Field Hearing Important Step to Fixing Indian Health Service
By Senator Mike Rounds

I recently joined Senate Indian Affairs Committee Chairman John Barrasso and the other members of the South Dakota congressional delegation in a field hearing in Rapid City to discuss the inadequate health care being provided to our tribal members. The purpose of the hearing was to shed additional light on the ongoing crisis at Indian Health Service (IHS) facilities within the Great Plains Area, and to work with tribal leaders toward permanent solutions.

Nearly every week, if not every day, our newspaper headlines tell the tale of new problems with IHS facilities. It is important to understand the impact that IHS is having on real people on our tribal land. The Great Plains Area IHS, which covers South Dakota, North Dakota, Nebraska and Iowa, has the second highest mortality rate among all IHS regions. We also have the highest diabetes death rate, almost double the average among all IHS regions. Tragically, our life expectancy rate is also the lowest of all IHS regions, at 68.1 years. The U.S. average life expectancy is nearly a decade longer at 77.7 years. It is clear the IHS is failing our tribal members, who are suffering and in some cases even dying due to this inadequate and disgraceful care.

As we all know, Rosebud has essentially had its emergency department shut down for approximately 200 days and counting, meaning tribal members are having to drive over 50 miles to receive emergency care. The same is true for their obstetrics and surgical departments. These circumstances are going to continue to occur until we demand a thorough review and reform of IHS. More specifically, we need an external audit.

I had the opportunity to meet with the Great Plains Tribal Chairman’s Association in April. We discussed an in-depth profile analysis on IHS that my office put together in an attempt to seek answers and gain a better understanding. We talked about the administrative imbalance; of the 15,000 employees at IHS, only 750 are doctors and nearly 4,000 are administrative “medical billers.” We also found that IHS employees and administrators can’t explain or don’t understand their own budget.

After reviewing the data with me, the Great Plains Tribal Chairmen voted on a resolution supporting an audit of IHS. The IHS needs major reform but more taxpayer money won’t solve the dysfunction, because what IHS lacks is an efficient system and accountability. I appreciate Health and Human Services Acting Deputy Secretary Mary Wakefield’s support for an independent audit and look forward to working with her to get the answers necessary to turn the agency around. From my standpoint, investing more taxpayer money in a dysfunctional system will only compound the problem.

This is a serious issue that requires tangible solutions, not temporary fixes. There are significant administrative, financial and quality-of-care issues that must be addressed. The hearing helped us better understand where the problems lie so IHS, working in close collaboration with the tribes, can take steps forward to fix these problems. IHS will never be able to deliver the timely, quality care the federal government has a trust responsibility to deliver, without broad reforms.

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Keep Fighting
By Rep. Kristi Noem

You have to do a double take when you get a letter like this: “My name is Maggie Einrem.  I am a 36 year old breast cancer survivor.”  Wow, a survivor – at 36.

Maggie, a mother of two from Watertown, was only 34 when she received the diagnosis.  She wrote: “I had no warning signs, never even thought that breast cancer could affect me.  Naïve, I know, however, it was not something that I had worried about…. At the ripe old age of 34, I found a lump.  Not thinking it was anything serious, I just let it go for a couple of months.”

She was a busy mom and the to-do list was already busting at the seams.  But by June of that year, the lump had grown.  She received an ultrasound and a mammogram.  Less than a month later, Maggie was in surgery and so her battle began.

“I made it through eight rounds of chemo and 36 radiation treatments,” Maggie wrote, “worked eight hours a day, raised two kids (ages 3 and 9), put supper on the table every night…. I knew if I stopped to think about everything, I would lose it and go into a very dark place.  So I put on a smile, lost all my hair, had burned skin, numerous surgeries, and felt like junk every day, but I kept going.”

Not only did Maggie keep going in her own fight, she began to reach out to help others with theirs. She’s become an activist even within her own family to make sure that all the women receive annual mammograms and that the men do self-checks.  She made a blanket for a co-worker that was diagnosed recently, as the transfusion room can be so cold.  And through her workplace, Sparton, she’s raised awareness about breast cancer by helping with a cancer walk, a soup cook-off, and a raffle.

After hearing her story, I chose Maggie to be my guest of honor at this year’s Congressional Women’s Softball Game.  Every year, female members of Congress team up to take on the female members of the press corps.  We play to benefit the Young Survival Coalition, an organization set up to help young women who have been diagnosed with breast cancer.

Sadly, too many of these diagnoses are happening in our state.  The number of incidents has risen steadily since 2010, putting South Dakota at the top of the list when it comes to breast cancer diagnoses per capita.

