Notice of Proposed Purchased/Referred Care Delivery Area Redesignation for the Mid-Atlantic Tribes, 50160-50162 [2023-16275]
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50160
Federal Register / Vol. 88, No. 146 / Tuesday, August 1, 2023 / Notices
2. OLC will focus on
• Leading government-wide
coordination of Long COVID strategy,
planning, and activities to address the
consequences of the COVID–19
pandemic, integrated into the HHS
mission to improve health in
disadvantaged communities and
vulnerable populations across the
nation.
• Supporting senior leadership at
OASH and HHS on Long COVID.
• Developing implementation plans
on Long COVID to drive strategy and
communicate to the public.
• Establish, support, and manage a
Federal Advisory Committee on Long
COVID and associated conditions to
facilitate perspectives from outside the
government to inform federal actions.
• Providing expertise and support to
federal agencies related to Long COVID
deliverables and activities.
Xavier Becerra,
Secretary.
[FR Doc. 2023–16251 Filed 7–31–23; 8:45 am]
BILLING CODE 4150–03–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Notice of Proposed Purchased/
Referred Care Delivery Area
Redesignation for the Mid-Atlantic
Tribes
Indian Health Service,
Department of Health and Human
Services.
ACTION: Notice.
AGENCY:
This Notice advises the public
that the Indian Health Service (IHS)
proposes to view the seven Mid-Atlantic
Tribes in the Commonwealth of Virginia
collectively and to expand the
geographic boundaries of their current
Purchased/Referred Care Delivery Areas
(PRCDA). The seven Mid-Atlantic
Tribes include the Pamunkey Indian
Tribe, Chickahominy Indian Tribe,
Chickahominy Indian Tribe—Eastern
Division, Upper Mattaponi Tribe,
Rappahannock Tribe, Monacan Indian
Nation, and Nansemond Indian Tribe.
The IHS previously designated a PRCDA
for each of the seven Tribes, which
include counties and/or independent
cities in the Commonwealth of Virginia.
The IHS is now proposing to expand
those individual PRCDAs by creating a
collective PRCDA for the seven Tribes.
The collective PRCDA will include all
of the counties and independent cities
in each of the current PRCDAs, plus
additional contiguous counties and
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independent cities in the
Commonwealth of Virginia, the State of
Maryland, and the State of North
Carolina.
Comments must be submitted
August 31, 2023.
ADDRESSES: In commenting, please refer
to file code [Federal Register insert file
code number]. Because of staff and
resource limitations, we cannot accept
comments by facsimile (FAX)
transmission. You may submit
comments in one of four ways (please
choose only one of the ways listed):
1. Electronically. You may submit
electronic comments on this regulation
to https://www.regulations.gov. Follow
the ‘‘Submit a Comment’’ instructions.
2. By regular mail. You may mail
written comments to the following
address ONLY: Carl Mitchell, Director,
Division of Regulatory and Policy
Coordination Indian Health Service,
5600 Fishers Lane, Mail Stop: 09E70,
Rockville, Maryland 20857.
Please allow sufficient time for mailed
comments to be received before the
close of the comment period.
3. By express or overnight mail. You
may send written comments to the
above address.
4. By hand or courier. If you prefer,
you may deliver (by hand or courier)
your written comments before the close
of the comment period to the address
above.
If you intend to deliver your
comments to the Rockville address,
please call telephone number (301) 443–
1116 in advance to schedule your
arrival with a staff member.
SUPPLEMENTARY INFORMATION: The
current PRCDAs for the seven MidAtlantic Tribes are:
Pamunkey Indian Tribe—Caroline,
Hanover, Henrico, King William, King
and Queen, and New Kent Counties;
and the independent city of Richmond
in the Commonwealth of Virginia.
Chickahominy Indian Tribe—New
Kent, James City, Charles City, and
Henrico Counties in the Commonwealth
of Virginia.
