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 Department of Health and Human Services Indian Health Service
 AGENCY: Indian Health Service, HHS.
 ACTION: Final notice.
 SUMMARY: The Secretary of the Department of Health and Human Services hereby issues this final notice to re-designate the Purchased/Referred Care Delivery Area (PRCDA) for the Tolowa Dee-ni' Nation (Tribe) (previously known as the Smith River Rancheria of Smith River, California), to provide Purchased/Referred Care (PRC) services to their Tribal members residing in Curry County, Oregon, which is in the Portland Area Indian Health Service (IHS). The Tolowa Dee-ni's Tribal Headquarters is located 3 miles south of the California-Oregon border in Northern California. The entire State of California, excluding the counties of Alameda, Contra Costa, Los Angeles, Marin, Orange, Sacramento, San Francisco, San Mateo, Santa Clara, Kern, Merced, Monterey, Napa, San Benito, San Joaquin, San Luis Obispo, Santa Cruz, Solano, Stanislaus, and Ventura, was designated by the IHS as a PRCDA, formerly known as a Contract Health Service Delivery Area, in accordance with statute. The current PRCDA for Tolowa Dee-ni' Tribal members is the statutorily specified California PRCDA. The expanded PRCDA for the Tolowa Dee-ni' Tribe includes the statutorily specified California PRCDA and Curry County in the State of Oregon.
 DATES: This notice shall take effect on October 10, 2017.
 FOR FURTHER INFORMATION CONTACT: Terri Schmidt, Acting Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mail stop: 10E85C, Rockville, Maryland 20857. Telephone 301/443-2694 (This is not a toll free number).


SUPPLEMENTARY INFORMATION:  *Background:*
                     The IHS currently provides services under regulations codified at 42 CFR part 136, subparts A through C. Subpart C defines a Purchased/Referred Care Delivery Area (PRCDA) as the geographic area within which Purchased/Referred Care will be made available by the Indian Health Service (IHS) to members of an identified Indian community who reside in the Area. PRCDAs were previously known as Contract Health Service Delivery Areas (CHSDAs) and more recently, the IHS referred to them as Purchased/Referred Care Service Delivery Areas (PRCSDAs) or PRCDAs, but the IHS intends to consistently refer to them as PRCDAs going forward. Residence in 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, 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 person's relative medical priority, and the actual availability and accessibility of alternate resources in accordance with the regulations. As applicable to the Tribes, these regulations provide that, unless otherwise designated, a PRCDA shall consist of a county that includes all or part of a reservation and any county or counties that 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, re-designate areas within the United States for inclusion in or exclusion from a PRCDA. The regulations require that certain criteria must be considered before any re-designation 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, 42 CFR 136.22(b). Additionally, the regulations require that any re-designation of a PRCDA must be made in accordance with the Administrative Procedures Act (5 U.S.C. 553). See 42 CFR 136.22(c). In compliance with this requirement, we are publishing this final notice. Congress directed the IHS to designate the entire State of California as a PRCDA, excluding certain counties, under section 810 of the Indian Healthcare Improvement Act, Public Law 94-437, as amended (25 U.S.C. 1680). The IHS has utilized the congressionally specified PRCDA for the purposes of administering PRC benefits to members of the Tribe. Thus, members of the Tribe who reside outside of the statutorily established California PRCDA do not reside within the Tolowa Dee-ni's current PRCDA and are currently not eligible for PRC services. The IHS has historically established PRCDAs in accordance with Congressional intent but has preserved regulatory flexibility to re-designate areas as appropriate for inclusion in or exclusion from PRCDA under PRC regulations. One of the criteria for such re-designations is the geographic proximity of the expanded area to the existing reservation or PRCDA. Here, the IHS is expanding the Tribe's PRCDA beyond the geographic description in 25 U.S.C. 1680 to include a county adjacent to the Tribe's existing PRCDA, in a neighboring state. There are already PRCDAs that include part of the State of California and part of another state, for example, Cocopah Tribe of Arizona, (Yuma, Arizona, and Imperial, California); Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California, (La Paz, Arizona; Riverside, California; San Bernardino, California; and Yuma, Arizona); Fort Mojave Indian Tribe of Arizona, California and Nevada, (Nevada; Mohave, Arizona; San Bernardino, California); and the Quechan Tribe of Fort Yuma Indian Reservation, California and Arizona, (Yuma, Arizona; and Imperial, California). The Tolowa Dee-ni' Tribe has a significant number of Tribal members who are not residents of California. The Tribe asserts that 177 Tribal members reside outside of its PRCDA, in Curry County, in the State of Oregon, and are not able to access PRC funds from either the California Area facility (Smith River Howonquet Indian Health Center) or from the closest Portland Area facility. 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 maintain close economic and social ties with the Tribe. In this case, in applying the aforementioned PRCDA re-designation criteria required by operative regulations codified at 42 CFR part 136, subpart C, the following findings are made: 1. By expanding, the Tribe estimates the current eligible population will be increased by 177.
                    ( print page 47005) 2. The Tribe has determined that these 177 individuals are members of the Tribe and they are socially and economically affiliated with the Tribe. 3. The expanded area, including Curry County in the State of Oregon, maintains a common boundary with the State of California and the statutorily created California PRCDA. 4. Generally, the Tribal members located in Curry County in the State of Oregon currently do not use the Indian health system for their PRC health care needs. The Tribe will use its existing Federal allocation for PRC funds to provide services to the expanded population. No additional financial resources will be allocated at this time by the IHS to the Tribe to provide services to Tribal members residing in Curry County in the State of Oregon. *Public Comments:*
                     The Agency received 32 comments, 31 of which were timely. The Agency carefully reviewed the submissions. The IHS did not consider one (1) of these comments, because it was received after the closing date. Of the 31 timely comments, 28 commenters supported the proposal to expand the Tolowa Dee-ni' PRCDA into Curry County, Oregon. These included 27 commenters from the California Area and one Congressional commenter. There were three (3) commenters representing two Tribes from the Portland Area that opposed the PRCDA expansion. The IHS will address those comments below: *Comment:*
                     The majority of commenters indicated support for the proposed PRCDA expansion and support for providing PRC to the Tribe's members living in Curry County, Oregon. *Response:*
                     The IHS appreciates the comments in support of the expansion and agrees that the expansion would allow the Tribe to authorize PRC services for its members residing in Curry County, Oregon. *Comment:*
                     Two commenters believed that the IHS should not be relying upon the Tribe's estimate of its members living in Curry County, Oregon, and that the IHS should either produce its own estimate or verify the Tribe's figure. *Response:*
                     In 2014, the IHS prepared a study of the Tolowa Dee-ni' Tribe's roster of Tribal Citizens matched with patient user activity data from the National Patient Information Reporting System. The findings of the patient matching study were consistent with a previous request conducted in 2013 by the former IHS California Area Director. The 
                    **Federal Register**
                     Notice states that the Smith River Tribe has estimated that 177 of its Tribal members reside in Curry County, in the State of Oregon, and they are not able to access PRC funds either at the California Area or the Portland Area. The IHS believes that this number is a fair approximation of the number of Smith River Tribal members residing in Curry County, given IHS's facility data, and recognizing that the Tribe has additional resources, such as a Tribal Membership Roll, to estimate the number of members residing in Curry County, Oregon, including those who have not yet sought services at IHS facilities and therefore would not be included in IHS data. *Comment:*
                     One commenter inquired about the “threshold” for expanding a PRCDA and whether there is a minimum number or percentage in terms of Tribal members. *Response:*
                     Each PRCDA expansion under consideration must be reviewed in accordance with the criteria set forth in 42 CFR 136.22(b), meaning this decision is a case-by-case determination based upon the facts of the particular expansion at issue. Regulations require the IHS to consider, among other factors, the “number of Indians residing in the area” of the proposed expansion, but the regulations do not require a minimum number or percentage. *Comment:*
                     One commenter asked why the IHS is advancing the proposal for the Tribe, after declining to accommodate requests from Oregon Tribes and whether this created a double standard. *Response:*
                     Previously, the IHS restricted certain PRCDA expansions based on the Agency's implementation of the regulatory “geographic proximity” requirement specified at 42 CFR 136.22(b)(3). While geographic proximity remains a necessary consideration in a PRCDA expansion, the IHS has reconsidered our previous position and recently adopted a more flexible approach. The IHS explained this change in an April 7, 2016, 
                    **Federal Register**
                     Notice (81 FR 20388), “Notice of the Redesignation of the Service Delivery Area for the Wampanoag Tribe of Gay Head (Aquinnah).” *Comment:*
                     One commenter asked how the IHS verified that the Tribal members residing in Curry County, Oregon, are economically and socially affiliated with the Tribe. *Response:*
                     Under 42 CFR 136.22(b)(2), the IHS is required to consider whether “the Tribal governing body has determined that Indians residing in the area near the reservation are socially and economically affiliated with the Tribes.” The regulation does not require an independent investigation by the IHS on this issue. The IHS would typically defer to the Tribal governing body's determination, given the language in the regulation and a Tribe's better position to make this conclusion. However, the IHS would note that the Tribe's estimate for the expanded population includes only its members residing in Curry County, Oregon, and its members are eligible for PRC under 42 CFR 136.23, as long as the members reside within the PRCDA. *Comment:*
                     Two commenters inquired about the financial aspects of the expansion, such as how this proposal would be paid for and what would be the motivation, since no additional funds are being provided to the Tribe. *Response:*
                     Tolowa Dee-ni' Tribal members living in Curry County, Oregon, are unfunded for both IHS direct care and PRC resources. A few Tribal members have sought direct services from Tribal health programs in Oregon. While these individuals can receive direct services at the Oregon programs, no funds are allocated to the Portland Area IHS or the California Area IHS to provide services to members of the Tolowa Dee-ni' Tribe residing in Curry County. The Agency is approving the requested PRCDA expansion to allow the Tolowa Dee-ni' Tribe to authorize the purchase of PRC services, within existing funds, for members of the Tribe who reside in Curry County. Without this expansion, such purchases would not be lawful and those Tribal members would not be eligible to receive PRC services. Since there are no additional funds being provided by the IHS for the PRCDA expansion, the Tribe's current level of PRC funding will be available to serve a larger population. *Comment:*
                     One commenter inquired about the potential future financial impact on Oregon Tribes and how this could be accurately measured, given the current data. *Response:*
                     Per Agency policy, expanding a PRCDA does not automatically increase the funding to a Tribe. Tribes will continue to use existing Federal allocation for PRC funds to provide services to expanding population until Congress appropriates additional funding. Each IHS Area will distribute future increases based on their own methodologies. The Tribe may benefit from future increases to PRC funding because of the additional active users from the PRCDA expansion, but the IHS determined that there will be very little to no financial impact as a result of the expansion on Portland Area Tribes. *Comment:*
                     One commenter inquired about the status of a proposed pilot project for an Area-wide PRCDA in the Portland Area IHS. *Response:*
                     The Coquille Tribe presented a suggestion for consideration 
                    ( print page 47006)
                    to the IHS Portland Area Funds Distribution Workgroup (FDWG). The FDWG is a Tribal consultative body that serves as a resource to the Portland Area Director on any Indian health system funds issue. The principal function of the FDWG is to develop recommendations regarding resource allocation within the Portland Area IHS. The IHS anticipates announcing a plan of action on this issue soon. Purchased/Referred Care Delivery Areas
Tribe/reservation
County/stateAk Chin Indian Community
Pinal, AZ.Alabama-Coushatta Tribes of Texas
Polk, TX.1Alaska
Entire State.2Arapahoe Tribe of the Wind River Reservation, Wyoming
Hot Springs, WY, Fremont, WY, Sublette, WY.Aroostook Band of Micmacs
Aroostook, ME.3Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Montana
Daniels, MT, McCone, MT, Richland, MT, Roosevelt, MT, Sheridan, MT, Valley, MT.Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin
Ashland, WI, Iron, WI.Bay Mills Indian Community, Michigan
Chippewa, MI.Blackfeet Tribe of the Blackfeet Indian Reservation of Montana
Glacier, MT, Pondera, MT.Brigham City Intermountain School Health Center, Utah. Permanently Closed on May 17, 1984
(4
                            )Burns Paiute Tribe
Harney, OR.California
Entire State, except for the counties listed in the footnote.5Catawba Indian Nation
All Counties in SC,6
                             Cabarrus, NC, Cleveland, NC, Gaston, NC, Mecklenburg, NC, Rutherford, NC, Union, NC.Cayuga Nation
Alleghany, NY,7
                             Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA.Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Dakota
Corson, SD, Dewey, SD, Haakon, SD, Meade, SD, Perkins, SD, Potter, SD, Stanley, SD, Sully, SD, Walworth, SD, Ziebach, SD.Chippewa-Cree Indians of the Rocky Boy's Reservation, Montana
Chouteau, MT, Hill, MT, Liberty, MT.Chitimacha Tribe of Louisiana
St. Mary Parish, LA.Cocopah Tribe of Arizona
Yuma, AZ, Imperial, CA.Coeur D'Alene Tribe
Benewah, ID, Kootenai, ID, Latah, ID, Spokane, WA, Whitman, WA.Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California
La Paz, AZ, Riverside, CA, San Bernardino, CA, Yuma, AZ.Confederated Salish and Kootenai Tribes of the Flathead Reservation
Flathead, MT, Lake, MT, Missoula, MT, Sanders, MT.Confederated Tribes and Bands of the Yakama Nation
Klickitat, WA, Lewis, WA, Skamania, WA,8
                             Yakima, WA.Confederated Tribes of Siletz Indians of Oregon
Benton, OR,9
                             Clackamas, OR, Lane, OR, Lincoln, OR, Linn, OR, Marion, OR, Multnomah, OR, Polk, OR, Tillamook, OR, Washington, OR, Yamhill, OR.Confederated Tribes of the Chehalis Reservation
Grays Harbor, WA, Lewis, WA, Thurston, WA.Confederated Tribes of the Colville Reservation
Chelan, WA,10
                             Douglas, WA, Ferry, WA, Grant, WA, Lincoln, WA, Okanogan, WA, Stevens, WA.Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians
Coos, OR,11
                             Curry, OR, Douglas, OR, Lane, OR, Lincoln, OR.Confederated Tribes of the Goshute Reservation, Nevada and Utah
