81 FR 20388 - Notice of the Redesignation of the Service Delivery Area for the Wampanoag Tribe of Gay Head (Aquinnah)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service Federal Register Volume 81, Issue 67 (April 7, 2016)
Indian Health Service
Federal Register Volume 81, Issue 67 (April 7, 2016)
| Page Range | 20388-20395 | |
| FR Document | 2016-07951 |
[Federal Register Volume 81, Number 67 (Thursday, April 7, 2016)] [Notices] [Pages 20388-20395] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-07951] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Notice of the Redesignation of the Service Delivery Area for the Wampanoag Tribe of Gay Head (Aquinnah) AGENCY: Indian Health Service. ACTION: Final notice. ----------------------------------------------------------------------- SUMMARY: This final notice advises the public that the Indian Health Service (IHS) has decided to expand the geographic boundaries of the Purchased/Referred Care (PRC) service delivery area for the Wampanoag Tribe of Gay Head (Aquinnah) of Massachusetts pursuant to 42 CFR 136.22. The Aquinnah service delivery area previously covered Martha's Vineyard, Dukes County in the State of Massachusetts. The expanded service delivery area includes counties of Barnstable, Bristol, Norfolk, Plymouth, Suffolk, and Dukes Counties in the State of Massachusetts. The sole purpose of this expansion is to authorize Aquinnah to cover additional tribal members and beneficiaries under Aquinnah's PRC program using the existing Federal allocation for PRC funds. DATES: The effective date of expansion will be 60 days from the date of this notice. FOR FURTHER INFORMATION CONTACT: Terri Schmidt, Acting Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mailstop 10E85C, Rockville, Maryland 20857. Telephone (301) 443-2694 (This is not a toll free number). Background: The Indian Health Service (IHS) currently provides services under regulations codified at 42 CFR part 136, subparts A through C. Subpart C defines a Contract Health Service Delivery Area (CHSDA), now referred to as a Purchased/Referred Care (PRC) service delivery area, as the geographic area within which PRC will be made available by the IHS to members of an identified Indian community who reside in the area. Residence in a PRC service delivery area by a person who is within the scope of the Indian health program, as set forth in 42 CFR 136.12, creates no legal entitlement to PRC but only potential eligibility for services. Services needed but not available at an IHS/Tribal facility are provided under the PRC program depending on the availability of funds, the person's relative medical priority, and the actual availability and accessibility of alternate resources in accordance with the regulations. As applicable to the Tribes, these regulations provide that, unless otherwise designated, a PRC service delivery area shall consist of a county which includes all or part of a reservation and any county or counties which have a common boundary with the reservation. 42 CFR 136.22(a)(6). The regulations also provide that after consultation with the Tribal governing body or bodies on those reservations included within the PRC service delivery area, the Secretary may from time to time, redesignate areas within the United States for inclusion in or exclusion from a PRC service delivery area. The regulations require that certain criteria must be considered before any redesignation is made. The criteria are as follows: (1) The number of Indians residing in the area proposed to be so included or excluded; (2) Whether the Tribal governing body has determined that Indians residing in the area near the reservation are socially and economically affiliated with the tribe; (3) The geographic proximity to the reservation of the area whose inclusion or exclusion is being considered; and (4) The level of funding which would be available for the provision of PRC. Additionally, the regulations require that any redesignation of a PRC service delivery area must be made in accordance with the Administrative Procedures Act (5 U.S.C. 553). In compliance with this requirement, IHS published a proposed notice of redesignation and requested public comments on August 24, 2015 (80 FR 51281). Aquinnah requested that IHS expand the Aquinnah service delivery area to include Barnstable, Bristol, Norfolk, Plymouth and Suffolk Counties in the State of Massachusetts. In support of this expansion, IHS adopts the following findings of the Aquinnah Tribe: (1) By expanding, the Tribe's estimated current eligible population will be increased by 268. (2) The Tribe has determined these 268 individuals are socially and economically affiliated with the Tribe. (3) The expanded area including Barnstable, Bristol, Norfolk, Plymouth, and Suffolk Counties in the State of Massachusetts are across the Bay from Martha's Vineyard, Dukes County, Massachusetts. (4) The Tribal members located in these counties currently do not use the Indian health system for their health care needs. Aquinnah will use its existing Federal allocation for PRC funds to provide services to the expanded population. No additional financial resources will be allocated by IHS to Aquinnah to provide services to its members residing in these counties nor should this expansion be construed to have any present or future effect on the allocation of resources between the Mashpee Wampanoag Tribe and Aquinnah. Public Comments: The Agency only received comments from the Mashpee Wampanoag Tribe (Mashpee). Mashpee incorporated several letters into its submission. Through these comments [[Page 20389]] and letters, Mashpee indicated that it does not support the proposed redesignation and articulated several objections to the expansion, which IHS addresses below: Comment: IHS has failed to meet its legal requirement to meaningfully consult with the Mashpee Tribe as the only other Tribal governing body within the proposed redesignated SDA in accordance with 42 CFR 136.22(b). Response: IHS disagrees. IHS consulted with the Mashpee Tribe regarding this proposed expansion. As Mashpee noted in its own submission, IHS engaged in government-to-government discussions and correspondence on this issue. IHS provided its answers to the Mashpee Tribe's questions in a letter from Deputy Director McSwain to Mashpee Chairman Cromwell, dated October 5, 2015. While Mashpee questions the adequacy of IHS's answers, they nonetheless demonstrate that IHS has engaged in meaningful consultation with Mashpee with respect to this expansion. Additionally, the opportunity to submit comments on a proposed notice is a form of consultation. IHS recognizes that Mashpee has concerns with the expansion and does not support the IHS decisions in this regard. IHS is not required, after consultation with a Tribe, to adopt the specific position of the Mashpee Tribe. Comment: IHS has no legal authority to contravene the clear legal mandate of the Wampanoag Tribal Council of Gay Head, Inc., Indian Claims Settlement Act of 1987. Response: IHS agrees with the Mashpee Tribe that the Agency cannot contravene the Settlement Act, but the Agency does not believe the expansion is prohibited by the Settlement Act. It is HHS's understanding that the Settlement Act is not implemented by Department of the Interior (DOI) as a limitation for DOI programs and services. Accordingly, after conferring with DOI regarding its position, IHS has decided to revisit the expansion issue. The establishment of PRC service delivery areas is an administrative function of IHS, governed by the regulations at 42 CFR 136.22. Historically, IHS has established service delivery areas in accordance with our understanding of Congressional intent, for example as evidenced by geographically designated areas identified in settlement acts, such as Public Law 100- 95. IHS does not intend to abandon that practice. Under PRC regulations, however, IHS has preserved flexibility to redesignate areas as appropriate for inclusion in or exclusion from PRC service delivery. One of the criteria for such redesignations is the geographic proximity of the expanded area to the existing reservation or service delivery area. In the few circumstances where it has arisen, IHS has aligned geographic proximity with Congressional findings of ``on or near''. Here, IHS proposed to expand a PRC delivery area beyond the geographic description of ``on or near'' that Congress set forth in a settlement or recognition act. IHS offered stakeholders the opportunity to comment on the departure from historic practice by issuing a notice of proposed expansion prior to issuing a final notice to ascertain whether the departure is disruptive to tribes that have previously relied on IHS's historic practice. IHS did not receive comments that identify a detrimental reliance interest. Accordingly, when considering the geographic proximity of the proposed expansion area under 42 CFR 136.22 to the existing reservation (or service delivery area), IHS will no longer rigidly apply a Congressional finding of ``on or near'' as prohibiting PRC delivery area expansion in considering expansion requests. Although this is a change in the implementation of the redesignation authority found at 42 CFR 136.22, no change is necessary to the text