Rounds Leads Letter Urging IHS to Improve Accessibility to Health Care Services

WASHINGTON – U.S. Senator Mike Rounds (R-S.D.), a member of the Senate Committee on Indian Affairs, led the South Dakota and North Dakota congressional delegations in sending a letter to Indian Health Service (IHS) Director Roselyn Tso urging IHS to expand access to outside health care services in both states.

“We write today in support of efforts to consider expanding the Purchased and Referred Care Delivery Area (PRCDA) to all counties in South Dakota and North Dakota,” wrote the members. “It is our understanding the Indian Health Service (IHS) is considering conducting a study to examine the feasibility of this potential residency expansion. We respectfully ask IHS to conduct this study in a timely manner and move to promptly analyze the results.”

The members’ letter continued, “According to census data, thousands of citizens of tribal descent are residing in counties not covered under the PRCDA. In addition to residency requirements, these tribal beneficiaries must abide by a number of other rules when attempting to access PRC, including medical priority and notification requirements. With the Great Plains Area (GPA) being a stronghold for IHS direct care, tribal members in South Dakota and North Dakota have little opportunity to access healthcare away from the agency. This may be problematic when a tribal beneficiary is unable to access IHS direct care or a service unit does not have the resources to provide care in a timely manner.”

In addition to Rounds, the letter was signed by Senators John Thune (R-S.D.), John Hoeven (R-N.D.) and Kevin Cramer (R-N.D.) and Representatives Dusty Johnson (R-S.D.) and Kelly Armstrong (R-N.D.).

Read the full letter HERE or below.

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Dear Director Tso:

We write today in support of efforts to consider expanding the Purchased and Referred Care Delivery Area (PRCDA) to all counties in South Dakota and North Dakota. It is our understanding the Indian Health Service (IHS) is considering conducting a study to examine the feasibility of this potential residency expansion. We respectfully ask IHS to conduct this study in a timely manner and move to promptly analyze the results.

As you are aware, IHS beneficiaries must reside within the PRCDA to be eligible for the PRC program. According to the 2010 reauthorization of the Indian Health Care Improvement Act, the entirety of South Dakota and North Dakota should fall under PRCDA status. It is our understanding IHS has opted not to implement statewide coverage in South Dakota and North Dakota on the basis such a change may impact services for those residing in PRCDA counties. With IHS service units in both states increasingly accessing funding from third-party collections, we believe this is an opportune time to seriously reexamine the possibility of expanding residency eligibility.

According to census data, thousands of citizens of tribal descent are residing in counties not covered under the PRCDA. In addition to residency requirements, these tribal beneficiaries must abide by a number of other rules when attempting to access PRC, including medical priority and notification requirements. With the Great Plains Area (GPA) being a stronghold for IHS direct care, tribal members in South Dakota and North Dakota have little opportunity to access healthcare away from the agency. This may be problematic when a tribal beneficiary is unable to access IHS direct care or a service unit does not have the resources to provide care in a timely manner.

We understand IHS has conducted similar studies in the past before moving to expand residency eligibility in other states. As your agency begins to work through this process, we encourage you to work closely with tribal leaders. With consideration given to the challenges outlined in this letter, we request you provide our offices with regular updates on the status of this study. Please do not hesitate to contact any of us if we can provide you with additional information.

Thank you for your consideration of these requests.

Sincerely,

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