Notice To Propose the Re-Designation of the Delivery Area for the Havasupai Tribe

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Federal RegisterMar 5, 2019
84 Fed. Reg. 7910 (Mar. 5, 2019)

AGENCY:

Indian Health Service.

ACTION:

Notice.

SUMMARY:

This notice is to advise the public that the Indian Health Service (IHS) proposes to expand the geographic boundaries of the Purchased/Referred Care (PRC) Delivery Area (DA) for the Havasupai Tribe in Arizona. The Havasupai Tribe's PRCDA is currently Coconino County in the State of Arizona. The IHS proposes to expand the Tribe's PRCDA to include Mojave County, which is adjacent to the Tribe's existing PRCDA in the State of Arizona.

DATES:

Comments due April 4, 2019.

ADDRESSES:

In commenting, please refer to file code [Federal Register insert file code number]. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. You may submit comments in one of four ways (please choose only one of the ways listed):

1. Electronically. You may submit comments electronically to http://www.regulations.gov. Follow the “Submit a Comment” instructions.

2. By postal mail. You may mail written comments to the following address ONLY: Ms. Emmalani Longenecker, Indian Health Service, 5600 Fishers Lane, Mailstop: 09E70, Rockville, Maryland 20857. Please allow sufficient time for mailed comments to be received before the close of the comment period.

3. By express or overnight mail. You may send written comments to the above address.

4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments before the close of the comment period to the following address. Ms. Emmalani Longenecker, Indian Health Service, 5600 Fishers Lane, Mailstop: 09E70, Rockville, Maryland 20857.

If you intend to deliver your comments to the Rockville address, please call telephone number (301) 443-1116 in advance to schedule your arrival with a staff member.

Comments will be made available for public inspection at the Rockville address from 8:30 a.m. to 5:00 p.m., Monday-Friday, two weeks after publication of this notice.

FOR FURTHER INFORMATION CONTACT:

CMDR John Rael, Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mailstop: 10E85C, Rockville, Maryland 20852. Telephone 301/443-2694 (This is not a toll free number).

SUPPLEMENTARY INFORMATION:

Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment.

Background: The IHS currently provides services under regulations in effect on September 15, 1987 and IHS republished at 42 CFR part 136, subparts A-C. Subpart C defines a PRCDA 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 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. 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 which 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 periodically re-designate areas within the United States (U.S.) 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 tribes;

(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 re-designation of a PRCDA must be made in accordance with the Administrative Procedures Act (5 U.S.C. 553). In compliance with this requirement, we are publishing this proposal and requesting public comments. The Havasupai Tribe's home is in Coconino County, Arizona, at the bottom of an extremely rugged section of the Grand Canyon. The reservation lies 3,000 feet below the canyon rim, surrounded by U.S. Forest Service and National Park Service lands. The reservation was initially established by an Executive Order on June 8, 1880. The Grand Canyon National Park Enlargement Act on March 4, 1944, set aside certain public domain lands and provided for an exchange of State-owned lands to be added to the reservation, bringing it to its present size.

The IHS operates a health station in the Havasupai Tribe's Village of Supai, Arizona, within Coconino County. When the health care needs of Havasupai Tribal members' are greater than the available services at the IHS health station, tribal members often move from Supai, Arizona, to the City of Kingman, Arizona. The City of Kingman is located in Mojave County, which is the nearest location that provides higher levels of health care services.

The Havasupai Tribe's current PRCDA is Coconino County in the State of Arizona. The IHS administratively established this PRCDA, based upon the location of the tribe's reservation, for the purposes of administering PRC benefits to tribal members. Members of the tribe who reside outside of Coconino County do not reside within the tribe's PRCDA, meaning they are not currently eligible for PRC services.

Members of the Tribe may be eligible for PRC in other counties based upon their residence on another Tribe's reservation, or their residence within another Tribe's PRCDA and close economic and social ties with that Tribe.

One of the criteria for re-designation is the geographic proximity of the expanded area to the existing reservation or delivery area. IHS proposes to expand the Havasupai Tribe's PRCDA to include Mojave County, which is adjacent to the existing PRCDA, in the State of Arizona. The Havasupai Tribe has a significant number of members who are residents of the shared county boundary with Mojave County. According to the most recent IHS Active User reports, there are approximately 122 enrolled Havasupai Tribal members who reside in Mojave County, Arizona, and remain actively involved with the tribe.

