Audit shows federal government needs more oversight at Indian Health facilities

An audit of five Indian Health Service hospitals, including the facility in Fort Yates, indicates doctors are not following their own rules when it comes to opioids.

The audit, from the Office of the Inspector General, says providers in the hospital are supposed to inform a patient before starting a pain treatment program, about the types of pain individuals may experience, the limitations of the medication and the possible side effects.

In a 21-patient sample , the Fort Yates facility scored 0 of 21 in the three areas.

Also, only seven of 21 patient records showed that a doctor had accessed a drug monitoring program before prescribing the medication. State leaders say there's only so much they can do.

“We can make recommendations to do it and we already have a lot of those connections with the pharmacy board and some of those groups and we could make it happen. It just takes the leadership from those communities to step up and say we're ready to do this,” said Brad Hawk, the Indian Health Systems Administrator for North Dakota’s Indian Affairs Commission.

Hawk said he’d like to see a public health unit attach to the hospital to provide education to patients about medications and substance abuse issues. He also says a revolving door of doctors and a lack of funding lead to some of the issues.

Indian Health Service issued this statement:

“The report is based on an OIG audit in 2017 that was a planned exercise intended to strengthen our clinical practice. A range of hospitals and clinics were selected from across the IHS to participate in the in-depth review of our opioid prescribing and monitoring processes as well as the security of our IT systems. The report highlights some of the challenges IHS still faces in regards to best practices in managing opioids. With the information provided in the OIG report, the IHS will continue to improve and ensure the best care for its patients. The IHS Fort Yates Hospital fully embraced the audit and participated with the OIG in this review. Corrective steps began immediately during the course of the audit. Since the audit, the IHS Fort Yates Hospital has refined our policies and procedures to align with the OIG’s recommendations. We remain committed to providing access to culturally appropriate prevention, treatment, and recovery support services for opioid use disorder. The IHS Fort Yates Hospital also offers many alternatives for pain treatment other than opioid therapy, including referrals for physical therapy, specialty care, and behavioral health therapeutic services specific to addiction for our patients.”

To read the report in its entirety, go to https://oig.hhs.gov/oas/reports/region18/181711400.pdf