I have only been in my job as Principal Deputy Director for a little over a week. Although I have been at the agency for a short time - I served for approximately five months in the role of Deputy Director - it has become quite clear to me that, while the IHS is firmly committed to the mission of providing quality health care for American Indians and Alaska Natives, we face steep operational and quality of care challenges.

This is unacceptable.

I want to underscore my commitment to fixing these challenges, including those in the Great Plains and the more systemic issues that we face as an agency such as staffing and housing. We are committed to fixing these issues not simply in the short-term but so that the changes are sustainable over time. I and the rest of the team at IHS am committed to creating a culture of quality, leadership, and accountability.

It is far from "business as usual" at IHS.

The annual budget request of the Indian Health Service is the result of a budget formulation and consultation process that involves IHS and Tribal Indian health program representatives and providers from the local to the national level. This year, as in previous years, quality health care, behavioral health and contract support costs have been prominent on the agenda and in the final budget request.