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Kalle Benallie
Indian Country Today

Roselyn Tso is President Joe Biden’s nominee for director of the Indian Health Service, after more than a year without an appointed leader.

If confirmed by the Senate, she will serve and manage the Indian Health Service’s administration of health care programs and services, including its approximately $7.4 billion budget and 15,000 employees. The agency provides healthcare to approximately 2.6 million Indigenous people across the country. Indian Health Service is part of the Department of Health and Human Services.

It’s unclear when a confirmation hearing will be held.

(Related: The state of COVID-19 in Native communities)

Tso, Navajo, brings nearly 40 years of service in the Indian health system, including most recently on the Navajo Nation.

She began her career with IHS in 1984 working a variety of jobs in the Portland, Oregon, area as the administrative officer for the Yakama Service Unit, the planning and statistical officer, the equal employment officer and the special assistant to the area director.

In 2005, she continued her work in Portland as the Office of Tribal and Service Unit Operations director and the acting director for the Office of Direct Services and Contracting Tribes in 2010 and 2016 to 2018. Since 2019, she has been the director of the Navajo Area of IHS.

She has a Bachelor of Arts in interdisciplinary studies from Marylhurst University in Oregon and a master’s in organizational management from the University of Phoenix in Portland.

The last IHS director to be confirmed was Rear Admiral Michael Weahkee, Zuni Pueblo, of New Mexico, in April 2020. He served as the principal deputy director from June 2017 until his confirmation. He resigned less than a year later on Jan. 20, 2021, the same day Biden was sworn in as president. He said he was asked to leave by the new administration to appoint new leadership. Elizabeth A. Fowler, a citizen of the Comanche Nation with descendancy from the Eastern Band of Cherokee Indians, has acted as the deputy director since.

(Related: Biden administration brings changes to Indian Country)

The Biden administration stated in the Biden-Harris Plan for Tribal Nations that it would strengthen the nation-to-nation relationship, provide "reliable, affordable, quality health care and address health disparities, restore tribal lands, address climate change, and safeguard natural and cultural resources.”

In the fiscal year 2022 budget presented to Congress, Biden requested that an additional $2.2 billion be allocated for Indian Health Service, pushing the budget to $8.5 billion, and for advanced appropriation of $9 billion for fiscal year 2023.

The “FY 2022 Tribal Budget Formulation Workgroup Recommendations,” released by the National Indian Health Board, stated that the Biden administration, at a minimum, should recommend a $12.759-billion budget for Indian Health Service. To be fully funded, the agency would need $48 billion. While Biden’s $8.5 billion recommendation does increase the budget by 20 percent, it would need an additional $40 billion to fulfill trust and treaty obligations made with Indigenous nations.

The advanced appropriation bill for Indian Health Service was introduced in the Senate by Sen. Ben Ray Lujan, a New Mexico Democrat, on Oct. 7 and a related bill was introduced in the house by U.S. Rep. Betty McCollum, a Minnesota Democrat, on Oct. 12. There has yet to be any other action on the bills.

Another position that remains empty is the commissioner of the Administration for Native Americans, according to the Washington Post’s political appointee tracker. Hope MacDonald LoneTree, Navajo, is currently acting as the deputy commissioner and manages a nationwide discretionary grant program. 

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