Feds hire contractor to run ERs at hospitals on reservations

SIOUX FALLS, S.D. (AP) – The emergency room at the only hospital on a Native American reservation in South Dakota could reopen after federal health officials on Tuesday hired a contractor to provide emergency services at that and two other government-run hospitals.

The Indian Health Service awarded a one-year contract to Arizona-based AB Staffing Solutions LLC to run the currently shuttered emergency department on the Rosebud Indian Reservation. The contract, with a $60-million ceiling and renewable to up to five years, also covers the emergency rooms at hospitals on South Dakota's Pine Ridge Indian Reservation and Nebraska's Winnebago Reservation.

“This new contract underscores the IHS commitment to pursuing creative new solutions that ensure high quality care for our patients, who are our top priority,” Mary Smith, principal deputy director of the IHS, said in a statement Tuesday. “The new contract will benefit IHS patients and providers by ensuring a 24-hour Emergency Department at IHS Rosebud Hospital and two others.”

The Indian Health Service, commonly referred to as IHS, is responsible for providing health care to enrolled tribal members as part of the government's treaty obligations to Native American tribes. The move to privatize the emergency rooms comes after federal inspectors found serious deficiencies at the three hospitals.

The failures found at the emergency department of the 35-bed Rosebud Hospital prompted the Indian Health Service to close the facility's ER in early December, forcing people needing immediate care to travel about 50 miles. According to tribal officials in Rosebud, in the six weeks following the emergency room's shutdown, five people died and two babies were born in ambulances on the way to the nearest hospitals.

The IHS has not disclosed an exact date to reopen the ER, but it had previously expressed the desire to do so by the summer. The agency said the department will reopen “as soon as it is safe to do so,” adding that the contract “marks a significant progress towards that goal.”

The contract calls for AB Staffing Solutions to provide the management and clinical staff of the emergency departments. The IHS said the current staff at the emergency rooms in Pine Ridge and Winnebago will be assigned to other departments, which in turn, will allow the hospitals to provide additional services at night and on weekends.

The IHS has previously hired AB Staffing Solutions to provide temporary health professionals at its hospitals. The Rosebud Sioux Tribe, however, would have preferred that a local health system had been granted the contract.

“We know Avera (Health), we know Sanford (Health),” Rosebud Sioux council representative William Bear Shield said referring to two health systems based in South Dakota. “If it would have been any one of those two, I would have said `Great. I feel comfortable.' But we are going to have to see what this AB Staffing Solutions is about. We are concerned, that's for sure.”

AB Staffing Solutions did not immediately return a call seeking comment on the contract.

Some of the deficiencies uncovered by inspectors during an unannounced survey of the Rosebud facility in November included the lack of any apparent infection-control measures taken when a patient with a history of untreated tuberculosis sought medical attention, as well as the lack of immediate assistance for another patient who was having a heart attack.

The closure of the emergency room prompted the Rosebud Sioux Tribe to file a federal lawsuit last month against the IHS and others asking that officials be forced to reopen it, citing “immediate and irreparable injury” to tribal members.

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