Privacy Act of 1974; Report of Modified or Altered System-Medical Staff Credentials and Privileges Records, 16320-16324 [06-3091]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 71, Number 62 (Friday, March 31, 2006)]
[Notices]
[Pages 16320-16324]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 06-3091]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Privacy Act of 1974; Report of Modified or Altered System--
Medical Staff Credentials and Privileges Records

AGENCY: Indian Health Service (IHS).

ACTION: Notice of proposed modification or alteration to a System or 
Records (SOR).

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SUMMARY: In accordance with the requirements of the Privacy Act of 
1974, the Indian Health Service (IHS) is proposing to modify or alter 
an SOR, ``Medical Staff Credentials and Privileges Records,'' System 
No. 09-17-0003. We propose to modify the SOR to reflect current program 
changes, technology changes, statutory and implementation changes. 
Under the system name, we propose to change to the current program 
office name. We are proposing to update the categories of individuals 
covered by the system with minor edits to the Active, Temporary and 
Courtesy or Associate. We are proposing to update the Authority for 
maintenance by including the Federal Records Act and the Privacy Act. 
We are proposing to update the Purposes to reflect the new program 
title of the National Practitioner Data Bank to include the Healthcare 
Integrity and Protection Data Bank and the inclusion of authorizing 
statute. We are proposing to update the Routine Uses to reflect the new 
program title of the National Practitioner Data Bank to include the 
Healthcare Integrity and Protection Data Bank and the inclusion of 
authorizing statute for routine use numbers 2 and 3. We will also take 
the opportunity to update any sections of the system notice to provide 
clarity on the changing environment to include for digital records and 
the initiative of transitioning from a paper-based record to a 
computerized-based or electronic medical record.

DATES: The Report of Intent to Amend a System of Records Notice and an 
advance copy of the system notice have been sent to the Chair of the 
House Committee on Government Reform and Oversight, the Chair of the 
Senate Committee on Governmental Affairs, and the Administrator, Office 
of Information and Regulatory Affairs, Office of Management and Budget 
(OMB). To ensure that all parties have adequate time in which to 
comment, the modified system of records, including routine uses, will 
become effective 40 days from the publication of the notice, or from 
the date it was submitted to OMB and the Congress, whichever is later, 
unless IHS receives comments that require alterations to this notice.

ADDRESSES: The public should address comments to: Mr. William Tibbitts, 
IHS Privacy Act Officer, Division of Regulatory, Records Access and 
Policy Liaison, 801 Thompson Avenue, TMP Suite 450, Rockville, MD 
20852-1627; call non-toll free (301) 443-1116; send via facsimile to 
(301) 443-2316, or send your email requests, comments, and return 
address to: wtibbitt@hqe.ihs.gov.

FOR FURTHER INFORMATION CONTACT: Stephen Heath, IHS Risk Management 
Consultant, Headquarters East (HQE) Office of Clinical and Preventative 
Services, 801 Vassar Drive, NE., Albuquerque, New Mexico 87106, 
Telephone (505) 248-4047.

SUPPLEMENTARY INFORMATION: A. Major Modification of 09-17-0003, is to 
reflect the statutory change in routine use numbers 2 and 3 of the 
National Practitioner Data Bank and the Healthcare and Integrity 
Protection Data Bank.
    In addition to updating and making editorial corrections to improve 
the clarify of the system notice, this alteration requires the updating 
of the system manager listing, and revisions of the Categories of 
Records, Purposes, Authority, Safeguard, Retention and Disposal, 
Notification and Access Procedures sections.

    Dated: March 23, 2006.
Charles W. Grim,
Assistant Surgeon General, Director, Indian Health Service, Department 
of Health and Human Services.
09-17-0003

System name:
    Indian Health Service Medical Staff Credentials and Privileges 
Records, HHS/IHS/OCPS.

Security classification:
    None.

System location:
    Each Indian Health Service (IHS) Area Office and each IHS Service 
Unit (Appendix 1). Records may also be located at hospitals and offices 
of health care providers who are under contract with IHS. A current 
list of contractor sites is available by writing to the appropriate 
System Manager (Area or Service Unit Director) at the address shown in 
Appendix I.

