IHS chief medical officer apologizes for comments about newborns

Thursday, February 4, 2016  

A senior Indian Health Service official apologized on Wednesday for comments she made the regarding the agency's treatment of pregnant women and their newborns.

Chief Medical Officer Susan V. Karol, a member of the Tuscarora Nation, admitted that she appeared dismissive about two infants who were delivered without assistance on the floor of the Rosebud Hospital in South Dakota. She had discussed the issue during a conference call with the Senate Indian Affairs Committee in December.

“If you’ve only had two babies hit the floor in eight years that's pretty good," Karol told staff at the time, according to Sen. John Barrasso (R-Wyoming), the chairman of the committee.

Barrasso gave Karol, who is based at IHS headquarters in Rockville, Maryland, a chance to explain herself at a heated oversight hearing on Capitol Hill.

Indianz.Com SoundCloud: Senate Indian Affairs Committee Oversight Hearing on Reexamining the Substandard Quality of Indian Health Care in the Great Plains

"Those comments [were] totally unacceptable," Karol said. "I really am sorry I made any reference to negativity in patient care."

Despite Karol's admission, she was the only government witness who expressed strong misgivings about the quality of care in the Great Plains Area, a region that includes South Dakota. Neither Mary Wakefield, who is acting as the second highest-ranking official at the Department of Health and Human Services nor IHS Principal Deputy Director Robert McSwain, who serves as the acting head of the agency, directly apologized to the tribal members who have complained for years about their level of treatment.

"What has to be acknowledged here is that ... people’s lives are in jeopardy," said Sen. John Thune (R-South Dakota), who also brought up the two newborn incidents during the hearing. "This is unacceptable. We cannot tolerate this."

The Rosebud Hospital is considered one of the worst in Indian Country. In December, the emergency room was placed under "diversion" -- the agency's term for cutting back services -- forcing patients with medical emergencies to travel to Valentine, Nebraska, about 45 miles from the facility, or to Winner, South Dakota, about 55 miles away.

"This diversion poses real, life or death risk to our people," William Bear Shield, a council member for the Rosebud Sioux Tribe, told the committee.

Just last month, a patient died while being transported to Valentine when he could have been taken to the Rosebud hospital, only seven miles from his home, Bear Shield said. The tribe was told the diversion would only last a few weeks but now it could last a few months, he said.

The hospital is also in danger of losing its certification from the Centers for Medicaid and Medicare Service due to numerous "violations of safety standards," Andy Slavitt, the acting administrator of the agency, testified. That would mean a loss in Medicare funding, a key source of revenue for patient care.

"For too long, the federal government has failed to live up to its promise, its trust responsibility, to provide adequate care for the Native American community," said Sen. Mike Rounds (R-South Dakota).

The Rosebud hospital isn't the only Great Plains facility in trouble. Last July, CMS cut certification to the Winnebago Service Unit, which serves the Omaha Tribe and the Winnebago Tribe in Nebraska. Both tribes repeatedly raised concerns and have accused the IHS of ignoring problems outlined in a CMS inspection report for years.

The Pine Ridge Service Unit, which serves the Oglala Sioux Tribe of South Dakota, also has been warned of a loss in CMS certification. HHS and CMS said at the hearing that they are working together to ensure Rosebud and Pine Ridge don't suffer the same fate as Winnebago.

Committee Notices:
Reexamining the Substandard Quality of Indian Health Care in the Great Plains (February 3, 2016)
A Listening Session on Putting Patients First: Addressing Indian Country’s Critical Concerns Regarding IHS (February 3, 2016)

Tribal leaders question management changes at IHS in Great Plains (2/4)
Indian Health Service makes changes ahead of big SCIA hearing (2/3)
Witness list for Senate Indian Affairs Committee hearing into IHS (2/1)
Inspections of IHS facilities in Great Plains turn up big problems (1/28)
Senate committee reschedules IHS hearing and listening session (01/25)
Senate Indian Affairs Committee expands look at substandard IHS (1/22)
Senate Indian Affairs Committee to look at 'substandard' care at IHS in Great Plains (01/12)
Mary Annette Pember: Native women affected by cutbacks at IHS (12/29)
Lakota Country Times: IHS restricts care at Rosebud hospital (12/24)
Nebraska tribes recognized for efforts to hold IHS accountable (09/24)
Tribes in Nebraska demand resignations of senior IHS officials (08/12)
Winnebago Tribe upset with IHS over loss of funds at hospital (8/6)
Winnebago Tribe looking to address deficiencies at IHS hospital (08/05)
Winnebago Tribe hopes to prevent Medicare cutoff at hospital (5/28)