“Certainly, the Indian Health Service as well as [Department of Health and Human Services] has a robust Tribal consultation process that we utilize. However, it is more than that. It’s not just meeting and having a conversation with Tribal leaders. It is really understanding the needs of each Tribal community to help them best serve the people in their communities.”

Roselyn Tso, Director of the Indian Health Service

The National Indian Health Board (NIHB) congratulates Roselyn Tso on becoming the Director of the Indian Health Service (IHS). The Senate voted under Unanimous Consent to confirm Roselyn Tso as the next Director of IHS. As previously reported by NIHB, President Biden nominated Roslyn on March 10, 2022, to serve as IHS Director. Nominee Tso appeared before the Senate Committee on Indian Affairs (SCIA) during her successful nomination hearing on May 25.

A citizen of the Navajo Nation, Roselyn Tso has served as a professional staffer with IHS since 1984 and is currently the Director of the Navajo Area of IHS. She held many positions within the Agency during her tenure, including the position of Director of the Office of Direct Services and Contracting Tribes at IHS.

Currently, IHS is led by Acting Principal Deputy Director Elizabeth Fowler, who has been serving on an interim basis since the resignation of Rear Admiral Michael Weahkee on January 20, 2021.  NIHB sends a special acknowledgement and thanks to Ms. Fowler for her excellent service as the Acting leader of IHS for the past two years.  

“Tribes assert that the absence of a confirmed Director has impeded the ability of the Tribes and the Administration to advance the President’s bold vision for the Indian, Tribal, and Urban ( I/T/U) health. We look forward to seeing, supporting, and partnering to ensure that significant progress will be made to advance the IHS Mission which is to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level,” said NIHB and Alaska Area Representative Chairman Bill Smith (Valdez Native Tribe).

NIHB passed Resolution 22-02 on February 24, 2022, calling on President Biden to nominate an IHS Director to ensure IHS has a leader who can set forth a vision to address the health disparities that American Indian/Alaska Native (AI/AN) people face.

On March 7, 2022, NIHB sent a letter to the SCIA to highlight the ambitious, necessary priorities the Tribes expect the new Director to embrace. The agency must have a permanent, competent leader who is capable and willing to advocate and act with diplomacy and tenacity, to respect Tribal nations and their voice, and to transform and reform institutional operations through innovative, effective, and sustainable systems-wide changes.

Among these changes is full, mandatory funding for IHS. For years, IHS has been funded at a rate that is far below its level of need, and the results of this historical neglect can be seen in the disparities in health outcomes for AI/AN people. The Director must lead the effort to work with Tribes, the Administration, and Congress to secure full mandatory funding. Meanwhile, an immediate opportunity exists to secure advance appropriations for IHS in the fiscal year (FY) 2023 appropriations process, which will begin to improve continuity of care, operations, and certainty in planning and management. Securing advance appropriations and, ultimately, full mandatory funding for IHS fulfills the commitment made to our people generations ago and breaks down the systemic healthcare funding inequities the federal government tolerates for Tribes but not for veterans or seniors.

FY 2023 also marks the final year of authorization of the Special Diabetes Program for Indians (SPDI), which has proven to be one of the most effective public health programs in the country and therefore deserving of permanent reauthorization at $400 million annually to meet the actual need. However, its very existence has proven to be remarkably unreliable and short-term, and its existing funding process ignores inherent Tribal sovereignty recognized by the Indian Self-Determination and Education Assistance Act. Successful programs like the SPDI deserve better.

The task ahead is long and difficult, and NIHB commends Roselyn Tso for other commitments and looks forward to working together to achieve health equity within, and for, IHS. 

For any questions regarding the nomination and confirmation process for the Director of the Indian Health Service, please contact the Director of Government Relations, Aaron Payment [email protected].