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Thune calls for more accountability from IHS

ROSEBUD--The Rosebud Indian Health Service Hospital is in declining condition, and Sen. John Thune is working toward a cure. Thune took to south central South Dakota on Friday, making stops in both White River and Wood, but he spent most of his t...

Sen. John Thune and Rosebud Sioux Tribal Health Administrator Evelyn Espinoza share a laugh as they exit the Rosebud IHS Hospital on Friday. (Evan Hendershot/Republic)
Sen. John Thune and Rosebud Sioux Tribal Health Administrator Evelyn Espinoza share a laugh as they exit the Rosebud IHS Hospital on Friday. (Evan Hendershot/Republic)

ROSEBUD-The Rosebud Indian Health Service Hospital is in declining condition, and Sen. John Thune is working toward a cure.

Thune took to south central South Dakota on Friday, making stops in both White River and Wood, but he spent most of his trip in Rosebud touring the health care facility serving 12,000 members of the 28,000-member Rosebud Sioux Tribe.

Last week, Thune and other members of the Senate Committee on Indian Affairs, including fellow South Dakota Sen. Mike Rounds, initiated a hearing to address concerns from tribal members in the IHS's Great Plains region regarding facility failures, which he categorized as a "life or death situation." Following the hearing, Thune decided to drop by the Rosebud facility to see the problems first-hand.

Officials with the U.S. Public Health Service, who were called upon to help guide the Rosebud facility back to satisfactory conditions, and Rosebud Sioux Tribal Health Administrator Evelyn Espinoza walked Thune through the facility, which has been stripped of its emergency room services for failing to meet compliance requirements.

During the tour of the 35-bed comprehensive medical and surgical hospital, USPHS officials barred the media from taking photographs of current conditions or recording comments from hospital employees.

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Thune, a Murdo native who grew up about an hour away from Rosebud, said it's frustrating to see the deteriorating conditions near his hometown.

"Growing up out here, I've seen some of these problems, I've seen some of these challenges, and here I am 40 years later and they have the same problems, the same challenges," Thune said.

Although no specifics were given as to the closure of the emergency room, the facility has been transitioned to an urgent care facility, with a banner labeled "Urgent Care" hastily taped over the "Emergency Room" sign and velvet ropes blocking off some of the beds in the emergency wing.

Espinoza said the lack of emergency services means ambulances can't legally deliver a patient to the hospital and recently resulted in the death of a patient.

Espinoza said one area resident required an ambulance after feeling chest pains, but due to the closed emergency room, the patient had to be sent to the hospital in Valentine, Nebraska. That patient died before reaching the hospital.

Seneca Smith, with the USPHS, said only about 5 to 10 percent of patients seeking emergency services can be helped in Rosebud, and only if they arrive at the hospital without using an ambulance and are facing life-threatening circumstances. It's situations like those highlighted by Smith and Espinoza that led to Thune's call for a monthly updates from the IHS.

"I think it will force them to up their game and sharpen their approach to dealing with these issues," Thune said. "It just creates a level of accountability that doesn't exist today."

Prior to touring the Rosebud facility, Thune said drawing attention to the chronic issues at Great Plains IHS facilities will increase awareness about the shortcomings and get people thinking about better alternatives.

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According to Thune, those alternatives could focus on changing the culture of the IHS by prioritizing responsiveness over bureaucracy and increasing communication between all involved parties, including the Department of Health and Human Services that oversees the IHS.

"Another short-term objective would be just changing the paradigm and the way that the Great Plains area interacts with the tribes and the IHS in Washington interacts with Congress," Thune said. "And the HHS above them, I think ultimately the buck stops there."

While the issues in Rosebud appear to be getting worse before they get better, as evidenced by the obstetrics unit temporarily closing on Friday due to lack of health care providers, Thune sees reason for optimism within the Great Plains IHS.

Aside from the monthly updates and increased attention on the issue, Thune said newly named IHS Great Plains Area Director Rear Adm. Kevin Meeks, who Thune called "a fixer," could lead to improvements within the regional IHS services.

Although Thune has heard some recommendations and has some of his own ideas on how to solve the issues in the IHS, he said those decisions should be made in collaboration with tribal members using the facilities.

"It's really up to the tribal leader, they have to make some of those decisions," Thune said. "But we want to be a resource that works with them, that consults with them and looks at doing a better job."

Related Topics: JOHN THUNEHEALTH
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