# Notice of Purchased/Referred Care Delivery Area Designations for the Chickahominy Indian Tribe, the Chickahominy Indian Tribe—Eastern Division, the Upper Mattaponi Tribe, the Rappahannock Tribe, Inc., the Monacan Indian Nation, and the Nansemond Indian Tribe
**AGENCY:**
Indian Health Service, HHS.
**ACTION:**
Notice.
**SUMMARY:**
Notice is hereby given that the Indian Health Service (IHS) is establishing the geographic boundaries of the Purchased/Referred Care Delivery Area (PRCDA) (formerly Contract Health Service Delivery Area or CHSDA) for six newly recognized Tribes: The Chickahominy Indian Tribe, the Chickahominy Indian Tribe—Eastern Division, the Upper Mattaponi Tribe, the Rappahannock Tribe, Inc., the Monacan Indian Nation, and the Nansemond Indian Tribe.
**DATES:**
This notice is effective as of February 21, 2020.
**ADDRESSES:**
This notice can be found at *https://www.federalregister.gov.* Written requests for information or comments submitted by postal mail or delivery should be addressed to: CDR John Rael, Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mail Stop: 10E85C, Rockville, MD 20857, (301) 443-0609 (This is not a toll-free number).
**SUPPLEMENTARY INFORMATION:**
The IHS currently provides services under regulations in effect on September 15, 1987, and republished in the Code of Federal Regulations (CFR) at 42 CFR part 136, subparts A-C. When Tribes are recognized under Federal law, either Congress legislatively designates counties to serve as PRCDAs, or the Director, IHS, exercises reasonable administrative discretion to designate PRCDAs to effectuate the intent of Congress for these Tribes. The Director, IHS, publishes a notice in the *Federal Register* (FR) when there are revisions or updates to the list of PRCDAs, including the designation of PRCDAs for newly recognized Tribes.
At 42 CFR part 136 subpart C, a PRCDA is defined as the geographic area within which Purchased/Referred Care (PRC) will be made available by the IHS to members of an identified Indian community who reside in the area. The 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 which have a common boundary with the reservation (42 CFR 136.22(a)(6)). 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 or 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.
Under the Thomasina E. Jordan Indian Tribes of Virginia Federal Recognition Act of 2017 (Recognition Act), Public Law 115-121, the Chickahominy Indian Tribe, the Chickahominy Indian Tribe—Eastern Division, the Upper Mattaponi Tribe, the Rappahannock Tribe, Inc., the Monacan Indian Nation, and the Nansemond Indian Tribe were officially recognized as Indian Tribes within the meaning of Federal law. The Recognition Act sets forth service areas for each of the six newly recognized Tribes, for the purpose of the delivery of Federal services to Tribal members. Four of these six service areas include specific references to counties and independent cities in the state of Virginia. IHS is establishing four PRCDAs in this notice based upon those specific references. The remaining two service areas enumerated by Congress in the Recognition Act do not specify either counties or independent cities. Instead, Congress has indicated a mileage radius for those two service areas. Since IHS establishes PRCDAs for the administration of PRC by county, IHS has interpreted this language to mean all counties within or intersected by the radius specified by Congress in the Recognition Act, as well as the independent cities within the contiguous area formed by those counties.
The purpose of this FR notice is to notify the public of the establishment of the six newly recognized Tribes' PRCDAs, consistent with the Congressional intent expressed in the Recognition Act. The Tribes' PRCDAs are designated as follows:
*Chickahominy Indian Tribe* —New Kent County, James City County, Charles City County, and Henrico County, Virginia.
*Chickahominy Indian Tribe—Eastern Division* —New Kent County, James City County, Charles City County, and Henrico County, Virginia.
*Upper Mattaponi Tribe* —Richmond County, Middlesex County, Essex County, King and Queen County, King William County, New Kent County, Hanover County, Caroline County, Henrico County, Charles City County, James City County, and the independent city of Richmond, Virginia.
*Rappahannock Tribe, Inc.* —King and Queen County, Caroline County, Essex County, and King William County, Virginia.
*Monacan Indian Nation* —Amherst County, Nelson County, Albemarle County, Buckingham County, Appomattox County, Campbell County, Bedford County, Botetourt County, Rockbridge County, Augusta County, and the independent cities of Lynchburg, Lexington, Buena Vista, Staunton, Waynesboro, and Charlottesville, Virginia.
*Nansemond Indian Tribe* —The independent cities of Chesapeake, Hampton, Newport News, Norfolk, Portsmouth, Suffolk, and Virginia Beach, Virginia.
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 maintain close economic and social ties with the Tribe. In this case, the Tribes estimated the eligible user populations to be as follows: 654 enrolled Chickahominy members; 59 enrolled Chickahominy Eastern Division members; 202 enrolled Upper Mattaponi members; 202 enrolled Rappahannock members; 881 enrolled Monacan members; 95 enrolled Nansemond members. The financial resources required to meet the immediate needs of the Tribal members residing in the PRCDAs were determined by the IHS, through consultation with the individual Tribes, and will be placed in the Nashville Area PRC budget.
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.
| 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. |
| Chickahominy Indian Tribe | New Kent, VA, James City, VA, Charles City, VA, Henrico, VA. |
| Chickahominy Indian Tribe—Eastern Division | New Kent, VA, James City, VA, Charles City, VA, Henrico, VA. |
| 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, MT, Sanders, MT. |
| 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 Reservation, Arizona | Coconino, 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. |
| Monacan Indian Nation. | Amherst, VA, Nelson, VA, Albemarle, VA, Buckingham, VA, Appomattox, VA, Campbell, VA, Bedford, VA, Botetourt, VA, Rockbridge, VA, Augusta, VA, and the independent cities of Lynchburg, VA, Lexington, VA, Buena Vista, VA, Staunton, VA, Waynesboro, VA, and Charlottesville, VA. |
| Muckleshoot Indian Tribe | King, WA, Pierce, WA. |
| Nansemond Indian Tribe | The independent cities of Chesapeake, VA, Hampton, VA, Newport News, VA, Norfolk, VA, Portsmouth, VA, Suffolk, VA, and Virginia Beach, VA. |
| 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 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, and the independent city of Richmond, VA. |
| 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. |
| Rappahannock Tribe, Inc. | King and Queen County, VA, Caroline County, VA, Essex County, VA, King William County, VA. |
| 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 state of Nevada, 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 Mattaponi Tribe | Caroline, VA, Charles City, VA, Essex, VA, Hanover, VA, Henrico, VA, James City, VA, King and Queen, VA, King William, VA, Middlesex, VA, New Kent, VA, Richmond, VA and the independent city of Richmond, VA. |
| 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. |
Chris Buchanan,
RADM, Assistant Surgeon General, Deputy Director, Indian Health Service.