IHS head stops in Lawton, addresses funding issues

LAWTON, Okla. – The head of Indian Health Services promised continued improvements to the aging Lawton Indian Hospital despite an upcoming presidential election. Dr. Yvette Roubideaux made an on-site visit at the southwest Okla. hospital Aug. 30 to meet with members of the Inter-tribal Indian Health Advisory Board .

“I’m surprised at how many improvements you’ve made,” Roubideaux told health board members, IHS administration and tribal officials. Representatives from the area’s tribes included the Western Delaware; Caddo Nation; Comanche; Kiowa Tribe of Oklahoma and the Fort Sill Apache.

The IHS director told attendees that her agency, under Health and Human Services (HHS), were going to continue to tackle problems even if Obama is defeated in the upcoming election. In the meantime, there would be six months to keep working on areas they know needs to be improved.

“I don’t know what will happen in the election but it’s full steam ahead until Jan 21, 2013,” she said.

Members of the health advisory board were able to ask Roubideaux about funding for the Lawton hospital. The hospital currently operates with upwards of  $30 million in federal funds, officials said.  She acknowledged that despite the budget recommendations to Congress, the overall budget amount could see a significant slash under Republican leadership.

“We want to protect what we have here and improve it,” said board member Lupe Gooday.  “Despite the renovations, the facility is aging and money is needed for improvements. Are we gonna go forward or are we going to be a clinic?”

Roubideaux answered questions but left specific details to local leadership, including area officials Admiral Kevin Meeks and Capt. Greg Ketcher who attended the meeting. Unit directors for both Anadarko and Lawton were also present.

Western Delaware official, C.J. Watkins said that improvements had targeted some areas but they were concerned with staffing shortages to treat patients who were coming from North Texas and Northeastern Okla., not just the local area. Increased patient loads currently outpaced current funding levels, board members said.

“They expect everything and it costs us a lot and we not funded for it,” Watkins said. “By the time the oil boom in the 1980s was over, our Indian hospital was in bad shape.”

The facility has reduced staff, discontinued labor and cut inpatient services, relying on contract health care by area mainstream providers over the past decade.  Because the Lawton service unit is for direct service tribes, it relies solely on IHSfunding, unlike neighboring tribes who operate under self-governance provisions.

“It’s kind of heartbreaking, we’re not the only one’s suffering, it’s going on all over the country,” said Lori Gooday Ware, Fort Sill Apache vice-chairman.

Roubideaux said she was hearing from some tribal leaders in southwest Okla. that things are getting better, but acknowledged that there’s an “enormous need,” in Lawton’s Indian hospital. She said she envisions a strong partnership between area IHS officials and the health board in the coming year to locate exactly what needs to be addressed.  She asked all area unit directors to be more transparent with budget information.

“I’ve heard so many horrible things about this facility,” Roubideaux said. “But it’s not so bad, there have been improvements.”

Among areas earmarked for improvements at Lawton are the reinstatement of an operating room and Intensive Care Unit (ICU) as well as the addition of medical specialists for conditions like autoimmune diseases. The immediate plans are to build two additional modular buildings for dental and behavioral health.  Improvements in these areas would allow them to update existing spaces for other uses like the emergency room and radiology.

Ketcher said he had a long-term and short-term plan for the Lawton hospital that he would be happy to share with area tribal leaders.

Roubideaux continued to emphasize funding shortages plaguing most Indian health facilities. In budget formulation sessions, IHS estimates that it needs about $7 billion to make all the recommended improvements to IHS facilities across the country. Only $80 million is budgeted for such, which presses IHS to amp up their third-party payments for government subsidized programs like Medicaid and Medicare.  At present, Oklahoma declines to expand Medicaid eligibility guidelines that could up government monies for operations, officials said.

At the end of the two-hour meeting, Roubideaux said that she maintains a strong vision for the Lawton Hospital and wanted to be updated whenever possible about its progress.

“Our plan for Lawton is to change and improve,” she said. “I think in a way, Lawton has an image problem but it’s changing and improving.”