# Notice To Propose the Re-Designation of the Delivery Area for the Havasupai Tribe
**AGENCY:**
Indian Health Service.
**ACTION:**
Notice.
**SUMMARY:**
This notice is to advise the public that the Indian Health Service (IHS) proposes to expand the geographic boundaries of the Purchased/Referred Care (PRC) Delivery Area (DA) for the Havasupai Tribe in Arizona. The Havasupai Tribe's PRCDA is currently Coconino County in the State of Arizona. The IHS proposes to expand the Tribe's PRCDA to include Mojave County, which is adjacent to the Tribe's existing PRCDA in the State of Arizona.
**DATES:**
Comments due April 4, 2019.
**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 comments electronically to *http://www.regulations.gov.* Follow the “Submit a Comment” instructions.
2. *By postal mail.* You may mail written comments to the following address ONLY: Ms. Emmalani Longenecker, Indian Health Service, 5600 Fishers Lane, Mailstop: 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 following address. Ms. Emmalani Longenecker, Indian Health Service, 5600 Fishers Lane, Mailstop: 09E70, Rockville, Maryland 20857.
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.
Comments will be made available for public inspection at the Rockville address from 8:30 a.m. to 5:00 p.m., Monday-Friday, two weeks after publication of this notice.
**FOR FURTHER INFORMATION CONTACT:**
CMDR John Rael, Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mailstop: 10E85C, Rockville, Maryland 20852. Telephone 301/443-2694 (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 currently provides services under regulations in effect on September 15, 1987 and IHS republished at 42 CFR part 136, subparts A-C. Subpart C defines 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 area. Residence in 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 needed but not available at an IHS/Tribal facility are provided under the PRC program depending on the availability of funds, the person's relative medical priority, and the actual availability and accessibility of alternate resources in accordance with the regulations.
As applicable to the tribes, these regulations 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 that 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 periodically re-designate areas within the United States (U.S.) for inclusion in or exclusion from a PRCDA. The regulations require that certain criteria must be considered before any 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 tribes;
(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 Administrative Procedures Act (5 U.S.C. 553). In compliance with this requirement, we are publishing this proposal and requesting public comments. The Havasupai Tribe's home is in Coconino County, Arizona, at the bottom of an extremely rugged section of the Grand Canyon. The reservation lies 3,000 feet below the canyon rim, surrounded by U.S. Forest Service and National Park Service lands. The reservation was initially established by an Executive Order on June 8, 1880. The Grand Canyon National Park Enlargement Act on March 4, 1944, set aside certain public domain lands and provided for an exchange of State-owned lands to be added to the reservation, bringing it to its present size.
The IHS operates a health station in the Havasupai Tribe's Village of Supai, Arizona, within Coconino County. When the health care needs of Havasupai Tribal members' are greater than the available services at the IHS health station, tribal members often move from Supai, Arizona, to the City of Kingman, Arizona. The City of Kingman is located in Mojave County, which is the nearest location that provides higher levels of health care services.
The Havasupai Tribe's current PRCDA is Coconino County in the State of Arizona. The IHS administratively established this PRCDA, based upon the location of the tribe's reservation, for the purposes of administering PRC benefits to tribal members. Members of the tribe who reside outside of Coconino County do not reside within the tribe's PRCDA, meaning they are not currently eligible for PRC services. [^42]
[^42] Members of the Tribe may be eligible for PRC in other counties based upon their residence on another Tribe's reservation, or their residence within another Tribe's PRCDA and close economic and social ties with that Tribe.
One of the criteria for re-designation is the geographic proximity of the expanded area to the existing reservation or delivery area. IHS proposes to expand the Havasupai Tribe's PRCDA to include Mojave County, which is adjacent to the existing PRCDA, in the State of Arizona. The Havasupai Tribe has a significant number of members who are residents of the shared county boundary with Mojave County. According to the most recent IHS Active User reports, there are approximately 122 enrolled Havasupai Tribal members who reside in Mojave County, Arizona, and remain actively involved with the tribe.
