Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 49931

activities and will issue a quarterly 

newsletter and develop a web page. 

4. To coordinate meetings for the 

Urban Indian health programs to 

provide training, technical assistance, 

and/or updated information addressing 

the health care needs of Urban Indians. 

Reporting Requirements:

1. Monthly Activity Report: The 

organization will provide to the IHS 

program office a monthly report 

detailing activities performed for the 

organization. These activity reports will 

include: 

• Trip reports for travel in connection 

to the organization 

• Information on meetings attended 

by NCUIH regarding Indian health care 

education activities, and any 

documentation provided by NCUIH at 

these meetings 

• Information relative to health status 

and health care needs of urban Indians 

in urban centers 

2. Program Progress Report: Program 

progress reports are required semiannually. These reports will include 

brief comparison of actual 

accomplishments to the goals 

established for the period, reasons for 

slippage (if applicable), and other 

pertinent information as required. A 

final report is to be submitted within 90 

days of expiration of the budget/project 

period. 

3. Financial Status Report: Financial 

status reports are required semiannually. Standard Form 269 (long 

form) will be used for financial 

reporting. A final report must be 

submitted within 90 days of expiration 

of the budget/project period. 

4. Financial Audit: A financial audit, 

conducted by an independent auditor 

will be completed annually for each 

year within the project period (three). 

Failure to submit required reports 

within the time allowed may result in 

suspension or termination of the active 

cooperative agreement, withholding of 

payments or converting to the 

reimbursement method of payment. 

Continued failure to submit required 

reports may result in the imposition of 

special award provisions, or cause other 

eligible projects or activities involving 

the grantee organization not to be 

funded. 

Justification for Single Source: This 

project has been awarded on a noncompetitive single source basis. NCUIH 

is the only nationwide Indian 

organization that is specifically 

established to address the health needs 

of American Indians and Alaska Natives 

living in urban areas with membership 

consisting of Urban Indian health 

organizations funded under Title V of 

the Indian Health Care Improvement 

Act, Public Law 93–437, as amended, 

and under authority 25 U.S.C. 1652. 

Furthermore, it is the only nationwide 

organization for urban American 

Indians and Alaska Natives supporting 

the growth of the Urban Indian health 

care delivery system. 

Use of Cooperative Agreement: A 

cooperative agreement has been 

awarded because of anticipated 

substantial Programmatic involvement 

by IHS staff in the project. Substantial 

programmatic involvement is as follows: 

1. IHS staff will participate in the 

Board of Director meetings. Purposes 

will be to present the IHS prospectus on 

current health care issues affecting the 

Urban Indian people and allow IHS the 

opportunity to hear the continuing 

unmet needs of Urban Indians. 

2. IHS staff may, at the request of 

NCUIH, participate on study groups and 

may recommend topics for 

consideration. 

3. IHS will be involved in the 

selection and approval process for 

hiring key personnel. Key personnel are 

the Executive Director, the Office 

Administrator, and may include the 

hiring of major consultants. NCUIH 

must submit the Executive Director and 

Office Administrator selection criteria to 

IHS for approval when there becomes a 

change in staffing.; 

4. IHS will be involved in meetings 

held by NCUIH. 

Contacts: For program information, 

contact Ms. Danielle Steward, Program 

Specialist, Office of Urban Indian 

Health Programs, Office of the Director, 

Indian Health Service, Reyes Building, 

801 Thompson Avenue, Rockville, MD, 

20852, (301) 443–4680. For grants 

management information, contact Lois 

Hodge, Grants Management Officer, 

Division of Grants Operations, Reyes 

Building, 801 Thompson Avenue, 

Rockville, MD, 20852, (301) 443–5204.

Dated: August 19, 2005. 

Mary Lou Stanton, 

Deputy Director for Indian Health Policy 

Indian Health Service.

[FR Doc. 05–16912 Filed 8–24–05; 8:45 am] 

BILLING CODE 4156–16–M

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

Privacy Act of 1974; Report of Modified 

or Altered System

AGENCY: Indian Health Service (IHS), 

HHS.

ACTION: Notice of proposed modification 

or Alteration to a System of Records 

(SOR). 

SUMMARY: In accordance with the 

requirements of the Privacy Act of 1974, 

we are proposing to modify or alter an 

SOR, ‘‘Health, Medical and Billing 

Records (formerly known as the Health 

and Medical Records Systems),’’ System 

No. 09–17–0001. We propose to include 

contract health service records, as an 

additional category of individuals 

covered by the system, which consists 

of medical records to eligible American 

Indians and Alaska Native (AI/AN) 

people that supplements the health care 

resources available with the purchase of 

medical care and services that are not 

available within the IHS direct care 

system which may include, but not 

limited to, basic and specialty health 

care services from local and community 

health care providers, including 

hospital care, physician services, 

outpatient care, laboratory, dental, 

radiology, pharmacy, and transportation 

services. Under the Purpose of the 

system, we propose to include several 

new purposes that are in line with the 

Health Insurance Portability and 

Accountability Act (HIPAA) Privacy 

Rule provisions which were 

incorporated into the published IHS 

Notice of Privacy Practices (NPP) and to 

include debt collection activities. We 

are proposing to modify/alter/delete 

several published routine uses, as 

explained, to accommodate for program 

and statutory changes as indicated: 

Number 1 is modified/altered by 

separating the medical treatment, 

payment and health care operations into 

two separate routine uses 1 and 2 to 

include payment, billing, third-party 

reimbursement and debt collection 

activities; numbers 3, 4 and 11 are to 

include business associate agreement 

language to comply with HIPAA Privacy 

standards and renumbered as 5, 6 and 

12 respectively; number 5 is to include 

a special requirement notice for 

sensitive protected health information 

(PHI) such as alcohol/drug abuse, HIV/

AIDS, STD or mental health patient 

information and renumbered as 7; 

number 6 is to reflect changes in 

research disclosures to comply with 

HIPAA Privacy standards and 

renumbered as 8; number 7 is to include 

various cases of abuses, neglect, sexual 

assault and domestic violence and 

emphasis on meeting the requirements 

of 42 CFR part 2 and renumbered as 9; 

number 8 is to clarify the disclosures 

regarding suspected cases of child abuse 

and renumbered as 10; number 9 is 

modified to include legal proceedings 

related to administrative claims and the 

inclusive provision of the Department of 

Health and Human Services (DHHS)/

Office of General Counsel (OGC) 

49932 Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 

representation in litigation matters and 

renumbered as 11; number 10 is 

modified to include business associate 

agreement language to comply with 

HIPAA Privacy standards and is 

renumbered as 5; numbers 12 and 16 are 

modified and incorporated into one 

proposed routine use 13 with minor 

edits; number 14 is modified to reflect 

the permitted use/disclosure 

requirements of 45 CFR 164.502(g) and 

remains as 14; number 15 is modified 

with some minor edits to reflect current 

changes to enable efficient 

administration of health care operations 

and planning and delivery of patient 

medical care and renumbered as 18; and 

number 16 is being deleted and 

incorporated into the proposed routine 

use 13.

