[awf-ahy-luhnd, of-]
located or tending away from the shore of an island: an off-island current.
away from the shore of an island: The ship sank about two miles off-island.

1915–20 Unabridged
Based on the Random House Dictionary, © Random House, Inc. 2014.
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Example sentences
Whatever materials are used to rebuild are likely to originate off-island,
  including wood and concrete, and even bamboo.
Also adding to these expenses are the lost wages incurred when a patient seeks
  off-island specialty care.
Off-island care without prior authorization, except in the case of emergency or
  eligible reciprocity benefits.
The procedure is critical for stabilizing cardiac patients who must receive
  surgery off-island.
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