of the regulation itself. In making this change, however, IHS notes that Congress has, at times, statutorily enacted PRC service delivery areas for some tribes or for entire States. See, e.g. 25 U.S.C. 1678 (designating the entire State of Arizona). Those enactments may limit changes in PRC delivery area boundaries in some circumstances. Congress did not specifically establish a PRC service delivery area for Aquinnah in the Settlement Act; IHS administratively established this area through its regulations. While IHS chose to establish and limit the Aquinnah PRC service delivery area consistent with the language of the Act, in keeping with our current understanding of DOI practices, the language of the Act does not have to be read as preventing IHS from exercising its administrative discretion to expand or reduce that initially established area going forward. Indeed, IHS has already interpreted its authority to permit the establishment of PRC service delivery areas that go beyond what may otherwise be considered ``on or near'' a reservation. For example, IHS has administratively designated entire states as PRC service delivery areas, even though all parts of such states were not necessarily ``on or near'' a reservation. Nor does there appear to be any legislative history of the Act that would suggest that Congress intended the language of Section 1771 to be a limitation on IHS programs or administrative flexibility. There is also no evidence to suggest that Congress intended to limit eligibility for PRC services. Unless IHS administratively expands the PRC service delivery, however, Aquinnah cannot cover hundreds of its tribal members under PRC. IHS has therefore revisited Aquinnah's request and believes that unique circumstances are present that warrant expanding the Aquinnah PRC service delivery area beyond the general geographic area identified by Congress in Public Law 100-95 as ``on or near''. These unique circumstances include the factors identified by the BIA in recognizing the Aquinnah prior to the enactment of Public Law 100-95, BIA's understanding of the settlement language, and Dukes County's status as an island and the significant number of Aquinnah's members who reside permanently off of the island and continue to maintain close economic and social ties with the Aquinnah. The BIA recognized the Aquinnah Tribe as an Indian Tribe eligible for Federal benefits on February 10, 1987, pursuant to a notice published in the Federal Register. See 52 FR 4193. As part of its findings, BIA concluded ``that the [Aquinnah] have an extensive and interrelated communication network connecting those Wampanoag members in Gay Head and elsewhere on Martha's Vineyard with each other and with those members living off-island.'' The BIA further concluded that the Tribal government ``maintained political influence and/or authority over both its resident and non-resident members.'' Aquinnah has a significant number of members who are not residents of Dukes County. According to Aquinnah's estimates, 268 enrolled Aquinnah members are non-residents who remain actively involved with the Tribe, reside in Barnstable, Bristol, Norfolk, Plymouth and Suffolk Counties and are not currently eligible for PRC care. Aquinnah provides limited direct services to its Tribal members by operating a small clinic in Dukes County that is open once or twice a month. To access direct care services, non-residents must travel over one and a half hours via ferry and car to receive the health care offered at the clinic. As a consequence, most non-residents do not seek care on the island. Comment: The Mashpee tribe commented that the publication of the notice is arbitrary, capricious, and contrary to law. Response: IHS disagrees. IHS's decision to publish a notice of the intention to expand the Aquinnah PRC [[Page 20390]] service delivery area was not arbitrary, capricious, or contrary to law. IHS rules expressly authorize IHS to expand a PRC service delivery area through a notice issued pursuant to the Administrative Procedures Act (5 U.S.C. 553) and that process has been followed here. IHS is implementing a change in the way it reviews PRC delivery expansion requests, but that change is fully consistent with the existing language in the rules. Comment: 42 CFR 136.22(a)(6) provides that ``the [CHSDA] shall consist of a county which includes all or part of a reservation, and any county or counties which have a common boundary with the reservation.'' As explained in the 2011 Declination Letter, ``since the county is coextensive with the Atlantic Ocean island of Martha's Vineyard, there is no adjacent county to consider for inclusion in the CHSDA.'' Response: The comment references the starting point for establishing a PRC service delivery area. As noted above, IHS retains the administrative discretion to redesignate PRC service delivery areas after they are initially designated. The criteria for expansion requires IHS to consider geographic proximity, but it does not require IHS to limit expansion to adjacent counties. Purchased/Referred Care Service Delivery Areas and Service Delivery Areas ------------------------------------------------------------------------ Tribe/Reservation County/State ------------------------------------------------------------------------ Ak Chin Indian Community of the Pinal, AZ. Maricopa (Ak Chin) Indian Reservation, Arizona. Alabama-Coushatta Tribes of Texas...... Polk, TX.\1\ Alaska................................. Entire State.\2\ Arapahoe Tribe of the Wind River Hot Springs, WY, Fremont, WY, Reservation, Wyoming. Sublette, WY. Aroostook Band of Micmacs.............. Aroostook, ME.\3\ Assiniboine and Sioux Tribes of the Daniels, MT, McCone, MT, Fort Peck Indian Reservation, Montana. Richland, MT, Roosevelt, MT, Sheridan, MT, Valley, MT. Bad River Band of the Lake Superior Ashland, WI, Iron, WI. Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin. Bay Mills Indian Community, Michigan... Chippewa, MI. Blackfeet Tribe of the Blackfeet Indian Glacier, MT, Pondera, MT. Reservation of Montana. Brigham City Intermountain School (\4\) Health Center, Utah. Burns Paiute Tribe..................... Harney, OR. California............................. Entire State, except for the counties listed in the footnote.\5\ Catawba Indian Nation.................. All Counties in SC \6\, Cabarrus, NC, Cleveland, NC, Gaston, NC, Mecklenburg, NC, Rutherford, NC, Union, NC. Cayuga Nation.......................... Allegany, NY \7\, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA. Cheyenne River Sioux Tribe of the Corson, SD, Dewey, SD, Haakon, Cheyenne River Reservation, South SD, Meade, SD, Perkins, SD, Dakota. Potter, SD, Stanley, SD, Sully, SD, Walworth, SD, Ziebach, SD. Chippewa-Cree Indians of the Rocky Chouteau, MT, Hill, MT, Boy's Reservation, Montana. Liberty, MT. Chitimacha Tribe of Louisiana.......... St. Mary Parish, LA. Cocopah Tribe of Arizona............... Yuma, AZ, Imperial, CA. Coeur D'Alene Tribe.................... Benewah, ID, Kootenai, ID, Latah, ID, Spokane, WA, Whitman, WA. Colorado River Indian Tribes of the La Paz, AZ, Riverside, CA, San Colorado River Indian Reservation, Bernardino, CA, Yuma, AZ. Arizona and California. Confederated Salish and Kootenai Tribes Flathead, MT, Lake, MT, of the Flathead Reservation. Missoula, MT, Sanders, MT. Confederated Tribes and Bands of the Klickitat, WA, Lewis, WA, Yakama Nation. Skamania, WA \8\, Yakima, WA. Confederated Tribes of Siletz Indians Benton, OR \9\, Clackamas, OR, of Oregon. Lane, OR, Lincoln, OR, Linn, OR, Marion, OR, Multnomah, OR, Polk, OR, Tillamook, OR, Washington, OR, Yam Hill, OR. Confederated Tribes of the Chehalis Grays Harbor, WA, Lewis, WA, Reservation. Thurston, WA. Confederated Tribes of the Colville Chelan, WA \10\, Douglas, WA, Reservation, Washington. Ferry, WA, Grant, WA, Lincoln, WA, Okanogan, WA, Stevens, WA. Confederated Tribes of the Coos, Lower Coos, OR \11\, Curry, OR, Umpqua and Siuslaw Indians. Douglas, OR, Lane, OR, Lincoln, OR. Confederated Tribes of the Goshute Nevada, Juab, UT, Toole, UT. Reservation, Nevada and Utah. Confederated Tribes of the Grand Ronde Polk, OR \12\, Washington, OR, Community of Oregon. Marion, OR, Yamhill, OR, Tillamook, OR, Multnomah, OR. Confederated Tribes of the Umatilla Umatilla, OR, Union, OR. Indian Reservation. Confederated Tribes of the Warm Springs Clackamas, OR, Jefferson, OR, Reservation of Oregon. Linn, OR, Marion, OR, Wasco, OR. Coquille Indian Tribe.................. Coos, OR, Curry, OR, Douglas, OR, Jackson, OR, Lane, OR. Coushatta Tribe of Louisiana........... Allen Parish, LA, Elton, LA.\13\ Cow Creek Band of Umpqua Tribe of Coos, OR \14\, Deshutes, OR, Indians. Douglas, OR, Jackson, OR, Josephine, OR, Klamath, OR, Lane, OR. Cowlitz Indian Tribe................... Clark, WA, Cowlitz, WA, King, WA, Lewis, WA, Pierce, WA, Skamania, WA, Thurston, WA, Columbia, OR \15\, Kittitas, WA, Wahkiakum, WA. Crow Creek Sioux Tribe of the Crow Brule, SD, Buffalo, SD, Hand, Creek Reservation, South Dakota. SD, Hughes, SD, Hyde, SD, Lyman, SD, Stanley, SD. Crow Tribe of Montana.................. Big Horn, MT, Carbon, MT, Treasure, MT \16\, Yellowstone, MT, Big Horn, WY, Sheridan, WY. Eastern Band of Cherokee Indians....... Cherokee, NC, Graham, NC, Haywood, NC, Jackson, NC, Swain, NC. Flandreau Santee Sioux Tribe of South Moody, SD. Dakota. Forest County Potawatomi Community, Forest, WI, Marinette, WI, Wisconsin. Oconto, WI. Fort Belknap Indian Community of the Blaine, MT, Phillips, MT. Fort Belknap Reservation of Montana. [[Page 20391]] Fort McDermitt Paiute and Shoshone Nevada, Malheur, OR. Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon. Fort McDowell Yavapai Nation, Arizona.. Maricopa, AZ. Fort Mojave Indian Tribe of Arizona, Nevada, Mohave, AZ, San California and Nevada. Bernardino, CA. Gila River Indian Community of the Gila Maricopa, AZ, Pinal, AZ. River Indian Reservation, Arizona. Grand Traverse Band of Ottawa and Antrim, MI \17\, Benzie, MI, Chippewa Indians, Michigan. Charlevoix, MI, Grand Traverse, MI, Leelanau, MI, Manistee, MI. Hannahville Indian Community, Michigan. Delta, MI, Menominee, MI. Haskell Indian Health Center........... Douglas, KS.\18\ Havasupai Tribe of the Havasupai Coconino, AZ. Reservation, Arizona. Ho-Chunk Nation of Wisconsin........... Adams, WI \19\, Clark, WI, Columbia, WI, Crawford, WI, Dane, WI, Eau Claire, WI, Houston, MN, Jackson, WI, Juneau, WI, La Crosse, WI, Marathon, WI, Monroe, WI, Sauk, WI, Shawano, WI, Vernon, WI, Wood, WI. Hoh Indian Tribe....................... Jefferson, WA. Hopi Tribe of Arizona.................. Apache, AZ, Coconino, AZ, Navajo, AZ. Houlton Band of Maliseet Indians....... Aroostook, ME.\20\ Hualapai Indian Tribe of the Hualapai Coconino, AZ, Mohave, AZ, Indian Reservation, Arizona. Yavapai, AZ. Iowa Tribe of Kansas and Nebraska...... Brown, KS, Doniphan, KS, Richardson, NE. Jamestown S'Klallam Tribe.............. Clallam, WA, Jefferson, WA. Jena Band of Choctaw Indians........... Grand Parish, LA \21\, LaSalle Parish, LA, Rapides Parish, LA. Jicarilla Apache Nation, New Mexico.... Archuleta, CO, Rio Arriba, NM, Sandoval, NM. Kaibab Band of Paiute Indians of the Coconino, AZ, Mohave, AZ, Kane, Kaibab Indian Reservation, Arizona. UT. Kalispel Indian Community of the Pend Oreille, WA, Spokane, WA. Kalispel Reservation. Kewa Pueblo, New Mexico................ Sandoval, NM, Santa Fe, NM. Keweenaw Bay Indian Community, Michigan Baraga, MI, Houghton, MI, Ontonagon, MI. Kickapoo Traditional Tribe of Texas.... Maverick, TX.\22\ Kickapoo Tribe of Indians of the Brown, KS, Jackson, KS. Kickapoo Reservation in Kansas. Klamath Tribes......................... Klamath, OR.\23\ Koi Nation of Northern California Lake, CA, Sonoma, CA.\24\ (formerly known as Lower Lake Rancheria, California). Kootenai Tribe of Idaho................ Boundary, ID. Lac Courte Oreilles Band of Lake Sawyer, WI. Superior Chippewa Indians of Wisconsin. Lac du Flambeau Band of Lake Superior Iron, WI, Oneida, WI, Vilas, Chippewa Indians of the Lac du WI. Flambeau Reservation of Wisconsin.. Lac Vieux Desert Band of Lake Superior Gogebic, MI. Chippewa Indians of Michigan. Little River Band of Ottawa Indians, Kent, MI \25\, Muskegon, MI, Michigan. Newaygo, MI, Oceana, MI, Ottawa, MI, Manistee, MI, Mason, MI, Wexford, MI, Lake, MI. Little Traverse Bay Bands of Odawa Alcona, MI \25\, Alger, MI, Indians, Michigan. Alpena, MI, Antrim, MI, Benzie, MI, Charlevoix, MI, Cheboygan, MI, Chippewa, MI, Crawford, MI, Delta, MI, Emmet, MI, Grand Traverse, MI, Iosco, MI, Kalkaska, MI, Leelanau, MI, Luce, MI, Mackinac, MI, Manistee, MI, Missaukee, MI, Montmorency, MI, Ogemaw, MI, Oscoda, MI, Otsego, MI, Presque Isle, MI, Schoolcraft, MI, Roscommon, MI, Wexford, MI. Lower Brule Sioux Tribe of the Lower Brule, SD, Buffalo, SD, Hughes, Brule Reservation, South Dakota. SD, Lyman, SD, Stanley, SD. Lower Elwha Tribal Community........... Clallam, WA. Lower Sioux Indian Community in the Redwood, MN, Renville, MN. State of Minnesota. Lummi Tribe of the Lummi Reservation... Whatcom, WA. Makah Indian Tribe of the Makah Indian Clallam, WA. Reservation. Mashantucket Pequot Tribe.............. New London, CT.\26\ Mashpee Wampanoag Tribe................ Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.\27\ Match-e-be-nash-she-wish Band of Allegan, MI \28\, Barry, MI, Pottawatomi Indians of Michigan. Kalamazoo, MI, Kent, MI, Ottawa, MI. Menominee Indian Tribe of Wisconsin.... Langlade, WI, Menominee, WI, Oconto, WI, Shawano, WI. Mescalero Apache Tribe of the Mescalero Chaves, NM, Lincoln, NM, Otero, Reservation, New Mexico. NM. Miccosukee Tribe of Indians............ Broward, FL, Collier, FL, Miami- Dade, FL, Hendry, FL. Minnesota Chippewa Tribe, Minnesota Itasca, MN, Koochiching, MN, Bois Forte Band (Nett Lake). St. Louis, MN. Minnesota Chippewa Tribe, Minnesota Carlton, MN, St. Louis, MN. Fond du Lac Band. Minnesota Chippewa Tribe, Minnesota Cook, MN. Grand Portage Band. Minnesota Chippewa Tribe, Minnesota Beltrami, MN, Cass, MN, Leech Lake Band. Hubbard, MN, Itasca, MN. Minnesota Chippewa Tribe, Minnesota Aitkin, MN, Kanebec, MN, Mille Mille Lacs Band. Lacs, MN, Pine, MN. Minnesota Chippewa Tribe, Minnesota Becker, MN, Clearwater, MN, White Earth Band. Mahnomen, MN, Norman, MN, Polk, MN. Mississippi Band of Choctaw Indians.... Attala, MS, Jasper, MS \29\, Jones, MS, Kemper, MS, Leake, MS, Neshoba, MS, Newton, MS, Noxubee, MS \29\, Scott, MS \30\, Winston, MS. Mohegan Tribe of Indians of Connecticut Fairfield, CT, Hartford, CT, Litchfield, CT, Middlesex, CT, New Haven, CT, New London, CT, Tolland, CT, Windham, CT. Muckleshoot Indian Tribe............... King, WA, Pierce, WA. [[Page 20392]] Narragansett Indian Tribe.............. Washington, RI.\31\ Navajo Nation, Arizona, New Mexico & Apache, AZ, Bernalillo, NM, Utah. Cibola, NM, Coconino, AZ, Kane, UT, McKinley, NM, Montezuma, CO, Navajo, AZ, Rio Arriba, NM, Sandoval, NM, San Juan, NM, San Juan, UT, Socorro, NM, Valencia, NM. Nevada................................. Entire State.\32\ Nez Perce Tribe........................ Clearwater, ID, Idaho, ID, Latah, ID, Lewis, ID, Nez Perce, ID. Nisqually Indian Tribe................. Pierce, WA, Thurston, WA. Nooksack Indian Tribe.................. Whatcom, WA. Northern Cheyenne Tribe of the Northern Big Horn, MT, Carter, MT \33\, Cheyenne Indian Reservation, Montana. Rosebud, MT. Northwestern Band of Shoshoni Nation... Box Elder, UT.\34\ Nottawaseppi Huron Band of the Allegan, MI \35\, Barry, MI, Potawatomi, Michigan. Branch, MI, Calhoun, MI, Kalamazoo, MI, Kent, MI, Ottawa, MI. Oglala Sioux Tribe..................... Bennett, SD, Cherry, NE, Custer, SD, Dawes, NE, Fall River, SD, Jackson, SD \36\, Mellete, SD, Pennington, SD, Shannon, SD, Sheridan, NE, Todd, SD. Ohkay Owingeh, New Mexico.............. Rio Arriba, NM. Oklahoma............................... Entire State.\37\ Omaha Tribe of Nebraska................ Burt, NE, Cuming, NE, Monona, IA, Thurston, NE, Wayne, NE. Oneida Nation of New York.............. Chenango, NY, Cortland, NY, Herkimer, NY, Madison, NY, Oneida, NY, Onondaga, NY. Oneida Tribe of Indians of Wisconsin... Brown, WI, Outagamie, WI. Onondaga Nation........................ Onondaga, NY. Paiute Indian Tribe of Utah............ Iron, UT \38\ Millard, UT, Sevier, UT, Washington, UT. Pascua Yaqui Tribe of Arizona.......... Pima, AZ.\39\ Passamaquoddy Tribe.................... Aroostook, ME \40\ \41\, Washington, ME. Penobscot Nation....................... Aroostook, ME \40\, Penobscot, ME. Poarch Band of Creeks.................. Baldwin, AL \42\, Elmore, AL, Escambia, AL, Mobile, AL, Monroe, AL, Escambia, FL. Pokagon Band of Potawatomi Indians, Allegan, MI \43\, Berrien, MI, Michigan and Indiana. Cass, MI, Elkhart, IN, Kosciusko, IN, La Porte, IN, Marshall, IN, St. Joseph, IN, Starke, IN, Van Buren, MI. Ponca Tribe of Nebraska................ Boyd, NE \44\, Burt, NE, Charles Mix, SD, Douglas, NE, Hall, NE, Holt, NE, Knox, NE, Lancaster, NE, Madison, NE, Platte, NE, Pottawattomie, IA, Sarpy, NE, Stanton, NE, Wayne, NE, Woodbury, IA. Port Gamble S'Klallam Tribe............ Kitsap, WA. Prairie Band of Potawatomi Nation...... Jackson, KS. Prairie Island Indian Community in the Goodhue, MN. State of Minnesota. Pueblo of Acoma, New Mexico............ Cibola, NM. Pueblo of Cochiti, New Mexico.......... Sandoval, NM, Santa Fe, NM. Pueblo of Isleta, New Mexico........... Bernalillo, NM, Torrance, NM, Valencia, NM. Pueblo of Jemez, New Mexico............ Sandoval, NM. Pueblo of Laguna, New Mexico........... Bernalillo, NM, Cibola, NM, Sandoval, NM, Valencia, NM. Pueblo of Nambe, New Mexico............ Santa Fe, NM. Pueblo of Picuris, New Mexico.......... Taos, NM. Pueblo of Pojoaque, New Mexico......... Rio Arriba, NM, Santa Fe, NM. Pueblo of San Felipe, New Mexico....... Sandoval, NM. Pueblo of San Ildefonso, New Mexico.... Los Alamos, NM, Rio Arriba, NM, Sandoval, NM, Santa Fe, NM. Pueblo of Sandia, New Mexico........... Bernalillo, NM, Sandoval, NM. Pueblo of Santa Ana, New Mexico........ Sandoval, NM. Pueblo of Santa Clara, New Mexico...... Los Alamos, NM, Sandoval, NM, Santa Fe, NM. Pueblo of Taos, New Mexico............. Colfax, NM, Taos, NM. Pueblo of Tesuque, New Mexico.......... Santa Fe, NM. Pueblo of Zia, New Mexico.............. Sandoval, NM. Puyallup Tribe of the Puyallup King, WA, Pierce, WA, Thurston, Reservation. WA. Quechan Tribe of the Fort Yuma Indian Yuma, AZ, Imperial, CA. Reservation, California and Arizona. Quileute Tribe of the Quileute Clallam, WA, Jefferson, WA. Reservation. Quinault Indian Nation................. Grays Harbor, WA, Jefferson, WA. Rapid City, South Dakota............... Pennington, SD.