What They're Saying About Rounds' Bill to Require a Comprehensive Assessment of IHS

Last month, the Senate Committee on Indian Affairs passed S.465 with broad, bipartisan support. S. 465 would require the Secretary of the Department of Health and Human Services (HHS) to contract an assessment of the Indian Health Service’s (IHS) health care delivery systems and financial management processes only at direct-care facilities. It now awaits consideration by the full Senate floor. Here is what stakeholders have been saying:

Harold C. Frazier, Chairman, Cheyenne River Sioux Tribe: “I endorse S. 465 - Independent Outside Audit of the Indian Health Service Act of 2017. This bill has been long overdue as the Indian Health Service (IHS) has been reluctant in giving information to the Tribes. When tribes are not given information, it hampers those tribe’s ability to plan with the IHS and provide effective medical care for our members and be an effective partner in preventative medicine. I fully support this bill and would like to personally thank Senator Mike Rounds for his work on S. 465 that would establish an independent outside audit of the Indian Health Service.”

Lester Thompson, Chairman, Crow Creek Sioux Tribe: “It is about time Congress took action to consider legislation, such as Senate Bill 465, that will facilitate a much needed audit of the Indian Health Services (IHS) incompetent health care delivery and financial management systems that plagues the numerous tribes in our region. IHS failures range from lack of access to health care for dialysis treatment to serious staffing concerns that have been inadequately addressed and outright ignored, resulting in a direct and harmful impact on our tribe. To address all issues of concern, the Crow Creek Sioux Tribe is hopeful that Senate Bill 465 will be amended to include in the scope of the IHS audit the current lack of access to critically needed dialysis centers that has had a detrimental effect on our tribal members suffering from Diabetes related kidney failure. The Crow Creek Sioux Tribe urges the immediate passage of Senate Bill 465.”

Tony Reider, President, Flandreau Santee Sioux Tribe: “The state of health care in Indian Country is troubled. The Flandreau Santee Sioux Tribe has successfully operated its own health care facility for decades, and has provided the best care it could with available resources.  The Indian Health Service has created barriers for the Tribe, mostly stemming from untimely payment of annual funding through the P.L. 93-638 agreement with the Indian Health Service.  The Tribe looks forward to a thorough assessment of the Indian Health Service, and believes that it is an opportunity for the Indian Health Service, the United States Congress, and the Tribe to fully understand the hurdles presented by the current regulatory framework, and to develop a plan to fix a failing system.” 

Boyd Gourneau, Chairman, Lower Brule Sioux Tribe: “With all that is happening on the hill, I can't express my gratitude enough for Senator Rounds’ efforts not only to the health and wellbeing of our members, but holding the IHS accountable for providing quality healthcare and that the funds are spent in a responsible manner. Our members deserve the same quality healthcare as anyone else and the Senator is seeing to that, he has never wavered on the issue and his efforts are much appreciated. Pilamaya.”

Troy S. Weston, President, Oglala Sioux Tribe: “One of the oldest treaties between the federal government and Indian Nations makes provision for providing health care. When the federal government fails to do their part, Native peoples suffer and too many times loss of life occurs. The trust responsibility is not a discretionary choice. It is not a line item. It is a solemn agreement that has been sustained over hundreds of years. The health disparities our tribal communities face need to be addressed immediately before another generation of American Indian and Alaska Native people lose their quality of life to debilitating health problems left untreated. American Indians and Alaska Natives have a life expectancy five years less than all other races in this country. Diabetes continues to be a devastating curse among American Indian and Alaska Native people. The mortality rates from diabetes for our Native communities are more than three times the national average. This is a statistic that can be reduced.  Authorization of S. 465 would address an independent outside audit of the Indian Health Service to that the most basic elements of health care: doctors and nurses, mental health professionals, addiction counselors and the medical equipment, facilities, even buildings required to provide even the most fundamental services will be copiously examined in this assessment. Today, I am calling upon the 115th Congress to continue to fulfill the federal trust responsibility by authorizing S. 465 to provide for an independent outside audit of the Indian Health Service.”

Rodney M. Bordeaux, President, Rosebud Sioux Tribe: “I received news that the Senate Committee on Indian Affairs approved S. 465, the Independent Outside Audit of the Indian Health Service Act of 2017. I would like to thank and commend Chairman John Hoeven, Vice-Chairman Udall, and committee members for their efforts to address inefficiencies in the Indian Health Service (IHS). I would also like to express gratitude on behalf of the Rosebud Sioux Tribe for the tireless efforts of Senator Mike Rounds and staff in the development, introduction, and continual support for this crucial legislation. It is not a secret that the IHS is historically underfunded. A combination of increased funding and assurances that the necessary metrics are in place to assess qualitative data that will ensure funding is provided to a system that is efficient and accountable. When this bill becomes law, it will mandate an assessment of the IHS that will provide the insight necessary to determine how the limited funding that the IHS receives can be more efficiently utilized and ensure that increases in funding will be used to improve the quality of healthcare provided to tribal members to the greatest extent possible.”

Dave Flute, Chairman, Sisseton-Wahpeton Sioux Tribe: “On behalf of the Sisseton-Wahpeton Sioux Tribe, I am grateful S. 465 is moving forward and encourage our congressional leaders to continue to support this legislation. Tribes like mine in the Great Plains region have experienced challenges with the Indian Health Service for years. Challenges such as funding, management and quality care are issues that my tribe and other tribes in our region have shared with our congressional leadership and I am very grateful Senator Rounds took the initiative to put forth S. 465 so that an independent outside audit can be conducted on I.H.S., and see why tribes like mine experience these challenges, but more importantly to get them fixed.  I am in full support of S. 465 and again want to thank Senator Rounds and his colleagues for moving this legislation forward.”

Tim Rave, President and CEO, South Dakota Association of Healthcare Organizations: “On behalf of South Dakota Association of Healthcare Organizations (SDAHO), which represents 32 Post-Acute Care providers, 54 hospitals and 3 health systems in South Dakota, we offer this statement of support for S. 465, the Assessment of Indian Health Service (IHS) Act of 2017. The basis for this support relates to long standing concerns involving the delivery of substandard care at IHS facilities.  These failures have resulted in numerous incidents of harm and inadequate coordination of care and administration of services. The Assessment is urgently needed and will provide invaluable information and data that can be utilized to research/recommend opportunities for improvements and ensure access to high quality, safe care for Native Americans in South Dakotans and throughout the country.”

Mike Faith, Chairman, Standing Rock Sioux Tribe: "The way to fix many problems is often to find the root cause, with the request for a comprehensive audit, we, the Standing Rock Sioux Tribe, believe this will find the root of the many problems and help address or fix the many issues and aspects of the Indian Health Service. The Standing Rock Sioux Tribe applauds Senator Rounds for introducing S.465: Independent Outside Audit of the Indian Health Service Act of 2017 and feels this is step in the right direction to fulfilling the federal government’s trust responsibility of delivering timely, adequate health care to tribal members." 

Robert Flying Hawk, Chairman, Yankton Sioux Tribe: "Quality health care is a critical component to the right to accessible healthcare services and to dignity of our tribal members. For too long Indian Health Services (IHS) has gone without an audit to verify the delivery of adequate and cost effective healthcare services. Quality healthcare is essential to the prevention and treatment of serious and chronic diseases such as diabetes and cancer. The long history of incompetent management of IHS clinics and lack of access to critical healthcare services has negatively impacted the health and livelihood of our tribe and the tribes in our region. The Yankton Sioux Tribe is very thankful that included in the scope of the audit stipulated in Senate Bill 465 is accessibility to cancer services for rural Indian reservations. The Yankton Sioux Tribe urges the immediate passage of Senate Bill 465.”

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