Re-Designation of the Delivery Area for the Tolowa Dee-ni' Nation, Formerly Known as Smith River Rancheria, 47004-47011 [2017-21758]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Indian Health Service

[Federal Register Volume 82, Number 194 (Tuesday, October 10, 2017)]
[Notices]
[Pages 47004-47011]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-21758]


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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 Dee-ni's Tribal 
Headquarters is located 3 miles south of the California-Oregon border 
in Northern California.
    The entire State of California, excluding the counties of Alameda, 
Contra Costa, Los Angeles, Marin, Orange, Sacramento, San Francisco, 
San Mateo, Santa Clara, Kern, Merced, Monterey, Napa, San Benito, San 
Joaquin, San Luis Obispo, Santa Cruz, Solano, Stanislaus, and Ventura, 
was designated by the IHS as a PRCDA, formerly known as a Contract 
Health Service Delivery Area, in accordance with statute. The current 
PRCDA for Tolowa Dee-ni' Tribal members is the statutorily specified 
California PRCDA. The expanded PRCDA for the Tolowa Dee-ni' Tribe 
includes the statutorily specified California PRCDA and Curry County in 
the State of Oregon.

DATES: This notice shall take effect on October 10, 2017.

FOR FURTHER INFORMATION CONTACT: Terri Schmidt, Acting Director, Office 
of Resource Access and Partnerships, Indian Health Service, 5600 
Fishers Lane, Mail stop: 10E85C, Rockville, Maryland 20857. Telephone 
301/443-2694 (This is not a toll free number).

SUPPLEMENTARY INFORMATION: 
    Background: The IHS currently provides services under regulations 
codified at 42 CFR part 136, subparts A through C. Subpart C defines a 
Purchased/Referred Care Delivery Area (PRCDA) as the geographic area 
within which Purchased/Referred Care will be made available by the 
Indian Health Service (IHS) to members of an identified Indian 
community who reside in the Area. PRCDAs were previously known as 
Contract Health Service Delivery Areas (CHSDAs) and more recently, the 
IHS referred to them as Purchased/Referred Care Service Delivery Areas 
(PRCSDAs) or PRCDAs, but the IHS intends to consistently refer to them 
as PRCDAs going forward. Residence in a PRCDA by a person who is within 
the scope of the Indian health program, as set forth in 42 CFR 136.12, 
creates no legal entitlement to PRC, only potential eligibility for 
services. Services needed, but not available at an IHS/Tribal facility, 
are provided under the PRC program depending on the availability of 
funds, the person's relative medical priority, and the actual 
availability and accessibility of alternate resources in accordance 
with the regulations.
    As applicable to the Tribes, these regulations provide that, unless 
otherwise designated, a PRCDA shall consist of a county that includes 
all or part of a reservation and any county or counties that have a 
common boundary with the reservation, 42 CFR 136.22(a)(6). The 
regulations also provide that after consultation with the Tribal 
governing body or bodies on those reservations included within the 
PRCDA, the Secretary may from time to time, re-designate areas within 
the United States for inclusion in or exclusion from a PRCDA. The 
regulations require that certain criteria must be considered before any 
re-designation is made. The criteria are as follows:
    (1) The number of Indians residing in the area proposed to be so 
included or excluded;
    (2) Whether the Tribal governing body has determined that Indians 
residing in the area near the reservation are socially and economically 
affiliated with the Tribe;
    (3) The geographic proximity to the reservation of the area whose 
inclusion or exclusion is being considered; and
    (4) The level of funding which would be available for the provision 
of PRC, 42 CFR 136.22(b).
    Additionally, the regulations require that any re-designation of a 
PRCDA must be made in accordance with the Administrative Procedures Act 
(5 U.S.C. 553). See 42 CFR 136.22(c). In compliance with this 
requirement, we are publishing this final notice. Congress directed the 
IHS to designate the entire State of California as a PRCDA, excluding 
certain counties, under section 810 of the Indian Healthcare 
Improvement Act, Public Law 94-437, as amended (25 U.S.C. 1680). The 
IHS has utilized the congressionally specified PRCDA for the purposes 
of administering PRC benefits to members of the Tribe. Thus, members of 
the Tribe who reside outside of the statutorily established California 
PRCDA do not reside within the Tolowa Dee-ni's current PRCDA and are 
currently not eligible for PRC services.
    The IHS has historically established PRCDAs in accordance with 
Congressional intent but has preserved regulatory flexibility to re-
designate areas as appropriate for inclusion in or exclusion from PRCDA 
under PRC regulations. One of the criteria for such re-designations is 
the geographic proximity of the expanded area to the existing 
reservation or PRCDA. Here, the IHS is expanding the Tribe's PRCDA 
beyond the geographic description in 25 U.S.C. 1680 to include a county 
adjacent to the Tribe's existing PRCDA, in a neighboring state. There 
are already PRCDAs that include part of the State of California and 
part of another state, for example, Cocopah Tribe of Arizona, (Yuma, 
Arizona, and Imperial, California); Colorado River Indian Tribes of the 
Colorado River Indian Reservation, Arizona and California, (La Paz, 
Arizona; Riverside, California; San Bernardino, California; and Yuma, 
Arizona); Fort Mojave Indian Tribe of Arizona, California and Nevada, 
(Nevada; Mohave, Arizona; San Bernardino, California); and the Quechan 
Tribe of Fort Yuma Indian Reservation, California and Arizona, (Yuma, 
Arizona; and Imperial, California).
    The Tolowa Dee-ni' Tribe has a significant number of Tribal members 
who are not residents of California. The Tribe asserts that 177 Tribal 
members reside outside of its PRCDA, in Curry County, in the State of 
Oregon, and are not able to access PRC funds from either the California 
Area facility (Smith River Howonquet Indian Health Center) or from the 
closest Portland Area facility.
    Under 42 CFR 136.23, those otherwise eligible Indians who do not 
reside on a reservation, but reside within a PRCDA must be either 
members of the Tribe or maintain close economic and social ties with 
the Tribe. In this case, in applying the aforementioned PRCDA re-
designation criteria required by operative regulations codified at 42 
CFR part 136, subpart C, the following findings are made:
    1. By expanding, the Tribe estimates the current eligible 
population will be increased by 177.