Nevada, Juab, UT, Toole, UT.Confederated Tribes of the Grand Ronde Community of Oregon
Marion, OR, Multnomah, OR, Polk, OR,12
                             Tillamook, OR, Washington, OR, Yamhill, OR.Confederated Tribes of the Umatilla Indian Reservation
Umatilla, OR, Union, OR.Confederated Tribes of the Warm Springs Reservation of Oregon
Clackamas, OR, Jefferson, OR, Linn, OR, Marion, OR, Wasco, OR.Coquille Indian Tribe
Coos, OR, Curry, OR, Douglas, OR, Jackson, OR, Lane, OR.Coushatta Tribe of Louisiana
Allen Parish, LA, Elton, LA.13Cow Creek Band of Umpqua Tribe of Indians
Coos, OR,14
                             Deshutes, OR, Douglas, OR, Jackson, OR, Josephine, OR, Klamath, OR, Lane, OR.Cowlitz Indian Tribe
Clark, WA, Cowlitz, WA, King, WA, Lewis, WA, Peirce, WA, Skamania, WA, Thurston, WA, Columbia, OR,15
                             Kittitas, WA, Wahkiakum, WA.Crow Creek Sioux Tribe of the Crow Creek Reservation, South Dakota
Brule, SD, Buffalo, SD, Hand, SD, Hughes, SD, Hyde, SD, Lyman, SD, Stanley, SD.Crow Tribe of Montana
Big Horn, MT, Carbon, MT, Treasure, MT,16
                             Yellowstone, MT, Big Horn, WY, Sheridan, WY.Eastern Band of Cherokee Indians
Cherokee, NC, Graham, NC, Haywood, NC, Jackson, NC, Swain, NC.Eastern Shoshone Tribe of the Wind River Reservation, Wyoming
Hot Springs, WY, Fremont, WY, Sublette, WY.Flandreau Santee Sioux Tribe of South Dakota
Moody, SD.Forest County Potawatomi Community, Wisconsin
Forest, WI, Marinette, WI, Oconto, WI.Fort Belknap Indian Community of the Fort Belknap Reservation of Montana
Blaine, MT, Phillips, MT.Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon
Nevada, Malheur, OR.Fort McDowell Yavapai Nation, Arizona
Maricopa, AZ.Fort Mojave Indian Tribe of Arizona, California and Nevada
Nevada, Mohave, AZ, San Bernardino, CA.Gila River Indian Community of the Gila River Indian Reservation, Arizona
Maricopa, AZ, Pinal, AZ.Grand Traverse Band of Ottawa and Chippewa Indians, Michigan
Antrim, MI,17
                             Benzie, MI, Charlevoix, MI, Grand Traverse, MI, Leelanau, MI, Manistee, MI.Hannahville Indian Community, Michigan
Delta, MI, Menominee, MI.Haskell Indian Health Center
Douglas, KS.18( print page 47007)Havasupai Tribe of the Havasupai 
                             Reservation, Arizona
Coconino, AZ.Ho-Chunk Nation of Wisconsin
Adams, WI,19
                             Clark, WI, Columbia, WI, Crawford, WI, Dane, WI, Eau Claire, WI, Houston, MN, Jackson, WI, Juneau, WI, La Crosse, WI, Marathon, WI, Monroe, WI, Sauk, WI, Shawano, WI, Vernon, WI, Wood, WI.Hoh Indian Tribe
Jefferson, WA.Hopi Tribe of Arizona
Apache, AZ, Coconino, AZ, Navajo, AZ.Houlton Band of Maliseet Indians
Aroostook, ME.20Hualapai Indian Tribe of the Hualapai Indian Reservation, Arizona
Coconino, AZ, Mohave, AZ, Yavapai, AZ.Iowa Tribe of Kansas and Nebraska
Brown, KS, Doniphan, KS, Richardson, NE.Jamestown S'Klallam Tribe
Clallam, WA, Jefferson, WA.Jena Band of Choctaw Indians
Grand Parish, LA,21
                             LaSalle Parish, LA, Rapides, LA.Jicarilla Apache Nation, New Mexico
Archuleta, CO, Rio Arriba, NM, Sandoval, NM.Kaibab Band of Paiute Indians of the Kaibab Indian Reservation, Arizona
Coconino, AZ, Mohave, AZ, Kane, UT.Kalispel Indian Community of the Kalispel Reservation
Pend Oreille, WA, Spokane, WA.Kewa Pueblo, New Mexico
Sandoval, NM, Santa Fe, NM.Keweenaw Bay Indian Community, Michigan
Baraga, MI, Houghton, MI, Ontonagon, MI.Kickapoo Traditional Tribe of Texas
Maverick, TX.22Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas
Brown, KS, Jackson, KS.Klamath Tribes
Klamath, OR.23Koi Nation of Northern California (formerly known as Lower Lake Rancheria, California)
Lake, CA, Sonoma, CA.24Kootenai Tribe of Idaho
Boundary, ID.Lac Courte Oreilles Band of Superior Chippewa Indians of Wisconsin
Sawyer, WI.Lac du Flambeau Band of Lake Superior Chippewa Indians of the Lac du Flambeau Reservation of Wisconsin
Iron, WI, Oneida, WI, Vilas, WI.Lac Vieux Desert Band of Lake Superior Chippewa Indians of Michigan
Gogebic, MI.Little River Band of Ottawa Indians, Michigan
Kent, MI,25
                             Muskegon, MI, Newaygo, MI, Oceana, MI, Ottawa, MI, Manistee, MI, Mason, MI, Wexford, MI, Lake, MI.Little Traverse Bay Bands of Odawa Indians, Michigan
Alcona, MI,26
                             Alger, MI, Alpena, MI, Antrim, MI, Benzie, MI, Charlevoix, MI, Cheboygan, MI, Chippewa, MI, Crawford, MI, Delta, MI, Emmet, MI, Grand Traverse, MI, Iosco, MI, Kalkaska, MI, Leelanau, MI, Luce, MI, Mackinac, MI, Manistee, MI, Missaukee, MI, Montmorency, MI, Ogemaw, MI, Oscoda, MI, Otsego, MI, Presque Isle, MI, Schoolcraft, MI, Roscommon, MI, Wexford, MI.Lower Brule Sioux Tribe of the Lower Brule Reservation, South Dakota
Brule, SD, Buffalo, SD, Hughes, SD, Lyman, SD, Stanley, SD.Lower Elwha Tribal Community
Clallam, WA.Lower Sioux Indian Community in the State of Minnesota
Redwood, MN, Renville, MN.Lummi Tribe of the Lummi Reservation
Whatcom, WA.Makah Indian Tribe of the Makah Indian Reservation
Clallam, WA.Mashantucket Pequot Indian Tribe
New London, CT.27Mashpee Wampanoag Tribe
Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.28Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan
Allegan, MI,29
                             Barry, MI, Kalamazoo, MI, Kent, MI, Ottawa, MI.Menominee Indian Tribe of Wisconsin
Langlade, WI, Menominee, WI, Oconto, WI, Shawano, WI.Mescalero Apache Tribe of the Mescalero Reservation, New Mexico
