Notice2025-11868
Notice of Purchased/Referred Care Delivery Area Redesignation for the Sac and Fox Nation of Missouri in Kansas and Nebraska
Primary source
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Published
June 27, 2025
Issuing agencies
Health and Human Services DepartmentIndian Health Service
Abstract
Notice is hereby given that the Indian Health Service (IHS) has decided to expand the geographic boundaries of the Purchased/ Referred Care Delivery Area (PRCDA) for the Sac and Fox Nation of Missouri in Kansas and Nebraska (Sac and Fox Nation of Missouri or Tribe) to include the counties of Doniphan and Jackson in the State of Kansas, and Holt in the State of Missouri. The final PRCDA for the Sac and Fox Nation of Missouri now includes the following counties: Brown, Doniphan, and Jackson in the State of Kansas; Holt in the State of Missouri; and Richardson in the State of Nebraska. The sole purpose of this expansion is to authorize additional Sac and Fox Nation of Missouri Tribal members and beneficiaries to receive Purchased/Referred Care (PRC) services.
Full Text
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<title>Federal Register, Volume 90 Issue 122 (Friday, June 27, 2025)</title>
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[Federal Register Volume 90, Number 122 (Friday, June 27, 2025)]
[Notices]
[Pages 27646-27647]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-11868]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Notice of Purchased/Referred Care Delivery Area Redesignation for
the Sac and Fox Nation of Missouri in Kansas and Nebraska
AGENCY: Indian Health Service, Department of Health and Human Services.
ACTION: Notice.
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SUMMARY: Notice is hereby given that the Indian Health Service (IHS)
has decided to expand the geographic boundaries of the Purchased/
Referred Care Delivery Area (PRCDA) for the Sac and Fox Nation of
Missouri in Kansas and Nebraska (Sac and Fox Nation of Missouri or
Tribe) to include the counties of Doniphan and Jackson in the State of
Kansas, and Holt in the State of Missouri. The final PRCDA for the Sac
and Fox Nation of Missouri now includes the following counties: Brown,
Doniphan, and Jackson in the State of Kansas; Holt in the State of
Missouri; and Richardson in the State of Nebraska. The sole purpose of
this expansion is to authorize additional Sac and Fox Nation of
Missouri Tribal members and beneficiaries to receive Purchased/Referred
Care (PRC) services.
DATES: This expansion is effective as of the date of publication of
this notice.
ADDRESSES: This notice can be found at <a href="https://www.federalregister.gov">https://www.federalregister.gov</a>.
Written requests for information should be delivered to: CDR Tracy
Sanchez, Acting Director, Office of Resource Access and Partnerships,
Indian Health Service, 5600 Fishers Lane, Mail Stop 10E85C, Rockville,
MD 20857.
FOR FURTHER INFORMATION CONTACT: CDR Tracy Sanchez, Acting Director,
Office of Resource Access and Partnerships by email at
<a href="/cdn-cgi/l/email-protection#baeec8dbd9c394e9dbd4d9d2dfc0fad3d2c994ddd5cc"><span class="__cf_email__" data-cfemail="6e3a1c0f0d17403d0f000d060b142e07061d40090118">[email protected]</span></a>, or by phone at (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 but only
potential eligibility for services. Services needed, but not
[[Page 27647]]
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 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 published a notice of proposed redesignation and
requested public comments on December 11, 2024 (89 FR 99885). The IHS
did not receive any comments in response to the notice of proposed
redesignation.
In support of this expansion, the IHS makes the following findings:
1. By expanding the PRCDA to include Doniphan and Jackson Counties
in Kansas, and Holt County, Missouri, the Sac and Fox Nation of
Missouri's PRC eligible population will increase by an estimated seven
Tribal members.
2. Through communication with the Tribe and information relayed by
the White Cloud Health Center, the IHS understands that the Tribe's
governing body has determined that its members residing in the proposed
expansion counties are socially and economically affiliated with the
Tribe. The IHS therefore finds that the Tribal members within the
proposed, expanded PRCDA are socially and economically affiliated with
the Sac and Fox Nation of Missouri.
3. The expanded PRCDA counties form a contiguous area with the
existing PRCDA, and members of the Sac and Fox Nation of Missouri
reside in each of the counties proposed for inclusion in the expanded
PRCDA. Jackson County, Kansas, and Doniphan County, Kansas, both share
a common boundary with Brown County, Kansas, where the Sac and Fox
Nation of Missouri has reservation lands. Holt County, Missouri, shares
a common boundary with Richardson County, Nebraska, where the Sac and
Fox Nation of Missouri has reservation lands. For these reasons, the
IHS has determined the additional counties proposed for inclusion
herein to be geographically proximate, meaning ``on or near,'' to the
Tribe's reservation.
4. The White Cloud Health Center 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 or reduction of the current medical priority level.
An updated listing of the PRCDAs for all federally-recognized
Tribes may be accessed via a link on the IHS PRCDA Expansion website
(<a href="https://www.ihs.gov/prc/prcda-expansion">https://www.ihs.gov/prc/prcda-expansion</a>).
Public Comments: The IHS did not receive any comments in response
to the notice of proposed expansion.
P. Benjamin Smith,
Acting Director, Indian Health Service.
[FR Doc. 2025-11868 Filed 6-26-25; 8:45 am]
BILLING CODE 4165-16-P
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