Overview
Title
Notice of Proposed Purchased/Referred Care Delivery Area Redesignation for the Shoshone-Bannock Tribes
Agencies
ELI5 AI
The Indian Health Service wants to change some lines on a map so more members of the Shoshone-Bannock Tribes in Idaho can receive special doctors' services. They are asking people to share their thoughts about this idea before January 15, 2025.
Summary AI
The Indian Health Service (IHS) has issued a notice proposing to expand the Purchased/Referred Care Delivery Area (PRCDA) for the Shoshone-Bannock Tribes in Idaho. The expansion would include additional counties, allowing approximately 323 more Tribal members to receive care services. The expansion aligns with criteria such as social and economic ties to the Tribe and geographic proximity to the existing PRCDA. Public comments on this proposal are being accepted until January 15, 2025.
Abstract
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 the Shoshone-Bannock Tribes of the Fort Hall Indian Reservation in Idaho to include the Idaho counties of Ada, Bear Lake, Blaine, Bonneville, Butte, Canyon, Cassia, Custer, Elmore, Franklin, Fremont, Gem, Gooding, Jefferson, Jerome, Madison, Minidoka, Oneida, Payette, Teton, Twin Falls, and Washington. The current PRCDA for the Shoshone-Bannock Tribes includes the Idaho counties of Bannock, Bingham, Caribou, Lemhi, and Power. Shoshone- Bannock 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 Shoshone-Bannock Tribal members and beneficiaries to receive PRC services.
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Sources
AnalysisAI
The document outlines a proposal by the Indian Health Service (IHS) to expand the Purchase/Referred Care Delivery Area (PRCDA) for the Shoshone-Bannock Tribes residing on the Fort Hall Indian Reservation in Idaho. This expansion seeks to extend the geographic boundaries to include additional counties within Idaho, thereby enabling an estimated 323 additional Tribal members to access care services. Presently, members residing outside the current PRCDA can receive direct care services but are excluded from the Purchased/Referred Care services, which provide for necessary services that aren't available within local facilities.
Overview and Purpose
The main goal of the proposed expansion is to authorize more Tribal members and beneficiaries to access these extended services, based on their geographic location relative to the expanded PRCDA. The initiative is framed within existing regulations, ensuring that the plan respects established criteria and adheres to necessary procedural standards.
Significant Issues and Concerns
One pressing concern is the lack of detailed financial information regarding the estimated cost or budget implications of this expansion. Understanding the financial aspect is crucial for stakeholders, as it can help gauge potential impacts, including concerns about efficient spending.
The document frequently references specific legal and regulatory criteria under 42 CFR part 136 and the Administrative Procedure Act. These references might not be easily grasped by the general public, who may struggle to comprehend these legal nuances without further simplification or explanation.
Additionally, the assumption that there are social and economic ties between the Tribal members in the proposed extension area and the Shoshone-Bannock Tribes raises questions. The criteria or evidence used to support these ties are not clearly detailed, which could lead to concerns about bias or the subjective nature of these determinations.
Public Impact
The expansion could significantly impact Tribal members by improving access to essential health services currently unavailable within their residing counties. This change might also positively affect health outcomes by reducing the distance members must travel to receive care.
For the public at large, the document signals an increased commitment to addressing healthcare accessibility in Native American communities, showcasing a broader intent to bridge healthcare gaps that marginalized groups face.
Impact on Specific Stakeholders
For the Shoshone-Bannock Tribes, the proposal may strengthen community ties and foster a sense of inclusion among members who currently live outside the designated areas yet maintain connections with the Tribe. The logistical ability to access nearby medical facilities for services not currently available thereby supports health and well-being.
However, the document's requirement for comments to be submitted via mail or electronically could limit participation. Some stakeholders may lack internet access or face resource constraints, potentially excluding valuable feedback from affected communities. This could challenge the inclusivity and comprehensiveness of the comment-gathering process.
Moreover, the document does not specify if there will be follow-up metrics or evaluation methods to measure the long-term effectiveness or impact of the PRCDA expansion. Having such assessments in place could help ensure the program's success and demonstrate accountability in its execution.
In conclusion, while the proposed expansion reflects a positive stride toward enhancing healthcare access for the Shoshone-Bannock Tribes, several areas within the proposal warrant further clarity and consideration, particularly concerning financial transparency, stakeholder inclusivity, and ongoing evaluation of the initiative's impact.
Issues
• The document does not provide detailed information about the estimated cost or budget allocation required for the expansion of the PRCDA, raising concerns about potential financial implications and wasteful spending without prior assessment.
• The document references the criteria and regulations at 42 CFR part 136, subparts A-C, and the Administrative Procedure Act (5 U.S.C. 553) which may not be easily understandable to the general public due to legal and regulatory references without explanation or simplification.
• The document assumes social and economic affiliation of Tribal members with the Shoshone-Bannock Tribes without providing detailed criteria or evidence for this assumption, which could raise concerns about the subjectivity or bias in the determination.
• The requirement of comments to be submitted by mail or electronically might limit participation due to resource limitations or lack of internet access for some stakeholders, potentially lacking inclusivity in the feedback process.
• The document does not outline if there will be any metrics or evaluation methods in place to assess the impact of the PRCDA expansion, which could be a concern for accountability and continuous improvement of the program.