The Pine Ridge Hospital on the Pine Ridge Reservation in South Dakota. Photo from Dean Kurtz Construction

'We Are Going To Close Down The Aberdeen Area Office'
By Brandon Ecoffey
Lakota Country Times Editor
www.lakotacountrytimes.com

PINE RIDGE-- Oglala Sioux Tribal President John Steele has called for the closure of the Indian Health Service's Aberdeen Area office as he has introduced massive recommendations for reform of healthcare on the Pine Ridge Indian Reservation.

In a statement released Monday, President Steele addressed concerns from tribal members about the possible closure of the IHS facility in Pine Ridge. The release stated that the Oglala Sioux Tribe had received notice on April 8 from the Centers for Medicare and Medicaid Services that the IHS facility in Pine Ridge was in violation of two provisions of Medicare Conditions of Operation. Under an agreement between all parties involved the facility now has until May 16 to become compliant with CMS standards of care or risk losing its ability to bill Medicare/Medicaid for costs of serving patients.

Both President Steele and Pine Ridge Service Unit Director Sophie Claymore assured tribal members on Monday that the facility in Pine Ridge had not closed its doors and was working to become compliant with the notice issued by CMS.

"The Emergency Department is not closing. We are open," said Claymore in her monthly report to the OST tribal council.

In an address to the Oglala Sioux Tribal Council, President John Steele announced plans to lead an effort to close the IHS Aberdeen Area office after both the Rosebud Service Unit and the Pine Ridge Service Unit found themselves in hot water with the Center Medicare and Medicaid services. The two hospitals that are responsible for serving tens of thousands of Lakota have been in danger of permanently losing their ability to bill Medicare/Medicaid on multiple occasions.

"We are going to close down the Aberdeen Area office," said President Steele.

In statements where he recalled his time as an Oglala Sioux councilman in the 1970's, President Steele said that, "In all my years the area office hasn't done anything for our people and we are going to close it down," said Steele.

The citizens of the Sicangu Nation in Rosebud has already seen their emergency room closed at its IHS facility. Patients who would normally use IHS hospital in Rosebud are now being transported nearly an hour away to a hospital in Valentine, NE. Sources in Rosebud have said that several tribal citizens have lost their lives during transport.

According to President Steele conversations between tribal governmental officials and representatives of the federal government have established the groundwork for a reconfiguring of healthcare delivery in Indian Country. Although President Steele did not go in to detail on his plans but he did present the council with options that included demanding that the federal government issue documentation to all Lakota people that would provide coverage at all not healthcare facilities, not just IHS.

Steele also announced that the tribe was foregoing IHS and had begun seeking a contractor to provide emergency room services to residents of the Pine Ridge Indian Reservation.

"We have already advertised the contract for our emergency room to whoever wants to provide these services," said Steele. "It could be Sanford, Avera, Rapid City Regional or someone else," he said.

Up until this point all healthcare services at the Pine Ridge Hospital have been provided by IHS but tribal-nations have the right to contract out services for any tribal program. While some have argued that this option affords tribal-governments a greater amount of self-determination, others believe that the move let's the federal government off the hook for its treaty and trust responsibilities to provide healthcare to tribal-citizens.

The struggle to find a sustainable source of healthcare those living on Reservations on the Great Plains has been a problem as underfunded and understaffed Indian Health Service facilities are now buckling under the weight of the sheer demand for services.

Healthcare is a right guaranteed to tribal-nations through both the treaty process and as a result of the trust relationship between tribes and the federal government. Funding for IHS facilities, however, has often been shortchanged by Congress as a rising national debt and a GOP controlled congress have chipped away at the IHS budget for years. The lack of funds have left tribal-nations with the burden of finding their own ways of guaranteeing healthcare for its citizens.

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"The federal government has an obligation to provide adequate healthcare to the Oglala Sioux Tribe. Unfortunately, that obligation goes widely unfulfilled. It is, therefore, up to the tribe to work directly with IHS and CMS to ensure the federal government upholds its side of the trust responsibility," said President Steele.

Efforts by the tribe to reform healthcare on the Pine Ridge Indian Reservation have been bolstered by congressional interest in the state of healthcare in Indian Country. In address to members of Congress earlier this year Wakpamni Representative Sonia Little Hawk-Weston attempted to explain just what the tribe is asking from the federal government.

"All we want is quality healthcare without the inordinately burdensome and oftentimes horrific struggles they receive to get any healthcare at all, this should not be an unachievable goal in the Untied States of America," said Sonia Little Hawk Weston.

In response to demands from the tribe for more staff and housing at the IHS facility in Pine Ridge President also stated that he had received a guarantee from federal officials that a small apartment building would be built immediately to assist in the recruitment and retention of qualified healthcare providers.

(Contact Brandon Ecoffey at editor@lakotacountrytimes.com)

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