A view of the Winnebago Hospital on the Winnebago Reservation in Nebraska. Image from Google Maps



The "substandard" health care in a particularly troublesome region of Indian Country will be the focus of a hearing on Capitol Hill later this month.

The Great Plains Area of the Indian Health Service has been under intense scrutiny for several years due to management failures and cutbacks in care. Despite the known deficiencies, top officials remain in charge within the region despite calls by tribal leaders for more accountability.

In Nebraska, the Winnebago Service Unit lost its Medicare funding last July. Leaders of the Omaha Tribe and the Winnebago Tribe were incensed because the IHS knew of the situation more than a year prior but did not correct the problems that were raised by the Centers for Medicare and Medicaid Services

Just last month, the IHS reduced the level of care at the Rosebud Service Unit , which serves the Rosebud Sioux Tribe in neighboring South Dakota. Again, tribal leaders were bothered by what they saw as a last-minute decision that was made without consultation

These issues and similar stories across the Great Plains will be examined by the Senate Indian Affairs Committee on January 27. The hearing marks the panel's first meeting of 2016 under the continued leadership of Sen. John Barrasso (R-Wyoming), a physician who has vowed to keep the IHS responsive to the needs of American Indians and Alaska Natives.

"As a doctor from Wyoming, I can tell you my priority is to help people of Indian Country live better lives," Barrasso said during in his response to the State of Indian Nations address in January 2015, when he became chairman of the committee.

Tori Kitcheyan, the secretary of the Winnebago Tribe of Nebraska, speaks at the National Indian Health Board conference in Washington, D.C., on September 23, 2015. Photo from Winnebago Tribe / Facebook



The committee has long been paying attention to the Great Plains Area, also known as the Aberdeen Area because the headquarters are located in Aberdeen, South Dakota. A December 2010 investigation warned that five facilities -- including the ones at Winnebago and Rosebud -- were at risk of losing certification from CMS and other entities, thus cutting them off from a significant source of revenue in a system that is already suffering from underfunding. Additionally, the Rosebud unit was singled out for multiple "diversions" -- the agency's term for cutting back services --- which seem to come without warning, parameters or clear policies.

"Our investigation found a chronic state of crisis at the Indian Health Service’s Aberdeen Area,” former Sen. Byron Dorgan (D-North Dakota), who was serving as chairman of the committee at the time, said in a press release

Five years later, tribes are wondering whether the IHS has been paying any attention. Ron Cornelius , a member of the Oneida Nation of Wisconsin, continues to serve as director of the Great Plains Area despite calls for his removal.

Vernon Miller, the chairman of the Omaha Tribe of Nebraska, speaks at the National Indian Health Board conference in Washington, D.C., on September 23, 2015. Photo from NIHB / Facebook



The Omaha Tribe and the Winnebago Tribe also called for the removal of Mark Jackson, the chief medical officer for the region, in a joint resolution last August. Three months later, he was delivering the bad news about "diversions" to the Rosebud Sioux Tribe, The Lakota Country Times reported.

The area's former director was Charlene Red Thunder, a member of the Cheyenne River Sioux Tribe . She was only there for two years before being replaced by Cornelius.

"Of course, Area Director Ms. Red Thunder and her leadership team have not always been perfect," then IHS Director Yvette Roubideaux, a member of the Rosebud Sioux Tribe, said in her written testimony to the committee in September 2010 . "Nevertheless, she has done a commendable job of making meaningful progress in addressing management issues, at times, under extremely challenging conditions – in an area known for having particularly serious problems."

The committee's hearing will take place at 2:15pm on January 27 in Room 628 of the Senate Dirksen Office Building. A witness list hasn't been posted online.

Committee Notice: Reexamining the Substandard Quality of Indian Health Care in the Great Plains (January 27, 2016)

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Related Stories: Mary Annette Pember: Native women affected by cutbacks at IHS (12/29) Lakota Country Times: IHS restricts care at Rosebud hospital (12/24) Nebraska tribes recognized for efforts to hold IHS accountable (09/24) Tribes in Nebraska demand resignations of senior IHS officials (08/12) Winnebago Tribe upset with IHS over loss of funds at hospital (8/6) Winnebago Tribe looking to address deficiencies at IHS hospital (08/05) Winnebago Tribe hopes to prevent Medicare cutoff at hospital (5/28)