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Rounds’ IHS Assessment Legislation Passes Out of Committee, Heads to Full Senate Floor

Senate Indian Affairs Committee Votes to Send Bill to Full Senate for Consideration

WASHINGTON—U.S. Sen. Mike Rounds (R-S.D.) announced that his legislation, S. 465, the Independent Outside Audit of the Indian Health Service Act, passed out of the Senate Indian Affairs Committee today with broad bipartisan support.


“South Dakota’s 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),” said Rounds. “Tribal members are suffering and even dying due to inadequate and disgraceful care. There is no excuse for hospitals not to reach basic benchmarks for providing proper care. Instead of threatening deadlines, requesting extensions, changing administrators and pointing fingers, the IHS, HHS and the Centers for Medicare and Medicaid Services (CMS) need to work together – in close, real consultation with the tribes - to immediately resolve these problems and improve care for our Native American communities.”


“The IHS will continue to fail unless we take a close look into the operations, funding, quality of care and management at the agency. That is why I introduced legislation calling for a comprehensive assessment of the IHS. I’m pleased that the Senate Indian Affairs Committee voted to pass this legislation today, and I look forward to considering it on the Senate floor. This bill is a necessary first step toward making real changes so the IHS can truly deliver the timely, adequate care the federal government has a trust and treaty obligation to provide to tribal members.”


Rounds’ legislation would require the Secretary of the Department of Health and Human Services (HHS) to contract an assessment of IHS’s health care delivery systems and financial management processes only at direct-care facilities. The Secretary of HHS shall use existing funds to enter into contracts with a reputable private entity to conduct an independent assessment in coordination with the U.S. Government Accountability Office and the Office of the Inspector General.


Rounds’ request for a comprehensive assessment of the IHS is supported by the Great Plains Tribal Chairman’s Association, which passed a resolution in 2016 calling upon Congress to demand an audit of IHS. In 2017, the South Dakota State Legislature passed a resolution urging Congress to audit the IHS. 


Since taking office in 2015, Rounds and his staff have analyzed the IHS and its shortcomings, concluding there are three primary areas of concern: there is no funding allocation strategy for the 12 IHS regions, there is no standard of quality measurement and there is high turnover of staff resulting in low accountability amongst management. Rounds’ assessment legislation is the first step toward addressing the agency’s longstanding failures.


Rounds sent a letter to the Inspector General of HHS in 2016, requesting an audit of the financial aspects of hospital and health care, medical services and overall financial management at the IHS. The HHS was only able to fulfill a portion of the audit request.