Notice2024-10845
Notice of Proposed Purchased/Referred Care Delivery Area Re-Designation for the Pokagon Band of Potawatomi Indians of Michigan and Indiana
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Published
May 17, 2024
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 Pokagon Band of Potawatomi Indians of Michigan and Indiana to include the counties of Kalamazoo, Kent, and Ottawa in the State of Michigan. The sole purpose of this expansion would be to authorize additional Pokagon Band of Potawatomi Indians of Michigan and Indiana citizens and other PRC-eligible individuals to receive PRC services.
Full Text
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<title>Federal Register, Volume 89 Issue 97 (Friday, May 17, 2024)</title>
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[Federal Register Volume 89, Number 97 (Friday, May 17, 2024)]
[Notices]
[Pages 43415-43416]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-10845]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Notice of Proposed Purchased/Referred Care Delivery Area Re-
Designation for the Pokagon Band of Potawatomi Indians of Michigan and
Indiana
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 Pokagon Band of Potawatomi
Indians of Michigan and Indiana to include the counties of Kalamazoo,
Kent, and Ottawa in the State of Michigan. The sole purpose of this
expansion would be to authorize additional Pokagon Band of Potawatomi
Indians of Michigan and Indiana citizens and other PRC-eligible
individuals to receive PRC services.
DATES: Comments must be submitted by June 17, 2024.
ADDRESSES: 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 <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 regulation 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 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, re-designate 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
[[Page 43416]]
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. Additionally, the regulations require that any re-designation
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 Pokagon Band of Potawatomi Indians of Michigan and Indiana
(Pokagon Band, or Tribe) is located in Dowagiac, Michigan, and operates
their PRC program as a Tribal Health Program. The IHS established the
Pokagon Band's current PRCDA consistent with the language of the Act of
September 21, 1994, restoring Federal recognition to the Pokagon Band.
Public Law 103-323 (108 Stat. 2152); see also 72 FR 34262 (June 21,
2007). Although the IHS has historically established PRCDAs in
accordance with Congressional intent, the IHS has also preserved
regulatory flexibility to re-designate areas as appropriate for
inclusion in or exclusion from a PRCDA under PRC regulations. See 81 FR
20388 (April 7, 2016).
The current PRCDA for the Pokagon Band of Potawatomi Indians of
Michigan and Indiana currently consists of 10 counties in Southwestern
Michigan and Northwestern Indiana. See 72 FR 34262 (June 21, 2007).
These counties are Allegan, Berrien, Cass, and Van Buren Counties in
Michigan; and Elkhart, Kosciusko, La Porte, Marshall, St. Joseph, and
Starke Counties in Indiana. Pokagon Band of Potawatomi Indians of
Michigan and Indiana citizens residing outside of the PRCDA are
eligible for direct care services; however, they are not eligible for
Purchased/Referred Care (PRC) services.
The Pokagon Band estimates that approximately 537 Pokagon citizens
reside in Kalamazoo, Kent, and Ottawa Counties in Michigan and would
become PRC eligible through the proposed re-designation and expansion
of the Tribe's PRCDA. The Pokagon Band states that these citizens, ``by
virtue of their citizenship with the Pokagon Band are socially and
economically affiliated with the Pokagon Band and belong to the Pokagon
Band community served by the [Health] Center . . .'' The Tribe also
considers certain other PRC-eligible individuals to be socially and
economically affiliated with the Pokagon Band and to belong to the
Pokagon Band community, including non-Indian women pregnant with a
Pokagon Band citizen's child, and children of Pokagon Band citizens as
detailed in the Tribe's PRCDA re-designation request. The Pokagon Band
would like to recognize these persons as eligible for PRC services. The
IHS confirmed that there are Pokagon Band citizens residing in each of
the proposed expansion counties. Accordingly, the IHS proposes to
expand the PRCDA of the Pokagon Band of Potawatomi Indians of Michigan
and Indiana to include the Michigan counties of Kalamazoo, Kent, and
Ottawa.
If the Pokagon Band's PRCDA re-designation and expansion is
finalized as proposed, the Tribe's expanded PRCDA would overlap the
existing PRCDAs of three other Tribes: the Nottawaseppi Band of Huron
Potawatomi (Kalamazoo, Kent, and Ottawa Counties); the Match-E-Be-Nash-
She-Wish Band of Pottawatomi Indians of Michigan (Kalamazoo, Kent, and
Ottawa Counties); and Little River Band of Ottawa Indians (Kent and
Ottawa Counties). The IHS has consulted with each of the overlapping
Tribes regarding the proposed expansion of the Pokagon Band's PRCDA,
and none of the overlapping Tribes has expressed a current concern
regarding the proposed re-designation and expansion.
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 re-designation 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 Kalamazoo, Kent, and Ottawa
Counties in Michigan, the Pokagon Band of Potawatomi Indians of
Michigan and Indiana's PRC eligible population will increase by an
estimated 537 Tribal citizens.
2. The IHS finds that the Tribal citizens and other PRC-eligible
individuals within the expanded PRCDA are socially and economically
affiliated with the Pokagon Band based on a Tribal resolution in which
the Pokagon Band Tribal Council identified its intent to expand the
PRCDA to include Kalamazoo, Kent, and Ottawa Counties in Michigan, and
stated that the Tribal citizens and certain other individuals residing
in such areas are socially and economically affiliated with the Pokagon
Band.
3. The expanded PRCDA counties form a contiguous area with the
existing PRCDA, and Pokagon Band citizens reside in each of the
counties proposed for inclusion in the expanded PRCDA. For these
reasons, the IHS has determined the additional counties proposed for
inclusion herein to be geographically proximate, meaning ``on or
near,'' to the existing PRCDA.
4. The Pokagon Band has indicated that its PRC program can continue
providing the same level of care to the PRC-eligible population if the
PRCDA is expanded as proposed, without requiring additional funding or
reduction of the current medical priority level.
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 1980.
Roselyn Tso,
Director, Indian Health Service.
[FR Doc. 2024-10845 Filed 5-16-24; 8:45 am]
BILLING CODE 4166-14-P
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