ROSEBUD – The Rosebud Sioux Tribe hosted a consultant and lawyer to answer questions about the plan to compact the existing hospital into a tribal healthcare system.
Consultant Chris Walker (Cherokee), founder of the Tribal Health Alliance (THA), and attorney Elliott Milhollin, of the Hobbs, Straus Dean & Walker law firm, were both hired by the tribe to assist with formalizing the plan to compact the Indian Health Service hospital at Rosebud.
The consultant firm THA has been working for several years assisting tribes to improve health care delivery by helping tribes assume operations away from the IHS and turning existing facilities into tribal healthcare systems. Most recently, THA helped the Winnebago Tribe of Nebraska compact their IHS facility in 2018.
The Rosebud Sioux Tribe has talked about compacting the hospital for several years. The process took a step forward on May 17, 2023, when the tribal council passed Resolution 2023-143 approving the charter forming the Sicangu Oyate Health System (SOHS).
The tribal council subsequently approved Resolution 2023-239 which appointed a seven-member board to oversee the compacting process. Board members include Dr. Donald Warne (Oglala Lakota), Dr. Allison Kelliher (Athabascan), Dr. Darrell Plumage, Bill Snyder, an unnamed pharmacist, Scott Herman (RST President) and Lisa White Pipe (Chairwoman of RST Health Board).
The difference between contracting and compacting the Indian Health Service is best answered by the federal agency itself. IHS has an Office of Tribal Self-Governance to oversee the contracting/compacting of health care facilities. The following is taken directly from their website:
“Both Title V and Title I provide for Tribal administration of programs formerly administered by the IHS. The major difference is a matter of oversight. Under Title V, a Tribe may redesign or consolidate PSFAs [Programs, Services, Functions and Activities] and reallocate or redirect funding without IHS approval in accordance with the ISDEAA [Indian Self-Determination and Education Assistance Act of 1975]. In contrast, IHS must approve any substantial changes to a Title I Contract. The programs are not exclusive. Because Tribes can choose which PSFAs (or portions thereof) to assume, a Tribe may combine Title V, Title I, and direct services to best meet the needs of its community.” https://www.ihs.gov/selfgovernance/faq/
In addition, in order to be determined as eligible to participate in the IHS Tribal Self Governance Program (TSGP), tribes are required to (1) complete a planning phase, (2) request participation in the self-governance program and (3) provide evidence of three years of financial stability and management capability. In other words, the tribe must have three years of clean audits to be eligible to compact a healthcare facility.
The Rosebud Sioux Tribe has received grant funding for the planning phase and hired the Tribal Health Alliance to assist with this process. However, only two attempts were made to inform the public of the process in the compacting project. One was a virtual question and answer session held on August 18, 2023 (https://tinyurl.com/ed4untu7). The other public information session was held in Antelope Community.
The RST Health Administration is responsible for scheduling future public meetings in the reservation communities to share information with tribal citizens. To learn when a meeting is scheduled for your community, tribal citizens can call the RST Health Administration program at 605-747-5100.
Interested persons can listen to the all-day discussion on the Indian Health Service compacting process by viewing the October 12, 2023 RST council meeting on YouTube at https://tinyurl.com/hcrp25ry
Sicangu News 