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, in applying the aforementioned PRC Delivery Area re-designation criteria required by operative regulations codified at 42 CFR part 136, subpart C, the following findings are made:
1. By expanding, the IHS estimates the current eligible population will be increased by 122.
2. The Havasupai Tribe has determined that these 122 individuals are members of the Havasupai Tribe and they are socially and economically affiliated with the Havasupai Tribe.
3. The expanded area including Mojave County in the State of Arizona maintains a common boundary with the statutorily created Coconino County PRCDA.
4. Generally, the Havasupai Tribal members located in Mojave County in the State of Arizona currently do not use the Indian health system for their PRC health care needs. The Havasupai Tribe will use its existing federal allocation for PRC funds to provide health care services to the expanded population. No additional financial resources will be allocated by the IHS to the Havasupai Tribe to provide services to tribal members residing in Mojave County in the State of Arizona.
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.
| Tribe/Reservation | County/State |
| --- | --- |
| Ak Chin Indian Community | Pinal, AZ. |
| Alabama-Coushatta Tribes of Texas | Polk, TX. |
| Alaska | Entire State. |
| Arapahoe Tribe of the Wind River Reservation, Wyoming | Hot Springs, WY, Fremont, WY, Sublette, WY. |
| Aroostook Band of Micmacs | Aroostook, ME. |
| Assiniboine and Sioux Tribes of the Fort Peck Indian Reservation, Montana | Daniels, MT, McCone, MT, Richland, MT, Roosevelt, MT, Sheridan, MT, Valley, MT. |
| Bad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, Wisconsin | Ashland, WI, Iron, WI. |
| Bay Mills Indian Community, Michigan | Chippewa, MI. |
| Blackfeet Tribe of the Blackfeet Indian Reservation of Montana | Glacier, MT, Pondera, MT. |
| Brigham City Intermountain School Health Center, Utah | Permanently closed on May 17, 1984. |
| Burns Paiute Tribe | Harney, OR. |
| California | Entire State, except for the counties listed in the footnote. |
| Catawba Indian Nation (aka Catawba Tribe of South Carolina) | All Counties in SC,
Cabarrus, NC, Cleveland, NC, Gaston, NC, Mecklenburg, NC, Rutherford, NC, Union, NC. |
| Cayuga Nation | Alleghany, NY,
Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA. |
| Cheyenne River Sioux Tribe of the Cheyenne River Reservation, South Dakota | Corson, SD, Dewey, SD, Haakon, SD, Meade, SD, Perkins, SD, Potter, SD, Stanley, SD, Sully, SD, Walworth, SD, Ziebach, SD. |
| Chippewa-Cree Indians of the Rocky Boy's Reservation, Montana | Chouteau, MT, Hill, MT, Liberty, MT. |
| Chitimacha Tribe of Louisiana | St. Mary Parish, LA. |
| Cocopah Tribe of Arizona | Yuma, AZ, Imperial, CA. |
| Coeur D'Alene Tribe | Benewah, ID, Kootenai, ID, Latah, ID, Spokane, WA, Whitman, WA. |
| Colorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and California | La Paz, AZ, Riverside, CA, San Bernardino, CA, Yuma, AZ. |
| Confederated Salish and Kootenai Tribes of the Flathead Reservation | Flathead, MT, Lake, MT, Missoula. |
| Confederated Tribes and Bands of the Yakama Nation | Klickitat, WA, Lewis, WA, Skamania, WA,
Yakima, WA. |
| Confederated Tribes of Siletz Indians of Oregon | Benton, OR,
Clackamas, OR, Lane, OR, Lincoln, OR, Linn, OR, Marion, OR, Multnomah, OR, Polk, OR, Tillamook, OR, Washington, OR, Yamhill, OR. |
| Confederated Tribes of the Chehalis Reservation | Grays Harbor, WA, Lewis, WA, Thurston, WA. |
| Confederated Tribes of the Colville Reservation | Chelan, WA,
Douglas, WA, Ferry, WA, Grant, WA, Lincoln, WA, Okanogan, WA, Stevens, WA. |
| Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians | Coos, OR,
Curry, OR, Douglas, OR, Lane, OR, Lincoln, OR. |
| Confederated Tribes of the Goshute Reservation, Nevada and Utah | Nevada, Juab, UT, Toole, UT. |
| Confederated Tribes of the Grand Ronde Community of Oregon | Marion, OR, Multnomah, OR, Polk, OR,
Tillamook, OR, Washington, OR, Yamhill, OR. |
| Confederated Tribes of the Umatilla Indian Reservation | Umatilla, OR, Union, OR. |
| Confederated Tribes of the Warm Springs Reservation of Oregon | Clackamas, OR, Jefferson, OR, Linn, OR, Marion, OR, Wasco, OR. |
| Coquille Indian Tribe | Coos, OR, Curry, OR, Douglas, OR, Jackson, OR, Lane, OR. |
| Coushatta Tribe of Louisiana | Allen Parish, LA, the city limits of Elton, LA. |
| Cow Creek Band of Umpqua Tribe of Indians | Coos, OR,
Deshutes, OR, Douglas, OR, Jackson, OR, Josephine, OR, Klamath, OR, Lane, OR. |
| Cowlitz Indian Tribe | Clark, WA, Cowlitz, WA, King, WA, Lewis, WA, Peirce, WA, Skamania, WA, Thurston, WA, Columbia, OR,
Kittitas, WA, Wahkiakum, WA. |
| Crow Creek Sioux Tribe of the Crow Creek Reservation, South Dakota | Brule, SD, Buffalo, SD, Hand, SD, Hughes, SD, Hyde, SD, Lyman, SD, Stanley, SD. |
| Crow Tribe of Montana | Big Horn, MT, Carbon, MT, Treasure, MT,
Yellowstone, MT, Big Horn, WY, Sheridan, WY. |
| Eastern Band of Cherokee Indians | Cherokee, NC, Graham, NC, Haywood, NC, Jackson, NC, Swain, NC. |
| Eastern Shoshone Tribe of the Wind River Reservation, Wyoming | Hot Springs, WY, Fremont, WY, Sublette, WY. |
| Flandreau Santee Sioux Tribe of South Dakota | Moody, SD. |
| Forest County Potawatomi Community, Wisconsin | Forest, WI, Marinette, WI, Oconto, WI. |
| Fort Belknap Indian Community of the Fort Belknap Reservation of Montana | Blaine, MT, Phillips, MT. |
| Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon | The entire State of Nevada, Malheur, OR. |
| Fort McDowell Yavapai Nation, Arizona | Maricopa, AZ. |
| Fort Mojave Indian Tribe of Arizona, California and Nevada | The entire State of Nevada, Mohave, AZ, San Bernardino, CA. |
