We recently saw it in the news, a prominent SD politician’s family member has a serious medical condition and they are seeking treatment . . . in Minnesota.

First off, I wish them the best, secondly I don’t blame them for wanting to go to one of the most advanced healthcare providers in the world. I have had many friends use the facility for all kinds of different treatments and have had great success.

But what I often find ironic is how our prominent politicians in the state will tell us how great our local Industrial Complex Healthcare providers are with research, treatment options, and jobs, jobs, jobs! Yet when one of them gets a serious condition, they run to Minnesota.

I wish they would go to Minnesota for legislative advice also, because we have a serious sickness in Pierre that needs advanced treatment.

When the state legislature was arguing to increase teacher pay from last place with a half-penny sales tax increase, I argued at the time ‘What about the rest of us?’ Especially other professionals in the state, like nurses;

According to the American Nurses Association, South Dakota’s registered nurses have the lowest annual salary of any state and the District of Columbia, ranking 51st behind Mississippi, Alabama and Iowa.

The association reports that South Dakota’s 12,530 registered nurses received an average annual salary of $57,010, or $27.41 per hour in 2017. California’s RNs posted the highest compensation at $102,700, $49.37 per hour.

Health care officials say many factors contribute to South Dakota’s comparatively poor compensation levels for nursing, including the rural nature of the state, as well as low reimbursement rates to hospitals from Medicare, Medicaid and Indian Health Services.

I would agree Medicare/Medicaid expansion probably would help. But I have argued for years that if we want to increase teacher pay, we should concentrate on raising EVERYONES PAY! I have had several friends leave the state who work in the healthcare industry for the same reason, PAY. In fact two of my friends that are RNs literally DOUBLED their pay overnight by leaving the state. Think about that. DOUBLED! They also told me the same stories about the healthcare industry in Sioux Falls, where pay is top heavy and run amuck with corruption and greed. They also said, when it comes to nursing pay between the two major hospitals, there is obvious wage collusion going on. One of my friends who worked at both systems before she left for greener pastures said to me, “Don’t you think it is a little strange that both hospital’s nursing pay is IDENTICAL?” Yeah, things that make you go hmmmm.

But I don’t want to make this about nursing alone, many professionals in our state are below average when compared to other states. So when I hear our teachers need more pay, I would agree, but in reality your pay is reflective of what the rest of us are making.

So why has it taken so long for a news agency to cover this story? I think we know the answer to that question.

As Washington debates the repeal of the ACA, right here in Sioux Falls one of our industrial hospital complexes seem to be so awash in money they are investing in a new Sports Bar at the Sanford Sports Complex. Correct me if I am wrong, but I think they own the original restaurant that was there, some ownership in the hotel and the sports complex itself which includes a basketball stadium.

Sanford has argued in the past that funding these things is a ‘small percentage’ of their entire budget. But I ask a two-part question, 1) If Sanford is losing money on these facilities, how does that affect healthcare costs in Sioux Falls and wages (SD is nearly last in nursing pay in the country) or 2) if these investments are actually making money, why aren’t healthcare costs going down and paying employees more?

Sanford would argue they need these amenities to bring in good doctors with families, I get it. But what should be the true duty of healthcare? Entertaining rich doctors or bringing top notch affordable healthcare to patients? I’ve never understood making a profit on healthcare, whether that is hospitals, pharma, insurance or even ambulance service.

While patients are drowning in debt or not getting care at all, our hospitals are worried about Sports Bars and basketball, and we wonder why healthcare in our country is such a mess.

Today we will look at the Health Department.

Did you know that some of the highest paid city employees are dentists?

The city health department employees 4 dentists with combined salaries of $620K. Seems odd, doesn’t it? When we think of snow plow operators or police officers, we think of direct service to the public, or at least most of it? But you wouldn’t likely use a city employed dentist unless you had to go to community health because financial restraints. In defense though, as I understand it, the community health department does try to receive some kind of payment. Sometimes through Medicare or Medicade. I would be curious how many patients are served by our city dentists each year?

It also seems the Health Department has many high paying jobs in the department besides dentists.

The Director receives $157K and the Chief Medical Officer about $205K a year. Oddly, even with these positions, the Director has 2 managers that receive the same wage of $88K a year. There are also 13 other mid-management that receives approximately between $80-$100K a year. The clinic even has its OWN finance director (even though the city has a well staffed finance division already) that makes $97K a year.

What is odd about these wages, that are probably not out of line of with a community our size is that many of the minions don’t even receive a living wage. Approximately 15 workers receive under $17 per hour (defined by Thrive as a living wage in Sioux Falls). With the remaining staff making a decent middle income of about $47K. The Sioux Health department has some of the highest wages (in management) of any department in the city) yet Sioux Falls continues to rank average or below average on National health rankings, especially when it comes to obesity and lack of exercise.

Here is the full doc: 2017-Wages

Cory touches on one side of the story;

Yesterday, the U.S. Department of Justice announced that South Dakota is violating Title II of the Americans with Disabilities Act by forcing thousands of South Dakotans into nursing homes instead of providing home-based and community-based care options.

According to the DOJ Civil Rights Division’s letter and findings released yesterday, the department notified the state of this investigation on August 11, 2014. DOJ says South Dakota has spent an inordinate amount of its Medicaid dollars on nursing home care that unnecessarily deny individuals with disabilities the “supports and services in the most integrated setting appropriate to their needs” that the ADA, as interpreted in the U.S. Supreme Court’s 1999 Olmstead decision, requires.

Oh, But Denny has an excuse;

Dennis Daugaard, South Dakota’s governor, said that his state had made progress but that, with such a sparse population, it faced problems not shared by more urban areas.

“Ideally, we want elderly residents and people with disabilities to be able to stay in their communities and receive the services they need without going to a nursing home,” Mr. Daugaard said in a statement. “That can be a challenge for a state like ours, which is made up of rural communities.”

The Justice Department, however, said South Dakota was not trying hard enough to address a problem it has known about for years. In 2013, it spent $133 million in Medicaid money on nursing homes and $27 million on in-home care, the department said.

Oh, baloney. Most of these people are forced into these nursing homes to suck what little estate they have left. They can live on their own with assistance. My 93 year old grandfather lives in un-assisted living apartment by himself. While he has the luxury of many different family members checking on him, he also has a traveling VA nurse that stops by (bi-monthly?) to make sure he has his meds in order and other OTC items. She told him he is her oldest veteran she sees. My grandfather has NO INTEREST in living in a nursing home, and really he is much happier (and healthier) because he is not.

I think the state needs to work with these people more to keep them in their homes.