[[Page 47005]]

    2. The Tribe has determined that these 177 individuals are members 
of the Tribe and they are socially and economically affiliated with the 
Tribe.
    3. The expanded area, including Curry County in the State of 
Oregon, maintains a common boundary with the State of California and 
the statutorily created California PRCDA.
    4. Generally, the Tribal members located in Curry County in the 
State of Oregon currently do not use the Indian health system for their 
PRC health care needs. The Tribe will use its existing Federal 
allocation for PRC funds to provide services to the expanded 
population. No additional financial resources will be allocated at this 
time by the IHS to the Tribe to provide services to Tribal members 
residing in Curry County in the State of Oregon.
    Public Comments: The Agency received 32 comments, 31 of which were 
timely. The Agency carefully reviewed the submissions. The IHS did not 
consider one (1) of these comments, because it was received after the 
closing date. Of the 31 timely comments, 28 commenters supported the 
proposal to expand the Tolowa Dee-ni' PRCDA into Curry County, Oregon. 
These included 27 commenters from the California Area and one 
Congressional commenter. There were three (3) commenters representing 
two Tribes from the Portland Area that opposed the PRCDA expansion. The 
IHS will address those comments below:
    Comment: The majority of commenters indicated support for the 
proposed PRCDA expansion and support for providing PRC to the Tribe's 
members living in Curry County, Oregon.
    Response: The IHS appreciates the comments in support of the 
expansion and agrees that the expansion would allow the Tribe to 
authorize PRC services for its members residing in Curry County, 
Oregon.
    Comment: Two commenters believed that the IHS should not be relying 
upon the Tribe's estimate of its members living in Curry County, 
Oregon, and that the IHS should either produce its own estimate or 
verify the Tribe's figure.
    Response: In 2014, the IHS prepared a study of the Tolowa Dee-ni' 
Tribe's roster of Tribal Citizens matched with patient user activity 
data from the National Patient Information Reporting System. The 
findings of the patient matching study were consistent with a previous 
request conducted in 2013 by the former IHS California Area Director.
    The Federal Register Notice states that the Smith River Tribe has 
estimated that 177 of its Tribal members reside in Curry County, in the 
State of Oregon, and they are not able to access PRC funds either at 
the California Area or the Portland Area. The IHS believes that this 
number is a fair approximation of the number of Smith River Tribal 
members residing in Curry County, given IHS's facility data, and 
recognizing that the Tribe has additional resources, such as a Tribal 
Membership Roll, to estimate the number of members residing in Curry 
County, Oregon, including those who have not yet sought services at IHS 
facilities and therefore would not be included in IHS data.
    Comment: One commenter inquired about the ``threshold'' for 
expanding a PRCDA and whether there is a minimum number or percentage 
in terms of Tribal members.
    Response: Each PRCDA expansion under consideration must be reviewed 
in accordance with the criteria set forth in 42 CFR 136.22(b), meaning 
this decision is a case-by-case determination based upon the facts of 
the particular expansion at issue. Regulations require the IHS to 
consider, among other factors, the ``number of Indians residing in the 
area'' of the proposed expansion, but the regulations do not require a 
minimum number or percentage.
    Comment: One commenter asked why the IHS is advancing the proposal 
for the Tribe, after declining to accommodate requests from Oregon 
Tribes and whether this created a double standard.
    Response: Previously, the IHS restricted certain PRCDA expansions 
based on the Agency's implementation of the regulatory ``geographic 
proximity'' requirement specified at 42 CFR 136.22(b)(3). While 
geographic proximity remains a necessary consideration in a PRCDA 
expansion, the IHS has reconsidered our previous position and recently 
adopted a more flexible approach. The IHS explained this change in an 
April 7, 2016, Federal Register Notice (81 FR 20388), ``Notice of the 
Redesignation of the Service Delivery Area for the Wampanoag Tribe of 
Gay Head (Aquinnah).''
    Comment: One commenter asked how the IHS verified that the Tribal 
members residing in Curry County, Oregon, are economically and socially 
affiliated with the Tribe.
    Response: Under 42 CFR 136.22(b)(2), the IHS is required to 
consider whether ``the Tribal governing body has determined that 
Indians residing in the area near the reservation are socially and 
economically affiliated with the Tribes.'' The regulation does not 
require an independent investigation by the IHS on this issue. The IHS 
would typically defer to the Tribal governing body's determination, 
given the language in the regulation and a Tribe's better position to 
make this conclusion. However, the IHS would note that the Tribe's 
estimate for the expanded population includes only its members residing 
in Curry County, Oregon, and its members are eligible for PRC under 42 
CFR 136.23, as long as the members reside within the PRCDA.
    Comment: Two commenters inquired about the financial aspects of the 
expansion, such as how this proposal would be paid for and what would 
be the motivation, since no additional funds are being provided to the 
Tribe.
    Response: Tolowa Dee-ni' Tribal members living in Curry County, 
Oregon, are unfunded for both IHS direct care and PRC resources. A few 
Tribal members have sought direct services from Tribal health programs 
in Oregon. While these individuals can receive direct services at the 
Oregon programs, no funds are allocated to the Portland Area IHS or the 
California Area IHS to provide services to members of the Tolowa Dee-
ni' Tribe residing in Curry County. The Agency is approving the 
requested PRCDA expansion to allow the Tolowa Dee-ni' Tribe to 
authorize the purchase of PRC services, within existing funds, for 
members of the Tribe who reside in Curry County. Without this 
expansion, such purchases would not be lawful and those Tribal members 
would not be eligible to receive PRC services. Since there are no 
additional funds being provided by the IHS for the PRCDA expansion, the 
Tribe's current level of PRC funding will be available to serve a 
larger population.
    Comment: One commenter inquired about the potential future 
financial impact on Oregon Tribes and how this could be accurately 
measured, given the current data.
    Response: Per Agency policy, expanding a PRCDA does not 
automatically increase the funding to a Tribe. Tribes will continue to 
use existing Federal allocation for PRC funds to provide services to 
expanding population until Congress appropriates additional funding. 
Each IHS Area will distribute future increases based on their own 
methodologies. The Tribe may benefit from future increases to PRC 
funding because of the additional active users from the PRCDA 
expansion, but the IHS determined that there will be very little to no 
financial impact as a result of the expansion on Portland Area Tribes.
    Comment: One commenter inquired about the status of a proposed 
pilot project for an Area-wide PRCDA in the Portland Area IHS.
    Response: The Coquille Tribe presented a suggestion for 
consideration

[[Page 47006]]

to the IHS Portland Area Funds Distribution Workgroup (FDWG). The FDWG 
is a Tribal consultative body that serves as a resource to the Portland 
Area Director on any Indian health system funds issue. The principal 
function of the FDWG is to develop recommendations regarding resource 
allocation within the Portland Area IHS. The IHS anticipates announcing 
a plan of action on this issue soon.

                 Purchased/Referred Care Delivery Areas
------------------------------------------------------------------------
           Tribe/reservation                       County/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         Hot Springs, WY, Fremont, WY,
 Reservation, Wyoming.                    Sublette, WY.
Aroostook Band of Micmacs..............  Aroostook, ME.\3\
Assiniboine and Sioux Tribes of the      Daniels, MT, McCone, MT,
 Fort Peck Indian Reservation, Montana.   Richland, MT, Roosevelt, MT,
                                          Sheridan, MT, Valley, MT.
Bad River Band of the Lake Superior      Ashland, WI, Iron, WI.
 Tribe of Chippewa Indians of the Bad
 River Reservation, Wisconsin.
Bay Mills Indian Community, Michigan...  Chippewa, MI.
Blackfeet Tribe of the Blackfeet Indian  Glacier, MT, Pondera, MT.
 Reservation of Montana.
Brigham City Intermountain School        (\4\)
 Health Center, Utah. Permanently
 Closed on May 17, 1984.
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        Corson, SD, Dewey, SD, Haakon,
 Cheyenne River Reservation, South        SD, Meade, SD, Perkins, SD,
 Dakota.                                  Potter, SD, Stanley, SD,
                                          Sully, SD, Walworth, SD,
                                          Ziebach, SD.
Chippewa-Cree Indians of the Rocky       Chouteau, MT, Hill, MT,
 Boy's Reservation, Montana.              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      La Paz, AZ, Riverside, CA, San
 Colorado River Indian Reservation,       Bernardino, CA, Yuma, AZ.
 Arizona and California.
Confederated Salish and Kootenai Tribes  Flathead, MT, Lake, MT,
 of the Flathead Reservation.             Missoula, MT, Sanders, MT.
Confederated Tribes and Bands of the     Klickitat, WA, Lewis, WA,
 Yakama Nation.                           Skamania, WA,\8\ Yakima, WA.
Confederated Tribes of Siletz Indians    Benton, OR,\9\ Clackamas, OR,
 of Oregon.                               Lane, OR, Lincoln, OR, Linn,
                                          OR, Marion, OR, Multnomah, OR,
                                          Polk, OR, Tillamook, OR,
                                          Washington, OR, Yamhill, OR.
Confederated Tribes of the Chehalis      Grays Harbor, WA, Lewis, WA,
 Reservation.                             Thurston, WA.
Confederated Tribes of the Colville      Chelan, WA,\10\ Douglas, WA,
 Reservation.                             Ferry, WA, Grant, WA, Lincoln,
                                          WA, Okanogan, WA, Stevens, WA.
Confederated Tribes of the Coos, Lower   Coos, OR,\11\ Curry, OR,
 Umpqua and Siuslaw Indians.              Douglas, OR, Lane, OR,
                                          Lincoln, OR.
Confederated Tribes of the Goshute       Nevada, Juab, UT, Toole, UT.
 Reservation, Nevada and Utah.
Confederated Tribes of the Grand Ronde   Marion, OR, Multnomah, OR,
 Community of Oregon.                     Polk, OR,\12\ Tillamook, OR,
                                          Washington, OR, Yamhill, OR.
Confederated Tribes of the Umatilla      Umatilla, OR, Union, OR.
 Indian Reservation.
Confederated Tribes of the Warm Springs  Clackamas, OR, Jefferson, OR,
 Reservation of Oregon.                   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        Coos, OR,\14\ Deshutes, OR,
 Indians.                                 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       Brule, SD, Buffalo, SD, Hand,
 Creek Reservation, South Dakota.         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       Hot Springs, WY, Fremont, WY,
 River Reservation, Wyoming.              Sublette, WY.
Flandreau Santee Sioux Tribe of South    Moody, SD.
 Dakota.
Forest County Potawatomi Community,      Forest, WI, Marinette, WI,
 Wisconsin.                               Oconto, WI.
Fort Belknap Indian Community of the     Blaine, MT, Phillips, MT.
 Fort Belknap Reservation of Montana.
Fort McDermitt Paiute and Shoshone       Nevada, Malheur, OR.
 Tribes of the Fort McDermitt Indian
 Reservation, Nevada and Oregon.
Fort McDowell Yavapai Nation, Arizona..  Maricopa, AZ.
Fort Mojave Indian Tribe of Arizona,     Nevada, Mohave, AZ, San
 California and Nevada.                   Bernardino, CA.
Gila River Indian Community of the Gila  Maricopa, AZ, Pinal, AZ.
 River Indian Reservation, Arizona.
Grand Traverse Band of Ottawa and        Antrim, MI,\17\ Benzie, MI,
 Chippewa Indians, Michigan.              Charlevoix, MI, Grand
                                          Traverse, MI, Leelanau, MI,
                                          Manistee, MI.
Hannahville Indian Community, Michigan.  Delta, MI, Menominee, MI.
Haskell Indian Health Center...........  Douglas, KS.\18\