| Gila River Indian Community of the Gila River Indian Reservation, Arizona | Maricopa, AZ, Pinal, AZ. |
| Grand Traverse Band of Ottawa and Chippewa Indians, Michigan | Antrim, MI,
Benzie, MI, Charlevoix, MI, Grand Traverse, MI, Leelanau, MI, Manistee, MI. |
| Hannahville Indian Community, Michigan | Delta, MI, Menominee, MI. |
| Haskell Indian Health Center | Douglas, KS. |
| Havasupai Tribe of the Havasupai | Coconino, AZ, Mojave, AZ. |
| Ho-Chunk Nation of Wisconsin | Adams, WI,
Clark, WI, Columbia, WI, Crawford, WI, Dane, WI, Eau Clarrie, WI, Houston, MN, Jackson, WI, Juneau, WI, La Crosse, WI, Marathon, WI, Monroe, WI, Sauk, WI, Shawano, WI, Vernon, WI, Wood, WI. |
| Hoh Indian Tribe | Jefferson, WA. |
| Hopi Tribe of Arizona | Apache, AZ, Coconino, AZ, Navajo, AZ. |
| Houlton Band of Maliseet Indians | Aroostook, ME. |
| Hualapai Indian Tribe of the Hualapai Indian Reservation, Arizona | Coconino, AZ, Mohave, AZ, Yavapai, AZ. |
| Iowa Tribe of Kansas and Nebraska | Brown, KS, Doniphan, KS, Richardson, NE. |
| Jamestown S'Klallam Tribe | Clallam, WA, Jefferson, WA. |
| Jena Band of Choctaw Indians | Grand Parish, LA,
LaSalle Parish, LA, Rapides, LA. |
| Jicarilla Apache Nation, New Mexico | Archuleta, CO, Rio Arriba, NM, Sandoval, NM. |
| Kaibab Band of Paiute Indians of the Kaibab Indian Reservation, Arizona | Coconino, AZ, Mohave, AZ, Kane, UT. |
| Kalispel Indian Community of the Kalispel Reservation | Pend Oreille, WA, Spokane, WA. |
| Kewa Pueblo, New Mexico (previously listed as the Pueblo of Santo Domingo) | Sandoval, NM, Santa Fe, NM. |
| Keweenaw Bay Indian Community, Michigan | Baraga, MI, Houghton, MI, Ontonagon, MI. |
| Kickapoo Traditional Tribe of Texas | Maverick, TX. |
| Kickapoo Tribe of Indians of the Kickapoo Reservation in Kansas | Brown, KS, Jackson, KS. |
| Klamath Tribes | Klamath, OR. |
| Koi Nation of Northern California (formerly known as Lower Lake Rancheria, California) | Lake, CA, Sonoma, CA. |
| Kootenai Tribe of Idaho | Boundary, ID. |
| Lac Courte Oreilles Band of Superior Chippewa Indians of Wisconsin | Sawyer, WI. |
| Lac du Flambeau Band of Lake Superior Chippewa Indians of the Lac du Flambeau Reservation of Wisconsin | Iron, WI, Oneida, WI, Vilas, WI. |
| Lac Vieux Desert Band of Lake Superior Chippewa Indians of Michigan | Gogebic, MI. |
| Little River Band of Ottawa Indians, Michigan | Kent, MI,
Muskegon, MI, Newaygo, MI, Oceana, MI, Ottawa, MI, Manistee, MI, Mason, MI, Wexford, MI, Lake, MI. |
| Little Traverse Bay Bands of Odawa Indians, Michigan | Alcona, MI,
Alger, MI, Alpena, MI, Antrim, MI, Benzie, MI, Charlevoix, MI, Cheboygan, MI, Chippewa, MI, Crawford, MI, Delta, MI, Emmet, MI, Grand Traverse, MI, Iosco, MI, Kalkaska, MI, Leelanau, MI, Luce, MI, Mackinac, MI, Manistee, MI, Missaukee, MI, Montmorency, MI, Ogemaw, MI, Oscoda, MI, Otsego, MI, Presque Isle, MI, Schoolcraft, MI, Roscommon, MI, Wexford, MI. |
