Notice2024-29689
Notice of Proposed Purchased/Referred Care Delivery Area Redesignation for the Chippewa Cree Tribe of the Rocky Boy's Reservation
Primary source
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Published
December 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 Chippewa Cree Tribe of the Rocky Boy's Reservation ("Chippewa Cree Tribe" or "Tribe") to include the Montana county of Cascade. The current PRCDA for the Chippewa Cree Tribe includes the Montana counties of Choteau, Hill and Liberty. Chippewa Cree Tribal members who reside 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 Chippewa Cree Tribal members and beneficiaries to receive PRC services.
Full Text
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<title>Federal Register, Volume 89 Issue 242 (Tuesday, December 17, 2024)</title>
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[Federal Register Volume 89, Number 242 (Tuesday, December 17, 2024)]
[Notices]
[Pages 102150-102151]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-29689]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Notice of Proposed Purchased/Referred Care Delivery Area
Redesignation for the Chippewa Cree Tribe of the Rocky Boy's
Reservation
AGENCY: Indian Health Service, HHS.
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 Chippewa Cree Tribe of the
Rocky Boy's Reservation (``Chippewa Cree Tribe'' or ``Tribe'') to
include the Montana county of Cascade. The current PRCDA for the
Chippewa Cree Tribe includes the Montana counties of Choteau, Hill and
Liberty. Chippewa Cree Tribal members who reside 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 Chippewa Cree Tribal members
and beneficiaries to receive PRC services.
DATES: Comments must be submitted by January 16, 2025.
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 <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.
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).
SUPPLEMENTARY INFORMATION: 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 services
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
[[Page 102151]]
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 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 Chippewa Cree Tribe of the Rocky Boy's Reservation is located
Hill and Choteau Counties of Montana. The Chippewa Cree Tribe operates
their PRC program under an Indian Self-Determination and Education
Assistance Act agreement with the IHS. The Chippewa Cree Tribe has
requested that the IHS expand its PRCDA to include Cascade County,
Montana. The requested PRCDA redesignation would share Cascade County
with the PRCDA of the Little Shell Tribe of Chippewa Indians of Montana
(``Little Shell Tribe''). The Billings Area held discussions with the
Little Shell Tribe, during which the Little Shell Tribe did not raise
any objections to the expansion of the Chippewa Cree Tribe's PRCDA to
include Cascade County. 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 Cascade County, Montana, the
IHS and the Chippewa Cree Tribe estimate that the Tribe's PRC eligible
population would increase by an estimated 251 Tribal members.
2. As part of their expansion request, the Chippewa Cree Tribe
submitted a resolution from the Tribe's governing body. The resolution
explains that the expansion is intended to serve their members living
in Cascade County, Montana and it describes those members as being
socially and economically tied to the Tribe's reservation. The IHS
therefore finds that the Tribal members within the proposed, expanded
PRCDA are socially and economically affiliated with the Chippewa Cree
Tribe.
3. The expanded PRCDA county forms a contiguous area with the
existing PRCDA. Members of the Chippewa Cree Tribe reside in the county
proposed for inclusion in the expanded PRCDA. Through their expansion
request, the Tribe described how close Cascade County, Montana is to
their reservation and explained that it is close enough for their
members residing there to return frequently to the Tribe's reservation
for ceremony and participation in Tribal elections. For these reasons,
the IHS has determined the additional county proposed for inclusion
herein to be geographically proximate, meaning ``on or near,'' to the
Tribe's reservation.
4. Through the Chippewa Cree Tribe's request to expand its PRCDA,
the Tribe has indicated that the 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 from the IHS
or reduction of the current medical priority level.
Accordingly, the IHS proposes to expand the PRCDA of the Chippewa
Cree Tribe to include the county of Cascade in the state of Montana.
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. 2024-29689 Filed 12-16-24; 8:45 am]
BILLING CODE 4166-14-P
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