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*Federal Register(s):*

*March 31, 2006 (Vol. 71, Number 62) Page 16320-16324; and*

*June 15, 2006 (Vol. 71, Number 115) Page 34626-34630.*

**DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**09**‑**17**‑**0003**

**System name:** Indian Health Service Medical Staff Credentials and
Privileges Records, HHS/IHS/OCPS.

**Security classification:** None.

**System location:** Each Indian Health Service (IHS) Area Office and
each IHS Service Unit (Appendix 1). Records may also be located at
hospitals and offices of health care providers who are under contract
with IHS. A current list of contractor sites is available by writing to
the appropriate System Manager (Area or Service Unit Director) at the
address shown in Appendix I.

**Categories of individuals covered by the system:** Prospective,
current and former IHS medical staff members. The term IHS medical staff
includes fully licensed individuals permitted by law to provide patient
care services independently and without concurrent professional
direction or supervision, within the scope of his/her license and in
accordance with individually granted clinical privileges. The IHS
medical staff includes physicians (M.D. and D.O.) and dentists and may
include other health care practitioners such as psychologists,
optometrists, podiatrists, audiologists, and, in some states, certified
nurse midwives. Types of assignment categories of current and former IHS
medical staff members include the following:

Provisional\--Those new members of the medical staff who are serving a
required initial probationary period, as specified in the local medical
staff bylaws. During this time, their qualifications for membership on
the active or courtesy IHS medical staff are assessed.

Active\--Those members who are Federal employees and/or spend at least
fifty percent of their professional time providing patient care related
services in the facility.

Temporary\--Those members who provide services on a short-term basis or
have applied for active medical staff membership and are awaiting a full
credential review.

Courtesy or Associate\--Those members who generally provide services on
a periodic or episodic basis (e.g., consultants for specialty clinics).

**Categories of records in the system:** Contains name, Social Security
number, IHS medical staff membership and privileges applications and
associated forms, employment data, liability insurance coverage,
credentialing history of licensed health professionals, personal,
educational, and demographic background information, professional
performance information consisting of continuing education, performance
awards, and adverse or disciplinary actions, and evaluations and
approvals completed by IHS medical staff reviewers.

**Authority for maintenance of the system:** Federal Records Act (44
U.S.C. §2901), Privacy Act of 1974, as amended (5 U.S.C. §552a), Indian
Self Determination and Education and Assistance Act (25 U.S.C. §450),
Snyder Act (25 U.S.C. §13), Indian Health Care Improvement Act (25
U.S.C. §1601 et seq.), Indian Health Service Transfer Act (42 U.S.C.
§2001-2004).

**Purpose(s):** The purposes of this system are:

1\. To ensure that IHS medical staff members are qualified, competent
and capable of delivering quality health services consistent with those
of the medical community at large and that they are granted privileges
commensurate with their training and competence and with the ability of
the facility to provide adequate support equipment, services, and staff.

2\. To inform health care practitioner(s) and staff of health care
facilities, state or county health professional societies or licensing
boards to whom the subject individual may apply for clinical privileges,
membership or licensure, of the subject individual\'s professional
competence, character and ethical qualifications. This may include
information regarding drug or alcohol abuse or dependency. Within the
Department such releases may be made to personnel staffs of DHHS
Regional Offices.

3\. To provide adverse health care practice information to the National
Practitioner Data Bank-Healthcare Integrity and Protection Data Bank
(NPDB-HIPDB) established under Title IV of Pub. L. 99-660, the Health
Care Quality Improvement Act of 1986, as amended, and Section 221(a) of
Pub. L. 104-191, the Heath Insurance Portability and Accountability Act
of 1996. The purpose of such a release is to provide information
concerning a current or former IHS medical staff member whose
professional health care activity failed to conform to generally
accepted standards of professional medical practice.

4\. To provide health care practice information concerning current or
former members of the IHS medical staff with Commissioned Corps status
to the Division of Commissioned Personnel, U.S. Public Health Service,
so that an informed decision may be made concerning the promotion,
retention, or reassignment of the subject individual.

**Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:**

1\. Records may be disclosed to organizations authorized to conduct
evaluation studies concerning the delivery of health care services by
the IHS (e.g., Joint Commission on the Accreditation of Healthcare
Organizations).