[[Page 47007]]

 
Havasupai Tribe of the Havasupai.......  Coconino, AZ.
Reservation, Arizona...................
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    Coconino, AZ, Mohave, AZ,
 Indian Reservation, Arizona.             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     Coconino, AZ, Mohave, AZ, Kane,
 Kaibab Indian Reservation, Arizona.      UT.
Kalispel Indian Community of the         Pend Oreille, WA, Spokane, WA.
 Kalispel Reservation.
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         Brown, KS, Jackson, KS.
 Kickapoo Reservation in Kansas.
Klamath Tribes.........................  Klamath, OR.\23\
Koi Nation of Northern California        Lake, CA, Sonoma, CA.\24\
 (formerly known as Lower Lake
 Rancheria, California).
Kootenai Tribe of Idaho................  Boundary, ID.
Lac Courte Oreilles Band of Superior     Sawyer, WI.
 Chippewa Indians of Wisconsin.
Lac du Flambeau Band of Lake Superior    Iron, WI, Oneida, WI, Vilas,
 Chippewa Indians of the Lac du           WI.
 Flambeau Reservation of Wisconsin.
Lac Vieux Desert Band of Lake Superior   Gogebic, MI.
 Chippewa Indians of Michigan.
Little River Band of Ottawa Indians,     Kent, MI,\25\ Muskegon, MI,
 Michigan.                                Newaygo, MI, Oceana, MI,
                                          Ottawa, MI, Manistee, MI,
                                          Mason, MI, Wexford, MI, Lake,
                                          MI.
Little Traverse Bay Bands of Odawa       Alcona, MI,\26\ Alger, MI,
 Indians, Michigan.                       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, SD, Buffalo, SD, Hughes,
 Brule Reservation, South Dakota.         SD, Lyman, SD, Stanley, SD.
Lower Elwha Tribal Community...........  Clallam, WA.
Lower Sioux Indian Community in the      Redwood, MN, Renville, MN.
 State of Minnesota.
Lummi Tribe of the Lummi Reservation...  Whatcom, WA.
Makah Indian Tribe of the Makah Indian   Clallam, WA.
 Reservation.
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         Allegan, MI,\29\ Barry, MI,
 Pottawatomi Indians of Michigan.         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  Chaves, NM, Lincoln, NM, Otero,
 Reservation, New Mexico.                 NM.
Miccosukee Tribe of Indians............  Broward, FL, Collier, FL, Miami-
                                          Dade, FL, Hendry, FL.
Minnesota Chippewa Tribe, Minnesota,     Itasca, MN, Koochiching, MN,
 Bois Forte Band (Nett Lake).             St. Louis, MN.
Minnesota Chippewa Tribe, Minnesota,     Carlton, MN, St. Louis, MN.
 Fond du Lac Band.
Minnesota Chippewa Tribe, Minnesota,     Cook, MN.
 Grand Portage Band.
Minnesota Chippewa Tribe, Minnesota,     Beltrami, MN, Cass, MN,
 Leech Lake Band.                         Hubbard, MN, Itasca, MN.
Minnesota Chippewa Tribe, Minnesota,     Aitkin, MN, Kanebec, MN, Mille
 Mille Lacs Band.                         Lacs, MN, Pine, MN.
Minnesota Chippewa Tribe, Minnesota,     Becker, MN, Clearwater, MN,
 White Earth Band.                        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, &    Apache, AZ, Bernalillo, NM,
 Utah.                                    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  Big Horn, MT, Carter, MT,\35\
 Cheyenne Indian Reservation, Montana.    Rosebud, MT.

