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South Dakota congressman pressured to assist tribal members

EAGLE BUTTE, S.D. ? Health care reform, tribal response to the reorganization of trust responsibilities for the Bureau of Indian Affairs, school facilities and economic development topped the list of issues U.S. Sen. Tim Johnson encountered during his swing across the state.

While tribal councilmen at the Cheyenne River Sioux Tribe thanked Johnson for his support of tribal interests, they made it clear their state Congressional representatives would have apply more pressure to Congress in dealing with a wide range of issues. Not the least significant is the reorganization of trust responsibilities at the Bureau of Indian Affairs.

Tribal Chairman Gregg Bourland warned the South Dakota Democrat that he will have to prevent the dismantling of the trust offices in favor of using the existing infrastructure, force the bureau to live up to Congressional mandates and push for better funded health care. Bourland also called for staffing reservation health facilities with more qualified and caring people. Johnson is approaching a close battle for his seat against Republican John Thune, currently U. S. Representative.

The tribe gave a stern warning that Johnson would have to take action to assist in helping tribal members because they will vote and the tribe has engaged in a strong voter registration and education program to get tribal members to the polls.

Bourland along with council members asked the senator for his help placing their request for a new hospital on the priority list for funding under new Indian Health Care facilities.

Bourland and councilmen took their opportunity to lobby for the construction of a new hospital to replace a nearly 40-year-old facility. The hospital, built in the early 1960s, is showing signs of age. Although there have been additions to the building, IHS officials say it isn't large enough to house all of the health care programs.

The Sisseton Wahpeton Sioux Tribe is also asking for a new facility and health officials there walked Johnson through the facility built in 1936. They urged Johnson to assist in efforts to include the first phase of the construction of a new facility in the 2003 budget, asking for $13 million.

Beyond bricks and mortar, the Cheyenne River Sioux Tribal Chairman told a horrifying account of the New Year's Eve death of an elderly tribal member who sat along a rural roadside in an ambulance after a contract care physician on emergency room duty at the Eagle Butte facility ordered an ambulance driver not to take him to the facility.

Family members, who believed the elder was in a diabetic coma, were left wondering if he might have been still alive when he was taken to the morgue and embalmed. Bourland was angry at remarks made by the physician, who was identified only by last name and not listed on the roster of IHS employees. Bourland said the doctor directed the ambulance either to return him to his Green Grass residence or dump his body in a ditch.

Since the incident, the tribe has called for the suspension of Service Unit Director Clayton Belgarde and called for the removal of Ambulance Director Tim Smith and the physician who had ordered the ambulance personnel not to take the elder to the facility. Bourland called for a full investigation into the matter including the Office of the Inspector General, Federal Bureau of Investigation and the Department of Justice.

Bourland told the senator, who sits on the Indian Affairs Committee, that a broader investigation into the entire Indian health care system is needed because tribal members are not getting the treatment they were promised under treaty obligations.

The tribal chairman and councilmen lobbied for other issues, including preventing the dismantling of the trust offices at the Bureau of Indian Affairs.

"The frame work is already there. You don't have to go out and reinvent the wheel. It is all there," Bourland said.

Harold Frazier, District 4 Council representative and Chairman of the Parks Committee, told the senator the Cheyenne River Sioux Tribe's buffalo program is in jeopardy due to market conditions and policies geared to assist non-Indian producers.

"Our buffalo program has been experiencing extremely difficult financial times over the past few years because the bottom has fallen out of the Buffalo market. A heifer that cost $2,500 three years ago can now be bought for $200_basically a 90 percent decrease in value," Frazier said.

"We are faced with losing a 2,200 head of buffalo and 22,000 acres of land on which they roam. This is in addition to the losses facing individual tribal members who are bison producers," he said.

Frazier asked for Johnson's help in assisting tribal bison enterprises with marketing their herds to the federal government, which has announced it will include the purchase of what he called "high fat" fed bison for use in the USDA's commodity program.

"It would only make sense for the USDA to purchase lean Native American range fed and produced bison," he said.

Vowing to help the tribe with its struggle, Johnson said, "Cheyenne River has long played a leading role in the nation in terms of re-establishing bison. I'm very mindful of the economic and the spiritual ramifications of the herds. I will do all that I can working with the USDA to see to it that steps are taken to address the economic downturn that we've seen," Johnson said.

Johnson also made key stops in areas off the reservations, talking about initiatives to assist the elderly, one of his largest constituencies.

The Medicare Program, which also provides income to Indian Health Care facilities under third party billing, is facing a crisis due to soaring costs, Johnson said.

Prescription drugs, he said, should be covered under the program.

"Prescription drugs are going up very fast. I am told of people who are literally choosing between groceries and staying on their prescriptions," he said

"We have $300 billion over 10 years set in last year's budget with a resolution that the federal should provide prescription drug coverage for Medicare," Johnson said.

Johnson noted that legislation is underway to cut the costs of prescription drugs by allowing providers to import drugs that are sold at a lesser cost by U.S. pharmaceuticals companies to suppliers in other countries.

Domestic suppliers, he said, pay a hefty price for medications that fill prescription needs for the elderly.

The United States is the only industrialized nation in the world without prescription-drug coverage for its citizens, Johnson said. In addition, drugs costs are much higher in the United States, he said, with many Americans buying their medications abroad.

"I am familiar with people who go to Canada and Mexico and buy it for half what it costs in the United States," he said. "I know Huron 'snowbirds' who went to Texas and paid for their entire winter with the savings from buying their drugs in Mexico."

The addition of prescription drug coverage won't be without an increase in Medicare premiums.

"It would be optional for seniors to sign up. Most of them would, and it would be a modest additional premium that would cost much less than they currently spend on prescription drugs," he said.

Johnson will face additional pressures in what promises to be one of the most widely watched Congressional races in the nations as the Democrats struggle to retain and gain seats.

National campaign ads already on the air suggest the Democrats have sent the nation into a recession.

"It's my hope that we can climb out of this red ink," Johnson said.

"Last year, we had a budget surplus as huge as the eye could see. In fact, we had three years of surpluses," Johnson said. "Now with war, recession and tax cuts, we are looking at three years of deficits."

Further recruitment opportunities, Johnson said, are necessary to bring doctors to rural regions. Indian Health Care officials at the Aberdeen Area Office say they have done what they can to recruit, but even after making the investment of assisting people in medical school, the agency is still understaffed and physician's positions are vacant. The picture isn't much different off the reservation in rural areas where people still must drive to regional facilities for health care as many of the state's hospitals struggle to attract physicians to remote areas.

Employee recruiting efforts have expanded beyond state lines as shortages of medical personnel become more prevalent. Johnson said South Dakota health organizations must be concerned with offering wages that are competitive with urban areas and not just other towns in the state.

"Recruiting and retaining have become national issues," Johnson said.

Johnson recently co-sponsored legislation to strengthen the nursing workforce by providing scholarships and encouraging people to work in rural areas.