82 FR 47004 - Re-Designation of the Delivery Area for the Tolowa Dee-ni' Nation, Formerly Known as Smith River Rancheria
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service Federal Register Volume 82, Issue 194 (October 10, 2017)
Indian Health Service
Federal Register Volume 82, Issue 194 (October 10, 2017)
| Page Range | 47004-47011 | |
| FR Document | 2017-21758 |
[Federal Register Volume 82, Number 194 (Tuesday, October 10, 2017)] [Notices] [Pages 47004-47011] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-21758] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Re-Designation of the Delivery Area for the Tolowa Dee-ni' Nation, Formerly Known as Smith River Rancheria AGENCY: Indian Health Service, HHS. ACTION: Final notice. ----------------------------------------------------------------------- SUMMARY: The Secretary of the Department of Health and Human Services hereby issues this final notice to re-designate the Purchased/Referred Care Delivery Area (PRCDA) for the Tolowa Dee-ni' Nation (Tribe) (previously known as the Smith River Rancheria of Smith River, California), to provide Purchased/Referred Care (PRC) services to their Tribal members residing in Curry County, Oregon, which is in the Portland Area Indian Health Service (IHS). The Tolowa Dee-ni's Tribal Headquarters is located 3 miles south of the California-Oregon border in Northern California. The 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, was designated by the IHS as a PRCDA, formerly known as a Contract Health Service Delivery Area, in accordance with statute. The current PRCDA for Tolowa Dee-ni' Tribal members is the statutorily specified California PRCDA. The expanded PRCDA for the Tolowa Dee-ni' Tribe includes the statutorily specified California PRCDA and Curry County in the State of Oregon. DATES: This notice shall take effect on October 10, 2017. FOR FURTHER INFORMATION CONTACT: Terri Schmidt, Acting Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mail stop: 10E85C, Rockville, Maryland 20857. Telephone 301/443-2694 (This is not a toll free number). SUPPLEMENTARY INFORMATION: Background: The IHS currently provides services under regulations codified at 42 CFR part 136, subparts A through C. Subpart C defines a Purchased/Referred Care Delivery Area (PRCDA) as the geographic area within which Purchased/Referred Care will be made available by the Indian Health Service (IHS) to members of an identified Indian community who reside in the Area. PRCDAs were previously known as Contract Health Service Delivery Areas (CHSDAs) and more recently, the IHS referred to them as Purchased/Referred Care Service Delivery Areas (PRCSDAs) or PRCDAs, but the IHS intends to consistently refer to them as PRCDAs going forward. Residence in a PRCDA 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, 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 PRCDA shall consist of a county that includes all or part of a reservation and any county or counties that 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 PRCDA, the Secretary may from time to time, re-designate areas within the United States for inclusion in or exclusion from a PRCDA. The regulations require that certain criteria must be considered before any re-designation 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, 42 CFR 136.22(b). Additionally, the regulations require that any re-designation of a PRCDA must be made in accordance with the Administrative Procedures Act (5 U.S.C. 553). See 42 CFR 136.22(c). In compliance with this requirement, we are publishing this final notice. Congress directed the IHS to designate the entire State of California as a PRCDA, excluding certain counties, under section 810 of the Indian Healthcare Improvement Act, Public Law 94-437, as amended (25 U.S.C. 1680). The IHS has utilized the congressionally specified PRCDA for the purposes of administering PRC benefits to members of the Tribe. Thus, members of the Tribe who reside outside of the statutorily established California PRCDA do not reside within the Tolowa Dee-ni's current PRCDA and are currently not eligible for PRC services. The IHS has historically established PRCDAs in accordance with Congressional intent but has preserved regulatory flexibility to re- designate areas as appropriate for inclusion in or exclusion from PRCDA under PRC regulations. One of the criteria for such re-designations is the geographic proximity of the expanded area to the existing reservation or PRCDA. Here, the IHS is expanding the Tribe's PRCDA beyond the geographic description in 25 U.S.C. 1680 to include a county adjacent to the Tribe's existing PRCDA, in a neighboring state. There are already PRCDAs that include part of the State of California and part of another state, for example, Cocopah Tribe of Arizona, (Yuma, Arizona, and Imperial, California); Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California, (La Paz, Arizona; Riverside, California; San Bernardino, California; and Yuma, Arizona); Fort Mojave Indian Tribe of Arizona, California and Nevada, (Nevada; Mohave, Arizona; San Bernardino, California); and the Quechan