Devils Tower - Sacred To Many People - Porcupine Clinic - Pine Ridge, SD:

HISTORY OF PORCUPINE CLINIC

The Porcupine Clinic Health Board was formed in 1982. Members of Porcupine community concluded there would be no improvements in local health care unless the members themselves initiated changes. Nine Community members were elected and appointed to the health board. During this period the Indian Heath Service cited a moratorium on new construction. This action prevented the health board from requesting construction funds from the Indian Health Service. It was requested, but was denied by the agency. The agency agreed to staff the facility if the local community was able to seek funding for the construction of the building. U.S. Department of Health and Human Service, The McArthur Foundation, and through private donors, the construction began in 1986 and was completed in 1989. With construction complete, the Porcupine Health Board was informed by the Indian Health Service Director, that they could not live up to its agreement to equip and staff the facility. The Agency cited severe funding shortage and personnel as reasons for refusing to assist with their commitment. The Health Board was successful in generating funds from foundations and private donors. The Northwest Area Foundation and the Nathan comings Foundation assisted the Clinic initial funding. The Clinic formally opened its doors in July, 1992.

INFRASTRUCTURE

 The main Clinic facility, 7,140 square feet, has five examination rooms, medical records, nurses station, emergency room, office space, fitness room, and a multi purpose and conference room. Also located here is the dialysis center which serves the community.

HEALTH BOARD AND STAFF

 The Health Board consists of nine members from the Porcupine community. Each member has some specific expertise and key contacts that are beneficial to the Clinic. The core staffs provide services needed to operate the Clinic and its programs on a daily basis. The Dialysis Center consists of three staff one nurse and two techs.

The Porcupine Clinic is located in the middle of the Pine Ridge Indian Reservation, home to nearly 40,000 Oglala Lakota. The Pine Ridge Reservation is partially located in Shannon County, Wyoming , the poorest county in the nation. The Pine Ridge Reservation has a higher rate of diabetes, infant mortality, alcoholism, heart disease, accidents, and suicide than the American Indian population as a whole and all other races.

The Lakota have the lowest life expectancy of any group in America (45 Years). Nearly half the adult population of the Oglala Sioux Tribe over the age of forty has diabetes. Over 62% are all at risk. Between 1996 to the year 2000, there was a 339% increase in diabetes among adults.

Porcupine Clinic is the only free-standing, non profit, community-supported health facility in rural Indian country. The Clinic is truly unique in that the Indian community itself provides resources for services. The rural and isolated setting of the Clinic makes service delivery a special challenge. The health care system is seriously under funded and understaffed. One hospital services the entire population.

Major accomplishments of Porcupine Clinic community member and medical supporters are that they have:

• Constructed basic facilities through community donated labor and resources, and the assistance of other funding sources.
• Completed construction of a new kidney dialysis facility adjacent to the Clinic in 1994 and provided oversight for operation.
• Provided leadership for the innovation in health care delivery especially in the areas of diabetes prevention, substance abuse prevention, and maternal child health.
• Provided a local facility, basic health care services, and referrals for specialized services for over 4,000 regular patients through the support of Indian Health Service, Medical Professionals, and community-based paraprofessionals.
• Screened over 5,000 school children and identified over 700 that are at high risk of becoming diabetic.

Recent major activities include:

• Negotiations with the Indian Health Service to increase health services available at the Clinic through their staff. Currently, the Indian Health Service provides full staffing for two days of medical services at the Clinic each week. In addition, a foot doctor and chiropractor are available each month.
• Ongoing negotiations with a number of potential funding sources.
• Initiation of a process through which Porcupine Clinic may be designated as a Rural Health Clinic. This designation will result in a substantial increase in the core budget of the Clinic and the opportunity of sustainability which in turn will increase the quantity and quality of health care services for Clinic patients.
• Provide improved dialysis services to all patients on the Pine Ridge Reservation. We currently transport patients to and from dialysis from our own pocket and are reimbursed through Medicaid. Although some patients we cannot bill, we still transport.
• Improving our financial system, including oversight of audits.
• On going collaboration with tribal and state programs: Health Education, Diabetes Prevention, USD Center for Disabilities, Healthy Smiles, Community Health Representatives and the Women Infants Children Program. We also have through the Indian Health Service, Well Baby Clinic/Immunizations and Women’s Four Direction Clinic.

The Porcupine Clinic provides the following services weekly: General clinic, diabetes clinic, well baby clinic, immunizations, dialysis, patient transport, CPR and First Aid training, health education-diabetes prevention and intervention, STD, and AIDS education, women’s clinic, and the WIC program.