Categories of individuals covered by the system:
    Prospective, current and former IHS medical staff members. The term 
IHS medical staff includes fully licensed individuals permitted by law 
to provide patient care services independently and without concurrent 
professional direction or supervision, within the scope of his/her 
license and in accordance with individually granted clinical 
privileges. The IHS medical staff includes physicians (M.D. and D.O.) 
and dentists and may include other health care practitioners such as 
psychologists, optometrists, podiatrists, audiologists, and, in some 
states, certified nurse midwives. Types of assignment categories of 
current and former IHS medical staff members include the following:

[[Page 16321]]

    Provisional--Those new members of the medical staff who are serving 
a required initial probationary period, as specified in the local 
medical staff bylaws. During this time, their qualifications for 
membership on the active or courtesy IHS medical staff are assessed.
    Active--Those members who are Federal employees and/or spend at 
least fifty percent of their professional time providing patient care 
related services in the facility.
    Temporary--Those members who provide services on a short-term basis 
or have applied for active medical staff membership and are awaiting a 
full credential review.
    Courtesy or Associate--Those members who generally provide services 
on a periodic or episodic basis (e.g., consultants for specialty 
clinics).

Categories of records in the system:
    Contains name, Social Security number, IHS medical staff membership 
and privileges applications and associated forms, employment data, 
liability insurance coverage, credentialing history of licensed health 
professionals, personal, educational, and demographic background 
information, professional performance information consisting of 
continuing education, performance awards, and adverse or disciplinary 
actions, and evaluations and approvals completed by IHS medical staff 
reviewers.

Authority for maintenance of the system:
    Federal Records Act (44 U.S.C. 2901), Privacy Act of 1974, as 
amended (5 U.S.C. 552a), Indian Self Determination and Education and 
Assistance Act (25 U.S.C. 450), Snyder Act (25 U.S.C. 13), Indian 
Health Care Improvement Act (25 U.S.C. 1601 et seq.), Indian Health 
Service Transfer Act ((42 U.S.C. 2001-2004).

Purpose(s):
    The purposes of this system are:
    1. To ensure that IHS medical staff members are qualified, 
competent and capable of delivering quality health services consistent 
with those of the medical community at large and that they are granted 
privileges commensurate with their training and competence and with the 
ability of the facility to provide adequate support equipment, 
services, and staff.
    2. To inform health care practitioner(s) and staff of health care 
facilities, state or county health professional societies or licensing 
boards to whom the subject individual may apply for clinical 
privileges, membership or licensure, of the subject individual's 
professional competence, character and ethical qualifications. This may 
include information regarding drug or alcohol abuse or dependency. 
Within the Department such releases may be made to personnel staffs of 
DHHS Regional Offices.
    3. To provide adverse health care practice information to the 
National Practitioner Data Bank-Healthcare Integrity and Protection 
Data Bank (NPDB-HIPDB) established under Title IV of Public Law 99-660, 
the Health Care Quality Improvement Act of 1986, as amended, and 
Section 221(a) of Public Law 104-191, the Heath Insurance Portability 
and Accountability Act of 1996. The purpose of such a release is to 
provide information concerning a current or former IHS medical staff 
member whose professional health care activity failed to conform to 
generally accepted standards of professional medical practice.
    4. To provide health care practice information concerning current 
or former members of the IHS medical staff with Commissioned Corps 
status to the Division of Commissioned Personnel, U.S. Public Health 
Service, so that an informed decision may be made concerning the 
promotion, retention, or reassignment of the subject individual.