\45\ Red Cliff Band of Lake Superior Bayfield, WI. Chippewa Indians of Wisconsin. Red Lake Band of Chippewa Indians, Beltrami, MN, Clearwater, MN, Minnesota. Koochiching, MN, Lake of the Woods, MN, Marshall, MN, Pennington, MN, Polk, MN, Roseau, MN. Rosebud Sioux Tribe of the Rosebud Bennett, SD, Cherry, NE, Indian Reservation, South Dakota. Gregory, SD, Lyman, SD, Mellette, SD, Todd, SD, Tripp, SD. Sac & Fox Nation of Missouri in Kansas Brown, KS, Richardson, NE. and Nebraska. Sac & Fox Tribe of the Mississippi in Tama, IA. Iowa. Saginaw Chippewa Indian Tribe of Arenac, MI \46\, Clare, MI, Michigan. Isabella, MI, Midland, MI, Missaukee, MI. Saint Regis Mohawk Tribe............... Franklin, NY, St. Lawrence, NY. Salt River Pima-Maricopa Indian Maricopa, AZ. Community of the Salt River Reservation, Arizona. [[Page 20393]] Samish Indian Nation................... Clallam, WA \47\, Island, WA, Jefferson, WA, King, WA, Kitsap, WA, Pierce, WA, San Juan, WA, Skagit, WA, Snohomish, WA, Whatcom, WA. San Carlos Apache Tribe of the San Apache, AZ, Cochise, AZ, Gila, Carlos Reservation, Arizona. AZ, Graham, AZ, Greenlee, AZ, Pinal, AZ. San Juan Southern Paiute Tribe of Coconino, AZ, San Juan, UT. Arizona. Santee Sioux Nation, Nebraska.......... Bon Homme, SD, Knox, NE. Sauk-Suiattle Indian Tribe............. Snohomish, WA, Skagit, WA. Sault Ste. Marie Tribe of Chippewa Alger, MI \48\, Chippewa, MI, Indians, Michigan. Delta, MI, Luce, MI, Mackinac, MI, Marquette, MI, Schoolcraft, MI. Seminole Tribe of Florida.............. Broward, FL, Collier, FL, Miami- Dade, FL, Glades, FL, Hendry, FL. Seneca Nation of Indians............... Allegany, NY, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA. Shakopee Mdewakanton Sioux Community of Scott, MN. Minnesota. Shinnecock Indian Nation............... Nassau, NY \49\, Suffolk, NY. Shoalwater Bay Tribe of the Shoalwater Pacific, WA. Bay Indian Reservation. Shoshone Tribe of the Wind River Hot Springs, WY, Fremont, WY, Reservation, Wyoming. Sublette, WY. Shoshone-Bannock Tribes of the Fort Bannock, ID, Bingham, ID, Hall Reservation. Caribou, ID, Lemhi, ID \50\, Power, ID. Shoshone-Paiute Tribes of the Duck Nevada, Owyhee, ID. Valley Reservation, Nevada. Sisseton-Wahpeton Oyate of the Lake Codington, SD, Day, SD, Grant, Traverse Reservation, South Dakota. SD, Marshall, SD, Richland, ND, Roberts, SD, Sargent, ND, Traverse, MN. Skokomish Indian Tribe................. Mason, WA. Skull Valley Band of Goshute Indians of Tooele, UT. Utah. Snoqualmie Indian Tribe................ King, WA \51\, Snohomish, WA, Pierce, WA, Island, WA, Mason, WA. Sokaogon Chippewa Community, Wisconsin. Forest, WI. Southern Ute Indian Tribe of the Archuleta, CO, La Plata, CO, Southern Ute Reservation, Colorado. Montezuma, CO, Rio Arriba, NM, San Juan, NM. Spirit Lake Tribe, North Dakota........ Benson, ND, Eddy, ND, Nelson, ND, Ramsey, ND. Spokane Tribe of the Spokane Ferry, WA, Lincoln, WA, Reservation. Stevens, WA. Squaxin Island Tribe of the Squaxin Mason, WA. Island Reservation. St. Croix Chippewa Indians of Wisconsin Barron, WI, Burnett, WI, Pine, MN, Polk, WI, Washburn, WI. Standing Rock Sioux Tribe of North & Adams, ND, Campbell, SD, South Dakota. Corson, SD, Dewey, SD, Emmons, ND, Grant, ND, Morton, ND, Perkins, SD, Sioux, ND, Walworth, SD, Ziebach, SD. Stillaguamish Tribe of Indians of Snohomish, WA. Washington. Stockbridge Munsee Community, Wisconsin Menominee, WI, Shawano, WI. Suquamish Indian Tribe of the Port Kitsap, WA. Madison Reservation. Swinomish Indian Tribal Community...... Skagit, WA. Tejon Indian Tribe..................... Kern, CA.\52\ Three Affiliated Tribes of the Fort Dunn, ND, Mercer, ND, McKenzie, Berthold Reservation, North Dakota. ND, McLean, ND, Mountrail, ND, Ward, ND. Tohono O'odham Nation of Arizona....... Maricopa, AZ, Pima, AZ, Pinal, AZ. Tonawanda Band of Seneca............... Genesee, NY, Erie, NY, Niagara, NY. Tonto Apache Tribe of Arizona.......... Gila, AZ. Trenton Service Unit, North Dakota and Divide, ND \53\, McKenzie, ND, Montana. Williams, ND, Richland, MT, Roosevelt, MT, Sheridan, MT. Tulalip Tribes of Washington........... Snohomish, WA. Tunica-Biloxi Indian Tribe............. Avoyelles, LA, Rapides, LA.\54\ Turtle Mountain Band of Chippewa Rolette, ND. Indians of North Dakota. Tuscarora Nation....................... Niagara, NY. Upper Sioux Community, Minnesota....... Chippewa, MN, Yellow Medicine, MN. Upper Skagit Indian Tribe.............. Skagit, WA. Ute Indian Tribe of the Uintah & Ouray Carbon, UT, Daggett, UT, Reservation, Utah. Duchesne, UT, Emery, UT, Grand, UT, Rio Blanco, CO, Summit, UT, Uintah, UT, Utah, UT, Wasatch, UT. Ute Mountain Tribe of the Ute Mountain Apache, AZ, La Plata, CO, Reservation, Colorado, New Mexico & Montezuma, CO, San Juan, NM, Utah. San Juan, UT. Wampanoag Tribe of Gay Head (Aquinnah). Dukes, MA \55\, Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.\56\ Washoe Tribe of Nevada & California.... Nevada, California except for the counties listed in footnote. White Mountain Apache Tribe of the Fort Apache, AZ, Coconino, AZ, Gila, Apache Reservation, Arizona. AZ, Graham, AZ, Greenlee, AZ, Navajo, AZ. Wilton Rancheria, California........... Sacramento, CA.\57\ Winnebago Tribe of Nebraska............ Dakota, NE, Dixon, NE, Monona, IA, Thurston, NE, Wayne, NE, Woodbury, IA. Yankton Sioux Tribe of South Dakota.... Bon Homme, SD, Boyd, NE, Charles Mix, SD, Douglas, SD, Gregory, SD, Hutchinson, SD, Knox, NE. Yavapai-Apache Nation of the Camp Verde Yavapai, AZ. Indian Reservation, Arizona. Yavapai-Prescott Indian Tribe.......... Yavapai, AZ. Ysleta Del Sur Pueblo of Texas......... El Paso, TX.\1\ [[Page 20394]] Zuni Tribe of the Zuni Reservation, New Apache, AZ, Cibola, NM, Mexico. McKinley, NM, Valencia, NM. ------------------------------------------------------------------------ \1\ Public Law 100-89, Restoration Act for Ysleta Del Sur and Alabama and Coushatta Tribes of Texas establishes service areas for ``members of the Tribe'' by sections 101(3) and 105(a) for the Pueblo and sections 201(3) and 206(a) respectively. \2\ Entire State of Alaska is included as a CHSDA by regulation (42 CFR 136.22(a)(1)). \3\ Aroostook Band of Micmacs was recognized by Congress on November 26, 1991, through the Aroostook Band of Micmac Settlement Act. Aroostook County, ME, was defined as the SDA. \4\ Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is based on the legislative history of the appropriation of funds for the particular facility rather than the eligibility regulations. Historically services have been provided at Brigham City Intermountain School Health Center, Utah (Pub. L. 88-358). \5\ Entire State of California, excluding the counties of Alameda, Contra Costa, Los Angeles, Marin, Orange, Sacramento, San Francisco, San Mateo, Santa Clara, Kern, Merced, Monterey, Napa, San Benito, San Joaquin, San Luis Obispo, Santa Cruz, Solano, Stanislaus, and Ventura, is designated a CHSDA (25 U.S.C. 1680). \6\ The counties were recognized after the January 1984 CHSDA FRN was published, in accordance with Pub. L. 103-116, Catawba Indian Tribe of South Carolina Land Claims Settlement Act of 1993, dated October 27, 1993. \7\ There is no reservation for the Cayuga Nation; the service delivery area consists of those counties identified by the Cayuga Nation. \8\ Skamania County, WA, has historically been a part of the Yakama Service Unit population since 1979. \9\ In order to carry out the Congressional intent of the Siletz Restoration Act, Pub. L. 95-195, as expressed in H. Report No. 95-623, at page 4, members of the Confederated Tribes of Siletz Indians of Oregon residing in these counties are eligible for contract health services. \10\ Chelan County, WA, has historically been a part of the Colville Service Unit population since 1970. \11\ Pursuant to Pub. L. 98-481 (H. Rept. No. 98-904), Coos, Lower Umpqua and Siuslaw Restoration Act, members of the Tribe residing in these counties were specified as eligible for Federal services and benefits without regard to the existence of a Federal Indian reservation. \12\ The Confederated Tribes of Grand Ronde Community of Oregon were recognized by Pub. L. 98-165 which was signed into law on November 22, 1983, and provides for eligibility in these six counties without regard to the existence of a reservation. \13\ The CHSDA for the Coushatta Tribe of Louisiana was expanded administratively by the Director, IHS, through regulation (42 CFR 136.22(6)) to include city limits of Elton, LA. \14\ Cow Creek Band of Umpqua Tribe of Indians recognized by Pub. L. 97- 391, signed into law on December 29, 1983. House Rept. No. 97-862 designates Douglas, Jackson, and Josephine Counties as a service area without regard to the existence of a reservation. The IHS later administratively expanded the CHSDA to include the counties of Coos, OR, Deshutes, OR, Klamath, OR, and Lane, OR. \15\ The Cowlitz Indian Tribe was recognized in July 2002 as documented at 67 FR 46329, July 12, 2002. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. The CHSDA was administratively expanded to included Columbia County, OR, Kittitas, WA, and Wahkiakum County, WA, as published at 67884 FR December 21, 2009. \16\ Treasure County, MT, has historically been a part of the Crow Service Unit population. \17\ The counties listed have historically been a part of the Grand Traverse Service Unit population since 1980. \18\ Haskell Indian Health Center has historically been a part of Kansas Service Unit since 1979. Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is based on the legislative history of the appropriation of funds for the particular facility rather than the eligibility regulations. Historically services have been provided at Haskell Indian Health Center (H. Rept. No. 95-392). \19\ CHSDA counties for the Ho-Chunk Nation of Wisconsin were designated by regulation (42 CFR 136.22(a)(5)). Dane County, WI, was added to the reservation by the Bureau of Indian Affairs in 1986. \20\ Public Law 97-428 provides that any member of the Houlton Band of Maliseet Indians in or around the Town of Houlton shall be eligible without regard to existence of a reservation. \21\ The Jena Band of Choctaw Indian was Federally acknowledged as documented at 60 FR 28480, May 31, 1995. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \22\ Kickapoo Traditional Tribe of Texas, formerly known as the Texas Band of Kickapoo, was recognized by Pub. L. 97-429, signed into law on January 8, 1983. The Act provides for eligibility for Kickapoo Tribal members residing in Maverick County without regard to the existence of a reservation. \23\ The Klamath Indian Tribe Restoration Act (Pub. L. 99-398, Sec. 2(2)) states that for the purpose of Federal services and benefits ``members of the tribe residing in Klamath County shall be deemed to be residing in or near a reservation''. \24\ The Koi Nation of Northern California, formerly known as the Lower Lake Rancheria, was reaffirmed by the Secretary of the Bureau of Indian Affairs on December 29, 2000. The counties listed were designated administratively as the SDA, to function as a PRC SDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Pub. L. 93-638. \25\ The Little Traverse Bay Bands of Odawa Indians and the Little River Band of Ottawa Indians Act recognized the Little River Band of Ottawa Indians and the Little Traverse Bay Bands of Odawa Indians. Pursuant to Pub. L. 103-324, Sec.4(b) the counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \26\ Mashantucket Pequot Indian Claims Settlement Act, Pub. L. 98-134, signed into law on October 18, 1983, provides a reservation for the Mashantucket Pequot Indian Tribe in New London County, CT. \27\ The Mashpee Wampanoag Tribe was recognized in February 2007, as documented at 72 FR 8007, February 22, 2007. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \28\ The Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan was recognized in October 1998, as documented at 63 FR 56936, October 23, 1998. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \29\ Members of the Mississippi Band of Choctaw Indians residing in Jasper and Noxubee Counties, MS, are eligible for contract health services; these two counties were inadvertently omitted from 42 CFR 136.22. \30\ Scott County, MS, has historically been a part of the Choctaw Service Unit population since 1970. \31\ The Narragansett Indian Tribe was recognized by Pub. L. 95-395, signed into law September 30, 1978. Lands in Washington County, RI, are now Federally restricted and the Bureau of Indian Affairs considers them as the Narragansett Indian Reservation. \32\ Entire State of Nevada is included as a CHSDA by regulation (42 CFR 136.22(a)(2)). \33\ Carter County, MT, has historically been a part of the Northern Cheyenne Service Unit population since 1979. \34\ Land of Box Elder County, Utah, was taken into trust for the Northwestern Band of Shoshoni Nation in 1986. \35\ The Nottawaseppi Huron Band of the Potawatomi, Michigan, formerly known as the Huron Band of Potawatomi, Inc., was recognized in December 1995, as documented at 60 FR 66315, December 21, 1995. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \36\ Washabaugh County, SD, merged and became part of Jackson County, SD, in 1983; both were/are CHSDA counties for the Oglala Sioux Tribe. \37\ Entire State of Oklahoma is included as a CHSDA by regulation (42 CFR 136.22(a)(3)). \38\ Paiute Indian Tribe of Utah Restoration Act, Pub. L. 96-227, provides for the extension of services for the Paiute Indian Tribe of Utah to these four counties without regard to the existence of a reservation. [[Page 20395]] \39\ Legislative history (H.R. Report No. 95-1021) to Pub. L.95-375, Extension of Federal Benefits to Pascua Yaqui Indians, Arizona, expresses congressional intent that lands conveyed to the Pascua Yaqui Tribe of Arizona pursuant to Act of October 8, 1964. (Pub. L. 88-350) shall be deemed a Federal Indian Reservation. \40\ The Maine Indian Claims Settlement Act of 1980 (Pub. L. 96-420; H. Rept. 96-1353) includes the intent of Congress to fund and provide contract health services to the Passamaquoddy Tribe and the Penobscot Nation. \41\ The Passamaquoddy Tribe has two reservations. The PRC SDA for the Passamaquoddy Tribe of Indian Township, ME, is Aroostook County, ME, and Washington County, ME. The PRC SDA for the Passamaquoddy Tribe of Pleasant Point, ME, is Aroostook County ME, and Washington County, ME, south of State Route 9. \42\ Counties in the Service Unit designated by Congress for the Poarch Band of Creek Indians (see H. Rept. 98-886, June 29, 1984; Cong. Record, October 10, 1984, Pg. H11929). \43\ Pub. L. 103-323 restored Federal recognition to the Pokagon Band of Potawatomi Indians, Michigan and Indiana, in 1994 and identified counties to serve as the SDA. \44\ The Ponca Restoration Act, Pub. L. 101-484, recognized members of the Ponca Tribe of Nebraska in Boyd, Douglas, Knox, Madison or Lancaster counties of Nebraska or Charles Mix county of South Dakota as residing on or near a reservation. Pub. L. 104-109 made technical corrections to laws relating to Native Americans and added Burt, Hall, Holt, Platte, Sarpy, Stanton, and Wayne counties of Nebraska and Pottawatomie and Woodbury counties of Iowa to the Ponca Tribe of Nebraska SDA. \45\ Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is based on the legislative history of the appropriation of funds for the particular facility, rather than the eligibility regulations. Historically services have been provided at Rapid City (S. Rept. No. 1154, FY 1967 Interior Approp. 89th Cong. 2d Sess.). \46\ Historically part of Isabella Reservation Area for the Saginaw Chippewa Indian Tribe of Michigan and the Eastern Michigan Service Unit population since 1979. \47\ The Samish Indian Tribe Nation was Federally acknowledged in April 1996 as documented at 61 FR 15825, April 9, 1996. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \48\ CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians, Michigan, were designated by regulation (42 CFR 136.22(a)(4)). \49\ The Shinnecock Indian Nation was Federally acknowledged in June 2010 as documented at 75 FR 34760, June 18, 2010. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \50\ Lemhi County, ID, has historically been a part of the Fort Hall Service Unit population since 1979. \51\ The Snoqualmie Indian Tribe was Federally acknowledged in August 1997 as documented at 62 FR 45864, August 29, 1997. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \52\ On December 30, 2011 the Office of Assistant Secretary-Indian Affairs reaffirmed the Federal recognition of the Tejon Indian Tribe. The county listed was designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Pub. L. 93-638. \53\ The Secretary acting through the Service is directed to provide contract health services to Turtle Mountain Band of Chippewa Indians that reside in Trenton Service Unit, North Dakota and Montana, in Divide, Mackenzie, and Williams counties in the state of North Dakota and the adjoining counties of Richland, Roosevelt, and Sheridan in the state of Montana (Sec. 815, Pub. L. 94-437). \54\ Rapides County, LA, has historically been a part of the Tunica Biloxi Service Unit population since 1982. \55\ According to Pub. L. 100-95, Sec. 12, members of the Wampanoag Tribe of Gay Head (Aquinnah) residing on Martha's Vineyard are deemed to be living on or near an Indian reservation for the purposes of eligibility for Federal services. \56\ The counties listed are designated administratively as the SDA, to function as a PRC SDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Pub. L. 93-638. \57\ The Wilton Rancheria, California had Federal recognition restored in July 2009 as documented at 74 FR 33468, July 13, 2009. Sacramento County, CA, was designated administratively as the SDA, to function as a CHSDA. Sacramento County was not covered when Congress originally established the State of California as a CHSDA excluding certain counties including Sacramento County (25 U.S.C. 1680). Dated: March 31, 2016. Elizabeth A. Fowler, Deputy Director for Management Operations, Indian Health Service. [FR Doc. 2016-07951 Filed 4-6-16; 8:45 am] BILLING CODE 4165-16-P
![20388 Federal Register / Vol. 81, No. 67 / Thursday, April 7, 2016 / Notices
TOTAL ESTIMATED ANNUALIZED BURDEN—HOURS
Average