Tribe of Fort Yuma Indian Reservation, California and Arizona, (Yuma, Arizona; and Imperial, California). The Tolowa Dee-ni' Tribe has a significant number of Tribal members who are not residents of California. The Tribe asserts that 177 Tribal members reside outside of its PRCDA, in Curry County, in the State of Oregon, and are not able to access PRC funds from either the California Area facility (Smith River Howonquet Indian Health Center) or from the closest Portland Area facility. Under 42 CFR 136.23, those otherwise eligible Indians who do not reside on a reservation, but reside within a PRCDA must be either members of the Tribe or maintain close economic and social ties with the Tribe. In this case, in applying the aforementioned PRCDA re- designation criteria required by operative regulations codified at 42 CFR part 136, subpart C, the following findings are made: 1. By expanding, the Tribe estimates the current eligible population will be increased by 177. [[Page 47005]] 2. The Tribe has determined that these 177 individuals are members of the Tribe and they are socially and economically affiliated with the Tribe. 3. The expanded area, including Curry County in the State of Oregon, maintains a common boundary with the State of California and the statutorily created California PRCDA. 4. Generally, the Tribal members located in Curry County in the State of Oregon currently do not use the Indian health system for their PRC health care needs. The Tribe will use its existing Federal allocation for PRC funds to provide services to the expanded population. No additional financial resources will be allocated at this time by the IHS to the Tribe to provide services to Tribal members residing in Curry County in the State of Oregon. Public Comments: The Agency received 32 comments, 31 of which were timely. The Agency carefully reviewed the submissions. The IHS did not consider one (1) of these comments, because it was received after the closing date. Of the 31 timely comments, 28 commenters supported the proposal to expand the Tolowa Dee-ni' PRCDA into Curry County, Oregon. These included 27 commenters from the California Area and one Congressional commenter. There were three (3) commenters representing two Tribes from the Portland Area that opposed the PRCDA expansion. The IHS will address those comments below: Comment: The majority of commenters indicated support for the proposed PRCDA expansion and support for providing PRC to the Tribe's members living in Curry County, Oregon. Response: The IHS appreciates the comments in support of the expansion and agrees that the expansion would allow the Tribe to authorize PRC services for its members residing in Curry County, Oregon. Comment: Two commenters believed that the IHS should not be relying upon the Tribe's estimate of its members living in Curry County, Oregon, and that the IHS should either produce its own estimate or verify the Tribe's figure. Response: In 2014, the IHS prepared a study of the Tolowa Dee-ni' Tribe's roster of Tribal Citizens matched with patient user activity data from the National Patient Information Reporting System. The findings of the patient matching study were consistent with a previous request conducted in 2013 by the former IHS California Area Director. The Federal Register Notice states that the Smith River Tribe has estimated that 177 of its Tribal members reside in Curry County, in the State of Oregon, and they are not able to access PRC funds either at the California Area or the Portland Area. The IHS believes that this number is a fair approximation of the number of Smith River Tribal members residing in Curry County, given IHS's facility data, and recognizing that the Tribe has additional resources, such as a Tribal Membership Roll, to estimate the number of members residing in Curry County, Oregon, including those who have not yet sought services at IHS facilities and therefore would not be included in IHS data. Comment: One commenter inquired about the ``threshold'' for expanding a PRCDA and whether there is a minimum number or percentage in terms of Tribal members. Response: Each PRCDA expansion under consideration must be reviewed in accordance with the criteria set forth in 42 CFR 136.22(b), meaning this decision is a case-by-case determination based upon the facts of the particular expansion at issue. Regulations require the IHS to consider, among other factors, the ``number of Indians residing in the area'' of the proposed expansion, but the regulations do not require a minimum number or percentage. Comment: One commenter asked why the IHS is advancing the proposal for the Tribe, after declining to accommodate requests from Oregon Tribes and whether this created a double standard. Response: Previously, the IHS restricted certain PRCDA expansions based on the Agency's implementation of the regulatory ``geographic proximity'' requirement specified at 42 CFR 136.22(b)(3). While geographic proximity remains a necessary consideration in a PRCDA expansion, the IHS has reconsidered our previous position and recently adopted a more flexible approach. The IHS