Noem Statement on Reopening of Rosebud Emergency Department

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Rep. Kristi Noem issued the following statement in the wake of a Centers for Medicare and Medicaid Services announcement that the Rosebud Hospital emergency department would reopen on Friday, July 15, and resume operations 24 hours a day, seven days a week:

“The dangerous conditions within the emergency department and the resulting diversionary status put too many lives in jeopardy. Today is a day of hope, but it is not the end of our work. So much still needs to be done. The problems that led to the grave conditions in Rosebud remain. Expansive reforms, such as giving tribes a role in running IHS facilities and reformulating how purchased-referred care dollars are allocated, must be made if we are going to see the lasting improvements tribal communities deserve.”

In June 2016, Noem introduced the Helping Ensuring Accountability, Leadership, and Trust in Tribal Healthcare (HEALTTH) Act, which among other things:
+ Gives tribes a seat at the table to encourage better, longer-term contracts by allowing for a partnership among IHS, tribal communities and healthcare stakeholders to collaborate throughout the contract negotiating process, rather than leaving those decisions solely to IHS.

+ Addresses the current recruitment problem – for both medical staff and hospital leadership – by putting provisions in place to:

· Allow for faster hiring.
· Make the existing student loan repayment program tax free, as an added incentive for high-quality employees.
· Provide incentives to attract competent and well-trained hospital administrators as well as medical staff.
+ Reforms the Purchased/Referred Care (PRC) Program by, among other things:

· Requiring IHS to develop a new formula for allocating PRC dollars. Under Noem’s bill, IHS would be required to develop a formula based on need, population size, and health status to ensure those areas that have the greatest need receive a greater portion of the funding.
· Requiring IHS to negotiate Medicare-like rates for services it pays for with private providers. IHS currently pays a premium for PRC services. Noem’s proposal would bring payments in line with what Medicare pays to stretch every dollar further.
· Requiring IHS to address the backlog of PRC payments to private providers. Private hospitals in the Great Plains Area have long expressed concern because IHS has failed to pay their bills. Noem would require IHS to put a strategy in place to get these hospitals paid what they are due.
+ Restores accountability through strategies, such as:

· Require IHS to be accountable for providing timely care.
· Require the Government Accountability Office to report on the financial stability of IHS hospitals that are threatened with sanction from the Centers for Medicare and Medicaid Services.
The legislation has been endorsed by the Rosebud Sioux Tribe, the National Indian Health Board, Avera, Rapid City Regional Health, Sanford Health, the South Dakota Association of Healthcare Organizations, the South Dakota State Medical Association, the South Dakota Dental Association and others.

U.S. Senator Mike Rounds (R-S.D.) issued the following statement on the reopening of the emergency department at the Rosebud Indian Health Service (IHS) hospital, which had been closed since December 2015. IHS announced today that the hospital is set to reopen tomorrow, July 15, 2016, and will resume 24-hour, 7-day-a-week care.

“The news that IHS and the Centers for Medicaid and Medicare Services have agreed to reopen the emergency department at the Rosebud IHS hospital is a positive step toward better and timely health care for patients,” said Rounds. “Emergency room services are an essential part of any hospital. However, there is still much work to be done to make certain our tribal members are receiving adequate and timely care. The problems within the bureaucracy of IHS, along with the lack of adequate consultation with tribes, are ongoing. I still believe that an outside audit is the best first step toward making significant, systemic changes at IHS.”

Rounds sent a letter this month to the Department of Health and Human Services Inspector General requesting an audit of the financial aspects of hospital and health care, medical services and overall financial management at IHS.

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