Chickahominy Indian Tribe—Eastern
Division—New Kent, James City,
Charles City, and Henrico Counties in
the Commonwealth of Virginia.
Upper Mattaponi Tribe—Richmond,
Middlesex, Essex, King and Queen, King
William, New Kent, Hanover, Caroline,
Henrico, Charles City, and James City
Counties; and the independent city of
Richmond in the Commonwealth of
Virginia.
Rappahannock Tribe, Inc.—King and
Queen, Caroline, Essex, and King
William Counties in the Commonwealth
of Virginia.
DATES:
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Monacan Indian Nation—Amherst,
Nelson, Albemarle, Buckingham,
Appomattox, Campbell, Bedford,
Botetourt, Rockbridge, and Augusta
Counties; and the independent cities of
Lynchburg, Lexington, Buena Vista,
Staunton, Waynesboro, and
Charlottesville in the Commonwealth of
Virginia.
Nansemond Indian Tribe—the
independent cities of Chesapeake,
Hampton, Newport News, Norfolk,
Portsmouth, Suffolk, and Virginia Beach
in the Commonwealth of Virginia.
The IHS is proposing to create a
collective PRCDA for the seven MidAtlantic Tribes that will include the
following counties and independent
cities:
Counties in the Commonwealth of
Virginia: Accomack, Albemarle,
Alleghany, Amelia, Amherst,
Appomattox, Arlington, Augusta, Bath,
Bedford, Botetourt, Buckingham,
Campbell, Caroline, Charlotte,
Chesterfield, Clarke, Cumberland,
Culpeper, Dinwiddie, Essex, Fauquier,
Floyd, Fluvanna, Gloucester, Greene,
Greensville, Goochland, Hanover,
Henrico, Isle of Wight, James City, King
and Queen, King George, King William,
Lancaster, Loudoun, Louisa, Lunenburg,
Mathews, Mecklenburg, Middlesex,
Montgomery, Nelson, New Kent,
Newport News, Norfolk, Nottoway,
Orange, Page, Patrick, Pittsylvania,
Powhatan, Prince Edward, Prince
George, Prince William, Pulaski,
Richmond, Rockbridge, Rockingham,
Southampton, Spotsylvania, Stafford,
Warren, Westmoreland, and York.
Independent Cities in the
Commonwealth of Virginia: Alexandria,
Buena Vista, Charlottesville,
Chesapeake, Colonial Heights,
Covington, Emporia, Fairfax, Falls
Church, Franklin, Fredericksburg,
Hampton, Harrisonburg, Hopewell,
Lexington, Lynchburg, Manassas,
Manassas Park, Newport News, Norfolk,
Petersburg, Poquoson, Portsmouth,
Radford, Richmond, Roanoke, Salem,
Staunton, Suffolk, Virginia Beach,
Waynesboro, and Williamsburg.
Counties in the State of Maryland:
Allegany, Anne Arundel, Baltimore,
Calvert, Carroll, Cecil, Charles,
Frederick, Harford, Howard, Kent,
Montgomery, Prince George’s, Queen
Anne’s, St. Mary’s, and Washington.
Independent Cities in the State of
Maryland: Baltimore City.
Counties in the State of North
Carolina: Alexander, Camden, Catawba,
Chowan, Currituck, Davidson, Davie,
Durham, Forsyth, Franklin, Gates,
Granville, Guilford, Johnston, Orange,
Pasquotank, Randolph, Rowan, Stanly,
Stokes, and Wake.
E:\FR\FM\01AUN1.SGM
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Federal Register / Vol. 88, No. 146 / Tuesday, August 1, 2023 / Notices
Members of the seven Mid-Atlantic
Tribes residing outside of the current
PRCDAs are eligible for direct care
services, however, they are not eligible
for Purchased/Referred Care (PRC)
services. The sole purpose of this
expansion would be to authorize
additional Tribal members and
beneficiaries to receive PRC services.
