ment of this Act using the updated authorities pro-
vided in the amendments made by this Act. 
(3) The appropriate details of removals, demo-
tions, and suspensions that lend necessary context. 
SEC. 107. TRIBAL CULTURE AND HISTORY. 
Section 113 of the Indian Health Care Improvement 
Act (25 U.S.C. 1616f) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘a program’’ and inserting 
‘‘an annual mandatory training program’’; and 
(B) by striking ‘‘appropriate employees of 
the Service’’ and inserting ‘‘employees of the 
Service, 
locum 
tenens 
medical 
providers, 
healthcare volunteers, and other contracted em-
ployees who work at Service hospitals or other 
Service units and whose employment requires 
regular direct patient access’’; and 
(2) by adding at the end the following: 
‘‘(c) Notwithstanding any other provision of law, be-
ginning with the year of the date of enactment of the Re-
storing Accountability in the Indian Health Service Act 
of 2018, each employee or provider described in subsection 
(a) who enters into a contract with the Service on or after 
the date of such implementation shall, as a condition of 
employment, annually participate in and complete such 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00036
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
training program. For purposes of the preceding sentence, 
participation in such training program may not be consid-
ered complete for the year involved until the individual 
satisfies each requirement, including testing, if applicable, 
of the training program for such year, as specified by the 
Secretary.’’. 
SEC. 108. STAFFING DEMONSTRATION PROJECT. 
Title VIII of the Indian Health Care Improvement 
Act (25 U.S.C. 1671 et seq.) is amended by adding at 
the end the following: 
‘‘SEC. 833. STAFFING DEMONSTRATION PROJECT. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Service, shall establish a demonstration project that 
authorizes the Service to provide federally managed Serv-
ice units with additional staffing resources with the goal 
that the resources become self-sustaining. 
‘‘(b) SELECTION.—In selecting Service units for par-
ticipation, the Secretary shall consider whether a Service 
unit services an Indian Tribe that— 
‘‘(1) has utilized or contributed substantial trib-
al funds to construct a health facility used by the 
Service or identified in the master plan for the Serv-
ice unit; 
‘‘(2) is located in a State or States with Med-
icaid reimbursements plans or policies that will in-
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00037
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
crease the likelihood that the staffing resources pro-
vided will be self-sustaining; and 
‘‘(3) is operating a health facility described in 
paragraph (1) under historical staffing ratios that 
have not been equalized or updated by the Service 
or any other Service program to reflect current 
staffing needs. 
‘‘(c) DURATION.—Staffing resources provided to a 
Service unit under this section shall be for a duration that 
the Secretary, in consultation with the applicable Indian 
Tribe, determines appropriate, except that each staffing 
position provided shall be for a period of not less than 
3 fiscal years. 
‘‘(d) EFFECT OF STAFFING AWARDS.—No staffing 
resources provided under this section shall reduce the re-
curring base funding for staffing for any Indian Tribe or 
federally managed Service unit. 
‘‘(e) REPORT.—Not later than 5 years after the Sec-
retary ends the demonstration project under this section, 
the Secretary shall prepare and submit a report to the 
Committee on Indian Affairs and the Committee on 
Health, Education, Labor, and Pensions of the Senate, 
and the Committee on Natural Resources and the Com-
mittee on Energy and Commerce of the House of Rep-
resentatives, regarding the project, including— 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00038
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
‘‘(1) whether the staffing resources resulted in 
additional revenue for the Service unit sufficient to 
maintain the staff on a permanent basis; 
‘‘(2) the levels to which the staffing resources 
reduced the unmet staffing need for the Service unit; 
and 
‘‘(3) whether the demonstration project could 
be deployed to reduce unmet staffing needs through-
out the Service.’’. 
SEC. 109. RULE ESTABLISHING TRIBAL CONSULTATION 
POLICY. 
Title VIII of the Indian Health Care Improvement 
Act (25 U.S.C. 1671 et seq.), as amended by section 108, 
is further amended by adding at the end the following: 
‘‘SEC. 834. RULE ESTABLISHING TRIBAL CONSULTATION 
POLICY. 
‘‘(a) IN GENERAL.—Not later than 1 year after the 
date of enactment of the Restoring Accountability in the 
Indian Health Service Act of 2018, the Secretary shall es-
tablish, after meaningful consultation with representatives 
of affected Indian Tribes, a rule establishing a tribal con-
sultation policy for the Service. 
‘‘(b) CONTENTS
OF TRIBAL CONSULTATION POL-
ICY.—The policy established under the rule described in 
subsection (a) shall— 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00039
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
‘‘(1) update, and replace, the tribal consultation 
policy established under Circular No. 2006–01 of the 
Service, or any successor policy; and 
‘‘(2) include the following: 
‘‘(A) A process for determining when the 
Service will notify Indian Tribes, and a descrip-
tion of how the Indian Tribes should be noti-
fied. 
‘‘(B) A determination of what actions or 
agency decisions by the Service will trigger a re-
quirement for meaningful consultation with In-
dian Tribes. 
‘‘(C) A determination of what actions con-
stitute meaningful consultation with Indian 
Tribes.’’. 
SEC. 110. TREATMENT OF CERTAIN HOSPITALS. 
