Sec. 203. Fiscal accountability
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Title VI of the Indian Health Care Improvement Act ( 25 U.S.C. 1661 et seq. ) (as amended by section 201) is amended by adding at the end the following: If the Secretary fails to submit a professional housing plan under section 302(a) of the Restoring Accountability in the Indian Health Service Act of 2023 or a staffing plan under section 302(b) of that Act by the applicable deadline, the Secretary may not receive, obligate, transfer, or expend any amounts for a salary increase or bonus of an individual described in paragraph
(2)until the professional housing plan or staffing plan, as applicable, is submitted. An individual referred to in paragraph
(1)is an individual employed in the Service— in a position that is— described in any of sections 5312 through 5316 of title 5, United States Code; placed in level IV or V of the Executive Schedule under section 5317 of title 5, United States Code; or described in section 213.3301 or 213.3302 of title 5, Code of Federal Regulations (or a successor regulation); or as a limited term appointee, limited emergency appointee, or noncareer appointee (as those terms are defined in section 3132(a) of title 5, United States Code). The Secretary shall use amounts available to the Service that are not obligated or expended, including base budget funding and third party collections, during the fiscal years for which the amounts are made available, and that remain available, and in keeping with the purpose for which the funds were appropriated, only to support patient care by using the funds for— the costs of— essential medical equipment; purchased or referred care; or staffing; or any other costs necessary to improve or maintain quality of care and patient safety. In using amounts under paragraph (1), the Secretary shall ensure that, in any case where the amounts were originally made available for a particular Service unit, the amounts are used to benefit Indians served by that Service unit. Each applicable fiscal year, the Secretary, in consultation with Indian tribes, shall establish a plan for distributing the amounts described in paragraph
(1)across the categories of uses described in subparagraphs
(A)through
(C)of that paragraph. The Secretary may not use amounts described in paragraph (1)— to remodel or interior decorate any Area office; or to increase the rate of pay of any employee of an Area office. Not later than 90 days after the end of each fiscal year, the Secretary shall submit a report describing the authorizations, expenditures, outlays, transfers, reprogramming, and obligations of each level of the Service, including the headquarters, each Area office, each Service unit, and each health clinic or facility, to— each Indian tribe; in the Senate— the Committee on Indian Affairs; the Committee on Health, Education, Labor, and Pensions; the Committee on Appropriations; and the Committee on the Budget; and in the House of Representatives— the Committee on Natural Resources; the Committee on Energy and Commerce; the Committee on Appropriations; and the Committee on the Budget. The purpose of the report described in paragraph
(2)is to identify the certification and accreditation status of each facility operated by the Service, Indian tribes, tribal organizations, and Urban Indian organizations. Subject to paragraph (3), not later than 180 days after the end of each fiscal year, the Secretary shall provide to each entity described in paragraphs
(1)through
(3)of subsection
(c)a report describing the safety, billing, certification, credential, and compliance statuses of each facility managed, operated, or otherwise supported by the Service. With respect to any change of a status described in paragraph (2), the Secretary shall immediately provide to each entity described in paragraphs
(1)through
(3)of subsection
(c)an update describing the change. Nothing in this section— negatively impacts the right of an Indian tribe to enter into a compact or contract under the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5301 et seq. ); or applies to such a compact or contract unless expressly agreed to by the Indian tribe. .
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