```

[Federal Register Volume 89, Number 242 (Tuesday, December 17, 2024)]
[Notices]
[Pages 102150-102151]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-29689]

-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

Notice of Proposed Purchased/Referred Care Delivery Area 
Redesignation for the Chippewa Cree Tribe of the Rocky Boy's 
Reservation

AGENCY: Indian Health Service, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

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 Chippewa Cree Tribe of the 
Rocky Boy's Reservation (``Chippewa Cree Tribe'' or ``Tribe'') to 
include the Montana county of Cascade. The current PRCDA for the 
Chippewa Cree Tribe includes the Montana counties of Choteau, Hill and 
Liberty. Chippewa Cree 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 Chippewa Cree Tribal members 
and beneficiaries to receive PRC services.

DATES: Comments must be submitted by January 16, 2025.

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 electronic comments on this 
regulation to http://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.
    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.

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: 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

[[Page 102151]]

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 Chippewa Cree Tribe of the Rocky Boy's Reservation is located 
Hill and Choteau Counties of Montana. The Chippewa Cree Tribe operates 
their PRC program under an Indian Self-Determination and Education 
Assistance Act agreement with the IHS. The Chippewa Cree Tribe has 
requested that the IHS expand its PRCDA to include Cascade County, 
Montana. The requested PRCDA redesignation would share Cascade County 
with the PRCDA of the Little Shell Tribe of Chippewa Indians of Montana 
(``Little Shell Tribe''). The Billings Area held discussions with the 
Little Shell Tribe, during which the Little Shell Tribe did not raise 
any objections to the expansion of the Chippewa Cree Tribe's PRCDA to 
include Cascade County. 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 PRCDA to include Cascade County, Montana, the 
IHS and the Chippewa Cree Tribe estimate that the Tribe's PRC eligible 
population would increase by an estimated 251 Tribal members.
    2. As part of their expansion request, the Chippewa Cree Tribe 
submitted a resolution from the Tribe's governing body. The resolution 
explains that the expansion is intended to serve their members living 
in Cascade County, Montana and it describes those members as being 
socially and economically tied to the Tribe's reservation. The IHS 
therefore finds that the Tribal members within the proposed, expanded 
PRCDA are socially and economically affiliated with the Chippewa Cree 
Tribe.
    3. The expanded PRCDA county forms a contiguous area with the 
existing PRCDA. Members of the Chippewa Cree Tribe reside in the county 
proposed for inclusion in the expanded PRCDA. Through their expansion 
request, the Tribe described how close Cascade County, Montana is to 
their reservation and explained that it is close enough for their 
members residing there to return frequently to the Tribe's reservation 
for ceremony and participation in Tribal elections. For these reasons, 
the IHS has determined the additional county proposed for inclusion 
herein to be geographically proximate, meaning ``on or near,'' to the 
Tribe's reservation.
    4. Through the Chippewa Cree Tribe's request to expand its PRCDA, 
the Tribe 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 from the IHS 
or reduction of the current medical priority level.
    Accordingly, the IHS proposes to expand the PRCDA of the Chippewa 
Cree Tribe to include the county of Cascade in the state of Montana.
    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. 2024-29689 Filed 12-16-24; 8:45 am]
BILLING CODE 4166-14-P
```