explained this change in an April 7, 2016, Federal Register Notice (81 FR 20388), ``Notice of the Redesignation of the Service Delivery Area for the Wampanoag Tribe of Gay Head (Aquinnah).'' Comment: One commenter asked how the IHS verified that the Tribal members residing in Curry County, Oregon, are economically and socially affiliated with the Tribe. Response: Under 42 CFR 136.22(b)(2), the IHS is required to consider whether ``the Tribal governing body has determined that Indians residing in the area near the reservation are socially and economically affiliated with the Tribes.'' The regulation does not require an independent investigation by the IHS on this issue. The IHS would typically defer to the Tribal governing body's determination, given the language in the regulation and a Tribe's better position to make this conclusion. However, the IHS would note that the Tribe's estimate for the expanded population includes only its members residing in Curry County, Oregon, and its members are eligible for PRC under 42 CFR 136.23, as long as the members reside within the PRCDA. Comment: Two commenters inquired about the financial aspects of the expansion, such as how this proposal would be paid for and what would be the motivation, since no additional funds are being provided to the Tribe. Response: Tolowa Dee-ni' Tribal members living in Curry County, Oregon, are unfunded for both IHS direct care and PRC resources. A few Tribal members have sought direct services from Tribal health programs in Oregon. While these individuals can receive direct services at the Oregon programs, no funds are allocated to the Portland Area IHS or the California Area IHS to provide services to members of the Tolowa Dee- ni' Tribe residing in Curry County. The Agency is approving the requested PRCDA expansion to allow the Tolowa Dee-ni' Tribe to authorize the purchase of PRC services, within existing funds, for members of the Tribe who reside in Curry County. Without this expansion, such purchases would not be lawful and those Tribal members would not be eligible to receive PRC services. Since there are no additional funds being provided by the IHS for the PRCDA expansion, the Tribe's current level of PRC funding will be available to serve a larger population. Comment: One commenter inquired about the potential future financial impact on Oregon Tribes and how this could be accurately measured, given the current data. Response: Per Agency policy, expanding a PRCDA does not automatically increase the funding to a Tribe. Tribes will continue to use existing Federal allocation for PRC funds to provide services to expanding population until Congress appropriates additional funding. Each IHS Area will distribute future increases based on their own methodologies. The Tribe may benefit from future increases to PRC funding because of the additional active users from the PRCDA expansion, but the IHS determined that there will be very little to no financial impact as a result of the expansion on Portland Area Tribes. Comment: One commenter inquired about the status of a proposed pilot project for an Area-wide PRCDA in the Portland Area IHS. Response: The Coquille Tribe presented a suggestion for consideration [[Page 47006]] to the IHS Portland Area Funds Distribution Workgroup (FDWG). The FDWG is a Tribal consultative body that serves as a resource to the Portland Area Director on any Indian health system funds issue. The principal function of the FDWG is to develop recommendations regarding resource allocation within the Portland Area IHS. The IHS anticipates announcing a plan of action on this issue soon. Purchased/Referred Care Delivery Areas ------------------------------------------------------------------------ Tribe/reservation County/state ------------------------------------------------------------------------ Ak Chin Indian Community............... Pinal, AZ. 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. Permanently Closed on May 17, 1984. 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.......................... Alleghany, 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, Yamhill, 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. 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 Marion, OR, Multnomah, OR, Community of Oregon. Polk, OR,\12\ Tillamook, OR, Washington, OR, Yamhill, 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, Peirce, 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. Eastern Shoshone Tribe of the Wind Hot Springs, WY, Fremont, WY, River Reservation, Wyoming. Sublette, WY. 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. 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\ [[Page 47007]] 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, 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 Superior Sawyer, WI. 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,\26\ 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 Indian Tribe....... New London, CT.\27\ Mashpee Wampanoag Tribe................ Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.