Chaves, NM, Lincoln, NM, Otero, NM.Miccosukee Tribe of Indians
Broward, FL, Collier, FL, Miami-Dade, FL, Hendry, FL.Minnesota Chippewa Tribe, Minnesota, Bois Forte Band (Nett Lake)
Itasca, MN, Koochiching, MN, St. Louis, MN.Minnesota Chippewa Tribe, Minnesota, Fond du Lac Band
Carlton, MN, St. Louis, MN.Minnesota Chippewa Tribe, Minnesota, Grand Portage Band
Cook, MN.Minnesota Chippewa Tribe, Minnesota, Leech Lake Band
Beltrami, MN, Cass, MN, Hubbard, MN, Itasca, MN.Minnesota Chippewa Tribe, Minnesota, Mille Lacs Band
Aitkin, MN, Kanebec, MN, Mille Lacs, MN, Pine, MN.Minnesota Chippewa Tribe, Minnesota, White Earth Band
Becker, MN, Clearwater, MN, Mahnomen, MN, Norman, MN, Polk, MN.Mississippi Band of Choctaw Indians
Attala, MS, Jasper, MS,30
                             Jones, MS, Kemper, MS, Leake, MS, Neshoba, MS, Newton, MS, Noxubee, MS,31
                             Scott, MS,32
                             Winston, MS.Mohegan Tribe of Indians of Connecticut
Fairfield, CT, Hartford, CT, Litchfield, CT, Middlesex, CT, New Haven, CT, New London, CT, Tolland, CT, Windham, CT.Muckleshoot Indian Tribe
King, WA, Pierce, WA.Narragansett Indian Tribe
Washington, RI.33Navajo Nation, Arizona, New Mexico, & Utah
Apache, AZ, Bernalillo, NM, Cibola, NM, Coconino, AZ, Kane, UT, McKinley, NM, Montezuma, CO, Navajo, AZ, Rio Arriba, NM, Sandoval, NM, San Juan, NM, San Juan, UT, Socorro, NM, Valencia, NM.Nevada
Entire State.34Nez Perce Tribe
Clearwater, ID, Idaho, ID, Latah, ID, Lewis, ID, Nez Perce, ID.Nisqually Indian Tribe
Pierce, WA, Thurston, WA.Nooksack Indian Tribe
Whatcom, WA.Northern Cheyenne Tribe of the Northern Cheyenne Indian Reservation, Montana
Big Horn, MT, Carter, MT,35
                             Rosebud, MT.( print page 47008)Northwestern Band of Shoshone Nation
Box Elder, UT.36Nottawaseppi Huron Band of the Pottawatomi, Michigan
Allegan, MI,37
                             Barry, MI, Branch, MI, Calhoun, MI, Kalamazoo, MI, Kent, MI, Ottawa, MI.Oglala Sioux Tribe
Bennett, SD, Cherry, NE, Custer, SD, Dawes, NE, Fall River, SD, Jackson, SD,38
                             Mellette, SD, Pennington, SD, Shannon, SD, Sheridan, NE, Todd, SD.Ohkay Owingeh, New Mexico
Rio Arriba, NM.Oklahoma
Entire State.39Omaha Tribe of Nebraska
Burt, NE, Cuming, NE, Monona, IA, Thurston, NE, Wayne, NE.Oneida Nation
Brown, WI, Outagamie, WI.Oneida Nation of New York
Chenango, NY, Cortland, NY, Herkimer, NY, Madison, NY, Oneida, NY, Onondaga, NY.Onondaga Nation
Onondaga, NY.Paiute Indian Tribe of Utah
Iron, UT,40
                             Millard, UT, Sevier, UT, Washington, UT.Pamunkey Indian Tribe
Caroline, Hanover, Henrico, King William, King and Queen, New Kent, Richmond (Independent City).41Pascua Yaqui Tribe of Arizona
Pima, AZ.42Passamaquoddy Tribe
Aroostook, ME,
                            43 44
                             Hancock, ME,45
                             Washington, ME.Penobscot Nation
Aroostook, ME 46
                            , Penobscot, ME.Poarch Band of Creeks
Baldwin, AL,47
                             Elmore, AL, Escambia, AL, Mobile, AL, Monroe, AL, Escambia, FL.Pokagon Band of Pottawatomi Indians, Michigan and Indiana
Allegan, MI,48
                             Berrien, MI, Cass, MI, Elkhart, IN, Kosciusko, IN, La Porte, IN, Marshall, IN, St. Joseph, IN, Starke, IN, Van Buren, MI.Ponca Tribe of Nebraska
Boyd, NE,49
                             Burt, NE, Charles Mix, SD, Douglas, NE, Hall, NE, Holt, NE, Knox, NE, Lancaster, NE, Madison, NE, Platte, NE, Pottawatomie, IA, Sarpy, NE, Stanton, NE, Wayne, NE, Woodbury, IA.Port Gamble S'Klallam Tribe
Kitsap, WA.Prairie Band of Pottawatomi Nation
Jackson, KS.Prairie Island Indian Community in the State of Minnesota
Goodhue, MN.Pueblo of Acoma, New Mexico
Cibola, NM.Pueblo of Cochiti, New Mexico
Sandoval, NM, Santa Fe, NM.Pueblo of Isleta, New Mexico
Bernalillo, NM, Torrance, NM, Valencia, NM.Pueblo of Jemez, New Mexico
Sandoval, NM.Pueblo of Laguna, New Mexico
Bernalillo, NM, Cibola, NM, Sandoval, NM, Valencia, NM.Pueblo of Nambe, New Mexico
Santa Fe, NM.Pueblo of Picuris, New Mexico
Taos, NM.Pueblo of Pojoaque, New Mexico
Rio Arriba, NM, Santa Fe, NM.Pueblo of San Felipe, New Mexico
Sandoval, NM.Pueblo of San Ildefonso, New Mexico
Los Alamos, NM, Rio Arriba, NM, Sandoval, NM, Santa Fe, NM.Pueblo of Sandia, New Mexico
Bernalillo, NM, Sandoval, NM.Pueblo of Santa Ana, New Mexico
Sandoval, NM.Pueblo of Santa Clara, New Mexico
Los Alamos, NM, Sandoval, NM, Santa Fe, NM.Pueblo of Taos, New Mexico
Colfax, NM, Taos, NM.Pueblo of Tesuque, New Mexico
Santa Fe, NM.Pueblo of Zia, New Mexico
Sandoval, NM.Puyallup Tribe of the Puyallup Reservation
King, WA, Pierce, WA, Thurston, WA.Quechan Tribe of the Fort Yuma Indian Reservation, Arizona and California
Yuma, AZ, Imperial, CA.Quileute Tribe of the Quileute Reservation
Clallam, WA, Jefferson, WA.Quinault Indian Nation
Grays Harbor, WA, Jefferson, WA.Rapid City, South Dakota
Pennington, SD.50Red Cliff Band of Lake Superior Chippewa Indians of Wisconsin
Bayfield, WI.Red Lake Band of Chippewa Indians, Minnesota
Beltrami, MN, Clearwater, MN, Koochiching, MN, Lake of the Woods, MN, Marshall, MN, Pennington, MN, Polk, MN, Roseau, MN.Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota
Bennett, SD, Cherry, NE, Gregory, SD, Lyman, SD, Mellette, SD, Todd, SD, Tripp, SD.Sac & Fox Nation of Missouri in Kansas and Nebraska
Brown, KS, Richardson, NE.Sac & Fox Tribe of the Mississippi in Iowa
Tama, IA.Saginaw Chippewa Indian Tribe of Michigan
