Aberdeen Area Comes Under Scrutiny of Senate Committee

by U.S. Medicine

November 14, 2010

WASHINGTON, DC—A Senate committee criticized IHS officials for serious mismanagement issues as well as poor performance by some employees in its Aberdeen Area at a hearing held in September.

The Aberdeen Area includes facilities that provide healthcare to about 122,000 Indians in rural and urban areas located in North Dakota, South Dakota, Nebraska, and Iowa.

The Senate Committee on Indian Affairs launched a formal investigation into the Aberdeen Area and Committee Chairman Byron Dorgan, D-ND, told IHS leaders that the investigation found instances in which doctors and nurses with expired licenses and certifications were treating patients, an increasingly high number of Equal Employment Opportunity complaints, and several facilities on the brink of losing their accreditation or certification. In addition, he said that the committee found substantial amounts of missing or stolen narcotics. “There are poor performing employees who, in my judgment, ill serve the very patients they are supposed to help. I am convinced that problem employees are able to wreak havoc and demoralize those who fight so hard to provide quality healthcare.”

Aberdeen Area Investigated

Dorgan noted that the committee investigation also found instances in which employees were working in impaired conditions, possibly under the influence of alcohol. In one instance, a nurse was found to be assisting a C-section in such an impaired state that she could not hold the patient’s skin together for staples, according to Dorgan.

In addition, the committee found that 176 employees in the Aberdeen Area were placed on paid administrative leave between 2005 and 2010 for a period of time totaling over eight years. “The committee found that in some cases, a single individual was placed on leave for over eight months due to a pending investigation. I simply do not understand why the federal government would pay this employee to stay at home for over eight months,” he said.

Dorgan suggested it was taking too long to resolve issues and said that he was especially troubled to learn that the current Aberdeen Area deputy director had been on paid administrative leave for 12 months. “What kind of investigation takes 12 months to resolve?”

Gerald Roy, deputy inspector general for investigations in HHS’s Office of Inspector General, recounted to the committee that in 2008 his office discovered during its investigation that a Sioux San Pharmacy technician in Rapid City had stolen large quantities of Vicodin® and Tramadol from the IHS pharmacy and sold the narcotics on the street for cash. Roy said that OIG found that the IHS pharmacy lacked effective security controls to prevent and detect drug diversion, such as security cameras and requiring two people to count the inventory.

Tighter security measures are needed at IHS pharmacies, he said. “We have determined that IHS pharmacies are vulnerable to controlled substance abuses, including diversion and trafficking by employees, contract providers, and patients.”

OIG’s investigations also found that IHS had hired individuals who were supposed to be barred from being hired. “OIG protects beneficiaries and the integrity of federal healthcare programs, including IHS, by excluding individuals for fraud and abuse violations, such as drug diversion and patient abuse. IHS must be vigilant in ensuring that it does not hire excluded individuals,” Roy said in testimony.

Roy said that IHS had no policy in place to verify employees and contractors against the List of Excluded Individuals and Entities. He said IHS agreed to review the names of all current employees and contractors against the excluded individuals and entities lists.

Addressing the Aberdeen Area

IHS Director Yvette Roubideaux, MD, acknowledged to the committee that what has happened in the Aberdeen area was “absolutely unacceptable,” and that the agency has already taken a number of steps to address challenges there. She said she is not surprised that EEO complaints filed by employees have increased in the Aberdeen Area, given efforts to better hold employees accountable for their actions. “We are starting to hold people more accountable, and people will complain when they are getting disciplinary action.”

Roubideaux also agreed with Dorgan that IHS cannot continue to put employees on paid administrative leave for long periods of time. “There are some cases where we do have to put people on leave while investigations are pending, but it should be for a very minimal time.”

Roubideaux said that steps taken by the Aberdeen Area director to address the problems included taking disciplinary action against five service unit directors related to management or fiscal incompetence, conduct and misuse of authority, or lack of Tribal consultation. In addition, the supervision of the EEO program was transferred from the Aberdeen Area to IHS headquarters.

Sen Al Franken, D-MN, told Roubideaux that it is difficult to convince members of Congress to increase funding for IHS when some members believe the bureaucracy is dysfunctional.

Also testifying was Ron His Horse Is Thunder, executive director for the Great Plains Tribal Chairmen’s Health Board in Rapid City, SD. He told the committee that despite the problems in the Aberdeen Area that he felt the current director, Charlene Red Thunder, is “probably the best regional director” that IHS has provided the area. “She needs more time and with some additional resources we think she could do an adequate job.”

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