RAPID CITY, S.D. — Today, Senate Committee on Indian Affairs (SCIA) Chairman John Barrasso (R-WY) delivered the following remarks at a committee field oversight and legislative hearing on “Improving Accountability and Quality of Care at the Indian Health Service through S. 2953,” which took place in Rapid City, South Dakota, at the Central High School Auditorium.
The hearing provided an opportunity for the committee to hear testimony on S. 2953, the Indian Health Service Accountability Act. The bill was introduced by Chairman Barrasso and Sen. John Thune (R-SD). Barrasso was joined at the hearing by Senators Thune and Mike Rounds (R-SD), as well as Rep. Kristi Noem (R-SD-1).
The hearing featured testimony from Mary Wakefield, PhD., R.N., the acting deputy secretary at the U.S. Department of Health and Human Services; the Honorable William Bear Shield, chairman of the Rosebud Sioux Tribal Health Board; Ms. Wehnona Stabler, tribal health director for the Omaha Tribe of Nebraska; Ms. Ardell Blueshield, tribal health director for Spirit Lake Tribal Health; and Ms. Stacy Bohlen, executive director for the National Indian Health Board.
Click here for more information on the witnesses’ testimony.
Chairman Barrasso’s remarks as prepared for delivery:
“The first order of business this morning is to recognize the tribal leaders in attendance.
“I would like to thank all of you for your continued leadership and dedication to making your people stronger and healthier.
“The progress we’ve made so far is a direct result of your hard work and feedback, and I greatly appreciate the important role you have played in this process.
“I look forward to working with each one of you to improve the legislation before us and move it forward for the betterment of Indian health in this region and beyond.
“I know our work is not finished.
“I would also like to thank the South Dakota Congressional delegation for their dedication to Indian health, and for providing us with such a warm welcome here in Rapid City.
“And of course, thank you to Central High School for hosting us.
“Today, the committee will examine one bill: S. 2953, the Indian Health Service Accountability Act.
“If you or your family relies on the Indian Health Service for medical care, please stand.
“This is why we’re here today. This is what the Indian Health Service Accountability Act is about.
“For everyone standing, for all IHS patients, we must get this right. We cannot accept failure or complacency.
“As a doctor, I know that real quality healthcare is about putting the patient first. This is the mentality we need to see at every level of the Indian Health Service.
“Thank each and every one of you for being here today.
“On May 19, 2016, Senator Thune and I introduced S. 2953, the Indian Health Service Accountability Act. Senator Rounds is also a cosponsor.
“This committee held an oversight hearing and listening session on February 3, 2016 to re-examine the substandard quality of Indian health care in the Great Plains area.
“Many of you were part of that hearing and listening session.
“What was clear from listening to you is the tremendous amount of pain and frustration you have had with the Indian Health Service.
“You shared many tragic events with the committee that day.
“The sad reality is that many of the problems we have identified over the last year are similar to those identified in the 2010 Dorgan Report.
“Some of these problems have gotten worse and new issues have developed over time.
“As you all recall, I referred to services provided by the Indian Health Service as ‘malpractice.’
“I stand by those words.
“As a physician for more than 20 years, I know this can only be rectified with significant improvements in delivery of medicine, accountability, transparency, and compassion for the patient.
“The bill Senator Thune and I introduced does just that.
“S. 2953, the IHS Accountability Act, is a critical first step on the road to reform because it targets the issues we believe are at the core of the dysfunction at the Indian Health Service.
“It will lay a sound foundation for IHS to actually deliver the healthcare that tribal members deserve.
“Before we go any further, I want to emphasize that this bill is a codification of what we’ve heard from Indian Country about what the problems are and how they should be fixed.
“All provisions in the IHS Accountability Act are tied directly to feedback we’ve already received from tribes.
“So this bill is really a series of solutions designed to solve specific problems.
“For example, the IHS Accountability Act would provide expanded removal and disciplinary authorities for the Indian Health Service to ensure it has all the tools it needs to address problem employees.
“This expanded authority also enhances accountability and transparency within the Indian Health Service through better reporting mechanisms and increased compliance.
“We also heard Indian tribes describe a lack of basic tribal consultation.
“S. 2953 would increase consultation between the Indian Health Service and tribes, and require that this consultation be meaningful and timely.
“It would also ensure that basic budget and spending information is available to the tribes and Congress, so that Indian Health Service funds are spent on patient care instead of union settlements.
“To address severe staffing shortfalls, S. 2953 would enhance the Indian Health Service’s ability to recruit and retain qualified employees by offering more incentives to work in Indian country.
“This bill will also reward employees who deliver quality care and innovative ideas to the tribal communities they serve.
“The bill includes a number of provisions that would help determine housing needs and staffing needs of the agency, so that we are all in a position to make informed decisions about what resources are needed and how they should be spent.
“The IHS Accountability Act will increase patient safety through quality measures and monitoring, and requirements for regular oversight by other Health and Human Services agencies.
“Among other things, it would help ensure that cases don’t fall through the cracks by requiring the HHS Inspector General to investigate suspect patient deaths.
“This bill will also help ensure that Indian Health Service employees who see something wrong feel comfortable coming forward to report problems.
“Increasing accountability and transparency will help ensure that problems are resolved, rather than repeated or covered up.
“This improves patient safety and quality of care.
“The Indian Health Service Accountability Act is a step in the right direction.
“Too many lives have been lost that could have been saved.
“It is my hope the Administration listens and responds to the testimony today, so that one day soon, Indian tribes can trust and again seek services from well-functioning Indian Health Service hospitals in all twelve areas of the country.
“The feedback we receive today will make the Indian Health Service Accountability Act stronger before we consider it in a committee markup.
“I am delighted that Acting Health and Human Service Deputy Secretary Mary Wakefield made the trip to South Dakota.
“Dr. Wakefield, I know you had a scheduling conflict earlier, but you decided to attend this hearing instead – so thank you.
“I appreciate your attention to this important matter.
“Thank you all for being here to testify today.”
On February 3, 2016, the Senate Committee on Indian Affairs held an oversight hearing on “Reexamining the Substandard Quality of Indian Health Care in the Great Plains.”
On February 3, 2016, the Senate Committee on Indian Affairs held a listening session on “Putting Patients First: Addressing Indian Country’s Critical Concerns Regarding IHS.”
The Indian Health Service Accountability Act of 2016 is based primarily on feedback and information received by the committee during the hearing and listening session. The committee continues to gather information from Indian Country for ideas on how to improve the legislation.