Notice2023-17058
Notice of Purchased/Referred Care Delivery Area Redesignation for the Spokane Tribe of Indians in the State of Washington
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
August 9, 2023
Issuing agencies
Health and Human Services DepartmentIndian Health Service
Abstract
This Notice advises the public that the Indian Health Service (IHS) proposes to expand the geographic boundaries of the Purchased/ Referred Care Delivery Area (PRCDA) for the Spokane Tribe of the Spokane Reservation to include the counties of Spokane and Whitman in the State of Washington. The current PRCDA for the Spokane Tribe of the Spokane Reservation includes the Washington counties of Ferry, Lincoln, and Stevens. Spokane Tribal members residing outside of the PRCDA 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 Spokane Tribal members and beneficiaries to receive PRC services.
Full Text
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<title>Federal Register, Volume 88 Issue 152 (Wednesday, August 9, 2023)</title>
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[Federal Register Volume 88, Number 152 (Wednesday, August 9, 2023)]
[Notices]
[Pages 53899-53900]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-17058]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Notice of Purchased/Referred Care Delivery Area Redesignation for
the Spokane Tribe of Indians in the State of Washington
AGENCY: Indian Health Service, Department of Health and Human Services.
ACTION: Notice.
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SUMMARY: This Notice advises the public that the Indian Health Service
(IHS) proposes to expand the geographic boundaries of the Purchased/
Referred Care Delivery Area (PRCDA) for the Spokane Tribe of the
Spokane Reservation to include the counties of Spokane and Whitman in
the State of Washington. The current PRCDA for the Spokane Tribe of the
Spokane Reservation includes the Washington counties of Ferry, Lincoln,
and Stevens. Spokane Tribal members residing outside of the PRCDA 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 Spokane Tribal members and
beneficiaries to receive PRC services.
DATES: Comments must be submitted September 8, 2023.
ADDRESSES: Because of staff and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. You may submit comments in
one of four ways:
1. Electronically. You may submit electronic comments on this
regulation to <a href="http://www.regulations.gov">http://www.regulations.gov</a>. 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.
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).
SUPPLEMENTARY INFORMATION:
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.
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 person's relative medical priority, 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 Spokane Tribe of the Spokane Reservation is located in the
Northeastern part of Washington State. The Tribe is located on an
approximately 157,000 acre reservation that is located in Stevens,
Lincoln, and Spokane Counties.
The PRC Program is operated as a Federal program through the
Wellpinit
[[Page 53900]]
Service Unit in Wellpinit, WA. The Portland Area IHS estimates there
are currently 480 Tribal members who live within Spokane and Whitman
Counties and would become PRC eligible through this proposed expansion.
The Tribe states that Tribal members who reside in Spokane and Whitman
Counties are socially and economically affiliated with the Tribe
through employment, family, community, or services. The Tribe would
like to recognize them as eligible for PRC. Accordingly, the IHS
proposes to expand the PRCDA of the Spokane Tribe of the Spokane
Reservation to include the Washington counties of Spokane and Whitman.
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 the PRCDA to include Spokane County and Whitman
County, the Spokane Tribe of the Spokane Reservation's eligible
population will be increased by an estimated 480 tribal members.
2. The IHS finds that the Tribal members within the expanded PRCDA
are socially and economically affiliated with the Spokane Tribe of the
Spokane Reservation based on letters from the Tribe, dated May 31, 2022
and August 8, 2022, which noted that the Spokane Tribal Council had
determined that tribal members residing in Spokane and Whitman counties
are socially and economically affiliated with the Tribe.
3. Spokane and Whitman counties in the State of Washington are ``on
or near'' the reservation, as they maintain a common boundary with the
current PRCDA consisting of the counties of Ferry, Lincoln, and Stevens
in the State of Washington. In addition to this, Spokane County
includes a recent addition to the Spokane reservation (see 83 FR
18860), and Whitman County includes the Tribe's aboriginal territory.
4. The IHS administers the Wellpinit Service Unit PRC program and
will use its existing Federal allocation for PRC to provide services to
the expanded population. The Portland Area Director acknowledged that
no additional financial resources will be allocated by the IHS to the
Portland Area IHS to provide services to Spokane Tribal members
residing in Spokane and Whitman counties in the State of Washington.
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. 2023-17058 Filed 8-8-23; 8:45 am]
BILLING CODE 4165-16-P
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</html>Indexed from Federal Register on August 9, 2023.
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