SIOUX FALLS, S.D. (AP) – A federal official acknowledged Tuesday that the level of care is "unacceptable" at some government-run hospitals serving Native American patients and assured tribal leaders her agency would work to enact swift and long-lasting reforms.
Mary Smith, principal deputy director of the Indian Health Service, spoke with Great Plains tribal leaders in Sioux Falls during the first in a series of meetings to discuss the hospitals' quality of care, including recent findings of woefully inadequate service at some of the facilities.
IHS provides free health care to enrolled members of Native American tribes as part of U.S. treaty obligations. In the Great Plains region, the agency provides services to about 130,000 people through seven hospitals, 15 health centers and several smaller satellite clinics.
"We are committed to fixing these issues not simply in the short-term but so that the changes are sustainable over time," said Smith, who has led the agency for about a month. "I am committed, along with the rest of the team, to creating a culture of quality, accountability and leadership. You have my assurance that is far from business as usual at IHS."
Most of the meeting Tuesday was focused on the need for significant improvements at two facilities in South Dakota and another in Nebraska where federal inspectors last year found serious deficiencies, some so concerning that the lives of patients were threatened.
In October, inspectors visiting the hospital on the Pine Ridge Indian Reservation in southwest South Dakota cited safety deficiencies including unsecured drugs and medical records and doctors without proper credentials.
An inspection of the hospital on the Rosebud Indian Reservation in November found conditions so alarming the emergency room was shut down, forcing patients to be diverted to facilities about 50 miles away.
And months earlier, an inspection report of the hospital in Winnebago, Nebraska, cited the case of a patient who died at a relative's house two days after he told hospital staffers about extreme back pain and was sent home. A hospital staff member then left him a voicemail telling him his kidneys were failing, but the staffer did not attempt to make additional contact.
Members of the Rosebud Sioux Tribe expressed their frustration Tuesday over the closure of their hospital's emergency department for four months.
"We have lost six patients in the back of those ambulances since this happened," said Evelyn Espinoza, a registered nurse and health director of the Rosebud Sioux Tribe. "... I cannot say with certainty that all six patients would still be alive today if Rosebud ER was opened, but I can say with absolute certainty that the Rosebud ER would have been the nearest ER for our relatives to be treated at."
Smith said the agency is currently accepting bids for a contract to manage the emergency rooms in Pine Ridge, Rosebud and Winnebago. She added the bidding soon will open for a contract to administer region-wide telemedicine services, which allow patients to access doctors remotely via video and other technology. The services are expected to focus on behavioral health and emergency medicine.
She also encouraged members of the audience, which included tribal members and health care workers, to work with the agency to fix problems.
"I'm treating every single day as urgent, but I need your help," said Smith, who will visit some of the hospitals later this week.
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