LINCOLN, Neb. - Oglala Sioux tribal leaders and Nebraska state officials held a brainstorming session addressing law enforcement, health care, economic development and crumbling roads during a summit at the state capitol.
Oglala Sioux Tribal President John Steele proposed construction of a nursing home at Whiteclay as part of a health care initiative and economic development option for the tribe during the daylong summit June 11.
Steele's move is the first in recent history of a South Dakota tribe seeking help from officials across the border in Nebraska.
The state of South Dakota has a moratorium on nursing homes that prevented the tribe from obtaining state certification for Medicare reimbursement. Obtaining certification through Nebraska would allow the tribe to apply Medicare monies to an operating budget for a sustainable facility, Steele said.
The tribe's efforts to establish the much-needed elderly care facility has met with resistance from the South Dakota Legislature and Gov. Bill Janklow.
Steele said choosing Whiteclay as a site would help improve the character of the community by adding a new industry while allowing tribal members access to a nearby tribally operated nursing home.
"We would like to work with the state of Nebraska with basic development of infrastructure," he said.
The tribe is building elderly apartments, he said. Two complexes are complete in Kyle and Porcupine and two more are under construction in Wounded Knee and Wanblee.
Steele said he wants elderly apartments in all nine districts.
Since nursing homes are long distances from the reservation, Steele said it is difficult for family members to visit.
"I don't think the elderly should have to be put out there and have to die lonely," he said. "We want to bring the elderly closer to home so they can be visited by their family and friends. Tribe has 600 acres near Whiteclay and we would like to build that nursing home there. It might help clean it up. "
While the tribe can build on its own tribal lands without state approval, there are limitations. It must have state certification before the federal government will authorize it as a Medicare provider.
"We don't recognize state lines, but the federal government does," Steele said.
Funding for the project would be through a series of loans tied to its Empowerment Zone. Some potential loans could be through the Department of Agriculture's Rural Development Office, he said.
David "Tally" Plume is executive director of Oglala Oyate Woitancan Empowerment Zone of the Rural Development Office of the USDA on the Pine Ridge Reservation and has been working with tribal officials for several weeks to explore such opportunities.
"If the Empowerment Zone got involved it would be a one-time investment," Plume said.
While the border suggests limitations, Plume was quick to point out the Empowerment Zone extends across state boundaries as part of the tribe's assets.
"We believe we have land in the state of Nebraska and the Empowerment Zone extends to it, Plume said.
"This nursing home is definitely needed."
Under Nebraska law, a certificate of need in the state isn't required for a federally recognized reservation.
"It appears they don't have to go through a certificate of need process" if the tribe approves it, Gov. Mike Johanns said.
The tribe would be the second within the boundaries of South Dakota to own and operate a nursing home. The Rosebud Sioux Tribe owns a nursing home in White River. It bought the nursing home when tribal leaders found they couldn't get certification for Medicare reimbursement if they built a new one. Tribal leaders are eyeing an assisted living center in an attempt to bring better care for the elderly on the reservation.
While Nebraska State Health and Human Service officials were open to the idea, they weren't sure how they would qualify the program since the state hasn't dealt with a reservation across the border in certifying such services.
"We don't see it as Nebraska land, we see it as our reservation. We want to work with you," Steele said.
Going beyond the nursing home issue, Steele told the group tribal members have difficulty getting health care even though the Indian Health Service Hospital is available. Because of budget constraints tribal members don't get medical care unless their conditions are life threatening.
Those who seek treatment elsewhere find themselves beleaguered by collection agencies and their credit histories are impaired because of debts the Indian Health Service refuses to pay at clinics and hospitals off the reservations.
"The medical clinics go after the patient and it affects their credit, making it difficult for them to get credit due to the IHS failure to pay for the medical cost," Plume said.
He said the result is that tribal members then have difficulty getting approval for home loans when their credit history has been blemished.
Civil rights was another issue Steele addressed in asking for fair enforcement of the law across the border. He spoke of the experiences of people who called his office about discriminatory landlords, unreasonable searches of their vehicles when roadblocks are set up at the border and unfair hiring practices.
"If anybody here wants greater law enforcement, I will deliver it with an even hand. You can't turn your back on the violations of the law," the governor said.
"Even-handedness and justice ... I would say I'm a little encouraged," answered Steele.
He suggested a one-way, cross-jurisdictional agreement to allow law enforcement to go after violators of the state's liquor laws as one option to slow bootlegging on the Pine Ridge Reservation, but officials are far from an agreement as to how it will work.
Lt. Col. Michael E. Behm, assistant superintendent of the Nebraska Highway Patrol, said he was more than willing to work with tribal leaders to help with the Whiteclay problem and look closely at how law enforcement is applied to the areas near reservation communities.
Roads were another issue. Steele said he is trying to get more federal funding to repair severe road conditions across the reservation. He met with federal highway department officials earlier this month looking for more money to fix massive potholes and crumbling roads.