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HRG. 114–375 REEXAMINING THE SUBSTANDARD QUALITY OF INDIAN HEALTH CARE IN THE GREAT PLAINS HEARING BEFORE THE COMMITTEE ON INDIAN AFFAIRS UNITED STATES SENATE ONE HUNDRED FOURTEENTH CONGRESS SECOND SESSION FEBRUARY 3, 2016 Printed for the use of the Committee on Indian Affairs ( U.S. GOVERNMENT PUBLISHING OFFICE 21–662 PDF WASHINGTON : 2016 For sale by the Superintendent of Documents, U.S. Government Publishing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Mar 15 2010 09:00 Oct 03, 2016 Jkt 021662 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 S:\DOCS\21662.TXT JACK COMMITTEE ON INDIAN AFFAIRS JOHN BARRASSO, Wyoming, Chairman JON TESTER, Montana, Vice Chairman JOHN MCCAIN, Arizona MARIA CANTWELL, Washington LISA MURKOWSKI, Alaska TOM UDALL, New Mexico JOHN HOEVEN, North Dakota AL FRANKEN, Minnesota JAMES LANKFORD, Oklahoma BRIAN SCHATZ, Hawaii STEVE DAINES, Montana HEIDI HEITKAMP, North Dakota MIKE CRAPO, Idaho JERRY MORAN, Kansas T. MICHAEL ANDREWS, Majority Staff Director and Chief Counsel ANTHONY WALTERS, Minority Staff Director and Chief Counsel (II) VerDate Mar 15 2010 09:00 Oct 03, 2016 Jkt 021662 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 S:\DOCS\21662.TXT JACK C O N T E N T S Page Hearing held on February 3, 2016 ......................................................................... 1 Statement of Senator Barrasso ............................................................................... 1 Statement of Senator Daines .................................................................................. 44 Statement of Senator Franken ............................................................................... 50 Statement of Senator Heitkamp ............................................................................. 8 Statement of Senator Hoeven ................................................................................. 5 Statement of Senator Rounds ................................................................................. 7 Statement of Senator Tester ................................................................................... 4 Statement of Senator Thune ................................................................................... 9 Statement of Senator Udall .................................................................................... 6 WITNESSES Bear Shield, Hon. William, Council Representative, Rosebud Sioux Tribe ........ 75 Prepared statement .......................................................................................... 78 Dorgan, Hon. Byron L., Former U.S. Senator from North Dakota; Founder and Chairman, Center for Native American Youth .......................................... 11 Prepared statement .......................................................................................... 14 Karol, Susan V., M.D., Chief Medical Officer, Indian Health Service, U.S. Department of Health and Human Services ...................................................... 35 Killsback, Jace, Executive Health Manager, Northern Cheyenne Tribal Board of Health ............................................................................................................... 80 Prepared statement .......................................................................................... 82 Kitcheyan, Victoria, Treasurer, Winnebago Tribal Council ................................. 54 Prepared statement .......................................................................................... 56 Little Hawk-Weston, Sonia, Chairwoman, Health And Human Services Com- mittee, Oglala Sioux Tribal Council ................................................................... 62 Prepared statement .......................................................................................... 64 Mcswain, Robert G., Principal Deputy Director, Indian Health Service, U.S. Department of Health and Human Services ...................................................... 28 Prepared statement .......................................................................................... 30 Slavitt, Andy, Acting Administrator, Centers for Medicare and Medicaid Serv- ices; accompanied by Thomas Hamilton, Director, Survey and Certification Group, Center for Clinical Standards and Quality ........................................... 22 Prepared statement .......................................................................................... 24 Wakefield, Mary, Ph.D., R.N.; Acting Deputy Secretary, U.S. Department of Health and Human Services ........................................................................... 18 Prepared statement .......................................................................................... 