2019 Annual Report (5)

The Suboxone program cares for 10-12 patients, helps these patients maintain sobriety from opioids and, by doing so,
helps keep the opioid epidemic from striking the reservation. They are treating patients for hepatitis C virus with new
antiviral therapies, the first such program in the Indian Health Service in South Dakota. Six patients are currently under
treatment for hepatitis C with more planned in the coming months. Their jail-based program continues to function well.
Each week, the team clinician has 15-20 patient visits at the tribal jail for acute and chronic medical needs. This jail clinic
is perhaps the most active such program in the nation, and they are working with the jail leadership to expand further.
Every two years, the Rosebud Indian Health Service, like all rural hospitals, faces an accreditation survey from the Center
for Medicare and Medicaid Services. MGH is working aggressively with the hospital to ensure they meet their accreditation
standards. They are working on tele-health with MAVEN (company). They are optimistic that this will have a significant
impact on their ability to care for patients.
Current fellows, Dr. Stephanie Sun and Dr. Hannah Wenger, are thriving despite the health system challenges in
Rosebud. Dr. Sun plans to become a leading educator and innovator with handheld ultrasound technology in rural areas.
Dr. Wenger has taken on leadership positions at Rosebud, including spearheading our hepatitis C virus treatment
program. Both are demonstrating great promise as future health leaders.
The senior leadership team includes Mass General Physician-in-Chief Katrina Armstrong, MD, and former Assistant
Secretary of Health Nicole Lurie, who remain engaged in the program and our fellows?development. Program founder and
director Matthew Tobey, MD continues at the helm for the program?s daily management. Affiliated faculty include Dr. Omar
Amir and Dr. Krupa Parikh.
Visit to the Rosebud Sioux Tribe Drug and Alcohol Treatment Program
This is one of the most successful treatment programs on the reservations. About 12 participants attended at varying
stages of recovery. It?s a good program offering psycho social support.
Pine Ridge- Ernest Pourier, Peri, Ernest - Pine Ridge Relief
I drove to Pine Ridge reservation this morning to meet with Peri and Ernest. They were held up and I had to make it to the
airport so we couldn?t meet in person, but plan to talk by phone. I did meet with Kevin Pourier there.
Conata Ranch: Your ranch is Magnificent! Doug and Dusty were so welcoming and generous with their time. The cabins
are so innovative and beautiful. The views were breathtaking and I saw my first Buffalo (photos attached)!
Funding Priorities: The health and health care needs of these communities require an interdisciplinary workforce that is
embedded and engaged in the communities they serve and supported by a consortium of committed academic medical
centers and local health care delivery systems. MGH has made substantial progress in four key aspects of this vision that
must be extended for this collaborative effort to achieve its full potential.
1. Rural Health Fellows The fellows are critical for the efforts to provide direct care and conduct quality improvement
and community health projects. To succeed in achieving their vision, they must expand internal medicine fellowship
training to provide staffing for inpatient and ambulatory services, create new fellowships in emergency medicine, pediatrics
and obstetrics and gynecology, and extend highly successful MGH leadership and professional development fellowship
opportunities to the clinical workforce in the Great Plains.
2. Interprofessional Education The challenged rural health system in South Dakota will benefit from enhanced
interprofessional health training. Their program is the region?s largest reservation-based clinical training program. Trainees
join from medical school, residency, dental, physician assistant and nursing training programs. They intend to strengthen
their interprofessional curriculum until Rosebud?s training into a leading model and expand to social work, physical
therapy, occupational therapy, pharmacy and community health work.
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3. Teaching Faculty The development of a long-term clinician workforce will be greatly supported by onsite clinical
rotations. The enhancement of local clinician training is endorsed by tribal and IHS leadership. They will build upon the