The ‘‘Parallel Low-Volume Hospital Payment Adjust-
ment Regarding Hospitals Operated by the Indian Health 
Services (IHS) or a Tribe’’ provisions described in the 
final rule published by the Centers for Medicare & Med-
icaid Services in the Federal Register on August 14, 2017, 
and entitled ‘‘Medicare Program; Hospital Inpatient Pro-
spective Payment Systems for Acute Care Hospitals and 
the Long-Term Care Hospital Prospective Payment Sys-
tem and Policy Changes and Fiscal Year 2018 Rates; 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00040
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
Quality Reporting Requirements for Specific Providers; 
Medicare and Medicaid Electronic Health Record (EHR) 
Incentive Program Requirements for Eligible Hospitals, 
Critical Access Hospitals, and Eligible Professionals; Pro-
vider-Based Status of Indian Health Service and Tribal 
Facilities and Organizations; Costs Reporting and Pro-
vider Requirements; Agreement Termination Notices’’ (82 
Fed Reg. 37990; 38188–38189), shall apply with respect 
to discharges occurring in fiscal year 2011 and subsequent 
fiscal years. 
TITLE II—EMPLOYEE 
PROTECTIONS 
SEC. 201. EMPLOYEE PROTECTIONS AGAINST RETALIA-
TION. 
(a) IN GENERAL.—Title VI of the Indian Health 
Care Improvement Act (25 U.S.C. 1661 et seq.), as 
amended by sections 105 and 106, is further amended by 
adding at the end the following: 
‘‘SEC. 608. EMPLOYEE PROTECTIONS AGAINST RETALIA-
TION. 
‘‘(a) EMPLOYEE ACCOUNTABILITY.— 
‘‘(1) AGENCY
REPORTING
PROCESS
REQUIRE-
MENT.—The Secretary shall designate an official in 
the Department who is not an employee of the Serv-
ice to— 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00041
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
‘‘(A) receive reports from an employee of 
the Service who witnesses retaliation against a 
whistleblower, a violation of a patient safety re-
quirement, or other similar conduct; and 
‘‘(B) conduct active and ongoing outreach 
to all employees of the Service about— 
‘‘(i) Federal and Department systems 
for reporting retaliation against whistle-
blowers; and 
‘‘(ii) the duty of individual employees 
of the Service to report violations of pa-
tient safety requirements and other similar 
conduct. 
‘‘(2) OVERSIGHT.—Not later than 3 days after 
the date on which the official designated by the Sec-
retary under paragraph (1) receives a report under 
paragraph (1)(A), the Secretary shall— 
‘‘(A) formally review the report; and 
‘‘(B) provide a copy of such report and any 
other relevant information to the Inspector 
General of the Department. 
‘‘(3) REMOVAL FOR WHISTLEBLOWER RETALIA-
TION.—The Secretary may remove for misconduct 
from the civil service (as defined in section 2101 of 
title 5, United States Code), in accordance with sec-
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00042
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
tions 606 and 607, an employee of the Service if the 
Secretary determines, after completing a report re-
view described in paragraph (2), that the employee 
has retaliated against a whistleblower and warrants 
removal. 
‘‘(4) ENHANCING PROTECTIONS FOR WHISTLE-
BLOWERS.—The Secretary shall carry out any ac-
tions determined necessary by the Secretary to en-
hance protection for whistleblowers, including identi-
fying appropriate Service employees and requiring 
the employees to complete the Office of Special 
Counsel’s Whistleblower Certification Program. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) RETALIATION.—The term ‘retaliation’— 
‘‘(A) means an adverse employment action 
or any significantly adverse action against a 
whistleblower, such as the refusal or delay of 
care provided through the Service; and 
‘‘(B) includes instances where the adverse 
action described in subparagraph (A) is per-
petrated against a family member or friend of 
the whistleblower because of the whistleblower’s 
disclosure of information. 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00043
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
‘‘(2) WHISTLEBLOWER.—The term ‘whistle-
blower’ means an employee of Service who discloses 
information— 
‘‘(A) that the employee reasonably believes 
evidences— 
‘‘(i) a violation of any law, rule, or 
regulation; or 
‘‘(ii) gross mismanagement, a gross 
waste of funds, an abuse of authority, or 
a substantial and specific danger to public 
health or safety; and 
‘‘(B) if such disclosure is not specifically 
prohibited by law and if such information is not 
specifically required by Executive Order to be 
kept secret in the interest of national defense or 
the conduct of foreign affairs.’’. 
SEC. 202. RIGHT OF FEDERAL EMPLOYEES TO PETITION 
CONGRESS. 
(a) ADVERSE ACTION FOR VIOLATION OF RIGHT TO 
PETITION CONGRESS.—Section 7211 of title 5, United 
States Code, is amended— 
(1) by striking ‘‘The right of’’ and inserting 
‘‘(a) IN GENERAL.—The right of’’; and 
(2) by adding at the end the following new sub-
section: 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00044
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS
‘‘(b) ADVERSE ACTION.—An employee who interferes 
with or denies a right protected under subsection (a) shall 
be subject to any adverse action described in paragraphs 
(1) through (5) of section 7512, in accordance with the 
procedure described in section 7513 and any other appli-
cable procedure.’’. 
(b) ELECTRONIC NOTIFICATION OF RIGHT OF EM-
PLOYEES OF INDIAN HEALTH SERVICE.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this subsection as 
the ‘‘Secretary’’), acting through the Director of the 
Indian Health Service, shall, in accordance with 
paragraphs (2) through (6), provide to each em-
ployee of the Indian Health Service, and electroni-
cally post, a memorandum providing notice of the 
right to petition Congress under section 7211 of title 
5, United States Code. 
(2) CONTENTS.—The memorandum described 
in paragraph (1) shall include the following state-
ment: ‘‘It is a violation of section 7211 of title 5, 
United States Code, for any Federal agency or em-
ployee to require a Federal employee to seek ap-
proval, guidance, or any other form of input prior to 
contacting Congress with information, even if that 
information is in relation to the job responsibilities 
VerDate Sep 11 2014 
23:41 Jun 01, 2018
Jkt 079200
PO 00000
Frm 00045
Fmt 6652
Sfmt 6201
E:\BILLS\H5874.IH
H5874
pbinns on DSK79D2C42PROD with BILLS