We propose to add 10 new routine 

uses to provide disclosures of records 

when all requirements are met: number 

2, to provide disclosure for third-part 

reimbursement, fiscal intermediary 

functions and debt collection activities; 

number 3, to provide disclosures to state 

Medicaid agencies or other entities 

acting pursuant to a contract with 

Centers for Medicare & Medicaid 

Services (CMS) for fraud and abuse 

control efforts to the extent required by 

law or under an agreement between IHS 

and respective state Medicaid agency or 

other entities; number 16, to an 

individual having authority to act on 

behalf of an incompetent individual 

concerning health care decisions to the 

extent permitted under 45 CFR 

164.502(g); number 17, information may 

be used or disclosed from an IHS facility 

directory unless the individual objects 

to the disclosure and may provide the 

religious affiliation only to members of 

the clergy; number 18, information may 

be disclosed to a relative, a close 

personal friend, or any other person 

identified by the individual that is 

directly relevant to that person’s 

involvement with their care or payment 

for health care and may be used or 

disclosed to notify family member, 

personal representative, or other person 

responsible for the individual’s care, of 

their location, general condition or 

death; number 20, to provide records to 

Federal and non-Federal protection and 

advocacy organizations for investigating 

incidents of abuse and neglect of 

individuals with development 

disabilities as defined in 42 U.S.C. 

10801–10805(a)(4) and 42 CFR 51.41–46 

to the extent authorized by law and the 

conditions of 45 CFR 1386.22(a)(2) are 

met; number 21, disclosure to a 

correctional institution or a law 

enforcement official, during the period 

of time the individual is either an 

inmate or is otherwise in lawful 

custody, for the provision of health care 

to the individual or for health and safety 

purposes; number 22, disclosure to the 

Social Security Administration (SSA) 

for validation of Social Security 

Number(s) (SSNs) purposes only; 

number 23, disclosure of relevant health 

care information may be made to funeral 

director or representatives of funeral 

homes to allow for necessary 

arrangements; number 24, disclosure to 

a public or private covered entity that is 

authorized by law or charter to assist in 

disaster relief efforts. Routine use 

previously numbered 13 is deleted as 

being no longer applicable to the 

system. Routine uses previously 

numbered 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 

and 15 have been renumbered as 4, 6, 

7, 8, 9, 10, 11, 12, 13, 14, and 19 

respectively. 

The security classification previously 

reported as ‘‘None’’ will remain. We 

have modified the language in the 

routine uses to provide clarification to 

IHS’ intention to disclose individualspecific information contained in this 

system. The routine uses will then be 

prioritized and reordered according to 

their usage. We will also take the 

opportunity to update any sections of 

the system notice to provide clarity on 

the changing environment to include for 

digital records and the initiative of 

transitioning from a paper-based record 

to a computerized-based or electronic 

medical record.

DATES: Effective Dates: The Report of 

Intent to Amend a System of Records 

Notice and an advance copy of the 

system notice have been sent to the 

Chair of the House Committee on 

Government Reform and Oversight, the 

Chair of the Senate Committee on 

Governmental Affairs, and the 

Administrator, Office of Information 

and Regulatory Affairs, Office of 

Management and Budget (OMB). To 

ensure that all parties have adequate 

time in which to comment, the modified 

system of records, including routine 

uses, will become effective 40 days from 

the publication of the notice, or from the 

date it was submitted to OMB and the 

Congress, whichever is later, unless IHS 

receives comments that require 

alterations to this notice.

ADDRESSES: The public should address 

comments to: Mr. William Tibbitts, IHS 

Privacy Act Officer, Division of 

Regulatory, Records Access and Policy 

Liaison, 801 Thompson Avenue, TMP 

450, Rockville, MD 20852–1627; call 

non-toll free (301) 443–1116; send via 

facsimile to (301) 443–2316, or send 

your e-mail requests, comments, and 

return address to: wtibbitt@hqe.ihs.gov.

FOR FURTHER INFORMATION CONTACT: Ms. 

Patricia Gowan, IHS Lead Health 

Information Management (HIM) 

Consultant, Office of Clinical and 

Preventative Services, Reyes Building, 

801 Thompson Avenue, Suite 314, 

Rockville, MD 20852–1627, Telephone 

(301) 443–2522.

SUPPLEMENTARY INFORMATION: 

A. Major Alteration of 09–17–0001, 

‘‘Indian Health Service Health and 

Medical Records Systems, HHS/IHS/

OHP’’: IHS provides care and treatment 

to patients at IHS health care facilities 

and under contract. Whenever possible, 

IHS seeks reimbursement through thirdparty payers such as Medicare, 

Medicaid, and private insurers. IHS is 

proposing to alter the existing system of 

records as follows: 

1. IHS is changing the title of the 

system from ‘‘Health and Medical 

Records System, HHS/IHS/OHP,’’ to 

‘‘Medical, Health, and Billing Records 

System, HHS/IHS/OCPS,’’ to clarify that 

IHS also uses the records in the system 

to process, document, and monitor 

third-party payment billing and 

reimbursement claims, in addition to 

debt collection activities.

2. IHS is proposing to include 

contract health service records as an 

additional category of individuals 

covered by the system. 

3. IHS is proposing to include several 

new purposes that are in line with the 

Health Insurance Portability and 

Accountability Act (HIPAA) Privacy 

Rule provisions. These seven (7) new 

purposes are as follow: (1) To provide 

information to organ procurement 

organizations or other entities engaged 

in the procurement, banking, or 

transplantation of organs to facilitate 

organ, eye, or tissue donation and 

transplant. (2) To provide information to 

individuals about treatment alternatives 

or other types of health-related benefits 

and services. (3) To provide information 

to the Food and Drug Administration 

(FDA) in connection with an FDAregulated product or activity. (4) To 

provide information to correctional 

institutions as necessary for health and 

safety purposes. (5) To provide 

information to governmental authorities 

(e.g., social service or protective services 

agencies) on victims of abuse, neglect, 

sexual assault or domestic violence. (6) 

To provide information to the National 

Archives and Records Administration in 

records management inspections 

conducted under the authority of 44 

U.S.C. 2901 et seq. (7) To provide 

relevant health care information to 

funeral directors or representatives of 

funeral homes to allow necessary 

arrangements prior to and in 

Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 49933

anticipation of an individual’s 

impending death. 

4. IHS is proposing to modify/alter/

delete several published routine uses 

and to include ten (10) new routine uses 

when all requirements have been met. 

