South Dakota tribal official urges improved health services

By Chet Brokaw
Pierre, South Dakota (AP) Jan. 2010

South Dakota’s authorities must certify and license more tribal substance abuse and mental health programs to improve services for American Indians and shift the cost to the federal government, an Indian health care advocate said during January.

Even though the federal government guaranteed health care services to Indians in treaties signed more than a century ago, Indians have more severe health problems than other Americans, said Dr. Donald Warne, executive director of the Aberdeen Area Tribal Chairmen’s Health Board.

Indians have a greater incidence of diabetes, infant mortality, smoking and cancer deaths, Warne said at an annual gathering on Indian issues held in the rotunda of the state Capitol. The average South Dakotan lives to be 81, but the average Indian in the state lives to only 59, he said.

“If you look at Indian Country as a whole, American Indians are less healthy than the rest of the population,” Warne said. “It’s worse than most third world countries, and it’s right here.”

Tribal members get treatment from the Indian Health Service, which is funded entirely by the federal government, Warne said. If they are treated in other facilities, they also may qualify for Medicaid, the state-federal program that covers health care expenses for impoverished people, he said.

The state pays one-third of the cost of Medicaid, while the federal government pays the other two-thirds.

If the state licensed and certified more tribal programs that provide treatment for mental health problems and drug and alcohol abuse, the federal government would pay 100 percent of the cost, Warne said. Tribal members now sometimes get treated at other facilities, which causes the state to cover a third of the cost under the Medicaid program, he said.

A change to more tribal programs not only would improve services, but also would save state government millions of dollars, said Warne, whose nonprofit organization is run by the chairmen of 17 tribes in North Dakota, South Dakota, Iowa and Nebraska.

“The beauty of this is it doesn’t cost the state a dime,” Warne said. “Not only are we saving money in the long run, we’re saving lives.”

State Human Services Secretary Jerry Hofer said the state has already started working with tribes to accredit mental health and substance abuse programs. “We’re certainly willing to collaborate wherever we can.”

Hofer said the South Dakota Legislature passed a law a year ago that allows the state to accredit tribal programs that have contracts with the Indian Health Service. One program from the Pine Ridge Indian Reservation has since been accredited, he said.

The state has done a lot of work with tribes on programs that deal with alcohol and drug abuse, he said.