2\. IHS may disclose records consisting of name, Social Security number,
employment history and any professional qualification information
concerning medical staff membership and privileges, professional
competence, clinical judgment and personal character to a state or local
government health professional licensing board, to the Federation of
State Medical Boards, to the NPDB-HIPDB, and/or to a similar entity
which has the authority to maintain records concerning the issuance,
retention or revocation of licenses or registrations necessary to
practice a health professional occupation or specialty. The purpose of
this disclosure is to inform medical profession licensing boards and
appropriate entities about the health care practices of a current,
terminated, resigned, or retired IHS medical staff member whose
professional health care activity significantly failed to conform to
generally accepted standards of professional medical practice. This will
be done within the guidelines for notice, hearing, and review as
delineated in the medical staff bylaws for the IHS facility and/or
within other HHS or IHS regulations or policies.

3\. IHS may disclose biographic data and information supplied by
potential applicants to (a) references listed on the IHS medical staff
and/or privileges application and associated forms for the purpose of
evaluating the applicant\'s professional qualifications, experience, and
suitability, and (b) a state or local government health profession
licensing board, to a health-related professional organization, to the
Federation of State Medical Boards, and to the NPDB-HIPDB or a similar
entity for the purpose of verifying that all claimed background and
employment data are valid and all claimed credentials are current and in
good standing.

4\. Records may be disclosed to other Federal agencies (including the
Office of Personnel Management for subject individuals applying for or
maintaining Civil Service appointments), to state and local governmental
agencies, and to organizations in the private sector to which the
subject individual applies for clinical privileges, membership or
licensure for the purpose of documenting the qualifications and
competency of the subject individual to provide health services in
his/her health profession based on the individual\'s professional
performance while employed by the IHS.

5\. The Department may disclose information from this system of records
to the Department of Justice, or to a court or other tribunal, when (a)
HHS, or any component thereof, or (b) any HHS employee in his or her
official capacity; or (c) any HHS employee in his or her individual
capacity where the Department of Justice (or HHS, where it is authorized
to do so) has agreed to represent the employee; or (d) the United States
or any agency thereof where HHS determines that the litigation is likely
to affect HHS or any of its components, is a party to litigation or has
an interest in such litigation, and HHS determines that the use of such
records by the Department of Justice, the court or other tribunal is
relevant and necessary to the litigation and would help in the effective
representation of the governmental party, provided, however, that in
each case, HHS determines that such disclosure is compatible with the
purpose for which the records were collected.

6\. Records may be disclosed to a congressional office from the record
of an individual in response to a verified inquiry from the
congressional office made at the written request of that individual.

7\. In the event that a system of records maintained by the IHS to carry
out its functions indicates a violation or potential violation of law,
whether civil, criminal, or regulatory in nature, and whether arising by
general statute or particular program statute, or by regulation, rule or
order issued pursuant thereto, the relevant records in the system of
records may be referred to the appropriate agency, whether Federal,
state, or local, charged with enforcing or implementing the statute or
rule, regulation or order issued pursuant thereto.

**Policies and practices for storing, retrieving, accessing, retaining,
and disposing of records in the system:**

**Storage:** File folders and computer-based or electronic files.

**Retrievability:** Indexed and retrieved by name, Social Security
number, and any other identifying numbers necessary to establish the
identity of an individual whose record is maintained in the system of
records.

**Safeguards:**

1\. **Authorized Users:** Access is limited to authorized personnel for
use in the performance of their official duties. Authorized personnel
include: Physician Recruitment and other Health Professions Branch Staff
and Area Governing Board Members at IHS Area Offices, and Service Unit
Directors, Clinical Directors and members of the Credentials and
Privilege Committee of each IHS Service Unit. At each location where
records in this system will be maintained, a list of personnel or
categories of personnel having an official need-to-know has been
developed and is maintained.

2\. **Physical Safeguards:** Records are kept in locked metal filing
cabinets or in locked desk drawers in secured rooms at all times when
not actually in use during working hours and at all times during
non-working hours. Record storage areas, including file cabinets and
desks, are not left unattended or unlocked during office hours,
including lunch hours. Computer-based or electronic records are password
protected security and any additional internal security for database
(linked or unlinked).

