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Dorgan Releases Damning IHS Report

WASHINGTON—Chairman of the Senate Committee on Indian Affairs Byron Dorgan, D-N.D., used his last days in office making good on one of his major goals of the 111th Congress: overseeing the broke IHS system and suggesting ways to make it better.

After a year of investigating horror-filled IHS regional findings, Dorgan kept a promise to release a report aimed at detailing conditions and moving forward. According to the senator’s office, the investigation reviewed 140,000 pages of IHS documents, visited three IHS facilities in the Aberdeen area, and met with tribal members and individual IHS employees. At the same time, more than 200 individuals contacted the committee to share their concerns.

“Our investigation found a chronic state of crisis at the Indian Health Service’s Aberdeen Area,” Dorgan said in a statement. “It requires urgent and immediate corrective action across a broad front. The federal government has treaty and trust obligations to provide quality health care to Native Americans. This investigation reveals that the health of the first Americans is directly and adversely impacted by the mismanagement of the area. Fixing these problems must be an urgent, national priority.”

The report described the region as being in immediate need of reform. “Serious management problems and a lack of oversight of this region have adversely affected the access and quality of health care provided to Native Americans in the Aberdeen area, which serves 18 tribes in the states of North Dakota, South Dakota, Nebraska and Iowa,” according to the report.

The investigation formed its roots June 23, after Dorgan and his team had heard from individuals for years, Indian tribes and IHS employees about poor health-care services and mismanagement of IHS facilities in the Aberdeen area.

In a statement, Dorgan said Yvette Roubideaux, IHS director, has made some improvements since she assumed office in 2009, but much more is needed.

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“I know that the director of IHS, Dr. Yvette Roubideaux, is working hard to set a tone of integrity and accountability throughout the agency. However, she cannot solve these problems by herself. Meaningful change will require a clear plan, with timeframes and the long-term commitment of the Department of Health and Human Services,” Dorgan said.

“IHS has cooperated fully with this investigation and has worked to implement a series of corrective actions and improvements in the Aberdeen Area and IHS-wide in response to the Committee’s findings,” Roubideaux posted on her blog. “We are also developing a plan to ensure that the problems identified by the Committee are not occurring elsewhere in IHS, and will begin reviews of the agency’s other areas in 2011.”

The senator’s office listed the following as major findings:

  • Chronic mismanagement, lack of employee accountability and financial integrity;
  • Several service units experienced substantial and recurring diversions of reduced health care services, due to lack of qualified providers or funds;
  • Five IHS hospitals in the Aberdeen area risk losing their accreditation or certification from the Centers for Medicare and Medicaid Services;
  • Several facilities cited as having health care providers on staff who lacked proper licensing or credentialing;
  • Key senior staff positions remained vacant for long periods of time, contributing to the lack of proper management;
  • Employees with a record of misconduct or poor performance being transferred to different health facilities within the Indian health system;
  • Pharmaceutical audits of narcotics and other controlled substances are not regularly performed, and three service units within the region have a history of missing or stolen narcotics.

“We will continue to work closely with the Senate Committee on Indian Affairs in 2011 on these and other issues as part of our ongoing effort to bring meaningful and lasting change to IHS,” Roubideaux posted.

The full report is available online at