Privacy Act; systems of records,

[Federal Register: March 31, 2006 (Volume 71, Number 62)]

[Notices]

[Page 16320-16324]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr31mr06-79]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

Privacy Act of 1974; Report of Modified or Altered System-- Medical Staff Credentials and Privileges Records

AGENCY: Indian Health Service (IHS).

ACTION: Notice of proposed modification or alteration to a System or Records (SOR).

SUMMARY: In accordance with the requirements of the Privacy Act of 1974, the Indian Health Service (IHS) is proposing to modify or alter an SOR, ``Medical Staff Credentials and Privileges Records,'' System No. 09-17-0003. We propose to modify the SOR to reflect current program changes, technology changes, statutory and implementation changes. Under the system name, we propose to change to the current program office name. We are proposing to update the categories of individuals covered by the system with minor edits to the Active, Temporary and Courtesy or Associate. We are proposing to update the Authority for maintenance by including the Federal Records Act and the Privacy Act. We are proposing to update the Purposes to reflect the new program title of the National Practitioner Data Bank to include the Healthcare Integrity and Protection Data Bank and the inclusion of authorizing statute. We are proposing to update the Routine Uses to reflect the new program title of the National Practitioner Data Bank to include the Healthcare Integrity and Protection Data Bank and the inclusion of authorizing statute for routine use numbers 2 and 3. We will also take the opportunity to update any sections of the system notice to provide clarity on the changing environment to include for digital records and the initiative of transitioning from a paper-based record to a computerized-based or electronic medical record.

DATES: The Report of Intent to Amend a System of Records Notice and an advance copy of the system notice have been sent to the Chair of the House Committee on Government Reform and Oversight, the Chair of the Senate Committee on Governmental Affairs, and the Administrator, Office of Information and Regulatory Affairs, Office of Management and Budget (OMB). To ensure that all parties have adequate time in which to comment, the modified system of records, including routine uses, will become effective 40 days from the publication of the notice, or from the date it was submitted to OMB and the Congress, whichever is later, unless IHS receives comments that require alterations to this notice.

ADDRESSES: The public should address comments to: Mr. William Tibbitts, IHS Privacy Act Officer, Division of Regulatory, Records Access and Policy Liaison, 801 Thompson Avenue, TMP Suite 450, Rockville, MD 20852-1627; call non-toll free (301) 443-1116; send via facsimile to (301) 443-2316, or send your email requests, comments, and return address to: wtibbitt@hqe.ihs.gov.

FOR FURTHER INFORMATION CONTACT: Stephen Heath, IHS Risk Management Consultant, Headquarters East (HQE) Office of Clinical and Preventative Services, 801 Vassar Drive, NE., Albuquerque, New Mexico 87106, Telephone (505) 248-4047.

SUPPLEMENTARY INFORMATION: A. Major Modification of 09-17-0003, is to reflect the statutory change in routine use numbers 2 and 3 of the National Practitioner Data Bank and the Healthcare and Integrity Protection Data Bank.

In addition to updating and making editorial corrections to improve the clarify of the system notice, this alteration requires the updating of the system manager listing, and revisions of the Categories of Records, Purposes, Authority, Safeguard, Retention and Disposal, Notification and Access Procedures sections.

Dated: March 23, 2006. Charles W. Grim, Assistant Surgeon General, Director, Indian Health Service, Department of Health and Human Services. 09-17-0003

System name:

Indian Health Service Medical Staff Credentials and Privileges Records, HHS/IHS/OCPS.

Security classification:

None.

System location:

Each Indian Health Service (IHS) Area Office and each IHS Service Unit (Appendix 1). Records may also be located at hospitals and offices of health care providers who are under contract with IHS. A current list of contractor sites is available by writing to the appropriate System Manager (Area or Service Unit Director) at the address shown in Appendix I.

Categories of individuals covered by the system:

Prospective, current and former IHS medical staff members. The term IHS medical staff includes fully licensed individuals permitted by law to provide patient care services independently and without concurrent professional direction or supervision, within the scope of his/her license and in accordance with individually granted clinical privileges. The IHS medical staff includes physicians (M.D. and D.O.) and dentists and may include other health care practitioners such as psychologists, optometrists, podiatrists, audiologists, and, in some states, certified nurse midwives. Types of assignment categories of current and former IHS medical staff members include the following:

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Provisional--Those new members of the medical staff who are serving a required initial probationary period, as specified in the local medical staff bylaws. During this time, their qualifications for membership on the active or courtesy IHS medical staff are assessed.

Active--Those members who are Federal employees and/or spend at least fifty percent of their professional time providing patient care related services in the facility.

Temporary--Those members who provide services on a short-term basis or have applied for active medical staff membership and are awaiting a full credential review.

Courtesy or Associate--Those members who generally provide services on a periodic or episodic basis (e.g., consultants for specialty clinics).

