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Tribes to Assume Control of all Tribal Healthcare in Pennington County

RAPID CITY –For the first time in history, healthcare for tribal citizens living in Pennington County will be 100% controlled by tribal nations, not the federal government, beginning February 26, 2022. 

On February 26, the Indian Health Service will officially step aside as the Oglala Sioux Tribe, Cheyenne River Sioux Tribe, and the Rosebud Sioux Tribe have formally authorized the Great Plains Tribal Leaders Health Board to assume complete control of the Rapid City Service Unit from the federal government on their behalf. Indian Health Service will continue to provide funding for care, but decisions on utilizing it –will be made locally.   

For the last two years, the Health Board has operated the Oyate Health Center on behalf of the Oglala and Cheyenne River Sioux Tribes. During this time Indian Health Service maintained a small presence on campus at the request of the Rosebud Sioux Tribe. In December, however, Rosebud voted to join its sister tribes in moving forward to take control of its people’s healthcare future using the 638 Self-Determination process. 

The Oyate Health Center is taking steps to assure that the closure of the Indian Health Service clinic on the Sioux San campus located on the second floor of the Oyate Health Center will be as seamless as possible for patients who are converting their care to OHC. The IHS clinic will remain open until February 26. 

Patients who previously utilized providers at the IHS clinic are encouraged to come to the Oyate Health Center to create a chart and sign a release of information so their new providers can access their healthcare history and assure a continuation of care for them.  

The Oyate Health Center and staff from the Indian Health Service are working together to ensure that the transition will be as easy as possible for the community. 

All IHS issued PRC referrals and claims generated by the Rapid City IHS Service Unit prior to February 26, 2022, are the responsibility of IHS. Before February 26, 2022, inquiries about these referrals may be directed to the Great Plains Area IHS at the following: 

Rapid City IHS PRC program at (605) 719-4021 or (605) 721-4022. 

For inquiries after February 26, 2022, regarding PRC referrals generated by the Rapid City IHS Service Unit, those inquiries may be directed to the Great Plains Area IHS at the following: 

For telephone inquiries: (605) 226-7286 or (605) 226-7405 

Or can be submitted to the following address: 

Great Plains Area IHS, PRC Program 

Federal Bldg., Room 309 

115 4th Ave SE 

Aberdeen, SD 57401 

For more information please visit the Great Plains Tribal Leaders’ Social Media pages, your local Native American newspapers or tune in to The Circle podcast that airs on KILI 90.1 at 5 PM on Tuesdays and Noon on Fridays and is available wherever podcast can be downloaded.

What is 638?  

The term “638 contract” is a quick way of referring to a contract (or compact) between IHS and a tribe or tribal organization under the Indian Self-Determination and Education Assistance Act (ISDEAA) of 1975 (Public Law 93-638), which has been amended many times since then to add new authority for tribes and tribal organizations.  

This law recognizes that American Indian tribes have an inherent status as sovereign nations, which is distinguished by their relationship with the federal government, through treaties and the trust relationship, and thus have a right to determine their own futures.  

What does it mean to 638 a program? 

Essentially, this means to cut out the middle-man. Congress allocates funding to federal agencies for use in Indian Country. When tribes choose to “638” a program, funding that would have gone to the BIA or IHS must be transferred by those agencies to the tribe, or authorized tribal organization, to use to deliver services to tribal citizens.  

Benefits of 638-contracting? 

Local control. No longer do tribes or tribal organizations need to reach out to area offices or Washington D.C. to adjust services on the ground. 

For example, if the community has a greater need for more behavioral health services, tribally managed programs can immediately respond to that need. The Oyate Health Center has expanded the number of behavioral health providers from 3 to 17 within the first 18 months of its existence as requested by the community in a 2019 community needs assessment. 

How 638 benefits the community. 

Jobs, training, and expanded community capacity come with the decision to “638” a program. Tribes that “638” federal programs build capacity in their local community through hiring local talent, providing training for tribal citizens, and generating revenue that helps to build professional infrastructure and economic development in a community. GPTLHB (Great Plains Tribal Leaders’ Health Board) and the Oyate Center combined employ 311 employees.  

Does Self-Governance or Self-Determination change the trust relationship with the Federal Government? 

No. Federal law prohibits termination or reduction of the special Federal trust responsibility to Indian tribes and Indian people. The statute states: “The Secretary is prohibited from waiving, modifying, or diminishing in any way the trust responsibility of the United States with respect to Indian tribes and individual Indians that exists under treaties, Executive orders, other laws, or court decisions.”  25 U.S.C. § 458aaa-6(g).  In addition, the compact or contract between the Secretary of Health and Human Services and the GPTLHB will expressly include statutory protection.