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Indian Health Service Continues to Let Down Tribal Members

Tribal members have been in the midst of a government-induced health care crisis for decades due to poor leadership and mismanagement at the Indian Health Service (IHS). For far too long, tribal members who rely on IHS for health care have faced unimaginable horrors. Troubling reports from a number of IHS facilities have found gross mismanagement, dirty medical equipment, broken sanitizers and blatant corruption. In one outrageous case, a woman gave birth to her baby on a bathroom floor with no nurses or doctors around to help her. Many of these horror stories happen right here in South Dakota.


The financial, structural and administrative problems at IHS have resulted in tribal members receiving misdiagnoses, waiting too long in emergency rooms, and in some cases dying due to inadequate care. There is no excuse for hospitals not to reach basic benchmarks for providing proper care and protect patients and tribal members.


IHS has a trust and treaty responsibility to provide proper health care to tribal members and it has failed in its duty. To help get the agency on the right path, I recently reintroduced legislation that would require the Department of Health and Human Services (HHS) Secretary to contract an assessment of IHS’ health care delivery and financial management processes. This is the same bill I introduced last Congress, which passed out of the Senate Indian Affairs Committee with bipartisan support. We’re optimistic we can bring it past the finish line this Congress.


An assessment will allow us to take a close look at the failures of IHS so we can work in close consultation with the tribes to immediately solve these problems and begin providing the reliable care our tribal members deserve. During our research of the agency, we found that despite a large user population and an annual appropriation of more than $5 billion, IHS does not have a funding formula. There are also no qualitative measurements to gauge quality of care. This mismanagement has taken a toll on tribal members, especially those in the IHS’ Great Plains Region, which includes our state. We have the worst health care disparities of all the IHS regions, including the lowest life expectancy, highest diabetes death rate, highest tuberculosis death rate and highest overall age adjusted death rate.


A recent report from the Wall Street Journal and FRONTLINE PBS shed light on the failure of the federal government to stop a child predator—an IHS pediatrician—in Indian Country. IHS moved this person from reservation to reservation, covering up decades of sexual abuse of Native American children in Pine Ridge and elsewhere. This is appalling. Failing to protect these vulnerable children is unacceptable.


Following the news report, HHS Secretary Azar announced an investigation into IHS’ policies regarding abuse allegations, which we welcome. However, IHS has had problems with abuse and other atrocities for decades. The problems are systemic. We need an assessment of the direct-service facilities within IHS as soon as possible.


IHS will continue to fail our tribal members unless we take a close look into the operations, funding, quality of care and management at the agency. My IHS assessment bill is a necessary first step toward making real changes so the IHS can deliver the timely, adequate care the federal government has a trust and treaty obligation to provide to tribal members.