Categories of records in the system:

Contains name, Social Security number, IHS medical staff membership and privileges applications and associated forms, employment data, liability insurance coverage, credentialing history of licensed health professionals, personal, educational, and demographic background information, professional performance information consisting of continuing education, performance awards, and adverse or disciplinary actions, and evaluations and approvals completed by IHS medical staff reviewers.

Authority for maintenance of the system:

Federal Records Act (44 U.S.C. 2901), Privacy Act of 1974, as amended (5 U.S.C. 552a), Indian Self Determination and Education and Assistance Act (25 U.S.C. 450), Snyder Act (25 U.S.C. 13), Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.), Indian Health Service Transfer Act ((42 U.S.C. 2001-2004).

Purpose(s):

The purposes of this system are:

1. To ensure that IHS medical staff members are qualified, competent and capable of delivering quality health services consistent with those of the medical community at large and that they are granted privileges commensurate with their training and competence and with the ability of the facility to provide adequate support equipment, services, and staff.

2. To inform health care practitioner(s) and staff of health care facilities, state or county health professional societies or licensing boards to whom the subject individual may apply for clinical privileges, membership or licensure, of the subject individual's professional competence, character and ethical qualifications. This may include information regarding drug or alcohol abuse or dependency. Within the Department such releases may be made to personnel staffs of DHHS Regional Offices.

3. To provide adverse health care practice information to the National Practitioner Data Bank-Healthcare Integrity and Protection Data Bank (NPDB-HIPDB) established under Title IV of Public Law 99-660, the Health Care Quality Improvement Act of 1986, as amended, and Section 221(a) of Public Law 104-191, the Heath Insurance Portability and Accountability Act of 1996. The purpose of such a release is to provide information concerning a current or former IHS medical staff member whose professional health care activity failed to conform to generally accepted standards of professional medical practice.

4. To provide health care practice information concerning current or former members of the IHS medical staff with Commissioned Corps status to the Division of Commissioned Personnel, U.S. Public Health Service, so that an informed decision may be made concerning the promotion, retention, or reassignment of the subject individual.

   Routine uses of records maintained in the system, including categories of users and the purposes of such uses:

1. Records may be disclosed to organizations authorized to conduct evaluation studies concerning the delivery of health care services by the IHS (e.g., Joint Commission on the Accreditation of Healthcare Organizations).

2. IHS may disclose records consisting of name, Social Security number, employment history and any professional qualification information concerning medical staff membership and privileges, professional competence, clinical judgment and personal character to a state or local government health professional licensing board, to the Federation of State Medical Boards, to the NPDB-HIPDB, and/or to a similar entity which has the authority to maintain records concerning the issuance, retention or revocation of licenses or registrations necessary to practice a health professional occupation or specialty. The purpose of this disclosure is to inform medical profession licensing boards and appropriate entities about the health care practices of a current, terminated, resigned, or retired IHS medical staff member whose professional health care activity significantly failed to conform to generally accepted standards of professional medical practice. This will be done within the guidelines for notice, hearing, and review as delineated in the medical staff bylaws for the IHS facility and/or within other HHS or IHS regulations or policies.

3. IHS may disclose biographic data and information supplied by potential applicants to (a) references listed on the IHS medical staff and/or privileges application and associated forms for the purpose of evaluating the applicant's professional qualifications, experience, and suitability, and (b) a state or local government health profession licensing board, to a health-related professional organization, to the Federation of State Medical Boards, and to the NPDB-HIPDB or a similar entity for the purpose of verifying that all claimed background and employment data are valid and all claimed credentials are current and in good standing.

4. Records may be disclosed to other Federal agencies (including the Office of Personnel Management for subject individuals applying for or maintaining Civil Service appointments), to state and local governmental agencies, and to organizations in the private sector to which the subject individual applies for clinical privileges, membership or licensure for the purpose of documenting the qualifications and competency of the subject individual to provide health services in his/her health profession based on the individual's professional performance while employed by the IHS.

5. The Department may disclose information from this system of records to the Department of Justice, or to a court or other tribunal, when (a) HHS, or any component thereof, or (b) any HHS employee in his or her official capacity; or (c) any HHS employee in his or her individual capacity where the Department of Justice (or HHS, where it is authorized to do so) has agreed to represent the employee; or (d) the United States or any agency thereof where HHS determines that the litigation is likely to affect HHS or any of its components, is a party to litigation or has an interest in such litigation, and HHS determines that the use of such records by the Department of Justice, the court or other tribunal is relevant and necessary to the litigation and would help in the effective representation of the governmental party, provided, however, that in each case, HHS determines that such disclosure is compatible with the purpose for which the records were collected.

6. Records may be disclosed to a congressional office from the record of

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   an individual in response to a verified inquiry from the congressional office made at the written request of that individual.

7. In the event that a system of records maintained by the IHS to carry out its functions indicates a violation or potential violation of law, whether civil, criminal, or regulatory in nature, and whether arising by general statute or particular program statute, or by regulation, rule or order issued pursuant thereto, the relevant records in the system of records may be referred to the appropriate agency, whether Federal, state, or local, charged with enforcing or implementing the statute or rule, regulation or order issued pursuant thereto.

