After lengthy wait, Biden nominates Indian Health Service director
White House won't explain why nomination of Roselyn Tso took so long during pandemic that killed many Natives.
WASHINGTON — Tribal advocates are widely heralding that President Joe Biden today finally made a nomination to head the Indian Health Service (IHS).
His selection is Roselyn Tso, a Navajo Nation citizen and longtime IHS official, and we’ll talk more about her record — and early support for her nomination — below.
The real story here, tribal health advocates say, surrounds the question of why the president and his team waited so long to fill this critical position with a permanent appointee during a devastating pandemic that killed far too many Indigenous people.
“It made us sick that so many of our people needed help and still do, but the White House dragged its feet for a year and almost three months,” said one health official who works with the administration, so they asked to remain anonymous for fear of retribution. “They should have been ready to fill this position in particular on day one.”
Without a permanent person in the job, the agency — responsible for overseeing a massive Indian healthcare and delivery system with a budget of a requested $8.5 billion — instead relied on acting officials. Within the federal government, such temporary officials simply don’t have as much clout to create initiatives and to advocate for the agency within the greater U.S. Department of Health and Human Services system.
In comparison, the Biden administration quickly filled many U.S. Department of Interior positions focused on Native affairs that are indeed important, but probably objectively less so than a top-level Indian health position during the COVID-19 era.
The National Indian Health Board was so alarmed by the situation that it sent a letter to the leadership of the U.S. Senate Committee on Indian Affairs on March 7 urging that the position be filled.
“The absence of a Director impedes the ability of both the Tribes, the Administration as well as Congress to carry out a bold vision for the Indian, Tribal and Urban, or I/T/U, system for which the IHS is responsible,” William Smith, chairman of the NIHB, wrote in the 5-page letter, along with several policy goals.
“We cannot overstate the importance of securing a competent, proven national leader to serve as the IHS Director to ensure quality health care and public health services are delivered through IHS,” wrote Smith, a citizen and board member of the Valdez Native Tribe. “The Tribes deserve an IHS Director of the highest caliber of leader that the I/T/U system warrants and deserves. The health and lives of millions of American Indians and Alaska Natives, from newborns to elders, is depending on it.”
Tribal advocates see it as no coincidence that only two days after the letter was delivered, the White House announced its nominee, although the administration has for months been interviewing multiple candidates from inside and outside the current IHS system, according to several knowledgeable sources.
Still, advocates say a decision should have been made much sooner, as many candidates who have been discussed since January 2021 have appeared more than capable and could have likely been confirmed by the Senate by now.
“Did they let the perfect be the enemy of the good during a national pandemic that killed way too many of our people?” asked the health official quoted above. “If so, that’s bullshit.”
Aaron Payment, chairman of the Sault Ste. Marie Tribe of Chippewa Indians, was more judicious, saying, “They did the due diligence to get it right.”
Payment said that he advocated to Xavier Becerra, secretary of the U.S. Department of Health and Human Services, which oversees IHS, during the agency’s Secretary Tribal Advisory Committee meetings for the White House to nominate someone “ASAP.”
When specifically asked why it took so long for the president to make a nomination to this important position during the COVID-19 pandemic and whether not having a permanent person in place in this position hurt COVID-19 outreach to Indian Country, the White House would not respond.
Instead, Jennifer Molina, director of coalitions media with the White House, sent along a press release noting the nomination of Tso.
The press release follows:
Roselyn Tso, Nominee for Director of the Indian Health Service, Department of Health and Human Services
Roselyn Tso is an enrolled member of the Navajo Nation. Tso began her career with the Indian Health Service (IHS) in 1984. She previously served in various roles in the Portland Area IHS and IHS Headquarters. Currently, Tso serves as the Area Director for the Navajo Area IHS. The Navajo Area IHS delivers health services to a user population of over 244,000 American Indians; the Navajo Nation is one of the largest Indian reservations in the United States consisting of more than 25,000 contiguous square miles and three satellite communities, and extends into portions of the states of Arizona, New Mexico, and Utah. In her leadership position, she was responsible for the implementation of the Indian Self-Determination and Education Act and worked directly with tribes and direct service tribes.
Tso holds a Bachelor of Arts in interdisciplinary studies from Marylhurst University in Portland, Oregon and a master’s degree in organizational management from the University of Phoenix, Portland, Oregon.
Sen. Brian Schatz (D-Hawaii), chairman of the Senate Committee on Indian Affairs, weighed in with a statement of his own:
The Indian Health Service Director plays a critical role in raising the health status of Native peoples and upholding the federal government’s trust responsibility to Native communities. I am committed to seeking Indian Country’s input on Ms. Tso’s nomination as the Committee carefully considers her qualifications.
As did Shannon O'Loughlin, the chief executive & attorney for the Association on American Indian Affairs:
The Association on American Indian Affairs looks forward to the Senate confirmation of Ms. Roselyn Tso. We are certain that Ms. Tso’s long history with the Indian Health Service and her citizenship with the Navajo Nation has provided her with valuable insight on changes needed to better Indian healthcare and services.
As did Payment:
As Navajo Regional IHS Director and with three decades of direct IHS/HHS experience, Roselyn is infinitely qualified to mitigate the maze of transitioning out of the pandemic while looking forward to needed reforms for the federal commitment to fully honor the treaty and trust obligation. Additionally, Roselyn has worked for 30 years at Tribal Health facilities across the Nation. This experience will lend a broad and national scope to meet the diverse needs of all tribes. HHS Secretary Becerra and the entire HHS and IHS team have embraced Indian Country’s request for Advanced Appropriations and are working hand and hand with tribes to educate the legislature of why this is necessary to fulfill the treaty and trust obligation. Roselyn’s IHS budgetary experience, work with Self-Governance, and the Contract Support Work Group make her extremely qualified to strike the balance between administration asks, legislative expectations and the needs and desires of Indian Country.
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