Emergency Room Closure Might Save Lives

By Vi Waln

The Emergency Room (ER) at the Rosebud Comprehensive Health Care Facility was diverted to Urgent Care on December 5. The upper echelon of the Indian Health Service (IHS) determined what many of us already knew; Rosebud’s ER is not a safe place for patients to seek medical treatment. This is nothing new. In fact, many people who were improperly diagnosed at Rosebud’s ER in the past, were sent home to die.

Rosebud’s Tribal Council held a special meeting on December 5 to hear from Dr. Mark Jackson, Chief Medical Officer of the Great Plains Area Office in Aberdeen. Dr. Jackson, along with Area Director Ronald Cornelius, made the final decision to divert the Rosebud’s ER to Urgent Care. The diversion was effective at 6pm on Saturday, December 5, 2015.

I attended part of the Rosebud Sioux Tribal Council meeting on Saturday. I do think Dr. Jackson is an excellent public speaker. He seemed very diplomatic and had many good words for the Tribal Council. Trouble is, I didn’t believe anything he said. Without fail, Indian Country can count on the promises made by a federal bureaucrat to be broken.

So, we no longer have an ER at Rosebud. Basically, the ER was downgraded to an after-hours clinic. Wikipedia defines urgent care as “a category of walk-in clinic focused on the delivery of ambulatory care in a dedicated medical facility outside of a traditional emergency room. Urgent care centers primarily treat injuries or illnesses requiring immediate care, but not serious enough to require an ER visit.”

Apparently, this decision was due to an inspection conducted last month on Rosebud’s facility by the Centers for Medicare and Medicaid Services (CMS). CMS provides oversight for medical services provided by the IHS. The recent findings by CMS resulted in a notice to discontinue Medicare payments to Rosebud Hospital, due to unsafe conditions for patients. The facility has until December 12 to come into compliance with deficiencies.

President William Kindle, along with members of the Rosebud Sioux Tribal Council, were notified of the ER closure at 4pm on Friday, December 4, 2015 by telephone. Rumors ran rampant throughout the weekend about the closure, or diversion as it was referred to by Dr. Jackson. The closing of our ER at Rosebud on short notice is a fine example of how we are at the mercy of the federal government and their employees. That is, a decision by a couple of IHS bureaucrats in Aberdeen has affected thousands of Lakota people lacking health insurance, who depend on the Rosebud Hospital for emergency care.

How rude for the IHS higher ups to give the Tribe such short notice. There was no attempt by the federal government to publicly inform our people who use the Rosebud Hospital about how the closure will affect them. The IHS higher ups basically left it up to our tribal leadership to explain to people what happened and how they will be affected. The way the decision was made and how our leadership was informed wasn’t right, it was downright abusive.

Still, the actions of the federal government don’t surprise me anymore. After all, they never cared about us, we are simply their wards. Just because they are obligated to provide for our health care needs doesn’t mean they actually care about us. This is obvious through the health care services, or the lack thereof, that we have received since being put on these reservations the government forced on us.

What’s even worse is we have some tribal people working right here in Rosebud who are supposed to ensure our hospital is top notch. Now, we all know that IHS hasn’t been fully funded for years. Still, the local and regional Bureau of Indian Affairs (BIA) and IHS employees make damn good money. They are also enjoy premium health insurance coverage, as well as a generous retirement. Yet, the lack of education, as well as the downright incompetence of key employees, is apparent by their obvious inability to keep our hospital in compliance with CMS requirements.

I’ve realized through my experience with the local IHS that many federal employees are also extremely rigid. That is, some are completely focused on their pay grade, cash awards and the government regulations they are required to follow. So, enforcing government regulations in order to move up the pay scale ladder is often more important than making sure the people’s health care needs are met.

There are some hard working people employed in the local federal system. Maybe the federal government should put those employees who genuinely have the patients’ best interests at heart in charge of the Rosebud Hospital. I can’t apologize to the federal employees working on my reservation if I’ve offended any of them with this, or any other column I’ve penned. Writing the truth will always offend some people.

Finally, this week will mark the 18th birthday of my first-born Takoja. Sadly, she won’t be enjoying cake and ice cream at a birthday party with her extended family. She no longer walks Mother Earth because Rosebud Hospital sent her home to die when she was only 5 years old. So, the closing of Rosebud’s ER might actually be a blessing in disguise. That is, sending our Lakota people to other health care facilities could save their lives.

Vi Waln is Sicangu Lakota and a correspondent for the Lakota Country Times. She can be reached at viwaln@sicanguscribe.com