Broad Changes Still Needed Within U.S. Indian Health Service to Prevent More Abuse, Task Force Finds

The Indian Health Service’s Pine Ridge Hospital, in Pine Ridge, S.D.

The Indian Health Service’s Pine Ridge Hospital, in Pine Ridge, S.D. (Mike Shum, FRONTLINE/Wall Street Journal)

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July 23, 2020

A White House task force called for broad changes at the U.S. Indian Health Service to protect children from abuse at the agency’s facilities, saying officials must redo earlier, insufficient attempts at fixes.

The task force was formed in spring 2019, after a joint investigation by The Wall Street Journal and FRONTLINE revealed the agency had mishandled a pediatrician who sexually abused his patients on Native American reservations over the course of two decades.

In a critical report released Thursday, the task force echoed many of the same findings and called for changes big and small at the federal agency that oversees care for 2.6 million Native Americans. It says the agency should reform the ways it recruits, vets and pays its medical providers. And it calls for the agency to replace child-protection policies and a staff training program it announced just last year in the wake of the Journal-FRONTLINE reports.

“What we saw was, one, the policy they developed was inadequate and inconsistent with federal law and IHS policy, [and] two, the implementation of it was wholly lacking,” said Trent Shores, the task force chairman and the U.S. attorney for the Northern District of Oklahoma, in an interview. “I think that IHS has a lot of work left to do,” he said.

The task force recommended the IHS standardize sex-abuse reporting policies across its entire network of hospitals and clinics, arrange yearly training conducted by federal law enforcement authorities on sex abuse for all employees, and centralize its efforts to screen new providers for problem backgrounds, an activity the IHS now allows local managers to conduct, among other things.

In a statement, the IHS’s current director, Rear Adm. Michael Weahkee, said the agency had cooperated fully with the task force, and that the agency recognizes that “there is always room for improvement” and would use the report to that end. The IHS had already requested congressional action to address some task force recommendations in its latest budget request, he said.

“Sexual assault and abuse will not be tolerated in the Indian Health Service,” he said.

A wave of scrutiny of the IHS’s practices began after the Journal and FRONTLINE detailed the case of Stanley Patrick Weber, a pediatrician who has now been convicted of sexually abusing young boys under his care at IHS hospitals in South Dakota and Montana. After complaints arose about Mr. Weber, the agency transferred him from one IHS hospital to another, where he went on to practice for another 21 years, according to a transfer order. Rather than act against him, the agency sought to punish whistleblowers over the course of two decades.

The Journal and FRONTLINE went on to show a broader pattern of mismanagement at the agency, including the mishandling of sex-abuse allegations at a North Carolina facility and that officials had knowingly hired dozens of doctors with troubled histories, including of sexual misconduct.

An attorney for Mr. Weber, who is appealing one of his convictions and lost an appeal over the other, didn’t respond to requests for comment.

While the agency has over the past 18 months dismissed some of the Journal’s findings or asserted it had corrected what it called at the time “long-standing” problems, the similar conclusions of the task force could prove harder to parry.

The group, appointed by President Trump, consisted of seven federal officials, including Mr. Shores. One of its members is an IHS pediatrician and administrator from a clinic at the edge of the Navajo Nation. They interviewed numerous IHS employees at all levels of the organization and from sites across the country, according to Mr. Shores and the report.

The group found numerous examples of the kind of failures and conduct the Journal identified.

Officials across the IHS were unaware of their specific obligations under federal law to report suspected abuse, such as what to report and whom to report it to, the task force said. It said the agency at times ignored doctors’ problematic work histories because it prioritized filling needed positions.

In one instance, Mr. Shores said, the group found an agency hiring committee had attempted to bring on a psychologist who had been suspended by the New York state licensing board five times after a position had sat empty for years. In that case, he said, the psychologist wasn’t hired.

Staff at IHS facilities told the task force that their bosses in Washington “didn’t want to make decisions and would push it down the chain,” Mr. Shores said. The report said officials complained they would sometimes receive no or “non-answer” responses when they asked their leaders for guidance.

One example of the pattern of deferring decision making, Mr. Shores said, is the latest version of the child-protection policy, which allows local managers to determine how suspected abuse should be reported at each facility.

The parts of the child-abuse policy that were standardized, the report said, sometimes contradict federal law. For instance, the law allows doctors or law enforcement officers to give consent for medical and psychological exams when a legal guardian, who might be a child’s abuser, won’t, but the IHS policy doesn’t account for such situations, the report found.

The task force, however, stopped short of recommending a wholesale reorganization of the agency. Mr. Shores said the group’s mandate was narrowly focused on its mishandling of sexual abuse.

The report also called for Congress to pass new laws, including one requiring all federal employees to report any suspicions of sex abuse to law enforcement, which would replace several narrower laws. It also asked Congress to clear the way for IHS to reclassify some jobs so the agency could offer better benefits to recruits, and called for action to strip child-sex offenders of federal pensions.

As of Wednesday, Mr. Weber continued to receive a federal pension, according to a spokeswoman for the Coast Guard, which processes pensions for the U.S. Public Health Service Commissioned Corps, which included Mr. Weber’s. The Journal estimated his pension is worth about $100,000 a year based on his career history and uniformed service pay tables.

More than a year ago, the U.S. Public Health Service Commissioned Corps said it would convene a board of inquiry to review whether to strip Mr. Weber of his pension. On Thursday, a spokeswoman for the agency declined to say whether the board had ever actually met or reached any conclusions.

The task force’s review is one of at least five federal investigations into the IHS’s handling of Mr. Weber, and its personnel practices in general, triggered by the Journal’s 2019 investigation. But it is the first to produce public findings.

A separate report, commissioned by the IHS itself, has been kept secret by the agency, which claims it is a confidential medical quality assurance record. The report draws from decades of internal documents and around 50 interviews to provide a detailed account of the agency’s handling of the matter, according to people familiar with its contents.

The agency denied public records requests by the Journal and the New York Times seeking disclosure of the report. Both news organizations are suing in federal court to compel its release.

The release of the task force’s report was initially slated for late last year, officials said when the group was formed. But, its release was repeatedly delayed amid impeachment proceedings and then the coronavirus pandemic, officials said.

On Thursday morning, the report was unveiled at a White House meeting with the first lady, Melania Trump, presiding in place of her husband.

“I know that this work will help to keep children safe,” Mrs. Trump said at the meeting. A White House spokesman said, “President Trump looks forward to reviewing the report.”

With the report’s arrival on the cusp of the general election season, the next test will be whether Washington has the focus to implement its recommendations. Attention to the IHS’s problems has slipped before, including when a 2010 investigation of alleged mismanagement at the agency ended with the retirement of a key senator.

“If we can’t put partisan politics aside to get behind policies that would protect children from child abuse and molestation at a government facility, then I really worry for our country,” Mr. Shores said.

This story has been updated.

Christopher Weaver, The Wall Street Journal

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