3\. **Procedural Safeguards:** Persons who have an official need-to-know
are entrusted with records from this system of records and are
instructed to safeguard the confidentiality of these records and to
destroy all copies or to return such records when the need to know has
expired. Instructions include the statutory penalties for noncompliance.
Proper charge-out procedures are followed for the removal of records
from the area in which they are maintained. Before an employee who will
control disclosure of records can work with the records (i.e., employees
who report to the system manager) the system manager or designee ensures
that the employee has received training in the safeguards applicable to
the records and is aware of the actions to take to restrict disclosure.
When copying records for authorized purposes, care is taken to ensure
that any imperfect pages are not left in the reproduction room where
they can be read but are destroyed or obliterated.

4\. **Implementation Guidelines:** DHHS Chapter 45-13 and supplementary
Chapter PHS.hf:45-13 of the General Administration Manual; DHHS,
"Automated Information Systems Security Program Handbook," as amended;
DHHS IRM Policy HHS-IRM-2000-0005, "IRM Policy for IT Security for
Remove Access; OMB Circular A-130 []{.mark}"Management of Federal
Information Resources"; and E-Government Act of 2002 (Public Law
107-347, 44 U.S.C. Ch 36).

**Retention and disposal:** Records are maintained by IHS for at least
ten years after the individual\'s termination of employment or
association with IHS. Records of unsuccessful applicants for medical
staff membership will be retained for three years after his/her
rejection. After these periods of retention expire, records are
destroyed by shredding or burning.

**System manager(s) and address:** See Appendix 1.

**Policy Coordinating Official:** Director, Office of Clinical and
Preventive Services, IHS, 801 Thompson Avenue, Suite 300, Rockville,
Maryland 20852. The IHS Clinical Directors at all IHS Service Units
listed in Appendix 1 are System Managers. IHS medical staff credentials
and privileges files are stored at these locations. Other addresses
listed in Appendix 1 are locations at which all or parts of these
records may also be stored (Physician Recruiter at IHS Area Offices).
Post Office Box designations appearing in Appendix 1 should be specified
when making requests by mail.

**Notification procedure:**

Requests must be made to the appropriate System Manager (Clinical
Director for the appropriate Service Unit) listed in Appendix 1.

**Requests by mail:** Requests for information and/or access to records
received by mail must contain information providing the identity of the
writer and a reasonable description of the record desired. Written
requests must contain, at a minimum, the name, signature, Social
Security number, and address of the requester, and for unsuccessful
applicants the date when the application was submitted, and for current
or former IHS health care providers the dates and locations of service.
We may request additional identification when we hold records for
different persons with the same name or where an apparent discrepancy
exists between information contained in the record and that provided by
the individual requesting access to the record.

**Other names used:** Where an individual is seeking to obtain
information about himself/herself which may be retrieved by a different
name than his/her current name, he/she shall be required to produce
evidence to verify that he/she is the person whose record he/she seeks.

**Requests in person:** A subject individual who appears in person at a
specific location (where he or she currently works or formerly worked)
seeking access or disclosure of records contained in this system of
records relating to him/her shall provide the information described in
"Requests by mail" (above) and at least one piece of tangible
identification such as a driver\'s license or passport.

**Requests by telephone:** Since positive identification of the caller
cannot be established, telephone requests are not honored.

**Record access procedures:**

**Same as Notification Procedure:** Requesters should also provide a
reasonable description of the record being sought. Requesters may also
request an accounting of disclosures that have been made of their
records, if any.

**Contesting record procedures:** Write to the appropriate Service Unit
Clinical Director at the address specified in Appendix 1 and reasonably
identify the record, specify the information being contested, and state
the corrective action sought, and the reasons for requesting the
correction, along with supporting information to show how the record is
inaccurate, incomplete, untimely, or irrelevant.

**Record source categories:** Subject individual, IHS health care
personnel, references supplied by the subject individual, professional
societies or associations, specialty boards, colleges and universities
attended by the subject individual, former employers, health facilities
or health providers with which the subject individual was associated,
liability insurance carriers, organizations providing cardiopulmonary
resuscitation (CPR) training to the subject individual, state and local
health and health care licensing or certifying organizations, and
organizations which serve as repositories of information on health care
professionals.

