Oyate Health Center urges tribe to release idle space, payments for dialysis expansion

RAPID CITY – The Oglala Sioux Tribe’s Health and Human Services (HHS) Committee met with tribal council members and staff from the Oyate Health Center (OHC) in Rapid City on July 7, 2026, to weigh proposals regarding whether OST should retain its space allocation at OHC for programs such as Native Women’s Health and Behavioral Health, or give up a portion to house new dialysis, infusion, and specialty-care services at OHC.

Jerilyn Church President and CEO of the Great Plains Tribal Health Board which operates OHC said she had requested the meeting be held in Rapid City so OHC staff could be present and give brief presentations on the services they provide.

The meeting opened with a reminder of political pressure on the council. “We have such a short time… we need to find common ground and work together and try to get some things done for this coming year,” committee chair Ryan Jumping Eagle said, pointing to upcoming elections and structural changes to the council.

Church told the committee that vacant clinical space inside the building could be converted into a hemodialysis and infusion area rather than leasing or buying space elsewhere in the city. She requested that OST unlock the roughly 8,000-square feet of unused clinical space and authorize release of overdue facility support payments, saying both steps are needed to expand dialysis and infusion services for tribal citizens in Rapid City.

OST currently occupies 7.93% of the space, but Indian Health Service (HIS) proposed reducing it to 4.41%. OST argued for maintaining the 7.93% due to unutilized space and growing patient needs. The cost of maintaining the 7.93% space is $1.5 million annually. OHC also highlighted the financial benefits of in-house dialysis, which could save $17-19 million annually. Under this proposal, they would be able to expand dialysis and infusion services for tribal citizens in Rapid City. It would also reduce travel burdens and protect patients from surprise bills. Church warned that pursuing off-site space “will be considerable costs” and argued those dollars “could be better used to bring services to the community and into the tribe” if the unused area within OHC is released for clinical use.

A senior clinical leader reported that 47 relatives are currently on dialysis, including 28 OST citizens. With six dialysis systems running in morning and afternoon shifts, the health center believes it could cover most of the current need and expand as demand grows. The plan includes telemedicine support from a nephrologist.

“If relatives do not live in Pennington County, we can coordinate their care, but we’re unable to pay for it through PRC ,” said an OHC representative. “If we’re able to provide the service right at Oyate, then it will be covered, and they’ll never get a bill.” Purchased Referred Care (PRC) is a program the authorizes and helps pay for medical and dental services provided by outside, non-direct care specialists and facilities.

Some committee members, however, stressed that the council had previously voted to pause decisions on space while negotiations with Indian Health Service (IHS) and tribally operated programs continue.

“Everything was put on hold until the negotiations were done,” one meeting participant said, adding they did not want to revisit that resolution prematurely or feel “bombarded” after the vote.

Another questioned how long the tribe could delay decisions while needs in Rapid City remain unmet, asking when there would be “progress for our community here in Rapid City” and calling for written plans and blueprints from all programs seeking space.

Alongside the space issue, OHC asked the committee to act on nine months of “facility support services” — including housekeeping, electronic health records, lab supplies, and pharmacy support — that IHS has been holding under the tribe’s 638 contract.

Church said IHS is retaining those funds to pay for shared services provided to tribally run programs in the building, including a Native women’s health program. In November, the tribe voted to withhold release of those payments until a three year reconciliation was completed.

OHC leadership said they have since met repeatedly with tribal representatives, provided detailed invoices, and identified a roughly $40,000 difference, which was moved into a maintenance and improvement reserve. In response to concerns from the Native women’s program about a key card system, OHC agreed to remove that cost entirely “because we just want this resolved,” said Church

A council member wanted to authorize payment for the services already rendered, warning that if the tribe allows the fiscal year to close without releasing the IHS held funds, it could later be required to repay those federal dollars out of tribal resources.

Church also responded to concerns about the organization’s audited assets, emphasizing that federal contract and grant funds are legally restricted.

“We utilize our funds only for what they’re intended to be used for, and that’s all we can use them for,” she said, arguing that within those constraints, using existing vacant space at OHC and releasing the overdue payments are the most cost effective ways to expand care.

The committee did not take final action on the space question during the meeting, but Jumping Eagle promised to set up another meeting with all parties involved. Meanwhile, attorneys for OST and OHC would review plans. Church said if the tribe doesn’t resolve the shared space issue soon, they’ll accept OST’s 7.93% as is and look for other space in town for dialysis and infusion services.

(Contact Marnie Cook at cookm8715@gmail.com)

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