Number of annualized Annualized
Number of
Type of respondent Form name responses per burden per total burden
respondents respondent response (hours)
(hours)
Grantees ............................................ FPAR ............................................... 93 grantees 1 36 3,348
Totals .......................................... .......................................................... 93 ........................ ........................ 3,348
OS specifically requests comments on FOR FURTHER INFORMATION CONTACT: the area near the reservation are socially
(1) the necessity and utility of the Terri Schmidt, Acting Director, Office of and economically affiliated with the
proposed information collection for the Resource Access and Partnerships, tribe;
proper performance of the agency’s Indian Health Service, 5600 Fishers (3) The geographic proximity to the
functions, (2) the accuracy of the Lane, Mailstop 10E85C, Rockville, reservation of the area whose inclusion
estimated burden, (3) ways to enhance Maryland 20857. Telephone (301) 443– or exclusion is being considered; and
the quality, utility, and clarity of the 2694 (This is not a toll free number). (4) The level of funding which would
information to be collected, and (4) the Background: The Indian Health be available for the provision of PRC.
use of automated collection techniques Service (IHS) currently provides Additionally, the regulations require
or other forms of information services under regulations codified at 42 that any redesignation of a PRC service
technology to minimize the information CFR part 136, subparts A through C. delivery area must be made in
collection burden. Subpart C defines a Contract Health accordance with the Administrative
Service Delivery Area (CHSDA), now Procedures Act (5 U.S.C. 553). In
Darius Taylor, referred to as a Purchased/Referred Care compliance with this requirement, IHS
Information Collection Clearance Officer. (PRC) service delivery area, as the published a proposed notice of
[FR Doc. 2016–07964 Filed 4–6–16; 8:45 am] geographic area within which PRC will redesignation and requested public
BILLING CODE 4150–34–P be made available by the IHS to comments on August 24, 2015 (80 FR
members of an identified Indian 51281). Aquinnah requested that IHS
community who reside in the area. expand the Aquinnah service delivery
DEPARTMENT OF HEALTH AND Residence in a PRC service delivery area area to include Barnstable, Bristol,
HUMAN SERVICES by a person who is within the scope of Norfolk, Plymouth and Suffolk Counties
the Indian health program, as set forth in the State of Massachusetts.
Indian Health Service in 42 CFR 136.12, creates no legal In support of this expansion, IHS
entitlement to PRC but only potential adopts the following findings of the
Notice of the Redesignation of the Aquinnah Tribe:
eligibility for services. Services needed
Service Delivery Area for the (1) By expanding, the Tribe’s
but not available at an IHS/Tribal
Wampanoag Tribe of Gay Head facility are provided under the PRC estimated current eligible population
(Aquinnah) program depending on the availability will be increased by 268.
of funds, the person’s relative medical (2) The Tribe has determined these
AGENCY: Indian Health Service. 268 individuals are socially and
priority, and the actual availability and
ACTION: Final notice. accessibility of alternate resources in economically affiliated with the Tribe.
accordance with the regulations. (3) The expanded area including
SUMMARY: This final notice advises the As applicable to the Tribes, these Barnstable, Bristol, Norfolk, Plymouth,
public that the Indian Health Service regulations provide that, unless and Suffolk Counties in the State of
(IHS) has decided to expand the otherwise designated, a PRC service Massachusetts are across the Bay from
geographic boundaries of the delivery area shall consist of a county Martha’s Vineyard, Dukes County,
Purchased/Referred Care (PRC) service which includes all or part of a Massachusetts.
delivery area for the Wampanoag Tribe reservation and any county or counties (4) The Tribal members located in
of Gay Head (Aquinnah) of which have a common boundary with these counties currently do not use the
Massachusetts pursuant to 42 CFR the reservation. 42 CFR 136.22(a)(6). Indian health system for their health
136.22. The Aquinnah service delivery The regulations also provide that after care needs.
area previously covered Martha’s consultation with the Tribal governing Aquinnah will use its existing Federal
Vineyard, Dukes County in the State of body or bodies on those reservations allocation for PRC funds to provide
Massachusetts. The expanded service included within the PRC service services to the expanded population. No
delivery area includes counties of delivery area, the Secretary may from additional financial resources will be
Barnstable, Bristol, Norfolk, Plymouth, time to time, redesignate areas within allocated by IHS to Aquinnah to provide
Suffolk, and Dukes Counties in the State the United States for inclusion in or services to its members residing in these
of Massachusetts. The sole purpose of exclusion from a PRC service delivery counties nor should this expansion be
this expansion is to authorize Aquinnah area. The regulations require that certain construed to have any present or future
mstockstill on DSK4VPTVN1PROD with NOTICES
to cover additional tribal members and criteria must be considered before any effect on the allocation of resources
beneficiaries under Aquinnah’s PRC redesignation is made. The criteria are between the Mashpee Wampanoag Tribe
program using the existing Federal as follows: and Aquinnah.
(1) The number of Indians residing in Public Comments: The Agency only
allocation for PRC funds.
the area proposed to be so included or received comments from the Mashpee
DATES: The effective date of expansion excluded; Wampanoag Tribe (Mashpee). Mashpee
will be 60 days from the date of this (2) Whether the Tribal governing body incorporated several letters into its
notice. has determined that Indians residing in submission. Through these comments
VerDate Sep<11>2014 16:35 Apr 06, 2016 Jkt 238001 PO 00000 Frm 00070 Fmt 4703 Sfmt 4703 E:\FR\FM\07APN1.SGM 07APN1](https://thefederalregister.org/doc/81_FR_20455/page/1.svg)
![Federal Register / Vol. 81, No. 67 / Thursday, April 7, 2016 / Notices 20389
and letters, Mashpee indicated that it criteria for such redesignations is the the language of Section 1771 to be a
does not support the proposed geographic proximity of the expanded limitation on IHS programs or
redesignation and articulated several area to the existing reservation or administrative flexibility. There is also
objections to the expansion, which IHS service delivery area. In the few no evidence to suggest that Congress
addresses below: circumstances where it has arisen, IHS intended to limit eligibility for PRC
Comment: IHS has failed to meet its has aligned geographic proximity with services. Unless IHS administratively
legal requirement to meaningfully Congressional findings of ‘‘on or near’’. expands the PRC service delivery,
consult with the Mashpee Tribe as the Here, IHS proposed to expand a PRC however, Aquinnah cannot cover
only other Tribal governing body within delivery area beyond the geographic hundreds of its tribal members under
the proposed redesignated SDA in description of ‘‘on or near’’ that PRC. IHS has therefore revisited
accordance with 42 CFR 136.22(b). Congress set forth in a settlement or Aquinnah’s request and believes that
Response: IHS disagrees. IHS recognition act. IHS offered stakeholders unique circumstances are present that
consulted with the Mashpee Tribe the opportunity to comment on the warrant expanding the Aquinnah PRC
regarding this proposed expansion. As departure from historic practice by service delivery area beyond the general
Mashpee noted in its own submission, issuing a notice of proposed expansion geographic area identified by Congress
IHS engaged in government-to- prior to issuing a final notice to in Public Law 100–95 as ‘‘on or near’’.
government discussions and ascertain whether the departure is These unique circumstances include the
correspondence on this issue. IHS disruptive to tribes that have previously factors identified by the BIA in
provided its answers to the Mashpee relied on IHS’s historic practice. IHS did recognizing the Aquinnah prior to the
Tribe’s questions in a letter from Deputy not receive comments that identify a enactment of Public Law 100–95, BIA’s
Director McSwain to Mashpee Chairman detrimental reliance interest. understanding of the settlement
Cromwell, dated October 5, 2015. While Accordingly, when considering the language, and Dukes County’s status as
Mashpee questions the adequacy of geographic proximity of the proposed an island and the significant number of
IHS’s answers, they nonetheless expansion area under 42 CFR 136.22 to Aquinnah’s members who reside
demonstrate that IHS has engaged in the existing reservation (or service permanently off of the island and
meaningful consultation with Mashpee delivery area), IHS will no longer rigidly continue to maintain close economic
with respect to this expansion. apply a Congressional finding of ‘‘on or and social ties with the Aquinnah.
