First of all, I’d like to clear up some popular misconceptions about what it means to be a member of the three Sioux tribes in central South Dakota.

Yes, we have access to Indian Health Services (IHS) on our reservations or if we remain in the “coverage area”. Pierre, SD, is the closest populated area to the Lower Brule, Crow Creek, and Cheyenne River Sioux Tribes, which are literally out in the middle of nowhere.

Having access to IHS is a catch 22, though. Poverty levels on our reservations are extremely high, meaning a large portion of the “on-rez” population doesn’t have access to a vehicle or the means to get to Pierre or Sioux Falls to see specialists.

If you leave your reservation, you must stay within your tribe’s IHS coverage area in order to maintain access to IHS medical and prescription coverage. All three coverage areas converge on Pierre and Ft. Pierre. However, the IHS pharmacy will mail prescriptions to you as long as they aren’t controlled substances like my Pregabalin and Clonazepam. I have to drive down there to pick those prescriptions up in-person or send my mom down to get them for me.

1st Example:

I live in Pierre, which is as far as I can live from my reservation and still have medical coverage by Lower Brule IHS. To access medical, you must have the means to drive an hour to an hour and half to your tribe’s IHS facility, that’s with good road conditions.

Currently, IHS is trying to deny payment for medical bills from my specialists at Sanford Health and Avera Health for which Lower Brule IHS PRC had already approved referrals in the past. I have been unable to schedule appointments in Lower Brule since my Disability approval in February 2024 to obtain new referrals even though they were to have switched my PCP to from Kyrstin to Sarah.

Okay, 2nd Example:

My son’s girlfriend and the mother of my three grandchildren is a member of the Cheyenne River Sioux Tribe. They live in Pierre. Cheyenne River IHS won’t help with medical expenses for her or their kids because she lives outside their coverage area. They told her she would either have to move across the bridge to Ft. Pierre which is inside their coverage OR be seen in Ft. Thompson at Crow Creek IHS as she is in their coverage area.