| Lower Brule Sioux Tribe of the Lower Brule Reservation, South Dakota | Brule, SD, Buffalo, SD, Hughes, SD, Lyman, SD, Stanley, SD. |
| Lower Elwha Tribal Community | Clallam, WA. |
| Lower Sioux Indian Community in the State of Minnesota | Redwood, MN, Renville, MN. |
| Lummi Tribe of the Lummi Reservation | Whatcom, WA. |
| Makah Indian Tribe of the Makah Indian Reservation | Clallam, WA. |
| Mashantucket Pequot Indian Tribe | New London, CT. |
| Mashpee Wampanoag Tribe | Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA. |
| Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan | Allegan, MI,
Barry, MI, Kalamazoo, MI, Kent, MI, Ottawa, MI. |
| Menominee Indian Tribe of Wisconsin | Langlade, WI, Menominee, WI, Oconto, WI, Shawano, WI. |
| Mescalero Apache Tribe of the Mescalero Reservation, New Mexico | Chaves, NM, Lincoln, NM, Otero, NM. |
| Miccosukee Tribe of Indians | Broward, FL, Collier, FL, Miami-Dade, FL, Hendry, FL. |
| Minnesota Chippewa Tribe, Minnesota, Bois Forte Band (Nett Lake) | Itasca, MN, Koochiching, MN, St. Louis, MN. |
| Minnesota Chippewa Tribe, Minnesota, Fond du Lac Band | Carlton, MN, St. Louis, MN. |
| Minnesota Chippewa Tribe, Minnesota, Grand Portage Band | Cook, MN. |
| Minnesota Chippewa Tribe, Minnesota, Leech Lake Band | Beltrami, MN, Cass, MN, Hubbard, MN, Itasca, MN. |
| Minnesota Chippewa Tribe, Minnesota, Mille Lacs Band | Aitkin, MN, Kanebec, MN, Mille Lacs, MN, Pine, MN. |
| Minnesota Chippewa Tribe, Minnesota, White Earth Band | Becker, MN, Clearwater, MN, Mahnomen, MN, Norman, MN, Polk, MN. |
| Mississippi Band of Choctaw Indians | Attala, MS, Jasper, MS,
Jones, MS, Kemper, MS, Leake, MS, Neshoba, MS, Newton, MS, Noxubee, MS,
Scott, MS,
Winston, MS. |
| Mohegan Tribe of Indians of Connecticut | Fairfield, CT, Hartford, CT, Litchfield, CT, Middlesex, CT, New Haven, CT, New London, CT, Tolland, CT, Windham, CT. |
| Muckleshoot Indian Tribe | King, WA, Pierce, WA. |
| Narragansett Indian Tribe | Washington, RI. |
| Navajo Nation, Arizona, New Mexico, & Utah | Apache, AZ, Bernalillo, NM, Cibola, NM, Coconino, AZ, Kane, UT, McKinley, NM, Montezuma, CO, Navajo, AZ, Rio Arriba, NM, Sandoval, NM, San Juan, NM, San Juan, UT, Socorro, NM, Valencia, NM. |
| Nevada | Entire State. |
| Nez Perce Tribe | Clearwater, ID, Idaho, ID, Latah, ID, Lewis, ID, Nez Perce, ID. |
| Nisqually Indian Tribe | Pierce, WA, Thurston, WA. |
| Nooksack Indian Tribe | Whatcom, WA. |
| Northern Cheyenne Tribe of the Northern Cheyenne Indian Reservation, Montana | Big Horn, MT, Carter, MT,
Rosebud, MT. |
| Northwestern Band of Shoshone Nation | Box Elder, UT. |
| Nottawaseppi Huron Band of the Pottawatomi, Michigan | Allegan, MI,
Barry, MI, Branch, MI, Calhoun, MI, Kalamazoo, MI, Kent, MI, Ottawa, MI. |
| Oglala Sioux Tribe | Bennett, SD, Cherry, NE, Custer, SD, Dawes, NE, Fall River, SD, Jackson, SD,
Mellette, SD, Pennington, SD, Shannon, SD, Sheridan, NE, Todd, SD. |
