its own formula. Unalaska sizes its community grant pool at 3.5 percent of average general fund revenue plus what is sitting in its bed-tax and tobacco-tax accounts, and it now spends that pool out every year. Staff describe the formula as "a guide, not a limit."

Eight organizations asked the city for a combined $2,252,752 this year, and the council approved every request. Iliuliuk's is the largest by a wide margin, taking more than a third of the total; the remaining seven split about $1.45 million.

The council also backed the clinic's Rural Health Transformation Program proposal in February.