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New leader of Indian Health Service plans big trip to Great Plains

Wednesday, March 23, 2016

The Rosebud Hospital is located on the Rosebud Sioux Reservation in South Dakota. Photo by Crystal R. Leighton via Facebook

The new leader of the Indian Health Service is heading to the troubled Great Plains region for a three-day visit next month, the agency announced on Wednesday.

Mary Smith, who was named acting director of the IHS earlier this month, was originally going to the area this week to meet with two tribes that have been affected by quality of care issues. But now she's wants to hear from "all of the tribes" in a region that has been under intense scrutiny in Indian Country and in Congress.

"I've only been in my job as principal deputy director for three weeks now and although I've been at the agency for only a few months, it has become quite clear to me that while the IHS is firmly committed to the mission of providing quality health care to American Indians and Alaska Natives, we face deep operational and quality of care challenges," Smith told the House Subcommittee on Indian, Insular and Alaska Native Affairs at a hearing on Tuesday, when she first disclosed her intent to go to the Great Plains.

"The current situation is unacceptable," added Smith, a member of the Cherokee Nation who joined the IHS last fall.

Indianz.Com SoundCloud: House Subcommittee on Indian, Insular and Native Alaska Affairs March 22 2016

The Great Plains includes Nebraska and South Dakota and tribes in those states have been upset with the failure of the IHS to address long-standing problems. The Winnebago Service Unit, which serves the Omaha Tribe and the Winnebago Tribe in Nebraska lost certification from the Centers for Medicaid and Medicare Service last summer.

"It's been said in my community that the Winnebago Hospital is the only place you can legally kill an Indian," Victoria Kitcheyan, the treasurer for the Winnebago Tribe, told the Senate Committee on Indian Affairs last month. She said the CMS identified instances in which five people died "unnecessarily."

"It's 2016 and our people are still suffering at the hands of the federal government," Kitcheyan said.

In neighboring South Dakota, the Rosebud Hospital had to shut down its emergency room in what the IHS officially labels a a "diversion." Leaders of the Rosebud Sioux Tribe have said their people have died while being transported to facilities 45 to 55 miles away.

"This diversion poses real, life or death risk to our people," council member William Bear Shield said at the Senate hearing.

Mary Smith of the Indian Health Service speaks at the National Congress of American Indians executive council winter session in Washington, D.C., on February 23, 2016. Photo by NCAI / Twitter

The CMS also threatened to withdraw certification for the hospital but Smith -- during her first appearance on Capitol Hill on March 9 following her new appointment -- said the IHS is working on a "systems improvement agreement" to prevent that from happening. The deadline to reach an agreement is coming at the end of next month.

Elsewhere in South Dakota, the Pine Ridge Service Unit, which serves the Oglala Sioux Tribe, is facing a loss of CMS certification as well. IHS officials have said they are trying to prevent that from happening too.

The Great Plains office is located in Aberdeen, South Dakota, a long distance from nearly every reservation in a service region that also includes North Dakota and Iowa. There are no IHS hospitals or clinics in Aberdeen, which is also home to a Bureau of Indian Affairs regional office.

Smith's meeting, though, is taking place in Sioux Falls, South Dakota, a city that's somewhat more accessible to a larger number of tribes in the region. She will be there from April 5-7, according to the letter that is being sent to tribal leaders on Wednesday.

"It is my intention to have participation in the forum from all perspectives as we listen to concerns and seek your ideas and input on ways we can continue to improve the Great Plains Area IHS," Smith wrote in the letter.

Committee Notice:
The President’s Fiscal Year 2017 Funding Priorities and Impacts on Indian Country and Insular Areas (March 22, 2016)

Senate Committee on Indian Affairs Report:
In Critical Condition: The urgent need to reform the Indian Health Service’s Aberdeen Area (December 2010)