RAPID CITY - Indian Health Services officials laid out an ambitious plan to expand the Sioux San health facility in west Rapid City - more than tripling its size - with $51 million in new construction, increasing staff from about 120 to about 300 and adding $41.5 million to its annual budget.

However, during a community meeting Wednesday night, the officials also emphasized that best-case funding would mean construction in 2012.

And the best case is not likely.

IHS associate area director Jon Fogarty said that at the current level of funding for new construction, it would taking nearly 20 years to build a new Sioux San.

Still, Fogarty also said community support for the plan could speed funding. "You get the public involved like they did at Ellsworth Air Force Base, and this will happen very quickly," he said. (Community and government leaders successfully rescued Ellsworth from a base closure list two years ago.)

Fogarty added that an expanded Sioux San could have the economic impact of about a quarter the size of the air base, which is one of the region's biggest employers.

The IHS plan for Sioux San did not, however, win universal approval Wednesday from local clients, in part because it would eliminate the few inpatient beds left at Sioux San.

Patient numbers do not justify inpatient services, IHS program analyst Sandy Coulter said - especially with Rapid City Regional Hospital so close. Rather, the IHS proposal would offer expanded hours for clinics, including an urgent-care clinic that would be open nights and weekends.

Joe Valandra of Rapid City, a member of a task force formed to protect services at Sioux San, said Rapid City needed inpatient services. "You are completely ignoring urban, off-reservation Indians," he said. "We need a hospital, a hospital, a hospital."

Still, the IHS plan would greatly expand health care at Sioux San, adding new services such as:

-Audiology.

-Physical therapy.

-Podiatry.

-A nutrition program.

-An addiction outpatient program.

The dental clinic would have 24 chairs for adults and 12 for children.

A primary care clinic would have nearly 50 exam rooms and offices.

New equipment in the plan would cost $12.5 million.

Most of the new and expanded services would go into new buildings, but the plan includes $500,000 for historic preservation of some structures.

The expansion plan for Sioux San - in the making since 1992 - has already been approved in a "program justification document," Fogarty said. Now, Sioux San is fifth in line behind three new projects in Arizona and a clinic in Eagle Butte.

The stumbling block remains money. Before the Iraq war, Fogarty said, Congress routinely awarded the IHS $80 million to $90 million each year for new construction. The past three years the average has been about $20 million, he said.

However, IHS employees cannot lobby Congress for more money. "The IHS has taken it as far as we can take it," he said.

Carole Anne Heart of the Aberdeen Area Tribal Chairman's Health Board urged IHS clients here to write members of Congress, even if they don't agree with every element of the current plan. Another plan being promoted in Washington would eliminate the Sioux San expansion entirely, she said.

Zelda Fast Horse Gallegos, who is originally from the Pine Ridge Reservation but who has lived in Rapid City since the 1950s, remained skeptical Sioux San would get the money. "Once again the plight of the Indian is put on the back burner," she said.

Contact Bill Harlan at 394-8424 or bill.harlan@rapidcityjournal.com