‘‘(B) In making a determination under this 
paragraph’’. 
SEC. 105. IMPROVEMENTS IN HIRING PRACTICES. 
(a) IN GENERAL.—Title VI of the Indian Health 
Care Improvement Act (25 U.S.C. 1661 et seq.) is amend-
ed by adding at the end the following: 
‘‘SEC. 605. IMPROVEMENTS IN HIRING PRACTICES. 
‘‘(a) DIRECT HIRE AUTHORITY.—The Secretary may 
appoint, without regard to subchapter I of chapter 33 of 
title 5, United States Code (other than sections 3303 and 
3328 of such title), a candidate directly to a position with-
in the Service for which the candidate meets the qualifica-
tions standard established by the Office of Personnel Man-
agement. 
‘‘(b) TRIBAL
NOTIFICATION.—Before appointing, 
hiring, promoting, transferring, or reassigning a candidate 
to a Senior Executive Service position or the position of 
a manager at an Area office or Service unit, the Secretary 
shall provide notice to each Indian Tribe located within 
the defined geographic area of such Area office or Service 
unit, as the case may be, of the content of an inclusion 
in an employment record. Each such Indian Tribe may 
submit comment to the Secretary during the 10-day period 
after the date of such notification regarding such con-
tent.’’. 
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(b) IN GENERAL.—Subsection (c) of section 2 of the 
Act of December 15, 1979 (25 U.S.C. 5117), is amended 
by adding the following: 
‘‘(3) IHS WAIVERS.—The Secretary of Health 
and Human Services may, at the request of an In-
dian Tribe, seek from each Indian Tribe concerned, 
a waiver of Indian preference laws for a personnel 
action that is with respect to— 
‘‘(A) an Indian Health Service unit in 
which 15 percent or more of the total positions 
or specific health professionals in the Service 
unit are not filled by a full-time employee of the 
Indian Health Service for a period of 6 months 
or longer; or 
‘‘(B) a former employee of the Indian 
Health Service or a former tribal employee who 
was removed from such former employment 
within, or demoted for performance or mis-
conduct that occurred during, the 5-year period 
following the date of such personnel action.’’. 
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SEC. 106. IMPROVED AUTHORITIES OF SECRETARY TO IM-
PROVE ACCOUNTABILITY OF SENIOR EXECU-
TIVES AND EMPLOYEES OF THE INDIAN 
HEALTH SERVICE. 
(a) IN GENERAL.—Title VI of the Indian Health 
Care Improvement Act (25 U.S.C. 1661 et seq.), as 
amended by section 105, is further amended by adding 
at the end the following: 
‘‘SEC. 606. IMPROVED AUTHORITIES OF SECRETARY TO IM-
PROVE ACCOUNTABILITY OF SENIOR EXECU-
TIVES OF THE INDIAN HEALTH SERVICE. 
‘‘(a) AUTHORITY.— 
‘‘(1) IN GENERAL.—The Secretary may, as pro-
vided in this section, reprimand or suspend, involun-
tarily reassign, demote, or remove a covered indi-
vidual from a senior executive position at the Service 
if the Secretary determines that the misconduct or 
performance of the covered individual warrants such 
action. 
‘‘(2) REMOVAL FROM CIVIL SERVICE.—If the 
Secretary removes an individual pursuant to para-
graph (1), the Secretary may remove the individual 
from the civil service (as defined in section 2101 of 
title 5, United States Code). 
‘‘(b) RIGHTS AND PROCEDURES.— 
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‘‘(1) IN GENERAL.—A covered individual who is 
the subject of an action under subsection (a) is enti-
tled to— 
‘‘(A) advance notice of the action and a file 
containing all evidence in support of the pro-
posed action; 
‘‘(B) be represented by an attorney or 
other representative of the covered individual’s 
choice; and 
‘‘(C) grieve the action in accordance with 
an internal grievance process that the Secretary 
shall establish for purposes of this subsection. 
‘‘(2) NOTICE.— 
‘‘(A) AGGREGATE PERIOD FOR NOTICE.— 
The aggregate period for notice, response, and 
decision on an action under subsection (a) may 
not exceed 15 business days. 
‘‘(B) RESPONSE.—The period for the re-
sponse of a covered individual to a notice under 
paragraph (1)(A) of an action under subsection 
(a) shall be 7 business days. 
‘‘(C) DECISION.—A decision under this 
paragraph on an action under subsection (a) 
shall be issued not later than 15 business days 
after notice of the action is provided to the cov-
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ered individual under paragraph (1)(A). The 
decision shall be in writing, and shall include 
the specific reasons for the decision. 