Routine uses of records maintained in the system, including categories 
of users and the purposes of such uses:
    1. Records may be disclosed to organizations authorized to conduct 
evaluation studies concerning the delivery of health care services by 
the IHS (e.g., Joint Commission on the Accreditation of Healthcare 
Organizations).
    2. IHS may disclose records consisting of name, Social Security 
number, employment history and any professional qualification 
information concerning medical staff membership and privileges, 
professional competence, clinical judgment and personal character to a 
state or local government health professional licensing board, to the 
Federation of State Medical Boards, to the NPDB-HIPDB, and/or to a 
similar entity which has the authority to maintain records concerning 
the issuance, retention or revocation of licenses or registrations 
necessary to practice a health professional occupation or specialty. 
The purpose of this disclosure is to inform medical profession 
licensing boards and appropriate entities about the health care 
practices of a current, terminated, resigned, or retired IHS medical 
staff member whose professional health care activity significantly 
failed to conform to generally accepted standards of professional 
medical practice. This will be done within the guidelines for notice, 
hearing, and review as delineated in the medical staff bylaws for the 
IHS facility and/or within other HHS or IHS regulations or policies.
    3. IHS may disclose biographic data and information supplied by 
potential applicants to (a) references listed on the IHS medical staff 
and/or privileges application and associated forms for the purpose of 
evaluating the applicant's professional qualifications, experience, and 
suitability, and (b) a state or local government health profession 
licensing board, to a health-related professional organization, to the 
Federation of State Medical Boards, and to the NPDB-HIPDB or a similar 
entity for the purpose of verifying that all claimed background and 
employment data are valid and all claimed credentials are current and 
in good standing.
    4. Records may be disclosed to other Federal agencies (including 
the Office of Personnel Management for subject individuals applying for 
or maintaining Civil Service appointments), to state and local 
governmental agencies, and to organizations in the private sector to 
which the subject individual applies for clinical privileges, 
membership or licensure for the purpose of documenting the 
qualifications and competency of the subject individual to provide 
health services in his/her health profession based on the individual's 
professional performance while employed by the IHS.
    5. The Department may disclose information from this system of 
records to the Department of Justice, or to a court or other tribunal, 
when (a) HHS, or any component thereof, or (b) any HHS employee in his 
or her official capacity; or (c) any HHS employee in his or her 
individual capacity where the Department of Justice (or HHS, where it 
is authorized to do so) has agreed to represent the employee; or (d) 
the United States or any agency thereof where HHS determines that the 
litigation is likely to affect HHS or any of its components, is a party 
to litigation or has an interest in such litigation, and HHS determines 
that the use of such records by the Department of Justice, the court or 
other tribunal is relevant and necessary to the litigation and would 
help in the effective representation of the governmental party, 
provided, however, that in each case, HHS determines that such 
disclosure is compatible with the purpose for which the records were 
collected.
    6. Records may be disclosed to a congressional office from the 
record of

[[Page 16322]]

an individual in response to a verified inquiry from the congressional 
office made at the written request of that individual.
    7. In the event that a system of records maintained by the IHS to 
carry out its functions indicates a violation or potential violation of 
law, whether civil, criminal, or regulatory in nature, and whether 
arising by general statute or particular program statute, or by 
regulation, rule or order issued pursuant thereto, the relevant records 
in the system of records may be referred to the appropriate agency, 
whether Federal, state, or local, charged with enforcing or 
implementing the statute or rule, regulation or order issued pursuant 
thereto.

Policies and practices for storing, retrieving, accessing, retaining, 
and disposing of records in the system:
Storage:
    File folders and computer-based or electronic files.

Retrievability:
    Indexed and retrieved by name, Social Security number, and any 
other identifying numbers necessary to establish the identity of an 
individual whose record is maintained in the system of records.

Safeguards:
    1. Authorized Users: Access is limited to authorized personnel for 
use in the performance of their official duties. Authorized personnel 
include: Physician Recruitment and other Health Professions Branch 
Staff and Area Governing Board Members at IHS Area Offices, and Service 
Unit Directors, Clinical Directors and members of the Credentials and 
Privilege Committee of each IHS Service Unit. At each location where 
records in this system will be maintained, a list of personnel or 
categories of personnel having an official need-to-know has been 
developed and is maintained.
    2. Physical Safeguards: Records are kept in locked metal filing 
cabinets or in locked desk drawers in secured rooms at all times when 
not actually in use during working hours and at all times during non-
working hours. Record storage areas, including file cabinets and desks, 
are not left unattended or unlocked during office hours, including 
lunch hours. Computer-based or electronic records are password 
protected security and any additional internal security for database 
(linked or unlinked).
    3. Procedural Safeguards: Persons who have an official need-to-know 
are entrusted with records from this system of records and are 
instructed to safeguard the confidentiality of these records and to 
destroy all copies or to return such records when the need to know has 
expired. Instructions include the statutory penalties for 
noncompliance. Proper charge-out procedures are followed for the 
removal of records from the area in which they are maintained. Before 
an employee who will control disclosure of records can work with the 
records (i.e., employees who report to the system manager) the system 
manager or designee ensures that the employee has received training in 
the safeguards applicable to the records and is aware of the actions to 
take to restrict disclosure. When copying records for authorized 
purposes, care is taken to ensure that any imperfect pages are not left 
in the reproduction room where they can be read but are destroyed or 
obliterated.
    4. Implementation Guidelines: DHHS Chapter 45-13 and supplementary 
Chapter PHS.hf:45-13 of the General Administration Manual; DHHS, 
``Automated Information System Security Program Handbook,'' as amended; 
DHHS IRM Policy HHS-IRM-2000-0005, ``IRM Policy for IT Security for 
Remove Access; OMB Circular A-130 ``Management of Federal Information 
Resources''; and E-Government Act of 2002 (Pub. L. 107-347, 44 U.S.C. 
Ch. 36).