It’s unclear what has caused the influx, and while not everything is in your control, there are steps you can take to reduce your risk.  According to the American Cancer Society, excessive drinking, being overweight or obese (particularly after menopause), and a lack of physical activity can increase a woman’s risk of developing breast cancer.  These are things you can take action on today.  Additionally, getting an annual mammogram can help make early detection possible.  This means treatment can start earlier, possibly even before the cancer has spread.

We have made tremendous strides when it comes to detecting and treating breast cancer.  Still, 680 South Dakotans are expected to learn they have breast cancer this year alone.  I pray they are able to approach this diagnosis as Maggie did in her letter when she wrote: “I have too much to live for and so much love to give to others that I will never stop fighting!”

Keep on fighting, Maggie.  You’re an inspiration to your children, your community, and women fighting this disease everywhere.

Rep. Kristi Noem & Maggie Einrem at 2016 Congressional Women’s Softball Game

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An Invitation to the Governor’s Mansion
A column by Gov. Dennis Daugaard:

Linda and I are very fortunate these days. We live in a big home on Capitol Lake where we have a great view of the Capitol Building. My place of employment is only a short walk away and, except when hundreds of geese arrive for the winter, our neighborhood is nice and quiet.

Some of South Dakota’s former governors weren’t quite as lucky. When Pierre was named as the state Capitol, there was no Governor’s residence. Instead, governors received a housing allowance of $75 per month. In 1925 the Legislature approved the purchase of a small yellow cottage on the eastern shore of Capitol Lake.

In 1936, Gov. Tom Berry thought it was time to make improvements to the Governor’s residence. State funds were limited at the time because of the Great Depression, so South Dakota accepted help from the Works Progress Administration (WPA) to construct a new home. From 1937 until 2003, governors lived in that home built by the WPA. It was a 57 x 97 foot, two-story house made with native brick, lumber and concrete.

By the time Gov. Mike Rounds came into office, the residence was in rough shape. The wiring was outdated, the plumbing leaked and dry rot had weakened the walls. One night, the Rounds family was preparing to host an evening event. Just before the guests arrived, as someone was upstairs taking a shower, water started pouring through one of the light fixtures. It was time for a new Governor’s Mansion.

The new Governor’s Mansion where Linda and I now reside was completed in the summer of 2005. It was funded entirely through private donations. Thousands of South Dakotans and numerous businesses from across the state donated money and materials to make this mansion possible. The mansion is approximately 14,000 square feet and is located in the precise location of the previous Governor’s Mansion. One-third of the mansion serves as the private residence for the governor and their family.  Two-thirds of the building is the public area where large groups can be hosted.

This summer my wife Linda and I are once again opening your Governor’s Mansion for public tours. The 45-minute tours begin at 1 p.m. Central Time on Wednesdays and they are conducted by the First Lady and volunteers. There is no charge for the tours, but you must reserve tickets in advance. June is already booked up, but there are still openings for tours in July and August. Reserve tickets by calling the Pierre Area Chamber of Commerce at 605-224-7361.

Linda and I are honored to stay in such a beautiful home. We know the Governor’s Mansion belongs to the people of South Dakota and we want South Dakotans to be able to experience it for themselves.

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Happy dad day from a fellow dad at the SDWC.

I had that fact underlined to me this weekend as I gave away my #2 daughter Meredith at her wedding on Friday in Sioux City, and was called up to dance with her at the reception. 

She did oblige me by not holding it on GOP convention weekend, so that’s good.

It was a bit weird seeing her take her husband’s name on Facebook, but yes, that happens with weddings. I can take heart in that her betrothed is a good person, one of the hardest working people I know, and I know he cares deeply for my awkward, overly loud and opinionated, and lovely daughter.  He’s the kind of son-in-law you hope your daughter would choose for themselves.

And I can say things like “awkward” and “loud” because I’m her dad. She’s both driven my car into a tree, and made me as proud as can be in many, many aspects of her life. 
Having 7 kids, 5 of whom are daughters, the wedding this weekend is probably only the first one of many I’ll experience. But coming this particular weekend as it did with the first marriage of one of my children as it did just underlined the whole Father’s Day Experience for me in a way it had never been before. 

There comes a time when that little girl who you watched those God-awful Barney the dinosaur videos with, and decorated princess and unicorn birthday cakes for is going to grow up, leave the nest, and start a nest of her own. It happens sooner than you would care to know, and you wish them all the happiness and prosperity in the world.

So, again, Happy Father’s Day for all my fellow fathers.   

(Now about those wedding bills….)