20 LISTENING SESSION Listening session held on February 3, 2016......................................................... 91–129 APPENDIX Archambault, Jacqueline, Cheyenne River Sioux Tribal Member, prepared statement .............................................................................................................. 154 Brown, Domnic L., Osage Tribal Member, prepared statement .......................... 154 Clown, Yvonne Kay, Cheyenne River Sioux Tribal Member, prepared state- ment ...................................................................................................................... 136 Colombe, Sunny, MBA, Rosebud Sioux Tribal Member, prepared statement .... 131 Dilldine, Jane, Supervisory General Supply Specialist, Pine Ridge IHS Hos- pital, prepared statement .................................................................................... 174 Espinoza, Evelyn, RN, BSN, Rosebud Sioux Tribe Health Administrator, pre- pared statement ................................................................................................... 168 (III) VerDate Mar 15 2010 09:00 Oct 03, 2016 Jkt 021662 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 S:\DOCS\21662.TXT JACK IV Page Frazier, Hon. Harold C., Chairman, Cheyenne River Sioux Tribe, prepared statement .............................................................................................................. 134 Goodwin, Tammy Rae, Sisseton Wahpeton Oyate Tribal Member, prepared statement .............................................................................................................. 166 Houle, Jay, Sisseton-Wahpeton Oyate Tribal Member, prepared statement ..... 153 Jones, Alexis, Registered Nurse, BSN, prepared statement ................................ 155 Malerba, Hon. Marilynn, Chief, Mohegan Tribe; Board Member of Self-Gov- ernance Communication and Education Tribal Consortium; Chairwoman, IHS Tribal Self-Governance Advisory Committee (TSGAC), prepared state- ment ...................................................................................................................... 187 Miller, Vernon, Chairman, Omaha Tribe of Nebraska, prepared statement ...... 181 National Indian Health Board (NIHB), prepared statement ............................... 138 Phillips, Brent R., President/CEO, Regional Health, Inc., prepared statement . 172 Salomon, Donna M. (Waters), Oglala Sioux Tribal Member, prepared state- ment ...................................................................................................................... 157 United South and Eastern Tribes, Inc., prepared statement ............................... 151 Waters, Stephanie L., Oglala Sioux Tribal Member, prepared statement .......... 163 Wilcox, Darlene M., Ph.D., LP, Licensed Clinical Psychologist, prepared state- ment ...................................................................................................................... 169 Additional letters and supplementary information for the record ................... 191–228 Response to written questions submitted by Hon. James Lankford to Andy Slavitt .................................................................................................................... 228 Response to written questions submitted by Hon. John Thune to Robert G. Mcswain ........................................................................................................... 230 VerDate Mar 15 2010 09:00 Oct 03, 2016 Jkt 021662 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 S:\DOCS\21662.TXT JACK REEXAMINING THE SUBSTANDARD QUALITY OF INDIAN HEALTH CARE IN THE GREAT PLAINS WEDNESDAY, FEBRUARY 3, 2016 U.S. SENATE, COMMITTEE ON INDIAN AFFAIRS, Washington, DC. The Committee met, pursuant to notice, at 2:33 p.m. in room 216, Hart Senate Office Building, Hon. John Barrasso, Chairman of the Committee, presiding. OPENING STATEMENT OF HON. JOHN BARRASSO, U.S. SENATOR FROM WYOMING The CHAIRMAN. I call this hearing to order. Today, the Committee will hold an oversight hearing entitled, Reexamining the Substandard Quality of Indian Health Care in the Great Plains. In 2010, the Committee held an oversight hearing entitled In Critical Condition: The Urgent Need to Reform Indian Health Serv- ice’s Aberdeen Area. At this hearing the Committee listened to tes- timony detailing an investigation led by the former Chairman Byron Dorgan and his report on the Indian Health Service. He is here with us today. The Dorgan Report found atrocious evidence showing the lack of quality of care by the Indian Health Service in the Aberdeen area, now called the Great Plains area, to Indian tribes. Over five years later, the very problems identified in the Dorgan Report have not been resolved. In fact, some issues have become worse