“This ain’t Burger King”

Photo courtesy of OSTAS Facebook page

PINE RIDGE—Last week, Oglala Sioux Tribe Ambulance Service (OSTAS) employees issued a statement via a live Facebook video. The video was posted at 1:54 PM on August 17 and shows a group of uniformed staff standing together, with one staff member reading a statement:

“For too long, our true frontline workers, the ambulance service, has been disregarded by the Oglala Sioux Tribe and been operating under abhorrent conditions. The tribal council has been presented with a list of 15 ways necessary to better the working conditions at Oglala Sioux Tribe Ambulance Service. Everyday Oglala Sioux Tribe Ambulance Service employees put their lives and well-being at risk for the betterment of the 1000s of lives across the Pine Ridge Indian Reservation. If a show of change hasn’t been presented by midnight, Friday August 20th, 2021 the OSTAS employees will be initiating a walkout. The Oglala Sioux Tribe took an oath of office to protect the general health of the people. And now is the time to honor that oath.”

Earlier that day, OSTAS staff met with the Health and Human Services (HHS) Committee to discuss their concerns and provided their list of 15 requests:

OST Ambulance Service necessities for safe operations

$10 pay increase for EMS
EMT starts at $8.89 with an increase to 18.89
EMT-A/1 starts at 10.52 with an increase to 20.52
Paramedic starts at 12.50 with an increase to 22.50
Cost of Living Allowances guaranteed (3.5% step increases) guaranteed every year.
Wage increases every year (0.25 – 1.00) depending on annual review scores every year.
Grade/Step increase for all existing Permanent/Regular employees that have not received them over the years that the program never submitted for them.
Ex: EMT who has been permanent since 2005 only received 5 step increases, should have 16 step increases.
When an employee becomes a supervisor, or they achieve a higher level of care. That employee keeps their leave and steps they earned and accrued.
Leave: Currently we are only allowed to use up to 40 hours per week in leave a week. We are scheduled various shifts 48-56-64-72-96 hours. If we want to use our leave, allow us to use what we were scheduled for.
If you have over 160 hours of annual leave at the end of the year, the balance is paid out to employee or it gets placed in an account for EMS personnel that need it in an emergency.
All current temporary employees are Grandfathered in as a Permanent/Regular employee (Positions were never advertised).
Ambulance Base repairs completed within a timely manner after work orders submitted.
New uniforms purchased for staff annually (boots, pants x2, shirts x2).
Staff attend annual recertification trainings.
Ensure supplies are provided to the staff so ambulances are stocked according to SD DOH EMS regulations.
$500.00 for EMS week annually for a staff get together and appreciation event.
Money to participate in parade and other PR Events.
Having our own Policy and Procedure manual that we approve to operate as an EMS agency. The Tribes P&P doesn’t have everything we need.

Council members discussed the situation in an OST Council Meeting Special Session on August 18. Jim Driving Hawk, the Acting Area Director for the Aberdeen IHS office, also joined the discussion. Driving Hawk made it clear that any staff who walked out would face consequences, saying, “Individuals in the healthcare industry do take an oath … and if they fail to uphold their oath, their license can be subject to be removed. Paramedics and EMTs fall in that category. We will hold all of our employees to those standards and if they fail to do those standards we will report them to their boards.”

Talks moved on to retroceding the ambulance service contract back to IHS, something that was discussed more than a year ago. When asked if services would be diminished if IHS took over, Driving Hawk stated that IHS would “meet or exceed the current services provided” by the OSTAS. He also said that after previous talks of IHS taking the service over, his team researched what it would take to properly run the ambulance service in Pine Ridge.

IHS concluded they would need 70 to 72 employees to run the EMS program. Currently, OSTAS has 16. Last week, IHS sent two additional ambulances to Pine Ridge in case of a walk-out—one from Eagle Butte and one from Belcourt. Normally, OSTAS only has two ambulances to cover their entire service area, which is over 2,000 square miles. In comparison, Rapid City has 6 ambulances and 44 employees on every shift to cover an area of less than 60 square miles. While the population in Rapid City is larger than Pine Ridge, homes are very spread out on the reservation making it a constant struggle for OSTAS to get to everyone who needs help.

The vast reservation geography has not been the only problem for OSTAS. Low pay and long hours have been a problem for years. The starting wage for an OSTAS EMT is $8.89 per hour, while the average starting wage for the same job in Rapid City is nearly $18 per hour. OSTAS workers have also mentioned their long hours—some working 70 to 90 hours per shift. Rapid City EMTs work 24 hour shifts with 48 hours off.

One social media post by an EMT worker stated that ambulance services are not considered “essential” by the government, and that only fire and police departments are recognized as essential in the state of South Dakota. Not being considered essential is hindering programs like OSTAS from getting more funding from Congress.

The post states, “I am requesting that all 9 Sovereign Nations gather and approach the State of South Dakota and Demand they add EMS/ Ambulance Service Programs to their “ESSENTIAL” Human Emergency Medical Response and Rescue….The Nine Sovereign Nations face this same Dilemma! Only 11 states deem EMS as an “essential service,” these states are—-Nevada, Oregon, Nebraska, Louisiana, Indiana, Virginia, West Virginia, Pennsylvania, Hawaii, Delaware, and Connecticut …. These are the ONLY states that the state government provides funding for EMS, whereas the remaining states rely on local funding for EMS services. The federal government does not recognize EMS as an essential service, it does not receive federal funding… This is alarming and concerning, as lower income or rural areas such as the 9 Sovereign Nations in South Dakota DEPEND on these services….”

During the August 18 Special Session, Councilman Garfield Steel (Wounded Knee District) had this to say, “Honestly, I’m in support of retroceding this program back to IHS. Right now, we can’t go for third party billing because of poor management in the past. A lot of this has to do with poor management. You know, our medics came yesterday and said that they don’t get sleep, they get 2 or 3 hours of sleep, and they sleep on their way to calls, which is scary for our patients and our people because they don’t know that. But they get on those medic units not knowing that our personnel are exhausted from working—they work 96-hour-straight shifts, which is a problem. And they set those hours themselves. From where I’m sitting, I believe that IHS will have better luck getting this program back on track, the way it should be operating… If it’s feasible, I want to make a motion that we direct the HHS Committee to come back to the next Council meeting with a document to retrocede this program back to IHS.”

After the motion to retrocede was made, Councilman Bernardo Rodriguez Jr. (Wounded Knee District) said this, “I’ll second the motion to give this back to IHS. They [OSTAS] want things their way, this ain’t McDonald’s or Burger King. It don’t work like that.”

The majority of the Council members voted to retrocede the contract back to IHS. After their decision, many OSTAS workers changed their social media profile pictures to the same “RIP OSTAS” image. Many comments on social media were in support of the OSTAS employees, praising them for speaking up for themselves and thanking them for all they have done for their community. Many comments also chastised the Council members for their decision and their remarks, with one comment saying, “This isn’t Burger King—they pay their workers $15 an hour!”