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Senators demand national investigation into Indian Health Service mismanagement

A letter to the secretary of health comes after an audit of one regional IHS showed management that Sen. Byron Dorgan described as “completely dysfunctional.”

WASHINGTON — Sen. Al Franken and leaders on the Senate Indian Affairs Committee from both parties later today will call for a national investigation of the Indian Health Service, MinnPost has learned, after an audit of one regional IHS showed management that led Chairman Byron Dorgan to describe it as “completely dysfunctional.”

The Indian Affairs Committee this week reported findings of its own investigation into the Aberdeen office of the IHS, which covers the Dakotas, Iowa and Nebraska.

Among the findings:

  • IHS employees “with a record of misconduct” were frequently reassigned or placed on paid administrative leave rather than being terminated. In some cases, employees stayed on the federal payroll for more than a year without working.
  • Employees stole narcotics from some facilities, and almost all of those facilities that weren’t stolen from had inadequate controls to prevent narcotics theft.
  • IHS failed to ensure that its employees maintained current licenses, and didn’t provide evidence it was aware of cases where employees state licenses were revokes or suspended.
  • Most IHS facilities in that region are now at risk of losing their Medicare and Medicaid certification.

“These problems have a detrimental impact on patient health care and are an unacceptable use of federal dollars,” wrote Franken, Dorgan, Indian Affairs Ranking Republican John Barrasso and others in a letter addressed to Health and Human Services Secretary Kathleen Sebelius to be published later today, adding that “we believe that the problems exposed in the Committee’s investigation may not be unique to the Aberdeen area.”

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Other notable senators who signed on to the investigation request include 2008 Republican presidential candidate John McCain, Senate President Pro Tempore Daniel Inouye and Oklahoma conservative stalwart Tom Coburn.

The Indian Health Service is the federal government’s agency for health care to Native Americans, somewhat analogous to VA hospitals and how they focus on veterans. The IHS fulfills a cornerstone commitment in many government-to-government treaties between the United States and Indian nations. One IHS region is headquartered in Minnesota; the Bemidji region includes Minnesota, Wisconsin, Michigan and urban centers in Illinois.

IHS spokesman Thomas Sweeney said the IHS had not received any request for investigation and when asked if the problems found at Aberdeen were locally contained or systemic replied that he “really couldn’t speculate” on that. Instead, he pointed me to Indian Health Service Director Yvette Roubideaux’s statement before the Indian Affairs Committee Tuesday and her official blog.

“While many of the problems mentioned occurred over the past several years and are very serious, we are committed to using our IHS reform efforts to address them,” Roubideaux wrote in her most recent blog posting, dated Wednesday. “This includes improving the way we do business and holding employees accountable for poor performance.”

In that committee hearing earlier this week, Franken signaled that he’d push for a nationwide investigation. “These findings indicate that there’s serious dysfunction and mismanagement in the Indian Health Service,” he said. “Instead of being good stewards of the scarce and desperately needed federal resources, there’s blatant misconduct and a serious lack of accountability.”

Responding to Franken’s questioning on the matter, Roubideaux said Tuesday the issues raised in the Indian Affairs investigation were “important, unacceptable, and we will be working on improving those areas.”