PIERRE, S.D. (CN) — Republican senators from South Dakota and Wyoming say their Indian Health Service Accountability Act will help cure the nation's ailing Indian Health Service, but a Sioux newspaper editor says it won't work without money.
Senators John Thune, of South Dakota, and John Barrasso, of Wyoming, say Senate Bill 2953, the Indian Health Service Accountability Act of 2016, will "promote patient-centered care and accountability at the Indian Health Service."
The bill would require consultation with tribes before key staff members, such as directors and hospital CEOs, could be placed in Indian Health Services hospitals, and would give the secretary of the Department of Health and Human Services direct hiring authority, to prevent lengthy vacancies for important positions.
It also lays out a plan for dealing with "problem employees," which could include demotion or removal from civil service.
The editor of Lakota Country Today, however, says the problem is that Congress has never fully funded the Indian Health Service, and that Thune has consistently voted against doing so.
H.S. 2953 is a long-delayed response to a 2010 report from the Senate Committee on Indian Affairs, "In Critical Condition: the Urgent Need to Reform the Indian Health Service's Aberdeen Area," known as the Dorgan Report. Sen. Byron Dorgan, D-N.D., was a three-term senator and six-term congressman, who left office weeks after delivering the report.
The report cited a laundry list of problems at IHS hospitals, including:
failure to remove employees for misconduct or poor performance,
failure to address theft of narcotics,
deficiencies so severe they put hospitals' accreditation at risk,
deficiencies in emergency rooms that put patients' safety at risk,
no system to check whether service providers' licenses have been revoked or suspended or expired,
lengthy vacancies in senior positions, and policies and directives that discourage staff from reporting problems to Congress.
Most tribes were promised health care by treaties, in exchange for giving up their traditional lands. Indian Health Service hospitals have difficulty hiring and retaining medical professionals for a welter of reasons, including pay scales and remoteness of the facilities.
More immediately, SB 2953 is a response to a series of crises in IHS hospitals over the past year, including the closure of the emergency room on the Rosebud Sioux Reservation in South Dakota due to its failure to meet standards to qualify for Medicare funding.
Investigations also revealed problems in hospitals on the Pine Ridge Reservation in South Dakota and the Winnebago Reservation in Nebraska, although those emergency rooms remained open.
The Indian Health Service has temporarily handed over staffing and oversight of all three troubled facilities to AB Staffing, a private firm.
Despite privatization, the Rosebud emergency room has not reopened since it closed in December 2015, and last week the troubled hospital also closed down its surgical and obstetrics departments after a key staff member died.
Its patients are being sent to South Dakota and Nebraska hospital 50 miles away for emergency, surgical and obstetric services.