Retention and disposal:
    Records are maintained by IHS for at least ten years after the 
individual's termination of employment or association with IHS. Records 
of unsuccessful applicants for medical staff membership will be 
retained for three years after his/her rejection. After these periods 
of retention expire, records are destroyed by shredding or burning.

System manager(s) and address:
    See Appendix 1.

Policy Coordinating Official:
    Director, Office of Clinical and Preventive Services, IHS, 801 
Thompson Avenue, Suite 300, Rockville, Maryland 20852. The IHS Clinical 
Directors at all IHS Service Units listed in Appendix 1 are System 
Managers. IHS medical staff credentials and privileges files are stored 
at these locations. Other addresses listed in Appendix 1 are locations 
at which all or parts of these records may also be stored (Physician 
Recruiter at IHS Area Offices). Post Office Box designations appearing 
in Appendix 1 should be specified when making requests by mail.

Notification procedure:
    Requests must be made to the appropriate System Manager (Clinical 
Director for the appropriate Service Unit) listed in Appendix 1.

Requests by mail:
    Requests for information and/or access to records received by mail 
must contain information providing the identity of the writer and a 
reasonable description of the record desired. Written requests must 
contain, at a minimum, the name, signature, Social Security number, and 
address of the requester, and for unsuccessful applicants the date when 
the application was submitted, and for current or former IHS health 
care providers the dates and locations of service. We may request 
additional identification when we hold records for different persons 
with the same name or where an apparent discrepancy exists between 
information contained in the record and that provided by the individual 
requesting access to the record.

Other names used:
    Where an individual is seeking to obtain information about himself/
herself which may be retrieved by a different name than his/her current 
name, he/she shall be required to produce evidence to verify that he/
she is the person whose record he/she seeks.

Requests in person:
    A subject individual who appears in person at a specific location 
(where he or she currently works or formerly worked) seeking access or 
disclosure of records contained in this system of records relating to 
him/her shall provide the information described in ``Requests by mail'' 
(above) and at least one piece of tangible identification such as a 
driver's license or passport.

Requests by telephone:
    Since positive identification of the caller cannot be established, 
telephone requests are not honored.

Record access procedures:
Same as Notification procedure:
    Requesters should also provide a reasonable description of the 
record being sought. Requesters may also request an accounting of 
disclosures that have been made of their records, if any.

Contesting record procedures:
    Write to the appropriate Service Unit Clinical Director at the 
address specified

[[Page 16323]]

in Appendix 1 and reasonably identify the record, specify the 
information being contested, and state the corrective action sought, 
and the reasons for requesting the correction, along with supporting 
information to show how the record is inaccurate, incomplete, untimely, 
or irrelevant.

Record source categories:
    Subject individual, IHS health care personnel, references supplied 
by the subject individual, professional societies or associations, 
specialty boards, colleges and universities attended by the subject 
individual, former employers, health facilities or health providers 
with which the subject individual was associated, liability insurance 
carriers, organizations providing cardiopulmonary resuscitation (CPR) 
training to the subject individual, state and local health and health 
care licensing or certifying organizations, and organizations which 
serve as repositories of information on health care professionals.

Systems exempted from certain provisions of the act:
    None.

