; (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 throughout the Service. . 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: 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 establish, after meaningful consultation with representatives of affected Indian Tribes, a rule establishing a tribal consultation policy for the Service. (b) Contents of tribal consultation policy The policy established under the rule described in subsection (a) shall— (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 description of how the Indian Tribes should be notified. (B) A determination of what actions or agency decisions by the Service will trigger a requirement for meaningful consultation with Indian Tribes. (C) A determination of what actions constitute meaningful consultation with Indian Tribes. . 110. Treatment of certain hospitals The Parallel Low-Volume Hospital Payment Adjustment Regarding Hospitals Operated by the Indian Health Services (IHS) or a Tribe provisions described in the final rule published by the Centers for Medicare & Medicaid Services in the Federal Register on August 14, 2017, and entitled Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers