Thune gets tour of health care 'mecca' in WagnerSen. John Thune spent three hours Wednesday listening and learning about health-care concerns and efforts to serve residents in and near this Charles Mix County community. Thune, R-S.D., toured the Wagner Community Based Outpatient Clinic, which provides health-care services for veterans.
By: Tom Lawrence, The Daily Republic
WAGNER — Sen. John Thune spent three hours Wednesday listening and learning about health-care concerns and efforts to serve residents in and near this Charles Mix County community.
Thune, R-S.D., toured the Wagner Community Based Outpatient Clinic, which provides health-care services for veterans.
After that, the senator, his staffers, some reporters and members of the community trooped through a parking lot and toured the adjacent Wagner Indian Health Service facility.
Following that, he was taken to the Wagner Community Memorial Hospital, which is nearing completion of a $7 million, three-year expansion and upgrade.
Finally, Thune went to the Bureau of Indian Affairs office on the edge of town and met with Yankton Sioux Tribe Chairman Bobby Cournoyer and other tribal officials.
Thune said he wanted to hear what people who are working in the health-care field and those who are supporting them had to say.
“It’s always good to see what’s going on on the frontline locally,” he said.
Thune noted that all the health-care facilities are within a few blocks of each other, and a privately operated retirement facility that offers skilled care and assisted living is adjacent to the hospital.
“It’s kind of a mecca for health care,” he said.
The new veterans’ facility opened March 29, 2010, and Thune had not visited it until Wednesday. He spoke with Dr. Douglas Mallory, registered nurse Marylou Morrow and Associate Director Sara Ackert, as well as patients and other staffers.
Gregory County Veterans Services Officer Roy Farabee also followed the senator as he toured the gleaming new building. Farabee said there are about 1,000 veterans in Charles Mix County and hundreds more in the nine other counties that are served by the facility.
Wagner Mayor Sharon Haar, who volunteers at the clinic, said as veterans age, many are returning to their hometowns. Some do so to be closer to family and friends while others find small-town life more affordable, Haar said.
She said health-care facilities are needed in rural areas because many veterans find going to Sioux Falls stressful.
Thune said devices that allow people to submit information from their homes or from rural facilities such as the ones in Wagner can serve people better and also save money. He said he has co-sponsored a bill with Sen. Amy Klobuchar, D-Minn., to provide payments to health care providers who utilize such technology.
The bill, the Fostering Independence Through Technology Act, has been introduced three times, Thune said, but has yet to receive enough support to become law. But he said he still supports it and will try it again.
“In the long run, it’s a way to save money,” Thune said.
Another way is for health-care facilities to cooperate. Jean Tjaden works as a nurse in Wagner and Watertown and said she feels area facilities work well together. Tjaden said the veterans facility and the IHS center are only a few hundred feet apart and have found ways to treat American Indian veterans that work for the patient.
“And I think it’s a good thing,” she said. “It’s really hard to get federal agencies to work together. We’ve had to work hard. It took a lot of time and effort on both sides.”
Cournoyer accompanied Thune on the tour of the veterans and IHS buildings and said he finds the senator accessible and interested in the people he serves.
“It’s always a pleasure to have him here,” Cournoyer said. “It shows he’s always interested in what we’re doing.”
The IHS clinic serves 50,000 people needing outpatient care and 12,000 people in need of urgent care, according to Mike Horned Eagle, a nurse who also serves as the facility’s CEO.
It does that despite a funding problem that forced it to abandon 24-hour care three years ago. It’s now open 7 a.m. to 11 p.m. Monday through Saturday and will add Sunday to its hours on May 8.
He said staffers deal with cases involving heart attacks, strokes, broken bones and more routine matters such as the common cold.
At the Wagner Community Memorial Hospital, Thune was greeted by CEO/Administrator Bryan Slaba and several members of the hospital board as well as people involved in local economic development efforts.
Wagner is losing population, Thune was told, and is down to 1,566 people, with hundreds of people living nearby in tribal housing. But the area population is aging, so health care is a bigger issue than ever.
The hospital, which has a management agreement with Avera, has responded by building a new clinic and patient wing and offering enhanced rehab facilities, a remodeled patient wing and a new and larger pharmacy. The community raised about $900,000 and more than $6 million came from grants and loans, including some through the U.S. Department of Agriculture.
Slaba said retaining doctors and providing quality care while dealing with financial problems is a daunting challenge. The hospital employs two doctors and has a third who is associated with it. There are 63 employees and a $4 million payroll, meaning the hospital provides health care and a healthy jolt for the local economy, Thune was told.
Slaba said South Dakota should provide a template for the rest of the nation on how to provide low-cost, high-quality health care.
“Take a look at what we’re doing and implement that elsewhere,” he said. “We’re about as efficient, in my mind, as we can be.”
Thune said South Dakota has been “punished” for its efficiency while other, larger states receive more federal money for their health-care services. He said the health-care law passed and signed in 2010 was supposed to answer problems in the nation’s health care but was instead “a missed opportunity.”
He said while it promised to provide access to health care for 32 million Americans, it has placed 16 million more people in the Medicaid system. These people were “put on the Titanic,” Thune said.
“Exactly,” Slaba said.
Thune’s final stop in a day that earlier included a high school assembly and Rotary luncheon in Gregory was at the BIA office.
He talked health care and other issues with Cournoyer, tribal Vice Chairwoman Karen Archambeau, Councilman Baptiste Cournoyer and BIA Superintendent Ben Kitto.
They told Thune that money remains the major stumbling block for providing adequate care for tribal members, with diabetes, methamphetamine addiction, as well as prescription medicine abuse and alcoholism contributing to a population struggling with health issues.
Some pregnant women are using meth, Thune was told. Gangs and youth crime are other issues to be watched. The cost of burying tribal members is a constant concern as well, Bobby Cournoyer said.
“We try to bury people with a little dignity,” he said.
If a tribal member dies in another location, the bodies are “held hostage” until payments are made to send them home for burial. He praised the local funeral director, who he said keeps costs down.
“So, we’ve got all these problems, but we’re working on them,” Bobby Cournoyer said. “Out here, we serve the poorest of the poor.”
The tribe does have some good news. An expansion of its Fort Randall Casino is nearing completion and will be ready for a “soft open” in late June in time for the annual powwow.
A detention facility for adults and juveniles is being built and more than 40 jobs will be created, with Indians given preference. Thune was invited back this summer to check on the progress of the tribal projects and said he plans to do so.