A lawsuit filed on behalf of the Rosebud Sioux Tribe last Thursday asks “the federal court to step in and exercise some control over the dysfunctional IHS (Indian Health Service) emergency room on the Rosebud Reservation.”
Tim Purdon, of Robins Kaplan LLP, the firm representing the tribe, said, “The filing of this case is necessary because IHS has been unable to solve this problem, at grave cost to the vulnerable, rural population of the Rosebud Reservation.” Purdon also said his firm has taken the case pro bono.
The Indian Health Service hospital located in the town of Rosebud announced the Emergency Room would be shut down on December 5, 2015 with a Notice of Intent to Terminate its Medicare Provider agreement on November 23.
The Notice stated: “deficiencies identified in a recent [Center for Medicare Services] survey were serious enough to constitute an immediate and serious threat to the health and safety of any individual who comes to the hospital to receive emergency services.” All ambulances were directed to send emergency patients to the nearest medical facility in Winner, South Dakota; Valentine, Nebraska; or Martin, South Dakota.
From its outset, the ER shutdown has been indefinite. The Rosebud Sioux Tribal Council convened the same day as the closure, seeking alternatives. Rosebud’s hospital and clinic remain open, but, given the tribe’s large land base, extending the distance for tribal members needing emergency room care left many unanswered questions.
The shutdown enters its sixth month with no end in sight. The tribe’s response is this lawsuit, said Purdon. “Shutting down the emergency room was a violation of the Indian Health Service’s duty to provide adequate care. Saying they had to because they couldn’t pass an inspection doesn’t sound to me like a very good explanation.”
Besides addressing the emergency room shutdown, the lawsuit alleges a host of federal inadequacies in respect to its treaty responsibility to provide adequate health care for Indigenous Peoples. “[D]espite the federal government’s trust duty to provide health care to Indians, the federal government spends less on Indian health care than on any other group receiving health care,” states the lawsuit. It cites disparities in access to and per-capita expenditures on health care compared to other public health care recipients, particularly noting military veterans receive $2,500 more per capita and federal prison inmates receive $1,100 above what is spent on Native care.
Purdon said his law firm is committed to remedy these disparities. “I spent 5 years as a U.S. Attorney in North Dakota fighting to improve conditions on the reservations. When we left the Department of Justice a year ago and founded the American Indian Law and Policy Group at Robins Kaplan LLP, one of the reasons was so that we would be able to continue that fight by taking on impactful pro bono cases like this one.”