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Report lays out Indian Health Service problems

WASHINGTON (AP) -- The Aberdeen Area of the Indian Health Service is in a "chronic state of crisis" stemming from serious management problems and a lack of oversight, Sen. Byron Dorgan said in releasing a congressional report on Wednesday.

IHS facilities in the Aberdeen Area, which serve more than 100,000 Native Americans from 18 tribes in North Dakota, South Dakota, Nebraska and Iowa, have been criticized for years over allegations of mismanagement and substandard services. The report Dorgan released follows an 18-month investigation by the Senate Indian Affairs Committee, which he chairs. The committee conducted hearings earlier this year.

"Our investigation found a chronic state of crisis at the Indian Health Service's Aberdeen Area," Dorgan, D-N.D., said in a statement released with the report. "It requires urgent and immediate corrective action."

Dorgan said mismanagement was hurting the health of the first Americans. "Fixing these problems must be an urgent, national priority," he said.

The Aberdeen Area includes nine hospitals, eight health centers, two school health stations and several smaller health stations and satellite clinics.

The Senate investigation found a lack of employee accountability and financial integrity; several service units experiencing substantial and recurring diversions of reduced health care services because of lack of qualified providers or funds; and key senior staff positions remaining vacant for long periods, contributing to the lack of proper management.

Five IHS hospitals in the Aberdeen Area are at risk of losing their accreditation or certification from the Centers for Medicare and Medicaid Services, the report found. Several facilities were cited as having health care providers on staff without proper licenses or credentials.

Employees with a record of misconduct or poor performance were transferred to different health facilities within the Indian health system, according to the report. It found pharmaceutical audits of narcotics and other controlled substances were not regularly performed, and three service units within the region have a history of missing or stolen narcotics.

Dorgan, who retires from the Senate next week, said "meaningful change" will require a plan and long-term commitment from the Health and Human Services Department.