\28\ Match-e-be-nash-she-wish Band of Allegan, MI,\29\ 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,\30\ Jones, MS, Kemper, MS, Leake, MS, Neshoba, MS, Newton, MS, Noxubee, MS,\31\ Scott, MS,\32\ 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. Narragansett Indian Tribe.............. Washington, RI.\33\ 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.\34\ 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,\35\ Cheyenne Indian Reservation, Montana. Rosebud, MT. [[Page 47008]] Northwestern Band of Shoshone Nation... Box Elder, UT.\36\ Nottawaseppi Huron Band of the Allegan, MI,\37\ Barry, MI, Pottawatomi, 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,\38\ Mellette, SD, Pennington, SD, Shannon, SD, Sheridan, NE, Todd, SD. Ohkay Owingeh, New Mexico.............. Rio Arriba, NM. Oklahoma............................... Entire State.\39\ Omaha Tribe of Nebraska................ Burt, NE, Cuming, NE, Monona, IA, Thurston, NE, Wayne, NE. Oneida Nation.......................... Brown, WI, Outagamie, WI. Oneida Nation of New York.............. Chenango, NY, Cortland, NY, Herkimer, NY, Madison, NY, Oneida, NY, Onondaga, NY. Onondaga Nation........................ Onondaga, NY. Paiute Indian Tribe of Utah............ Iron, UT,\40\ Millard, UT, Sevier, UT, Washington, UT. Pamunkey Indian Tribe.................. Caroline, Hanover, Henrico, King William, King and Queen, New Kent, Richmond (Independent City).\41\ Pascua Yaqui Tribe of Arizona.......... Pima, AZ.\42\ Passamaquoddy Tribe.................... Aroostook, ME,43 44 Hancock, ME,\45\ Washington, ME. Penobscot Nation....................... Aroostook, ME \46\, Penobscot, ME. Poarch Band of Creeks.................. Baldwin, AL,\47\ Elmore, AL, Escambia, AL, Mobile, AL, Monroe, AL, Escambia, FL. Pokagon Band of Pottawatomi Indians, Allegan, MI,\48\ 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,\49\ Burt, NE, Charles Mix, SD, Douglas, NE, Hall, NE, Holt, NE, Knox, NE, Lancaster, NE, Madison, NE, Platte, NE, Pottawatomie, IA, Sarpy, NE, Stanton, NE, Wayne, NE, Woodbury, IA. Port Gamble S'Klallam Tribe............ Kitsap, WA. Prairie Band of Pottawatomi 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, Arizona and California. Quileute Tribe of the Quileute Clallam, WA, Jefferson, WA. Reservation. Quinault Indian Nation................. Grays Harbor, WA, Jefferson, WA. Rapid City, South Dakota............... Pennington, SD.\50\ 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,\51\ 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. Samish Indian Nation................... Clallam, WA,\52\ 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. [[Page 47009]] Sault Ste. Marie Tribe of Chippewa Alger, MI,\53\ 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............... Alleghany, NY, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA. Shakopee Mdewakanton Sioux Community of Scott, MN. Minnesota. Shinnecock Indian Nation............... Nassau, NY,\54\ Suffolk, NY. Shoalwater Bay Tribe of the Shoalwater Pacific, WA. Bay Indian Reservation. Shoshone-Bannock Tribes of the Fort Bannock, ID, Bingham, ID, Hall Reservation. Caribou, ID, Lemhi, ID,\55\ 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,\56\ 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.\57\ 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. Tolowa Dee-ni' Nation (formerly known California, Curry, OR.\58\ as Smith River Rancheria of California). Tonto Apache Tribe of Arizona.......... Gila, AZ. Trenton Service Unit, North Dakota and Divide, ND,\59\ 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.\60\ 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 Ute Tribe................. Apache, AZ, La Plata, CO, Montezuma, CO, San Juan, NM, San Juan, UT. Wampanoag Tribe of Gay Head (Aquinnah). Dukes, MA,\61\ Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.\62\ 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.\63\ 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.\64\ 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. [[Page 47010]] \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). The Brigham Intermountain School Health Center was renamed to Intermountain Inter- Tribal School in 1974 and was permanently closed on May 17, 1984. \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 Public Law 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, Public Law 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 Public Law 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 Public Law 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 Public Law 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, Deschutes, 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, Public Law 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, Public Law 93-638. \22\ Kickapoo Traditional Tribe of Texas, formerly known as the Texas Band of Kickapoo, was recognized by Public Law 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 PRCDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 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 Public Law 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, Public