Mark Cruz to lead Indian Health Service amid staffing and infrastructure challenges

The U.S. Senate recently confirmed Mark Cruz, a citizen of the Klamath Tribes, as the new director of the Indian Health Service (IHS). With a four-year term ahead, Cruz will lead an agency tasked with providing healthcare to approximately 2.8 million Native American and Alaska Native patients. The Indian Health Service currently operates 21 hospitals and 78 smaller health centers across the country, but faces significant challenges.

These include a backlog of 30-year-old facilities needing replacement, an average age of 40 years for these facilities, and a high provider vacancy rate.

During his July confirmation hearing, Cruz expressed his commitment to improving health outcomes in Indian Country and bringing his lived experience to the role. He emphasized that his family, friends, and tribal community will bear the consequences of his work for decades. Cruz, a senior adviser on tribal health to Health Secretary Robert F. Kennedy Jr., will continue to hold this newly created position while leading the IHS.

In his previous role under President Donald Trump’s administration, Cruz oversaw the Office of Indian Energy and Economic Development within the U.S. Bureau of Indian Affairs.

The Senate confirmed Cruz by a 51-47 vote, marking one of the final actions of the Senate before its August recess. As the agency faces ongoing struggles, Cruz has pledged to address the provider vacancy issues and better insulate tribal health programs from federal budget impasses. Additionally, he aims to fund the overhead costs tribes incur when managing their own healthcare systems.