The new director of the Indian Health Service is grateful that her boss is urging Congress to address problems at the underfunded agency, but Dr. Yvette Roubideaux defended IHS and its staff as much more than a "historic failure."

Roubideaux responded Wednesday to Health and Human Services Secretary Kathleen Sebelius' characterization of health care for Native Americans as "an historic failure."

"It's clear that there's a call for change and improvement in the Indian Health Service, and it's also clear that IHS has been significantly underfunded for many years," Roubideaux said. "The staff of IHS has been doing the best it can with limited resources, and in some cases they are providing excellent quality of care with limited resources."

She is excited by Sebelius' calls for reforms and said President Barack Obama's proposed 13 percent increase in IHS funding for FY 2010 is "a great step in the right direction." That would bring the agency's annual budget to about $4 billion and give it the largest funding increase it has had in 20 years, she said.

"I'm really grateful that Secretary Sebelius is urging Congress to address the problems in Indian health and … that Secretary Sebelius recognizes that IHS has great needs and is willing to work with us to make improvements."

Roubideaux's goals for her tenure at IHS include:

• Strengthening partnerships with tribes.
• Reform of the system by looking at "what we do well and implement strategies to improve the things we don't."
• Improve the quality of care and access to it.
• Make IHS transparent and accountable to the public by "keeping people aware of what we're doing."

Roubideaux, 46, graduated from high school in Rapid City. She spoke by phone from Tucson, Ariz., where she's been on staff at the University of Arizona for the past 10 years. She was sworn in as President Obama's choice to head IHS in May and will make the transition from Tucson to Washington, D.C., sometime this summer.

"It's a big life change to go from Tucson to D.C. for me," she said. Making the move with her will be her mother, Cecelia, a longtime Rapid City resident who lives with Roubideaux in Tucson. Roubideaux's late father, Ramon, was a well-known attorney in Rapid City and the first Native American licensed to practice law in the state.

"I think his advice to me would have been what his advice always was: Do the best job that I possibly can. He always encouraged us to be the best we could be and to work as hard as I could," she said.

Growing up in Rapid City as an enrolled member of the Rosebud Sioux Tribe, Roubideaux received medical care at Sioux San Hospital, an IHS facility. It proved to be a motivating experience in her choice of careers.

"All I really remember was waiting a long time to get care," she said. "And I also noticed that I never saw an American Indian physician, which is where I got the idea that maybe I could become one."

Now that she is the director of the agency that is charged with the federal trust responsibility of free health care for Native Americans and Alaska Natives, Roubideaux is herself one of an estimated 1.9 million people who use IHS services.

She still uses IHS for some of her medical care, she said, in combination with private insurance. "My entire family continues to use the Indian Health Service for medical care."

She was "home" in Rapid City at Christmas 2008, and said she'll look for ways to get back as part of her work.

"I plan to get out in the field as much as I can to visit sites, and I'll always look for an excuse to visit Rapid City," she said.

Roubideaux hopes to encourage more young Native students to follow her lead and take advantage of IHS health education scholarships and educational debt repayment programs that are designed to recruit and retain health professionals.

She attended Harvard Medical School on an IHS scholarship and went on to become an expert for the agency in diabetes and other chronic diseases among Native Americans.

Minority communities need to grow their own health professionals, she said. "Many Natives have the dream of going back and working in their home communities," she said. "Anything we can do to help them do that, we should."

Roubideaux said IHS "needs their energy to help us continue to deliver quality services and improve the work we do. We need all the help we can get. We need our young American Indian and Alaska Native students to come back to our communities."

Contact Mary Garrigan at 394-8424 or mary.garrigan@rapidcityjournal.com