**Systems exempted from certain provisions of the act:** None.

**Appendix 1: System Managers and IHS Locations Under Their Jurisdiction
Where Records are Maintained.**

**Director, Aberdeen Area Indian Health Service**, Room 309, Federal
Building, 115 Fourth Avenue, SE, Aberdeen, South Dakota 57401**.**

Director, Cheyenne River Service Unit, Eagle Butte Indian Hospital, P.O.
Box 1012, Eagle Butte, South Dakota 57625.

Director, Crow Creek Service Unit, Ft. Thompson Indian Health Center,
P.O. Box 200, Ft. Thompson, South Dakota 57339.

Director, Fort Berthold Service Unit, Fort Berthold Indian Health
Center, P.O. Box 400, New Town, North Dakota 58763.

Director, Carl T. Curtis Health Center, P.O. Box 250, Macy,

Nebraska 68039.

Director, Fort Totten Service Unit, Fort Totten Indian Health Center,
P.O. Box 200, Fort Totten, North Dakota 58335.

Director, Kyle Indian Health Center, P.O. Box 540, Kyle, South Dakota
57752.

Director, Lower Brule Indian Health Center, P.O. Box 191, Lower Brule,
South Dakota 57548.

Director, McLaughlin Indian Health Center, P.O. Box 879,

McLaughlin, South Dakota 57642.

Director, Omaha-Winnebago Service Unit, Winnebago Indian Hospital,
Winnebago, Nebraska 68071.

Director, Pine Ridge Service Unit, Pine Ridge Indian Hospital, Pine
Ridge, South Dakota 57770.

Director, Rapid City Service Unit, Rapid City Indian Hospital, 3200
Canyon Lake Drive, Rapid City, South Dakota 57701.

Director, Rosebud Service Unit, Rosebud Indian Hospital, Rosebud, South
Dakota 57570.

Director, Sisseton-Wahpeton Service Unit, Sisseton Indian

Hospital, P.O. Box 189, Sisseton, South Dakota 57262.

Director, Standing Rock Service Unit, Fort Yates Indian Hospital, P.O.
Box J, Fort Yates, North Dakota 58538.

Director, Trenton-Williston Indian Health Center, P.O. Box 210, Trenton,
North Dakota 58853.

Director, Turtle Mountain Service Unit, Belcourt Indian Hospital, P.O.
Box 160, Belcourt, North Dakota 58316.

Director, Wanblee Indian Health Center, 100 Clinic Drive, Wanblee, South
Dakota 57577.

Director, Yankton-Wagner Service Unit, Wagner Indian Hospital, 110
Washington Street, Wagner, South Dakota 57380.

Director, Youth Regional Treatment Center, P.O. Box #68,

Mobridge, South Dakota 57601.

Director, Sac & Fox Health Center, 307 Meskwaki Road, Tama, Iowa 52339.

Director, Santee Health Center, 425 Frazier Avenue, Main Street #2,
Niobrara, Nebraska 68760.

**Director, Alaska Area Native Health Service***,* 4141 Ambassador
Drive, Suite 300, Anchorage, Alaska 99508-5928.

**Director, Albuquerque Area Health Service,** 5300 Homestead Road, NE,
Albuquerque, New Mexico 87110.

Director, Acoma-Canoncito-Laguna Service Unit, Acoma-Canoncito-Laguna
Indian Hospital, P.O. Box 130, San Fidel, New Mexico 87049.

Director, To-Hajille Health Center, P.O. Box 3528, Canoncito, New Mexico
87026.

Director, New Sunrise Treatment Center, P.O. Box 219, San Fidel, New
Mexico 87049.

Director, Albuquerque Service Unit, Albuquerque Indian Hospital, 801
Vassar Drive, NE, Albuquerque, New Mexico 87049.

Director, Albuquerque Indian Dental Clinic, P.O. Box 67830,

Albuquerque, New Mexico 87193.

Director, Alamo Navajo Health Center, P.O. Box 907, Magdalena, New
Mexico 87825.

Director, Jemez PHS Health Center, P.O. Box 279, Jemez, New

Mexico 87024.

Director, Santa Ana PHS Health Center, P.O. Box 37, Bernalillo, New
Mexico 87004.

Director, Sandia PHS Health Center, P.O. Box 6008, Bernalillo, New
Mexico 87004.

Director, Zia PHS Health Center, 155 Capital Square, Zia, New Mexico
87053.