Inspection of Public Comments: All
comments received before the close of
the comment period are available for
viewing by the public, including any
personally identifiable or confidential
business information that is included in
a comment.
FOR FURTHER INFORMATION CONTACT:
CAPT John Rael, Director, Office of
Resource Access and Partnerships,
Indian Health Service, 5600 Fishers
Lane, Mail Stop: 10E85C, Rockville,
Maryland 20857. Telephone (301) 443–
0969. (This is not a toll free number).
Background: The IHS provides
services under regulations in effect as of
September 15, 1987, and republished at
42 CFR part 136, subparts A–C. Subpart
C defines a Contract Health Service
Delivery Area (CHSDA), now referred to
as a PRCDA, as the geographic area
within which PRC will be made
available by the IHS to members of an
identified Indian community who reside
in the PRCDA. Residence within 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, but 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 relative
medical priority of the services to be
provided, and the actual availability and
accessibility of alternate resources in
accordance with the regulations.
The regulations at 42 CFR part 136,
subpart C provide that, unless otherwise
designated, a PRCDA shall consist of a
county which includes all or part of a
reservation and any county or counties
which 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,
redesignate areas within the United
States for inclusion in or exclusion from
a PRCDA—42 CFR 136.22(b). The
regulations require that certain criteria
must be considered before any
redesignation is made. The criteria are
as follows:
(1) The number of Indians residing in
the area proposed to be so included or
excluded;
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(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.
Additionally, the regulations require
that any redesignation of a PRCDA must
be made in accordance with the
procedures of the Administrative
Procedure Act (5 U.S.C. 553)—42 CFR
136.22(c). In compliance with this
requirement, the IHS is publishing this
Notice and requesting public comments.
The Pamunkey Indian Tribe was the
first federally recognized Tribe in the
Commonwealth of Virginia, recognized
through the Department of the Interior’s
Federal Acknowledgement of American
Indian Tribes administrative process
effective January 28, 2016. The
Pamunkey Indian Tribe does not have a
reservation land base within the
meaning of 42 CFR 136.22(a)(6). As a
result, the Director, IHS, exercised
reasonable administrative discretion to
designate a PRCDA for the Pamunkey
Indian Tribe, effective August 28, 2017,
82 FR 35227.
On January 29, 2018, the President
signed into law H.R. 984, the
‘‘Thomasina E. Jordan Indian Tribes of
Virginia Federal Recognition Act of
2017,’’ which provided Federal
recognition to six additional Tribes in
the Commonwealth of Virginia, and
identified geographical (e.g., county or
city) service delivery areas for each.
These service delivery areas included
overlapping areas for many of the
Tribes, and also overlapped the
Pamunkey Indian Tribe’s designated
PRCDA. The IHS designated the
PRCDAs for each of these six Tribes,
effective February 21, 2020, in
accordance with Congressional intent.
The IHS has historically established
PRCDAs in accordance with
Congressional intent while preserving
regulatory flexibility to re-designate
areas as appropriate for inclusion in or
exclusion from a PRCDA under PRC
regulations. Expansion of the PRCDAs
for the seven Mid-Atlantic Tribes would
extend these already existing and
overlapping PRCDAs, to create a
collective PRCDA for these seven
Tribes, for the sole purpose of
authorizing additional Tribal members
and beneficiaries to receive PRC
services. Representatives from all seven
Mid-Atlantic Tribes unanimously
sought to move forward collectively to
request re-designation of their PRCDAs
to include the entire Commonwealth of
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50161
Virginia. Following consultation with
those Tribes, the IHS also considered
portions of Maryland and North
Carolina that are close to the border of
Virginia. Since all seven of the MidAtlantic Tribes requested the same
PRCDA, the IHS is proposing to
consider these Tribes collectively for
purposes of the PRCDA expansions.
