Senator John Barrasso, M.D. (R-WY) Chairman of the Committee on Indian Affairs www.indian.senate.gov and a doctor practicing medicine for 25 years, remains deeply concerned about the significant challenges facing the Indian Health System www.ihs.gov especially in the Great Plains.
Chairman Barrasso presented his opening statement at the February 3, 2016 Senate Committee on Indian Affairs Oversight Hearing “Reexamining the Substandard Quality of Indian Health Care in the Great Plains” by saying, “What is happening in the Great Plains Area related to healthcare is unacceptable.”
Three Indian Health Service hospitals located within the Great Plains area including the Winnebego Tribal Reservation, the Oglala Sioux Tribe Pine Ridge Reservation, and the Rose Bud Sioux Tribal Reservation have been found deficient in providing healthcare by CMS.
Robert McSwain Principal Deputy Director, Indian Health Service (IHS) appearing before the Senate Committee pointed out, “Some of the biggest challenges we face in the Great Plains are associated with providing healthcare in rural geographically isolated communities which includes recruiting and retaining qualified healthcare staff.” The Great Plains Area currently has over 250 vacancies for healthcare professionals and a physician vacancy rate of 37 percent.
“In addition, the relatively low inpatient volume and complexity of cases at some facilities does not support maintenance of clinical competencies plus the geographic remoteness reduces access to training resources.”
He also was upbeat about how the IHS is moving forward with telemedicine which includes teleradiology and telebehavioral health with the hours of available service for these specialties increasing. At Pine Ridge, telebehavioral health providers are seeing patients at three reservation locations, resulting in 46 hours of new services provided per month since June 2015.
The National Indian Health Board (NIHB) attended the hearing and participated in the listening session following the hearing. Charles Headdress, the Rocky Mountain Region representative to the NIHB’s Board of Directors and Vice Chairman for the Assiniboine and Sioux tribes of the Fort Peck Reservation presented his views.
Headdress commented that in many ways, IHS is still operating a health system designed for the 1950s. In Alaska, the Tribes have pioneered a health system that works closely with VA and focuses on a hub and spoke system to get better access to care to rural villages.
NIHB will be conducting listening sessions with Tribal leaders, patients, and medical professionals to determine new policy steps that IHS should take to achieve sustainable, long term change across the system.