The Indian Health Service has banked $72 million worth of funding to construct a new outpatient facility in Rapid City and is now seeking information from potential designers and builders.
The agency published a request for information Dec. 14. The request invites interested design-build companies or teams of companies to submit information about themselves to IHS by 3 p.m. Jan. 4.
The submissions are not intended to include architectural drawings, cost estimates or bids. Rather, the request for information seeks only to identify capable firms. Interested parties are asked to submit no more than five pages of basic information about their business, their experience and their past performance, along with a point of contact and proof of at least $75 million worth of bonding.
The request for information says the price of the project is estimated between $80 million and $120 million.
The request describes the desired structure as a 200,000 square-foot outpatient facility. The IHS has said it will be called Rapid City Health Center, and it will replace existing facilities on the campus of Sioux San Hospital at 3200 Canyon Lake Drive.
The request says the campus is currently home to “29 buildings and 3 structures, of which 19 of the buildings and 2 of the structures (root cellar and barn) are categorized with some historical significance.” The main building on the campus dates to 1938.
The request does not specify whether some, all or none of the historically significant buildings and structures will be demolished, but it does say that the contractor ultimately chosen for the project will be expected to “demolish/dispose of existing facilities and abandoned infrastructure.”
The IHS disclosure of the $72 million it has on hand for the project came in response to Journal questions submitted and answered by email after IHS published its request for information.
A Washington-based IHS spokeswoman, Jennifer Buschick, wrote that IHS received congressional appropriations in fiscal years 2016 and 2017 that total $42.5 million, and another $29.5 million was received in fiscal year 2016 from the Nonrecurring Expenses Fund of the U.S. Department of Health and Human Services, of which IHS is a part.
“The funding appropriated to IHS is no-year funds,” Buschick wrote, “meaning it will remain available until expended without a fiscal year limitation.”
Buschick wrote that IHS has incurred $1.5 million in costs so far, on a contract that was awarded in September to obtain a schematics-level design.
The request for information is the beginning of a process intended to culminate in an actual design and construction. The request does not mention a completion date, but a July announcement from the IHS said the new center is scheduled for completion in fiscal year 2022.
Construction of a new outpatient facility is part of a broader effort by the IHS to improve the objectively poor health care that is being delivered to Native American tribal members not only in Rapid City but throughout the Great Plains.
Several IHS facilities in the region have failed inspections in recent years by the federal Centers for Medicare & Medicaid Services, leading to potential and actual losses of Medicare and Medicaid funding. IHS encourages Native American patients to enroll in those government programs if they qualify, because the extra funding from the programs can be used to supplement regular IHS funding.
The crisis of poor care at IHS Great Plains facilities led U.S. Sen. Mike Rounds, R-S.D., to introduce a bill that would require an exhaustive audit of the IHS. That bill, the Independent Outside Audit of the Indian Health Service Act of 2017, received a hearing last month by the Senate Indian Affairs Committee but has not been acted upon.
In a statement to the Journal last week, Rounds reiterated his call for an audit and said the IHS has a "well-documented history of poor management, poor decision-making and delivering poor care to tribal members."
"As progress moves forward on IHS’ decision to close the Sioux San Hospital and develop an outpatient clinic, the agency must work in close consultation with the tribes to make certain they are putting the best interests of tribal members first," Rounds said. "Delivering timely, quality, adequate care to our Native population is the top priority. High-quality care also includes access to care provided by Rapid City Regional, and payment for their services should not be withheld from IHS.”
Sioux San Hospital has been among the Great Plains IHS hospitals under duress in recent years. In May 2016, the hospital was placed in immediate jeopardy of losing its Medicare and Medicaid funding, but that designation was lifted a month later. In September 2016, IHS temporarily closed the emergency department at Sioux San. In July of this year, IHS announced that the closure of the emergency department will become permanent as of July.
An IHS report to Congress on the closure said the upgrades necessary to bring Sioux San’s emergency department back up to snuff would cost $6.3 million, plus recurring costs of $2.2 million annually.
Instead of spending that money, IHS opted to transfer patients requiring emergency department services to Rapid City Regional Hospital, 4 miles away, where many patients requiring such services were already being transferred due to the inadequacy of the emergency department at Sioux San.
The care at Sioux San has since shifted to outpatient and urgent care services, and IHS intends to continue that dual focus at the proposed new Rapid City Health Center.
“By providing the services the vast majority of our patients require, we will be able to serve those patient populations more efficiently and effectively,” said a July statement from Jim Driving Hawk, acting director of the Great Plains Area of the IHS.
This story isn't for children anticipating Santa Claus’ arrival on Christmas Eve.
Eleven months of the year, Vivian Reub is like any of Rapid City's dozens of U.S. Postal Service employees who process our mail. But once December arrives, she takes on a magical role: as guardian of children's sense of wonder, a bridge to the fulfillment of their wishes, the fuel for their excitement on Christmas morning.
She becomes Santa Claus. Well, specifically, Santa's letter writer.
This holiday season, if your child received mail from Santa — postmarked Rapid City — it bears a signature in Reub's handwriting. The enclosed coloring sheet, she personally picked from a coloring book.
Reub, 65, has volunteered for the job since 2013, when the local U.S. Postal Service sought someone to respond to letters addressed to “Santa Claus, The North Pole.” The first letters arrive after Thanksgiving, and Reub spends about 30 hours in December preparing Santa’s response letters.
