Gazette opinion: Remedies urgently needed for Indian health care

2014-05-07T00:00:00Z Gazette opinion: Remedies urgently needed for Indian health care The Billings Gazette
May 07, 2014 12:00 am

Don’t get sick after July.

That’s a sad commentary on the availability of health care services in Indian Country where Indian Health Service funding runs out before the fiscal year ends on Sept. 30.

Montana’s U.S. Senators Jon Tester and John Walsh summarized the problem last week in a letter asking the U.S. comptroller general to review IHS performance, particularly in the Billings area, which is responsible for serving tribal members on seven reservations in Montana and one in Wyoming.

“Issues have plagued the facilities in the Billings service area for years as patients endure poor to no services and extraordinary delays in seeing physicians or filling a prescription,” the senators wrote. “In one troubling case, we heard of a provider who only sees one patient a day. Related to the efficiency of the medical workforce, we have heard concerns that these facilities are not seeking reimbursement from third-party insurers, thereby denying the service unit desperately needed capital.”

Tester, who chairs the Senate Indian Affairs Committee, said that “despite increased funding in the last couple of years, the agency remains tragically underfunded.”

Fragmented care

However, IHS is just one player in a tragically fragmented system charged with caring for the health of Indian people. Tribal governments receive funding to provide some health services. Tribal members may be eligible for Medicaid, Medicare, VA care or have private insurance. Getting all of these entities to work together for the best patient care is an enormous task in a system that all too often falls short of that goal.

Last week, U.S. Rep. Steve Daines, R-Mont., sent a letter asking IHS Acting Director Yvette Roubidoux to “swiftly evaluate” the Billings area administration.

It is unclear how much of the problem is in the Billings area office and how much is in the agency’s Washington, D.C., headquarters.

Congressional correspondence flew upon a request by the Crow Legislature for an investigation and coincided with the resignation of Anna Whiting-Sorrell who had been the Billings area director for just 18 months. A member of the Confederated Salish Kootenai Tribes and former director of the Montana Department of Public Health and Human Services, Whiting-Sorrell said her efforts to improve care for Indians were stymied by a system that doesn’t work. She told Gazette reporter Cindy Uken that she could no longer defend “the level of service provided and the quality.”

“There are a lot of really good people at IHS,” Whiting-Sorrell said, but she added: “There needs to be a much broader conversation as to what the federal health care system looks like.”

The Billings area is responsible for serving about 70,000 Indian people.

This agency is charged with providing vital services that are especially needed in these communities where poverty is high and the next closest health care facilities are too far away for patients who don’t have transportation.

Moreover, the IHS is part of the trust responsibilities the U.S. government must provide under historic treaty agreements with tribal governments.

Tester sets May 27 hearing

The same day that Tester and Walsh formally requested a Government Accountability Office review of IHS, Tester announced that he will hold a field hearing on May 27 in Billings to determine next steps to improve IHS care in the Montana-Wyoming region.

We welcome scrutiny of Indian Health Service operations. Dedicated IHS employees and the communities they serve deserve much better that what they have been getting.

Copyright 2014 The Billings Gazette. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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