Appendix 1: System Managers and IHS Locations Under Their Jurisdiction 
Where Records are Maintained

Director, Aberdeen Area Indian Health Service, Room 309, Federal 
Building, 115 Fourth Avenue, SE., Aberdeen, South Dakota 57401
Director, Cheyenne River Service Unit, Eagle Butte Indian Hospital, 
P.O. Box 1012, Eagle Butte, South Dakota 57625
Director, Crow Creek Service Unit, Ft. Thompson Indian Health 
Center, P.O. Box 200, Ft. Thompson, South Dakota 57339
Director, Fort Berthold Service Unit, Fort Berthold Indian Health 
Center, P.O. Box 400, New Town, North Dakota 58763
Director, Carl T. Curtis Health Center, P.O. Box 250, Macy, Nebraska 
68039
Director, Fort Totten Service Unit, Fort Totten Indian Health 
Center, P.O. Box 200, Fort Totten, North Dakota 58335
Director, Kyle Indian Health Center, P.O. Box 540, Kyle, South 
Dakota 57752
Director, Lower Brule Indian Health Center, P.O. Box 191, Lower 
Brule, South Dakota 57548
Director, McLaughlin Indian Health Center, P.O. Box 879, McLaughlin, 
South Dakota 57642
Director, Omaha-Winnebago Service Unit, Winnebago Indian Hospital, 
Winnebago, Nebraska 68071
Director, Pine Ridge Service Unit, Pine Ridge Indian Hospital, Pine 
Ridge, South Dakota 57770
Director, Rapid City Service Unit, Rapid City Indian Hospital, 3200 
Canyon Lake Drive, Rapid City, South Dakota 57701
Director, Rosebud Service Unit, Rosebud Indian Hospital, Rosebud, 
South Dakota 57570
Director, Sisseton-Wahpeton Service Unit, Sisseton Indian Hospital, 
P.O. Box 189, Sisseton, South Dakota 57262
Director, Standing Rock Service Unit, Fort Yates Indian Hospital, 
P.O. Box J, Fort Yates, North Dakota 58538
Director, Trenton-Williston Indian Health Center, P.O. Box 210, 
Trenton, North Dakota 58853
Director, Turtle Mountain Service Unit, Belcourt Indian Hospital, 
P.O. Box 160, Belcourt, North Dakota 58316
Director, Wanblee Indian Health Center, 100 Clinic Drive, Wanblee, 
South Dakota 57577
Director, Yankton-Wagner Service Unit, Wagner Indian Hospital, 110 
Washington Street, Wagner, South Dakota 57380
Director, Youth Regional Treatment Center, P.O. Box 68, 
Mobridge, South Dakota 57601
Director, Sac & Fox Health Center, 307 Meskwaki Road, Tama, Iowa 
52339
Director, Santee Health Center, 425 Frazier Avenue, Main Street 
2, Niobrara, Nebraska 68760
Director, Alaska Area Native Health Service, 4141 Ambassador Drive, 
Suite 300, Anchorage, Alaska 99508-5928
Director, Albuquerque Area Health Service, 5300 Homestead Road, NE., 
Albuquerque, New Mexico 87110
Director, Acoma-Canoncito-Laguna Service Unit, Acoma-Canoncito-
Laguna Indian Hospital, P.O. Box 130, San Fidel, New Mexico 87049
Director, To-Hajille Health Center, P.O. Box 3528, Canoncito, New 
Mexico 87026
Director, New Sunrise Treatment Center, P.O. Box 219, San Fidel, New 
Mexico 87049
Director, Albuquerque Service Unit, Albuquerque Indian Hospital, 801 
Vassar Drive, NE., Albuquerque, New Mexico 87049
Director, Albuquerque Indian Dental Clinic, P.O. Box 67830, 
Albuquerque, New Mexico 87193
Director, Alamo Navajo Health Center, P.O. Box 907, Magdalena, New 
Mexico 87825
Director, Jemez PHS Health Center, P.O. Box 279, Jemez, New Mexico 
87024
Director, Santa Ana PHS Health Center, P.O. Box 37, Bernalillo, New 
Mexico 87004
Director, Sandia PHS Health Center, P.O. Box 6008, Bernalillo, New 
Mexico 87004
Director, Zia PHS Health Center, 155 Capital Square, Zia, New Mexico 
