WINNEBAGO, Neb. | In a perfect world, the Winnebago Tribe would not be entering negotiations to take over control of the embattled Omaha Winnebago Hospital, Tribal Councilwoman Victoria Kitcheyan says.
Kitcheyan and other Winnebago authorities on Tuesday pointed to the inability of the Indian Health Service, which provides federal health services to American Indians, to regain the Omaha Winnebago Hospital's Medicare contract after the contract's termination more than two years ago.
The Centers for Medicare & Medicaid Services had ceased the hospital's Medicare contract in July 2015, after IHS and hospital officials failed to correct deficiencies found by the agencies. Kitcheyan said since the hospital lost its Medicare contract, it has lost out on approximately $11 million in federal funding.
"In an ideal world, IHS would have corrected those deficiencies, restored that revenue, and we would have quality patient care," Kitcheyan said.
But a year went by, and confidence waned.
"Time and time again, their deadlines were passed," she said. "We have no more confidence left in IHS to correct the action plan and restore the certification."
About a year ago, the Winnebago Tribe began putting the pieces in place to prepare to enter negotiations to assume management. That included receiving a clean audit, building up the finance department, bringing on a chief financial officer and putting team members in place.
Then, on Thursday, the tribal council voted to initiate the self-governance process, meaning the tribe will soon ask the Indian Health Service to begin negotiations for the tribal takeover of the federally operated health care facility in Winnebago.
Located in Winnebago, Nebraska, the 13-bed Omaha Winnebago Hospital provides free health care to a population of approximately 10,000 Native Americans enrolled as members of the Winnebago, Omaha, Santee Sioux and Ponca tribes, as well as others. It includes inpatient hospital care, a clinic, emergency services, a pharmacy, radiology and other support services.
The Winnebago Tribe has voted to pursue self-governance of the facility, which allows American Indian tribes to assume administration of federal programs. Kitcheyan said nearly 370 tribes have initiated such processes, and the Winnebago Tribe will be working with legal experts and consultants to ensure it navigates the process smoothly.
"Our immediate goal is to stabilize the operation," Kitcheyan said. "For seven years, we haven't had a consistent leadership in that facility, and that has led to some of the dysfunction that permeates through the building."
Tuesday, the council met with community members for a press conference to discuss the move. As a crowd of between 60 and 70 gathered, Kitcheyan and tribal council chairman Frank White fielded several concerns about the process and the funding.
One came from Omaha Tribal Council chairman Mike Wolfe, asking where his tribe's involvement would fall in.
"We have a partnership. We have a relationship. We have a commitment to each other," Wolfe said. "When are we going to get together and unite in this?"
White replied that the tribe has been in touch with the Omaha and that they hope to work together in the negotiations.
"We look forward to working cooperatively with the Omaha Nation, and I think your council shares the same concern we do," White said.
The Winnebago Tribe has eyed July 1, 2018 as the target date to assume management. Kitcheyan said the tribe will be simultaneously working to form a new Medicare contract with CMS. White said the council hopes to retain current employees and will prioritize the filling of several vacancies at the hospital as it can.
In recent years, the hospital has been troubled by several incidents. The CMS released a report that identified a number of life-threatening deficiencies at the hospital, located about 20 miles south of Sioux City. Critics have blamed problems at the hospital for multiple deaths and misdiagnosis of patients.
Trust in the hospital took another hit in August, after it was revealed that up to 35 podiatry patients may have been inadvertently infected with diseases including HIV and hepatitis because a podiatry instrument was not properly sterilized between procedures. The podiatrist responsible for the mistake was fired.
IHS officials have said improvements have been made at the hospital, where some top staff were replaced and day-to-day management of the emergency department was turned over to a private contractor based in Arizona.
White referred to the troubles at the hospital during Tuesdays' press conference, saying that in the end, what matters is the care of loved ones.
"The number one issue, the number one focus that we should have is the care of our relatives," he said. "That's what we're working towards. Right now Indian Health Services is not doing that."
The tribe plans to hold another public meeting Dec. 4 to address more community concerns.
SIOUX CITY | The Iowa Air National Guard will break ground Wednesday on a $12.4 million building that will consolidate several of the 185th Air Refueling Wing's departments under one roof.
Construction of the 37,000-square-foot, one-story building at the air base next to Sioux Gateway Airport is scheduled to begin this fall and be finished by the end of 2018.
When completed, the composite support facility will house the 185th's clinic, food services and communications functions, accommodating nearly 500 people. The building will be more energy efficient and is designed specifically for the military functions using it. It will replace two existing buildings, which will be demolished, Lt. Col. Kris Aldrich, 185th civil engineer, said in a news release.
"The building that houses our communications or IT function was originally constructed as a jet engine repair shop. Our base clinic and dining facility was originally the base supply building. These buildings are 44 and 60 years old and are becoming increasingly expensive to maintain," Aldrich said.
The building also was designed to meet the latest anti-terrorism and force protection standards. It will include modern, high-efficiency mechanical systems and LED lighting.
SIOUX CITY | Based on a traffic model, a new Interstate 29 interchange between Sergeant Bluff and Port Neal could not be justified, officials said. But if the proposed ramps can be shown to boost economic development in rural Woodbury County the $20 million project could still move forward, county supervisors heard Tuesday.
At the board's weekly meeting, chairman Matthew Ung gave an update on the work underway to convince the Iowa Department of Transportation to fund and build the long-sought interchange.
At a stakeholder meeting last week, Ung said a traffic model finalized by the IDOT did not justify the estimated $20 million cost of the interchange that would be built somewhere between mile markers 136 and 140.
Sandwiched between the Port Neal industrial area and Sioux Gateway Airport and Sergeant Bluff, the interchange would provide access to Sioux City's Southbridge Business Park.
Sioux City, Woodbury County, the cities of Sergeant Bluff and Salix and the Siouxland Chamber of Commerce since 2012 have cooperated to push IDOT to add the new exit to boost new development by helping to create large shovel-ready industrial sites. The entities have combined to pay for a $600,000 Interstate Justification Report, which will be completed next month and be formally presented to the DOT.
Ung said the county is currently having consultants review the project to identify any economic development factors that could give the report some added context to illustrate its importance.
"That is a different case for us to make to the taxpayers," Ung said. "That will be the big decision at the next meeting" of the Iowa Transportation Commission.
"Of course (the interchange) would help. The question is, 'Does it justify the cost to all the stakeholders?'" Ung said. "This is a very large project that will take several years. If it is speculative, the commission may not approve it. But if they see encouraging signs in the area they may agree with that characterization.
"From an economic development standpoint, it makes sense. From a financial standpoint, that is where the stakeholders will have to decide."
Woodbury County Engineer Mark Nahra in October 2016 advised 13 landowners in an 860-acre tract near the Port Neal Industrial Area that crews were beginning work on an archaeological study. The study found that there were not any artifacts or other items that need to be taken into account in the quest of determining the best place for a new exit. The study has a three-year shelf life, Ung said.