In­dian Health Ser­vice sets stan­dards for wait times

Watch­dog crit­i­cized agency over lax over­sight

Las Vegas Review-Journal (Sunday) - - THE WEST - By Feli­cia Fon­seca

FLAGSTAFF, Ariz. — The In­dian Health Ser­vice has set stan­dards for pa­tient wait times more than a year after be­ing crit­i­cized by a gov­ern­ment watch­dog for do­ing a poor job track­ing them.

Amer­i­can Indians and Alaska Na­tives seek­ing ap­point­ments for rou­tine or pre­ven­ta­tive care will be sched­uled within 28 days and be seen in ur­gent care within 48 hours, on aver­age, the agency re­cently an­nounced. The stan­dards are part of an ef­fort to im­prove health care and have con­sis­tency within the agency that’s been la­beled “high-risk” by the U.S. Gov­ern­ment Ac­count­abil­ity Of­fice for in­ad­e­quate over­sight of its hos­pi­tals and clin­ics.

“Our aim is that pa­tients re­ceiv­ing care in IHS di­rect-ser­vice fa­cil­i­ties have ac­cess to timely, com­pre­hen­sive and qual­ity health care ser­vices to pro­mote and main­tain health, avoid pre­ventable dis­ease, man­age dis­ease, re­duce un­nec­es­sary dis­abil­ity and pre­ma­ture death and achieve health eq­uity,” IHS Chief Med­i­cal Of­fi­cer Capt. Michael Toedt wrote in an email.

The stan­dards in place since late Au­gust ap­ply only to IHS fa­cil­i­ties run by the fed­eral gov­ern­ment, and the IHS plans even­tu­ally to in­clude emer­gency room vis­its and other ser­vices.

Most In­dian Health fa­cil­i­ties are run by tribes or tribal en­ti­ties un­der con­tract with IHS and can set their own stan­dards.

The IHS said it worked with the U.S. Depart­ment of Vet­er­ans Af­fairs, an­other fed­eral health care agency, on a pa­tient man­age­ment sys­tem that’s be­ing phased out. But Toedt said the VA will sup­port the sys­tem for sev­eral years while the IHS tran­si­tions to a new one.

The U.S. Gov­ern­ment Ac­count­abil­ity Of­fice re­ported last year that pa­tient wait times at IHS ser­vice ar­eas were re­viewed in­con­sis­tently or not at all, hin­der­ing the agency’s abil­ity to tell whether it’s best serv­ing its pa­tients. Some Navajo Nation mem­bers, for ex­am­ple, waited four months to see a physi­cian. Other tribal mem­bers in Billings, Mon­tana, waited up to a month for a rou­tine vi­sion check, ac­cord­ing to the re­port.

Wil­liam Bear Shield, the tribal ad­min­is­tra­tor for the Rose­bud Sioux Tribe in South Dakota, said he un­der­stands the chal­lenges IHS faces with re­cruit­ment and re­ten­tion of providers but would like to see wait times in line with the pri­vate sec­tor.

“If they’re say­ing that’s the norm, they’re prob­a­bly right,” he said. “To me, it can be bet­ter.”

The IHS said it wants pa­tients to be seen in a timely man­ner, but the stan­dards aren’t guar­an­teed. The wait times can change due to re­sources at hos­pi­tals and clin­ics, pa­tient needs and emer­gency re­sponse with­out the pa­tient be­ing no­ti­fied, the agency said.

Sen. Tom Udall, D-N.M., high­lighted the Al­bu­querque, New Mex­ico, ser­vice area in a hear­ing Wed­nes­day. He said wait times there are tracked elec­tron­i­cally and pa­tients can fill out sur­veys about their ex­pe­ri­ences.

Rear Adm. Michael Weah­kee, act­ing di­rec­tor of IHS, said the agency will col­lect data on wait times to con­tin­u­ally im­prove them and take ac­tion if they’re not met. The abil­ity to mea­sure and re­port the stan­dards should be im­ple­mented by the end of the year, the agency said.

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