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http://www.lakotajournal.com
Feb 28-March 7,2003
By: Ruth Steinberger
Lakota Journal Correspondent
PINE RIDGE -- When the Oglala Sioux Tribal Council held its first
meeting following last fall's elections, tribal officials and members had
questions for the Pine Ridge Indian Health Services Hospital.
Last week, several months later, the same questions and concerns were raised.
This time, however, the tribal officials and community members paid a visit
to the Pine Ridge I.H.S Hospital.
Many came carrying banners and signs, most of which called attention to what
the sign carriers felt was the needless suffering and untimely deaths of
loved ones. They all came with questions or concerns. And this time, Pine
Ridge I.H.S Hospital Director, Vern Donnell was present to hear the stories,
take note of the concerns and do his best to field the questions. At the end
of the three-hour meeting, he had promised to address each of the concerns
and questions raised within 60 days.
"I have always had an open-door policy. My belief is that I and the whole
staff are here to serve the patients and the community," Donnell said.
The previous week, the Rosebud Sioux Tribe had called for a rally to call
attention to healthcare problems they face. Rosebud I.H.S Hospital
Administrators did not meet with the protesters, and in fact told organizers
of the rally that they intended to lock all of the doors to the facility
except for the main and emergency entrances and to secure all files kept in
the hospital.
Police and security guards lined the hospital walkways, driveways and parking
lots. No hospital administrator met with the tribal members, many of who came
from other South Dakota tribes to show their support of the RST marchers.
Such was not the case in Pine Ridge, where only a handful of security guards
were visible, and where many of the members of the hospital administration
were on hand to listen including Bill Pourier, Kathy Ecoffey, and Marge
Murdock.
Oliver Red Cloud opened the meeting by saying that nearly every day people
come to him and tell him of problems they encounter at the I.H.S. facility.
He reminded the administrators that the 1851 and 1868 treaties guarantee
quality healthcare and that it is an obligation of the government.
"Every time there is a new hospital or new building, we are promised better
healthcare, but it has never happened. I am tired of hearing of people who
pass away before their time because of I.H.S.," he said.
Floyd Hand, Headsman for the Grass Roots Oyate and one of the organizers of
the meeting, presented Donnell with a list of key issues.
"We came here peacefully and because there are many of us here, there is
truth to what we are saying about the problems at the hospital. There would
be more people here, but there is always a fear of reprisal," he said.
First, on the list of concerns was the directorship of the hospital. Concern
had been expressed that the directorship of the hospital should be more of a
partnership between tribal members. It had been heard that Donnell was
planning to transfer to the Aberdeen office, and thus it was suggested that
the tribe have some input into choosing an interim director.
Donnell, after reporting that he did not plan on leaving Pine Ridge, said
that he asks tribal officials to come to meetings, most recently to their
strategic planning meetings, and that not many attend. He said that they had
recently surveyed patients and that the results of those surveys were used as
they planned future services and improvements.
It was noted that only one tribal councilperson was in attendance at that day'
s meeting, Alice Perkins. In addition, Gerald Big Crow, an assistant in the
office of the tribal vice-chairman's office was on hand.
"Things will get better in that area. I think, we have a good council now,
lots of women, so things should improve," Hand said.
The next area addressed concerned the providing of health care services to
all tribal members including veterans. There had been concerns raised that
veterans were being sent to Hot Springs and that sometimes they were being
billed.
Donnell explained that the only time veterans would be sent to a veteran's
facility would be if they needed services that were not offered at the I.H.S.
facility according to federal policy.
"No veteran should be billed for any service if our facility referred him to
Hot Springs or anywhere for that matter," Donnell said.
Donnell also heard from tribal members who stated that they receive bills for
services when they go to get services not offered by I.H.S; Donnell again
said that no one should have to pay a bill if they were sent by an I.H.S.
official to other services. He asked that any specific incidents be submitted
to him in writing and that he would personally look into each one.
Donnell also heard from several tribal members who believed that their family
members or themselves had either been misdiagnosed or had received the wrong
treatment at the Pine Ridge facility.
Again, Donnell asked that each concern be submitted to him and that he would
look into each case.
Hand also spoke about a 1952 resolution that the OST had passed that put the
tribe under the umbrella of the Public Health System. After speaking with
other tribal leaders, he said that research needed to be done to see if that
resolution could be rescinded. Some believe that if that were the case, that
the tribe "might have a better leg to stand on" as far as negotiating for
better health, education and housing services.
There was also a concern that I.H.S. administration was sending unused money
back to Washington, money that could be used to improve healthcare services
locally.