‘‘(3) GRIEVANCE
PROCESS.—The Secretary 
shall ensure that the grievance process established 
under paragraph (1)(C) takes fewer than 21 days. 
‘‘(4) FINAL AND CONCLUSIVE DECISION.—A de-
cision under paragraph (2) that is not grieved, and 
a grievance decision under paragraph (3), shall be 
final and conclusive. 
‘‘(5) JUDICIAL REVIEW.—A covered individual 
adversely affected by a decision under paragraph (2) 
that is not grieved, or by a grievance decision under 
paragraph (3), may obtain judicial review of such 
decision. 
‘‘(6) COURT REVIEW.—In any case in which ju-
dicial review is sought under paragraph (5), the 
court shall review the record and may set aside any 
Department action found to be— 
‘‘(A) arbitrary, capricious, an abuse of dis-
cretion, or otherwise not in accordance with a 
provision of law; 
‘‘(B) obtained without procedures required 
by a provision of law having been followed; or 
‘‘(C) unsupported by substantial evidence. 
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‘‘(c) RELATION TO OTHER PROVISIONS OF LAW.— 
Section 3592(b)(1) of title 5, United States Code, does 
not apply to an action under subsection (a). 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) COVERED
INDIVIDUAL.—The term ‘cov-
ered individual’ means a career appointee (as that 
term is defined in section 3132(a) of title 5, United 
States Code). 
‘‘(2) MISCONDUCT.—The term ‘misconduct’ in-
cludes neglect of duty, malfeasance, or failure to ac-
cept a directed reassignment or to accompany a po-
sition in a transfer of function. 
‘‘(3) SECRETARY.—The term ‘Secretary’ means 
the Secretary of Health and Human Services, acting 
through the Director of the Service. 
‘‘(4) SENIOR EXECUTIVE POSITION.—The term 
‘senior executive position’ means a Senior Executive 
Service position (as that term is defined in section 
3132(a) of title 5, United States Code). 
‘‘SEC. 607. IMPROVED AUTHORITIES OF SECRETARY TO IM-
PROVE ACCOUNTABILITY OF EMPLOYEES OF 
THE INDIAN HEALTH SERVICE. 
‘‘(a) IN GENERAL.— 
‘‘(1) AUTHORITY.—The Secretary may remove, 
demote, or suspend a covered individual who is an 
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employee of the Service if the Secretary determines 
the performance or misconduct of the covered indi-
vidual warrants such removal, demotion, or suspen-
sion. 
‘‘(2) ACTIONS.—If the Secretary removes, de-
motes, or suspends a covered individual pursuant to 
paragraph (1), the Secretary may— 
‘‘(A) remove the covered individual from 
the civil service (as defined in section 2101 of 
title 5, United States Code); 
‘‘(B) demote the covered individual by 
means of a reduction in grade for which the 
covered individual is qualified, that the Sec-
retary determines is appropriate, and that re-
duces the annual rate of pay of the covered in-
dividual; or 
‘‘(C) suspend the covered individual. 
‘‘(b) PAY OF CERTAIN DEMOTED INDIVIDUALS.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of law, any covered individual subject to a 
demotion under subsection (a)(2) shall, beginning on 
the date of such demotion, receive the annual rate 
of pay applicable to such grade. 
‘‘(2) RESTRICTIONS.— 
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‘‘(A) PROHIBITION
ON
ADMINISTRATIVE 
LEAVE.—A covered individual subject to a de-
motion under subsection (a)(2) may not be 
placed on administrative leave during the period 
during which an appeal (if any) under this sec-
tion is ongoing, and may only receive pay if the 
covered individual reports for duty or is ap-
proved to use accrued unused annual, sick, fam-
ily medical, military, or court leave. 
‘‘(B) RESTRICTION
ON
PAY
AND
BENE-
FITS.—If a covered individual subject to a de-
motion under subsection (a)(2) does not report 
for duty or receive approval to use accrued un-
used leave, such covered individual shall not re-
ceive pay or other benefits pursuant to sub-
section (d)(5). 
‘‘(c) PROCEDURES.— 
‘‘(1) IN GENERAL.— 
‘‘(A) AGGREGATE PERIOD.—The aggregate 
period for notice, response, and final decision in 
a removal, demotion, or suspension under this 
section may not exceed 15 business days. 
