Opinion

Vi Waln: Holding Indian Health Service accountable to its patients

Monday, January 24, 2011

The Centers for Medicare and Medicaid Services (CMS) recently spent some time at the Rosebud Hospital. Kevin Stiffarm, who serves as the Chief Executive Officer, told the Rosebud Sioux Tribal Council last week that a “full hospital survey” was done. The facility has 10 days to submit a plan of correction to CMS to address deficiencies. A follow-up visit will be conducted within 60-90 days.

Apparently, issues of concern for the Rosebud Hospital revolve around staff, or the lack thereof. Stiffarm stated they are working to “supplement the outpatient department and emergency room staff” in order to “provide primary care.”

There are many of us at Rosebud who have an extremely difficult, if not impossible, time scheduling an appointment for something as routine as getting our medication refilled. For example, I have two days of doses remaining on a prescription I need to take every day. I called the clinic last week trying to get an appointment but was told the January calendar was already full. The difficulty in getting an appointment goes back to a shortage of providers, I believe.

Sick people call the clinic at 8am every weekday morning to compete with other callers for a limited number of same day appointments. If we fail to get an appointment, we show up at noon to stand in line to wait for a few walk-in slots to open up. We sign up and then sit down to pray that someone will not show up for their appointment so we can take their place. We might be there until 6pm.

I have always wanted to hold the Rosebud Hospital accountable to the Lakota people. Earlier this month I filed a written complaint on an emergency room (ER) provider. A family member visited the ER and was sent home with a dose of antibiotics after being scolded by the physician for making what he determined as a clinic visit to the ER. The family member, who happens to be a child, did not really show any improvement. A few days later we took the child to an off-reservation provider who diagnosed a case of pneumonia.

I received a phone call last week informing me that the ER provider I filed the complaint on had been reprimanded. I listened to an explanation about why chest x-rays aren’t ordered and why certain antibiotics are prescribed. I stated I would continue to file complaints to hold medical providers accountable. So then I was told about the great credentials held by the doctor I had filed the complaint on.

I will continue to file complaints because of a past experience I had with a granddaughter who died from a strep infection because her condition was not diagnosed and treated soon enough. There was never any call from the Rosebud Hospital explaining what happened when she died. Her death was investigated as a homicide until the autopsy results were returned. A federal investigator informed me what the cause of death was. I never did get an explanation from Rosebud Hospital as to why they allowed her to die.

So even though I received a personal phone call informing me of a reprimand regarding my most recent complaint, I will never be convinced that the IHS system at Rosebud has reached a place where they are accountable to the beneficiaries they serve. There are deep seated problems within the system going all the way up the chain of command.

Still, there are some excellent health care providers and nurses at Rosebud. I hope we are able to keep them here. However, I believe employee morale is at an all time low. I know of employees who are no longer at Rosebud because they grew weary of the way they were treated by supervisors.

People need to know there is a certain amount of ugly politics going on within our hospital. If you look at the positions there and examine the qualifications of the employees in those positions, some things are out of kilter. The atmosphere of any organization is usually determined by the people in charge. Their attitudes, morals, behaviors and beliefs certainly permeate the entire system. Thus, employee morale is very low at the Rosebud Hospital.

Health care professionals should be just that – professionals. I believe they take an oath promising to work for the people they serve in the health care industry. An oath requires these professionals to maintain their own mental, emotional, and spiritual well being. If you have not achieved wellness in these areas, how can we expect you to work as a health care provider seeking to improve the ailments of our Lakota people?

Furthermore, South Dakota’s Congresswoman Kristi Noem recently spoke in favor of H.R. 2, the health care reform repeal bill. She wants to “replace it with common sense policies that actually lower costs for families…and expand access for affordable care.”

For those of us who live and work on the Indian reservations across this country, the IHS is probably the only source of health care that we can afford. Ask any IHS beneficiary what they think a common sense policy really means. I am sure we would tell you that a fully funded, fully staffed hospital would be at the very top of our common sense policy wish list.

Noem also stated “South Dakota small business owners are simply waiting…because of the looming threat of the health care bill.” Those of us who use IHS fully understand the concept of waiting. We wait for an appointment. We wait to be seen by a health care provider. We wait for our prescribed medication. But most of all, we are waiting for our IHS hospitals to be fully funded and fully staffed.

Noem will never understand the concept of “simply waiting” when it comes to adequate health care being provided in an IHS facility. My five year old granddaughter died waiting for adequate health care. Need I say more?

Vi Waln is Sicangu Lakota and an enrolled member of the Rosebud Sioux Tribe. Her columns were awarded first place in the South Dakota Newspaper Association 2010 contest. She is Editor of the Lakota Country Times and can be reached through email at vi@lakotacountrytimes.com.