Federal Register / Vol. 88, No. 246 / Tuesday, December 26, 2023 / Notices 88927 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of 

respondent 

Number of 

respondents 

Number 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Total burden 

hours 

Transfusing Hospitals ............................................................. 2754 1 1 hour, 46 min ........................ 4,865 

Hospital Blood Banks .............................................................. 83 1 1 hour, 46 min ........................ 147 

Community-based blood center .............................................. 53 1 1 hour, 46 min ........................ 94 

Total ................................................................................. 2,890 ........................ ................................................. 5,106 

James Berger, 

Senior Advisor for Blood and Tissue Safety, 

Office of the Assistant Secretary for Health. 

[FR Doc. 2023–28412 Filed 12–22–23; 8:45 am] 

BILLING CODE 4150–41–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

Notice of Purchased/Referred Care 

Delivery Area Redesignation for the 

Spokane Tribe of Indians in the State 

of Washington 

AGENCY: Indian Health Service, HHS. 

ACTION: Notice. 

SUMMARY: Notice is hereby given that 

the Indian Health Service (IHS) has 

decided to expand the geographic 

boundaries of the Purchased/Referred 

Care Delivery Area (PRCDA) for the 

Spokane Tribe to include the counties of 

Spokane and Whitman in the State of 

Washington. The final PRCDA for the 

Spokane Tribe now includes the 

Washington counties of Ferry, Lincoln, 

Spokane, Stevens, and Whitman. The 

sole purpose of this expansion is to 

authorize additional Spokane Tribal 

members and beneficiaries to receive 

Purchased/Referred Care (PRC) services. 

DATES: This expansion is effective as of 

the publication date of this notice. 

ADDRESSES: This notice can be found at 

https://www.federalregister.gov. Written 

requests for information should be 

delivered to: CAPT John Rael, Director, 

Office of Resource Access and 

Partnerships, Indian Health Service, 

5600 Fishers Lane, Mail Stop 10E85C, 

Rockville, MD 20857, or by phone at 

(301) 443–0969 (this is not a toll-free 

number). 

SUPPLEMENTARY INFORMATION: The IHS 

provides services under regulations in 

effect as of September 15, 1987, and 

republished at 42 CFR part 136, 

subparts A–C. Subpart C defines a 

Contract Health Service Delivery Area 

(CHSDA), now referred to as 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 PRCDA. 

Residence within 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 but only potential eligibility for 

services. Services needed, but not 

available at an IHS/Tribal facility, are 

provided under the PRC program 

depending on the availability of funds, 

the relative medical priority of the 

services to be provided, and the actual 

availability and accessibility of alternate 

resources in accordance with the 

regulations. 

The regulations at 42 CFR part 136, 

subpart C 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 

which have a common boundary with 

the reservation. 42 CFR 136.22(a)(6). 

The regulations also provide that after 

consultation with the Tribal governing 

body or bodies on those reservations 

included within the PRCDA, the 

Secretary may from time to time, 

redesignate areas within the United 

States for inclusion in or exclusion from 

a PRCDA. 42 CFR 136.22(b). The 

regulations require that certain criteria 

must be considered before any 

redesignation is made. The criteria are 

as follows: 

(1) The number of Indians residing in 

the area proposed to be so included or 

excluded; 

(2) Whether the Tribal governing body 

has determined that Indians residing in 

the area near the reservation are socially 

and economically affiliated with the 

Tribe; 

(3) The geographic proximity to the 

reservation of the area whose inclusion 

or exclusion is being considered; and 

(4) The level of funding which would 

be available for the provision of PRC. 

Additionally, the regulations require 

that any redesignation of a PRCDA must 

be made in accordance with the 

procedures of the Administrative 

Procedure Act (5 U.S.C. 553). 42 CFR 

136.22(c). In compliance with this 

requirement, the IHS published a 

proposed notice of redesignation and 

requested public comments on August 

9, 2023 (88 FR 53899). The IHS did not 

receive any comments to the notice of 

the proposed expansion. 

Two other Tribes currently have 

PRCDAs which include one or both of 

the counties to be included in the 

Spokane Tribe’s expanded PRCDA—the 

Coeur d’Alene Tribe (both Spokane and 

Whitman Counties) and the Kalispel 

Tribe of Indians (Spokane County only). 

On December 10, 2021, the Portland 

Area Director notified both Tribes of the 

Spokane Tribe’s request to expand their 

PRCDA, and requested any comments in 

response. The Kalispel Tribe of Indians 

did not provide any comments. The 

Coeur d’Alene Tribe responded with 

objections to the proposed expansion. 