[[Page 47008]]

 
Northwestern Band of Shoshone Nation...  Box Elder, UT.\36\
Nottawaseppi Huron Band of the           Allegan, MI,\37\ Barry, MI,
 Pottawatomi, Michigan.                   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, ME \46\, Penobscot,
                                          ME.
Poarch Band of Creeks..................  Baldwin, AL,\47\ Elmore, AL,
                                          Escambia, AL, Mobile, AL,
                                          Monroe, AL, Escambia, FL.
Pokagon Band of Pottawatomi Indians,     Allegan, MI,\48\ Berrien, MI,
 Michigan and Indiana.                    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   Goodhue, MN.
 State of Minnesota.
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           King, WA, Pierce, WA, Thurston,
 Reservation.                             WA.
Quechan Tribe of the Fort Yuma Indian    Yuma, AZ, Imperial, CA.
 Reservation, Arizona and California.
Quileute Tribe of the Quileute           Clallam, WA, Jefferson, WA.
 Reservation.
Quinault Indian Nation.................  Grays Harbor, WA, Jefferson,
                                          WA.
Rapid City, South Dakota...............  Pennington, SD.\50\
Red Cliff Band of Lake Superior          Bayfield, WI.
 Chippewa Indians of Wisconsin.
Red Lake Band of Chippewa Indians,       Beltrami, MN, Clearwater, MN,
 Minnesota.                               Koochiching, MN, Lake of the
                                          Woods, MN, Marshall, MN,
                                          Pennington, MN, Polk, MN,
                                          Roseau, MN.
Rosebud Sioux Tribe of the Rosebud       Bennett, SD, Cherry, NE,
 Indian Reservation, South Dakota.        Gregory, SD, Lyman, SD,
                                          Mellette, SD, Todd, SD, Tripp,
                                          SD.
Sac & Fox Nation of Missouri in Kansas   Brown, KS, Richardson, NE.
 and Nebraska.
Sac & Fox Tribe of the Mississippi in    Tama, IA.
 Iowa.
Saginaw Chippewa Indian Tribe of         Arenac, MI,\51\ Clare, MI,
 Michigan.                                Isabella, MI, Midland, MI,
                                          Missaukee, MI.
Saint Regis Mohawk Tribe...............  Franklin, NY, St. Lawrence, NY.
Salt River Pima-Maricopa Indian          Maricopa, AZ.
 Community of the Salt River
 Reservation, Arizona.
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       Apache, AZ, Cochise, AZ, Gila,
 Carlos Reservation, Arizona.             AZ, Graham, AZ, Greenlee, AZ,
                                          Pinal, AZ.
San Juan Southern Paiute Tribe of        Coconino, AZ, San Juan, UT.
 Arizona.
Santee Sioux Nation, Nebraska..........  Bon Homme, SD, Knox, NE.
Sauk-Suiattle Indian Tribe.............  Snohomish, WA, Skagit, WA.

[[Page 47009]]

 
Sault Ste. Marie Tribe of Chippewa       Alger, MI,\53\ Chippewa, MI,
 Indians, Michigan.                       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  Scott, MN.
 Minnesota.
Shinnecock Indian Nation...............  Nassau, NY,\54\ Suffolk, NY.
Shoalwater Bay Tribe of the Shoalwater   Pacific, WA.
 Bay Indian Reservation.
Shoshone-Bannock Tribes of the Fort      Bannock, ID, Bingham, ID,
 Hall Reservation.                        Caribou, ID, Lemhi, ID,\55\
                                          Power, ID.
Shoshone-Paiute Tribes of the Duck       Nevada, Owyhee, ID.
 Valley Reservation, Nevada.
Sisseton-Wahpeton Oyate of the Lake      Codington, SD, Day, SD, Grant,
 Traverse Reservation, South Dakota.      SD, Marshall, SD, Richland,
                                          ND, Roberts, SD, Sargent, ND,
                                          Traverse, MN.
Skokomish Indian Tribe.................  Mason, WA.
Skull Valley Band of Goshute Indians of  Tooele, UT.
 Utah.
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         Archuleta, CO, La Plata, CO,
 Southern Ute Reservation, Colorado.      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             Ferry, WA, Lincoln, WA,
 Reservation.                             Stevens, WA.
Squaxin Island Tribe of the Squaxin      Mason, WA.
 Island Reservation.
St. Croix Chippewa Indians of Wisconsin  Barron, WI, Burnett, WI, Pine,
                                          MN, Polk, WI, Washburn, WI.
Standing Rock Sioux Tribe of North &     Adams, ND, Campbell, SD,
 South Dakota.                            Corson, SD, Dewey, SD, Emmons,
                                          ND, Grant, ND, Morton, ND,
                                          Perkins, SD, Sioux, ND,
                                          Walworth, SD, Ziebach, SD.
Stillaguamish Tribe of Indians of        Snohomish, WA.
 Washington.
Stockbridge Munsee Community, Wisconsin  Menominee, WI, Shawano, WI.
Suquamish Indian Tribe of the Port       Kitsap, WA.
 Madison Reservation.
Swinomish Indian Tribal Community......  Skagit, WA.
Tejon Indian Tribe.....................  Kern, CA.\57\
Three Affiliated Tribes of the Fort      Dunn, ND, Mercer, ND, McKenzie,
 Berthold Reservation, North Dakota.      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    California, Curry, OR.\58\
 as Smith River Rancheria of
 California).
Tonto Apache Tribe of Arizona..........  Gila, AZ.
Trenton Service Unit, North Dakota and   Divide, ND,\59\ McKenzie, ND,
 Montana.                                 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         Rolette, ND.
 Indians of North Dakota.
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   Carbon, UT, Daggett, UT,
 Reservation, Utah.                       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, AZ, Coconino, AZ, Gila,
 Apache Reservation, Arizona.             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  Yavapai, AZ.
 Indian Reservation, Arizona.
Yavapai-Prescott Indian Tribe..........  Yavapai, AZ.
Ysleta Del Sur Pueblo of Texas.........  El Paso, TX.\64\
Zuni Tribe of the Zuni Reservation, New  Apache, AZ, Cibola, NM,
 Mexico.                                  McKinley, NM, Valencia, NM.
------------------------------------------------------------------------
\1\ Public Law 100-89, Restoration Act for Ysleta Del Sur and Alabama
  and Coushatta Tribes of Texas establishes service areas for ``members
  of the Tribe'' by sections 101(3) and 105(a) for the Pueblo and
  sections 201(3) and 206(a) respectively.
\2\ Entire State of Alaska is included as a CHSDA by regulation (42 CFR
  136.22(a)(1)).
\3\ Aroostook Band of Micmacs was recognized by Congress on November 26,
  1991, through the Aroostook Band of Micmac Settlement Act. Aroostook
  County, ME, was defined as the SDA.

