47004 Federal Register / Vol. 82, No. 194 / Tuesday, October 10, 2017 / Notices 

Dated: October 2, 2017. 

Michael D. Weahkee, 

Assistant Surgeon General, U.S. Public Health 

Service, Acting Director, Indian Health 

Service. 

[FR Doc. 2017–21759 Filed 10–6–17; 8:45 a.m.] 

BILLING CODE 4165–16–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

Re-Designation of the Delivery Area for 

the Tolowa Dee-ni’ Nation, Formerly 

Known as Smith River Rancheria 

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 Deeni’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 redesignation is made. The criteria are as 

follows: 

(1) The number of Indians residing in 

the area proposed to be so included or 

excluded; 

(2) Whether the Tribal governing body 

has determined that Indians residing in 

the area near the reservation are socially 

and economically affiliated with the 

Tribe; 

(3) The geographic proximity to the 

reservation of the area whose inclusion 

or exclusion is being considered; and 

(4) The level of funding which would 

be available for the provision of PRC, 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 redesignation 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. 


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Federal Register / Vol. 82, No. 194 / Tuesday, October 10, 2017 / Notices 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 


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47006 Federal Register / Vol. 82, No. 194 / Tuesday, October 10, 2017 / Notices 

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/state 

Ak Chin Indian Community ....................................................................... Pinal, AZ. 

Alabama-Coushatta Tribes of Texas ........................................................ Polk, TX.1

Alaska ....................................................................................................... Entire State.2

Arapahoe Tribe of the Wind River Reservation, Wyoming ...................... Hot Springs, WY, Fremont, WY, Sublette, WY. 

Aroostook Band of Micmacs .................................................................... Aroostook, ME.3

Assiniboine 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.5

Catawba 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.13

Cow 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


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PURCHASED/REFERRED CARE DELIVERY AREAS—Continued 

Tribe/reservation County/state 

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.20

Hualapai 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.22

Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas ......... Brown, KS, Jackson, KS. 

Klamath Tribes ......................................................................................... Klamath, OR.23

Koi Nation of Northern California (formerly known as Lower Lake 

Rancheria, California).

Lake, CA, Sonoma, CA.24

Kootenai 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.27

Mashpee Wampanoag Tribe .................................................................... Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, 

MA.28

Match-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.33

Navajo 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.34

Nez 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. 


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PURCHASED/REFERRED CARE DELIVERY AREAS—Continued 

Tribe/reservation County/state 

Northwestern Band of Shoshone Nation .................................................. Box Elder, UT.36

Nottawaseppi 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.39

Omaha 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).41

Pascua Yaqui Tribe of Arizona ................................................................ Pima, AZ.42

Passamaquoddy Tribe .............................................................................. Aroostook, ME,43 44 Hancock, ME,45 Washington, ME. 

Penobscot Nation ..................................................................................... Aroostook, ME46, 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.50

Red 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. 


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PURCHASED/REFERRED CARE DELIVERY AREAS—Continued 

Tribe/reservation County/state 

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.57

Three 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.58

Tonto 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.60

Turtle 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.62

Washoe 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.63

Winnebago 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.64

Zuni Tribe of the Zuni Reservation, New Mexico .................................... Apache, AZ, Cibola, NM, McKinley, NM, Valencia, NM. 

1Public 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. 2Entire State of Alaska is included as a CHSDA by regulation (42 CFR 136.22(a)(1)). 

3Aroostook 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. 


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4Special 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. 5Entire 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). 6The 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. 7There is no reservation for the Cayuga Nation; the service delivery area consists of those counties identified by the Cayuga Nation. 8Skamania 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. 11Pursuant 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. 12The 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. 13The 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. 15The 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. 16Treasure County, MT, has historically been a part of the Crow Service Unit population. 17The 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. 20Public 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. 21The 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. 22Kickapoo 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. 23The 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’’. 24The 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. 25The 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. 26The 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. 28The 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. 29The 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. 31Members 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. 32Scott County, MS, has historically been a part of the Choctaw Service Unit population since 1970. 33The 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. 34Entire 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. 37The 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. 38Washabaugh County, SD, merged and became part of Jackson County, SD, in 1983; both were/are CHSDA counties for the Oglala Sioux

Tribe. 39Entire State of Oklahoma is included as a CHSDA by regulation (42 CFR 136.22(a)(3)). 40Paiute 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. 


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43The 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. 44The 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. 45The 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. 46The 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). 48Public 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. 49The 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. 50Special 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. 52The 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)). 54The 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. 56The 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. 57On 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. 58The 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. 59The 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. 61According 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. 62The 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. 63The 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). 64Public 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 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

National Institutes of Health 

Office of the Director; Notice of 

Meeting 

Pursuant to section 10(d) of the 

Federal Advisory Committee Act, as 

amended, notice is hereby given of a 

meeting of the NIH Clinical Center 

Research Hospital Board. 

The meeting will be open to the 

public as indicated below, with 

attendance limited to space available. 

Individuals who plan to attend and 

need special assistance, such as sign 

language interpretation or other 

reasonable accommodations, should 

notify the Contact Person listed below 

in advance of the meeting. 

The portion of the meeting devoted to 

the identification and evaluation of 

specific candidates for consideration for 

leadership positions in the Clinical 

Center will be closed to the public in 

accordance with the provisions set forth 

in section 552b(c)(9)(B) and 552b(c)(6), 

Title 5 U.S.C., as amended. Premature 

disclosure of potential candidates and 

their qualifications, as well as the 

discussions by the committee, could 

significantly frustrate NIH’s ability to 

recruit these individuals and the 

consideration of personnel 

qualifications, performance, and the 

competence of individuals as candidates 

would constitute a clearly unwarranted 

invasion of personal privacy. 

Name of Committee: NIH Clinical Center 

Research Hospital Board. 

Date: October 20, 2017. 

Open: 9:00 a.m. to 3:45 p.m. 

Agenda: Patient Safety Racking and 

Reporting System; Quality Improvement 

Assessment Results; IRB Consolidation. 

Place: National Institutes of Health 

Building 31, 31 Center Drive, Bethesda, MD 

20892. 

Closed: 3:45 p.m. to 5:00 p.m. 

Agenda: Identification of Candidates for 

Leadership Role. 

Place: National Institutes of Health 

Building 31, 31 Center Drive, Bethesda, MD 

20892. 

Contact Person: Gretchen Wood, Staff 

Assistant, Office of the Director, National 

Institutes of Health, One Center Drive, 

Building 1, Room 126, Bethesda, MD 20892, 

301–496–4272, woodgs@od.nih.gov. 

Any interested person may file 

written comments with the committee 

by forwarding the statement to the 

Contact Person listed on this notice. The 

statement should include the name, 

address, telephone number and when 

applicable, the business or professional 

affiliation of the interested person. 


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