; and (2) in paragraph (1), by striking date of enactment of the Indian Health Care Improvement Reauthorization and Extension Act of 2009 and inserting date of enactment of the Stronger Engagement for Indian Health Needs Act of 2023 . (c) Authority Section 601(d)(1) of the Indian Health Care Improvement Act ( 25 U.S.C. 1661(d)(1) ) is amended in the matter before subparagraph (A), by striking Director and inserting Assistant Secretary . (d) References Section 601 of the Indian Health Care Improvement Act ( 25 U.S.C. 1661 ) is amended by adding at the end the following new subsection: (e) References Any reference to the Director of the Indian Health Service in any Federal law, Executive order, rule, regulation, or delegation of authority, or in any document of or relating to the Director of the Indian Health Service, shall be deemed to refer to the Assistant Secretary. . (e) Rate of basic pay (1) Positions at level IV Section 5315 of title 5, United States Code, is amended by striking Assistant Secretaries of Health and Human Services (6) and inserting Assistant Secretaries of Health and Human Services (7) . (2) Positions at level V Section 5316 of title 5, United States Code, is amended by striking Director, Indian Health Service, Department of Health and Human Services. .