IHS is modifying/altering routine use #1 

by separating the medical treatment, 

payment, and health care operations to 

routine uses #1 and #2 respectively; 

routine uses #2 is renumbered as #4; 

routine uses #3 and #4 are modified to 

include business associate agreement 

language to comply with HIPAA Privacy 

standards and renumbered as #6 and #7 

respectively; routine use #5 is altered to 

include a special requirement notice for 

sensitive protected health information 

(PHI) as such alcohol/drug abuse, HIV/

AIDS, STD or mental health patient 

information and renumbered as #8; 

routine use #6 is modified/altered to 

reflect changes in research disclosures 

to comply with HIPAA Privacy 

standards and renumbered as #9; 

routine use #7 is modified/altered to 

include various cases of abuses, neglect, 

sexual assault and domestic violence 

with an emphasis on 42 CFR part 2 and 

renumbered as #10; routine use #8 is 

modified to clarify the disclosure under 

(a) and (b) with no statutory language 

change on child abuse and the deletion 

of statutory citation of 42 CFR Part 2 

and renumbered as #11; routine use #9 

is modified to include legal proceedings 

related to administrative claims and the 

inclusive provision of the DHHS/Office 

of General Counsel (OGC) 

representation in litigation matters and 

renumbered as #12; routine use #10 was 

modified/altered to reflect statutory 

requirement and renumbered as #5; 

routine use #11 is modified to include 

business associate agreement language 

to comply with the HIPAA Privacy 

standards and altered to eliminate the 

safeguard requirements of the Privacy 

Act and was renumbered as #13; routine 

uses #12 and #16 were modified and 

incorporated into one proposed routine 

use disclosure with minor edits and to 

efficiently administer health care 

operations and to assist in the planning 

and delivery of patient’s medical care 

and renumbered as #14; routine use #13 

was deleted as no longer applicable to 

the purpose and function of IHS; routine 

use #14 is modified to reflect the 

permitted use/disclosure requirement of 

45 CFR 164.502(g) citation and 

renumbered as #15; routine use #15 is 

modified with some minor edits to 

reflect current changes and remains as 

#15; and routine use #16 is being 

deleted and incorporated into the new 

routine use #13.

IHS is proposing to add ten (10) new 

routine uses as follows: routine use #2 

is to provide disclosure for third-party 

reimbursement, fiscal intermediary 

functions, and debt collection activities; 

routine use #3 is to provide state 

agencies or other entities acting 

pursuant to a contract with CMS for 

fraud and abuse control efforts to the 

extent required by law or under an 

agreement between IHS and respective 

state Medicaid agency or other entities; 

routine use #16 is to provide an 

individual having authority to act on 

behalf of an incompetent individual 

concerning health care decisions to the 

extent permitted under 45 CFR 

164.502(g); routine use #17 is that 

certain protected health information 

may be used or disclosed from an IHS 

facility directory unless the individual 

objects to the disclosure and IHS may 

provide the religious affiliation only to 

members of the clergy to the extent 

permitted under 45 CFR 164.510; 

routine use #18 is that relevant 

protected health information may be 

disclosed to a relative, a close personal 

friend, or any other person identified by 

the individual with their care or 

payment for health care. Information 

may be used or disclosed to notify 

family members, personal 

representative, or other person 

responsible for the individual’s care, of 

their location, general condition or 

death; routine use #20 to Federal and 

non-Federal protection and advocacy 

organization for purpose of investigating 

incidents of abuse and neglect of 

individuals with development 

disabilities as defined in 42 U.S.C. 

10801–10805(a)(4) and 42 CFR 51.41–46 

to the extent authorized by law and the 

conditions of 45 CFR 1386.22(a)(2) are 

met; routine use #21 is for disclosure to 

a correctional institution or a law 

enforcement official, during the period 

of time the individual is either an 

inmate or is otherwise in lawful 

custody, for the provision of health care 

to the individual or for health and safety 

purposes; routine use #22 is for 

disclosure to the Social Security 

Administration for validation of SSN(s) 

purposes only; routine use #23 is that 

disclosure of relevant health care 

information may be made to funeral 

director or representatives of funeral 

homes to allow for necessary 

arrangements; and routine use #24 is for 

disclosure to a public or private covered 

entity that is authorized by law or 

charter to assist in disaster relief efforts. 

In addition to updating and making 

editorial corrections to improve the 

clarity of the system notice, this 

alteration requires the updating of the 

system manager listing, and revisions of 

the Categories of Records, Purposes, 

Authority, Safeguard, Retention and 

Disposal, Notification and Access 

Procedures sections.

Dated: August 15, 2005. 

Charles W. Grim, 

Assistant Surgeon General, Director, Indian 

Health Service.

09–17–0001 

SYSTEM NAME: 

Medical, Health, and Billing Records 

Systems, HHS/IHS/OCPS. 

SECURITY CLASSIFICATION: 

None. 

SYSTEM LOCATION: 

Indian Health Service (IHS) hospitals, 

health centers, school health centers, 

health stations, field clinics, Service 

Units, IHS Area Offices (Appendix 1), 

and Federal Archives and Records 

Centers (Appendix 2). Automated, 

electronic and computerized records, 

including Patient Care Component 

(PCC) records, are stored at the 

Information Technology Support Center 

(ITSC), IHS, located in Albuquerque, 

New Mexico (Appendix 1). Records may 

also be located at contractor sites. A 

current list of contractor sites is 

available by writing to the appropriate 

System Manager (Area or Service Unit 

Director/Chief Executive Officer) at the 

address shown in Appendix 1.

CATEGORIES OF INDIVIDUALS COVERED BY THE

SYSTEM: 

Individuals, including both IHS 

beneficiaries and non-beneficiaries, who 

are examined/treated on an inpatient 

and/or outpatient basis by IHS staff and/

or contract health care providers 

(including tribal contractors). 

CATEGORIES OF RECORDS IN THE SYSTEM:

Note: Records relating to claims by and 

against the Department of Health and Human 

Services (DHHS) are maintained in the 

Administrative Claims System, 09–90–0062, 

HHS/OS/OGC. Such claims include those 

arising under the Federal Torts Claims Act, 

Military Personnel and Civilian Employees 

Claims Act, Federal Claims Collection Act, 

Federal Medical Care Recovery Act, and Act 

for Waiver of Overpayment of Pay.

1. Health and medical records 

containing examination, diagnostic and 

treatment data, proof of IHS eligibility, 

social data (such as name, address, date 

of birth, Social Security Number (SSN), 

tribe), laboratory test results, and dental, 

social service, domestic violence, sexual 

abuse and/or assault, mental health, and 

nursing information. 

2. Follow-up registers of individuals 

with a specific health condition or a 

particular health status such as cancer, 

diabetes, communicable diseases, 

49934 Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 

suspected and confirmed abuse and 

neglect, immunizations, suicidal 

behavior, or disabilities. 

3. Logs of individuals provided health 

care by staff of specific hospital or clinic 

departments such as surgery, 

emergency, obstetric delivery, medical 

imaging, and laboratory. 

4. Surgery and/or disease indices for 

individual facilities that list each 

relevant individual by the surgery or 

disease. 

5. Monitoring strips and tapes such as 

fetal monitoring strips and EEG and 

EKG tapes. 

6. Third-party reimbursement and 

billing records containing name, 

address, date of birth, dates of service, 

third party insurer claim numbers, SSN, 

health plan name, insurance number, 

employment status, and other relevant 

claim information necessary to process 

and validate third-party reimbursement 

claims. 