“It kinda relaxes me at night,” Reub said in an interview at the post office the week before Christmas. “And it’s really kinda interesting to see what kids want.”
This year, electronics are apparently the most coveted. Specifically, iPads for kids, cellphones, the Xbox and PlayStations. They have overtaken traditional toys in popularity, though Barbies and Legos still remain on many children’s list, Reub said.
Ranch children, meanwhile, want real horses and puppies. “Never cats, just puppies,” Reub added.
Letters arrive from Rapid City, as well as surrounding towns like Box Elder, Sturgis, Deadwood, Spearfish and Lead.
The Rapid City Post Office’s Santa letter program is a way to spread goodwill and give children something to look forward to on Christmas, said Postmaster Lyle LaCroix. The post office is already planning to redecorate a 1980s mailbox to be its dedicated “Letters to Santa” mailbox next year.
A mother of two and grandmother of four, Reub said the children who write to Santa are somewhere from 3 to 12 years old. Some letters are clearly written by adults, she said.
And a few of the grownups write to Santa for themselves.
Reub thinks they just need somebody with whom to share their problems. “I think it’s a way for them to release a little bit of pressure off of themselves,” she said.
Reub doesn’t write Santa’s response from scratch; she can choose from six prewritten versions provided by the Postal Service. She prints out each letter on special Santa Claus stationery, puts it in a matching Santa envelope, which then gets a red Christmas stamp as the finishing touch.
The prepared letters are done to ensure their contents are appropriate for children, including not getting the young ones’ hopes up that they’ll receive everything they ask for.
But there was a time, Reub said, she was tempted to send a child some candy canes. One year, she received a letter from a boy who asked for gifts for his parent and siblings. For himself, he only wanted a box of small candy canes, which Reub believes costs $1.
“It’s these ones you feel sorry for … and wish you can reach out to and give them something,” she said. But it’s company policy that she can’t make direct contact with the letter writers, and Reub said she hopes the children with the most need get the necessary assistance.
This year has so far been the busiest in Reub’s Santa writer career. As of Friday, when she would have mailed the last letters in time for delivery on Saturday, the post office had received about 150 letters for Santa. Unfortunately, a dozen kids won’t be getting any Santa mail this year since they forgot to write their return addresses.
“I know Santa’s supposed to know where you live,” Reub said, but the post office is not yet equipped with that type of magic.
South Dakota Commission on Gaming statistics released Friday show a modest increase for November gaming revenues in Deadwood casinos and a continued slide in gaming revenues for the year in the Northern Hills tourist town.
Table games — blackjack, poker, craps, roulette and keno — brought in $4.91 million, a 6.35 percent increase over November 2016. Slot machine play, by far the bulk of gaming action in Deadwood, tallied $75.26 million for the month, a .09 percent decrease from the same month last year.
November's $80.17 million handle was a slight 0.28 percent increase over November 2016.
Mike Rodman, executive director of the Deadwood Gaming Association, said table games, approved by the state legislature for play in Deadwood starting in July 2015, continued to account for any monthly growth in gaming revenues.
“We’ve only had four months this year we’ve been in the black, but in those instances the table numbers have been very strong,” Rodman said.
He said the drop in slot machine activity may reflect a drop in the number of machines after August’s closure of the Midnight Star Casino and other consolidations, including the Celebrity Hotel and Casino filing for bankruptcy protection.
But with December left to tally, 2017’s overall take for Deadwood’s casinos continues to be flat, with $1.02 billion thus far representing a 2.12 percent decrease from the same 11-month period in 2016.
November’s slight increase in revenue matches a 1.3 percent increase in room occupancy rates for November, an increase of about 600 room nights, over the same month last year.
Rodman hadn’t had a chance to look at the numbers in depth, but he said higher monthly hotel occupancy rates don’t necessarily translate to higher gaming revenues.
A part of that disconnect, Rodman said, is a national trend for gaming communities showing fewer visitor dollars being spent on gaming and more on other activities.
“It’s going to take more visitors to keep those gaming numbers up,” he said.
Rodman said this summer’s completion and opening of a new welcome center near the entrance to Deadwood’s Main Street will serve as a gathering point for visitors seeking information on all activities in Deadwood, Central City, Lead and the northern Black Hills.
“Deadwood is so unique in its history and really the setting in the Black Hills, it’s a natural place for people to come to,” he said.
The gaming association continues to work with the city on plans for a pair of Main Street Square concepts. The Deadwood City Council moved this week to tear down the old Deadwood pavilion, a move that will increase parking for the nearby Deadwood Elementary School along with “what we hope will be increased traffic on Main Street,” Rodman said.
Deadwood will continue to face increased competition for gaming revenues from nearby states that also offer limited stakes gaming.
While state agriculture commodity prices remain flat, Rodman is seeing some light at the end of the tunnel with other factors also adversely impacting the regional economy.
Job losses in the Wyoming coal industry and in the North Dakota oil fields have started to see some reverses, he said.
Despite the ups and downs over the last two years, Rodman remains bullish on the 2018 outlook for Deadwood gaming, which started 28 years ago last month, on Nov. 1, 1989.
“We hope all this comes together for a good year for Deadwood,” he said.