Additionally, the opportunity to submit near’’ as prohibiting PRC delivery area The BIA recognized the Aquinnah
comments on a proposed notice is a expansion in considering expansion Tribe as an Indian Tribe eligible for
form of consultation. IHS recognizes requests. Although this is a change in Federal benefits on February 10, 1987,
that Mashpee has concerns with the the implementation of the redesignation pursuant to a notice published in the
expansion and does not support the IHS authority found at 42 CFR 136.22, no Federal Register. See 52 FR 4193. As
decisions in this regard. IHS is not change is necessary to the text of the part of its findings, BIA concluded ‘‘that
required, after consultation with a Tribe, regulation itself. the [Aquinnah] have an extensive and
to adopt the specific position of the In making this change, however, IHS interrelated communication network
Mashpee Tribe. notes that Congress has, at times, connecting those Wampanoag members
Comment: IHS has no legal authority statutorily enacted PRC service delivery in Gay Head and elsewhere on Martha’s
to contravene the clear legal mandate of areas for some tribes or for entire States. Vineyard with each other and with
the Wampanoag Tribal Council of Gay See, e.g. 25 U.S.C. 1678 (designating the those members living off-island.’’ The
Head, Inc., Indian Claims Settlement entire State of Arizona). Those BIA further concluded that the Tribal
Act of 1987. enactments may limit changes in PRC government ‘‘maintained political
Response: IHS agrees with the delivery area boundaries in some influence and/or authority over both its
Mashpee Tribe that the Agency cannot circumstances. Congress did not resident and non-resident members.’’
contravene the Settlement Act, but the specifically establish a PRC service Aquinnah has a significant number of
Agency does not believe the expansion delivery area for Aquinnah in the members who are not residents of Dukes
is prohibited by the Settlement Act. It is Settlement Act; IHS administratively County. According to Aquinnah’s
HHS’s understanding that the established this area through its estimates, 268 enrolled Aquinnah
Settlement Act is not implemented by regulations. While IHS chose to members are non-residents who remain
Department of the Interior (DOI) as a establish and limit the Aquinnah PRC actively involved with the Tribe, reside
limitation for DOI programs and service delivery area consistent with the in Barnstable, Bristol, Norfolk,
services. Accordingly, after conferring language of the Act, in keeping with our Plymouth and Suffolk Counties and are
with DOI regarding its position, IHS has current understanding of DOI practices, not currently eligible for PRC care.
decided to revisit the expansion issue. the language of the Act does not have to Aquinnah provides limited direct
The establishment of PRC service be read as preventing IHS from services to its Tribal members by
delivery areas is an administrative exercising its administrative discretion operating a small clinic in Dukes
function of IHS, governed by the to expand or reduce that initially County that is open once or twice a
regulations at 42 CFR 136.22. established area going forward. Indeed, month. To access direct care services,
Historically, IHS has established service IHS has already interpreted its authority non-residents must travel over one and
delivery areas in accordance with our to permit the establishment of PRC a half hours via ferry and car to receive
understanding of Congressional intent, service delivery areas that go beyond the health care offered at the clinic. As
for example as evidenced by what may otherwise be considered ‘‘on a consequence, most non-residents do
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geographically designated areas or near’’ a reservation. For example, IHS not seek care on the island.
identified in settlement acts, such as has administratively designated entire Comment: The Mashpee tribe
Public Law 100–95. IHS does not intend states as PRC service delivery areas, commented that the publication of the
to abandon that practice. Under PRC even though all parts of such states were notice is arbitrary, capricious, and
regulations, however, IHS has preserved not necessarily ‘‘on or near’’ a contrary to law.
flexibility to redesignate areas as reservation. Nor does there appear to be Response: IHS disagrees. IHS’s
appropriate for inclusion in or exclusion any legislative history of the Act that decision to publish a notice of the
from PRC service delivery. One of the would suggest that Congress intended intention to expand the Aquinnah PRC
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![20390 Federal Register / Vol. 81, No. 67 / Thursday, April 7, 2016 / Notices
service delivery area was not arbitrary, Comment: 42 CFR 136.22(a)(6) Response: The comment references
capricious, or contrary to law. IHS rules provides that ‘‘the [CHSDA] shall the starting point for establishing a PRC
expressly authorize IHS to expand a consist of a county which includes all service delivery area. As noted above,
PRC service delivery area through a or part of a reservation, and any county IHS retains the administrative discretion
notice issued pursuant to the or counties which have a common to redesignate PRC service delivery
Administrative Procedures Act (5 U.S.C. boundary with the reservation.’’ As areas after they are initially designated.
553) and that process has been followed explained in the 2011 Declination The criteria for expansion requires IHS
here. IHS is implementing a change in Letter, ‘‘since the county is coextensive to consider geographic proximity, but it
the way it reviews PRC delivery with the Atlantic Ocean island of does not require IHS to limit expansion
expansion requests, but that change is Martha’s Vineyard, there is no adjacent
to adjacent counties.
fully consistent with the existing county to consider for inclusion in the
language in the rules. CHSDA.’’
PURCHASED/REFERRED CARE SERVICE DELIVERY AREAS AND SERVICE DELIVERY AREAS
Tribe/Reservation County/State
Ak Chin Indian Community of the Maricopa (Ak Chin) Indian Reserva- Pinal, AZ.
tion, Arizona.
Alabama-Coushatta Tribes of Texas ........................................................ Polk, TX.1
Alaska ....................................................................................................... Entire State.2
Arapahoe Tribe of the Wind River Reservation, Wyoming ...................... Hot Springs, WY, Fremont, WY, Sublette, WY.
Aroostook Band of Micmacs .................................................................... Aroostook, ME.3
Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Daniels, MT, McCone, MT, Richland, MT, Roosevelt, MT, Sheridan,
Montana. MT, Valley, MT.
Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Ashland, WI, Iron, WI.
Bad River Reservation, Wisconsin.
Bay Mills Indian Community, Michigan .................................................... Chippewa, MI.
Blackfeet Tribe of the Blackfeet Indian Reservation of Montana ............ Glacier, MT, Pondera, MT.
Brigham City Intermountain School Health Center, Utah ........................ (4)
Burns Paiute Tribe .................................................................................... Harney, OR.
California ................................................................................................... Entire State, except for the counties listed in the footnote.5
Catawba Indian Nation ............................................................................. All Counties in SC 6, Cabarrus, NC, Cleveland, NC, Gaston, NC, Meck-
lenburg, NC, Rutherford, NC, Union, NC.
Cayuga Nation .......................................................................................... Allegany, NY 7, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren,
PA.
Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Corson, SD, Dewey, SD, Haakon, SD, Meade, SD, Perkins, SD, Pot-
Dakota. ter, SD, Stanley, SD, Sully, SD, Walworth, SD, Ziebach, SD.
Chippewa-Cree Indians of the Rocky Boy’s Reservation, Montana ........ Chouteau, MT, Hill, MT, Liberty, MT.
Chitimacha Tribe of Louisiana .................................................................. St. Mary Parish, LA.
Cocopah Tribe of Arizona ........................................................................ Yuma, AZ, Imperial, CA.
Coeur D’Alene Tribe ................................................................................. Benewah, ID, Kootenai, ID, Latah, ID, Spokane, WA, Whitman, WA.
Colorado River Indian Tribes of the Colorado River Indian Reservation, La Paz, AZ, Riverside, CA, San Bernardino, CA, Yuma, AZ.
Arizona and California.
Confederated Salish and Kootenai Tribes of the Flathead Reservation Flathead, MT, Lake, MT, Missoula, MT, Sanders, MT.
Confederated Tribes and Bands of the Yakama Nation .......................... Klickitat, WA, Lewis, WA, Skamania, WA 8, Yakima, WA.
Confederated Tribes of Siletz Indians of Oregon .................................... Benton, OR 9, Clackamas, OR, Lane, OR,
Lincoln, OR, Linn, OR, Marion, OR, Multnomah, OR, Polk, OR,
Tillamook, OR, Washington, OR, Yam Hill, OR.
Confederated Tribes of the Chehalis Reservation ................................... Grays Harbor, WA, Lewis, WA, Thurston, WA.
Confederated Tribes of the Colville Reservation, Washington ................ Chelan, WA 10, Douglas, WA, Ferry, WA, Grant, WA, Lincoln, WA,
Okanogan, WA, Stevens, WA.
Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians Coos, OR 11, Curry, OR, Douglas, OR, Lane, OR, Lincoln, OR.
Confederated Tribes of the Goshute Reservation, Nevada and Utah ..... Nevada, Juab, UT, Toole, UT.
Confederated Tribes of the Grand Ronde Community of Oregon ........... Polk, OR 12, Washington, OR, Marion, OR,
Yamhill, OR, Tillamook, OR, Multnomah, OR.
Confederated Tribes of the Umatilla Indian Reservation ......................... Umatilla, OR, Union, OR.
