[Congressional Record Volume 149, Number 36 (Thursday, March 6, 2003)]
[Senate]
[Pages S3316-S3317]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. McCAIN (for himself, Mr. Bingaman, Mr. Campbell, Mrs. 
        Murray, Mr. Johnson, and Mr. Domenici):
  S. 558. A bill to elevate the position 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 the 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. I'm pleased that my colleagues, Senators Bingaman, Campbell, 
Murray, Johnson, and Domenici are joining me in this effort as original 
co-sponsors.
  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.
  The Indian Health Service is the primary health care delivery system 
and principal advocate for Indian health care needs, both on the 
reservation level and for urban populations. More than 1.6 million 
Indian people are served every year by the IHS, yet the agency has not 
had the necessary resources to fully meet 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 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 Administration to ensure prompt passage of this 
legislation. I ask unanimous consent that the text of this bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 558

       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) Definitions.--In this section:
       (1) Assistant secretary.--The term ``Assistant Secretary'' 
     means the Assistant Secretary for Indian Health appointed 
     under subsection (b)(2)(A).

[[Page S3317]]

       (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.
                                 ______