Is Jay Williams already bringing in out-of-state help? Because someone needs to brush up on their South Dakota Geography. (Tabor, guys)

From the Casper Star Tribune, Senator Thune and Congresswoman Noem had a lot to say about IHS and how they deliver care on the Reservations:

“What I’ve concluded is we can’t fix the problem here by a tweak here or a fine-tune here. This requires systemic change,” U.S. Sen. John Thune, a Republican from South Dakota, said of the deep-rooted challenges the agency faces. “You can’t fix this by changing the oil and replacing the tires. We need a whole new car.”

Tribal leaders and legislators exhorted the Indian Health Service, commonly referred to as IHS, to share copies of contracts with Congress and tribes, consult tribal members before making key decisions and agree to an independent audit of the agency’s budget.

Legislators and tribal leaders cited instances when the IHS delayed notifying the tribes of upcoming changes affecting the hospitals. The examples included the last-minute notification regarding the closure of the emergency department of the hospital on South Dakota’s Rosebud Indian Reservation and the appointment of a new director responsible for overseeing all IHS facilities on the Great Plains.

And…

Legislators on Friday did not hold back their criticism toward the agency. Barrasso described some of the agency’s services as “malpractice,” while South Dakota’s Republican U.S. Rep. Kristi Noem said the IHS provides “Third World” care.

Read it all here.

Indian Affairs Committee Field Hearing Shines Light on IHS Crisis, Response

Hearing Part of Coordinated Effort Between Tribes, Delegation, and Administration

RAPID CITY, S.D. — Today the Senate Committee on Indian Affairs, at the request of U.S. Sen. John Thune (R-S.D.), convened an oversight and legislative hearing in Rapid City to receive testimony from stakeholders impacted by the years-long crisis at Indian Health Service (IHS) facilities across the Great Plains area and examine comprehensive IHS reform legislation recently introduced by Thune and Sen. John Barrasso (R-Wyo.), chairman of the Indian Affairs Committee. Sen. Mike Rounds (R-S.D.) and Rep. Kristi Noem (R-S.D.) joined Thune and Barrasso at today’s hearing, which highlighted the importance and need for a coordinated effort to properly respond to this crisis.

“The laundry list of issues plaguing the IHS has been well-litigated over the last six years,” said Thune. “No one knows those problems better than the tribal members who’ve been directly affected by them. While that conversation is far from over, today’s hearing was an important turning point toward examining the concrete areas in which we can make improvements and reforms to an agency tasked with the critical role of providing quality health care to tribal citizens in South Dakota and around the country. Not only do I want to thank Chairman Barrasso for convening today’s hearing, but also the witnesses who provided constructive feedback about my bill and what can be done to finally fix this crisis.”

“Today’s hearing helped us better understand the problems at IHS,” said Rounds. “We had a productive discussion with tribal leaders and IHS representatives that reiterates the need to fix the health care crisis in Indian country. I thank Chairman Barrasso for holding this important hearing, and I thank Sen. Thune, Rep. Noem and all the witnesses for their participation today. It is clear that IHS is dealing with serious administrative, financial and quality-of-care issues that still need to be addressed. In order to fulfill its trust responsibility to tribal members, IHS must undergo major reform, under close collaboration with the tribes. Consultation with the tribes is critical. Further, today’s hearing reaffirmed the importance of an external audit of IHS so we can work to fix their systemic problems. I appreciate Acting Deputy Secretary Wakefield’s support for an independent audit and look forward to working with her to get the answers necessary to turn the agency around.”

“IHS should get out of the hospital business,” said Noem. “The medical and administrative malpractice in the Great Plains is killing our tribal communities. Expansive reforms are necessary to end the corruption, mismanagement and life-threatening care. I am encouraged that we already have broad agreement between the House and Senate on some of the legislative changes, but cooperation from federal agencies will be paramount to our success. I thank Chairman Barrasso, Senators Thune and Rounds, the witnesses, and the many tribal members who attended today’s hearing. In the end, we are all partners in fixing this problem.”

Today’s witnesses included Dr. Mary Wakefield, acting deputy secretary of the U.S. Department of Health and Human Services (HHS); the Honorable William Bear Shield, chairman of the Rosebud Sioux Tribal Health Board; Ms. Wehnona Stabler, tribal health director of the Omaha Tribe of Nebraska; Ms. Ardell Blueshield, tribal health director for Spirit Lake Tribal Health; and Ms. Stacy Bohlen, executive director of the National Indian Health Board.

