Indian Health Service diverts care again at South Dakota hospital

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

An Indian Health Service facility whose emergency room has been shut down for six months is seeing another reduction in care.

Effective immediately, the Rosebud Hospital on the Rosebud Sioux Reservation in South Dakota is no longer offering surgical and obstetrics care, the IHS announced on Monday. A key staff clinician died over the weekend, the agency said.

"IHS is currently exploring several strategies to staff these departments so that we can resume these services as quickly as possible," the announcement read.

While the hospital continues to offer other services, patients seeking surgical and obstetrics care are being urged to go to the Cherry County Hospital in Valentine, Nebraska, about 44 miles away; the Bennet County Hospital in Martin, South Dakota, about 53 miles away; or the Winner Regional Hospital in Winner, South Dakota, about 55 miles away.

Patients on the reservation have already been forced to travel long distances ever since the IHS shut down the emergency room at the hospital in December due to quality of care issues. At least six members of the Rosebud Sioux Tribe have died while being transported to those facilities.

"Lives have been lost because of what’s happening," Rep. Kristi Noem (R-South Dakota) wrote in a column.

Last week, Noem led a bi-partisan group of lawmakers in introducing H.R.5406, the Helping Ensure Accountability, Leadership, and Transparency in Tribal Healthcare Act (HEALTTH Act), a bill to reform the agency. Several provisions are aimed at reducing vacancies and drawing more staff to the IHS in hopes of preventing diversions like the one seen at Rosebud.

"These hospitals are typically in remote areas and the incentives to move there just haven’t been offered," Noem said. "My legislation tries to make hiring a bit easier, while also giving additional help to medical professionals and administrators for things like paying back their student loans."

The diversion in surgical and obstetrics care is meant to be temporary, much like the one affecting the emergency department. The IHS is still working to address the latter situation through a systems improvement agreement that requires the agency to follow several steps before being given approval to reopen the emergency department. The hiring of an outside contractor is part of that process.

Tribal leaders, meanwhile, continue to express concerns about the way the IHS has been handling the crisis. They suing the agency in order to force the reopening of the emergency department. The Robins Kaplan law firm is handling the case free of charge.

Senate Committee on Indian Affairs Notices:
Town Hall Meeting "Discussing S. 2953: Improving the Indian Health Service." (June 16, 2016)
Oversight/Legislative FIELD Hearing on "Improving Accountability and Quality of Care at the Indian Health Service though S. 2953." (June 17, 2016)

Federal Register Notice:
Notice of Tribal Consultation and Urban Confer Sessions on the State of the Great Plains Area Indian Health Service (June 3, 2016)

Government Accountability Office Report:
INDIAN HEALTH SERVICE: Actions Needed to Improve Oversight of Patient Wait Times (April 29, 2016)

Senate Committee on Indian Affairs Report:
In Critical Condition: The urgent need to reform the Indian Health Service’s Aberdeen Area (December 2010)

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