This includes considering their Tribal
members collectively under the criteria
set forth in 42 CFR 136.22(b), as
described above. In doing so, the IHS
has determined which portions of the
Commonwealth of Virginia, Maryland,
and North Carolina would meet the
necessary criteria for one or more of the
seven Mid-Atlantic Tribes. For example,
the IHS is not proposing to add any
counties where no members of any MidAtlantic Tribe reside, or counties that
are not contiguous with the existing or
proposed PRCDAs. Accordingly, the IHS
proposes to expand the individual
PRCDAs for these seven Mid-Atlantic
Tribes to create a collective PRCDA that
includes sixty-six (66) counties and
thirty-two (32) independent cities in the
Commonwealth of Virginia; twenty-one
(21) counties in North Carolina; and
sixteen (16) counties and one (1)
independent city in Maryland.
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
other IHS beneficiaries who maintain
close economic and social ties with the
Tribe. In this case, applying the
aforementioned PRCDA redesignation
criteria required by operative
regulations codified at 42 CFR part 136,
subpart C, the following findings are
made:
1. By expanding each Tribe’s PRCDA
and creating one collective PRCDA, the
seven Mid-Atlantic Tribes estimate the
current eligible population will
collectively increase by 1006
individuals.
2. The seven Mid-Atlantic Tribes have
determined that these 1006 individuals
are members of the federally recognized
Tribes in the Commonwealth of Virginia
and that these members are socially and
economically affiliated with these MidAtlantic Tribes.
3. The existing PRCDAs for these
seven Mid-Atlantic Tribes, consisting of
twenty-one (21) counties and fourteen
(14) independent cities collectively, will
be expanded to include sixty-six (66)
counties and thirty-two (32)
independent cities in the
Commonwealth of Virginia; twenty-one
(21) counties in North Carolina; and
sixteen (16) counties, and one (1)
independent city in Maryland. Members
of one or more of the Tribes reside in
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Federal Register / Vol. 88, No. 146 / Tuesday, August 1, 2023 / Notices
each county that is included in the
proposed expansion, and those
members live near enough to their
Tribe’s seat of government to maintain
close social and economic ties with
their Tribe. According to the leadership
for each of the Tribes, those members
live close enough to regularly
participate in-person in Tribal affairs,
events, activities, or other functions
held by or carried out by the Tribe
within its current PRCDA. Furthermore,
the proposed counties and independent
cities form a contiguous area with the
existing PRCDAs. Considering the
Tribes collectively, the IHS has
determined the additional counties and
independent cities proposed for
inclusion herein to be geographically
proximate, meaning ‘‘on or near,’’ to the
area analogous to reservations for the
seven Mid-Atlantic Tribes.
4. PRC programs operated by/for the
seven Mid-Atlantic Tribes will use their
existing Federal allocation for PRC
funds to provide services to the
expanded population. No additional
financial resources will be allocated by
the IHS to these programs to provide
services to members residing in the
expanded counties and independent
cities in the Commonwealth of Virginia,
State of Maryland, or State of North
Carolina.
This Notice does not contain
reporting or recordkeeping requirements
subject to prior approval by the Office
of Management and Budget under the
Paperwork Reduction Act of 1995.
Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2023–16275 Filed 7–31–23; 8:45 am]
BILLING CODE 4165–16–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Submission for OMB Review; 30-Day
Comment Request; Generic Clearance
for the Collection of Customer
Participation and Performance
Management With NIH Programs,
Processes, Products, and Services
(National Institutes of Health)
AGENCY:
National Institutes of Health,
HHS.
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ACTION:
Notice.
In compliance with the
Paperwork Reduction Act of 1995, the
National Institutes of Health (NIH) has
SUMMARY:
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submitted to the Office of Management
and Budget (OMB) a request for review
and approval of the information
collection listed below.
DATES: Comments regarding this
information collection are best assured
of having their full effect if received
within 30 days of the date of this
publication.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or using the
search function.
