[Congressional Record Volume 147, Number 12 (Tuesday, January 30, 2001)]
[Senate]
[Page S774]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. McCAIN (for himself, Mr. Inouye, Mr. Conrad, Mr. Daschle, 
        and Mr. Campbell):
  S. 214. 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; to 
Committee on Indian Affairs.
  Mr. McCAIN. Mr. President, I rise to introduce legislation to 
designate the Director of the Indian Health Service as an Assistant 
Secretary for Indian Health within the Department of Health and Human 
Services. My colleagues, Senators Inouye, Conrad, Daschle and Campbell 
are joining me in this effort as original co-sponsors. I am pleased to 
note that Congressman Nethercutt from Washington will introduce 
companion legislation on the House side.
  The purpose of this legislation is simple. It will redesignate the 
current Director of the Indian Health Service, IHS, as a new Assistant 
Secretary within the Department of Health and Human Services to be 
responsible for Indian health policy and budgetary matters.
  As the primary health care delivery system, the Indian Health Service 
is the principal advocate for Indian health care needs, both on the 
reservation level and for urban populations. More than 1.5 million 
Indian people are served every year by the IHS. At its current 
capacity, the IHS estimates that it can only meet about 60 percent of 
tribal health care needs. The IHS will continue to be challenged by a 
growing Indian population as well as an increasing disparity between 
the health status of Indian people as compared to other Americans. 
Thousands of Indian people continue to suffer from the worst imaginable 
health care conditions in Indian country--from diabetes to cancer to 
infant mortality. In nearly every category, the health status of Native 
Americans falls far below the national standard.
  The purpose of this bill is to respond to the desire by Indian people 
for a stronger leadership and policy role within the primary health 
care agency, the Department of Health and Human Services. The Assistant 
Secretary for Indian Health will ensure that critical policy and 
budgetary decisions will be made with the full involvement and 
consultation of not only the Indian Health Service, but also the direct 
involvement of the Tribal governments.
  This legislation is long overdue in bringing focus and national 
attention to the health care status of Indian people and fulfilling the 
federal trust responsibility toward Indian tribes. Implementation of 
this bill is intended to support the long-standing policies of Indian 
self-determination and tribal self-governance and assist Indian tribes 
who are making positive strides in providing direct health care to 
their own communities.
  Tribal communities are in dire need of a senior policy official who 
is knowledgeable about the programs administered by the IHS and who can 
provide the leadership for the health care needs of American Indians 
and Alaska Natives. We continue to pursue passage of this legislation 
as many believe that the priority of Indian health issues within the 
Department should be raised to the highest levels within our federal 
government.
  I look forward to working with my colleagues on both sides of the 
aisle and the new Administration to ensure prompt passage of this 
legislation. I ask unanimous consent that the full text of this bill be 
included in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 214

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. OFFICE OF ASSISTANT SECRETARY FOR INDIAN HEALTH.

       (a) Establishment.--There is established within the 
     Department of Health and Human Services the Office of the 
     Assistant Secretary for Indian Health in order to, in a 
     manner consistent with the government-to-government 
     relationship between the United States and Indian tribes--
       (1) facilitate advocacy for the development of appropriate 
     Indian health policy; and
       (2) promote consultation on matters related to Indian 
     health.
       (b) Assistant Secretary for Indian Health.--In addition to 
     the functions performed on the date of enactment of this Act 
     by the Director of the Indian Health Service, the Assistant 
     Secretary for Indian Health shall perform such functions as 
     the Secretary of Health and Human Services (referred to in 
     this section as the ``Secretary'') may designate. The 
     Assistant Secretary for Indian Health 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 of 
     Health and Human Services 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 of Health and Human Services concerning matters of 
     Indian health with respect to which those heads have 
     authority and responsibility; and
       (5) coordinate the activities of the Department of Health 
     and Human Services concerning matters of Indian health.
       (c) References.--Reference in any other Federal law, 
     Executive order, rule, regulation, or delegation of 
     authority, or any document of or relating to the Director of 
     the Indian Health Service shall be deemed to refer to the 
     Assistant Secretary for Indian Health.
       (d) Rate of Pay.--
       (1) Positions at level iv.--Section 5315 of title 5, United 
     States Code, is amended--
       (A) by striking the following:
       ``Assistant Secretaries of Health and Human Services 
     (6).''; and
       (B) by inserting the following:
       ``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 the following:
       ``Director, Indian Health Service, Department of Health and 
     Human Services.''.
       (e) Duties of Assistant Secretary for Indian Health.--
     Section 601(a) of the Indian Health Care Improvement Act (25 
     U.S.C. 1661(a)) is amended--
       (1) by inserting ``(1)'' after ``(a)'';
       (2) in the second sentence of paragraph (1), as so 
     designated, by striking ``a Director,'' and inserting ``the 
     Assistant Secretary for Indian Health,''; and
       (3) by striking the third sentence of paragraph (1) and all 
     that follows through the end of the subsection and inserting 
     the following: ``The Assistant Secretary for Indian Health 
     shall carry out the duties specified in paragraph (2).
       ``(2) The Assistant Secretary for Indian Health 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; and
       ``(E) coordinate the activities of the Department of Health 
     and Human Services concerning matters of Indian health.''.
       (f) Continued Service by Incumbent.--The individual serving 
     in the position of Director of the Indian Health Service on 
     the date preceding the date of enactment of this Act may 
     serve as Assistant Secretary for Indian Health, at the 
     pleasure of the President after the date of enactment of this 
     Act.
       (g) Conforming Amendments.--
       (1) Amendments to indian health care improvement act.--The 
     Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.) 
     is amended--
       (A) in section 601--
       (i) in subsection (c), by striking ``Director of the Indian 
     Health Service'' both places it appears and inserting 
     ``Assistant Secretary for Indian Health''; and
       (ii) in subsection (d), by striking ``Director of the 
     Indian Health Service'' and inserting ``Assistant Secretary 
     for Indian Health''; and
       (B) in section 816(c)(1), by striking ``Director of the 
     Indian Health Service'' and inserting ``Assistant Secretary 
     for Indian Health''.
       (2) Amendments to other provisions of law.--The following 
     provisions are each amended by striking ``Director of the 
     Indian Health Service'' each place it appears and inserting 
     ``Assistant Secretary for Indian Health'':
       (A) Section 203(a)(1) of the Rehabilitation Act of 1973 (29 
     U.S.C. 761b(a)(1)).
       (B) Subsections (b) and (e) of section 518 of the Federal 
     Water Pollution Control Act (33 U.S.C. 1377 (b) and (e)).
       (C) Section 803B(d)(1) of the Native American Programs Act 
     of 1974 (42 U.S.C. 2991b-2(d)(1)).
                                 ______