[[Page 47010]]

 
\4\ Special programs have been established by Congress irrespective of
  the eligibility regulations. Eligibility for services at these
  facilities is based on the legislative history of the appropriation of
  funds for the particular facility rather than the eligibility
  regulations. Historically services have been provided at Brigham City
  Intermountain School Health Center, Utah (Pub. L. 88-358). The Brigham
  Intermountain School Health Center was renamed to Intermountain Inter-
  Tribal School in 1974 and was permanently closed on May 17, 1984.
\5\ Entire State of California, excluding the counties of Alameda,
  Contra Costa, Los Angeles, Marin, Orange, Sacramento, San Francisco,
  San Mateo, Santa Clara, Kern, Merced, Monterey, Napa, San Benito, San
  Joaquin, San Luis Obispo, Santa Cruz, Solano, Stanislaus, and Ventura,
  is designated a CHSDA (25 U.S.C. 1680).
\6\ The counties were recognized after the January 1984 CHSDA FRN was
  published, in accordance with Public Law 103-116, Catawba Indian Tribe
  of South Carolina Land Claims Settlement Act of 1993, dated October
  27, 1993.
\7\ There is no reservation for the Cayuga Nation; the service delivery
  area consists of those counties identified by the Cayuga Nation.
\8\ Skamania County, WA, has historically been a part of the Yakama
  Service Unit population since 1979.
\9\ In order to carry out the Congressional intent of the Siletz
  Restoration Act, Public Law 95-195, as expressed in H. Report No. 95-
  623, at page 4, members of the Confederated Tribes of Siletz Indians
  of Oregon residing in these counties are eligible for contract health
  services.
\10\ Chelan County, WA, has historically been a part of the Colville
  Service Unit population since 1970.
\11\ Pursuant to Public Law 98-481 (H. Rept. No. 98-904), Coos, Lower
  Umpqua and Siuslaw Restoration Act, members of the Tribe residing in
  these counties were specified as eligible for Federal services and
  benefits without regard to the existence of a Federal Indian
  reservation.
\12\ The Confederated Tribes of Grand Ronde Community of Oregon were
  recognized by Public Law 98-165 which was signed into law on November
  22, 1983, and provides for eligibility in these six counties without
  regard to the existence of a reservation.
\13\ The CHSDA for the Coushatta Tribe of Louisiana was expanded
  administratively by the Director, IHS, through regulation (42 CFR
  136.22(6)) to include city limits of Elton, LA.
\14\ Cow Creek Band of Umpqua Tribe of Indians recognized by Public Law
  97-391, signed into law on December 29, 1983. House Rept. No. 97-862
  designates Douglas, Jackson, and Josephine Counties as a service area
  without regard to the existence of a reservation. The IHS later
  administratively expanded the CHSDA to include the counties of Coos,
  OR, Deschutes, OR, Klamath, OR, and Lane, OR.
\15\ The Cowlitz Indian Tribe was recognized in July 2002 as documented
  at 67 FR 46329, July 12, 2002. The counties listed were designated
  administratively as the SDA, to function as a CHSDA, for the purposes
  of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.
  The CHSDA was administratively expanded to included Columbia County,
  OR, Kittitas, WA, and Wahkiakum County, WA, as published at 67884 FR
  December 21, 2009.
\16\ Treasure County, MT, has historically been a part of the Crow
  Service Unit population.
\17\ The counties listed have historically been a part of the Grand
  Traverse Service Unit population since 1980.
\18\ Haskell Indian Health Center has historically been a part of Kansas
  Service Unit since 1979. Special programs have been established by
  Congress irrespective of the eligibility regulations. Eligibility for
  services at these facilities is based on the legislative history of
  the appropriation of funds for the particular facility rather than the
  eligibility regulations. Historically services have been provided at
  Haskell Indian Health Center (H. Rept. No. 95-392).
\19\ CHSDA counties for the Ho-Chunk Nation of Wisconsin were designated
  by regulation (42 CFR 136.22(a)(5)). Dane County, WI, was added to the
  reservation by the Bureau of Indian Affairs in 1986.
\20\ Public Law 97-428 provides that any member of the Houlton Band of
  Maliseet Indians in or around the Town of Houlton shall be eligible
  without regard to existence of a reservation.
\21\ The Jena Band of Choctaw Indian was Federally acknowledged as
  documented at 60 FR 28480, May 31, 1995. The counties listed were
  designated administratively as the SDA, to function as a CHSDA, for
  the purposes of operating a CHS program pursuant to the ISDEAA, Public
  Law 93-638.
\22\ Kickapoo Traditional Tribe of Texas, formerly known as the Texas
  Band of Kickapoo, was recognized by Public Law 97-429, signed into law
  on January 8, 1983. The Act provides for eligibility for Kickapoo
  Tribal members residing in Maverick County without regard to the
