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This
Nov. 23, 2016 photo shows a sign with an architectural rendering
of a clinic that's under construction on the reservation of
the Flandreau Santee Sioux Tribe in Flandreau, S.D. The tribe
is spending $13 million to build a facility that will offer
medical, dental, behavioral and vision services and feature
a large pharmacy with a drive thru.
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Flandreau, SD A clinic featuring medical, dental, behavioral
and vision services will serve hundreds of members of the Flandreau
Santee Sioux Tribe and students from a federally operated boarding
school when it opens its doors in mid-2017 after several years of
planning and a $13 million investment from the tribe.
That investment by the tribe in the eastern part of the state
is part of an agreement with the federal government, allowing the
tribe to manage its own health care services and bypass some of
the bureaucracy of the long-struggling Indian Health Service.
"We are going to have more exam rooms (and) offices instead
of having to use closets," tribal treasurer Ryan Kills A Hundred
said. "They are doing a good job don't get me wrong, but the poor
guys are working out of a tin can from the '80s ... patient privacy
isn't all that great."
The new facility also will have a drive-thru pharmacy
a staple in urban areas but a luxury in tribal communities
radiology services that aren't currently available, a community
health educator and a public health nurse focused in nutrition.
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This
Nov. 23, 2016 photo shows a clinic that is under construction
on the reservation of the Flandreau Santee Sioux Tribe in
Flandreau, S.D. The tribe is spending about $13 million to
build a facility that will offer medical, dental, behavioral
and vision services and feature a large pharmacy with a drive
thru.
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The federal government is responsible for providing health care
to enrolled members of tribes considered sovereign nations
based on treaties, acts of Congress and other laws. The Indian
Health Service, or IHS, directly operates 26 hospitals and dozens
of smaller facilities, while some tribes, like the Flandreau Santee
Sioux, receive the funding and administer their own facilities.
The IHS has been under intense scrutiny over the past year due
to federal health inspectors uncovering severe deficiencies in some
Great Plains facilities
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In
this Nov. 23, 2016 photo, an employee of the Flandreau Santee
Sioux Clinic and Health Center works on the pharmacy's computer
in Flandreau, S.D. The Flandreau Santee Sioux Tribe is spending
about $13 million to build a brand new clinic that will offer
medical, dental, behavioral and vision services and feature
a larger pharmacy with a drive thru.
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After years of seeing the underfunded agency struggle to fulfill
its responsibilities, some tribal health care administrators and
experts believe success lies with the tribes themselves.
"Under tribal management, we tend to see greater access to funding
streams that IHS could not access, and as a result, we can hire
more providers and more staff," Dr. Donald Warne, the chair of the
Department of Public Health at North Dakota State University, told
The Associated Press earlier this year.
The Flandreau Santee Sioux issued bonds to fund the $13 million
project, which on a recent afternoon had construction crews working
on the entrance as snow covered the ground and some equipment.
The existing clinic has 30 employees and 6,000 registered patients
that are members of the Flandreau Santee Sioux Tribe, other tribes
and boarding school students. The new facility will employ close
to 90 people, and tribal officials expect to see a small increase
in patient load early on.
Not every member of the tribe, whose reservation is about 45
miles north of Sioux Falls, agreed with the decision to pay for
the facility, arguing that that is a responsibility of the federal
government.
"It became very political amongst the membership itself," Flandreau
Santee Sioux tribal president Anthony Reider said.
A recent federal watchdog report said IHS-managed facilities
are outdated, with the average age or length of time since major
renovations being 37 years nearly four times the average
age of hospitals nationwide. The need for an update at the South
Dakota clinic managed by the tribe appears clear: displays for eye
glasses are on top of filing cabinets, the packed pharmacy is the
size of a walk-in closet and the ceiling shows the signs of a few
water leaks.
"We try not to point those out," said Leah Fyten, the clinic's
administrator.
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