Notice2025-11889
Notice of Purchased/Referred Care Delivery Area Redesignation for the Iowa Tribe of 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 Iowa Tribe of Kansas and Nebraska (Iowa Tribe or Tribe) to include the counties of Jackson in the State of Kansas, and Holt in the State of Missouri. The final PRCDA for the Iowa Tribe 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 Iowa 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 27645-27646]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-11889]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Notice of Purchased/Referred Care Delivery Area Redesignation for
the Iowa Tribe of 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 Iowa Tribe of Kansas and
Nebraska (Iowa Tribe or Tribe) to include the counties of Jackson in
the State of Kansas, and Holt in the State of Missouri. The final PRCDA
for the Iowa Tribe 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 Iowa 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
[[Page 27646]]
of Resource Access and Partnerships by email at <a href="/cdn-cgi/l/email-protection#75210714160c5b26141b161d100f351c1d065b121a03"><span class="__cf_email__" data-cfemail="06527467657f28556768656e637c466f6e7528616970">[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 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 99884). 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 Jackson County, Kansas, and
Holt County, Missouri, the Iowa Tribe's PRC eligible population will
increase by an estimated 77 Tribal members.
2. The Iowa Tribe communicated its governing body's determination
that their members residing in the proposed expansion counties are
socially and economically affiliated with the Tribe. The IHS therefore
finds that the Tribe's members within the proposed, expanded PRCDA are
socially and economically affiliated with the Iowa Tribe.
3. The expanded PRCDA counties form a contiguous area with the
existing PRCDA. Holt County, Missouri, shares a common boundary with
the Iowa Tribe's reservation lands in Richardson County, Nebraska.
Jackson County, Kansas, is contiguous with Brown County, which includes
part of the Iowa Tribe's reservation lands and is currently included in
the Iowa Tribe's PRCDA. Members of the Iowa Tribe 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 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. 2025-11889 Filed 6-26-25; 8:45 am]
BILLING CODE 4166-14-P
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