  existence of a reservation.
\23\ The Klamath Indian Tribe Restoration Act (Pub. L. 99-398, Sec.
  2(2)) states that for the purpose of Federal services and benefits
  ``members of the tribe residing in Klamath County shall be deemed to
  be residing in or near a reservation''.
\24\ The Koi Nation of Northern California, formerly known as the Lower
  Lake Rancheria, was reaffirmed by the Secretary of the Bureau of
  Indian Affairs on December 29, 2000. The counties listed were
  designated administratively as the SDA, to function as a PRCDA, for
  the purposes of operating a PRC program pursuant to the ISDEAA, Public
  Law 93-638.
\25\ The Little Traverse Bay Bands of Odawa Indians and the Little River
  Band of Ottawa Indians Act recognized the Little River Band of Ottawa
  Indians and the Little Traverse Bay Bands of Odawa Indians. Pursuant
  to Public Law 103-324, Sec. 4(b) the counties listed were designated
  administratively as the SDA, to function as a CHSDA, for the purposes
  of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.
\26\ The Little Traverse Bay Bands of Odawa Indians and the Little River
  Band of Ottawa Indians Act recognized the Little River Band of Ottawa
  Indians and the Little Traverse Bay Bands of Odawa Indians. Pursuant
  to Public Law 103-324, Sec. 4(b) the counties listed were designated
  administratively as the SDA, to function as a CHSDA, for the purposes
  of operating a CHS program pursuant to the ISDEAA, Public Law 93-638.
\27\ Mashantucket Pequot Indian Claims Settlement Act, Public Law 98-
  134, signed into law on October 18, 1983, provides a reservation for
  the Mashantucket Pequot Indian Tribe in New London County, CT.
\28\ The Mashpee Wampanoag Tribe was recognized in February 2007, as
  documented at 72 FR 8007, February 22, 2007. The counties listed were
  designated administratively as the SDA, to function as a CHSDA, for
  the purposes of operating a CHS program pursuant to the ISDEAA, Public
  Law 93-638.
\29\ The Match-e-be-nash-she-wish Band of Pottawatomi Indians of
  Michigan was recognized in October 1998, as documented at 63 FR 56936,
  October 23, 1998. The counties listed were designated administratively
  as the SDA, to function as a CHSDA, for the purposes of operating a
  CHS program pursuant to the ISDEAA, Public Law 93-638.
\30\ Members of the Mississippi Band of Choctaw Indians residing in
  Jasper and Noxubee Counties, MS, are eligible for contract health
  services; these two counties were inadvertently omitted from 42 CFR
  136.22.
\31\Members of the Mississippi Band of Choctaw Indians residing in
  Jasper and Noxubee Counties, MS, are eligible for contract health
  services; these two counties were inadvertently omitted from 42 CFR
  136.22.
\32\ Scott County, MS, has historically been a part of the Choctaw
  Service Unit population since 1970.
\33\ The Narragansett Indian Tribe was recognized by Public Law 95-395,
  signed into law September 30, 1978. Lands in Washington County, RI,
  are now Federally restricted and the Bureau of Indian Affairs
  considers them as the Narragansett Indian Reservation.
\34\ Entire State of Nevada is included as a CHSDA by regulation (42 CFR
  136.22(a)(2)).
\35\ Carter County, MT, has historically been a part of the Northern
  Cheyenne Service Unit population since 1979.
\36\ Land of Box Elder County, Utah, was taken into trust for the
  Northwestern Band of Shoshoni Nation in 1986.
\37\ The Nottawaseppi Huron Band of the Potawatomi, Michigan, formerly
  known as the Huron Band of Potawatomi, Inc., was recognized in
  December 1995, as documented at 60 FR 66315, December 21, 1995. The
  counties listed were designated administratively as the SDA, to
  function as a CHSDA, for the purposes of operating a CHS program
  pursuant to the ISDEAA, Public Law 93-638.
\38\ Washabaugh County, SD, merged and became part of Jackson County,
  SD, in 1983; both were/are CHSDA counties for the Oglala Sioux Tribe.
\39\ Entire State of Oklahoma is included as a CHSDA by regulation (42
  CFR 136.22(a)(3)).
\40\ Paiute Indian Tribe of Utah Restoration Act, Public Law 96-227,
  provides for the extension of services for the Paiute Indian Tribe of
  Utah to these four counties without regard to the existence of a
  reservation.
\41\ In the Federal Register on July 08, 2015 (80 FR 39144), the
  Pamunkey Indian Tribe was officially recognized as an Indian Tribe
  within the meaning of Federal law. The counties listed were designated
  administratively as the Tribe's PRCDA, as announced in the Federal
  Register on July 28, 2017 (82 FR 35227).
\42\ Legislative history (H.R. Report No. 95-1021) to Public Law 95-375,
  Extension of Federal Benefits to Pascua Yaqui Indians, Arizona,
  expresses congressional intent that lands conveyed to the Pascua Yaqui
  Tribe of Arizona pursuant to Act of October 8, 1964. (Pub. L. 88-350)
  shall be deemed a Federal Indian Reservation.

