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.

SECTION 1. OFFICE OF ASSISTANT SECRETARY FOR INDIAN HEALTH.

    (a) Definitions.--In this section:
            (1) Assistant secretary.--The term ``Assistant Secretary'' 
        means the Assistant Secretary for Indian Health appointed under 
        subsection (b)(2)(A).
            (2) Department.--The term ``Department'' means the 
        Department of Health and Human Services.
            (3) Office.--The term ``Office'' means the Office of the 
        Assistant Secretary for Indian Health established by subsection 
        (b)(1).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
    (b) Establishment.--
            (1) In general.--There is established within the Department 
        the Office of the Assistant Secretary for Indian Health.
            (2) Assistant secretary.--
                    (A) In general.--Except as provided in subparagraph 
                (B), the Office shall be headed by an Assistant 
                Secretary for Indian Health, to be appointed by the 
                President, by and with the advice and consent of the 
                Senate.
                    (B) Continued service by incumbent.--The individual 
                serving in the position of Director of the Indian 
                Health Service on the day before the date of enactment 
                of this Act may serve as Assistant Secretary at the 
                pleasure of the President after the date of enactment 
                of this Act.
            (3) Duties.--The position of Assistant Secretary is 
        established to, in a manner consistent with the government-to-
        government relationship between the United States and Indian 
        tribes--
                    (A) facilitate advocacy for the development of 
                appropriate Indian health policy; and
                    (B) promote consultation on matters relating to 
                Indian health.
    (c) Assistant Secretary for Indian Health.--In addition to the 
functions performed as of the date of enactment of this Act by the 
Director of the Indian Health Service, the Assistant Secretary shall--
            (1) report directly to the Secretary concerning all policy- 
        and budget-related matters affecting Indian health;
            (2) collaborate with the Assistant Secretary for Health 
        concerning appropriate matters of Indian health that affect the 
        agencies of the Public Health Service;
            (3) advise each Assistant Secretary of the Department 
        concerning matters of Indian health with respect to which that 
        Assistant Secretary has authority and responsibility;
            (4) advise the heads of other agencies and programs of the 
        Department concerning matters of Indian health with respect to 
        which those heads have authority and responsibility;
            (5) coordinate the activities of the Department concerning 
        matters of Indian health; and
            (6) perform such other functions as the Secretary may 
        designate.
    (d) Rate of Pay.--
            (1) Positions at level iv.--Section 5315 of title 5, United 
        States Code, is amended by striking ``Assistant Secretaries of 
        Health and Human Services (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.''.
    (e) Duties of Assistant Secretary for Indian Health.--Section 601 
of the Indian Health Care Improvement Act (25 U.S.C. 1661) is amended 
by striking the section heading and all that follows through subsection 
(a) and inserting the following:

``SEC. 601. ESTABLISHMENT OF THE INDIAN HEALTH SERVICE AS AN AGENCY OF 
              THE PUBLIC HEALTH SERVICE.

    ``(a) Establishment.--
            ``(1) In general.--In order to more effectively and 
        efficiently carry out the responsibilities, authorities, and 
        functions of the United States to provide health care services 
        to Indians and Indian tribes, there is established within the 
        Public Health Service of the Department of Health and Human 
        Services the Indian Health Service.
            ``(2) Administration.--The Indian Health Service shall be 
        administered by the Assistant Secretary for Indian Health.
            ``(3) Duties.--In carrying out paragraph (2), the Assistant 
        Secretary shall--
                    ``(A) report directly to the Secretary concerning 
                all policy- and budget-related matters affecting Indian 
                health;
                    ``(B) collaborate with the Assistant Secretary for 
                Health concerning appropriate matters of Indian health 
                that affect the agencies of the Public Health Service;
                    ``(C) advise each Assistant Secretary of the 
                Department of Health and Human Services concerning 
                matters of Indian health with respect to which that 
                Assistant Secretary has authority and responsibility;
                    ``(D) advise the heads of other agencies and 
                programs of the Department of Health and Human Services 
                concerning matters of Indian health with respect to 
                which those heads have authority and responsibility;
                    ``(E) coordinate the activities of the Department 
                of Health and Human Services concerning matters of 
                Indian health; and
                    ``(F) perform such other functions as the Secretary 
                may designate.''.
    (f) Conforming Amendments.--
            (1) Amendments to indian health care improvement act.--The 
        Indian Health Care Improvement Act is amended--
                    (A) in section 601 (25 U.S.C. 1661)--
                            (i) in subsection (c), by striking 
                        ``Director of the Indian Health Service'' each 
                        place it appears and inserting ``Assistant 
                        Secretary for Indian Health''; and
                            (ii) in subsection (d)(1), by striking 
                        ``Director of the Indian Health Service'' and 
                        inserting ``Assistant Secretary for Indian 
                        Health''; and
                    (B) in section 816(c)(1) (25 U.S.C. 1680f(c)(1)), 
                by striking ``Director of the Indian Health Service'' 
                and inserting ``Assistant Secretary for Indian 
                Health''.
            (2) Amendments to other provisions of law.--
                    (A) Section 3307(b)(1)(C) of the Children's Health 
                Act of 2000 (25 U.S.C. 1671 note; Public Law 106-310) 
                is amended by striking ``Director of the Indian Health 
                Service'' and inserting ``Assistant Secretary for 
                Indian Health''.
                    (B) The Indian Lands Open Dump Cleanup Act of 1994 
                is amended--
                            (i) in section 3 (25 U.S.C. 3902)--
                                    (I) by striking paragraph (2);
                                    (II) by redesignating paragraphs 
                                (1), (3), (4), (5), and (6) as 
                                paragraphs (4), (5), (2), (6), and (1), 
                                respectively, and moving those 
                                paragraphs so as to appear in numerical 
                                order; and
                                    (III) by inserting before paragraph 
                                (4) (as redesignated by subclause (II)) 
                                the following:
            ``(3) Assistant secretary.--The term `Assistant Secretary' 
        means the Assistant Secretary for Indian Health.'';
                            (ii) in section 5 (25 U.S.C. 3904), by 
                        striking the section heading and inserting the 
                        following:

``SEC. 5. AUTHORITY OF ASSISTANT SECRETARY FOR INDIAN HEALTH.'';

                            (iii) in section 6(a) (25 U.S.C. 3905(a)), 
                        in the subsection heading, by striking 
                        ``Director'' and inserting ``Assistant 
                        Secretary'';
                            (iv) in section 9(a) (25 U.S.C. 3908(a)), 
                        in the subsection heading, by striking 
                        ``Director'' and inserting ``Assistant 
                        Secretary''; and
                            (v) by striking ``Director'' each place it 
                        appears and inserting ``Assistant Secretary''.
                    (C) Section 5504(d)(2) of the Augustus F. Hawkins-
                Robert T. Stafford Elementary and Secondary School 
                Improvement Amendments of 1988 (25 U.S.C. 2001 note; 
                Public Law 100-297) is amended by striking ``Director 
                of the Indian Health Service'' and inserting 
                ``Assistant Secretary for Indian Health''.
                    (D) Section 203(a)(1) of the Rehabilitation Act of 
                1973 (29 U.S.C. 763(a)(1)) is amended by striking 
                ``Director of the Indian Health Service'' and inserting 
                ``Assistant Secretary for Indian Health''.
                    (E) Subsections (b) and (e) of section 518 of the 
                Federal Water Pollution Control Act (33 U.S.C. 1377) 
                are amended by striking ``Director of the Indian Health 
                Service'' each place it appears and inserting 
                ``Assistant Secretary for Indian Health''.
                    (F) Section 317M(b) of the Public Health Service 
                Act (42 U.S.C. 247b-14(b)) is amended--
                            (i) by striking ``Director of the Indian 
                        Health Service'' each place it appears and 
                        inserting ``Assistant Secretary for Indian 
                        Health''; and
                            (ii) in paragraph (2)(A), by striking ``the 
                        Directors referred to in such paragraph'' and 
                        inserting ``the Director of the Centers for 
                        Disease Control and Prevention and the 
                        Assistant Secretary for Indian Health''.
                    (G) Section 417C(b) of the Public Health Service 
                Act (42 U.S.C. 285-9(b)) is amended by striking 
                ``Director of the Indian Health Service'' and inserting 
                ``Assistant Secretary for Indian Health''.
                    (H) Section 1452(i) of the Safe Drinking Water Act 
                (42 U.S.C. 300j-12(i)) is amended by striking 
                ``Director of the Indian Health Service'' each place it 
                appears and inserting ``Assistant Secretary for Indian 
                Health''.
                    (I) Section 803B(d)(1) of the Native American 
                Programs Act of 1974 (42 U.S.C. 2991b-2(d)(1)) is 
                amended in the last sentence by striking ``Director of 
                the Indian Health Service'' and inserting ``Assistant 
                Secretary for Indian Health''.
                    (J) Section 203(b) of the Michigan Indian Land 
                Claims Settlement Act (Public Law 105-143; 111 Stat. 
                2666) is amended by striking ``Director of the Indian 
                Health Service'' and inserting ``Assistant Secretary 
                for Indian Health''.
    (g) References.--Any reference to the Director of the Indian Health 
Service in any other 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.

            Passed the Senate July 16, 2003.

            Attest:

                                             EMILY J. REYNOLDS,

                                                             Secretary.

Summary: Establishes within the Department of Health and Human Services (HHS) the Office of the Assistant Secretary for Indian Health to facilitate advocacy for the development of appropriate Indian health policy, and promote consultation on matters related to Indian health, in a manner consistent with the government-to-government relationship between the United States and Indian tribes. Elevates the position of Director of the Indian Health Service to such Assistant Secretary position. Makes the Indian Health Service an agency of the Public Health Service.