The Portland Area IHS engaged in 

further conversations and 

correspondence with the Coeur d’Alene 

Tribe throughout 2021 and 2022. 

Through letters from the Spokane 

Tribe, dated May 31, 2022 and August 

8, 2022, the Tribe expressed its support 

for the expansion, described the 

geographic proximity of Spokane and 

Whitman counties to the Tribe’s 

reservation, and explained that the 

Tribe’s reservation expanded into 

Spokane County in 2001 and that some 

of the Tribe’s members reside in 

Whitman County. 

In support of this expansion, the IHS 

adopts the following findings: 

1. By expanding the PRCDA to 

include Spokane County and Whitman 

County, the Spokane Tribe’s eligible 

population will be increased by an 

estimated 480 Tribal members. 

Although the Coeur d’Alene Tribe has a 

PRCDA which includes these two 

counties, the Coeur d’Alene Tribe does 

not provide PRC services to Spokane 

Tribal members residing in those 

counties. Expansion of the Spokane 

Tribe’s PRCDA to include Spokane and 

Whitman Counties will therefore 

increase access to care for those 

individuals. 

2. The IHS finds that the Tribal 

members within the expanded PRCDA 

are socially and economically affiliated 

with the Spokane based on letters from 

the Spokane Tribe, dated May 31, 2022 

and August 8, 2022, which noted that 

the Spokane Tribal Council had 


khammond on DSKJM1Z7X2PROD with NOTICES
88928 Federal Register / Vol. 88, No. 246 / Tuesday, December 26, 2023 / Notices 

determined that Tribal members 

residing in Spokane and Whitman 

counties are socially and economically 

affiliated with the Tribe. 

3. Spokane and Whitman Counties in 

the State of Washington are ‘‘on or near’’ 

the reservation, as they maintain 

common boundaries with the current 

PRCDA consisting of the counties of 

Ferry, Lincoln, and Stevens in the State 

of Washington. Additionally, Spokane 

County includes part of the Spokane 

reservation, and Whitman County 

includes the Tribe’s aboriginal territory. 

4. The IHS administers the Wellpinit 

Service Unit PRC program and will use 

its existing Federal allocation for PRC to 

provide services to the expanded 

population. No additional financial 

resources will be allocated by the IHS to 

the Portland Area IHS to provide 

services to Spokane Tribal members 

residing in Spokane and Whitman 

Counties in the State of Washington. 

An updated listing of the PRCDAs for 

all federally-recognized Tribes may be 

accessed via a link under the 

‘‘Purchased/Referred Care Delivery 

Area’’ heading on the IHS PRC 

Resources website (https://www.ihs.gov/ 

prc/resources). 

Public Comments: The IHS did not 

receive any comments to the notice of 

the proposed expansion. 

Roselyn Tso, 

Director, Indian Health Service. 

[FR Doc. 2023–28311 Filed 12–22–23; 8:45 am] 

BILLING CODE 4165–16–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

Notice of Purchased/Referred Care 

Delivery Area Redesignation for the 

Mid-Atlantic Tribes in the States of 

Maryland, North Carolina, and Virginia 

AGENCY: Indian Health Service, HHS. 

ACTION: Notice. 

SUMMARY: Notice is hereby given that 

the Indian Health Service (IHS) has 

decided to view the seven Mid-Atlantic 

Tribes in the Commonwealth of Virginia 

collectively and to expand the 

geographic boundaries of their current 

Purchased/Referred Care Delivery Areas 

(PRCDAs). The seven Mid-Atlantic 

Tribes include the Pamunkey Indian 

Tribe, Chickahominy Indian Tribe, 

Chickahominy Indian Tribe—Eastern 

Division, Upper Mattaponi Tribe, 

Rappahannock Tribe, Monacan Indian 

Nation, and Nansemond Indian Tribe. 

DATES: This expansion is effective as of 

the publication date of this notice. 

ADDRESSES: This notice can be found at 

https://www.federalregister.gov. Written 

requests for information should be 

delivered to: CAPT John Rael, Director, 

Office of Resource Access and 

Partnerships, Indian Health Service, 

5600 Fishers Lane, Mail Stop 10E85C, 

Rockville, MD 20857, or by phone at 

(301) 443–0969 (this is not a toll-free 

number). 