Donnell said that that is not done. He gave all in attendance a listing of
summaries of the Pine Ridge, Kyle and Wanblee I.H.S. facilities' Fiscal Year
2003financial data. The data showed the budgeted amounts, the dollars already
obligated to be spent, undisbursed dollars and the amounts that had not yet
been obligated to be spent in all areas of the services provided.
The next item addressed was the requested return of a snack voucher
program for diabetes patients and elders who sometimes have to wait several
hours to see a doctor. Some of these same patients have to drive a long dista
nce just to meet their appointments.
"I realize that we need to do something about the long waits. We have reduced
the wait time, but we need to do more. In our most recent planning session,
we addressed that. We are making room in the very near future for more
outpatient space, which will help. We also need more doctors and more
mid-levels (physician's assistants and mid-wives) to really be able to meet
the needs more fully," Donnell said.
Those present understood that Donnell would look into making sure that
patients were offered snacks when appropriate.
"Some of the people do not step forward and say that they need food when they
need it. There needs to be someone, maybe a patient advocate who patients can
go to with their needs," Perkins said.
Donnell said that that one of the plans included developing a patent advocate
position at the Pine Ridge facility. He said that other facilities in the
Aberdeen district have them and that it has proven to be a beneficial
position.
Community members had also voiced concern that I.H.S. focused too heavily on
reactive medical care and not enough on preventive care.
Donnell said that I.H.S. works closely with the tribe's Community Health
Representatives in the area of health education.
Natalie Hand noted that in the budget Donnell provided, there were no funds
allocated to health education.
Donnell said that one of his employees, Joe Amiotte, had attended a recent
meeting with tribal housing.
Amiotte reported on the meeting saying that 55 homes were being tested,
representative homes in each of the districts. After testing was complete and
preliminary data had been analyzed, the levels of hazard would be ascertained
and a plan of action would be put into place to either fix the homes or "
whatever it takes"
It was stated that it is basically the responsibility of housing to remove
and to prevent mold.
Floyd Hand thought it might be possible to look into who was responsible for
the mold in the first place. It was his understanding that the architects for
HUD should have put adequate venting in the homes.
Donnell pledged to work from the I.H.S. side to address the black mold issue.
Perkins challenged Donnell to be more specific about when he planned to do
the things he was saying he would do.
Natalie Hand suggested that a mailer be sent to all homes explaining what is
known about black mold including preventative measures and mold removal.
The next issue raised was the amount of money the I.H.S. spends to send
patients to Rapid City on Life Flights.
Donnell told those present that it costs between $5,000 and $7,000 for each
flight, and he estimated that there were 300 flights a year.
"That's nearly $2 million. Couldn't we hire doctors and handle trauma cases
here for that amount," one tribal member, Bruce Whalen asked.
Donnell said that the Pine Ridge hospital did not have the needed equipment
or staff to handle some cases. It said that it was difficult to recruit
doctors to the "remote area" and that each flight was at the discretion of
the treating ER physician.
"I applaud the Doctors for the tough decisions they have to make. I would
rather them err on the side of caution when it comes to those decisions to
ensure that patients are getting the best care possible," he said.
Donnell also said that one way to reduce the numbers of life flights would be
to improve roads, to "get rid of some of the alcohol, drugs and drug dealers
on the reservation," and to promote healthier diets and lifestyles.
Regardless, his staff dealt with the "realities" they face each day.
Others present talked about the difficulty and hardships it places on
families to have to drive to Rapid City when their loved ones were
transferred there.
Donnell admitted that Rapid City Regional Hospital gets nearly 10% of its
budget from treating I.H.S. patients.
One tribal member present said, "I demand that what I purchase here be equal
to that anywhere. Maybe our tribe needs to go to Washington and tell them
that our healthcare dollars aren't buying equality."
Whalen said, "You keep saying that it is federal policy that restricts some
of your actions. We say ‘maybe it is time to go to Daschle and Johnson. We
helped elect them.' Maybe we shouldn't elect Daschle next time, in light of
the Mitigation Act. Maybe we should be sending treaty people and people who
are suffering to Washington. Our advocate is the treaty."
The subject then turned to the type of disrespect tribal members are often
shown at the Rapid City Hospital. Kathy Ducheneaux, who currently works as a
patent rights advocate in Rapid City suggested that I.H.S. here partner with
Rapid City services to help ensure that patients who must go to Rapid City
have a Lakota speaker and other services that are needed.
Whalen said, "If it has to be that we send so many people there, then they
should better serve us."
Again, Donnell said that he would look into the situations and assured those
present that his facility was trying to do all it could to hire more ER
doctors and to improve services to cut down the number of flights.
He praised his staff saying, "Recently on one week-end alone there were
several hundred visits to the ER here."
The last topic addressed was the need for quality dialysis care at Pine
Ridge.
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