Arenac, MI,51
                             Clare, MI, Isabella, MI, Midland, MI, Missaukee, MI.Saint Regis Mohawk Tribe
Franklin, NY, St. Lawrence, NY.Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona
Maricopa, AZ.Samish Indian Nation
Clallam, WA,52
                             Island, WA, Jefferson, WA, King, WA, Kitsap, WA, Pierce, WA, San Juan, WA, Skagit, WA, Snohomish, WA, Whatcom, WA.San Carlos Apache Tribe of the San Carlos Reservation, Arizona
Apache, AZ, Cochise, AZ, Gila, AZ, Graham, AZ, Greenlee, AZ, Pinal, AZ.San Juan Southern Paiute Tribe of Arizona
Coconino, AZ, San Juan, UT.Santee Sioux Nation, Nebraska
Bon Homme, SD, Knox, NE.Sauk-Suiattle Indian Tribe
Snohomish, WA, Skagit, WA.( print page 47009)Sault Ste. Marie Tribe of Chippewa Indians, Michigan
Alger, MI,53
                             Chippewa, MI, Delta, MI, Luce, MI, Mackinac, MI, Marquette, MI, Schoolcraft, MI.Seminole Tribe of Florida
Broward, FL, Collier, FL, Miami-Dade, FL, Glades, FL, Hendry, FL.Seneca Nation of Indians
Alleghany, NY, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA.Shakopee Mdewakanton Sioux Community of Minnesota
Scott, MN.Shinnecock Indian Nation
Nassau, NY,54
                             Suffolk, NY.Shoalwater Bay Tribe of the Shoalwater Bay Indian Reservation
Pacific, WA.Shoshone-Bannock Tribes of the Fort Hall Reservation
Bannock, ID, Bingham, ID, Caribou, ID, Lemhi, ID,55
                             Power, ID.Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada
Nevada, Owyhee, ID.Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota
Codington, SD, Day, SD, Grant, SD, Marshall, SD, Richland, ND, Roberts, SD, Sargent, ND, Traverse, MN.Skokomish Indian Tribe
Mason, WA.Skull Valley Band of Goshute Indians of Utah
Tooele, UT.Snoqualmie Indian Tribe
King, WA,56
                             Snohomish, WA, Pierce, WA, Island, WA, Mason, WA.Sokaogon Chippewa Community, Wisconsin
Forest, WI.Southern Ute Indian Tribe of the Southern Ute Reservation, Colorado
Archuleta, CO, La Plata, CO, Montezuma, CO, Rio Arriba, NM, San Juan, NM.Spirit Lake Tribe, North Dakota
Benson, ND, Eddy, ND, Nelson, ND, Ramsey, ND.Spokane Tribe of the Spokane Reservation
Ferry, WA, Lincoln, WA, Stevens, WA.Squaxin Island Tribe of the Squaxin Island Reservation
Mason, WA.St. Croix Chippewa Indians of Wisconsin
Barron, WI, Burnett, WI, Pine, MN, Polk, WI, Washburn, WI.Standing Rock Sioux Tribe of North & South Dakota
Adams, ND, Campbell, SD, Corson, SD, Dewey, SD, Emmons, ND, Grant, ND, Morton, ND, Perkins, SD, Sioux, ND, Walworth, SD, Ziebach, SD.Stillaguamish Tribe of Indians of Washington
Snohomish, WA.Stockbridge Munsee Community, Wisconsin
Menominee, WI, Shawano, WI.Suquamish Indian Tribe of the Port Madison Reservation
Kitsap, WA.Swinomish Indian Tribal Community
Skagit, WA.Tejon Indian Tribe
Kern, CA.57Three Affiliated Tribes of the Fort Berthold Reservation, North Dakota
Dunn, ND, Mercer, ND, McKenzie, ND, McLean, ND, Mountrail, ND, Ward, ND.Tohono O'odham Nation of Arizona
Maricopa, AZ, Pima, AZ, Pinal, AZ.Tonawanda Band of Seneca
Genesee, NY, Erie, NY, Niagara, NY.Tolowa Dee-ni' Nation (formerly known as Smith River Rancheria of California)
California, Curry, OR.58Tonto Apache Tribe of Arizona
Gila, AZ.Trenton Service Unit, North Dakota and Montana
Divide, ND,59
                             McKenzie, ND, Williams, ND, Richland, MT, Roosevelt, MT, Sheridan, MT.Tulalip Tribes of Washington
Snohomish, WA.Tunica-Biloxi Indian Tribe
Avoyelles, LA, Rapides, LA.60Turtle Mountain Band of Chippewa Indians of North Dakota
Rolette, ND.Tuscarora Nation
Niagara, NY.Upper Sioux Community, Minnesota
Chippewa, MN, Yellow Medicine, MN.Upper Skagit Indian Tribe
Skagit, WA.Ute Indian Tribe of the Uintah & Ouray Reservation, Utah
Carbon, UT, Daggett, UT, Duchesne, UT, Emery, UT, Grand, UT, Rio Blanco, CO, Summit, UT, Uintah, UT, Utah, UT, Wasatch, UT.Ute Mountain Ute Tribe
Apache, AZ, La Plata, CO, Montezuma, CO, San Juan, NM, San Juan, UT.Wampanoag Tribe of Gay Head (Aquinnah)
Dukes, MA,61
                             Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA.62Washoe Tribe of Nevada & California
Nevada, California except for the counties listed in footnote.White Mountain Apache Tribe of the Fort Apache Reservation, Arizona
Apache, AZ, Coconino, AZ, Gila, AZ, Graham, AZ, Greenlee, AZ, Navajo, AZ.Wilton Rancheria, California
Sacramento, CA.63Winnebago Tribe of Nebraska
Dakota, NE, Dixon, NE, Monona, IA, Thurston, NE, Wayne, NE, Woodbury, IA.Yankton Sioux Tribe of South Dakota
Bon Homme, SD, Boyd, NE, Charles Mix, SD, Douglas, SD, Gregory, SD, Hutchinson, SD, Knox, NE.Yavapai-Apache Nation of the Camp Verde Indian Reservation, Arizona
Yavapai, AZ.Yavapai-Prescott Indian Tribe
Yavapai, AZ.Ysleta Del Sur Pueblo of Texas
El Paso, TX.64Zuni Tribe of the Zuni Reservation, New Mexico
Apache, AZ, Cibola, NM, McKinley, NM, Valencia, NM.1
                         Public Law 100-89, Restoration Act for Ysleta Del Sur and Alabama and Coushatta Tribes of Texas establishes service areas for “members of the Tribe” by sections 101(3) and 105(a) for the Pueblo and sections 201(3) and 206(a) respectively.2
                         Entire State of Alaska is included as a CHSDA by regulation (42 CFR 136.22(a)(1)).3
                         Aroostook Band of Micmacs was recognized by Congress on November 26, 1991, through the Aroostook Band of Micmac Settlement Act. Aroostook County, ME, was defined as the SDA.
