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[Federal Register Volume 89, Number 241 (Monday, December 16, 2024)]
[Notices]
[Pages 101608-101609]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-29506]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

Notice of Proposed Purchased/Referred Care Delivery Area 
Redesignation for the Shoshone-Bannock Tribes

AGENCY: Indian Health Service, HHS.

ACTION: Notice.

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SUMMARY: This Notice advises the public that the Indian Health Service 
(IHS) proposes to expand the geographic boundaries of the Purchased/
Referred Care Delivery Area (PRCDA) for the Shoshone-Bannock Tribes of 
the Fort Hall Indian Reservation in Idaho to include the Idaho counties 
of Ada, Bear Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, 
Elmore, Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, 
Minidoka, Oneida, Payette, Teton, Twin Falls, and Washington. The 
current PRCDA for the Shoshone-Bannock Tribes includes the Idaho 
counties of Bannock, Bingham, Caribou, Lemhi, and Power. Shoshone-
Bannock Tribal members who reside outside of the PRCDA are eligible for 
direct care services; however, they are not eligible for Purchased/
Referred Care (PRC) services. The sole purpose of this expansion would 
be to authorize additional Shoshone-Bannock Tribal members and 
beneficiaries to receive PRC services.

DATES: Comments must be submitted by January 15, 2025.

ADDRESSES: 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 electronic comments on this 
regulation to https://www.regulations.gov. Follow the ``Submit a 
Comment'' instructions.
    2. By regular mail. You may mail written comments to the following 
address ONLY: Carl Mitchell, Director, Division of Regulatory and 
Policy Coordination, Indian Health Service, 5600 Fishers Lane, Mail 
Stop: 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 address above.
    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.

FOR FURTHER INFORMATION CONTACT: CAPT John Rael, Director, Office of 
Resource Access and Partnerships, Indian Health Service, 5600 Fishers 
Lane, Mail Stop: 10E85C, Rockville, Maryland 20857. Telephone (301) 
443-0969 (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 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 services 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 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 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 is publishing this Notice and requesting public 
comments.
    The Shoshone-Bannock Tribes of the Fort Hall Indian Reservation is 
located in Fort Hall, Idaho, and operates their PRC program under an 
Indian Self-Determination and Education Assistance Act (ISDEAA) 
agreement with the IHS. The IHS and the Shoshone-Bannock Tribes 
estimate that approximately 323 Tribal members reside in Ada, Bear 
Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, Elmore, 
Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, Minidoka, 
Oneida, Payette, Teton, Twin Falls, and Washington Counties of Idaho 
and would become PRC eligible through the proposed redesignation and 
expansion of the Tribes' PRCDA. The Shoshone-Bannock Tribes states that 
the Tribal members who reside in the proposed expansion counties are 
socially and economically affiliated with the Tribe, and that the Tribe 
would like to recognize these persons as eligible for PRC services. 
Accordingly, the IHS proposes to expand the PRCDA

[[Page 101609]]

of the Shoshone-Bannock Tribes to include the counties of Ada, Bear 
Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, Elmore, 
Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, Minidoka, 
Oneida, Payette, Teton, Twin Falls, and Washington in the State of 
Idaho. The proposed, expanded PRCDA would not create an overlap with 
any other existing PRCDA.
    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, applying the 
aforementioned PRCDA redesignation criteria required by operative 
regulations codified at 42 CFR part 136, subpart C, the following 
findings are made:
    1. By expanding the Shoshone-Bannock Tribes' PRCDA to include Ada, 
Bear Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, Elmore, 
Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, Minidoka, 
Oneida, Payette, Teton, Twin Falls, and Washington Counties of Idaho, 
the Shoshone-Bannock Tribes' PRC-eligible population will increase by 
an estimated 323 Tribal members.
    2. The IHS finds that the Tribal members within the proposed, 
expanded PRCDA are socially and economically affiliated with the 
Shoshone-Bannock Tribes, based on a statement from the Shoshone-Bannock 
Tribes that Tribal members who reside in Idaho and receive direct care 
services from Tribal and Federal health programs located on the Tribes' 
reservation retain social and economic ties to the Tribes.
    3. The expanded PRCDA counties form a contiguous area with the 
existing PRCDA, and members of the Shoshone-Bannock Tribes reside in 
each of the counties proposed for inclusion in the expanded PRCDA. 
Additionally, as noted above, Tribal members who reside in these 
counties seek direct care services from programs located on the Tribes' 
reservation. For these reasons, the IHS has determined the additional 
counties proposed for inclusion herein to be geographically proximate, 
meaning ``on or near,'' to the Tribes' reservation.
    4. The governing body of the Shoshone-Bannock Tribes has indicated 
that the PRC program can continue providing the same level of care to 
the PRC-eligible population if the PRCDA is expanded as proposed, 
without requiring additional funding or reduction of the current 
medical priority level.
    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.

Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2024-29506 Filed 12-13-24; 8:45 am]
BILLING CODE 4166-14-P
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