,,ii  #aaith ,,congress  #b;d ,session  
,s4 #cgfg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,february #c1  
#bjbf,ms4 ,cortez ,masto 7for herself   
and ,mr4 ,rounds7 introduced the        
following bill2 which was read twice and
 referred to the ,committee on ,indian  
,affairs  ,a ,,bill  ,to amend the      
,indian ,health ,care ,improvement ,act 
to elevate the position of ,director of 
the ,indian ,health ,service within the 
,department of ,health and ,human       
,services to ,assistant ,secretary for  
,indian ,health1 and for other purposes4
  #a4 ,short title ,this ,act may be    
cited as the ,stronger ,engagement for  
,indian ,health ,needs ,act of #bjbf4   
#b4 ,assistant ,secretary for ,indian   
,health  7a7 ,in general ,section #fja  
of the ,indian ,health ,care            
,improvement ,act 7#be ,u4,s4,c4 #affa7 
is amended-- 7#a7 in subsection 7a7--   
7,a7 in paragraph 7#b7-- 7i7 in the     
paragraph heading1 by striking ,director
 and inserting ,assistant ,secretary for

 ,indian ,health2  7ii7 in the first    
sentence1 by striking a ,director and   
inserting an ,assistant ,secretary for  
,indian ,health 7referred to in this    
section as the ,assistant ,secretary72  
7iii7 in the second sentence1 by        
striking ,the ,director shall report and
 inserting ,the ,assistant ,secretary   
shall report directly2  7iv7 in the     
third sentence1 by striking the         
,director and inserting the ,assistant  
,secretary2 and  7v7 in the fourth      
sentence1 by striking ,a ,director and  
inserting ,an ,assistant ,secretary2    
7,b7 in paragraph 7#c71 by striking date
 of enactment of the ,indian ,health    
,care ,improvement ,reauthorization and 
,extension ,act of #bjji shall serve as 
,director and inserting date of         
enactment of the ,stronger ,engagement  
for ,indian ,health ,needs ,act of #bjbf
 shall serve as ,assistant ,secretary2  
7,c7 in paragraph 7#d71 in the matter   
preceding subparagraph 7,a71 by striking
 ,director and inserting ,assistant     

,secretary2 and  7,d7 by adding at the  
end the following3  7#e7 ,deputy        
,assistant ,secretary2 other officers   
and employees ,the ,assistant           
,secretary1 with the approval of the    
,secretary1 may-- 7,a7 appoint a ,deputy
 ,assistant ,secretary2 and  7,b7 employ
 and prescribe the functions of such    
officers and employees1 including       
attorneys1 as are necessary to          
administer the activities of the        
,service4  2  7#b7 in subsection 7c7--  
7,a7 in the matter preceding paragraph  
7#a71 by striking ,director and         
inserting ,assistant ,secretary2  7,b7  
in paragraph 7#a71 by striking date of  
enactment of the ,indian ,health ,care  
,improvement ,reauthorization and       
,extension ,act of #bjji and inserting  
date of enactment of the ,stronger      
,engagement for ,indian ,health ,needs  
,act of #bjbf2 and  7,c7 in paragraph   
7#c7-- 7i7 in subparagraph 7,b71 by     
inserting 7commonly known as the ,snyder
 ,act7 before 7#be ,u4,s4,c4 #ac72 and  

7ii7 in subparagraph 7,e71 by striking  
7#be ,u4,s4,c4 #dej et seq47 and        
inserting 7#be ,u4,s4,c4 #ecja et seq472
  7#c7 in subsection 7d77#a71 in the    
matter preceding subparagraph 7,a71 by  
striking ,director and inserting        
,assistant ,secretary2 and  7#d7 by     
adding at the end the following3  7e7   
,salary ,the salary of the ,assistant   
,secretary shall be paid from amounts in
 the ,indian ,health ,services account  
of the ,service4  4  7b7 ,references    
,any reference to the ,director of the  
,indian ,health ,service in any ,federal
 law1 ,executive order1 rule1           
regulation1 or delegation of authority1 
or in any document of or relating to the
 ,director of the ,indian ,health       
,service1 shall be deemed to be a       
reference to the ,assistant ,secretary  
for ,indian ,health4  7c7 ,conforming   
amendments  7#a7 ,section #fjc7;b7 of   
the ,indian ,health ,care ,improvement  
,act 7#be ,u4,s4,c4 #affc7;b77 is       
amended by striking ,office of the      

,director and inserting ,office of the  
,assistant ,secretary for ,indian       
,health4  7#b7 ,section #fjd7;b7 of the 
,indian ,health ,care ,improvement ,act 
7#be ,u4,s4,c4 #affc;a7b77 is amended1  
in each of paragraphs 7#b7 and 7#c71 by 
striking ,office of the ,director and   
inserting ,office of the ,assistant     
,secretary for ,indian ,health4  7d7    
,rate of basic pay  7#a7 ,positions at  
level ,,iv ,section #ecae of title #e1  
,united ,states ,code1 is amended by    
striking ,assistant ,secretaries of     
,health and ,human ,services 7#f7 and   
inserting ,assistant ,secretaries of    
,health and ,human ,services 7#g74  7#b7
 ,positions at level ,v ,section #ecaf  
of title #e1 ,united ,states ,code1 is  
amended by striking ,director1 ,indian  
,health ,service1 ,department of ,health
 and ,human ,services44