Timeline Set For Handover Of IHS Programs
Indian Health Service employees and area residents, who utilize IHS programs on the Fort Peck Indian Reservation, have expressed concerns about a pending handover of responsibility following a July 8 vote by the Fort Peck Tribal Executive Board in Poplar.
The board voted to trigger Public Law 93-638 for the coming fiscal year, bringing some programs under the authority of the Fort Peck Tribes following a lengthy transition. The motion passed unanimously. TEB members Dana Buckles and Jestin Dupree were absent for the vote.
PL 93-638 is part of the Indian Self Determination Act passed by Congress in 1975, enabling tribal governments to exert control over federal programs and services.
Adriann Ricker, director of dental operations within the tribal health department, told area media the move is intended to deliver more autonomy into the hands of tribal members. Dental operations and Public Health Nursing have been under Tribes’ authority since 2023.
“We will be moving forward now on audiology and optometry,” TEB member Roxanne Gourneau told the Northern Plains Independent.
Some tribal members shared concerns during the past week about transparency and accountability around services and administration and terms of employment for local IHS staff moving forward.
“I would like to ask if IHS employees will have jobs once the Tribes take over,” said Wade Kirn via social media. “Please let us know if we need to start searching for jobs.”
Local attorney Montana Wilson responded to the conversation online, speculating that some changes in employment will likely take place.
“If the tribes enter into a Public Law 93-638 contract with IHS, it means IHS will hand over full administration of the health services to the tribal government,” Wilson said. “The responsibility for healthcare services then becomes that of the tribal government. All IHS employees will no longer be classified as federal employees with federal benefits. They will all become Tribal employees (those that choose to stay).”
Gourneau said the board will likely address the question of employee benefits and classifications in coming weeks.
“That is clearly the intention this week and certainly at full board this coming Monday,” Gourneau said.
TEB member Stacey Summers told NPI that a meeting is scheduled with the tribes’ legal counsel to explore details about the transition and other related matters. She said the timeline for the handover will allow for community education efforts and public input. She said the process is lengthy and will take from 15 months to two years.
“We want to be a self-governance tribe,” Summers said. “It’s about getting more services to people.”
Gourneau estimated the process could take as long as five years.
“We are undertaking a comprehensive analysis of what it looks like to totally contract all health services,” Gourneau said. “We are committed to seeking factual data and information before that decision is made. That is the reason why we will be addressing this in committee Thursday. The written language did not align with our legislative intent.”
Summers said the Tribes have been covering deficits in essential health services to make up for IHS neglect for many years. She said the changes should allow for the Tribes to offer a better standard of care, including podiatry and optometry services and help with reimbursements for off-reservation medical travel and transportation costs.
Summers cited broken chairs at the Wolf Point IHS dental facility and other longstanding problems with IHS services as the reasoning behind the move. She said goals for the transition include better access to oxygen for at-risk patients, wound care training for nursing staff dealing with diabetes patients and homes and lodging for medical providers.
The next full TEB meeting is set for July 22 in Poplar.
