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

RST brings fight to feds over emergency room
By Brandon Ecoffey
Lakota Country Times Editor
www.lakotacountrytimes.com

PINE RIDGE— In an effort to hold the federal government responsible for its promises made to the Lakota people the Rosebud Sioux Tribe has partnered with some heavy hitters in the world of federal Indian Law in the hopes of reopening the Rosebud Hospital’s emergency room.

Late last week attorneys from the law firm Robins Kaplan asked a federal judge on behalf of the Rosebud Sioux Tribe to issue an immediate injunction that would order the reopening of much the much maligned emergency room at the Rosebud Hospital. The hospital has been closed for several weeks after deficiencies in care had been reported. The closing has forced citizens of the Sicangu nation to transported over forty miles to the nearest emergency room located off the reservation.

“The tribe came to us and asked if there was anything that could be done,” said Timothy Purdon, a lawyer who works for Robins Kaplan and who is also the former U.S. Attorney for the North Dakota.

Purdon is one of several big name lawyers -including former U.S. Attorney for South Dakota Brendan Johnson- who are now working at the North Dakota based law firm. As a service to tribal-nations Robins Kaplan has invested heavily in its Pro-Bono efforts designed to provide tribal governments with top-notch legal representation. The work on behalf of the Rosebud Sioux Tribe is being conducted Pro-Bono.

The complaint filed in the United States District Court, “Alleges that the closing of the emergency room at the Rosebud Hospital is a violation of a bunch of different things,” said Purdon.

The filing alleges that the closing of the emergency room at Rosebud violates federal statutes; that the closing of the emergency room is a violation of the fiduciary trust duty that the government owes to tribes through treaties, statutes and common law; that the federal government is failing in its fiduciary duties to provide healthcare to the people of Rosebud; and finally that the methods used to close the emergency room are a violation of the equal protection and due process clauses of the constitution.

The argument that the closing of the emergency room is a violation of the Due Process Clause is based in technicalities that may actually pave the way for the reopening of the emergency room. Factual evidence presented in the complaint indicates that procedures were not followed by Indian Health Service prior to the closing of the facility. The other three arguments, however, get at some of the core underpinnings of the trust-relationship between tribal-nations and the federal government.

"The crux of the deal is that the complaint alleges that the closing of the emergency room is violation of federal law but also more broadly that they(the federal government) are not living up to their responsibility to provide reasonable medical care to the tribe as well," said Purdon.

The roots of federal Indian law in the United States are ultimately set in promises made by both parties through treaties. These treaties guaranteed healthcare for Lakota people but also rulings by the Supreme Court and legislation passed by congress have further solidified the existence of these agreements.

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Early Supreme Court decisions found tribes did exist as a sovereign nations but that the relationship between the federal government and tribal-nations was similar to that of a "ward to its guardian." This ruling in Cherokee Nation vs. Georgia in 1831, was a misinterpretation of the nation-state status of the Cherokee Nation, but it did further embed the notion that there was a fiduciary trust relationship between tribes and the United States government.

The relationship outlined by Chief Justice Marshall in the case is the keystone upon which much of federal Indian policy has been derived. Basically tribes as a ward of the government have given up certain rights like the ability to establish a standing military or print its own currency in exchange for certain protections from the federal government. These protections extend to healthcare as legal precedent has established that it is the duty of the federal government to provide these services to tribes who were deemed "domestic dependent nations" by the court.

More recent legislation from Congress has furthered imbedded this precedent but many in Indian Country have long argued that the U.S. has failed to reasonably meet its duties.

Healthcare in Indian Country has been a contentious debate as efforts to reign in the national debt have often come at the expense of funding in Indian Country. Most Indian Health Service facilities are operating with budgets allocated by congress that do not provide sufficient funds to meet the demand for care. The complaint filed by the Rosebud Sioux Tribe will look to remedy these fiscal shortcomings by demanding that the courts order the White House to act and reopen the facility.

"They haven't been able to get this solved for years," said Purdon. "The executive branch has not met its obligations to the people of the Rosebud Sioux Tribe and we are asking that the judicial branch step in and exercise some control here," said Purdon.

(Contact Brandon Ecoffey at editor@lakotacountrytimes.com)

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