87053
Director, Santa Fe Service Unit, Santa Fe Indian Hospital, 1700 
Cerrillos Road, Santa Fe, New Mexico 87501
Director, Santa Clara Health Center, RR5, Box 446, Espanola, New 
Mexico 87532
Director, San Felipe Health Center, P.O. Box 4344, San Felipe, New 
Mexico 87001
Director, Cochiti Health Center, P.O. Box 105, 255 Cochiti Street, 
Cochiti, New Mexico 87072
Director, Santo Domingo Health Center, P.O. Box 340, Santo Domingo, 
New Mexico 87052
Director, Southern Colorado-Ute Service Unit, P.O. Box 778, Ignacio, 
Colorado 81137
Director, Ignacio Indian Health Center, P.O. Box 889, Ignacio, 
Colorado 81137
Director, Towaoc Ute Health Center, Towaoc, Colorado 81334
Director, Jicarilla Indian Health Center, P.O. Box 187, Dulce, New 
Mexico 87528
Director, Mescalero Service Unit, Mescalero Indian Hospital, P.O. 
Box 210, Mescalero, New Mexico 88340
Director, Taos/Picuris Indian Health Center, P.O. Box 1956, 1090 
Goat Springs Road, Taos, New Mexico 87571
Director, Zuni Service Unit, Zuni Indian Hospital, Zuni, New Mexico 
87327
Director, Pine Hill Health Center, P.O. Box 310, Pine Hill, New 
Mexico 87357
Director, Bemidji Area Indian Health Service, 522 Minnesota Avenue, 
NW., Bemidji, Minnesota 56601
Director, Red Lake Service Unit, PHS Indian Hospital, Highway 1, Red 
Lake, Minnesota 56671
Director, Leech Lake Service Unit, PHS Indian Hospital, 425 7th 
Street, NW., Cass Lake, Minnesota 56633
Director, White Earth Service Unit, PHS Indian Hospital, P.O. Box 
358, White Earth, Minnesota 56591
Director, Billings Area Indian Health Service, P.O. Box 36600, 2900 
4th Avenue North, Billings, Montana 59101
Director, Blackfeet Service Unit, Browning Indian Hospital, P.O. Box 
760, Browning, Montana 59417
Director, Heart Butte PHS Indian Health Clinic, Heart Butte, Montana 
59448
Director, Crow Service Unit, Crow Indian Hospital, Crow Agency, 
Montana 59022
Director, Lodge Grass PHS Indian Health Center, Lodge Grass, Montana 
59090
Director, Pryor PHS Indian Health Clinic, P.O. Box 9, Pryor, Montana 
59066
Director, Fort Peck Service Unit, Poplar Indian Hospital, Poplar, 
Montana 59255
Director, Fort Belknap Service Unit, Harlem Indian Hospital, Harlem, 
Montana 59526
Director, Hays PHS Indian Health Clinic, Hays, Montana 59526
Director, Northern Cheyenne Service Unit, Lame Dear Indian Health 
Center, Lame Deer, Montana 59043
Director, Wind River Service Unit, Fort Washakie Indian Health 
Center, Fort Washakie, Wyoming 82514
Director, Arapahoe Indian Health Center, Arapahoe, Wyoming 82510
Director, Chief Redstone Indian Health Center, Wolf Point, Montana 
59201
Director, California Area Indian Health Service, John E. Moss 
Federal Building, 650 Capitol Mall, Suite 7-100, Sacramento, 
California 95814
Director, Nashville Area Indian Health Service, 711 Stewarts Ferry 
Pike, Nashville, Tennessee 37214-2634
Director, Catawba PHS Indian Nation of South Carolina, P.O. Box 188, 
Catawba, South Carolina 29704
Director, Unity Regional Youth Treatment Center, P.O. Box C-201, 
Cherokee, North Carolina 28719
Director, Navajo Area Indian Health Service, P.O. Box 9020, Highway 
264, Window Rock, Arizona 86515-9020
Director, Chinle Service Unit, Chinle Comprehensive Health Care 
Facility, P.O. Drawer PH, Chinle, Arizona 86503
Director, Tsaile Health Center, P.O. Box 467, Navajo Routes 64 & 12, 
Tsaile, Arizona 86556