Director, Santa Fe Service Unit, Santa Fe Indian Hospital, 1700
Cerrillos Road, Santa Fe, New Mexico 87501.

Director, Santa Clara Health Center, RR5, Box 446, Espanola, New Mexico
87532.

Director, San Felipe Health Center, P.O. Box 4344, San Felipe, New
Mexico 87001.

Director, Cochiti Health Center, P.O. Box 105, 255 Cochiti Street,
Cochiti, New Mexico 87072.

Director, Santo Domingo Health Center, P.O. Box 340, Santo Domingo, New
Mexico 87052.

Director, Southern Colorado-Ute Service Unit, P.O. Box 778,

Ignacio, Colorado 81137.

Director, Ignacio Indian Health Center, P.O. Box 889, Ignacio, Colorado
81137.

Director, Towaoc Ute Health Center, Towaoc, Colorado 81334.

Director, Jicarilla Indian Health Center, P.O. Box 187, Dulce, New
Mexico 87528.

Director, Mescalero Service Unit, Mescalero Indian Hospital, P.O. Box
210, Mescalero, New Mexico 88340.

Director, Taos/Picuris Indian Health Center, P.O. Box 1956, 1090 Goat
Springs Road, Taos, New Mexico 87571.

Director, Zuni Service Unit, Zuni Indian Hospital, Zuni, New Mexico
87327.

Director, Pine Hill Health Center, P.O. Box 310, Pine Hill, New Mexico
87357.

Director, Bemidji Area Indian Health Service, 522 Minnesota Avenue,
N.W., Bemidji, Minnesota 56601.

Director, Red Lake Service Unit, PHS Indian Hospital, Highway 1, Red
Lake, Minnesota 56671.

Director, Leech Lake Service Unit, PHS Indian Hospital, 425 7^th^
Street, NW, Cass Lake, Minnesota 56633.

Director, White Earth Service Unit, PHS Indian Hospital, P.O. Box 358,
White Earth, Minnesota 56591.

**Director, Billings Area Indian Health Service,** P.O. Box 36600, 2900
4^th^ Avenue North, Billings, Montana 59101.

Director, Blackfeet Service Unit, Browning Indian Hospital, P.O. Box
760, Browning, Montana 59417.

Director, Heart Butte PHS Indian Health Clinic, Heart Butte, Montana
59448.

Director, Crow Service Unit, Crow Indian Hospital, Crow Agency, Montana
59022.

Director, Lodge Grass PHS Indian Health Center, Lodge Grass, Montana
59090.

Director, Pryor PHS Indian Health Clinic, P.O. Box 9, Pryor, Montana
59066.

Director, Fort Peck Service Unit, Poplar Indian Hospital,

Poplar, Montana 59255.

Director, Fort Belknap Service Unit, Harlem Indian Hospital, Harlem,
Montana 59526.

Director, Hays PHS Indian Health Clinic, Hays, Montana 59526.

Director, Northern Cheyenne Service Unit, Lame Dear Indian

Health Center, Lame Deer, Montana 59043.

Director, Wind River Service Unit, Fort Washakie Indian Health Center,
Fort Washakie, Wyoming 82514.

Director, Arapahoe Indian Health Center, Arapahoe, Wyoming 82510.

Director, Chief Redstone Indian Health Center, Wolf Point,

Montana 59201.

**Director, California Area Indian Health Service,** John E. Moss
Federal Building, 650 Capitol Mall, Suite 7-100, Sacramento, California
95814.

**Director, Nashville Area Indian Health Service,** 711 Stewarts Ferry
Pike, Nashville, Tennessee 37214-2634.

Director, Catawba PHS Indian Nation of South Carolina, P.O. Box 188,
Catawba, South Carolina 29704.

Director, Unity Regional Youth Treatment Center, P.O. Box C - 201,
Cherokee, North Carolina 28719.

**Director, Navajo Area Indian Health Service,** P.O. Box 9020,

Highway 264, Window Rock, Arizona 86515-9020.

Director, Chinle Service Unit, Chinle Comprehensive Health Care
Facility, PO Drawer PH, Chinle, Arizona 86503.

Director, Tsaile Health Center, P.O. Box 467, Navajo Routes 64 & 12,
Tsaile, Arizona 86556.

