Troubled ER Reopens on Sioux Reservation

     ROSEBUD, S.D. (CN) — The emergency room on the Rosebud Indian Reservation will reopen Friday after eight months of closure due to health code violations, a South Dakota congresswoman said.
     The federal government closed the Rosebud Indian Health Services emergency room in December 2015 for failing to comply with standards for medical facilities that get Medicaid funding.
     Since then, patients needing emergency care have been sent to hospitals outside the reservation in South Dakota and Nebraska, about 50 miles away.
     The emergency room will reopen under management of AB Staffing, a private health care firm that secured a temporary government contract to oversee Rosebud and two other troubled reservation emergency rooms, in Pine Ridge, S.D, and Winnebago, Neb.
     AB Staffing’s contract runs from one to five years. In that time, it must address the emergency room’s chronic patient safety issues, including lack of critical equipment, such as a sterilizer for medical instruments, and difficulty retaining qualified staff.
     “This has been a collaborative effort with IHS headquarters and facility management to ensure resumption of emergency department services,” AB Staffing president Evan Burks said in an email.
     “Clinical personnel have been vetted, credentialed, oriented and are ready to provide emergency department services to the local community. We view this as a significant milestone that is part of a broader effort to improve the quality of patient care to tribal members throughout the region. Our entire staff is truly honored to be a part of this most important initiative.”
     Burks said his company is seeking employees to work in the three IHS emergency departments it manages.
     “Personally, I can’t think of anything more gratifying than being part of the solution to improve the delivery and quality of medical care to American Indian communities,” he said.
     But Congresswoman Kristi Noem, R-S.D., said Thursday that the emergency room’s problems are not over.
     “The dangerous conditions within the emergency department and the resulting diversionary status put too many lives in jeopardy,” she said in a statement. “Today is a day of hope, but it is not the end of our work. So much still needs to be done.”
     Debate still rages on how to resolve the Indian health care crisis on the Great Plains. The Rosebud Sioux Tribe sued the federal government in late April, blaming its health care woes on chronic underfunding of the Indian Health Service.
     The federal government is obligated by treaties to provide health care on reservations.
     But Republican politicians from South Dakota, including Noem and Sens. Mike Rounds and John Thune, say the IHS needs more accountability, not money, to whip it into shape.
     Rather than increasing funding, Noem suggested that IHS focus on “reformulating how purchased-referred care dollars are allocated.”
     This is in line with Noem’s voting record. Noem has voted for $1 billion in cuts to Indian Health Service funding during her time in office, her campaign opponent Paula Hawks, a Democratic member of the South Dakota House, said in June.
     Hawks also blasted Noem for missing 17 of 22 meetings of the U.S. House Subcommittee on Indian and Alaskan Native Affairs since she took office in January 2011.
     “During one year-long stretch from May 2011 to June of 2012, Noem didn’t attend a single meeting,” Hawks said.
     Noem and Thune, both of whom seek re-election in November, are pushing IHS reform bills in Washington, and Rounds is calling for an external audit of the department.
     According to 2012 Census Bureau estimates, 8.9 percent of South Dakota’s 833,354 population is Native American — about 74,168 people.

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