Press "Enter" to skip to content

Noem Noticed IHS Crisis “8 to 10 Months” Ago; Hawks Cites Dorgan 2010 Report on IHS Problems

Kristi Noem with cinnamon rolls
“It’s a crisis when I say it’s a crisis! Now let’s have some cinnamon rolls!” (From Twitter, 2016.06.03.)

Senator Mike Rounds, who sure as heck wouldn’t have wanted an audit of his EB-5 program and Future Fund grants when he was Governor, says he wants an audit of Indian Health Service. Rep. Kristi Noem says she’s going to “war” with IHS to solve the “crisis” she says “my tribes” are in. Rep. Noem also says she “did not realize until this came up in the last 8 to 10 months how bad it was.”

Last 8 to 10 months? asks Rep. Paula Hawks, Noem’s challenger in the race for South Dakota’s lone U.S. House seat, who apparently spends more time reading than our current Congresswoman:

Within weeks of Kristi Noem taking office, the United States Committee on Indian Affairs released a comprehensive study called “In Critical Condition: The Urgent Need to Reform the Indian Health Service’s Aberdeen Area” which visited three Aberdeen-area hospitals, interviewed over 200 individuals and analyzed over 140,000 documents related to the deficient care at Aberdeen-area Indian Health Service hospitals.

Senator Byron Dorgan said the report was commissioned after he and “his team had heard for years about poor health-care services and mismanagement of IHS facilities in the Aberdeen area.”

“It begs the question: where did the breakdown in communication occur? The warning signs were clear. They were entered into the congressional record. How could her office miss a report detailing a life and death emergency affecting over 10% of South Dakota’s population for six years? It shouldn’t take an emergency room closing and people dying for our congressional leadership to act,” said Hawks [Hawks for House, campaign press release, 2016.07.06].

The December 2010 report cited by Hawks offers these findings:

  • Over the course of the last ten years, IHS repeatedly used transfers, reassignments, details, or lengthy administrative leave to deal with employees who had a record of misconduct or poor performance.
  • There were higher numbers of Equal Employee Opportunity (EEO) complaints in the Aberdeen Area in comparison to the entire IHS, as well as insufficient numbers of EEO counselors and mediators.
  • Three service units have a history of missing or stolen narcotics and nearly all facilities failed to provide evidence of performing consistent monthly pharmaceutical audits of narcotics and other controlled substances.
  • Three service units experienced substantial and recurring diversions or reduced health care services from 2007 to 2010, which negatively impacts patients and quickly diminishes limited Contract Health Service (CHS) funding.
  • Mismanagement of CHS program funding has resulted in some facilities having funding surpluses and the transfer of dollars to likely non-CHS programs.
  • Five IHS hospitals are at risk of losing their accreditation or certification from the Centers for Medicare and Medicaid Services (CMS) or other deeming entities. Several Aberdeen Area facilities were cited as having providers with licensure and credentialing problems, Emergency Medical Treatment and Active Labor Act (EMTALA) violations, emergency department deficiencies or other conditions that could place a patient‟s safety at risk.
  • IHS lacks an adequate system to detect instances of IHS health care providers whose licenses have been revoked, suspended or under other disciplinary actions by licensing boards.
  • IHS health care providers treating patients with expired state licenses and/or other certifications on numerous occasions, which violates federal regulations and internal IHS policies.
  • Particular health facilities continue to have significant backlogs in posting, billing and collecting claims from third party insurers (i.e., Medicare, Medicaid and private insurers). One facility repeatedly transferred its third party payments to other facilities in the Aberdeen Area.
  • There were lengthy periods of senior staff vacancies in the Clinical Director and Chief Executive Officer positions, resulting in inconsistent management and leadership at Aberdeen Area facilities.
  • The use of contract providers (locum tenens) is costly ($17.2 million in the last three years). While the overall cost of contract providers has decreased in comparison to last year, two facilities have increased their locum tenens expenses this year.
  • IHS policies and directives discourage employees from communicating with Congress [Sen. Byron Dorgan, “In Critical Condition: The Urgent Need to Reform the Indian Health Service’s Aberdeen Area,” report to Senate Committee on Indian Affairs, 2010.12.28, pp. 5–6].

The problems at IHS were on the record before Rep. Noem took office five and a half years ago. She has throttled IHS’s budget throughout her tenure in Washington, starting right off in 2011 with a vote to cut IHS by $220 million.

See, Kristi? Spend all your time clicking through parade photos on your lap-blog, and you miss the real policy problems that you’ve been not only ignoring but making worse since 2011.

Paula Hawks has evidently read the 2010 report on IHS. Unlike Noem, Hawks won’t wait for her third re-election bid to suggest doing something to bring better health care to out Indian neighbors.


  1. SDBlue 2016-07-06 22:48

    I look forward to a debate between Hawks and Noem. I enjoy the light Hawks is shining on Noem’s failed representation of South Dakota.

  2. Paul Seamans 2016-07-06 23:23

    Kristi didn’t get the memo about her tribes health care problems.