[[Page 47011]]

 
\43\ The Maine Indian Claims Settlement Act of 1980 (Pub. L. 96-420; H.
  Rept. 96-1353) includes the intent of Congress to fund and provide
  contract health services to the Passamaquoddy Tribe and the Penobscot
  Nation.
\44\ The Passamaquoddy Tribe has two reservations: Indian Township and
  Pleasant Point. The PRCDA for the Passamaquoddy Tribe at Indian
  Township, ME, is Aroostook County, ME, Washington County, ME, and
  Hancock County, ME. The PRCDA for the Passamaquoddy Tribe at Pleasant
  Point, ME, is Washington County, ME, south of State Route 9, and
  Aroostook County, ME.
\45\ The Passamaquoddy Tribe's counties listed are designated
  administratively as the SDA, to function as a PRCDA, for the purposes
  of operating a PRC program pursuant to the ISDEAA, Public Law 93-638.
\46\ The Maine Indian Claims Settlement Act of 1980 (Pub. L. 96-420; H.
  Rept. 96-1353) includes the intent of Congress to fund and provide PRC
  to the Passamaquoddy Tribe and the Penobscot Nation.
\47\ Counties in the Service Unit designated by Congress for the Poarch
  Band of Creek Indians (see H. Rept. 98-886, June 29, 1984; Cong.
  Record, October 10, 1984, Pg. H11929).
\48\ Public Law 103-323 restored Federal recognition to the Pokagon Band
  of Potawatomi Indians, Michigan and Indiana, in 1994 and identified
  counties to serve as the SDA.
\49\ The Ponca Restoration Act, Public Law 101-484, recognized members
  of the Ponca Tribe of Nebraska in Boyd, Douglas, Knox, Madison or
  Lancaster counties of Nebraska or Charles Mix county of South Dakota
  as residing on or near a reservation. Public Law 104-109 made
  technical corrections to laws relating to Native Americans and added
  Burt, Hall, Holt, Platte, Sarpy, Stanton, and Wayne counties of
  Nebraska and Pottawatomie and Woodbury counties of Iowa to the Ponca
  Tribe of Nebraska SDA.
\50\ Special programs have been established by Congress irrespective of
  the eligibility regulations. Eligibility for services at these
  facilities is based on the legislative history of the appropriation of
  funds for the particular facility, rather than the eligibility
  regulations. Historically services have been provided at Rapid City
  (S. Rept. No. 1154, FY 1967 Interior Approp. 89th Cong. 2d Sess.).
\51\ Historically part of Isabella Reservation Area for the Saginaw
  Chippewa Indian Tribe of Michigan and the Eastern Michigan Service
  Unit population since 1979.
\52\The Samish Indian Tribe Nation was Federally acknowledged in April
  1996 as documented at 61 FR 15825, April 9, 1996. The counties listed
  were designated administratively as the SDA, to function as a CHSDA,
  for the purposes of operating a CHS program pursuant to the ISDEAA,
  Public Law 93-638.
\53\ CHSDA counties for the Sault Ste. Marie Tribe of Chippewa Indians,
  Michigan, were designated by regulation (42 CFR 136.22(a)(4)).
\54\ The Shinnecock Indian Nation was Federally acknowledged in June
  2010 as documented at 75 FR 34760, June 18, 2010. The counties listed
  were designated administratively as the SDA, to function as a CHSDA,
  for the purposes of operating a CHS program pursuant to the ISDEAA,
  Public Law 93-638.
\55\ Lemhi County, ID, has historically been a part of the Fort Hall
  Service Unit population since 1979.
\56\ The Snoqualmie Indian Tribe was Federally acknowledged in August
  1997 as documented at 62 FR 45864, August 29, 1997. The counties
  listed were designated administratively as the SDA, to function as a
  CHSDA, for the purposes of operating a CHS program pursuant to the
  ISDEAA, Public Law 93-638.
\57\ On December 30, 2011 the Office of Assistant Secretary-Indian
  Affairs reaffirmed the Federal recognition of the Tejon Indian Tribe.
  The county listed was designated administratively as the SDA, to
  function as a CHSDA, for the purposes of operating a CHS program
  pursuant to the ISDEAA, Public Law 93-638.
\58\ The counties listed are designated administratively as the SDA, to
  function as a PRC SDA, for the purposes of operating a PRC program
  pursuant to the ISDEAA, Public Law 93-638.
\59\ The Secretary acting through the Service is directed to provide
  contract health services to Turtle Mountain Band of Chippewa Indians
  that reside in Trenton Service Unit, North Dakota and Montana, in
  Divide, Mackenzie, and Williams counties in the state of North Dakota
  and the adjoining counties of Richland, Roosevelt, and Sheridan in the
  state of Montana (Sec. 815, Pub. L. 94-437).
\60\ Rapides County, LA, has historically been a part of the Tunica
  Biloxi Service Unit population since 1982.
\61\ According to Public Law 100-95, Sec. 12, members of the Wampanoag
  Tribe of Gay Head (Aquinnah) residing on Martha's Vineyard are deemed
  to be living on or near an Indian reservation for the purposes of
  eligibility for Federal services.
\62\ The counties listed are designated administratively as the SDA, to
  function as a PRCDA, for the purposes of operating a PRC program
  pursuant to the ISDEAA, Public Law 93-638.
\63\ The Wilton Rancheria, California had Federal recognition restored
  in July 2009 as documented at 74 FR 33468, July 13, 2009. Sacramento
  County, CA, was designated administratively as the SDA, to function as
  a CHSDA. Sacramento County was not covered when Congress originally
  established the State of California as a CHSDA excluding certain
  counties including Sacramento County (25 U.S.C. 1680).
\64\ Public Law 100-89, Restoration Act for Ysleta Del Sur and Alabama
  and Coushatta Tribes of Texas establishes service areas for ``members
  of the Tribe'' by sections 101(3) and 105(a) for the Pueblo and
  sections 201(3) and 206(a) respectively.


    Dated: October 2, 2017.
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Acting 
Director, Indian Health Service.
[FR Doc. 2017-21758 Filed 10-6-17; 8:45 a.m.]
BILLING CODE 4165-16-P