7. Contract Health Service (CHS) 

records containing name, address, date 

of birth, dates of care, Medicare or 

Medicaid claim numbers, SSN, health 

plan name, insurance number, 

employment status, and other relevant 

claim information necessary to 

determine CHS eligibility and to process 

CHS claims. 

AUTHORITY FOR MAINTENANCE OF THE SYSTEM: 

Departmental Regulations (5 U.S.C. 

301); Privacy Act of 1974 (5 U.S.C. 

552a); Federal Records Act (44 U.S.C. 

2901); Section 321 of the Public Health 

Service Act, as amended (42 U.S.C. 

248); Section 327A of the Public Health 

Service Act, as amended (42 U.S.C. 

254a); Snyder Act (25 U.S.C. 13); Indian 

Health Care Improvement Act (25 U.S.C. 

1601 et seq.); and the Transfer Act of 

1954 (42 U.S.C. 2001–2004). 

PURPOSES: 

The purposes of this system are: 

1. To provide a description of an 

individual’s diagnosis, treatment and 

outcome, and to plan for immediate and 

future care of the individual. 

2. To provide statistical data to IHS 

officials in order to evaluate health care 

programs and to plan for future needs. 

3. To serve as a means of 

communication among members of the 

health care team who contribute to the 

individual’s care; e.g., to integrate 

information from field visits with 

records of treatment in IHS facilities and 

with non-IHS health care providers.

4. To serve as the official 

documentation of an individual’s health 

care. 

5. To contribute to continuing 

education of IHS staff to improve the 

delivery of health care services. 

6. For disease surveillance purposes. 

For example: 

(a) The Centers for Disease Control 

and Prevention may use these records to 

monitor various communicable 

diseases; 

(b) The National Institutes of Health 

may use these records to review the 

prevalence of particular diseases (e.g., 

malignant neoplasms, diabetes mellitus, 

arthritis, metabolism, and digestive 

diseases) for various ethnic groups of 

the United States; or 

(c) Those public health authorities 

that are authorized by law may use 

these records to collect or receive such 

information for purposes of preventing 

or controlling disease, injury, or 

disability, including, but not limited to, 

the reporting of disease, injury, vital 

events such as birth or death and the 

conduct of public health surveillance, 

investigations, and interventions. 

7. To compile and provide aggregated 

program statistics. Upon request of other 

components of DHHS, IHS will provide 

statistical information, from which 

individual/personal identifiers have 

been removed, such as: 

(a) To the National Committee on 

Vital and Health Statistics for its 

dissemination of aggregated health 

statistics on various ethnic groups; 

(b) To the Assistant Secretary for 

Planning and Evaluation, Health Policy 

to keep a record of the number of 

sterilizations provided by Federal 

funding; 

(c) To the Centers for Medicare & 

Medicaid Services (CMS) to document 

IHS health care covered by the Medicare 

and Medicaid programs for third-party 

reimbursement; or 

(d) To the Office of Clinical Standards 

and Quality, CMS to determine the 

prevalence of end-stage renal disease 

among the American Indian and Alaska 

Native (AI/AN) population and to 

coordinate individual care. 

8. To process and collect third-party 

claims and facilitate fiscal intermediary 

functions and to process debt collection 

activities. 

9. To improve the IHS national 

patient care database by means of 

obtaining and verifying an individual’s 

SSN with the Social Security 

Administration (SSA). 

10. To provide information to organ 

procurement organizations or other 

entities engaged in the procurement, 

banking, or transplantation of organs to 

facilitate organ, eye, or tissue donation 

and transplant. 

11. To provide information to 

individuals about treatment alternatives 

or other types of health-related benefits 

and services. 

12. To provide information to the 

Food and Drug Administration (FDA) in 

connection with an FDA-regulated 

product or activity. 

13. To provide information to 

correctional institutions as necessary for 

health and safety purposes. 

14. To provide information to 

governmental authorities (e.g., social 

services or protective services agencies) 

on victims of abuse, neglect, sexual 

assault or domestic violence.

15. To provide information to the 

National Archives and Records 

Administration in records management 

inspections conducted under the 

authority of 44 U.S.C 2901 et seq.

16. To provide relevant health care 

information to funeral directors or 

representatives of funeral homes to 

allow necessary arrangements prior to 

and in anticipation of an individual’s 

impending death. 

ROUTINE USES OF RECORDS MAINTAINED IN THE

SYSTEM, INCLUDING CATEGORIES OF USERS AND

THE PURPOSES OF SUCH USES: 

This system of records contains 

individually identifiable health 

information. The DHHS Privacy Act 

Regulations (45 CFR Part 5b) and the 

Privacy Rule (45 CFR Parts 160 and 164) 

issued pursuant to the Health Insurance 

Portability and Accountability Act 

(HIPAA) of 1996 apply to most health 

information maintained by IHS. Those 

regulations may place additional 

procedural requirements on the uses 

and disclosures of such information 

beyond those found in the Privacy Act 

of 1974 or mentioned in this system of 

records notice. An accounting of all 

disclosures of a record made pursuant to 

the following routine uses will be made 

and maintained by IHS for five years or 

for the life of the records, whichever is 

longer.

Note: Special requirements for alcohol and 

drug abuse patients: If an individual receives 

treatment or a referral for treatment for 

alcohol or drug abuse, then the 

Confidentiality of Alcohol and Drug Abuse 

Patient Records Regulations, 42 CFR Part 2 

may apply. In general, under these 

regulations, the only disclosures of the 

alcohol or drug abuse record that may be 

made without patient consent are: (1) To 

meet medical emergencies (42 CFR 2.51), (2) 

for research, audit, evaluation and 

examination (42 CFR 2.52 and 2.53), (3) 

pursuant to a court order (42 CFR 2.61–2.67), 

and (4) pursuant to a qualified service 

organization agreement, as defined in 42 CFR 

2.11. In all other situations, written consent 

of the individual is usually required prior to 

disclosure of alcohol or drug abuse 

information under the routine uses listed 

below.

1. Records may be disclosed to 

Federal and non-Federal (public or 

Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 49935

private) health care providers that 

provide health care services to IHS 

individuals for purposes of planning for 

or providing such services, or reporting 

results of medical examination and 

treatment. 

2. Records may be disclosed to 

Federal, state, local or other authorized 

organizations that provide third-party 

reimbursement or fiscal intermediary 

functions for the purposes of billing or 

collecting third-party reimbursements. 

Relevant records may be disclosed to 

debt collection agencies under a 

business associate agreement 

arrangement directly or through a third 

party. 

3. Records may be disclosed to state 

agencies or other entities acting 

pursuant to a contract with CMS, for 

fraud and abuse control efforts, to the 

extent required by law or under an 

agreement between IHS and respective 

state Medicaid agency or other entities.

4. Records may be disclosed to school 

health care programs that serve AI/AN 

for the purpose of student health 

maintenance. 

