Health | National

Indian Health Service crisis continues with shutdown at hospital






The Sioux San Hospital is an Indian Health Service facility in Rapid City, South Dakota. Photo by Colorado National Guard Medical Detachment

The Cheyenne River Sioux Tribe is firing back at the Indian Health Service after the agency announced -- without prior consultation -- a shutdown of an emergency room at a hospital in South Dakota.

Chairman Harold Frazier and other leaders were called to a meeting at the Sioux San Hospital in Rapid City on Tuesday but he said they weren't told why in advance. Once there, they learned that the emergency department at the facility will be closing, effective September 20.

"I do not support the closing of any emergency room department," Frazier said in response. "This is another example of poor consultation with tribes that have members immediately affected by the federal government’s failure to abide by the trust responsibilities provided by treaty."

In a press release, the IHS described the closure as "temporary" and said its decision came about as a result of ongoing "consultation" efforts with tribes in the Great Plains Area. William Bear Shield, the chairman of the Cheyenne River Sioux Tribe's health board, scoffed at that suggestion.

"What happened today reminded me of early this year when IHS came to Rosebud and the outcome was in the media before the meeting was over!” Bear Shield said.

The Sioux San Hospital serves the large urban Indian population in Rapid City and members of tribes who live on reservations in the area also go there for care. The IHS is now telling them to seek emergency services elsewhere.

"Sioux San Hospital has a strong commitment to urgent care and will continue to provide urgent care services and all other current non-emergency care hospital services to patients in the Rapid City region," Chris Buchanan, the acting director of the Great Plains Area, said in the press release. "By shifting the focus of our clinicians to the services the vast majority of our patients require, we will be able to serve those patient populations more efficiently and effectively."

According to the IHS, the nearest emergency room is located four miles from Sioux San in Rapid City. The agency is apparently referring to the Rapid City Regional Hospital on the other side of town.

The shutdown is the latest crisis to hit the Great Plains, a region that includes Nebraska and South Dakota. The Omaha Winnebago Hospital in Nebraska, which serves the Omaha Tribe and the Winnebago Tribe lost certification from the Centers for Medicaid and Medicare Service more than a year ago. The facility can no longer bill Medicaid and Medicare for services, which represents a key source of revenue.

Three facilities in South Dakota -- the Pine Ridge Hospital, the Rosebud Hospital and Sioux San -- were threatened with the same. But the IHS reached systems improvement agreements with CMS to continue billing for Medicaid and Medicare while improvements are made at all three locations.

Additionally, the emergency room at the Rosebud Hospital was shut down for seven months, during which seven people died while being transported to facilities further away from the reservation. The IHS finally restored service in July.

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