South Dakota Sen. Mike Rounds Calls for Evaluation of Indian Health Service

Sen. Mike Rounds (R-SD) speaks with reporters at the U.S. Capitol January 19, 2018 in Washington, DC.

Sen. Mike Rounds (R-SD) speaks with reporters at the U.S. Capitol January 19, 2018 in Washington, DC. (Aaron P. Bernstein/Getty Images)

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February 15, 2019

U.S. Sen. Mike Rounds, a South Dakota Republican, introduced legislation Thursday calling for a broad assessment of the U.S. Indian Health Service, following an investigation of the agency by The Wall Street Journal and FRONTLINE.

The bill calls for a sweeping evaluation of the agency’s performance, including its long-term vacancies, how it allocates money to its more than two dozen hospitals and the competency of the agency’s leadership.

The Journal/FRONTLINE investigation revealed the Indian Health Service mishandled allegations of sexual assault by a pediatrician it employed for decades and routinely hired physicians with troubled backgrounds to fill slots at its remote hospitals on Native American reservations.

The doctor, Stanley Patrick Weber, was convicted of sexually assaulting two patients while working at a Montana IHS hospital and was sentenced in January to more than 18 years in prison. He faces another trial later this year on allegations he abused Native American boys while working at another hospital run by the agency — this time in Pine Ridge, S.D., the seat of one of the nation’s poorest Indian reservations — after officials transferred him there despite their concerns about his conduct.

The investigation brings “to light something that should never have happened in the first place,” Mr. Rounds said in an interview Thursday. “It might very well help us in getting some stuff done that we have been trying to do for the last three years,” he said.

A spokeswoman for the Indian Health Service said, “We look forward to continuing to work with tribal leadership and community members, Congress and other stakeholders to improve the quality of care across Indian health facilities.” She said the agency doesn’t comment on pending legislation.

The agency’s current head, Rear Adm. Michael Weahkee, ordered an external review of the case and said he implemented several policies to help prevent any repeats of the episode.

One of the new policies states, according to the agency’s online manual, that “providers should under no circumstances engage in sexual activity… with current or former patients under the age of 18, whether such contact is voluntary or forced.”

Adm. Weahkee briefed the Senate Committee on Indian Affairs about the agency’s response to the scandal at the committee’s request Wednesday, Senate staff members said.

Mr. Rounds, a former two-term South Dakota governor, had previously called for a broad assessment of the agency in 2017, and while the bill was approved by the Indian affairs committee, it didn’t advance from there.

Lawmakers have grappled intermittently for years with concerns that the IHS’s care has fallen short, with hospitals facing regulatory sanctions and causing unnecessary patient deaths and turning away gravely ill patients. The agency’s intractable problems were highlighted in a Journal investigation in 2017.

In 2010, a Senate investigation showed sweeping deficiencies at the agency’s hospitals in the Dakotas and Nebraska, but when the senator who spurred the probe retired months later, the effort sputtered.

This time, Mr. Rounds, who was elected in 2014, says it will be different. “Come hell or high water, we’re going to get to the bottom of what the problems are,” he said.

“The committee is aggressively working with the Indian Health Service to determine the full magnitude of this problem and what further action needs to immediately be taken,” said Sen. John Hoeven (R., N.D.), chairman of the Indian Affairs committee, of the scandal around Mr. Weber. He called the legislation introduced by Mr. Rounds “a first step” toward improving the agency’s performance.

Sen. Tom Udall (D., N.M.), vice chair of the Indian Affairs committee, said in a statement to the Journal that the fact that Mr. Weber “was allowed to remain a federal employee for so many years after IHS became aware of his despicable conduct is intolerable,” and that the agency “must be held accountable for its failure to protect Native children.”

When Mr. Rounds issued his call last year for the same broad assessment he now proposes for the health service, Mr. Udall raised concerns about whether the costs involved would pull away funding from the IHS and duplicate other federal reviews of the agency.

The bill would require the Department of Health and Human Services to enlist a contractor to perform the review and would cost roughly $56 million, according to Mr. Rounds. He said existing HHS funding would pay for the cost. An HHS spokesman declined to comment on pending legislation.

On Wednesday, HHS Secretary Alex Azar in a speech asked the department’s watchdog arm to conduct a separate review of IHS policies for handling sexual-abuse allegations.

Mr. Rounds also said he wanted to examine alternative ways of financing care on reservations in South Dakota, such as grants to tribes that run their own clinics and hospitals, an arrangement that has become more widespread in some parts of the country.

“I just don’t know that IHS is ever going to be the right avenue to provide quality health care,” Mr. Rounds said.

This article has been updated. 

Christopher Weaver, The Wall Street Journal

Dan Frosch, The Wall Street Journal

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