                        ( print page 47010)4
                         Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is based on the legislative history of the appropriation of funds for the particular facility rather than the eligibility regulations. Historically services have been provided at Brigham City Intermountain School Health Center, Utah (Pub. L. 88-358). The Brigham Intermountain School Health Center was renamed to Intermountain Inter-Tribal School in 1974 and was permanently closed on May 17, 1984.5
                         Entire State of California, excluding the counties of Alameda, Contra Costa, Los Angeles, Marin, Orange, Sacramento, San Francisco, San Mateo, Santa Clara, Kern, Merced, Monterey, Napa, San Benito, San Joaquin, San Luis Obispo, Santa Cruz, Solano, Stanislaus, and Ventura, is designated a CHSDA (25 U.S.C. 1680).6
                         The counties were recognized after the January 1984 CHSDA FRN was published, in accordance with Public Law 103-116, Catawba Indian Tribe of South Carolina Land Claims Settlement Act of 1993, dated October 27, 1993.7
                         There is no reservation for the Cayuga Nation; the service delivery area consists of those counties identified by the Cayuga Nation.8
                         Skamania County, WA, has historically been a part of the Yakama Service Unit population since 1979.9
                         In order to carry out the Congressional intent of the Siletz Restoration Act, Public Law 95-195, as expressed in H. Report No. 95-623, at page 4, members of the Confederated Tribes of Siletz Indians of Oregon residing in these counties are eligible for contract health services.10
                         Chelan County, WA, has historically been a part of the Colville Service Unit population since 1970.11
                         Pursuant to Public Law 98-481 (H. Rept. No. 98-904), Coos, Lower Umpqua and Siuslaw Restoration Act, members of the Tribe residing in these counties were specified as eligible for Federal services and benefits without regard to the existence of a Federal Indian reservation.12
                         The Confederated Tribes of Grand Ronde Community of Oregon were recognized by Public Law 98-165 which was signed into law on November 22, 1983, and provides for eligibility in these six counties without regard to the existence of a reservation.13
                         The CHSDA for the Coushatta Tribe of Louisiana was expanded administratively by the Director, IHS, through regulation (42 CFR 136.22(6)) to include city limits of Elton, LA.14
                         Cow Creek Band of Umpqua Tribe of Indians recognized by Public Law 97-391, signed into law on December 29, 1983. House Rept. No. 97-862 designates Douglas, Jackson, and Josephine Counties as a service area without regard to the existence of a reservation. The IHS later administratively expanded the CHSDA to include the counties of Coos, OR, Deschutes, OR, Klamath, OR, and Lane, OR.15
                         The Cowlitz Indian Tribe was recognized in July 2002 as documented at 67 FR 46329, July 12, 2002. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638. The CHSDA was administratively expanded to included Columbia County, OR, Kittitas, WA, and Wahkiakum County, WA, as published at 67884 FR December 21, 2009.16
                         Treasure County, MT, has historically been a part of the Crow Service Unit population.17
                         The counties listed have historically been a part of the Grand Traverse Service Unit population since 1980.18
                         Haskell Indian Health Center has historically been a part of Kansas Service Unit since 1979. Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is based on the legislative history of the appropriation of funds for the particular facility rather than the eligibility regulations. Historically services have been provided at Haskell Indian Health Center (H. Rept. No. 95-392).19
                         CHSDA counties for the Ho-Chunk Nation of Wisconsin were designated by regulation (42 CFR 136.22(a)(5)). Dane County, WI, was added to the reservation by the Bureau of Indian Affairs in 1986.20
                         Public Law 97-428 provides that any member of the Houlton Band of Maliseet Indians in or around the Town of Houlton shall be eligible without regard to existence of a reservation.21
                         The Jena Band of Choctaw Indian was Federally acknowledged as documented at 60 FR 28480, May 31, 1995. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.22
                         Kickapoo Traditional Tribe of Texas, formerly known as the Texas Band of Kickapoo, was recognized by Public Law 97-429, signed into law on January 8, 1983. The Act provides for eligibility for Kickapoo Tribal members residing in Maverick County without regard to the existence of a reservation.23
                         The Klamath Indian Tribe Restoration Act (Pub. L. 99-398, Sec. 2(2)) states that for the purpose of Federal services and benefits “members of the tribe residing in Klamath County shall be deemed to be residing in or near a reservation”.24
                         The Koi Nation of Northern California, formerly known as the Lower Lake Rancheria, was reaffirmed by the Secretary of the Bureau of Indian Affairs on December 29, 2000. The counties listed were designated administratively as the SDA, to function as a PRCDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 93-638.25
                         The Little Traverse Bay Bands of Odawa Indians and the Little River Band of Ottawa Indians Act recognized the Little River Band of Ottawa Indians and the Little Traverse Bay Bands of Odawa Indians. Pursuant to Public Law 103-324, Sec. 4(b) the counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.26
                         The Little Traverse Bay Bands of Odawa Indians and the Little River Band of Ottawa Indians Act recognized the Little River Band of Ottawa Indians and the Little Traverse Bay Bands of Odawa Indians. Pursuant to Public Law 103-324, Sec. 4(b) the counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.27
                         Mashantucket Pequot Indian Claims Settlement Act, Public Law 98-134, signed into law on October 18, 1983, provides a reservation for the Mashantucket Pequot Indian Tribe in New London County, CT.28
                         The Mashpee Wampanoag Tribe was recognized in February 2007, as documented at 72 FR 8007, February 22, 2007. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.29
                         The Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan was recognized in October 1998, as documented at 63 FR 56936, October 23, 1998. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.30
                         Members of the Mississippi Band of Choctaw Indians residing in Jasper and Noxubee Counties, MS, are eligible for contract health services; these two counties were inadvertently omitted from 42 CFR 136.22.31
                        Members of the Mississippi Band of Choctaw Indians residing in Jasper and Noxubee Counties, MS, are eligible for contract health services; these two counties were inadvertently omitted from 42 CFR 136.22.32
                         Scott County, MS, has historically been a part of the Choctaw Service Unit population since 1970.33
                         The Narragansett Indian Tribe was recognized by Public Law 95-395, signed into law September 30, 1978. Lands in Washington County, RI, are now Federally restricted and the Bureau of Indian Affairs considers them as the Narragansett Indian Reservation.34
                         Entire State of Nevada is included as a CHSDA by regulation (42 CFR 136.22(a)(2)).35
                         Carter County, MT, has historically been a part of the Northern Cheyenne Service Unit population since 1979.36
                         Land of Box Elder County, Utah, was taken into trust for the Northwestern Band of Shoshoni Nation in 1986.37
                         The Nottawaseppi Huron Band of the Potawatomi, Michigan, formerly known as the Huron Band of Potawatomi, Inc., was recognized in December 1995, as documented at 60 FR 66315, December 21, 1995. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.38
                         Washabaugh County, SD, merged and became part of Jackson County, SD, in 1983; both were/are CHSDA counties for the Oglala Sioux Tribe.39
                         Entire State of Oklahoma is included as a CHSDA by regulation (42 CFR 136.22(a)(3)).40
                         Paiute Indian Tribe of Utah Restoration Act, Public Law 96-227, provides for the extension of services for the Paiute Indian Tribe of Utah to these four counties without regard to the existence of a reservation.41
                         In the 
                        **Federal Register**
                         on July 08, 2015 (80 FR 39144), the Pamunkey Indian Tribe was officially recognized as an Indian Tribe within the meaning of Federal law. The counties listed were designated administratively as the Tribe's PRCDA, as announced in the 
                        **Federal Register**
                         on July 28, 2017 (82 FR 35227).42
                         Legislative history (H.R. Report No. 95-1021) to Public Law 95-375, Extension of Federal Benefits to Pascua Yaqui Indians, Arizona, expresses congressional intent that lands conveyed to the Pascua Yaqui Tribe of Arizona pursuant to Act of October 8, 1964. (Pub. L. 88-350) shall be deemed a Federal Indian Reservation.