The Barrasso-Thune bill, the IHS Accountability Act of 2016, would improve transparency and accountability at the IHS by:

• Expanding removal and discipline authorities for problem employees at the agency;
• Providing the HHS secretary with direct hiring and other authorities to avoid long delays in the traditional hiring process;
• Requiring tribal consultation prior to hiring area directors, hospital CEOs, and other key leadership positions;
• Commissioning Government Accountability Office reports on staffing and professional housing needs;
• Improving protections for employees who report violations of patient safety requirements;
• Mandating that the HHS secretary provide timely IHS spending reports to Congress; and
• Ensuring the HHS inspector general investigates patient deaths in which the IHS is alleged to be involved by act or omission.

The IHS Accountability Act also addresses staff recruitment and retention shortfalls at IHS by:

• Addressing gaps in IHS personnel by giving the HHS secretary flexibility to create competitive pay scales and provide temporary housing assistance for medical professionals;
• Improving patient-provider relationships and continuity of care by providing incentives to employees; and
• Giving the HHS secretary the ability to reward employees for good performance and finding innovative ways to improve patient care, promote patient safety, and eliminate fraud, waste, and abuse.

Noem has also introduced comprehensive legislation in the House that offers critical structural changes to how IHS operates, addressing both medical and administrative challenges with bipartisan support.

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Secretary of State recognizes New Political Party (Libertarian) 

Pierre, SD – Today, Secretary of State Shantel Krebs announced that a new recognized political party has been formed. The Libertarian Party submitted 7,859 valid signatures. The required number of signatures that must be submitted to form a new political party are 6,936 (2.5% of total vote for Governor in 2014: 277,403) (SDCL 12-5-1)

There are currently 1,570 active and inactive registered Libertarians in South Dakota.
The only deadline for a new party is if they wish to participate in the primary election process. That deadline was the last Tuesday in March.

The Libertarian Party may hold a party convention in which they would be able to nominate a candidate for Public Utilities Commission and the 3 Electors for President of the United States.

From Jon Ellis at the Argus Leader:

Which was why Mickelson was in Aberdeen last week. Only, the Brown County Republicans went ahead and announced Mickelson as a candidate, even though there has been no announcement. From the group’s invite:

“Thursday, June 9th, Mark Mickelson will be our guest speaker at the Reagan Lunch in Mavericks. Mark will be running for the SD Governor spot in 2018. He would like to introduce himself to you on Thursday.”

It was a good turnout, according to one person at the lunch. About 50 people attended, and Mickelson gave a bio speech that talked about his background, his roots etc.

“I think he was well received,” said the person I spoke to.

Read the entire story here.

REMINDER: Senate Committee on Indian Affairs to Hold Town Hall Meeting Today in Rapid City, Oversight Hearing Tomorrow
Hearing to Be Streamed Live Online

WASHINGTON — Tomorrow, Friday, June 17, at the request of U.S. Sen. John Thune (R-S.D.), the Senate Committee on Indian Affairs will hold a field hearing in Rapid City, South Dakota, on the IHS Accountability Act of 2016, introduced last month by Thune and Sen. John Barrasso (R-Wyo.), chairman of the Indian Affairs Committee. Thune and Barrasso, as well as Sen. Mike Rounds (R-S.D.) and Rep. Kristi Noem (R-S.D.), will participate in the field hearing, which will be streamed live here.

Today, Thursday, June 16, staff from the Indian Affairs Committee will host a town hall meeting to discuss Thune’s bill and will be available to answer questions or receive feedback from the public.

Thursday, June 16:

WHAT: Staff-Led Town Hall Meeting on the IHS Accountability Act
WHEN: 2:00 p.m. MDT
WHERE: Rapid City Administration Building
3rd Floor Meeting Room East & West
300 Sixth Street
Rapid City, S.D.

Friday, June 17:

WHAT: Field Hearing on the IHS Accountability Act
WHEN: 10:30 a.m. MDT
WHERE: Central High School Auditorium
433 Mt. Rushmore Rd.
Rapid City, S.D.

WITNESSES:

Mary Wakefield, PhD., R.N.,
Acting Deputy Secretary, U.S. Department of Health and Human Services, Washington, D.C.

The Honorable William Bear Shield
Chairman, Rosebud Sioux Tribal Health Board, Rosebud, South Dakota

Ms. Wehnona Stabler
Tribal Health Director, Omaha Tribe of Nebraska, Walthill, Nebraska

Ms. Ardell Blueshield
Tribal Health Director, Spirit Lake Tribal Health, Fort Totten, North Dakota

Ms. Stacy Bohlen
Executive Director, National Indian Health Board, Washington, D.C.

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