UPDATE: After unexplained delays and amid declining Native life expectancy, U.S. Senate confirms Tso as IHS director

(courtesy Centers for Disease Control and Prevention)

Updated Sept. 22, 9:30 a.m.

WASHINGTON — The Indian Health Service (IHS) finally has a permanent director in Roselyn Tso, a longtime Native health advocate has who has worked as a career employee for the IHS system since the 1980s.

A citizen of the Navajo Nation, Tso was supported by numerous tribal advocates for this position, which oversees a multi-billion dollar, nationwide tribal health network.

She was unanimously confirmed by the U.S. Senate on Sept. 21.

The Biden administration nominated Tso to the nation’s top Indian health position in March of this year after being criticized by top tribal health officials, including those with the National Indian Health Board, for keeping the position unfilled since Jan. 2021.

Rear Adm. Michael Weahkee, who served in the position since June 2017, in first an acting and then an official capacity, announced in Jan. 2021 that he was resigning at the request of the incoming Biden administration.

Some tribal officials have said they would have liked to see the Biden administration keep Weahkee, a citizen of the Pueblo of Zuni, in the position during the height of the Covid-19 pandemic until Biden officials had firm plans on who they would like to fill it permanently.

Instead, an acting official, Elizabeth Fowler, was tapped as a temporary placeholder. Acting officials have less authority within the federal system to be held accountable and produce results.

Tribal leaders have placed blame on Biden transition team members, as well as former White House Special Assistant to the President for Native Affairs Libby Washburn — who resigned from that position in May in order to become a director of ethics with the San Diego Zoo Wildlife Alliance — for not moving much more quickly to fill the permanent position.

Tribal officials say the Biden administration was surprisingly unprepared to deal with serious health challenges faced by Native communities, especially during the pandemic.

“They treated us like we have been treated during many previous administrations — like an afterthought,” a tribal leader told Indigenous Wire after Tso’s confirmation. “The only difference this time is that hundreds — thousands — of our people were dying from Covid … we needed a leader in place from the very beginning.”

Why the Biden White House took over a year to nominate a person to this position during an ongoing pandemic that has killed many Native Americans has been a widespread question in Indian Country.

Many tribal advocates are calling for the administration to create an assistant secretary of Indian health position within the U.S. Department of Health and Human Services, which includes IHS, so that better accountability and trust responsibility can happen in the future for Natives.

“The absence of a confirmed IHS Director has prevented Tribes, Tribal organizations, and [urban Indian organizations] from addressing the health care needs of their Native American populations, which directly falls under the responsibility of IHS,” the National Council of Urban Indian Health (NCUIH) noted in a press release after Tso’s confirmation.

“Since the resignation of Rear Admiral Weahkee, there have been countless requests from Indian Country calling on Congress and the Administration to nominate a new IHS director to address the growing health disparities experienced by AI/ANs. NCUIH has previously stressed the importance of appointing a permanent IHS Director and called for the elevation of the role to Assistant Secretary.”

Alarming federal statistics, released just last month, indicate that the life expectancy rate for Natives has been greatly impacted by Covid-19.

“In 2020 and 2021, as the coronavirus swept across the United States, life expectancy for Native Americans and Alaska Natives fell by six and a half years — a decline that left the researchers aghast,” The New York Times reported after reviewing federal numbers. “The comparable figure for all Americans was about three years, itself a terrible milestone not seen in nearly a century.”

The White House has failed to answer several questions from tribal leaders and the press on why it was so lax in promoting a permanent Indian health leader within the federal system during the height of Covid-19.

At the same time, the White House has celebrated the numerous tribal hires it has made across the administration — leaving the IHS situation during the biggest U.S. health crisis in a century all the more noteworthy and perplexing.

The U.S. Senate took an additional 6 months after Tso's March nomination to confirm her.

Tribal leaders have also expressed ire toward U.S. Senate Committee on Indian Affairs Chairman Brian Schatz (D-HI) for not pressing Senate Majority Leader Chuck Schumer (D-NY) to move her nomination to a confirmation vote more rapidly.

Schatz did hold non-controversial hearings on her nomination in May and in July, but it still took 2 more months to confirm her.

Schatz candidly said during a hearing on Sept. 21 on a separate pressing matter — the digital divide still experienced by many tribal communities — that it has taken him some time to get up to speed on Native issues. He became chairman of the committee in Feb. 2021.

Tribal leaders from the lower 48 states say that Schatz, being from Hawaii — which has the highest life expectancy rate in the nation — may not fully understand the need to be a strong advocate for tribal health needs within the Democratic Senate leadership hierarchy.

“Sen. Schatz should have been pushing the administration to get this nomination in faster and then to get his colleagues to approve her immediately,” the previously quoted tribal leader told Indigenous Wire. “His Native Hawaiian constituents have different needs than most tribes, so he is not always paying attention to our [lower 48] needs.”

Both Schatz and Sen. Lisa Murkowski (R-AK), the ranking member of the Indian affairs committee, have not responded to requests for comment on the slow speed of Tso’s confirmation during the pandemic.

“Dedicated, long-serving leadership at the Indian Health Service is vital to fulfilling its mission,” Schatz said in a prepared statement. “I’m confident that Ms. Tso will lead the Service with distinction, having the qualifications, willingness to serve Indian Country, and commitment to educating other HHS agencies on the federal government’s special political and trust relationship with the Native Hawaiians, who also receive healthcare services through HHS.”

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