Law 93-638. \26\ 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 Public Law 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, Public Law 93-638. \27\ Mashantucket Pequot Indian Claims Settlement Act, Public Law 98- 134, signed into law on October 18, 1983, provides a reservation for the Mashantucket Pequot Indian Tribe in New London County, CT. \28\ 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, Public Law 93-638. \29\ 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, Public Law 93-638. \30\ 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. \31\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. \32\ Scott County, MS, has historically been a part of the Choctaw Service Unit population since 1970. \33\ The Narragansett Indian Tribe was recognized by Public Law 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. \34\ Entire State of Nevada is included as a CHSDA by regulation (42 CFR 136.22(a)(2)). \35\ Carter County, MT, has historically been a part of the Northern Cheyenne Service Unit population since 1979. \36\ Land of Box Elder County, Utah, was taken into trust for the Northwestern Band of Shoshoni Nation in 1986. \37\ 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, Public Law 93-638. \38\ Washabaugh County, SD, merged and became part of Jackson County, SD, in 1983; both were/are CHSDA counties for the Oglala Sioux Tribe. \39\ Entire State of Oklahoma is included as a CHSDA by regulation (42 CFR 136.22(a)(3)). \40\ Paiute Indian Tribe of Utah Restoration Act, Public Law 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. \41\ In the Federal Register on July 08, 2015 (80 FR 39144), the Pamunkey Indian Tribe was officially recognized as an Indian Tribe within the meaning of Federal law. The counties listed were designated administratively as the Tribe's PRCDA, as announced in the Federal Register on July 28, 2017 (82 FR 35227). \42\ Legislative history (H.R. Report No. 95-1021) to Public Law 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. [[Page 47011]] \43\ 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. \44\ The Passamaquoddy Tribe has two reservations: Indian Township and Pleasant Point. The PRCDA for the Passamaquoddy Tribe at Indian Township, ME, is Aroostook County, ME, Washington County, ME, and Hancock County, ME. The PRCDA for the Passamaquoddy Tribe at Pleasant Point, ME, is Washington County, ME, south of State Route 9, and Aroostook County, ME. \45\ The Passamaquoddy Tribe's counties listed are designated administratively as the SDA, to function as a PRCDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 93-638. \46\ 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 PRC to the Passamaquoddy Tribe and the Penobscot Nation. \47\ 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). \48\ Public Law 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. \49\ The Ponca Restoration Act, Public Law 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. Public Law 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. \50\ 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.). \51\ Historically part of Isabella Reservation Area for the Saginaw Chippewa Indian Tribe of Michigan and the Eastern Michigan Service Unit population since 1979. \52\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, Public Law 93-638. \53\ CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians, Michigan, were designated by regulation (42 CFR 136.22(a)(4)). \54\ 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, Public Law 93-638. \55\ Lemhi County, ID, has historically been a part of the Fort Hall Service Unit population since 1979. \56\ 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, Public Law 93-638. \57\ 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, Public Law 93-638. \58\ 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, Public Law 93-638. \59\ 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). \60\ Rapides County, LA, has historically been a part of the Tunica Biloxi Service Unit population since 1982. \61\ According to Public Law 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. \62\ The counties listed are designated administratively as the SDA, to function as a PRCDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 93-638. \63\ 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). \64\ 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. Dated: October 2, 2017. Michael D. Weahkee, RADM, Assistant Surgeon General, U.S. Public Health Service, Acting Director, Indian Health Service. [FR Doc. 2017-21758 Filed 10-6-17; 8:45 a.m.] BILLING CODE 4165-16-P
![47004 Federal Register / Vol. 82, No. 194 / Tuesday, October 10, 2017 / Notices
Dated: October 2, 2017. Purchased/Referred Care Delivery Area PRCDA, excluding certain counties,
Michael D. Weahkee, (PRCDA) as the geographic area within under section 810 of the Indian
Assistant Surgeon General, U.S. Public Health which Purchased/Referred Care will be Healthcare Improvement Act, Public
Service, Acting Director, Indian Health made available by the Indian Health Law 94–437, as amended (25 U.S.C.