FOR FURTHER INFORMATION CONTACT:
Diane Kreinbrink, Program Manager,
Office of Management Policy and
Compliance, National Cancer Institute,
9609 Medical Center Drive, Room
2W446, Bethesda, Maryland, 20892 or
call non-toll-free number (240) 276–
7283 or email your request, including
your address to: diane.kreinbrink@
nih.gov. Formal requests for additional
plans and instruments must be
requested in writing.
SUPPLEMENTARY INFORMATION: This
proposed information collection was
previously published in the Federal
Register on May 8, 2023, page 29681
(Vol. 88, No. 88 FR 29681) and allowed
60 days for public comment. No public
comments were received. The purpose
of this notice is to allow an additional
30 days for public comment. The
National Cancer Institute (NCI),
National Institutes of Health, may not
conduct or sponsor, and the respondent
is not required to respond to, an
information collection that has been
extended, revised, or implemented on or
after October 1, 1995, unless it displays
a currently valid OMB control number.
In compliance with section
3507(a)(1)(D) of the Paperwork
Reduction Act of 1995, the National
Institutes of Health (NIH) has submitted
to the Office of Management and Budget
(OMB) a request for review and
approval of the information collection
listed below.
Proposed Collection Title: Generic
Clearance for the Collection of Customer
Participation and Performance
Management with NIH Programs,
Processes, Products, and Services (NIH),
0925–XXXX: Expiration Date XX/XX/
XXXX, NEW, National Institutes of
Health (NIH).
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Need and Use of Information
Collection: Evaluating the effectiveness
of leadership, programs, and services is
essential for the vitality of any
institution. Leadership review at NIH
focuses on the productivity of the IC,
management of resources and budget
allocations, training activities, and
influence on dimensions of diversity,
accessibility, inclusion, promotion of
investigators and staff (including NIH
Equity Committee (NEC) reports), and
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Program and service reviews may
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Reviews and evaluations may solicit
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Director, Deputy Director, E.O.) and
relevant program participants and
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may include comparisons with other ICs
or programs, external benchmarks, and
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This clearance will allow direct
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OMB approval is requested for 3
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Agencies
[Federal Register Volume 88, Number 146 (Tuesday, August 1, 2023)]
[Notices]
[Pages 50160-50162]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-16275]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Notice of Proposed Purchased/Referred Care Delivery Area
Redesignation for the Mid-Atlantic Tribes
AGENCY: Indian Health Service, Department of Health and Human Services.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This Notice advises the public that the Indian Health Service
(IHS) proposes to view the seven Mid-Atlantic Tribes in the
Commonwealth of Virginia collectively and to expand the geographic
boundaries of their current Purchased/Referred Care Delivery Areas
(PRCDA). The seven Mid-Atlantic Tribes include the Pamunkey Indian
Tribe, Chickahominy Indian Tribe, Chickahominy Indian Tribe--Eastern
Division, Upper Mattaponi Tribe, Rappahannock Tribe, Monacan Indian
Nation, and Nansemond Indian Tribe. The IHS previously designated a
PRCDA for each of the seven Tribes, which include counties and/or
independent cities in the Commonwealth of Virginia. The IHS is now
proposing to expand those individual PRCDAs by creating a collective
PRCDA for the seven Tribes. The collective PRCDA will include all of
the counties and independent cities in each of the current PRCDAs, plus
additional contiguous counties and independent cities in the
Commonwealth of Virginia, the State of Maryland, and the State of North
Carolina.
DATES: Comments must be submitted August 31, 2023.
ADDRESSES: In commenting, please refer to file code [Federal Register
insert file code number]. Because of staff and resource limitations, we
cannot accept comments by facsimile (FAX) transmission. You may submit
comments in one of four ways (please choose only one of the ways
listed):
1. Electronically. You may submit electronic comments on this
regulation to https://www.regulations.gov. Follow the ``Submit a
Comment'' instructions.