[[Page 16324]]

Director, Rock Point Field Clinic, c/o Tsaile Health Center, P.O. 
Box 647, Tsaile, Arizona 86557
Director, Pinon Health Station, Pinon, Arizona 86510
Director, Crownpoint Service Unit, Crownpoint Comprehensive Health 
Care Facility, P.O. Box 358, Crownpoint, New Mexico 87313
Director, Pueblo Pintado Health Station, c/o Crownpoint 
Comprehensive Health Care Facility, P.O. Box 358, Crownpoint, New 
Mexico 87313
Director, Fort Definance Service Unit, Fort Definance Indian 
Hospital, P.O. Box 649, Intersection of Navajo Routes N12 & N7, Fort 
Defiance, Arizona 86515
Director, Nahata Dziil Health Center, P.O. Box 125, Sanders, Arizona 
86512
Director, Gallup Service Unit, Gallup Indian Medical Center, P.O. 
Box 1337, Nizhoni Boulevard, Gallup, New Mexico 87305
Director, Tohatchi Indian Health Center, P.O. Box 142, Tohatchi, New 
Mexico 87325
Director, Ft. Wingate Health Station, c/o Gallup Indian Medical 
Center, P.O. Box 1337, Gallup, New Mexico 87305
Director, Kayenta Service Unit, Kayenta Indian Health Center, P.O. 
Box 368, Kayenta, Arizona 86033
Director, Inscription House Health Center, P.O. Box 7397, Shonto, 
Arizona 86054
Director, Dennhotso Clinic, c/o Kayenta Health Center, P.O. Box 368, 
Kayenta, Arizona 86033
Director, Shiprock Service Unit, Northern Navajo Medical Center, 
P.O. Box 160, U.S. Hwy 491 North, Shiprock, New Mexico 87420
Director, Dzilth-Na-O-Dith-Hle Indian Health Center, 6 Road 7586, 
Bloomfield, New Mexico 87413
Director, Teecnospos Health Center, P.O. Box 103, N5114 BIA School 
Road, Teecnospos, Arizona 86514
Director, Sanostee Health Station, c/o Northern Navajo Medical 
Center, P.O. Box 160, Shiprock, New Mexico 87420
Director, Toadlena Health Station, c/o Northern Navajo Medical 
Center, P.O. Box 160, Shiprock, New Mexico 87420
Director, Teen Life Center, c/o Northern Navajo Medical Center, P.O. 
Box 160, Shiprock, New Mexico 87420
Director, Oklahoma City Area Indian Health Service, Five Corporation 
Plaza, 3625 NW. 56th Street, Oklahoma City, Oklahoma 73112
Director, Claremore Service Unit, Claremore Comprehensive Indian 
Health Facility, West Will Rogers Boulevard and Moore, Claremore, 
Oklahoma 74017
Director, Clinton Service Unit, Clinton Indian Hospital, Route 1, 
Box 3060, Clinton, Oklahoma 73601-9303
Director, El Reno PHS Indian Health Clinic, 1631A E. Highway 66, El 
Reno, Oklahoma 73036
Director, Watonga Indian Health Center, Route 1, Box 34-A, Watonga, 
Oklahoma 73772
Director, Haskell Service Unit, PHS Indian Health Center, 2415 
Massachusetts Avenue, Lawrence, Kansas 66044
Director, Lawton Service Unit, Lawton Indian Hospital, 1515 Lawrie 
Tatum Road, Lawton, Oklahoma 73501
Director, Anadarko Indian Health Center, P.O. Box 828, Anadarko, 
Oklahoma 73005
Director, Carnegie Indian Health Center, P.O. Box 1120, Carnegie, 
Oklahoma 73150
Director, Holton Service Unit, PHS Indian Health Center, 100 West 
6th Street, Holton, Kansas 66436
Director, Pawnee Service Unit, Pawnee Indian Service Center, RR2, 
Box 1, Pawnee, Oklahoma 74058-9247
Director, Pawhuska Indian Health Center, 715 Grandview, Pawhuska, 
Oklahoma 74056
Director, Tahlequah Service Unit, W.W. Hastings Indian Hospital, 100 
S. Bliss, Tahlequah, Oklahoma 74464
Director, Wewoka Indian Health Center, P.O. Box 1475, Wewoka, 
Oklahoma 74884
Director, Phoenix Area Indian Health Service, Two Renaissance 
Square, 40 North Central Avenue, Phoenix, Arizona 85004
Director, Colorado River Service Unit, Chemehuevi Indian Health 