Service. Service (IHS) to members of an 1680). The IHS has utilized the
[FR Doc. 2017–21759 Filed 10–6–17; 8:45 a.m.] identified Indian community who reside congressionally specified PRCDA for the
BILLING CODE 4165–16–P in the Area. PRCDAs were previously purposes of administering PRC benefits
known as Contract Health Service to members of the Tribe. Thus, members
Delivery Areas (CHSDAs) and more of the Tribe who reside outside of the
DEPARTMENT OF HEALTH AND recently, the IHS referred to them as statutorily established California
HUMAN SERVICES Purchased/Referred Care Service PRCDA do not reside within the Tolowa
Delivery Areas (PRCSDAs) or PRCDAs, Dee-ni’s current PRCDA and are
Indian Health Service but the IHS intends to consistently refer currently not eligible for PRC services.
to them as PRCDAs going forward. The IHS has historically established
Re-Designation of the Delivery Area for Residence in a PRCDA by a person who PRCDAs in accordance with
the Tolowa Dee-ni’ Nation, Formerly is within the scope of the Indian health Congressional intent but has preserved
Known as Smith River Rancheria program, as set forth in 42 CFR 136.12, regulatory flexibility to re-designate
AGENCY: Indian Health Service, HHS. creates no legal entitlement to PRC, only areas as appropriate for inclusion in or
potential eligibility for services. exclusion from PRCDA under PRC
ACTION: Final notice.
Services needed, but not available at an regulations. One of the criteria for such
SUMMARY: The Secretary of the IHS/Tribal facility, are provided under re-designations is the geographic
Department of Health and Human the PRC program depending on the proximity of the expanded area to the
Services hereby issues this final notice availability of funds, the person’s existing reservation or PRCDA. Here, the
to re-designate the Purchased/Referred relative medical priority, and the actual IHS is expanding the Tribe’s PRCDA
Care Delivery Area (PRCDA) for the availability and accessibility of alternate beyond the geographic description in 25
Tolowa Dee-ni’ Nation (Tribe) resources in accordance with the U.S.C. 1680 to include a county adjacent
(previously known as the Smith River regulations. to the Tribe’s existing PRCDA, in a
Rancheria of Smith River, California), to As applicable to the Tribes, these neighboring state. There are already
provide Purchased/Referred Care (PRC) regulations provide that, unless PRCDAs that include part of the State of
services to their Tribal members otherwise designated, a PRCDA shall California and part of another state, for
residing in Curry County, Oregon, consist of a county that includes all or example, Cocopah Tribe of Arizona,
which is in the Portland Area Indian part of a reservation and any county or (Yuma, Arizona, and Imperial,
Health Service (IHS). The Tolowa Dee- counties that have a common boundary California); Colorado River Indian
ni’s Tribal Headquarters is located 3 with the reservation, 42 CFR Tribes of the Colorado River Indian
miles south of the California-Oregon 136.22(a)(6). The regulations also Reservation, Arizona and California, (La
border in Northern California. provide that after consultation with the Paz, Arizona; Riverside, California; San
The entire State of California, Tribal governing body or bodies on Bernardino, California; and Yuma,
excluding the counties of Alameda, those reservations included within the Arizona); Fort Mojave Indian Tribe of
Contra Costa, Los Angeles, Marin, PRCDA, the Secretary may from time to Arizona, California and Nevada,
Orange, Sacramento, San Francisco, San time, re-designate areas within the (Nevada; Mohave, Arizona; San
Mateo, Santa Clara, Kern, Merced, United States for inclusion in or Bernardino, California); and the
Monterey, Napa, San Benito, San exclusion from a PRCDA. The Quechan Tribe of Fort Yuma Indian
Joaquin, San Luis Obispo, Santa Cruz, regulations require that certain criteria Reservation, California and Arizona,
Solano, Stanislaus, and Ventura, was must be considered before any re- (Yuma, Arizona; and Imperial,
designated by the IHS as a PRCDA, designation is made. The criteria are as California).