5. Records may be disclosed to the 

Bureau of Indian Affairs (BIA) or its 

contractors under an agreement between 

IHS and the BIA relating to disabled AI/

AN children for the purposes of carrying 

out its functions under the Individuals 

with Disabilities Education Act (IDEAS), 

20 U.S.C.1400, et seq.

6. Records may be disclosed to 

organizations deemed qualified by the 

Secretary of DHHS and under a business 

associate agreement to carry out quality 

assessment/improvement, medical 

audits, utilization review or to provide 

accreditation or certification of health 

care facilities or programs. 

7. Records may be disclosed under a 

business associate agreement to 

individuals or authorized organizations 

sponsored by IHS, such as the National 

Indian Women’s Resource Center, to 

conduct analytical and evaluation 

studies. 

8. Disclosure may be made to a 

congressional office from the record of 

an individual in response to an inquiry 

from the congressional office made at 

the request of that individual. An 

authorization, Form IHS 810, is required 

for the disclosure of sensitive protected 

health information (PHI) (e.g., alcohol/

drug abuse patient information, human 

immunodeficiency virus (HIV)/AIDS, 

STD, or mental health) that is 

maintained in the medical record. 

9. Records may be disclosed for 

research purposes to the extent 

permitted by: 

(a) Determining that the use(s) or 

disclosure(s) are met under 45 CFR 

164.512(i), or

(b) Determining that the use(s) or 

disclosure(s) are met under 45 CFR 

164.514(a) through (c) for de-identified 

PHI, and 5 U.S.C. 552a(b)(5), or 

(c) Determining that the requirements 

of 45 CFR 164.514(e) for limited data 

sets, and 5 U.S.C. 552a(b)(5) are met. 

10. Information from records, such as 

information concerning the commission 

of crimes, suspected cases of abuse 

(including child, elder and sexual 

abuse), neglect, sexual assault or 

domestic violence, births, deaths, 

alcohol or drug abuse, immunizations, 

cancer, or the occurrence of 

communicable diseases, may be 

disclosed to public health authorities or 

other appropriate government 

authorities, as authorized by Federal, 

state, Tribal or local law or regulation of 

the jurisdiction in which the facility is 

located.

Note: In Federally conducted or assisted 

alcohol or drug abuse programs, under 42 

CFR Part 2, disclosure of patient information 

for purposes of criminal investigations must 

be authorized by court order issued under 42 

CFR Part 2.65, except that reports of 

suspected child abuse may be made to the 

appropriate state or local authorities under 

state law.

11. Information may be disclosed 

from these records regarding suspected 

cases of child abuse to: 

(a) Federal, state or Tribal agencies 

that need to know the information in the 

performance of their duties, and 

(b) Members of community child 

protection teams for the purposes of 

investigating reports of suspected child 

abuse, establishing a diagnosis, 

formulating or monitoring a treatment 

plan, and making recommendations to 

the appropriate court. Community child 

protection teams are comprised of 

representatives of Tribes, the Bureau of 

Indian Affairs, child protection service 

agencies, the judicial system, law 

enforcement agencies and IHS. 

12. IHS may disclose information 

from these records in litigations and/or 

proceedings related to an administrative 

claim when: 

(a) IHS has determined that the use of 

such records is relevant and necessary 

to the litigation and/or proceedings 

related to an administrative claim and 

would help in the effective 

representation of the affected party 

listed in subsections (i) through (iv) 

below, and that such disclosure is 

compatible with the purpose for which 

the records were collected. Such 

disclosure may be made to the DHHS/

Office of General Counsel (OGC) and/or 

Department of Justice (DOJ), pursuant to 

an agreement between IHS and OGC, 

when any of the following is a party to 

litigation and/or proceedings related to 

an administrative claim or has an 

interest in the litigation and/or 

proceedings related to an administrative 

claim: 

(i) DHHS or any component thereof; 

or 

(ii) Any DHHS employee in his or her 

official capacity; or 

(iii) Any DHHS employee in his or her 

individual capacity where the DOJ (or 

DHHS, where it is authorized to do so) 

has agreed to represent the employee; or 

(iv) The United States or any agency 

thereof (other than DHHS) where 

DHHS/OGC has determined that the 

litigation and/or proceedings related to 

an administrative claim is likely to 

affect DHHS or any of its components.

(b) In the litigation and/or 

proceedings related to an administrative 

claim described in subsection (a) above, 

information from these records may be 

disclosed to a court or other tribunal, or 

to another party before such tribunal in 

response to an order of a court or 

administrative tribunal, provided that 

the covered entity discloses only the 

information expressly authorized by 

such order. 

13. Records may be disclosed under a 

business associate agreement to an IHS 

contractor for the purpose of 

computerized data entry, medical 

transcription, duplication services, or 

maintenance of records contained in 

this system. 

14. Records may be disclosed under a 

personal services contract or other 

agreement to student volunteers, 

individuals working for IHS, and other 

individuals performing functions for 

IHS who do not technically have the 

status of agency employees, if they need 

the records in the performance of their 

agency functions. 

15. Records regarding specific 

medical services provided to an 

unemancipated minor individual may 

be disclosed to the unemancipated 

minor’s parent or legal guardian who 

previously consented to those specific 

medical services, to the extent permitted 

under 45 CFR 164.502(g). 

16. Records may be disclosed to an 

individual having authority to act on 

behalf of an incompetent individual 

concerning health care decisions, to the 

extent permitted under 45 CFR 

164.502(g). 

17. Information may be used or 

disclosed from an IHS facility directory 

in response to an inquiry about a named 

individual from a member of the general 

public to establish the individual’s 

presence (and location when needed for 

visitation purposes) or to report the 

individual’s condition while 

hospitalized (e.g., satisfactory or stable), 

49936 Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 

unless the individual objects to 

disclosure of this information. IHS may 

provide the religious affiliation only to 

members of the clergy. 

18. Information may be disclosed to a 

relative, a close personal friend, or any 

other person identified by the 

individual that is directly relevant to 

that person’s involvement with the 

individual’s care or payment for health 

care. 

Information may also be used or 

disclosed in order to notify a family 

member, personal representative, or 

other person responsible for the 

individual’s care, of the individual’s 

location, general condition or death. 

If the individual is present for, or 

otherwise available prior to, a use or 

disclosure, and is competent to make 

health care decisions; 

(a) May use or disclose after the 

facility obtains the individual’s consent, 

(b) Provides the individual with the 

opportunity to object and the individual 

does not object, or 

(c) It could reasonably infer, based on 

professional judgment, that the 

individual does not object. 

If the individual is not present, or the 

opportunity to agree or object cannot 

practicably be provided due to 

incapacity or emergent circumstances, 

an IHS health care provider may 

determine, based on professional 

judgment, whether disclosure is in the 

individual’s best interest, and if so, may 

disclose only what is directly relevant to 

the individual’s health care. 

