Indian Affairs Committee Field Hearing Shines Light on IHS Crisis, Response

RAPID CITY, S.D. — Today the Senate Committee on Indian Affairs, at the request of U.S. Sen. John Thune (R-S.D.), convened an oversight and legislative hearing in Rapid City to receive testimony from stakeholders impacted by the years-long crisis at Indian Health Service (IHS) facilities across the Great Plains area and examine comprehensive IHS reform legislation recently introduced by Thune and Sen. John Barrasso (R-Wyo.), chairman of the Indian Affairs Committee. Sen. Mike Rounds (R-S.D.) and Rep. Kristi Noem (R-S.D.) joined Thune and Barrasso at today’s hearing, which highlighted the importance and need for a coordinated effort to properly respond to this crisis.

“The laundry list of issues plaguing the IHS has been well-litigated over the last six years,” said Thune. “No one knows those problems better than the tribal members who’ve been directly affected by them. While that conversation is far from over, today’s hearing was an important turning point toward examining the concrete areas in which we can make improvements and reforms to an agency tasked with the critical role of providing quality health care to tribal citizens in South Dakota and around the country. Not only do I want to thank Chairman Barrasso for convening today’s hearing, but also the witnesses who provided constructive feedback about my bill and what can be done to finally fix this crisis.”

“Today’s hearing helped us better understand the problems at IHS,” said Rounds. “We had a productive discussion with tribal leaders and IHS representatives that reiterates the need to fix the health care crisis in Indian country. I thank Chairman Barrasso for holding this important hearing, and I thank Sen. Thune, Rep. Noem and all the witnesses for their participation today. It is clear that IHS is dealing with serious administrative, financial and quality-of-care issues that still need to be addressed. In order to fulfill its trust responsibility to tribal members, IHS must undergo major reform, under close collaboration with the tribes. Consultation with the tribes is critical. Further, today’s hearing reaffirmed the importance of an external audit of IHS so we can work to fix their systemic problems. I appreciate Acting Deputy Secretary Wakefield’s support for an independent audit and look forward to working with her to get the answers necessary to turn the agency around.”

“IHS should get out of the hospital business,” said Noem. “The medical and administrative malpractice in the Great Plains is killing our tribal communities. Expansive reforms are necessary to end the corruption, mismanagement and life-threatening care. I am encouraged that we already have broad agreement between the House and Senate on some of the legislative changes, but cooperation from federal agencies will be paramount to our success. I thank Chairman Barrasso, Senators Thune and Rounds, the witnesses, and the many tribal members who attended today’s hearing. In the end, we are all partners in fixing this problem.”

Today’s witnesses included Dr. Mary Wakefield, acting deputy secretary of the U.S. Department of Health and Human Services (HHS); the Honorable William Bear Shield, chairman of the Rosebud Sioux Tribal Health Board; Ms. Wehnona Stabler, tribal health director of the Omaha Tribe of Nebraska; Ms. Ardell Blueshield, tribal health director for Spirit Lake Tribal Health; and Ms. Stacy Bohlen, executive director of the National Indian Health Board.

The Barrasso-Thune bill, the IHS Accountability Act of 2016, would improve transparency and accountability at the IHS by:

• Expanding removal and discipline authorities for problem employees at the agency;
• Providing the HHS secretary with direct hiring and other authorities to avoid long delays in the traditional hiring process;
• Requiring tribal consultation prior to hiring area directors, hospital CEOs, and other key leadership positions;
• Commissioning Government Accountability Office reports on staffing and professional housing needs;
• Improving protections for employees who report violations of patient safety requirements;
• Mandating that the HHS secretary provide timely IHS spending reports to Congress; and
• Ensuring the HHS inspector general investigates patient deaths in which the IHS is alleged to be involved by act or omission.

The IHS Accountability Act also addresses staff recruitment and retention shortfalls at IHS by:

• Addressing gaps in IHS personnel by giving the HHS secretary flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals;
• Improving patient-provider relationships and continuity of care by providing incentives to employees; and
• Giving the HHS secretary the ability to reward employees for good performance and finding innovative ways to improve patient care, promote patient safety, and eliminate fraud, waste, and abuse.  

Noem has also introduced comprehensive legislation in the House that offers critical structural changes to how IHS operates, addressing both medical and administrative challenges with bipartisan support.

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