2. By regular mail. You may mail written comments to the following
address ONLY: Carl Mitchell, Director, Division of Regulatory and
Policy Coordination Indian Health Service, 5600 Fishers Lane, Mail
Stop: 09E70, Rockville, Maryland 20857.
Please allow sufficient time for mailed comments to be received
before the close of the comment period.
3. By express or overnight mail. You may send written comments to
the above address.
4. By hand or courier. If you prefer, you may deliver (by hand or
courier) your written comments before the close of the comment period
to the address above.
If you intend to deliver your comments to the Rockville address,
please call telephone number (301) 443-1116 in advance to schedule your
arrival with a staff member.
SUPPLEMENTARY INFORMATION: The current PRCDAs for the seven Mid-
Atlantic Tribes are:
Pamunkey Indian Tribe--Caroline, Hanover, Henrico, King William,
King and Queen, and New Kent Counties; and the independent city of
Richmond in the Commonwealth of Virginia.
Chickahominy Indian Tribe--New Kent, James City, Charles City, and
Henrico Counties in the Commonwealth of Virginia.
Chickahominy Indian Tribe--Eastern Division--New Kent, James City,
Charles City, and Henrico Counties in the Commonwealth of Virginia.
Upper Mattaponi Tribe--Richmond, Middlesex, Essex, King and Queen,
King William, New Kent, Hanover, Caroline, Henrico, Charles City, and
James City Counties; and the independent city of Richmond in the
Commonwealth of Virginia.
Rappahannock Tribe, Inc.--King and Queen, Caroline, Essex, and King
William Counties in the Commonwealth of Virginia.
Monacan Indian Nation--Amherst, Nelson, Albemarle, Buckingham,
Appomattox, Campbell, Bedford, Botetourt, Rockbridge, and Augusta
Counties; and the independent cities of Lynchburg, Lexington, Buena
Vista, Staunton, Waynesboro, and Charlottesville in the Commonwealth of
Virginia.
Nansemond Indian Tribe--the independent cities of Chesapeake,
Hampton, Newport News, Norfolk, Portsmouth, Suffolk, and Virginia Beach
in the Commonwealth of Virginia.
The IHS is proposing to create a collective PRCDA for the seven
Mid-Atlantic Tribes that will include the following counties and
independent cities:
Counties in the Commonwealth of Virginia: Accomack, Albemarle,
Alleghany, Amelia, Amherst, Appomattox, Arlington, Augusta, Bath,
Bedford, Botetourt, Buckingham, Campbell, Caroline, Charlotte,
Chesterfield, Clarke, Cumberland, Culpeper, Dinwiddie, Essex, Fauquier,
Floyd, Fluvanna, Gloucester, Greene, Greensville, Goochland, Hanover,
Henrico, Isle of Wight, James City, King and Queen, King George, King
William, Lancaster, Loudoun, Louisa, Lunenburg, Mathews, Mecklenburg,
Middlesex, Montgomery, Nelson, New Kent, Newport News, Norfolk,
Nottoway, Orange, Page, Patrick, Pittsylvania, Powhatan, Prince Edward,
Prince George, Prince William, Pulaski, Richmond, Rockbridge,
Rockingham, Southampton, Spotsylvania, Stafford, Warren, Westmoreland,
and York.
Independent Cities in the Commonwealth of Virginia: Alexandria,
Buena Vista, Charlottesville, Chesapeake, Colonial Heights, Covington,
Emporia, Fairfax, Falls Church, Franklin, Fredericksburg, Hampton,
Harrisonburg, Hopewell, Lexington, Lynchburg, Manassas, Manassas Park,
Newport News, Norfolk, Petersburg, Poquoson, Portsmouth, Radford,
Richmond, Roanoke, Salem, Staunton, Suffolk, Virginia Beach,
Waynesboro, and Williamsburg.
Counties in the State of Maryland: Allegany, Anne Arundel,
Baltimore, Calvert, Carroll, Cecil, Charles, Frederick, Harford,
Howard, Kent, Montgomery, Prince George's, Queen Anne's, St. Mary's,
and Washington.