Clinic, P.O. Box 1858, Havasu Landing, California 92363
Director, Colorado River Service Unit, Havasupai Indian Health 
Station, P.O. Box 129, Supai, Arizona 86435
Director, Colorado River Service Unit, Parker Indian Health Center, 
12033 Agency Road, Parker, Arizona 85344
Director, Colorado River Service Unit, Peach Springs Indian Health 
Center, P.O. Box 190, Peach Springs, Arizona 86434
Director, Colorado River Service Unit, Sherman Indian High School, 
9010 Magnolia Avenue, Riverside, California 92503
Director, Elko Service Unit, Newe Medical Clinic, 400 ``A'' Newe 
View, Ely, Nevada 89301
Director, Elko Service Unit, Southern Bands Health Center, 515 
Shoshone Circle, Elko, Nevada 89801
Director, Fort Yuma Service Unit, Fort Yuma Indian Hospital, P.O. 
Box 1368, Fort Yuma, Arizona 85366
Director, Keams Canyon Service Unit, Hopi Health Care Center, P.O. 
Box 4000, Polacca, Arizona 86042
Director, Phoenix Service Unit, Phoenix Indian Medical Center, 4212 
North 16th Street, Phoenix, Arizona 85016
Director, Phoenix Service Unit, Salt River Health Center, 10005 East 
Osborn Road, Scottsdale, Arizona 85256
Director, San Carlos Service Unit, Bylas Indian Health Center, P.O. 
Box 208, Bylas, Arizona 85550
Director, San Carlos Service Unit, San Carlos Indian Hospital, P.O. 
Box 208, San Carlos, Arizona 85550
Director, Schurz Service Unit, Schurz Service Unit Administration, 
Drawer A, Schurz, Nevada 89427
Director, Fort McDermitt Clinic, P.O. Box 315, McDermitt, Nevada 
89421
Director, Unitah and Ouray Service Unit, Fort Duchesne Indian Health 
Center, P.O. Box 160, Fort Duchesne, Utah 84026
Director, Whiteriver Service Unit, Cibecue Health Center, P.O. Box 
37, Cibecue, Arizona 85941
Director, Whiteriver Service Unit, Whiteriver Indian Hospital, P.O. 
Box 860, Whiteriver, Arizona 85941
Director, Desert Vision Youth Wellness Center/RTC, P.O. Box 458, 
Sacaton, AZ 85247
Director, Portland Area Indian Health Service, Room 476, Federal 
Building, 1220 Southwest Third Avenue, Portland, Oregon 97204-2829
Director, Colville Service Unit, Colville Indian Health Center, P.O. 
Box 71-Agency Campus, Nespelem, Washington 99155
Director, Fort Hall Service Unit, Not-Tsoo Gah-Nee Health Center, 
P.O. Box 717, Fort Hall, Idaho 83203
Director, Neah Bay Service Unit, Sophie Trettevick Indian Health 
Center, P.O. Box 410, Neah Bay, Washington 98357
Director, Warm Springs Service Unit, Warm Springs Indian Health 
Center, P.O. Box 1209, Warm Springs, Oregon 97761
Director, Wellpinit Service Unit, David C. Wynecoop Memorial Clinic, 
P.O. Box 357, Wellpinit, Washington 99040
Director, Western Oregon Service Unit, Chemawa Indian Health Center, 
3750 Chemawa Road, NE., Salem, Oregon 97305-1198
Director, Yakama Service Unit, Yakama Indian Health Center, 401 
Buster Road, Toppenish, Washington 98948
Director, Tucson Area Indian Health Service, 7900 South ``J'' Stock 
Road, Tucson, Arizona 85746-9352
Director, Pascua Yaqui Service Unit, Division of Public Health, 7900 
South ``J'' Stock Road, Tucson, Arizona 85746
Director, San Xavier Indian Health Center, 7900 South ``J'' Stock 
Road, Tucson, Arizona 85746
Director, Sells Service Unit, Santa Rosa Indian Health Center, HCO1, 
Box 8700, Sells, Arizona 85634
Director, Sells Service Unit, Sells Indian Hospital, P.O. Box 548, 
Sells, Arizona 85634
Director, Sells Service Unit, West Side Health Station, P.O. Box 
548, Sells, Arizona 85634

[FR Doc. 06-3091 Filed 3-30-06; 8:45 am]
BILLING CODE 4165-16-M