SUPPLEMENTARY INFORMATION: The final 

collective PRCDA for the seven MidAtlantic Tribes now includes the 

following counties and independent 

cities: 

Counties in the Commonwealth of 

Virginia: Accomack, Albemarle, 

Alleghany, Amelia, Amherst, 

Appomattox, Arlington, Augusta, Bath, 

Bedford, Botetourt, Buckingham, 

Campbell, Caroline, Charlotte, 

Chesterfield, Clarke, Cumberland, 

Culpeper, Dinwiddie, Essex, Fauquier, 

Floyd, Fluvanna, Gloucester, Greene, 

Greensville, Goochland, Hanover, 

Henrico, Isle of Wight, James City, King 

and Queen, King George, King William, 

Lancaster, Loudoun, Louisa, Lunenburg, 

Mathews, Mecklenburg, Middlesex, 

Montgomery, Nelson, New Kent, 

Newport News, Norfolk, Nottoway, 

Orange, Page, Patrick, Pittsylvania, 

Powhatan, Prince Edward, Prince 

George, Prince William, Pulaski, 

Richmond, Rockbridge, Rockingham, 

Southampton, Spotsylvania, Stafford, 

Warren, Westmoreland, and York. 

Independent Cities in the 

Commonwealth of Virginia: Alexandria, 

Buena Vista, Charlottesville, 

Chesapeake, Colonial Heights, 

Covington, Emporia, Fairfax, Falls 

Church, Franklin, Fredericksburg, 

Hampton, Harrisonburg, Hopewell, 

Lexington, Lynchburg, Manassas, 

Manassas Park, Newport News, Norfolk, 

Petersburg, Poquoson, Portsmouth, 

Radford, Richmond, Roanoke, Salem, 

Staunton, Suffolk, Virginia Beach, 

Waynesboro, and Williamsburg. 

Counties in the State of Maryland: 

Allegany, Anne Arundel, Baltimore, 

Calvert, Carroll, Cecil, Charles, 

Frederick, Harford, Howard, Kent, 

Montgomery, Prince George’s, Queen 

Anne’s, St. Mary’s, and Washington. 

Independent Cities in the State of 

Maryland: Baltimore City. 

Counties in the State of North 

Carolina: Alexander, Camden, Catawba, 

Chowan, Currituck, Davidson, Davie, 

Durham, Forsyth, Franklin, Gates, 

Granville, Guilford, Johnston, Orange, 

Pasquotank, Randolph, Rowan, Stanly, 

Stokes, and Wake. 

The sole purpose of this expansion is 

to authorize additional Tribal members 

and beneficiaries to receive Purchased/ 

Referred Care (PRC) services. 

The IHS provides services under 

regulations in effect as of September 15, 

1987, and republished at 42 CFR part 

136, subparts A–C. Subpart C defines a 

Contract Health Service Delivery Area 

(CHSDA), now referred to as 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 PRCDA. 

Residence within 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 but only potential eligibility for 

services. Services needed, but not 

available at an IHS/Tribal facility, are 

provided under the PRC program 

depending on the availability of funds, 

the relative medical priority of the 

services to be provided, and the actual 

availability and accessibility of alternate 

resources in accordance with the 

regulations. 

The regulations at 42 CFR part 136, 

subpart C 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 

which have a common boundary with 

the reservation. 42 CFR 136.22(a)(6). 

The regulations also provide that after 

consultation with the Tribal governing 

body or bodies on those reservations 

included within the PRCDA, the 

Secretary may, from time to time, 

redesignate areas within the United 

States for inclusion in or exclusion from 

a PRCDA. 42 CFR 136.22(b). The 

regulations require that certain criteria 

must be considered before any 

redesignation is made. The criteria are 

as follows: 

(1) The number of Indians residing in 

the area proposed to be so included or 

excluded; 

(2) Whether the Tribal governing body 

has determined that Indians residing in 

the area near the reservation are socially 

and economically affiliated with the 

Tribe; 

(3) The geographic proximity to the 

reservation of the area whose inclusion 

or exclusion is being considered; and 

(4) The level of funding which would 

be available for the provision of PRC. 

Additionally, the regulations require 

that any redesignation of a PRCDA must 

be made in accordance with the 

procedures of the Administrative 

Procedure Act (5 U.S.C. 553). 42 CFR 

136.22(c). In compliance with this 

requirement, the IHS published a 

proposed notice of redesignation and 

requested public comments on August 

1, 2023 (88 FR 50160). In response, the 

IHS received one comment. The 


khammond on DSKJM1Z7X2PROD with NOTICES