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Proposed, not yet in effect. IHS announced the realignment to Tribal and Urban Indian Organization leaders on December 5, 2025 and is consulting on it. It would take legal effect only when IHS publishes a Statement of Organization, Functions, and Delegations of Authority (Part G) in the Federal Register. As of June 2, 2026, that notice has not published.
IHS has not yet published an office-by-office map showing how each existing Headquarters office moves into the new Divisions. Because of that, a small number of office placements in the underlying data are marked as inferred and should be read as provisional until the Federal Register notice publishes. The Organization Chart tab flags those offices individually.
[IHS Realignment consultation] [Executive Narrative, Dec 4, 2025]
IHS delivers care through 12 geographic Area Offices (Alaska, Albuquerque, Bemidji, Billings, California, Great Plains, Nashville, Navajo, Oklahoma City, Phoenix, Portland, and Tucson). Each Area Office oversees local Service Units, and Headquarters offices are based in Rockville, Maryland. [IHS Indian Health Manual org charts] [Federal Register, Part G, 2018]
The plan reorganizes Headquarters and the Area Offices into a restructured Office of the Director plus three Divisions. Functions at hospitals, clinics, and residential treatment centers stay the same; the changes are at the Headquarters and Area level. [Draft organization chart]
A December 17, 2025 reporting chart shows Area Directors reporting through the Deputy Director for Field Operations to the Deputy Director and then the Director. That document notes that it is a reporting guide rather than a formal organization chart. [Reporting Relationships, Dec 17, 2025]
Under the proposal, the Area Offices become Area Tribal Relations Offices, the local point of contact for government to government relations, and there would be 11 of them because the Tucson Area Office would merge with the Phoenix Area Office. Functions tied to self-determination contracting and compacting under the Indian Self-Determination and Education Assistance Act (Title I and Title V) are consolidated, including a new Office of Agency Negotiations. IHS states that the realignment preserves Tribal Shares, is budget neutral, and does not reduce staff. [Executive Narrative, Key Items]
IHS describes three goals for the change: strengthen patient-centered care, advance Tribal self-determination through the ISDEAA, and modernize the agency's enterprise (business) services. [Executive Narrative]
This summary is one part of a larger analysis of HHS structure and funding.
The Organization Chart reads left to right. The Indian Health Service is on the left, and each step to the right is one level deeper. Branches start closed; the number on an office is how many offices sit directly under it. Click an office to open it and to read its details on the right, including whether the proposed reorganization could affect it and its official description from the federal source. The chart shows full-size, readable text and scrolls; use Fit width or the zoom buttons if you prefer. The small map in the corner always shows where you are.
331 IHS offices and positions: 305 in the enacted current structure (levels 3 to 8) and 26 in the proposed realignment. 263 offices cite a controlling Federal Register Part G entry; the rest cite the agency organization charts or the realignment consultation materials. Official descriptions are quoted from the federal sources where available.