| Ohkay Owingeh, New Mexico | Rio Arriba, NM. |
| Oklahoma | Entire State. |
| Omaha Tribe of Nebraska | Burt, NE, Cuming, NE, Monona, IA, Thurston, NE, Wayne, NE. |
| Oneida Nation (previously listed as the Oneida Tribe of Indians of Wisconsin) | Brown, WI, Outagamie, WI. |
| Oneida Nation Indian Nation (previously listed as the Oneida Nation of New York) | Chenango, NY, Cortland, NY, Herkimer, NY, Madison, NY, Oneida, NY, Onondaga, NY. |
| Onondaga Nation | Onondaga, NY. |
| Paiute Indian Tribe of Utah | Iron, UT,
Millard, UT, Sevier, UT, Washington, UT. |
| Pamunkey Indian Tribe | Caroline, VA, Hanover, VA, Henrico, VA, King William, VA, King and Queen, VA, New Kent, VA, Richmond (Independent City). |
| Pascua Yaqui Tribe of Arizona | Pima, AZ. |
| Passamaquoddy Tribe | Aroostook, ME,
Hancock, ME,
Washington, ME. |
| Penobscot Nation | Aroostook, ME,
Penobscot, ME. |
| Poarch Band of Creeks | Baldwin, AL,
Elmore, AL, Escambia, AL, Mobile, AL, Monroe, AL, Escambia, FL. |
| Pokagon Band of Pottawatomi Indians, Michigan and Indiana | Allegan, MI,
Berrien, MI, Cass, MI, Elkhart, IN, Kosciusko, IN, La Porte, IN, Marshall, IN, St. Joseph, IN, Starke, IN, Van Buren, MI. |
| Ponca Tribe of Nebraska | Boyd, NE,
Burt, NE, Charles Mix, SD, Douglas, NE, Hall, NE, Holt, NE, Knox, NE, Lancaster, NE, Madison, NE, Platte, NE, Pottawatomie, IA, Sarpy, NE, Stanton, NE, Wayne, NE, Woodbury, IA. |
| Port Gamble S'Klallam Tribe | Kitsap, WA. |
| Prairie Band of Pottawatomi Nation | Jackson, KS. |
| Prairie Island Indian Community in the State of Minnesota | Goodhue, MN. |
| Pueblo of Acoma, New Mexico | Cibola, NM. |
| Pueblo of Cochiti, New Mexico | Sandoval, NM, Santa Fe, NM. |
| Pueblo of Isleta, New Mexico | Bernalillo, NM, Torrance, NM, Valencia, NM. |
| Pueblo of Jemez, New Mexico | Sandoval, NM. |
| Pueblo of Laguna, New Mexico | Bernalillo, NM, Cibola, NM, Sandoval, NM, Valencia, NM. |
| Pueblo of Nambe, New Mexico | Santa Fe, NM. |
| Pueblo of Picuris, New Mexico | Taos, NM. |
| Pueblo of Pojoaque, New Mexico | Rio Arriba, NM, Santa Fe, NM. |
| Pueblo of San Felipe, New Mexico | Sandoval, NM. |
| Pueblo of San Ildefonso, New Mexico | Los Alamos, NM, Rio Arriba, NM, Sandoval, NM, Santa Fe, NM. |
| Pueblo of Sandia, New Mexico | Bernalillo, NM, Sandoval, NM. |
| Pueblo of Santa Ana, New Mexico | Sandoval, NM. |
| Pueblo of Santa Clara, New Mexico | Los Alamos, NM, Sandoval, NM, Santa Fe, NM. |
| Pueblo of Taos, New Mexico | Colfax, NM, Taos, NM. |
| Pueblo of Tesuque, Mexico | Sana Fe, NM. |
| Pueblo of Zia, New Mexico | Sandoval, NM. |
| Puyallup Tribe of the Puyallup Reservation | King, WA, Pierce, WA, Thurston, WA. |
| Quechan Tribe of the Fort Yuma Indian Reservation, Arizona and California | Yuma, AZ, Imperial, CA. |
| Quileute Tribe of the Quileute Reservation | Clallam, WA, Jefferson, WA. |
| Quinault Indian Nation | Grays Harbor, WA, Jefferson, WA. |
