This report documents observations and findings from a site visit to Southern Hills Developmental Services (SHDS), an agency providing services to people with disabilities in the South Dakota community of Hot Springs. Half of the people using the services are American Indians. The report discusses the Pine Ridge Indian Reservation and traditions of the Lakota Sioux Indian culture, the oppression faced by these Indians due to White domination, the Hot Springs community, and the challenges to SHDS in providing culturally sensitive services. Services provided by SHDS include a group home, community training services, and employment services. The problem with removing individuals from their reservation community to acquire other needed services is discussed. Language problems between staff and clients are noted, along with issues of privacy, cultural differences in dress, and development of assertiveness. Throughout the report, the need for community connections, at both an individual level and an agency level, is stressed. (JDD)