HHS secretary outlines plan to modernize Indian Health Service: mercury phase-out, major hiring push and $1 billion for facilities

The HHS secretary told tribal leaders at a tribal advisory committee that the department will phase out mercury-containing dental amalgams at Indian Health Service facilities, launch the largest hiring initiative in IHS history to address a reported 30% personnel deficit, and direct $1 billion in existing departmental resources toward priority IHS facility projects beginning in fiscal 2027.

Why it matters: The Indian Health Service is central to the federal trust responsibility to provide health care for American Indian and Alaska Native communities. Officials say chronic staffing shortages and an estimated $8 billion construction backlog limit access to care; the announced measures aim to increase staffing, modernize infrastructure and reduce clinical risks identified in department reviews.

The secretary said the department reviewed scientific evidence and operational impacts and decided to “transition to much safer materials” by phasing out mercury dental amalgams at IHS clinics, citing concerns that mercury in fillings can harm children’s brains and off-gas when exposed to heat.

On staffing, the secretary described a systemwide assessment that identified critical gaps across hospitals, clinics and administrative offices and announced a 2026 hiring plan to recruit physicians, nurses, behavioral health providers, dentists and support staff. The secretary said IHS faces about a 30% staffing deficit and that the hiring initiative is designed to target high-need roles and locations while streamlining recruitment and retention.

Addressing facilities, the secretary said the department has cataloged an approximately $8,000,000,000 construction backlog and plans to direct $1,000,000,000 in existing departmental resources starting in fiscal year 2027 to projects that are ready to move forward. The secretary described prioritizing projects that “need the most” and said workforce and infrastructure form the foundation of care.

The speech also emphasized prevention and nutrition. The secretary said HHS worked with the U.S. Department of Agriculture on updated dietary guidance emphasizing whole foods and traditional foods, and pledged to support tribal food sovereignty projects — from restoring fisheries to expanding bison herds and community greenhouses. The secretary described restoring a long-delayed greenhouse project in an Alaskan community with an estimated $1 million–$2 million investment.

On behavioral health, the secretary said IHS and the Substance Abuse and Mental Health Services Administration are expanding access to treatment and recovery services, increasing behavioral health staffing, supporting sober housing and funding culturally grounded recovery programs designed and operated by tribes.

The secretary announced internal changes to strengthen tribal representation inside the department, including creating a senior advisor role for tribal affairs filled by Mark Cruz (Klamath Tribe), appointing Dr. Kim Hartwig (Nez Perce) to an IHS leadership post, and delegating IHS director authorities to Clayton Fulton (Cherokee Tribe).

The secretary closed by asking tribal governments to give the department “concrete things that we can do” so the department can point to measurable accomplishments during the term. No vote or formal tribal endorsement of the announced actions was recorded during the session.

The secretary said these steps will be implemented over the coming years, with the infrastructure funding starting in fiscal 2027.