formerly known as a Contract Health follows: The Tolowa Dee-ni’ Tribe has a
Service Delivery Area, in accordance (1) The number of Indians residing in significant number of Tribal members
with statute. The current PRCDA for the area proposed to be so included or who are not residents of California. The
Tolowa Dee-ni’ Tribal members is the excluded; Tribe asserts that 177 Tribal members
(2) Whether the Tribal governing body reside outside of its PRCDA, in Curry
statutorily specified California PRCDA.
has determined that Indians residing in County, in the State of Oregon, and are
The expanded PRCDA for the Tolowa
the area near the reservation are socially not able to access PRC funds from either
Dee-ni’ Tribe includes the statutorily
and economically affiliated with the the California Area facility (Smith River
specified California PRCDA and Curry
Tribe; Howonquet Indian Health Center) or
County in the State of Oregon.
(3) The geographic proximity to the from the closest Portland Area facility.
DATES: This notice shall take effect on Under 42 CFR 136.23, those otherwise
reservation of the area whose inclusion
October 10, 2017. or exclusion is being considered; and eligible Indians who do not reside on a
FOR FURTHER INFORMATION CONTACT: (4) The level of funding which would reservation, but reside within a PRCDA
Terri Schmidt, Acting Director, Office of be available for the provision of PRC, 42 must be either members of the Tribe or
Resource Access and Partnerships, CFR 136.22(b). maintain close economic and social ties
Indian Health Service, 5600 Fishers Additionally, the regulations require with the Tribe. In this case, in applying
Lane, Mail stop: 10E85C, Rockville, that any re-designation of a PRCDA
sradovich on DSK3GMQ082PROD with NOTICES
the aforementioned PRCDA re-
Maryland 20857. Telephone 301/443– must be made in accordance with the designation criteria required by
2694 (This is not a toll free number). Administrative Procedures Act (5 U.S.C. operative regulations codified at 42 CFR
SUPPLEMENTARY INFORMATION: 553). See 42 CFR 136.22(c). In part 136, subpart C, the following
Background: The IHS currently compliance with this requirement, we findings are made:
provides services under regulations are publishing this final notice. 1. By expanding, the Tribe estimates
codified at 42 CFR part 136, subparts A Congress directed the IHS to designate the current eligible population will be
through C. Subpart C defines a the entire State of California as a increased by 177.
VerDate Sep<11>2014 17:26 Oct 06, 2017 Jkt 244001 PO 00000 Frm 00051 Fmt 4703 Sfmt 4703 E:\FR\FM\10OCN1.SGM 10OCN1](https://thefederalregister.org/doc/82_FR_47198/page/1.svg)
![Federal Register / Vol. 82, No. 194 / Tuesday, October 10, 2017 / Notices 47011
43 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.
44 The Passamaquoddy Tribe has two reservations: Indian Township and Pleasant Point. The PRCDA for the Passamaquoddy Tribe at Indian
Township, ME, is Aroostook County, ME, Washington County, ME, and Hancock County, ME. The PRCDA for the Passamaquoddy Tribe at
Pleasant Point, ME, is Washington County, ME, south of State Route 9, and Aroostook County, ME.
45 The Passamaquoddy Tribe’s counties listed are designated administratively as the SDA, to function as a PRCDA, for the purposes of oper-
ating a PRC program pursuant to the ISDEAA, Public Law 93–638.
46 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
PRC to the Passamaquoddy Tribe and the Penobscot Nation.