Director, Rock Point Field Clinic, c/o Tasaile Health Center, P.O. Box
647, Tsaile, Arizona 86557.

Director, Pinon Health Station, Pinon, Arizona 86510.

Director, Crownpoint Service Unit, Crownpoint Comprehensive Health Care
Facility, P.O. Box 358, Crownpoint, New Mexico 87313.

Director, Pueblo Pintado Health Station, c/o Crownpoint Comprehensive
Health Care Facility, P.O. Box 358, Crownpoint, New Mexico 87313.

Director, Fort Defiance Service Unit, Fort Defiance Indian Hospital,
P.O. Box 649, Intersection of Navajo Routes N12 & N7, Fort Defiance,
Arizona 86515.

Director, Nahata Dziil Health Center, P.O. Box 125, Sanders, Arizona
86512

Director, Gallup Service Unit, Gallup Indian Medical Center, P.O. Box
1337, Nizhoni Boulevard, Gallup, New Mexico 87305.

Director, Tohatchi Indian Health Center, P.O. Box 142, Tohatchi, New
Mexico 87325.

Director, Ft. Wingate Health Station, c/o Gallup Indian Medical Center,
P.O. Box 1337, Gallup, New Mexico 87305.

Director, Kayenta Service Unit, Kayenta Indian Health Center, P.O. Box
368, Kayenta, Arizona 86033.

Director, Inscription House Health Center, P.O. Box 7397, Shonto,
Arizona 86054.

Director, Dennehotso Clinic, c/o Kayenta Health Center, P.O. Box 368,
Kayenta, Arizona 86033.

Director, Shiprock Service Unit, Northern Navajo Medical Center, P.O.
Box 160, U.S. Hwy 491 North, Shiprock, New Mexico 87420.

Director, Dzilth-Na-O-Dith-Hle Indian Health Center, 6 Road 7586,
Bloomfield, New Mexico 87413.

Director, Teecnospos Health Center, P.O. Box 103, N5114 BIA School Road,
Teecnospos, Arizona 86514.

Director, Sanostee Health Station, c/o Northern Navajo Medical Center,
P.O. Box 160, Shiprock, New Mexico 87420.

Director, Toadlena Health Station, c/o Northern Navajo Medical Center,
P.O. Box 160, Shiprock, New Mexico 87420.

Director, Teen Life Center, c/o Northern Navajo Medical Center, P.O. Box
160, Shiprock, New Mexico 87420.

**Director, Oklahoma City Area Indian Health Service,** Five Corporation
Plaza, 3625 NW 56^th^ Street, Oklahoma City, Oklahoma 73112.

Director, Claremore Service Unit, Claremore Comprehensive Indian Health
Facility, West Will Rogers Boulevard and Moore, Claremore, Oklahoma
74017.

Director, Clinton Service Unit, Clinton Indian Hospital, Route 1, Box
3060, Clinton, Oklahoma 73601-9303.

Director, El Reno PHS Indian Health Clinic, 1631A E. Highway 66, El
Reno, Oklahoma 73036.

Director, Watonga Indian Health Center, Route 1, Box 34-A, Watonga,
Oklahoma 73772.

Director, Haskell Service Unit, PHS Indian Health Center, 2415
Massachusetts Avenue, Lawrence, Kansas 66044.

Director, Lawton Service Unit, Lawton Indian Hospital, 1515

Lawrie Tatum Road, Lawton, Oklahoma 73501.

Director, Anadarko Indian Health Center, P.O. Box 828, Anadarko,
Oklahoma 73005.

Director, Carnegie Indian Health Center, P.O. Box 1120, Carnegie,
Oklahoma 73150.

Director, Holton Service Unit, PHS Indian Health Center, 100 West 6^th^
Street, Holton, Kansas 66436.

Director, Pawnee Service Unit, Pawnee Indian Service Center, RR2, Box 1,
Pawnee, Oklahoma 74058-9247.

Director, Pawhuska Indian Health Center, 715 Grandview, Pawhuska,
Oklahoma 74056.

Director, Tahlequah Service Unit, W. W. Hastings Indian Hospital, 100 S.
Bliss, Tahlequah, Oklahoma 74464.

Director, Wewoka Indian Health Center, P.O. Box 1475, Wewoka, Oklahoma
74884.

