Post by blackcrowheart on Jun 4, 2007 20:39:45 GMT -5
Indian agency to quit taking drugs to Billings Change would have
prescriptions filled in Crow Agency only
By DIANE COCHRAN
Of The Gazette Staff
Ten months after announcing a policy that would force American Indians
in Billings to fill prescriptions in Crow Agency, Indian Health Service
officials have vowed to finally enforce it.
Set to go into effect March 1, the change would prohibit a decadeslong
practice of ferrying prescription drugs between the Crow-Northern
Cheyenne Hospital on the Crow Indian Reservation and the Indian Health
Board of Billings clinic.
It would also prohibit the hospital pharmacy from filling prescriptions
ordered by providers who do not work at the medical center.
"There is no logic to any of it," said Marjorie Bear Don't Walk,
executive director of the Indian Health Board of Billings. "It is pure
and simple discrimination." Like American Indians living
on reservations, so-called urban Indians are entitled to free health
care through the Indian Health Service, or IHS. For years, American
Indians living in Billings have been able to receive that care at a
clinic operated by the local Indian Health Board.
But the clinic does not run a pharmacy, so it sends prescription orders
by courier to the medical center at Crow Agency. Pharmacists there fill
the orders and send back medications on an Indian Health Board van,
which also transports patients.
Last spring, IHS announced it would no longer honor the arrangement
because of concerns about funding and liability.
Agency officials said pharmacists disliked filling prescriptions for
patients they hadn't met, and the desperately underfunded hospital
wanted to increase its revenue by increasing patient visits.
Bear Don't Walk and Indian Health Board clients vehemently objected to
the change, saying it would create hardships for Billings residents who
have no means to get to Crow Agency or cannot take time off from work to
make the trip.
A series of meetings between the agencies over the ensuing months failed
to reach a resolution.
"Based on advice from Headquarters the practice of transporting
medication is discouraged and places our agency at risk for liability,"
Charlene Johnson, head of the IHS Crow Service Unit wrote to Bear Don't
Walk in a letter dated Jan. 22. "Therefore, our proposal is to fully
implement the prescription policy as originally proposed."
An IHS spokeswoman did not return a telephone call seeking comment
Thursday.
But in the letter to Bear Don't Walk, Johnson indicated that the Indian
Health Board's practice of ferrying medications between Crow Agency and
Billings has amounted to special treatment for its clients.
"Transportation of medication is not offered to any other
community in or surrounding the Crow Reservation," she wrote.
In a scathing response, Bear Don't Walk accused IHS of discriminating
against urban American Indians.
"When we were young and foolish in the '60s, we use to say that someday,
Indian people would be making decisions for Indian people and that
Indian people would be better off than when white people were making
decisions for us," Bear Don't Walk wrote in the Feb. 2 letter.
"We were wrong. Indian people are as heartless and vicious toward Indian
people as any white person ever was. Indians are now killing Indians,
using the Indian Health Service, or in this case the IHS refusing
services and killing Indians."
Indian Health Board clients have also written letters opposing the
change. At least a dozen were sent to Sen. Max Baucus, D-Mont.
"To make an appointment or go to Crow or Pryor IHS makes it a hardship
in terms of loss time at work, financial (gas costs) and the long wait
time for follow-up services (such as pharmacy)," one woman wrote. "This
makes us less apt to seek medical care and (I) am so thankful Indian
Health Board is here."
"I need my medications delivered to me in Billings," another wrote. "I
am 73 years old and the last trip to Crow I nearly sideswiped a passing
car."
On Thursday, Baucus reacted with a letter to national Indian Health
Service Director Charles Grim asking that the situation be given his
"personal attention."
"I realize that funding constraints and possible liability concerns may
have been factors that necessitated the policy change; it was my hope
that a compromise could have been reached that would have allowed the
continuation of some services," Baucus wrote.
"I trust it is not too late for open dialogue between the Indian Health
Service and the Indian Health Board of Billings."
But Bear Don't Walk said the next move is up to IHS.