Independent Cities in the State of Maryland: Baltimore City.
Counties in the State of North Carolina: Alexander, Camden,
Catawba, Chowan, Currituck, Davidson, Davie, Durham, Forsyth, Franklin,
Gates, Granville, Guilford, Johnston, Orange, Pasquotank, Randolph,
Rowan, Stanly, Stokes, and Wake.
[[Page 50161]]
Members of the seven Mid-Atlantic Tribes residing outside of the
current PRCDAs are eligible for direct care services, however, they are
not eligible for Purchased/Referred Care (PRC) services. The sole
purpose of this expansion would be to authorize additional Tribal
members and beneficiaries to receive PRC services.
Inspection of Public Comments: All comments received before the
close of the comment period are available for viewing by the public,
including any personally identifiable or confidential business
information that is included in a comment.
FOR FURTHER INFORMATION CONTACT: CAPT John Rael, Director, Office of
Resource Access and Partnerships, Indian Health Service, 5600 Fishers
Lane, Mail Stop: 10E85C, Rockville, Maryland 20857. Telephone (301)
443-0969. (This is not a toll free number).
Background: The IHS provides services under regulations in effect
as of September 15, 1987, and republished at 42 CFR part 136, subparts
A-C. Subpart C defines a Contract Health Service Delivery Area (CHSDA),
now referred to as a PRCDA, as the geographic area within which PRC
will be made available by the IHS to members of an identified Indian
community who reside in the PRCDA. Residence within 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, but 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 relative medical priority of the services to
be provided, and the actual availability and accessibility of alternate
resources in accordance with the regulations.
The regulations at 42 CFR part 136, subpart C provide that, unless
otherwise designated, a PRCDA shall consist of a county which includes
all or part of a reservation and any county or counties which 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, redesignate areas within
the United States for inclusion in or exclusion from a PRCDA--42 CFR
136.22(b). The regulations require that certain criteria must be
considered before any redesignation is made. The criteria are as
follows:
(1) The number of Indians residing in the area proposed to be so
included or excluded;
(2) Whether the Tribal governing body has determined that Indians
residing in the area near the reservation are socially and economically
affiliated with the Tribe;
(3) The geographic proximity to the reservation of the area whose
inclusion or exclusion is being considered; and
(4) The level of funding which would be available for the provision
of PRC.
Additionally, the regulations require that any redesignation of a
PRCDA must be made in accordance with the procedures of the
Administrative Procedure Act (5 U.S.C. 553)--42 CFR 136.22(c). In
compliance with this requirement, the IHS is publishing this Notice and
requesting public comments.
The Pamunkey Indian Tribe was the first federally recognized Tribe
in the Commonwealth of Virginia, recognized through the Department of
the Interior's Federal Acknowledgement of American Indian Tribes
administrative process effective January 28, 2016. The Pamunkey Indian
Tribe does not have a reservation land base within the meaning of 42
CFR 136.22(a)(6). As a result, the Director, IHS, exercised reasonable
administrative discretion to designate a PRCDA for the Pamunkey Indian
Tribe, effective August 28, 2017, 82 FR 35227.