‘‘(B) PERIOD FOR RESPONSE.—The period 
for the response of a covered individual to a no-
tice of a proposed removal, demotion, or sus-
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pension under this section shall be 7 business 
days. 
‘‘(C) REPRESENTATION BY ATTORNEY OR 
OTHER
REPRESENTATIVE.—Paragraph (3) of 
subsection (b) of section 7513 of title 5, United 
States Code, shall apply with respect to a re-
moval, demotion, or suspension under this sec-
tion. 
‘‘(D) PROCEDURES SUPERSEDING CBAS.— 
The procedures in this subsection shall super-
sede any collective bargaining agreement to the 
extent that such agreement is inconsistent with 
such procedures. 
‘‘(2) FINAL
DECISION.—The Secretary shall 
issue a final decision with respect to a removal, de-
motion, or suspension under this section not later 
than 15 business days after the Secretary provides 
notice, including a file containing all the evidence in 
support of the proposed action, to the covered indi-
vidual of the removal, demotion, or suspension. The 
decision shall be in writing and shall include the spe-
cific reasons for the decision. 
‘‘(3) PERFORMANCE
APPRAISAL.—The proce-
dures under chapter 43 of title 5, United States 
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Code, shall not apply to a removal, demotion, or sus-
pension under this section. 
‘‘(4) APPEAL TO MERIT SYSTEMS PROTECTION 
BOARD.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B) and subsection (d), any removal or 
demotion under this section, and any suspen-
sion of more than 14 days under this section, 
may be appealed to the Merit Systems Protec-
tion Board, which shall refer such appeal to an 
administrative 
judge 
pursuant 
to 
section 
7701(b)(1) of title 5, United States Code. 
‘‘(B) TIME
PERIOD.—An appeal under 
subparagraph (A) of a removal, demotion, or 
suspension may only be made if such appeal is 
made not later than 10 business days after the 
date of such removal, demotion, or suspension. 
‘‘(d) EXPEDITED REVIEW.— 
‘‘(1) IN GENERAL.—Upon receipt of an appeal 
under subsection (c)(4)(A), the administrative judge 
shall expedite any such appeal under section 
7701(b)(1) of title 5, United States Code, and, in 
any such case, shall issue a final and complete deci-
sion not later than 180 days after the date of the 
appeal. 
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‘‘(2) UPHOLDING DECISION.— 
‘‘(A) IN GENERAL.—Notwithstanding sec-
tion 7701(c)(1)(B) of title 5, United States 
Code, the administrative judge shall uphold the 
decision of the Secretary to remove, demote, or 
suspend an employee under subsection (a) if the 
decision is supported by substantial evidence. 
‘‘(B) PROHIBITION OF MITIGATION.—Not-
withstanding title 5, United States Code, or any 
other provision of law, if the decision of the 
Secretary is supported by substantial evidence, 
the administrative judge shall not mitigate the 
penalty prescribed by the Secretary. 
‘‘(3) APPEAL TO MERIT SYSTEMS PROTECTION 
BOARD.— 
‘‘(A) IN GENERAL.—The decision of the 
administrative judge under paragraph (1) may 
be appealed to the Merit Systems Protection 
Board. 
‘‘(B) 
UPHOLDING
DECISION.—Notwith-
standing section 7701(c)(1)(B) of title 5, 
United States Code, the Merit Systems Protec-
tion Board shall uphold the decision of the Sec-
retary to remove, demote, or suspend an em-
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ployee under subsection (a) if the decision is 
supported by substantial evidence. 
‘‘(C) PROHIBITION OF MITIGATION.—Not-
withstanding title 5, United States Code, or any 
other provision of law, if the decision of the 
Secretary is supported by substantial evidence, 
the Merit Systems Protection Board shall not 
mitigate the penalty prescribed by the Sec-
retary. 
‘‘(4) REPORT.—In any case in which the ad-
ministrative judge cannot issue a decision in accord-
ance with the 180-day requirement under paragraph 
(1), the Merit Systems Protection Board shall, not 
later than 14 business days after the expiration of 
the 180-day period, submit to the appropriate com-
mittees of Congress a report that explains the rea-
sons why a decision was not issued in accordance 
with such requirement. 
‘‘(5) APPEAL.—A decision of the Merit Systems 
Protection Board under paragraph (3) may be ap-
pealed to the United States Court of Appeals for the 
Federal Circuit pursuant to section 7703 of title 5, 
United States Code, or to any court of appeals of 
competent 
jurisdiction 
pursuant 
to 
subsection 
(b)(1)(B) of such section. 
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