"They have all the power," she said. "They can make their government
salaries, have their government insurance and make decisions about poor
Indian people and obviously not feel bad about it at all."
prescriptions filled in Crow Agency only
By DIANE COCHRAN
Of The Gazette Staff
Ten months after announcing a policy that would force American Indians
in Billings to fill prescriptions in Crow Agency, Indian Health Service
officials have vowed to finally enforce it.
Set to go into effect March 1, the change would prohibit a decadeslong
practice of ferrying prescription drugs between the Crow-Northern
Cheyenne Hospital on the Crow Indian Reservation and the Indian Health
Board of Billings clinic.
It would also prohibit the hospital pharmacy from filling prescriptions
ordered by providers who do not work at the medical center.
"There is no logic to any of it," said Marjorie Bear Don't Walk,
executive director of the Indian Health Board of Billings. "It is pure
and simple discrimination." Like American Indians living
on reservations, so-called urban Indians are entitled to free health
care through the Indian Health Service, or IHS. For years, American
Indians living in Billings have been able to receive that care at a
clinic operated by the local Indian Health Board.
But the clinic does not run a pharmacy, so it sends prescription orders
by courier to the medical center at Crow Agency. Pharmacists there fill
the orders and send back medications on an Indian Health Board van,
which also transports patients.
Last spring, IHS announced it would no longer honor the arrangement
because of concerns about funding and liability.
Agency officials said pharmacists disliked filling prescriptions for
patients they hadn't met, and the desperately underfunded hospital
wanted to increase its revenue by increasing patient visits.
Bear Don't Walk and Indian Health Board clients vehemently objected to
the change, saying it would create hardships for Billings residents who
have no means to get to Crow Agency or cannot take time off from work to
make the trip.
A series of meetings between the agencies over the ensuing months failed
to reach a resolution.
"Based on advice from Headquarters the practice of transporting
medication is discouraged and places our agency at risk for liability,"
Charlene Johnson, head of the IHS Crow Service Unit wrote to Bear Don't
Walk in a letter dated Jan. 22. "Therefore, our proposal is to fully
implement the prescription policy as originally proposed."
An IHS spokeswoman did not return a telephone call seeking comment
Thursday.
But in the letter to Bear Don't Walk, Johnson indicated that the Indian
Health Board's practice of ferrying medications between Crow Agency and
Billings has amounted to special treatment for its clients.
"Transportation of medication is not offered to any other
community in or surrounding the Crow Reservation," she wrote.
In a scathing response, Bear Don't Walk accused IHS of discriminating
against urban American Indians.
"When we were young and foolish in the '60s, we use to say that someday,
Indian people would be making decisions for Indian people and that
Indian people would be better off than when white people were making
decisions for us," Bear Don't Walk wrote in the Feb. 2 letter.
"We were wrong. Indian people are as heartless and vicious toward Indian
people as any white person ever was. Indians are now killing Indians,
using the Indian Health Service, or in this case the IHS refusing
services and killing Indians."
Indian Health Board clients have also written letters opposing the
change. At least a dozen were sent to Sen. Max Baucus, D-Mont.
"To make an appointment or go to Crow or Pryor IHS makes it a hardship
in terms of loss time at work, financial (gas costs) and the long wait
time for follow-up services (such as pharmacy)," one woman wrote. "This
makes us less apt to seek medical care and (I) am so thankful Indian
Health Board is here."
"I need my medications delivered to me in Billings," another wrote. "I
am 73 years old and the last trip to Crow I nearly sideswiped a passing
car."
On Thursday, Baucus reacted with a letter to national Indian Health
Service Director Charles Grim asking that the situation be given his
"personal attention."
"I realize that funding constraints and possible liability concerns may
have been factors that necessitated the policy change; it was my hope
that a compromise could have been reached that would have allowed the
continuation of some services," Baucus wrote.
"I trust it is not too late for open dialogue between the Indian Health
Service and the Indian Health Board of Billings."
But Bear Don't Walk said the next move is up to IHS.
"They have all the power," she said. "They can make their government
salaries, have their government insurance and make decisions about poor
Indian people and obviously not feel bad about it at all."