On January 29, 2018, the President signed into law H.R. 984, the
``Thomasina E. Jordan Indian Tribes of Virginia Federal Recognition Act
of 2017,'' which provided Federal recognition to six additional Tribes
in the Commonwealth of Virginia, and identified geographical (e.g.,
county or city) service delivery areas for each. These service delivery
areas included overlapping areas for many of the Tribes, and also
overlapped the Pamunkey Indian Tribe's designated PRCDA. The IHS
designated the PRCDAs for each of these six Tribes, effective February
21, 2020, in accordance with Congressional intent. The IHS has
historically established PRCDAs in accordance with Congressional intent
while preserving regulatory flexibility to re-designate areas as
appropriate for inclusion in or exclusion from a PRCDA under PRC
regulations. Expansion of the PRCDAs for the seven Mid-Atlantic Tribes
would extend these already existing and overlapping PRCDAs, to create a
collective PRCDA for these seven Tribes, for the sole purpose of
authorizing additional Tribal members and beneficiaries to receive PRC
services. Representatives from all seven Mid-Atlantic Tribes
unanimously sought to move forward collectively to request re-
designation of their PRCDAs to include the entire Commonwealth of
Virginia. Following consultation with those Tribes, the IHS also
considered portions of Maryland and North Carolina that are close to
the border of Virginia. Since all seven of the Mid-Atlantic Tribes
requested the same PRCDA, the IHS is proposing to consider these Tribes
collectively for purposes of the PRCDA expansions. This includes
considering their Tribal members collectively under the criteria set
forth in 42 CFR 136.22(b), as described above. In doing so, the IHS has
determined which portions of the Commonwealth of Virginia, Maryland,
and North Carolina would meet the necessary criteria for one or more of
the seven Mid-Atlantic Tribes. For example, the IHS is not proposing to
add any counties where no members of any Mid-Atlantic Tribe reside, or
counties that are not contiguous with the existing or proposed PRCDAs.
Accordingly, the IHS proposes to expand the individual PRCDAs for these
seven Mid-Atlantic Tribes to create a collective PRCDA that includes
sixty-six (66) counties and thirty-two (32) independent cities in the
Commonwealth of Virginia; twenty-one (21) counties in North Carolina;
and sixteen (16) counties and one (1) independent city in Maryland.
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 other IHS beneficiaries who maintain close
economic and social ties with the Tribe. In this case, applying the
aforementioned PRCDA redesignation criteria required by operative
regulations codified at 42 CFR part 136, subpart C, the following
findings are made:
1. By expanding each Tribe's PRCDA and creating one collective
PRCDA, the seven Mid-Atlantic Tribes estimate the current eligible
population will collectively increase by 1006 individuals.
2. The seven Mid-Atlantic Tribes have determined that these 1006
individuals are members of the federally recognized Tribes in the
Commonwealth of Virginia and that these members are socially and
economically affiliated with these Mid-Atlantic Tribes.
3. The existing PRCDAs for these seven Mid-Atlantic Tribes,
consisting of twenty-one (21) counties and fourteen (14) independent
cities collectively, will be expanded to include sixty-six (66)
counties and thirty-two (32) independent cities in the Commonwealth of
Virginia; twenty-one (21) counties in North Carolina; and sixteen (16)
counties, and one (1) independent city in Maryland. Members of one or
more of the Tribes reside in
[[Page 50162]]
each county that is included in the proposed expansion, and those
members live near enough to their Tribe's seat of government to
maintain close social and economic ties with their Tribe. According to
the leadership for each of the Tribes, those members live close enough
to regularly participate in-person in Tribal affairs, events,
activities, or other functions held by or carried out by the Tribe
within its current PRCDA. Furthermore, the proposed counties and
independent cities form a contiguous area with the existing PRCDAs.
Considering the Tribes collectively, the IHS has determined the
additional counties and independent cities proposed for inclusion
herein to be geographically proximate, meaning ``on or near,'' to the
area analogous to reservations for the seven Mid-Atlantic Tribes.
4. PRC programs operated by/for the seven Mid-Atlantic Tribes will
use their existing Federal allocation for PRC funds to provide services
to the expanded population. No additional financial resources will be
allocated by the IHS to these programs to provide services to members
residing in the expanded counties and independent cities in the
Commonwealth of Virginia, State of Maryland, or State of North
Carolina.
This Notice does not contain reporting or recordkeeping
requirements subject to prior approval by the Office of Management and
Budget under the Paperwork Reduction Act of 1995.
Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2023-16275 Filed 7-31-23; 8:45 am]
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