Dana Ferguson

dferguson@argusleader.com

Tribal representatives said Friday they were left in the dark until the last minute about a federal agency's effort to privatize three ailing emergency departments.

The Indian Health Service (IHS) quietly put out a request for proposals last month seeking a private health care provider to take over management of emergency rooms in Pine Ridge and Rosebud as well as at another hospital in Winnebago, Neb.

Rosebud Sioux Tribal Health Administrator Evelyn Espinoza and Rosebud Health Board Chairman William Bear Shield said Friday that IHS officials didn't notify tribal leaders about the request until April 7, the day before the initial April 8 deadline for proposals. The deadline was extended until April 11.

"We've had some challenges during the time we've worked with IHS, but right now the lack of communication that is at an all-time low right now," Espinoza said.

The three hospitals have been flagged by the Centers for Medicare and Medicaid Services (CMS) for inadequate health care and the two in South Dakota have one week to prove that they've improved the quality of care they provide or will risk losing a key funding source.

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Spokespeople for the state's three largest health systems, Avera Health, Sanford Health and Rapid City Regional Hospital, said Thursday that the organizations hadn't submitted proposals to take over the emergency departments because they didn't have enough time or information about the request or they weren't asked to apply.

An IHS spokeswoman said the agency was unable to provide additional information about the process, including the number of bidders, until an award is made.

For more than four months the emergency department at the Rosebud hospital has been shuttered and patients have been diverted to the nearest emergency rooms in Winner and Valentine, Neb., 45 and 55 miles away respectively.

IHS officials have said the emergency room closed because of the poor quality of care and the agency's inability to fully staff it.

RELATED: In tense meeting, tribal leaders, IHS head talk solutions

“This whole situation we don’t know what’s going to happen and that’s the frustrating part,” Espinoza said. “My optimism is gone.”

In a meeting with the Rosebud Sioux Tribe earlier this month, Smith said the Rosebud emergency room likely wouldn't re-open until early this summer. She couldn't provide a specific date.

But the agency's request for proposals indicates that contracts could put a new health organization in place beginning May 1. Health organizations have options to contract to take over the emergency departments for a minimum one-year period or up to a five-year time frame.

Follow Dana Ferguson on Twitter @bydanaferguson

Medicaid expansion work continues as clock winds down