Indian Health Service Expands Purchased/Referred Care Delivery Area for Iowa Tribe

Content

ACTION:

Notice.

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 https://www.federalregister.gov. 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 *Tracy.Sanchez@ihs.gov,* 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 (https://www.ihs.gov/prc/prcda-expansion).

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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