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Montana and Wyoming Tribes Testify to Dire State of Healthcare, Funding Shortfalls

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Representatives of seven Montana and Wyoming reservations testified to the critical state of health care services and injustices suffered by their members during a U.S. Senate Indian Affairs Committee hearing in Billings, Montana, on May 27. The Indian Health Service regional office in Billings, Montana, serves approximately 80,000 tribal members from Montana and Wyoming.

“All too often, tribal members complain of ailments but get sent home from the Indian Health Service with cough medicine or pain killers. Later we learn the situation is much more serious, like cancer,” testified A.T. “Rusty” Stafne, chairman of the Assiniboine and Sioux Tribes of northeast Montana’s Fort Peck Indian Reservation, reported the Associated Press.

In early May, U.S. Senators Jon Tester and John Walsh of Montana asked the U.S. Government Accountability Office to examine the significant problems at the Billings office.

“We implore this Committee to assist the tribe in demanding that the correct people within the Indian Health Service are being held accountable for the poor access and quality of care provided to the Crow people. It is imperative that the Indian Health Service live up to its obligation to provide quality health care to our community because our tribal members have the right to be treated with dignity and respect by Indian Health Service employees, and to have their medical issues addressed and treated,” said Chairman Darrin Old Coyote of the Crow Tribe.

Montana’s recent State of the State Medical Report underscored that non-Indian men in Montana lived 19 years longer than Indian men, whose life expectancy is just 56 years, and non-Indian women lived 20 years longer than Indian women, whose life expectancy is 62 years.

“There is no question there are problems in this region that need to be corrected,” said Chairman Tester. “We need to live up to our trust responsibility and offer tribes the health care they deserve. Ongoing issues around service delivery, transportation for critical care, billing and reimbursement issues abound. We need to prioritize these issues and solve them.”

Yvette Roubideaux, acting director of the Indian Health Service, listened to their testimonies of health woes. She highligted the reforms intended to streamline the bureaucratic redtape faced by patients, though she added that more efforts needed to be made at the local level, and more money would be required than the $4.4 billion the federal agency receives annually, reported the AP. “We need a completely different mindset within IHS. A more tribal and patient focused approach is essential,” she said.

Matthew Brown/ Associated Press

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Yvette Roubideaux, acting director of the U.S. Indian Health Service, talks with leaders of Montana’s Crow Tribe following a U.S. Senate committee field hearing in Billings, Mont., Tuesday, May 27, 2014. Complaints from the tribe about poor health service on their southeast Montana reservation helped prompt the hearing.

“Not only do Indian people live fewer years but we have worse indicators in almost all known ways of measuring health. So is the IHS living up to its trust responsibility? Not even remotely,” Tim Rosette, Interim Chief Executive Officer of the Rocky Boy Tribal Health Board, said

Carole Lankford, Vice Chair of the Confederated Salish and Kootenai Tribes, spoke of the life threatening concerns that come with restrictions, such as life or limb conditions, on health care services. “Let me give you a common example. Let’s say a provider conducts a series of tests and determines a patient’s gall bladder needs to be removed but it has not burst. The procedure would be denied and most likely the patient would be sent home with pain medication. This scenario has been repeatedly played out and results in poor care and increased prescription drug addiction.”

A.T. Stafne, Chairman of the Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, said, “The Fort Peck Reservation remains one of the most impoverished communities in the country. Nearly half of the people living on the Reservation are below the federal poverty level. Our review of recent data suggests that the average age of death of Fort Peck Tribal members in the past two years is 51 years of age. We can no longer tolerate our people dying, living in chronic pain, or suffering permanent disability because they lack access to health care.”

Matthew Brown/ Associated Press

U.S. Senate Indian Affairs Committee Chairman Jon Tester listens to a tribal leader’s answer during a field hearing on the problems faced by the Indian Health Service in Billings, Mont., Tuesday, May 27, 2014. Tester said more needs to be done to improve health care for tribal members in Montana and Wyoming.

Tester brought several members of his Committee staff to the hearing so they too could hear first-hand from tribal leaders and help to find solutions to IHS’s problems. Following the hearing, members of the public met with Committee staff and other members of Tester’s staff to share their issues and experiences with the Indian Health Services.

Other members of the panel included President Mark Azure of the Fort Belknap Indian Community; President Llevando Fisher of the Northern Cheyenne Tribe and Chairman Darrell O’Neal of the Arapaho Tribe of Wind River Reservation.