‘straining Everything In Our System’: Indian Health Service Transfers Leave Leadership Vacuum

Health Secretary Robert F. Kennedy Jr. is transferring dozens of public health corps officers from their posts around the country to work multi-month stints at Indian Health Service centers with severe staffing shortages.

The perennially under-resourced clinics for Native Americans are welcoming the help. But current and former officials warn the 120-day details for about 70 officers will strain the health agencies they are leaving behind while failing to solve the clinics’ staffing woes in the long term.

Public health corps officers, who can by law work during the government shutdown, are struggling to keep federal health agencies running while tens of thousands of their colleagues are furloughed — making it hard to lose key leaders for a four-month stretch. Others are being moved from local health departments already bracing for disease outbreaks in the fall and winter. Some health officials even fear the Indian Health Service assignments, which are significantly longer than usual and target a chronic issue rather than an isolated emergency, are designed to pressure more federal workers to resign their posts.

The Trump administration did not disclose who is being deployed, but internal emails reviewed by POLITICO show top officials stationed at the Substance Abuse and Mental Health Services Administration were among those transferred, including Dr. Chris Jones, a rear admiral in the public health corps who runs both SAMHSA’s Center for Substance Abuse Prevention and Center for Behavioral Health Statistics and Quality.

A recent SAMHSA appointee, granted anonymity for fear of retaliation, said the prospect of losing Jones’ “institutional knowledge,” even temporarily, could disrupt programs that distribute overdose prevention medication and coordinate with states to address the scourge of tainted and counterfeit drugs.

“They're kind of the backbone folks who can keep things running,” the appointee said of Jones and the other SAMHSA leaders sent to IHS sites. Following mass layoffs earlier this year and the current government shutdown, the former official added, the deployments could be the final straw for some employees.

“I have heard multiple people say, ‘At least Chris is still here.’ He's someone that folks rely on and they trust,” the appointee said. “And so this just worsens morale that much more.”

The mobilization is also pulling some officers from local governments, including the head of disease control for the New York City Department of Health, which is one of the country’s largest public health agencies. That official, Dr. Celia Quinn, was sent to the Hopi Health Center in Arizona until February.

A staffer with New York City’s health department said the abrupt mobilization coincides with an anticipated uptick in measles, since transmission goes up around major holidays associated with large gatherings and travel.

“If we have an outbreak, then we’re fucked,” said the staffer, who was granted anonymity because they are not authorized to speak publicly. “It’s straining everything in our system.”

An HHS spokesperson said Indian Health Service centers with job vacancy rates above 30 percent would receive a mix of senior officers and rank-and-file clinicians, but the department declined requests for a list of the assignments.

The 120-day details are not unprecedented, and officers have in the past worked longer deployments to respond to natural disasters or public health emergencies like the Covid pandemic. But the circumstances are unusual. The Public Health Service corps, one of the country’s eight uniformed services, typically deploys portions of its roughly 6,000 public health and medical professionals for weeks at a time.

In April, as Kennedy purged health agencies of tens of thousands of federal workers, some senior leaders were put on administrative leave and told they may be permanently reassigned to far-flung IHS sites around the country — a move widely seen by current and former employees as a tool to get them to resign without severance. Some fear a similar motivation for the most recent assignments, which came with less than two weeks’ notice and will overlap with the holiday season.

“He's making commissioned corps officers spend an extended period of time away from their family and their homes to deploy,” said one CDC employee, granted anonymity due to fear of retaliation. “These centers obviously need help, but I think that the underlying strategy is, ‘Well, if you don't want to deploy, your only option is to quit.’ They're trying to make conditions miserable, so people do the layoffs for them.”

Yet Jacqueline Rychnovsky, a retired Naval captain and the executive director of the Commissioned Officers Association, said she has not heard of resignations among the health officers ordered to deploy to IHS.

“Many officers are truly seeing this as an opportunity to shine in a new environment and to gain some leadership and additional clinical sustainment skills,” she said. “An opportunity to go back to clinical for a while can actually be sort of a respite and fun and rewarding.

While the transfers were “a little bit sudden,” she acknowledged, all corps officers enlist knowing they could be sent somewhere with little notice.

“They’re always directed to have what they call a ‘go bag’ packed and ready,” she said. “Because if there's going to be some catastrophic earthquake somewhere, they're going to be on a plane in 24 to 48 hours.”

In an email obtained by POLITICO, Deputy Secretary of Health for the Chickasaw Nation Kevin Meeks thanked the officers being sent to IHS clinics. He wrote that their assistance was “essential” and stressed that “the health and welfare of entire communities” depends on them.

“I can think of no higher calling for officers than to continue to fulfill our Nation’s commitment to providing healthcare to our Tribal communities,” wrote Meeks, himself a retired rear admiral in the public health corps.

Kennedy framed the transfers as a fulfilment of his repeated pledges to prioritize health care services for Indigenous communities. The IHS provides care to about 2.8 million Native Americans and Alaska Natives through a network of federally funded hospitals and clinics.

“For too long, tribal communities have gone without the care they deserve,” he said in a Sept. 22 statement. “With vacancy rates above 30%, this mobilization takes bold action to close gaps and deliver timely, quality care to Native families. By working hand-in-hand with Tribal leaders, providers, and families, we are restoring trust and driving the mission to Make America Healthy Again — starting in Indian Country.”

But while the Trump administration is asking Congress for a slight increase in the department’s budget, it is also slashing staff and programs that support tribal health, such as the CDC’s Healthy Tribes program for chronic disease prevention and funding to help the IHS pay for epidemiology centers.

Current and former officials told POLITICO they’re worried the IHS assignments, while needed, are a temporary Band-Aid for a problem that needs a lasting fix.

“HHS needs to allow the hiring and strong recruiting for permanent officers to work in the Indian Health Service,” said Brett Giroir, a retired four-star admiral in the U.S. Public Health Service Commissioned Corps who served as assistant secretary for health in the first Trump administration. “The Commissioned Corps is way down in size and this needs to be fixed.”

Joe Heath, general counsel for the Onondaga Nation in New York, said Kennedy seems to recognize that Indigenous communities’ health care access is inadequate, but he is skeptical the transfers will be impactful.

He said the Onondaga and nearby Tonawanda and Tuscarora Nations tend to rely on state-funded health clinics because the closest IHS facility is too far away — another example, he said, of federal officials’ top-down approach to American Indians’ health needs.

“It doesn’t seem like it’s going to change anything in the long run,” he said of Kennedy’s IHS mobilization. “I used to joke decades ago when I first started this job that every white person knows what’s good for Indians. The problem is they don’t understand that they need to listen to them.”

Sophie Gardner contributed reporting.