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 other IHS beneficiaries who maintain close economic and social ties with the tribe. In this case, in applying the aforementioned PRC Delivery Area re-designation criteria required by operative regulations codified at 42 CFR part 136, subpart C, the following findings are made:

1. By expanding, the IHS estimates the current eligible population will be increased by 122.

2. The Havasupai Tribe has determined that these 122 individuals are members of the Havasupai Tribe and they are socially and economically affiliated with the Havasupai Tribe.

3. The expanded area including Mojave County in the State of Arizona maintains a common boundary with the statutorily created Coconino County PRCDA.

4. Generally, the Havasupai Tribal members located in Mojave County in the State of Arizona currently do not use the Indian health system for their PRC health care needs. The Havasupai Tribe will use its existing federal allocation for PRC funds to provide health care services to the expanded population. No additional financial resources will be allocated by the IHS to the Havasupai Tribe to provide services to tribal members residing in Mojave County in the State of Arizona.

This notice does not contain reporting or recordkeeping requirements subject to prior approval by the Office of Management and Budget under the Paperwork Reduction Act of 1980.

Purchased/Referred Care Delivery Areas

Tribe/Reservation County/State
Ak Chin Indian Community Pinal, AZ.
Alabama-Coushatta Tribes of Texas Polk, TX.
Alaska Entire State.
Arapahoe Tribe of the Wind River Reservation, Wyoming Hot Springs, WY, Fremont, WY, Sublette, WY.
Aroostook Band of Micmacs Aroostook, ME.
Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Montana Daniels, MT, McCone, MT, Richland, MT, Roosevelt, MT, Sheridan, MT, Valley, MT.
Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin Ashland, WI, Iron, WI.
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 Permanently closed on May 17, 1984.
Burns Paiute Tribe Harney, OR.
California Entire State, except for the counties listed in the footnote.
Catawba Indian Nation (aka Catawba Tribe of South Carolina) All Counties in SC, Cabarrus, NC, Cleveland, NC, Gaston, NC, Mecklenburg, NC, Rutherford, NC, Union, NC.
Cayuga Nation Alleghany, NY, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA.
Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Dakota Corson, SD, Dewey, SD, Haakon, SD, Meade, SD, Perkins, SD, Potter, 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, Arizona and California La Paz, AZ, Riverside, CA, San Bernardino, CA, Yuma, AZ.
Confederated Salish and Kootenai Tribes of the Flathead Reservation Flathead, MT, Lake, MT, Missoula.
Confederated Tribes and Bands of the Yakama Nation Klickitat, WA, Lewis, WA, Skamania, WA, Yakima, WA.
Confederated Tribes of Siletz Indians of Oregon Benton, OR, Clackamas, OR, Lane, OR, Lincoln, OR, Linn, OR, Marion, OR, Multnomah, OR, Polk, OR, Tillamook, OR, Washington, OR, Yamhill, OR.
Confederated Tribes of the Chehalis Reservation Grays Harbor, WA, Lewis, WA, Thurston, WA.
Confederated Tribes of the Colville Reservation Chelan, WA, Douglas, WA, Ferry, WA, Grant, WA, Lincoln, WA, Okanogan, WA, Stevens, WA.
Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians Coos, OR, 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 Marion, OR, Multnomah, OR, Polk, OR, Tillamook, OR, Washington, OR, Yamhill, 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, the city limits of Elton, LA.
Cow Creek Band of Umpqua Tribe of Indians Coos, OR, Deshutes, OR, 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, 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, Stanley, SD.
Crow Tribe of Montana Big Horn, MT, Carbon, MT, Treasure, MT, 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 River Reservation, Wyoming Hot Springs, WY, Fremont, WY, Sublette, WY.
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 Montana Blaine, MT, Phillips, MT.
Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon The entire State of Nevada, Malheur, OR.
Fort McDowell Yavapai Nation, Arizona Maricopa, AZ.
Fort Mojave Indian Tribe of Arizona, California and Nevada The entire State of Nevada, Mohave, AZ, San Bernardino, CA.
Gila River Indian Community of the Gila River Indian Reservation, Arizona Maricopa, AZ, Pinal, AZ.
Grand Traverse Band of Ottawa and Chippewa Indians, Michigan Antrim, MI, Benzie, MI, Charlevoix, MI, Grand Traverse, MI, Leelanau, MI, Manistee, MI.
Hannahville Indian Community, Michigan Delta, MI, Menominee, MI.
Haskell Indian Health Center Douglas, KS.
Havasupai Tribe of the Havasupai Reservation, Arizona Coconino, AZ, Mojave, AZ.