19. Information concerning exposure 

to the HIV may be disclosed, to the 

extent authorized by Federal, state or 

Tribal law, to the sexual and/or needlesharing partner(s) of a subject individual 

who is infected with HIV under the 

following circumstances:

(a) The information has been obtained 

in the course of clinical activities at IHS 

facilities; 

(b) IHS has made reasonable efforts to 

counsel and encourage the subject 

individual to provide information to the 

individual’s sexual or needle-sharing 

partner(s); 

(c) IHS determines that the subject 

individual is unlikely to provide the 

information to the sexual or needlesharing partner(s) or that the provision 

of such information cannot reasonably 

be verified; and 

(d) The notification of the partner(s) is 

made, whenever possible, by the subject 

individual’s physician or by a 

professional counselor and shall follow 

standard counseling practices. 

(e) IHS has advised the partner(s) to 

whom information is disclosed that they 

shall not re-disclose or use such 

information for a purpose other than 

that for which the disclosure was made. 

20. Records may be disclosed to 

Federal and non-Federal protection and 

advocacy organizations that serve AI/

AN for the purpose of investigating 

incidents of abuse and neglect of 

individuals with developmental 

disabilities (including mental 

disabilities), as defined in 42 U.S.C. 

§§ 10801–10805(a)(4) and 42 CFR 

§§ 51.41–46, to the extent that such 

disclosure is authorized by law and the 

conditions of 45 CFR § 1386.22(a)(2) are 

met. 

21. Records of an individual may be 

disclosed to a correctional institution or 

a law enforcement official, during the 

period of time the individual is either 

an inmate or is otherwise in lawful 

custody, for the provision of health care 

to the individual or for health and safety 

purposes. Disclosure may be made upon 

the representation of either the 

institution or a law enforcement official 

that disclosure is necessary for the 

provision of health care to the 

individual, for the health and safety of 

the individual and others (e.g., other 

inmates, employees of the correctional 

facility, transport officers), and for 

facility administration and operations. 

This routine use applies only for as long 

as the individual remains in lawful 

custody, and does not apply once the 

individual is released on parole or 

placed on either probation or on 

supervised release, or is otherwise no 

longer in lawful custody. 

22. Records including patient name, 

date of birth, SSN, gender and other 

identifying information may be 

disclosed to the SSA as is reasonably 

necessary for the purpose of conducting 

an electronic validation of the SSN(s) 

maintained in the record to the extent 

required under an agreement between 

IHS and SSA. 

23. Disclosure of relevant health care 

information may be made to funeral 

directors or representatives of funeral 

homes in order to allow them to make 

necessary arrangements prior to and in 

anticipation of an individual’s 

impending death. 

24. Records may be disclosed to a 

public or private covered entity that is 

authorized by law or charter to assist in 

disaster relief efforts (e.g., the Red Cross 

and the Federal Emergency Management 

Administration), for purposes of 

coordinating information with other 

similar entities concerning an 

individual’s health care, payment for 

health care, notification of the 

individual’s whereabouts and his or her 

health status or death. 

POLICIES AND PRACTICES FOR STORING, 

RETRIEVING, ACCESSING, RETAINING, AND

DISPOSING OF RECORDS IN THE SYSTEM: 

STORAGE: 

File folders, ledgers, card files, 

microfiche, microfilm, computer tapes, 

disk packs, digital photo discs, and 

automated, computer-based or 

electronic files.

RETRIEVABILITY: 

Indexed by name, record number, and 

SSN and cross-indexed. 

SAFEGUARDS: 

Safeguards apply to records stored onsite and off-site. 

1. Authorized Users: Access is limited 

to authorized IHS personnel, volunteers, 

IHS contractors, subcontractors, and 

other business associates in the 

performance of their duties. Examples of 

authorized personnel include: Medical 

records personnel, business office 

personnel, contract health staff, health 

care providers, authorized researchers, 

medical audit personnel, health care 

team members, and legal and 

administrative personnel on a need to 

know basis. 

2. Physical Safeguards: Records are 

kept in locked metal filing cabinets or 

in a secured room or in other monitored 

areas accessible to authorized users at 

all times when not actually in use 

during working hours and at all times 

during non-working hours. Magnetic 

tapes, disks, other computer equipment 

(e.g., pc workstations) and other forms 

of personal data are stored in areas 

where fire and life safety codes are 

strictly enforced. Telecommunication 

equipment (e.g., computer terminal, 

servers, modems and disks) of the 

Resource and Patient Management 

System (RPMS) are maintained in 

locked rooms during non-working 

hours. Network (Internet or Intranet) 

access of authorized individual(s) to 

various automated and/or electronic 

programs or computers (e.g., desktop, 

laptop, handheld or other computer 

types) containing protected personal 

identifiers or personal health 

information (PHI) is reviewed 

periodically and controlled for 

authorizations, accessibility levels, 

expirations or denials, including 

passwords, encryptions or other devices 

to gain access. Combinations and/or 

electronic passcards on door locks are 

changed periodically and whenever an 

IHS employee resigns, retires or is 

reassigned. 

3. Procedural Safeguards: Within each 

facility a list of personnel or categories 

of personnel having a demonstrable 

need for the records in the performance 

of their duties has been developed and 

Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 49937

is maintained. Procedures have been 

developed and implemented to review 

one-time requests for disclosure to 

personnel who may not be on the 

authorized user list. Proper charge-out 

procedures are followed for the removal 

of all records from the area in which 

they are maintained. Records may not 

be removed from the facility except in 

certain circumstances, such as 

compliance with a valid court order or 

shipment to the Federal Records 

Center(s). Persons who have a need to 

know are entrusted with records from 

this system of records and are instructed 

to safeguard the confidentiality of these 

records. These individuals are to make 

no further disclosure of the records 

except as authorized by the system 

manager and permitted by the Privacy 

Act and the HIPAA Privacy Rule as 

adopted, and to destroy all copies or to 

return such records when the need to 

know has expired. Procedural 

instructions include the statutory 

penalties for noncompliance.

The following automated information 

systems (AIS) security procedural 

safeguards are in place for automated 

health and medical records maintained 

in the RPMS. A profile of automated 

systems security is maintained. Security 

clearance procedures for screening 

individuals, both Government and 

contractor personnel, prior to their 

participation in the design, operation, 

use or maintenance of IHS AIS are 

implemented. The use of current 

passwords and log-on codes are 

required to protect sensitive automated 

data from unauthorized access. Such 

passwords and codes are changed 

periodically. An automated or electronic 

audit trail is maintained and reviewed 

periodically. Only authorized IHS 

Division of Information Resources staff 

may modify automated files in batch 

mode. Personnel at remote terminal 

sites may only retrieve automated or 

electronic data. Such retrievals are 

password protected. Privacy Act 

requirements, HIPAA Privacy Rule and 

Security requirements and specified AIS 

security provisions are specifically 

included in contracts and agreements 

and the system manager or his/her 

designee oversee compliance with these 

contract requirements. 

4. Implementing Guidelines: DHHS 

Chapter 45–10 and supplementary 

Chapter PHS.hf: 45–10 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 Remote Access’; OMB Circular A–

130 ‘‘Management of Federal 

Information Resources’; HIPAA Security 

Standards for the Protection of 

Electronic Protected Health Information, 

45 CFR §§ 164.302 through 164.318; and 

E-Government Act of 2002 (Pub. L. 107–

347, 44 U.S.C. Ch 36). 