  3. leslie 2016-07-07 05:58

    Rounds had his cabinet member suicide while getting a multi engine instrument rating. Daugaard had his DOE murder-arson-suicide while doing Putin-style foto-ops wearing his tool-belt around the mansion. Christie mugs for the camera w her infamous Downton Abbey Buddy after speeding to boost her adrenalin to get to the Great Wall wearing an Oh-So-Cute BDU CAP as a Lakota woman back home is forced to deliver in an IHS bathroom.

    These r serious jobs republicans elect light weight GOP members for…to do…something … other than for self interest. Trey Gowdy. Tom Cotton. John Thune. These folks r just … placeholders.

    Does Christie have time for FACEBOOK?

  4. mike from iowa 2016-07-07 06:55

    Noem’s response, “Peanut butter. I think I’ll buy some peanut butter.”

  5. Dana P 2016-07-07 08:05

    Like SDBlue, I am also very happy with the way Hawks is pointing out (very effectively) Ms Noem’s faux outrage about IHS failures. Noem only pays attention to what the puppet masters tell her to. Oh, it’s a campaign season? “I better pay attention to “other things” and express that I’m so darn mad!” Hawks pointing out the many missed meetings is also very good. And who can forget, Noem (during the few meetings she does attend) more attentive to her cell phone than what is going on in the meeting.

    And the news of Mike Rounds calling for an audit!!!! Howl! After Benda-gate happening when smilin’ Mike was at the helm. My goodness, Mr Rounds, that is rich. Very rich. And just what might have been on that hard drive that was stolen when your Sioux Falls office was burgled the other day? Hmmmm, normal burglars go for things that have value to assist them in paying bills/supporting drug habits. Stealing hard drive from a SD senator’s office? Hmmmm.

  6. jerry 2016-07-07 08:06

    All of this makes me wonder where the do gooders are. There seems to be a lack of compassion within the religious hierarchy, and in particular, their flocks on the perils of the local poor. They send their missionaries to all parts of the world, at a large cost, to bring medicine and hope to those folks. In the meantime, just down the road, it is worse here than there. Our people live in such squalid conditions, with medicine and treatment within a relative short distance, but not to them. I bring up the religions because that may be the only humanitarian response to the deliberate decimation of the tribes. They would be the light to shine on this and they could be the voice. BTW, where are our so called legislators at the state level to put pressure on?

    NOem speaks in tongues but does not have the voice to defend the rights of all and in particular, the Native tribes she supposedly represents. NOem and the rest of the thugs in congress have cut funding to the IHS to the point that it is no longer functioning. Then she asks why. The racism is blatant on our three amigos that represent the white folks in South Dakota.

  7. MD 2016-07-07 17:56

    The longer the leadership keep stalling about real problems, the closer they will get to their solution. Unfortunately, that solution is more akin to a Stalin, Hussein, or Hitler solution versus a Jesus, Mother Theresa, or Gandhi solution.

  8. Baby Moon 2016-07-07 20:43

    Jerry, anyone who thinks the churches’ do-gooders can affect this problem positively obviously doesn’t know the history of the churches and Natives. Saying what you said is, I’m sorry to say, laughable and somewhat off-point bc can churches provide medical care? Are we to pray and tithe our way out of poor health? I’m confused by your post.

    But, in any event, the whole IHS Accountability Act of 2016 (S. 2953, 114th Congress) is a strange creature (for which the Great Plains Tribal Chairman’s Association (GPTCA) already provided its imprimatur at some point way before any tribal people even knew any of this was afoot). In the “findings” part of the proposed senate bill the focus is exclusively on the Great Plains area generally and the Aberdeen Area specifically. But the statute goes on to impose interesting “accountability” measures on the entire IHS nationwide. If this is really an IHS bill and not an Aberdeen Area Office bill it seems like there should be broader, IHS wide information. Sen. Barrasso (R-WY) and John Thune (R-SD) are the only two co-sponsors and WY tribes are served by the Billings Area Office. I’m not sure how the entire IHS got pulled in on this if this is, as is implied if not outright stated, not an entire IHS problem but only an Aberdeen Area problem. The bill imposes a lot of “accountability” measures primarily on those in the very VERY privileged group of “Senior Executive” folks which made me think, first, “I wonder who they’re trying to get rid of” and then, “I wonder who they’re trying to install?” It provides some whistleblower protections for, well, whistleblowers but wouldn’t other federal whistleblower laws suffice? Maybe not. There are some other curious things and the bill didn’t strike me as especially well-drafted. I think they paid out monies for an employee EEO lawsuit (and someone correct me if I am wrong on this), which lawsuit funds came out of the monies for direct patient care (which, if true, seems completely outrageous to me). This bill needs a lot of improvement.

  9. jerry 2016-07-07 21:25

    Sorry for the confusion. I only met that the dogooders were the ones who got Natives into the hole they are in from the first black robes to the Dawes Act, all done by dogooders. A tithe for tat would not make a hill of beans, but an acknowledgment that there is a huge racist issue happening should be an affront to their religions.

    Regarding whistle blowers, check out Edward Snowden to give you an idea of how the Obama administration takes care of them. No one will ever know if Richard Benda was not gonna drop a dime on our local heroes either.

    The IHS and the BIA being in Aberdeen is ripe fruit for corruption. Does anyone ever make the connection that the EB-5 was hatched there?

Leave a Reply

Your email address will not be published.