| Rapid City, South Dakota | Pennington, SD. |
| Red Cliff Band of Lake Superior Chippewa Indians of Wisconsin | Bayfield, WI. |
| Red Lake Band of Chippewa Indians, Minnesota | Beltrami, MN, Clearwater, MN, Koochiching, MN, Lake of the Woods, MN, Marshall, MN, Pennington, MN, Polk, MN, Roseau, MN. |
| Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota | Bennett, SD, Cherry, NE, Gregory, SD, Lyman, SD, Mellette, SD, Todd, SD, Tripp, SD. |
| Sac & Fox Nation of Missouri in Kansas and Nebraska | Brown, KS, Richardson, NE. |
| Sac & Fox Tribe of the Mississippi in Iowa | Tama, IA. |
| Saginaw Chippewa Indian Tribe of Michigan | Arenac, MI,
Clare, MI, Isabella, MI, Midland, MI, Missaukee, MI. |
| Saint Regis Mohawk Tribe | Franklin, NY, St. Lawrence, NY. |
| Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona | Maricopa, AZ. |
| Samish Indian Nation | Clallam, WA,
Island, WA, Jefferson, WA, King, WA, Kitsap, WA, Pierce, WA, San Juan, WA, Skagit, WA, Snohomish, WA, Whatcom, WA. |
| San Carlos Apache Tribe of the San Carlos Reservation, Arizona | Apache, AZ, Cochise, AZ, Gila, AZ, Graham, AZ, Greenlee, AZ, Pinal, AZ. |
| San Juan Southern Paiute Tribe of Arizona | Coconino, AZ, San Juan, UT. |
| Santee Sioux Nation, Nebraska | Bon Homme, SD, Knox, NE. |
| Sauk-Suiattle Indian Tribe | Snohomish, WA, Skagit, WA. |
| Sault Ste. Marie Tribe of Chippewa Indians, Michigan | Alger, MI,
Chippewa, MI, Delta, MI, Luce, MI, Mackinac, MI, Marquette, MI, Schoolcraft, MI. |
| Seminole Tribe of Florida | Broward, FL, Collier, FL, Miami-Dade, FL, Glades, FL, Hendry, FL. |
| Seneca Nation of Indians | Alleghany, NY, Cattaraugus, NY, Chautauqua, NY, Erie, NY, Warren, PA. |
| Shakopee Mdewakanton Sioux Community of Minnesota | Scott, MN. |
| Shinnecock Indian Nation | Nassau, NY,
Suffolk, NY. |
| Shoalwater Bay Tribe of the Shoalwater Bay Indian Reservation | Pacific, WA. |
| Shoshone-Bannock Tribes of the Fort Hall Reservation | Bannock, ID, Bingham, ID, Caribou, ID, Lemhi, ID,
Power, ID. |
| Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada | The entire SNevada, Owyhee, ID. |
| Sisseton-Wahpeton Oyate of the Lake Traverse Reservation, South Dakota | Codington, SD, Day, SD, Grant, SD, Marshall, SD, Richland, ND, Roberts, SD, Sargent, ND, Traverse, MN. |
| Skokomish Indian Tribe | Mason, WA. |
| Skull Valley Band of Goshute Indians of Utah | Tooele, UT. |
| Snoqualmie Indian Tribe | King, WA,
Snohomish, WA, Pierce, WA, Island, WA, Mason, WA. |
| Sokaogon Chippewa Community, Wisconsin | Forest, WI. |
| Southern Ute Indian Tribe of the Southern Ute Reservation, Colorado | Archuleta, CO, La Plata, CO, Montezuma, CO, Rio Arriba, NM, San Juan, NM. |
| Spirit Lake Tribe, North Dakota | Benson, ND, Eddy, ND, Nelson, ND, Ramsey, ND. |
| Spokane Tribe of the Spokane Reservation | Ferry, WA, Lincoln, WA, Stevens, WA. |
| Squaxin Island Tribe of the Squaxin Island Reservation | Mason, WA. |
