Organizational chart for the Indian Health Service. Source: Fiscal Year 2017 Budget Justification

The Indian Health Service faces recruitment and retention challenges, officials said at a hearing on Capitol Hill last week, a situation that extends to the agency's leadership positions.

Six of the 12 area offices are led by directors in an "acting" capacity, according to a budget justification document released on Tuesday. The list includes the Albuquerque, Billings, Great Plains, Navajo, Oklahoma City and Phoenix regions, which collectively serve the overwhelming majority of tribal members.

But the leadership void doesn't stop there. According to the agency's organizational chart, five of the eight senior office directors at the IHS headquarters in Rockville, Maryland, are held by people in "acting" capacities.

The IHS itself is being led by principal deputy director Robert McSwain, a member of the North Fork Rancheria of Mono Indians, rather than a director following the departure of Yvette Roubideaux exactly a year ago. With less than a year left in the administration of President Barack Obama, the situation isn't likely to change until 2017, when his successor comes on board.

The IHS employs more than 15,000 people, including 2,504 nurses, 737 physicians, 462 engineers, 132 sanitarians, 747 pharmacists, and 271 dentists, according to the budget justification.

FY2017 Indian Health Service Budget Documents:
Budget Request | Budget Justification | HHS Budget In Brief

Related Stories:
Obama seeks another increase for Indian Health Service budget (2/10)
Kristi Noem: Indian Health Service remains in state of emergency (2/10)
Tribal leaders question management changes at IHS in Great Plains (02/04)
IHS chief medical officer apologizes for comments about newborns (02/04)
Indian Health Service makes changes ahead of big Senate hearing (02/03)
Witness list for Senate Indian Affairs Committee hearing into IHS (02/01)
Inspections of IHS facilities in Great Plains turn up big problems (1/28)
Senate committee reschedules IHS hearing and listening session (01/25)
Senate Indian Affairs Committee expands look at substandard IHS (1/22)
Senate Indian Affairs Committee to look at 'substandard' care at IHS in Great Plains (01/12)
Mary Annette Pember: Native women affected by cutbacks at IHS (12/29)
Lakota Country Times: IHS restricts care at Rosebud hospital (12/24)
Nebraska tribes recognized for efforts to hold IHS accountable (09/24)
Tribes in Nebraska demand resignations of senior IHS officials (08/12)
Winnebago Tribe upset with IHS over loss of funds at hospital (8/6)
Winnebago Tribe looking to address deficiencies at IHS hospital (08/05)
Winnebago Tribe hopes to prevent Medicare cutoff at hospital (5/28)