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
Federal Register / Vol. 88, No. 246 / Tuesday, December 26, 2023 / Notices 88929 

comment received expressed support of 

the proposed expansion. 

Representatives from all seven MidAtlantic Tribes unanimously sought to 

move forward collectively to request redesignation of their PRCDAs to include 

the entire Commonwealth of Virginia. 

Following consultation with those 

Tribes, the IHS also considered portions 

of Maryland and North Carolina that are 

close to the border of Virginia. Since all 

seven of the Mid-Atlantic Tribes 

requested the same PRCDA, the IHS 

considered these Tribes collectively for 

purposes of the PRCDA expansion. This 

included considering their Tribal 

members collectively under the criteria 

set forth in 42 CFR 136.22(b). In support 

of this expansion, the IHS adopts the 

following findings: 

1. By expanding each Tribe’s PRCDA 

and creating one collective PRCDA, the 

seven Mid-Atlantic Tribes estimate the 

current eligible population will 

collectively increase by 1006 

individuals. 

2. The seven Mid-Atlantic Tribes have 

determined that these 1006 individuals 

are members of the federally recognized 

Tribes in the Commonwealth of Virginia 

and that these members are socially and 

economically affiliated with these MidAtlantic Tribes. 

3. Members of one or more of the 

Tribes reside in each county that is 

included in the proposed expansion, 

and those members live near enough to 

their Tribe’s seat of government to 

maintain close social and economic ties 

with their Tribe. According to the 

leadership for each of the Tribes, those 

members live close enough to regularly 

participate—in-person—in Tribal 

affairs, events, activities, or other 

functions held by or carried out by the 

Tribe within its current PRCDA. 

Furthermore, the expanded PRCDA 

counties and independent cities form a 

contiguous area with the existing 

PRCDAs. Considering the seven MidAtlantic Tribes collectively, the IHS has 

determined the additional counties and 

independent cities proposed for 

inclusion herein to be geographically 

proximate, meaning ‘‘on or near,’’ to the 

area analogous to reservations for the 

seven Mid-Atlantic Tribes. 

4. PRC programs operated by/for the 

seven Mid-Atlantic Tribes will use their 

existing Federal allocation for PRC 

funds to provide services to the 

expanded population. No additional 

financial resources will be allocated by 

the IHS to these programs to provide 

services to members residing in the 

expanded counties and independent 

cities in the Commonwealth of Virginia, 

State of Maryland, or State of North 

Carolina. 

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 received 

one comment. The comment received 

expressed support of the proposed 

expansion. 

Roselyn Tso, 

Director, Indian Health Service. 

[FR Doc. 2023–28313 Filed 12–22–23; 8:45 am] 

BILLING CODE 4166–14–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Institute of Diabetes and 

Digestive and Kidney Diseases; Notice 

of Closed Meeting 

Pursuant to section 1009 of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of the 

following meeting. 

The meeting will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with the grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: National Institute of 

Diabetes and Digestive and Kidney Diseases 

Initial Review Group; Fellowships in 

Digestive Diseases and Nutrition. 

Date: February 15–16, 2024. 

Time: 10:00 a.m. to 6:00 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institutes of Health, 

NIDDK, Democracy II, Suite 7000A, 6707 

Democracy Boulevard, Bethesda, MD 20892 

(Virtual Meeting). 

Contact Person: Jian Yang, Ph.D., Scientific 

Review Officer, Review Branch, Division of 

Extramural Activities, NIDDK, National 

Institutes of Health, Room 7111, 6707 

Democracy Boulevard, Bethesda, MD 20892– 

5452, (301) 594–7799, yangj@

extra.niddk.nih.gov. 

(Catalogue of Federal Domestic Assistance 

Program Nos. 93.847, Diabetes, 

Endocrinology and Metabolic Research; 

93.848, Digestive Diseases and Nutrition 

Research; 93.849, Kidney Diseases, Urology 

and Hematology Research, National Institutes 

of Health, HHS) 

Dated: December 20, 2023. 

Miguelina Perez, 

Program Analyst, Office of Federal Advisory 

Committee Policy. 

[FR Doc. 2023–28388 Filed 12–22–23; 8:45 am] 

BILLING CODE 4140–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Institute on Aging; Notice of 

Closed Meeting 

Pursuant to section 1009 of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of the 

following meeting. 

The meeting will be closed to the 

public in accordance with the 

provisions set forth in sections 

552b(c)(4) and 552b(c)(6), title 5 U.S.C., 

as amended. The grant applications and 

the discussions could disclose 

confidential trade secrets or commercial 

property such as patentable material, 

and personal information concerning 

individuals associated with the grant 

applications, the disclosure of which 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: National Institute on 

Aging Special Emphasis Panel; Dominantly 

Inherited Alzheimer Network. 

Date: March 22, 2024. 

Time: 12:00 p.m. to 5:00 p.m. 

Agenda: To review and evaluate grant 

applications. 

Place: National Institute on Aging, 

Gateway Building, 7201 Wisconsin Avenue, 

Bethesda, MD 20892, (Virtual Meeting). 

Contact Person: Joshua Jin-Hyouk Park, 

Ph.D., Scientific Review Officer, Scientific 

Review Branch, National Institute on Aging, 

7201 Wisconsin Avenue, Gateway Bldg. Suite 

2W200, Bethesda, MD 20892, (301) 496– 

6208, joshua.park4@nih.gov. 

(Catalogue of Federal Domestic Assistance 

Program Nos. 93.866, Aging Research, 

National Institutes of Health, HHS) 

Dated: December 20, 2023. 

Miguelina Perez, 

Program Analyst, Office of Federal Advisory 

Committee Policy. 

[FR Doc. 2023–28390 Filed 12–22–23; 8:45 am] 

BILLING CODE 4140–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

National Institute of General Medical 

Sciences; Notice of Closed Meeting 

Pursuant to section 1009 of the 

Federal Advisory Committee Act, as 


khammond on DSKJM1Z7X2PROD with NOTICES