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Si Tanka students face health care challenges away from home

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HURON, S.D. ? Health care is one of the many transitional problems facing tribal students attending Si Tanka Huron University, as tribal culture melds with what was earlier a private college in northeastern South Dakota.

The addition of a tribally owned, off-reservation campus has created an entirely new set of circumstances for federal agencies servicing tribal members, especially the Indian Health Service (IHS).

Tribal students attending the Huron campus face the same issues many face when leaving the boundaries of the reservation for business, job prospects and other opportunities. The health care issue arose when students needing medical care found themselves lost in a maze of red tape. The IHS, it turns out, has no policies concerning the enrollment of students so far removed from the reservations.

Normally IHS provides health care to residents of the reservation. Students attending Huron are still considered residents, but they have to drive to the nearest IHS facility to access care, which is nearly two hours away in any direction. Even then, students who go to an IHS facility other than one on their home reservation, may not get contract care services. IHS policy for contract care demands that the students seek medical treatment at their "home agency." Complicating the matter further, Aberdeen area officials have told the university staff that each of the medical facilities follows its own protocol, said Robert Begay, director of cultural development.

"Aberdeen said each agency sets its own criteria," said Begay.

The lack of options for medical treatment has administrators concerned because of the expense faced by students if forced to seek treatment from a private physician or use the local hospital, a non-IHS facility. Others fear college students would accumulate a debt that could haunt their credit histories.

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Huron officials suggested getting a local practitioner to provide services for the students, but Bob Chasing Hawk, a representative from the Eagle Butte campus, said the debt potential is a concern. Even if students get the nod for contract health coverage, health care providers may be reluctant to provide services because of the delay in reimbursement.

"It will take a year and up to two years for contract health to pay," he said.

Chasing Hawk had heart surgery a number of years ago and IHS delayed the payment of $23,000 in medical bills. "They didn't pay for my heart surgery for two years," he said.

Begay confirmed that Aberdeen Area officials had failed to offer any option for health care apart from the existing tribal service units. The administration has contacted each of the service units requesting their protocol for treatment off the reservation.

"We should have a proposal put together for health, dental and counseling services by the end of next week," said Begay on April 19. University officials are also working on a grant that will fund an on-campus nurse for students' basic health care needs and referrals.

Sara May, a spokesman for student services, said her office deals with referring students for counseling. She said that students had already needed to see doctors, but they have had to go through contact after contact trying to get to the doctor.