SIOUX FALLS, S.D. (AP) – The Indian Health Service is looking to expand telehealth care across the Great Plains in the wake of federal inspections that uncovered serious quality-of care deficiencies at some of its facilities.

The IHS on Thursday issued a request for proposals from providers to offer remote care at its seven hospitals and other facilities in Iowa, Nebraska, South Dakota and North Dakota. Patients would receive emergency medical services and could set appointments with specialists in behavioral health, cardiology and other areas.

Kevin Steele, spokesman for the Oglala Sioux Tribe, said telehealth is a great way to provide care to tribal members living on remote parts of the vast Pine Ridge Indian Reservation in South Dakota.

“This telehealth is going to be put in communities that don’t have clinics or services,” Steele said. “We have communities that are 50 miles away in which people have to drive that far, but they have a school system and a small building capable to house telehealth.”

Mary Smith, IHS’ principal deputy director, said in a statement that integrating telemedicine especially expands access to specialty care.

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.

Earlier this year, the Centers for Medicare and Medicaid Services threatened to end the ability of hospitals on the Pine Ridge and Rosebud Indian Reservations to bill the government for services provided to Medicare- and Medicaid-eligible patients after inspectors uncovered serious deficiencies during unannounced visits.

On Sunday, IHS announced that it reached last-chance remediation agreements with the Centers for Medicare and Medicaid Services that will overhaul the hospitals’ management and appoint a monitor to provide periodic assessment reports. Emergency rooms at both facilities will be privatized, as previously proposed.

The agreement for the hospital on the Rosebud Indian Reservation, however, did not immediately result in the reopening of its ER, which has been shut down since early December.

Steele said the Oglala Sioux Tribe has been working through other grants to improve technology across Pine Ridge in preparation for the push toward remote care.

“These first two years are basically just putting the infrastructure in, getting them set up so they can provide telehealth services,” he said.

The deadline for proposals is June 6.

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