Ho-Chunk Nation of Wisconsin Adams, WI, Clark, WI, Columbia, WI, Crawford, WI, Dane, WI, Eau Clarrie, 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.
Hualapai Indian Tribe of the Hualapai Indian Reservation, Arizona Coconino, AZ, Mohave, AZ, 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, LaSalle Parish, LA, Rapides, LA.
Jicarilla Apache Nation, New Mexico Archuleta, CO, Rio Arriba, NM, Sandoval, NM.
Kaibab Band of Paiute Indians of the Kaibab Indian Reservation, Arizona Coconino, AZ, Mohave, AZ, Kane, UT.
Kalispel Indian Community of the Kalispel Reservation Pend Oreille, WA, Spokane, WA.
Kewa Pueblo, New Mexico (previously listed as the Pueblo of Santo Domingo) Sandoval, NM, Santa Fe, NM.
Keweenaw Bay Indian Community, Michigan Baraga, MI, Houghton, MI, Ontonagon, MI.
Kickapoo Traditional Tribe of Texas Maverick, TX.
Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas Brown, KS, Jackson, KS.
Klamath Tribes Klamath, OR.
Koi Nation of Northern California (formerly known as Lower Lake Rancheria, California) Lake, CA, Sonoma, CA.
Kootenai Tribe of Idaho Boundary, ID.
Lac Courte Oreilles Band of Superior Chippewa Indians of Wisconsin Sawyer, WI.
Lac du Flambeau Band of Lake Superior Chippewa Indians of the Lac du Flambeau Reservation of Wisconsin Iron, WI, Oneida, WI, Vilas, WI.
Lac Vieux Desert Band of Lake Superior Chippewa Indians of Michigan Gogebic, MI.
Little River Band of Ottawa Indians, Michigan Kent, MI, Muskegon, MI, Newaygo, MI, Oceana, MI, Ottawa, MI, Manistee, MI, Mason, MI, Wexford, MI, Lake, MI.
Little Traverse Bay Bands of Odawa Indians, Michigan Alcona, MI, Alger, MI, 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 Reservation, South Dakota Brule, SD, Buffalo, SD, Hughes, SD, Lyman, SD, Stanley, SD.
Lower Elwha Tribal Community Clallam, WA.
Lower Sioux Indian Community in the State of Minnesota Redwood, MN, Renville, MN.
Lummi Tribe of the Lummi Reservation Whatcom, WA.
Makah Indian Tribe of the Makah Indian Reservation Clallam, WA.
Mashantucket Pequot Indian Tribe New London, CT.
Mashpee Wampanoag Tribe Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.
Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan Allegan, MI, Barry, MI, 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 Reservation, New Mexico Chaves, NM, Lincoln, NM, Otero, NM.
Miccosukee Tribe of Indians Broward, FL, Collier, FL, Miami-Dade, FL, Hendry, FL.
Minnesota Chippewa Tribe, Minnesota, Bois Forte Band (Nett Lake) Itasca, MN, Koochiching, MN, St. Louis, MN.
Minnesota Chippewa Tribe, Minnesota, Fond du Lac Band Carlton, MN, St. Louis, MN.
Minnesota Chippewa Tribe, Minnesota, Grand Portage Band Cook, MN.
Minnesota Chippewa Tribe, Minnesota, Leech Lake Band Beltrami, MN, Cass, MN, Hubbard, MN, Itasca, MN.
Minnesota Chippewa Tribe, Minnesota, Mille Lacs Band Aitkin, MN, Kanebec, MN, Mille Lacs, MN, Pine, MN.
Minnesota Chippewa Tribe, Minnesota, White Earth Band Becker, MN, Clearwater, MN, Mahnomen, MN, Norman, MN, Polk, MN.
Mississippi Band of Choctaw Indians Attala, MS, Jasper, MS, Jones, MS, Kemper, MS, Leake, MS, Neshoba, MS, Newton, MS, Noxubee, MS, Scott, MS, 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.
Navajo Nation, Arizona, New Mexico, & Utah Apache, AZ, Bernalillo, NM, 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.
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 Cheyenne Indian Reservation, Montana Big Horn, MT, Carter, MT, Rosebud, MT.
Northwestern Band of Shoshone Nation Box Elder, UT.
Nottawaseppi Huron Band of the Pottawatomi, Michigan Allegan, MI, Barry, MI, 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, Mellette, SD, Pennington, SD, Shannon, SD, Sheridan, NE, Todd, SD.
Ohkay Owingeh, New Mexico Rio Arriba, NM.
Oklahoma Entire State.
Omaha Tribe of Nebraska Burt, NE, Cuming, NE, Monona, IA, Thurston, NE, Wayne, NE.
Oneida Nation (previously listed as the Oneida Tribe of Indians of Wisconsin) Brown, WI, Outagamie, WI.
Oneida Nation Indian Nation (previously listed as the 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, Millard, UT, Sevier, UT, Washington, UT.
Pamunkey Indian Tribe Caroline, VA, Hanover, VA, Henrico, VA, King William, VA, King and Queen, VA, New Kent, VA, Richmond (Independent City).
Pascua Yaqui Tribe of Arizona Pima, AZ.
Passamaquoddy Tribe Aroostook, ME, Hancock, ME, Washington, ME.
Penobscot Nation Aroostook, ME, Penobscot, ME.
Poarch Band of Creeks Baldwin, AL, Elmore, AL, Escambia, AL, Mobile, AL, Monroe, AL, Escambia, FL.
Pokagon Band of Pottawatomi Indians, Michigan and Indiana Allegan, MI, Berrien, MI, 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, 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 State of Minnesota Goodhue, MN.
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, Mexico Sana Fe, NM.