RETENTION AND DISPOSAL: 

Patient listings which may identify 

individuals are maintained in IHS Area 

and Program Offices permanently. 

Inactive records are held at the facility 

that provided health and billing services 

from three to seven years and then are 

transferred to the appropriate Federal 

Records Center. Monitoring strips and 

tapes (e.g., fetal monitoring strips, EEG 

and EKG tapes) that are not stored in the 

individual’s official medical record are 

stored at the health facility for one year 

and are then transferred to the 

appropriate Federal Records Center. 

(See Appendix 2 for Federal Records 

Center addresses.) In accordance with 

the records disposition authority 

approved by the Archivist of the United 

States, paper records are maintained for 

75 years after the last episode of 

individual care except for billing 

records. The retention and disposal 

methods for billing records will be in 

accordance with the approved IHS 

Records Schedule. The disposal 

methods of paper medical and health 

records will be in accordance with the 

approved IHS Records Schedule. The 

electronic data consisting of the 

individual personal identifiers and PHI 

maintained in the RPMS or any 

subsequent revised IHS database system 

should be inactivated once the paper 

record is forwarded to the appropriate 

Federal Records Center. 

SYSTEM MANAGER(S) AND ADDRESS: 

Policy Coordinating Official: Director, 

Office of Clinical and Preventive 

Services, Indian Health Service, Reyes 

Building, 801 Thompson Avenue, Suite 

300, Rockville, Maryland 20852–1627. 

See Appendix 1. The IHS Area Office 

Directors, Service Unit Directors/Chief 

Executive Officers and Facility Directors 

listed in Appendix 1 are System 

Managers. 

NOTIFICATION PROCEDURE: 

GENERAL PROCEDURE: 

Requests must be made to the 

appropriate System Manager (IHS Area, 

Program Office Director or Service Unit 

Director/Chief Executive Officer). A 

subject individual who requests a copy 

of, or access to, his or her medical 

record shall, at the time the request is 

made, designate in writing a responsible 

representative who will be willing to 

review the record and inform the subject 

individual of its contents. Such a 

representative may be an IHS health 

professional. When a subject individual 

is seeking to obtain information about 

himself/herself that may be retrieved by 

a different name or identifier than his/

her current name or identifier, he/she 

shall be required to produce evidence to 

verify that he/she is the person whose 

record he/she seeks. No verification of 

identity shall be required where the 

record is one that is required to be 

disclosed under the Freedom of 

Information Act. Where applicable, fees 

for copying records will be charged in 

accordance with the schedule set forth 

in 45 CFR Part 5b. 

REQUESTS IN PERSON: 

Identification papers with current 

photographs are preferred but not 

required. If a subject individual has no 

identification but is personally known 

to the designated agency employee, 

such employee shall make a written 

record verifying the subject individual’s 

identity. If the subject individual has no 

identification papers, the responsible 

system manager or designated agency 

official shall require that the subject 

individual certify in writing that he/she 

is the individual whom he/she claims to 

be and that he/she understands that the 

knowing and willful request or 

acquisition of records concerning an 

individual under false pretenses is a 

criminal offense subject to a $5,000 fine. 

If an individual is unable to sign his/her 

name when required, he/she shall make 

his/her mark and have the mark verified 

in writing by two additional persons.

REQUESTS BY MAIL: 

Written requests must contain the 

name and address of the requester, his/

her date of birth and at least one other 

piece of information that is also 

contained in the subject record, and his/

her signature for comparison purposes. 

If the written request does not contain 

sufficient information, the System 

Manager shall inform the requester in 

writing that additional, specified 

information is required to process the 

request. 

REQUESTS BY TELEPHONE: 

Since positive identification of the 

caller cannot be established, telephone 

requests are not honored. 

PARENTS, LEGAL GUARDIANS AND PERSONAL

REPRESENTATIVES: 

Parents of minor children and legal 

guardians or personal representatives of 

legally incompetent individuals shall 

verify their own identification in the 

manner described above, as well as their 

relationship to the individual whose 

record is sought. A copy of the child’s 

birth certificate or court order 

establishing legal guardianship may be 

49938 Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 

required if there is any doubt regarding 

the relationship of the individual to the 

patient. 

RECORD ACCESS PROCEDURES: 

SAME AS NOTIFICATION PROCEDURES: 

Requesters may write, call or visit the 

last IHS facility where medical care was 

provided. 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 

record, if any. 

CONTESTING RECORD PROCEDURES: 

Requesters may write, call or visit the 

appropriate IHS Area/Program Office 

Director or Service Unit Director/Chief 

Executive Officer at his/her address 

specified in Appendix 1, and specify the 

information being contested, 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: 

Individual and/or family members, 

IHS health care personnel, contract 

health care providers, State and local 

health care provider organizations, 

Medicare and Medicaid funding 

agencies, and the SSA. 

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, N ST Street #2, Niobrara, 

Nebraska 68760. 

Director, Alaska Area Native Indian Health 

Service, 4141 Ambassador Drive, Suite 

300, Anchorage, Alaska 99508–5928. 

Director, Albuquerque Area Indian 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 7th 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 4th 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 Deer 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. 

Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 49939

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 and 12, Tsaile, Arizona 

86556. 

Director, Rock Point Field Clinic, c/o Tsaile 

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 

56th 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 6th 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, Newe Medical 

Clinic, 400 ‘‘A’’ Newe View, Ely, Nevada 

89301. 

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, Schurz Service Unit, Schurz Service 

Unit Administration, Drawer A, Schurz, 

Nevada 89427. 

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, Unitah and Ouray Service Unit, Fort 

Duchesne Indian Health Center, P.O. Box 

160, Ft. 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.

Appendix 2—Federal Archives and 

Records Centers 

District of Columbia, Maryland Except U.S. 

Court Records for Maryland, Washington 

National Records Center, 4205 Suitland 

Road, Suitland, Maryland 20746–8001. 

Connecticut, Maine, Massachusetts, New 

Hampshire, Rhode Island, and Vermont, 

Federal Archives and Records Center, 

Frederick C. Murphy Federal Center, 380 

Trapelo Road, Waltham, Massachusetts 

02452–6399. 

Northeast Region, Federal Archives and 

Records Center, 10 Conte Drive, Pittsfield, 

Massachusetts 01201–8230. 

Mid-Atlantic Region and Pennsylvania, 

Federal Archives and Records Center, 

14700 Townsend Road, Philadelphia, 

Pennsylvania 19154–1096. 

Alabama, Florida, Georgia, Kentucky, 

Mississippi, North Carolina, South 

Carolina, and Tennessee, Federal Archives 

49940 Federal Register / Vol. 70, No. 164 / Thursday, August 25, 2005 / Notices 

and Records Center, 1557 St. Joseph 

Avenue, East Point, Georgia 30344–2593. 

