Notice of Proposed Purchased/Referred Care Delivery Area Redesignation for Ysleta Del Sur Pueblo

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

Notice of Proposed Purchased/Referred Care Delivery Area Redesignation for Ysleta Del Sur Pueblo

AGENCY:

Indian Health Service, Department of Health and Human Services

ACTION:

Notice.

SUMMARY:

This notice advises the public that the Indian Health Service (IHS) proposes to expand the geographic boundaries of the Purchased/Referred Care Delivery Area (PRCDA) for Ysleta Del Sur Pueblo (“YDSP” or “Tribe”) to include the Dona Ana County of New Mexico. The current PRCDA for YDSP includes the Texas counties of El Paso and Hudspeth. While recent PRCDA listings have not included Hudspeth County, this was a clerical error and unintentional omission that the IHS has corrected.

YDSP Tribal members who reside outside of the PRCDA are eligible for direct care services; however, they are not eligible for Purchased/Referred Care (PRC) services. The sole purpose of this expansion would be to authorize additional YDSP Tribal members and beneficiaries to receive PRC services.

DATES:

Comments must be submitted by July 31, 2026.

ADDRESSES:

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 electronic comments on this regulation to

http://www.regulations.gov.

Follow the “Submit a Comment” instructions.

2.

By regular mail.

You may mail written comments to the following address ONLY:

Carl Mitchell, Director, Division of Regulatory and Policy Coordination, Indian Health Service, 5600 Fishers Lane, Mail Stop: 06SWH03, 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 address above.

If you intend to deliver your comments to the Rockville address, please call the telephone number (301) 651-0489 in advance to schedule your arrival with a staff member.

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.

FOR FURTHER INFORMATION CONTACT:

CDR Tracy Sanchez, Acting Director, Office of Resource Access and Partnerships, Indian Health Service, 5600 Fishers Lane, Mail Stop 06SEH03, Rockville, Maryland 20857. Telephone (301) 443-0969 (This is not a toll-free number).

Background:

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 services 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 Tribal 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 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 is publishing this Notice and requesting public comments.

YDSP is in El Paso, Texas. YDSP operates their PRC program under an Indian Self-Determination and Education Assistance Act agreement with the IHS. The YDSP has requested that the IHS expand its PRCDA to include Dona Ana County, New Mexico. 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, applying the aforementioned PRCDA redesignation criteria required by operative regulations codified at 42 CFR part 136, subpart C, the following findings are made:

1. By expanding the PRCDA to include Dona Ana County, New Mexico, the IHS and YDSP estimate that the Tribe's PRC eligible population would increase by an estimated 500 Tribal members.

2. As part of their expansion request, YDSP submitted a resolution from the Tribe's governing body. The resolution explains that the expansion is intended to serve their Tribal members living in Dona Ana County, New Mexico, and it describes those Tribal members as being socially and economically tied to the Tribe's reservation. The resolution also states that YDSP intends to include other eligible American Indians and Alaska Natives who maintain close economic and social ties with the Tribe, consistent with 42 CFR 136.23(a)(2)(ii).

3. The requested expansion would form a contiguous area with the existing PRCDA. Tribal members of YDSP reside in the county proposed for inclusion in the expanded PRCDA. Through their expansion request, the Tribe described how close Dona Ana County, New Mexico is to their reservation and health clinic, approximately 45 miles. The Tribe explained that it is close enough for their Tribal members residing in Dona Ana County to utilize the YDSP Health Clinic as their primary site of care. For these reasons, the IHS has determined the additional county proposed for inclusion herein to be geographically proximate, meaning “on or near,” to the Tribe's reservation.

4. Through YDSP's request to expand its PRCDA, the Tribe 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 from the IHS or reduction of the current medical priority level.

Accordingly, the IHS proposes to expand the PRCDA of YDSP to include the county of Dona Ana in the state of New Mexico.

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 1995.

Clayton W. Fulton,

Chief of Staff, Delegated Authority of the IHS Director. Indian Health Service.

[FR Doc. 2026-13288 Filed 6-30-26; 8:45 am]

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