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Sen. Rounds seeks support for audit into Indian Health Service

Thursday, May 12, 2016

Sen. Mike Rounds (R-South Dakota), third from left, met with leaders of the Oglala Sioux Tribe and the Rosebud Sioux Tribe in Washington, D.C., on February 4, 2016, to discuss Indian Health Service issues. Photo from Facebook

Sen. Mike Rounds (R-South Dakota) is asking the Senate Committee on Indian Affairs to support his request for a system-wide audit of the Indian Health Service.

Rounds, a first-term member of Congress, said tribal leaders have helped identify a series of issues that need improvement at the IHS. Administrative management, financial management and quality of care are the over-arching concerns.

"In the Great Plains Area – particularly in South Dakota – the failings of the IHS have reached a crisis level," Rounds said in a press release. "Tribal members are literally dying due to inadequate care."

Rounds laid out his request for the audit in a letter to Sen. John Barrasso (R-Wyoming), the chairman of the Senate Committee on Indian Affairs. He included a resolution passed by the Great Plains Tribal Chairman’s Association that calls on the Government Accountability Office to investigate the IHS.

"The inadequate quality of health care in the Great Plains Region has resulted in actual genocide of our tribal members, who suffer from the highest diabetes death rates, the highest tuberculosis death rates, higher incidences of other diseases than mainstream America, and the lowest life expectancy among all IHS regions in the United States and mainstream America, itself," the April 15 resolution reads.

Indianz.Com SoundCloud: Senate Committee on Indian Affairs Hearing May 11, 2016. Comments by Sen. John Thune (R-South Dakota) about the Indian Health Service can be found in Track 1, Opening Statements.

In February, Barrasso's committee held a hearing and listening session to look into the "substandard" quality of care within the Great Plains Area of the IHS, a region that includes Nebraska and South Dakota. One hospital in the region already lost certification from the Centers for Medicaid and Medicare Service and two others were threatened with the same until improvement agreements were reached at the last minute.

The loss of CMS certification means the IHS cannot bill Medicare and Medicaid for patient care at the Winnebago Service Unit in Nebraska. The hospital there serves the Omaha Tribe and the Winnebago Tribe.

"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 committee in February. 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.

Although the IHS was able to prevent the CMS from terminating certification at the Rosebud Service Unit, the emergency room at the hospital has been placed on diversion since December. Since then, six members of the Rosebud Sioux Tribe have died while being transported to urgent care centers up to 55 miles away.

"Six families are left wondering whether their loved ones would be alive today if the IHS had not failed in its responsibility to provide safe and quality care," Sen. John Thune (R-South Dakota) said at a committee hearing on an unrelated matter on Wednesday. "This is a disgrace."

As of Wednesday, Thune said the emergency room has been shut down for 158 days. The IHS has indicated that the diversion will last at least through the early summer.

The IHS also reached an agreement with CMS to prevent the loss of certification at the Pine Ridge Service Unit in South Dakota, which serves the Oglala Sioux Tribe.

Government Accountability Office Report:
INDIAN HEALTH SERVICE: Actions Needed to Improve Oversight of Patient Wait Times (April 29, 2016)

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