I 
118TH CONGRESS 
1ST SESSION H. R. 2535 
To elevate the position of Director of the Indian Health Service within 
the Department of Health and Human Services to Assistant Secretary 
for Indian Health, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 6, 2023 
Mr. STANTON (for himself and Mr. JOYCE of Ohio) introduced the following 
bill; which was referred to the Committee on Natural Resources, and in 
addition to the Committee on Energy and Commerce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To elevate the position of Director of the Indian Health 
Service within the Department of Health and Human 
Services to Assistant Secretary for Indian Health, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Stronger Engagement 
for Indian Health Needs Act of 2023’’. 
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SEC. 2. ASSISTANT SECRETARY FOR INDIAN HEALTH. 
(a) ESTABLISHMENT.—Section 601(a) of the Indian 
Health Care Improvement Act (25 U.S.C. 1661(a)) is 
amended— 
(1) in paragraph (1), by striking ‘‘tribes’’ and 
inserting ‘‘Tribes’’; 
(2) in paragraph (2)— 
(A) by striking ‘‘a Director’’ and inserting 
‘‘an Assistant Secretary for Indian Health (in 
this section referred to as the ‘Assistant Sec-
retary’)’’; 
(B) by striking ‘‘The Director shall report’’ 
and inserting ‘‘The Assistant Secretary shall re-
port directly’’; 
(C) by striking ‘‘the Director’’ and insert-
ing ‘‘the Assistant Secretary’’; and 
(D) by striking ‘‘A Director’’ and inserting 
‘‘An Assistant Secretary’’; 
(3) in paragraph (3), by striking ‘‘date of en-
actment of the Indian Health Care Improvement Re-
authorization and Extension Act of 2009 shall serve 
as Director’’ and inserting ‘‘date of enactment of the 
Stronger Engagement for Indian Health Needs Act 
of 2023 shall serve as Assistant Secretary’’; 
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(4) in paragraph (4), in the matter before sub-
paragraph (A), by striking ‘‘Director’’ and inserting 
‘‘Assistant Secretary’’; and 
(5) by adding at the end the following new 
paragraph: 
‘‘(5) DEPUTY ASSISTANT SECRETARY.—The As-
sistant Secretary, with the approval of the Secretary, 
may appoint a Deputy Assistant Secretary and may 
employ and prescribe the functions of such officers 
and employees, including attorneys, as are necessary 
to administer the activities of the Service.’’. 
(b) DUTIES.—Section 601(c) of the Indian Health 
Care Improvement Act (25 U.S.C. 1661(c)) is amended— 
(1) in the matter before paragraph (1), by 
striking ‘‘Director’’ and inserting ‘‘Assistant Sec-
retary’’; and 
(2) in paragraph (1), by striking ‘‘date of en-
actment of the Indian Health Care Improvement Re-
authorization and Extension Act of 2009’’ and in-
serting ‘‘date of enactment of the Stronger Engage-
ment for Indian Health Needs Act of 2023’’. 
(c) AUTHORITY.—Section 601(d)(1) of the Indian 
Health Care Improvement Act (25 U.S.C. 1661(d)(1)) is 
amended in the matter before subparagraph (A), by strik-
ing ‘‘Director’’ and inserting ‘‘Assistant Secretary’’. 
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(d) REFERENCES.—Section 601 of the Indian Health 
Care Improvement Act (25 U.S.C. 1661) is amended by 
adding at the end the following new subsection: 
‘‘(e) REFERENCES.—Any reference to the Director of 
the Indian Health Service in any Federal law, Executive 
order, rule, regulation, or delegation of authority, or in 
any document of or relating to the Director of the Indian 
Health Service, shall be deemed to refer to the Assistant 
Secretary.’’. 
(e) RATE OF BASIC PAY.— 
(1) POSITIONS AT LEVEL IV.—Section 5315 of 
title 5, United States Code, is amended by striking 
‘‘Assistant Secretaries of Health and Human Serv-
ices (6)’’ and inserting ‘‘Assistant Secretaries of 
Health and Human Services (7)’’. 
(2) POSITIONS AT LEVEL V.—Section 5316 of 
title 5, United States Code, is amended by striking 
‘‘Director, Indian Health Service, Department of 
Health and Human Services.’’. 
Æ 
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