Confederated Tribes of the Warm Springs Reservation of Oregon ........ Clackamas, OR, Jefferson, OR, Linn, OR,
Marion, OR, Wasco, OR.
Coquille Indian Tribe ................................................................................ Coos, OR, Curry, OR, Douglas, OR, Jackson, OR, Lane, OR.
Coushatta Tribe of Louisiana ................................................................... Allen Parish, LA, Elton, LA.13
Cow Creek Band of Umpqua Tribe of Indians ......................................... Coos, OR 14, Deshutes, OR, Douglas, OR,
Jackson, OR, Josephine, OR, Klamath, OR, Lane, OR.
Cowlitz Indian Tribe .................................................................................. Clark, WA, Cowlitz, WA, King, WA, Lewis, WA, Pierce, WA, Skamania,
WA, Thurston, WA, Columbia, OR 15, Kittitas, WA, Wahkiakum, WA.
Crow Creek Sioux Tribe of the Crow Creek Reservation, South Dakota Brule, SD, Buffalo, SD, Hand, SD, Hughes, SD, Hyde, SD, Lyman, SD,
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Stanley, SD.
Crow Tribe of Montana ............................................................................. Big Horn, MT, Carbon, MT, Treasure, MT 16, Yellowstone, MT, Big
Horn, WY, Sheridan, WY.
Eastern Band of Cherokee Indians .......................................................... Cherokee, NC, Graham, NC, Haywood, NC, Jackson, NC, Swain, NC.
Flandreau Santee Sioux Tribe of South Dakota ...................................... Moody, SD.
Forest County Potawatomi Community, Wisconsin ................................. Forest, WI, Marinette, WI, Oconto, WI.
Fort Belknap Indian Community of the Fort Belknap Reservation of Blaine, MT, Phillips, MT.
Montana.
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39 Legislative history (H.R. Report No. 95–1021) to Pub. L.95–375, Extension of Federal Benefits to Pascua Yaqui Indians, Arizona, expresses
congressional intent that lands conveyed to the Pascua Yaqui Tribe of Arizona pursuant to Act of October 8, 1964. (Pub. L. 88–350) shall be
deemed a Federal Indian Reservation.
40 The Maine Indian Claims Settlement Act of 1980 (Pub. L. 96–420; H. Rept. 96–1353) includes the intent of Congress to fund and provide
contract health services to the Passamaquoddy Tribe and the Penobscot Nation.
41 The Passamaquoddy Tribe has two reservations. The PRC SDA for the Passamaquoddy Tribe of Indian Township, ME, is Aroostook Coun-
ty, ME, and Washington County, ME. The PRC SDA for the Passamaquoddy Tribe of Pleasant Point, ME, is Aroostook County ME, and Wash-
ington County, ME, south of State Route 9.
42 Counties in the Service Unit designated by Congress for the Poarch Band of Creek Indians (see H. Rept. 98–886, June 29, 1984; Cong.
Record, October 10, 1984, Pg. H11929).
43 Pub. L. 103–323 restored Federal recognition to the Pokagon Band of Potawatomi Indians, Michigan and Indiana, in 1994 and identified
counties to serve as the SDA.
44 The Ponca Restoration Act, Pub. L. 101–484, recognized members of the Ponca Tribe of Nebraska in Boyd, Douglas, Knox, Madison or
Lancaster counties of Nebraska or Charles Mix county of South Dakota as residing on or near a reservation. Pub. L. 104–109 made technical
corrections to laws relating to Native Americans and added Burt, Hall, Holt, Platte, Sarpy, Stanton, and Wayne counties of Nebraska and
Pottawatomie and Woodbury counties of Iowa to the Ponca Tribe of Nebraska SDA.
45 Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is
based on the legislative history of the appropriation of funds for the particular facility, rather than the eligibility regulations. Historically services
have been provided at Rapid City (S. Rept. No. 1154, FY 1967 Interior Approp. 89th Cong. 2d Sess.).
46 Historically part of Isabella Reservation Area for the Saginaw Chippewa Indian Tribe of Michigan and the Eastern Michigan Service Unit pop-
ulation since 1979.
47 The Samish Indian Tribe Nation was Federally acknowledged in April 1996 as documented at 61 FR 15825, April 9, 1996. The counties list-
ed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the
ISDEAA, Pub. L. 93–638.
48 CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians, Michigan, were designated by regulation (42 CFR 136.22(a)(4)).
49 The Shinnecock Indian Nation was Federally acknowledged in June 2010 as documented at 75 FR 34760, June 18, 2010. The counties list-
ed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the
ISDEAA, Pub. L. 93–638.
50 Lemhi County, ID, has historically been a part of the Fort Hall Service Unit population since 1979.
51 The Snoqualmie Indian Tribe was Federally acknowledged in August 1997 as documented at 62 FR 45864, August 29, 1997. The counties
listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the
ISDEAA, Pub. L. 93–638.
52 On December 30, 2011 the Office of Assistant Secretary-Indian Affairs reaffirmed the Federal recognition of the Tejon Indian Tribe. The
county listed was designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the
ISDEAA, Pub. L. 93–638.
53 The Secretary acting through the Service is directed to provide contract health services to Turtle Mountain Band of Chippewa Indians that
reside in Trenton Service Unit, North Dakota and Montana, in Divide, Mackenzie, and Williams counties in the state of North Dakota and the ad-
joining counties of Richland, Roosevelt, and Sheridan in the state of Montana (Sec. 815, Pub. L. 94–437).
54 Rapides County, LA, has historically been a part of the Tunica Biloxi Service Unit population since 1982.
55 According to Pub. L. 100–95, Sec. 12, members of the Wampanoag Tribe of Gay Head (Aquinnah) residing on Martha’s Vineyard are
deemed to be living on or near an Indian reservation for the purposes of eligibility for Federal services.
56 The counties listed are designated administratively as the SDA, to function as a PRC SDA, for the purposes of operating a PRC program
pursuant to the ISDEAA, Pub. L. 93–638.
57 The Wilton Rancheria, California had Federal recognition restored in July 2009 as documented at 74 FR 33468, July 13, 2009. Sacramento
County, CA, was designated administratively as the SDA, to function as a CHSDA. Sacramento County was not covered when Congress origi-
nally established the State of California as a CHSDA excluding certain counties including Sacramento County (25 U.S.C. 1680).
Dated: March 31, 2016. Lesbian, Gay, Bisexual, Transgender and DATES: The first public teleconference
Elizabeth A. Fowler, Two-Spirit (LGBT2S) community (80 FR will be held on May 5, 2016 from 3:00
Deputy Director for Management Operations, 43447 and 80 FR 51824). IHS is p.m. to 5:00 p.m. (Eastern Standard
Indian Health Service. continuing to seek feedback from the Time).
[FR Doc. 2016–07951 Filed 4–6–16; 8:45 am] LGBT2S community by holding a series ADDRESSES: The teleconference will be
BILLING CODE 4165–16–P of public teleconferences. In these conducted by telephone only. Please see
teleconferences, participants will be SUPPLEMENTARY INFORMATION for the call-
asked to comment on several key in information.
DEPARTMENT OF HEALTH AND dimensions of the health needs of the
FOR FURTHER INFORMATION CONTACT:
HUMAN SERVICES AI/AN LGBT2S community, including
Members of the public who wish to
but not limited to the following
Indian Health Service obtain further information regarding this
questions:
public teleconference may contact Lisa
a. Are there effective models and best
Notification of a Public Teleconference Neel, MPH, Program Coordinator, Office
practices surrounding the health care of
on American Indian/Alaska Native of Clinical and Preventive Services,
the LGBT2S community that should be
Lesbian, Gay, Bisexual, Transgender Indian Health Service, 5600 Fishers
considered for replication?
and Two-Spirit Health Issues b. What are the specific measures that Lane, Mailstop 08N34A, Rockville, MD
could be used to track progress in 20857, Telephone 301–443–4305. (This
AGENCY: Indian Health Service. is not a toll-free number.)
improving the health of LGBT2S
ACTION: Notice of meeting. persons? SUPPLEMENTARY INFORMATION: This
c. How can IHS better engage with meeting is open to the public. The
SUMMARY: In 2015, the Indian Health stakeholders around the implementation virtual meeting is available via
mstockstill on DSK4VPTVN1PROD with NOTICES
Service (IHS) sought public input in of improvements? teleconference line and will
writing and in person through a Notice d. Are there gaps or disparities in accommodate 200 people. Join the
of Request for Information (80 FR existing IHS services offered to LGBT2S meeting by calling the toll free phone
32167) and two meetings in the persons? number at 800–857–9744 and providing
Washington, DC area to gather feedback e. What additional information the public participant passcode number:
on best practices to advance and should the agency consider while 3618057. Participants should call and
promote the health needs of the developing plans to improve health care connect 15 minutes prior to the meeting
American Indian/Alaska Native (AI/AN) for the LGBT2S community? in order for logistics to be set up. Call
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Document Created: 2016-04-06 23:44:04
Document Modified: 2016-04-06 23:44:04
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Final notice. | |
| Dates | The effective date of expansion will be 60 days from the date of this notice. | |
| Contact | Terri Schmidt, Acting Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mailstop 10E85C, Rockville, Maryland 20857. Telephone (301) 443-2694 (This is not a toll free number). | |
| FR Citation | 81 FR 20388 |
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