**Director, Phoenix Area Indian Health Service,** Two Renaissance
Square, 40 North Central Avenue, Phoenix, Arizona 85004.

Director, Colorado River Service Unit, Chemehuevi Indian Health Clinic,
P.O. Box 1858, Havasu Landing, California 92363.

Director, Colorado River Service Unit, Havasupai Indian Health Station,
P.O. Box 129, Supai, Arizona 86435.

Director, Colorado River Service Unit, Parker Indian Health

Center, 12033 Agency Road, Parker, Arizona 85344.

Director, Colorado River Service Unit, Peach Springs Indian

Health Center, P.O. Box 190, Peach Springs, Arizona 86434.

Director, Colorado River Service Unit, Sherman Indian High School, 9010
Magnolia Avenue, Riverside, California 92503.

Director, Elko Service Unit, Southern Bands Health Center, 515 Shoshone
Circle, Elko, Nevada 89801.

Director, Fort Yuma Service Unit, Fort Yuma Indian Hospital, P.O. Box
1368, Fort Yuma, Arizona 85366.

Director, Keams Canyon Service Unit, Hopi Health Care Center, P.O. Box
4000, Polacca, Arizona 86042.

Director, Phoenix Service Unit, Phoenix Indian Medical Center, 4212
North 16th Street, Phoenix, Arizona 85016.

Director, Phoenix Service Unit, Salt River Health Center, 10005 East
Osborn Road, Scottsdale, Arizona 85256.

Director, San Carlos Service Unit, Bylas Indian Health Center, P.O. Box
208, Bylas, Arizona 85550.

Director, San Carlos Service Unit, San Carlos Indian Hospital, P.O. Box
208, San Carlos, Arizona 85550.

Director, Schurz Service Unit, Schurz Service Unit Administration,
Drawer A, Schurz, Nevada 89427.

Director, Fort McDermitt Clinic, P.O. Box 315, McDermitt, Nevada 89421.

Director, Unitah and Ouray Service Unit, Fort Duchesne Indian Health
Center, P.O. Box 160, Fort Duchesne, Utah 84026.

Director, Whiteriver Service Unit, Cibecue Health Center, P.O. Box 37,
Cibecue, Arizona 85941.

Director, Whiteriver Service Unit, Whiteriver Indian Hospital, P.O. Box
860, Whiteriver, Arizona 85941.

Director, Desert Vision Youth Wellness Center/RTC, P.O. Box 458,
Sacaton, AZ 85247.

**Director, Portland Area Indian Health Service,** Room 476, Federal
Building, 1220 Southwest Third Avenue, Portland, Oregon 97204-2829.

Director, Colville Service Unit, Colville Indian Health Center, P.O. Box
71-Agency Campus, Nespelem, Washington 99155.

Director, Fort Hall Service Unit, Not-Tsoo Gah-Nee Health Center, P.O.
Box 717, Fort Hall, Idaho 83203.

Director, Neah Bay Service Unit, Sophie Trettevick Indian Health Center,
P.O. Box 410, Neah Bay, Washington 98357.

Director, Warm Springs Service Unit, Warm Springs Indian Health Center,
P.O. Box 1209, Warm Springs, Oregon 97761.

Director, Wellpinit Service Unit, David C. Wynecoop Memorial Clinic,
P.O. Box 357, Wellpinit, Washington 99040.

Director, Western Oregon Service Unit, Chemawa Indian Health Center,
3750 Chemawa Road, NE, Salem, Oregon 97305-1198.

Director, Yakama Service Unit, Yakama Indian Health Center, 401 Buster
Road, Toppenish, Washington 98948.

**Director, Tucson Area Indian Health Service,** 7900 South "J" Stock
Road, Tucson, Arizona 85746-9352.

Director, Pascua Yaqui Service Unit, Division of Public Health, 7900
South "J" Stock Road, Tucson, Arizona 85746.

Director, San Xavier Indian Health Center, 7900 South "J" Stock Road,
Tucson, Arizona 85746.

Director, Sells Service Unit, Santa Rosa Indian Health Center, HCO1, Box
8700, Sells, Arizona 85634.

Director, Sells Service Unit, Sells Indian Hospital, P.O. Box 548,
Sells, Arizona 85634.

Director, Sells Service Unit, West Side Health Station, P.O. Box 548,
Sells, Arizona 85634.