Pueblo of Zia, New Mexico Sandoval, NM.
Puyallup Tribe of the Puyallup Reservation King, WA, Pierce, WA, Thurston, WA.
Quechan Tribe of the Fort Yuma Indian Reservation, Arizona and California Yuma, AZ, Imperial, CA.
Quileute Tribe of the Quileute Reservation Clallam, WA, Jefferson, WA.
Quinault Indian Nation Grays Harbor, WA, Jefferson, WA.
Rapid City, South Dakota Pennington, SD.
Red Cliff Band of Lake Superior Chippewa Indians of Wisconsin Bayfield, WI.
Red Lake Band of Chippewa Indians, Minnesota Beltrami, MN, Clearwater, MN, Koochiching, MN, Lake of the Woods, MN, Marshall, MN, Pennington, MN, Polk, MN, Roseau, MN.
Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota Bennett, SD, Cherry, NE, Gregory, SD, Lyman, SD, Mellette, SD, Todd, SD, Tripp, SD.
Sac & Fox Nation of Missouri in Kansas and Nebraska Brown, KS, Richardson, NE.
Sac & Fox Tribe of the Mississippi in Iowa Tama, IA.
Saginaw Chippewa Indian Tribe of Michigan Arenac, MI, Clare, MI, Isabella, MI, Midland, MI, Missaukee, MI.
Saint Regis Mohawk Tribe Franklin, NY, St. Lawrence, NY.
Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona Maricopa, AZ.
Samish Indian Nation Clallam, WA, 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 Carlos Reservation, Arizona Apache, AZ, Cochise, AZ, Gila, AZ, Graham, AZ, Greenlee, AZ, Pinal, AZ.
San Juan Southern Paiute Tribe of Arizona Coconino, AZ, San Juan, UT.
Santee Sioux Nation, Nebraska Bon Homme, SD, Knox, NE.
Sauk-Suiattle Indian Tribe Snohomish, WA, Skagit, WA.
Sault Ste. Marie Tribe of Chippewa Indians, Michigan Alger, MI, Chippewa, MI, 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 Minnesota Scott, MN.
Shinnecock Indian Nation Nassau, NY, Suffolk, NY.
Shoalwater Bay Tribe of the Shoalwater Bay Indian Reservation Pacific, WA.
Shoshone-Bannock Tribes of the Fort Hall Reservation Bannock, ID, Bingham, ID, Caribou, ID, Lemhi, ID, Power, ID.
Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada The entire SNevada, Owyhee, ID.
Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota Codington, SD, Day, SD, Grant, SD, Marshall, SD, Richland, ND, Roberts, SD, Sargent, ND, Traverse, MN.
Skokomish Indian Tribe Mason, WA.
Skull Valley Band of Goshute Indians of Utah Tooele, UT.
Snoqualmie Indian Tribe King, WA, Snohomish, WA, Pierce, WA, Island, WA, Mason, WA.
Sokaogon Chippewa Community, Wisconsin Forest, WI.
Southern Ute Indian Tribe of the Southern Ute Reservation, Colorado Archuleta, CO, La Plata, CO, 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 Reservation Ferry, WA, Lincoln, WA, Stevens, WA.
Squaxin Island Tribe of the Squaxin Island Reservation Mason, WA.
St. Croix Chippewa Indians of Wisconsin Barron, WI, Burnett, WI, Pine, MN, Polk, WI, Washburn, WI.
Standing Rock Sioux Tribe of North & South Dakota Adams, ND, Campbell, SD, Corson, SD, Dewey, SD, Emmons, ND, Grant, ND, Morton, ND, Perkins, SD, Sioux, ND, Walworth, SD, Ziebach, SD.
Stillaguamish Tribe of Indians of Washington Snohomish, WA.
Stockbridge Munsee Community, Wisconsin Menominee, WI, Shawano, WI.
Suquamish Indian Tribe of the Port Madison Reservation Kitsap, WA.
Swinomish Indian Tribal Community Skagit, WA.
Tejon Indian Tribe Kern, CA.
Three Affiliated Tribes of the Fort Berthold Reservation, North Dakota Dunn, ND, Mercer, ND, McKenzie, ND, McLean, ND, Mountrail, ND, Ward, ND.
Tohono O'odham Nation of Arizona Maricopa, AZ, Pima, AZ, Pinal, AZ.
Tolowa Dee-ni' Nation (formerly known as Smith River Rancheria of California) California, Curry, OR.
Tonawanda Band of Seneca Genesee, NY, Erie, NY, Niagara, NY.
Tonto Apache Tribe of Arizona Gila, AZ.
Trenton Service Unit, North Dakota and Montana Divide, ND, McKenzie, ND, Williams, ND, Richland, MT, Roosevelt, MT, Sheridan, MT.
Tulalip Tribes of Washington Snohomish, WA.
Tunica-Biloxi Indian Tribe Avoyelles, LA, Rapides, LA.
Turtle Mountain Band of Chippewa Indians of North Dakota Rolette, ND.
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 Reservation, Utah Carbon, UT, Daggett, UT, 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, Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.
Washoe Tribe of Nevada & California Nevada, California except for the counties listed in footnote.
White Mountain Apache Tribe of the Fort Apache Reservation, Arizona Apache, AZ, Coconino, AZ, Gila, AZ, Graham, AZ, Greenlee, AZ, Navajo, AZ.
Wilton Rancheria, California Sacramento, CA.
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 Indian Reservation, Arizona Yavapai, AZ.
Yavapai-Prescott Indian Tribe Yavapai, AZ.
Ysleta Del Sur Pueblo of Texas El Paso, TX.
Zuni Tribe of the Zuni Reservation, New Mexico Apache, AZ, Cibola, NM, McKinley, NM, Valencia, NM.
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.
