Chairman Llevando "Cowboy" Fisher, Northern Cheyenne testified at the IHS hearing, May 28, 2014 in Billings, Montana.
Old Coyote suggests I.H.S. area offices be eliminated
By Clara Caufield BILLINGS, Mont. - More than 100 tribal members from Montana and Wyoming packed the community meeting room at the Parmley Library, Billings, MT, at a field hearing on May 27, 2014 to consider Indian Health Service problems, focusing on the Billings Area. Senator Jon Tester D-MT, Chairman of the Senate Committee on Indian Affairs conducted the hearing, demonstrating his compassion and concern for Native Americans, “We are here today in order to hear from the I.H.S., tribal leaders and individual Natives to develop a partnership that will identify problems, find ways to solve them and improve I.H.S. health care,” Tester said. Tester also noted Montana’s recent State of the State Medical Report confirming that non-Indian men in Montana lived 19 years longer than Indian men and non-Indian women lived 20 years longer than Indian women. “There is no question there are problems in this region that need to be corrected,” said Chairman Tester. “We need to live up to our trust responsibility and offer tribes the health care they deserve. Ongoing issues around service delivery, transportation for critical care, billing and reimbursement issues abound. We need to prioritize these issues and solve them.” Formal testimony was reserved for the I.H.S. Director, Dr. Yvette Roubideaux and two panels of elected tribal officials and tribal staff. Yet, the crowd included a large number of ordinary Native folks, many hobbling in walkers or foot casts illustrating the effects of the I.H.S. “Life or Limb” policy. Many of these individuals attended the hearing in hopes of sharing personal experiences or telling about what happened to their family or friends under I.H.S. care. During the formal hearing which ran from 10:00 a.m. until past noon, Tester heard from several tribal leaders. He also welcomed all the audience, reminding them that staff members would be available after the hearing to hear individual concerns. “We want to hear your stories and make them part of the official record,” the Chairman said. In addition, the hearing record will remain open until June 10, 2014 Individuals who want to share their stories or concerns can submit written testimony to the Senate Committee on Indian Affairs: 838 Hart Senate Office Building, Washington, D.C. 20510. The fax number is (202) 228-2589. “We need to hear from Indian people who receive I.H.S. Services,” Chairman Tester stressed. “This will help us identify the problems and find ways to improve health services.” In opening remarks, Tester also referred to events that prompted the hearing. The Crow Legislature recently enacted a Resolution requesting a Congressional investigation into the Indian Health Service, specifically the Billings Area (serving 8 Tribes) and the Northern Cheyenne/Crow Hospital. About the same time, Anna Sorrell Whiting, Billings I.H.S. Area Director resigned because she found it impossible to effect change within the system. Those two events were not related, Whiting has emphasized. “I only found out about the Crow Resolution after I had decided to resign.” I.H.S. National Director, Dr. Yvette Roubideaux was the first to testify before Tester. While she acknowledged that I.H.S. faces serious problems in health care delivery to Native Americans, she also suggested that budget constraints are at the core of the problem and that an infusion of additional cash would go a long way to providing more quality health care services. The Director also discussed several efforts currently underway to improve communication between the local I.H.S. Service Units and tribal leaders. “In the past, communication with tribal leaders has not been a top priority, but it is now. We want to convene working groups to improve services at the local level,” Roubideaux informed Tester. “We have taken steps to make sure that is happening.” Tribal leaders, on the other hand, did not agree. “We rarely hear from our CEO at the Lame Deer Clinic,” President Fisher, Northern Cheyenne Tribe said in his testimony. “Usually, the tribal leaders do not know what is going on. All we hear is the complaints from our tribal members.” Crow Tribal Chairman Darren Old Coyote was more graphic. “The Crow Tribe recommends that the I.H.S. Area Offices be closed. Normally about 66% of the I.H.S. budget is absorbed by administration. Very little of the I.H.S. budget reaches the Reservation level. When we complain to the Area level, we are referred to the Central office. They hear us out, but nothing ever changes.” Old Coyote went on to explain that after severe flooding at Crow in 2011, several critical services at the Northern Cheyenne/Crow Hospital were suspended and have not been resumed: OB-GYN; local surgery and several key positions were eliminated including ER staff; nurses; doctors; health practitioners and support staff. Carole Lankford, Vice Chair of the Confederated Salish and Kootenai Tribes, spoke of the life threatening concerns that come with restrictions, such as life or limb conditions, on health care services. “Let me give you a common example. Let’s say a provider conducts a series of tests and determines a patient’s gall bladder needs to be removed but it has not burst. The procedure would be denied and most likely the patient would be sent home with pain medication. This scenario has been repeatedly played out and results in poor care and increased prescription drug addiction.” A key concern addressed by all of the tribal witnesses was Contract Health Care (the practice of referring Native patients to specialists when the local I.H.S. Service Units cannot provide those services. Tribal leaders said that often the I.H.S. is not timely on payments to those providers causing tribal members to get “dunned” by collection agencies. “At least one of our tribal members is going bankrupt as a result and many others have been referred to collection agencies, ruining their credit.” said Northern Cheyenne President Cowboy Fisher. Other Tribal leaders spoke about budgetary issues: “I.H.S. funds every Indian about $3,000” said Tim Rosette, Rocky Boy’s Tribal Health Director. ”That is much less than budgeted for Medicaid recipients, the federal prison system and the V.A. Why does not the I.H.S. request more funding to address our needs? Are they racist? Perhaps they and the U.S. Congress just don’t care.” Chairman Tester said that the Billings Field Hearing is a “first” step in dealing with the crises. He indicated that additional field hearings are very possible, depending upon interest. Tester said that the testimony from the Billings hearing will be digested by the Committee which will come up with a series of recommendations from the easiest to the most difficult solutions. “We will forward that to the I.H.S. and see what happens,” Tester promised. Tester also acknowledged that legislation to correct the multitude of problems within the I.H.S. could be necessary. “When you talk about closing Area Offices or the I.H.S. going on a two-year budget cycle, that would require authorizing legislation,” he said. “We have a long way to go to solve these problems, but we are committed to doing that.” (Clara Caufield can be reached @ acheyennevoice.com) Copyright permission Native Sun News
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