| St. Croix Chippewa Indians of Wisconsin | Barron, WI, Burnett, WI, Pine, MN, Polk, WI, Washburn, WI. |
| Standing Rock Sioux Tribe of North & South Dakota | Adams, ND, Campbell, SD, Corson, SD, Dewey, SD, Emmons, ND, Grant, ND, Morton, ND, Perkins, SD, Sioux, ND, Walworth, SD, Ziebach, SD. |
| Stillaguamish Tribe of Indians of Washington | Snohomish, WA. |
| Stockbridge Munsee Community, Wisconsin | Menominee, WI, Shawano, WI. |
| Suquamish Indian Tribe of the Port Madison Reservation | Kitsap, WA. |
| Swinomish Indian Tribal Community | Skagit, WA. |
| Tejon Indian Tribe | Kern, CA. |
| Three Affiliated Tribes of the Fort Berthold Reservation, North Dakota | Dunn, ND, Mercer, ND, McKenzie, ND, McLean, ND, Mountrail, ND, Ward, ND. |
| Tohono O'odham Nation of Arizona | Maricopa, AZ, Pima, AZ, Pinal, AZ. |
| Tolowa Dee-ni' Nation (formerly known as Smith River Rancheria of California) | California, Curry, OR. |
| Tonawanda Band of Seneca | Genesee, NY, Erie, NY, Niagara, NY. |
| Tonto Apache Tribe of Arizona | Gila, AZ. |
| Trenton Service Unit, North Dakota and Montana | Divide, ND,
McKenzie, ND, Williams, ND, Richland, MT, Roosevelt, MT, Sheridan, MT. |
| Tulalip Tribes of Washington | Snohomish, WA. |
| Tunica-Biloxi Indian Tribe | Avoyelles, LA, Rapides, LA. |
| Turtle Mountain Band of Chippewa Indians of North Dakota | Rolette, ND. |
| Tuscarora Nation | Niagara, NY. |
| Upper Sioux Community, Minnesota | Chippewa, MN, Yellow Medicine, MN. |
| Upper Skagit Indian Tribe | Skagit, WA. |
| Ute Indian Tribe of the Uintah & Ouray Reservation, Utah | Carbon, UT, Daggett, UT, Duchesne, UT, Emery, UT, Grand, UT, Rio Blanco, CO, Summit, UT, Uintah, UT, Utah, UT, Wasatch, UT. |
| Ute Mountain Ute Tribe | Apache, AZ, La Plata, CO, Montezuma, CO, San Juan, NM, San Juan, UT. |
| Wampanoag Tribe of Gay Head (Aquinnah) | Dukes, MA,
Barnstable, MA, Bristol, MA, Norfolk, MA, Plymouth, MA, Suffolk, MA. |
| Washoe Tribe of Nevada & California | Nevada, California except for the counties listed in footnote. |
| White Mountain Apache Tribe of the Fort Apache Reservation, Arizona | Apache, AZ, Coconino, AZ, Gila, AZ, Graham, AZ, Greenlee, AZ, Navajo, AZ. |
| Wilton Rancheria, California | Sacramento, CA. |
| Winnebago Tribe of Nebraska | Dakota, NE, Dixon, NE, Monona, IA, Thurston, NE, Wayne, NE, Woodbury, IA. |
| Yankton Sioux Tribe of South Dakota | Bon Homme, SD, Boyd, NE, Charles Mix, SD, Douglas, SD, Gregory, SD, Hutchinson, SD, Knox, NE. |
| Yavapai-Apache Nation of the Camp Verde Indian Reservation, Arizona | Yavapai, AZ. |
| Yavapai-Prescott Indian Tribe | Yavapai, AZ. |
| Ysleta Del Sur Pueblo of Texas | El Paso, TX. |
| Zuni Tribe of the Zuni Reservation, New Mexico | Apache, AZ, Cibola, NM, McKinley, NM, Valencia, NM. |
Michael D. Weahkee,
RADM, Assistant Surgeon General, U.S. Public Health Service, Principal Deputy Director, Indian Health Service.