Entire State of Alaska is included as a CHSDA by regulation (42 CFR 136.22(a)(1)).
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.
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).
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).
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.
There is no reservation for the Cayuga Nation; the service delivery area consists of those counties identified by the Cayuga Nation.
Skamania County, WA, has historically been a part of the Yakama Service Unit population since 1979.
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.
Chelan County, WA, has historically been a part of the Colville Service Unit population since 1970.
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.
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.
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.
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.
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.
Treasure County, MT, has historically been a part of the Crow Service Unit population.
The counties listed have historically been a part of the Grand Traverse Service Unit population since 1980.
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).
The PRCDA for the Havasupai Tribe of Arizona is being expanded administratively by the Director, IHS, through regulation (42 CFR 136.22(6)) to include Mojave County in the State of Arizona.
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.
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.
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.
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.
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”.
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.
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.
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.
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.
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.
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.
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.
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.
Scott County, MS, has historically been a part of the Choctaw Service Unit population since 1970.
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.
Entire State of Nevada is included as a CHSDA by regulation (42 CFR 136.22 (a)(2)).
Carter County, MT, has historically been a part of the Northern Cheyenne Service Unit population since 1979.
Land of Box Elder County, Utah, was taken into trust for the Northwestern Band of Shoshoni Nation in 1986.
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.
Washabaugh County, SD, merged and became part of Jackson County, SD, in 1983; both were/are CHSDA counties for the Oglala Sioux Tribe.
Entire State of Oklahoma is included as a CHSDA by regulation (42 CFR 136.22 (a)(3)).
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.
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 SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.
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.
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.
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.
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.
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.
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).
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.
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.
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.).
Historically part of Isabella Reservation Area for the Saginaw Chippewa Indian Tribe of Michigan and the Eastern Michigan Service Unit population since 1979.
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.
CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians, Michigan, were designated by regulation (42 CFR 136.22(a)(4)).
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.
Lemhi County, ID, has historically been a part of the Fort Hall Service Unit population since 1979.
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.
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.
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.
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).
Rapides County, LA, has historically been a part of the Tunica Biloxi Service Unit population since 1982.
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.
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.
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).
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.

Michael D. Weahkee,

RADM, Assistant Surgeon General, U.S. Public Health Service, Principal Deputy Director, Indian Health Service.

[FR Doc. 2019-03884 Filed 3-4-19; 8:45 a.m.]

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