47 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).
48 Public Law 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.
49 The Ponca Restoration Act, Public Law 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. Public Law 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.
50 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.).
51 Historically part of Isabella Reservation Area for the Saginaw Chippewa Indian Tribe of Michigan and the Eastern Michigan Service Unit pop-
ulation since 1979.
52The 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, Public Law 93–638.
53 CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians, Michigan, were designated by regulation (42 CFR 136.22(a)(4)).
54 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, Public Law 93–638.
55 Lemhi County, ID, has historically been a part of the Fort Hall Service Unit population since 1979.
56 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, Public Law 93–638.
57 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, Public Law 93–638.
58 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, Public Law 93–638.
59 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).
60 Rapides County, LA, has historically been a part of the Tunica Biloxi Service Unit population since 1982.
61 According to Public Law 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.
62 The counties listed are designated administratively as the SDA, to function as a PRCDA, for the purposes of operating a PRC program pur-
suant to the ISDEAA, Public Law 93–638.
63 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).
64 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.
Dated: October 2, 2017. need special assistance, such as sign Date: October 20, 2017.
Michael D. Weahkee, language interpretation or other Open: 9:00 a.m. to 3:45 p.m.
RADM, Assistant Surgeon General, U.S. reasonable accommodations, should Agenda: Patient Safety Racking and
Public Health Service, Acting Director, Indian notify the Contact Person listed below Reporting System; Quality Improvement
Health Service. Assessment Results; IRB Consolidation.
in advance of the meeting. Place: National Institutes of Health
[FR Doc. 2017–21758 Filed 10–6–17; 8:45 a.m.] The portion of the meeting devoted to Building 31, 31 Center Drive, Bethesda, MD
BILLING CODE 4165–16–P the identification and evaluation of 20892.
specific candidates for consideration for Closed: 3:45 p.m. to 5:00 p.m.
leadership positions in the Clinical Agenda: Identification of Candidates for
DEPARTMENT OF HEALTH AND Center will be closed to the public in Leadership Role.
HUMAN SERVICES Place: National Institutes of Health
accordance with the provisions set forth Building 31, 31 Center Drive, Bethesda, MD
National Institutes of Health in section 552b(c)(9)(B) and 552b(c)(6), 20892.
Title 5 U.S.C., as amended. Premature Contact Person: Gretchen Wood, Staff
Office of the Director; Notice of disclosure of potential candidates and Assistant, Office of the Director, National
Meeting their qualifications, as well as the Institutes of Health, One Center Drive,
discussions by the committee, could Building 1, Room 126, Bethesda, MD 20892,
Pursuant to section 10(d) of the significantly frustrate NIH’s ability to 301–496–4272, woodgs@od.nih.gov.
Federal Advisory Committee Act, as recruit these individuals and the Any interested person may file
sradovich on DSK3GMQ082PROD with NOTICES
amended, notice is hereby given of a consideration of personnel written comments with the committee
meeting of the NIH Clinical Center qualifications, performance, and the by forwarding the statement to the
Research Hospital Board. competence of individuals as candidates Contact Person listed on this notice. The
The meeting will be open to the would constitute a clearly unwarranted statement should include the name,
public as indicated below, with invasion of personal privacy. address, telephone number and when
attendance limited to space available. Name of Committee: NIH Clinical Center applicable, the business or professional
Individuals who plan to attend and Research Hospital Board. affiliation of the interested person.
VerDate Sep<11>2014 17:26 Oct 06, 2017 Jkt 244001 PO 00000 Frm 00058 Fmt 4703 Sfmt 4703 E:\FR\FM\10OCN1.SGM 10OCN1](https://thefederalregister.org/doc/82_FR_47198/page/8.svg)
Document Created: 2017-10-07 10:32:17
Document Modified: 2017-10-07 10:32:17
| 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 | This notice shall take effect on October 10, 2017. | |
| Contact | Terri Schmidt, Acting Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mail stop: 10E85C, Rockville, Maryland 20857. Telephone 301/443-2694 (This is not a toll free number). | |
| FR Citation | 82 FR 47004 |
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