                        ( print page 47011)43
                         The Maine Indian Claims Settlement Act of 1980 (Pub. L. 96-420; H. Rept. 96-1353) includes the intent of Congress to fund and provide contract health services to the Passamaquoddy Tribe and the Penobscot Nation.44
                         The Passamaquoddy Tribe has two reservations: Indian Township and Pleasant Point. The PRCDA for the Passamaquoddy Tribe at Indian Township, ME, is Aroostook County, ME, Washington County, ME, and Hancock County, ME. The PRCDA for the Passamaquoddy Tribe at Pleasant Point, ME, is Washington County, ME, south of State Route 9, and Aroostook County, ME.45
                         The Passamaquoddy Tribe's counties listed are designated administratively as the SDA, to function as a PRCDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 93-638.46
                         The Maine Indian Claims Settlement Act of 1980 (Pub. L. 96-420; H. Rept. 96-1353) includes the intent of Congress to fund and provide PRC to the Passamaquoddy Tribe and the Penobscot Nation.47
                         Counties in the Service Unit designated by Congress for the Poarch Band of Creek Indians (see H. Rept. 98-886, June 29, 1984; Cong. Record, October 10, 1984, Pg. H11929).48
                         Public Law 103-323 restored Federal recognition to the Pokagon Band of Potawatomi Indians, Michigan and Indiana, in 1994 and identified counties to serve as the SDA.49
                         The Ponca Restoration Act, Public Law 101-484, recognized members of the Ponca Tribe of Nebraska in Boyd, Douglas, Knox, Madison or Lancaster counties of Nebraska or Charles Mix county of South Dakota as residing on or near a reservation. Public Law 104-109 made technical corrections to laws relating to Native Americans and added Burt, Hall, Holt, Platte, Sarpy, Stanton, and Wayne counties of Nebraska and Pottawatomie and Woodbury counties of Iowa to the Ponca Tribe of Nebraska SDA.50
                         Special programs have been established by Congress irrespective of the eligibility regulations. Eligibility for services at these facilities is based on the legislative history of the appropriation of funds for the particular facility, rather than the eligibility regulations. Historically services have been provided at Rapid City (S. Rept. No. 1154, FY 1967 Interior Approp. 89th Cong. 2d Sess.).51
                         Historically part of Isabella Reservation Area for the Saginaw Chippewa Indian Tribe of Michigan and the Eastern Michigan Service Unit population since 1979.52
                        The Samish Indian Tribe Nation was Federally acknowledged in April 1996 as documented at 61 FR 15825, April 9, 1996. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.53
                         CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians, Michigan, were designated by regulation (42 CFR 136.22(a)(4)).54
                         The Shinnecock Indian Nation was Federally acknowledged in June 2010 as documented at 75 FR 34760, June 18, 2010. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.55
                         Lemhi County, ID, has historically been a part of the Fort Hall Service Unit population since 1979.56
                         The Snoqualmie Indian Tribe was Federally acknowledged in August 1997 as documented at 62 FR 45864, August 29, 1997. The counties listed were designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.57
                         On December 30, 2011 the Office of Assistant Secretary-Indian Affairs reaffirmed the Federal recognition of the Tejon Indian Tribe. The county listed was designated administratively as the SDA, to function as a CHSDA, for the purposes of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.58
                         The counties listed are designated administratively as the SDA, to function as a PRC SDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 93-638.59
                         The Secretary acting through the Service is directed to provide contract health services to Turtle Mountain Band of Chippewa Indians that reside in Trenton Service Unit, North Dakota and Montana, in Divide, Mackenzie, and Williams counties in the state of North Dakota and the adjoining counties of Richland, Roosevelt, and Sheridan in the state of Montana (Sec. 815, Pub. L. 94-437).60
                         Rapides County, LA, has historically been a part of the Tunica Biloxi Service Unit population since 1982.61
                         According to Public Law 100-95, Sec. 12, members of the Wampanoag Tribe of Gay Head (Aquinnah) residing on Martha's Vineyard are deemed to be living on or near an Indian reservation for the purposes of eligibility for Federal services.62
                         The counties listed are designated administratively as the SDA, to function as a PRCDA, for the purposes of operating a PRC program pursuant to the ISDEAA, Public Law 93-638.63
                         The Wilton Rancheria, California had Federal recognition restored in July 2009 as documented at 74 FR 33468, July 13, 2009. Sacramento County, CA, was designated administratively as the SDA, to function as a CHSDA. Sacramento County was not covered when Congress originally established the State of California as a CHSDA excluding certain counties including Sacramento County (25 U.S.C. 1680).64
                         Public Law 100-89, Restoration Act for Ysleta Del Sur and Alabama and Coushatta Tribes of Texas establishes service areas for “members of the Tribe” by sections 101(3) and 105(a) for the Pueblo and sections 201(3) and 206(a) respectively.
 Dated: October 2, 2017. Michael D. Weahkee, RADM, Assistant Surgeon General, U.S. Public Health Service, Acting Director, Indian Health Service.


[FR Doc. 2017-21758 Filed 10-6-17; 8:45 a.m.] BILLING CODE 4165-16-P