Rural and reservation areas in South Dakota face significant challenges in providing adequate health care, with barriers to access and negative health outcomes prevalent, according to health care providers and administrators across the state.
The patchwork nature of the rural and reservation health care system often requires compassion, innovation, and teamwork to keep people healthy. Chronic underfunding of Indian Health Services (IHS) and other government tribal health programs exacerbates these issues, particularly for Native American communities.
Sara DeCoteau, who runs the health program for the Sisseton-Wahpeton Oyate tribe, highlighted staff recruitment and retention as a major issue. “For years and years we used to say ‘don’t get sick after June’ because funding would evaporate by then, and only the highest priority cases would be considered for care,” she said.
Transportation challenges, lack of health literacy, and limited service hours create additional barriers for tribal residents. The IHS acknowledged these issues, citing the need for more nurses, community outreach workers, and better-funded emergency services.
Rural hospitals like Coteau des Prairies in Sisseton struggle to balance revenues and costs, with 70% of gross revenues coming from sources that do not cover the full cost of treatment.
Innovative solutions, such as mobile health clinics and telehealth services, are being implemented to address some of these challenges. However, providers stress the need for increased funding, expanded Medicaid, and incentive programs to attract more health care workers to rural areas and reservations.
See “Rural and reservation health providers face major hurdles in South Dakota” (June 20, 2024)