Illinois, Indiana, Michigan, Minnesota, Ohio 

and Wisconsin and U.S. Court Records for 

the mentioned States, Federal Archives 

and Records Center, 7358 South Pulaski 

Road, Chicago, Illinois 60629–5898. 

Michigan, Except U.S. Court Records, Federal 

Records Center, 3150 Springboro Road, 

Dayton, Ohio 45439–1883. 

Kansas, Iowa, Missouri and Nebraska, and 

U.S. Court Records for the mentioned 

States, Federal Archives and Records 

Center, 2312 East Bannister Road, Kansas 

City, Missouri 64131–3011. 

New Jersey, New York, Puerto Rico, and the 

U.S. Virgin Islands, and U.S. Court Records 

for the mentioned States and territories, 

200 Space Center Drive, Lee’s Summit, 

Missouri 64064–1182.

Arkansas, Louisiana, Oklahoma and Texas, 

and U.S. Courts Records for the mentioned 

States, Federal Archives and Records 

Center, P.O. Box 6216, Ft. Worth, Texas 

76115–0216. 

Colorado, Wyoming, Utah, Montana, New 

Mexico, North Dakota, and South Dakota, 

and U.S. Courts Records for the mentioned 

States, Federal Archives and Records 

Center, P.O. Box 25307, Denver, Colorado 

80225–0307. 

Northern California Except Southern 

California, Hawaii, and Nevada Except 

Clark County, the Pacific Trust Territories, 

and American Samoa, and U.S. Courts 

Records for the mentioned States and 

territories, Federal Archives and Records 

Center, 1000 Commodore Drive, San 

Bruno, California 94066–2350. 

Arizona, Southern California, and Clark 

County, Nevada, and U.S. Courts Records 

for the mentioned States, Federal Archives 

and Records Center, 24000 Avila Road, 1st 

Floor, East Entrance, Laguna Niguel, 

California 92677–3497. 

Washington, Oregon, Idaho and Alaska, and 

U.S. Courts Records for the mentioned 

States, Federal Archives and Records 

Center, 6125 Sand Point Way NE, Seattle, 

Washington 98115–7999.

[FR Doc. 05–16890 Filed 8–24–05; 8:45 am] 

BILLING CODE 4165–16–P

DEPARTMENT OF HOUSING AND 

URBAN DEVELOPMENT 

[Docket No. FR–4975–N–26] 

Notice of Proposed Information 

Collection: Comment Request; 

Contractor’s Requisition Project 

Mortgages

AGENCY: Office of the Assistant 

Secretary for Housing-Federal Housing 

Commissioner, HUD.

ACTION: Notice.

SUMMARY: The proposed information 

collection requirement described below 

will be submitted to the Office of 

Management and Budget (OMB) for 

review, as required by the Paperwork 

Reduction Act. The Department is 

soliciting public comments on the 

subject proposal.

DATES: Comments Due Date: October 24, 

2005.

ADDRESSES: Interested persons are 

invited to submit comments regarding 

this proposal. Comments should refer to 

the proposal by name and/or OMB 

Control Number and should be sent to: 

Wayne Eddins, Reports Management 

Officer, Department of Housing and 

Urban Development, 451 7th Street, 

SW., L’Enfant Plaza Building, Room 

8001, Washington, DC 20410 or 

Wayne_Eddins@hud.gov.

FOR FURTHER INFORMATION CONTACT:

Michael McCullough, Director, Office of 

Multifamily Development, Department 

of Housing and Urban Development, 

451 7th Street SW., Washington, DC 

20410, telephone (202) 708–1142 (this is 

not a toll free number) for copies of the 

proposed forms and other available 

information.

SUPPLEMENTARY INFORMATION: The 

Department is submitting the proposed 

information collection to OMB for 

review, as required by the Paperwork 

Reduction Act of 1995 (44 U.S.C. 

Chapter 35, as amended). 

This Notice is soliciting comments 

from members of the public and affected 

agencies concerning the proposed 

collection of information to: (1) Evaluate 

whether the proposed collection is 

necessary for the proper performance of 

the functions of the agency, including 

whether the information will have 

practical utility; (2) Evaluate the 

accuracy of the agency’s estimate of the 

burden of the proposed collection of 

information; (3) Enhance the quality, 

utility, and clarity of the information to 

be collected; and (4) Minimize the 

burden of the collection of information 

on those who are to respond; including 

the use of appropriate automated 

collection techniques or other forms of 

information technology, e.g., permitting 

electronic submission of responses. 

This Notice also lists the following 

information: 

Title of Proposal: Contractor’s 

Requisition Project Mortgages. 

OMB Control Number, if applicable:

2502–0028. 

Description of the need for the 

information and proposed use: This 

information is collected on form HUD–

92448 from contractors and is used to 

obtain program benefits, consisting of 

distribution of insured mortgage 

proceeds when construction costs are 

involved. The information regarding 

completed work items is used by the 

Multifamily Hub Centers to ensure that 

payments from mortgage proceeds are 

made for work actually completed in a 

satisfactory manner. The certification 

regarding prevailing wages is used by 

the Multifamily Hub Centers to ensure 

compliance with prevailing wage rates. 

Agency form numbers, if applicable:

HUD–92448. 

Estimation of the total numbers of 

hours needed to prepare the information 

collection including number of 

respondents, frequency of response, and 

hours of response: The number of 

respondents is 1,300 generating 15,600 

responses annually, the estimated time 

needed to prepare each response is 

approximately 6 hours, the frequency of 

response is monthly, and the total 

burden hours requested is 93,600. 

Status of the proposed information 

collection: This is an extension of a 

currently approved collection.

Authority: The Paperwork Reduction Act 

of 1995, 44 U.S.C., Chapter 35, as amended.

Dated: August 16, 2005. 

Frank L. Davis, 

General Deputy Assistant Secretary for 

Housing—Deputy Federal Housing 

Commissioner.

[FR Doc. E5–4635 Filed 8–24–05; 8:45 am] 

BILLING CODE 4210–27–P

DEPARTMENT OF HOUSING AND 

URBAN DEVELOPMENT 

[Docket No. FR–4975–N–27] 

Notice of Proposed Information 

Collection: Comment Request; 

Application for Housing Assistance 

Payments; Special Claims Processing

AGENCY: Office of the Assistant 

Secretary for Housing-Federal Housing 

Commissioner, HUD.

ACTION: Notice.

SUMMARY: The proposed information 

collection requirement described below 

will be submitted to the Office of 

Management and Budget (OMB) for 

review, as required by the Paperwork 

Reduction Act. The Department is 

soliciting public comments on the 

subject proposal.

DATES: Comments Due Date: October 24, 

2005.

ADDRESSES: Interested persons are 

invited to submit comments regarding 

this proposal. Comments should refer to 

the proposal by name and/or OMB 

Control Number and should be sent to: 

Wayne Eddins, Reports Management 

Officer, Department of Housing and 

Urban Development, 451 7th Street, 

SW., L’Enfant Plaza Building, Room 

8001, Washington, DC 20410 or 

Wayne_Eddins@hud.gov.