   Policies and practices for storing, retrieving, accessing, retaining, and disposing of records in the system: Storage:

   File folders and computer-based or electronic files.

   Retrievability:

   Indexed and retrieved by name, Social Security number, and any other identifying numbers necessary to establish the identity of an individual whose record is maintained in the system of records.

   Safeguards:

1. Authorized Users: Access is limited to authorized personnel for use in the performance of their official duties. Authorized personnel include: Physician Recruitment and other Health Professions Branch Staff and Area Governing Board Members at IHS Area Offices, and Service Unit Directors, Clinical Directors and members of the Credentials and Privilege Committee of each IHS Service Unit. At each location where records in this system will be maintained, a list of personnel or categories of personnel having an official need-to-know has been developed and is maintained.

2. Physical Safeguards: Records are kept in locked metal filing cabinets or in locked desk drawers in secured rooms at all times when not actually in use during working hours and at all times during non- working hours. Record storage areas, including file cabinets and desks, are not left unattended or unlocked during office hours, including lunch hours. Computer-based or electronic records are password protected security and any additional internal security for database (linked or unlinked).

3. Procedural Safeguards: Persons who have an official need-to-know are entrusted with records from this system of records and are instructed to safeguard the confidentiality of these records and to destroy all copies or to return such records when the need to know has expired. Instructions include the statutory penalties for noncompliance. Proper charge-out procedures are followed for the removal of records from the area in which they are maintained. Before an employee who will control disclosure of records can work with the records (i.e., employees who report to the system manager) the system manager or designee ensures that the employee has received training in the safeguards applicable to the records and is aware of the actions to take to restrict disclosure. When copying records for authorized purposes, care is taken to ensure that any imperfect pages are not left in the reproduction room where they can be read but are destroyed or obliterated.

4. Implementation Guidelines: DHHS Chapter 45-13 and supplementary Chapter PHS.hf:45-13 of the General Administration Manual; DHHS, ``Automated Information System Security Program Handbook,'' as amended; DHHS IRM Policy HHS-IRM-2000-0005, ``IRM Policy for IT Security for Remove Access; OMB Circular A-130 ``Management of Federal Information Resources''; and E-Government Act of 2002 (Pub. L. 107-347, 44 U.S.C. Ch. 36).

   Retention and disposal:

   Records are maintained by IHS for at least ten years after the individual's termination of employment or association with IHS. Records of unsuccessful applicants for medical staff membership will be retained for three years after his/her rejection. After these periods of retention expire, records are destroyed by shredding or burning.

   System manager(s) and address:

   See Appendix 1.

   Policy Coordinating Official:

   Director, Office of Clinical and Preventive Services, IHS, 801 Thompson Avenue, Suite 300, Rockville, Maryland 20852. The IHS Clinical Directors at all IHS Service Units listed in Appendix 1 are System Managers. IHS medical staff credentials and privileges files are stored at these locations. Other addresses listed in Appendix 1 are locations at which all or parts of these records may also be stored (Physician Recruiter at IHS Area Offices). Post Office Box designations appearing in Appendix 1 should be specified when making requests by mail.

   Notification procedure:

   Requests must be made to the appropriate System Manager (Clinical Director for the appropriate Service Unit) listed in Appendix 1.

   Requests by mail:

   Requests for information and/or access to records received by mail must contain information providing the identity of the writer and a reasonable description of the record desired. Written requests must contain, at a minimum, the name, signature, Social Security number, and address of the requester, and for unsuccessful applicants the date when the application was submitted, and for current or former IHS health care providers the dates and locations of service. We may request additional identification when we hold records for different persons with the same name or where an apparent discrepancy exists between information contained in the record and that provided by the individual requesting access to the record.

   Other names used:

   Where an individual is seeking to obtain information about himself/ herself which may be retrieved by a different name than his/her current name, he/she shall be required to produce evidence to verify that he/ she is the person whose record he/she seeks.

   Requests in person:

   A subject individual who appears in person at a specific location (where he or she currently works or formerly worked) seeking access or disclosure of records contained in this system of records relating to him/her shall provide the information described in ``Requests by mail'' (above) and at least one piece of tangible identification such as a driver's license or passport.

   Requests by telephone:

   Since positive identification of the caller cannot be established, telephone requests are not honored.

   Record access procedures: Same as Notification procedure:

   Requesters should also provide a reasonable description of the record being sought. Requesters may also request an accounting of disclosures that have been made of their records, if any.

   Contesting record procedures:

   Write to the appropriate Service Unit Clinical Director at the address specified

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   in Appendix 1 and reasonably identify the record, specify the information being contested, and state the corrective action sought, and the reasons for requesting the correction, along with supporting information to show how the record is inaccurate, incomplete, untimely, or irrelevant.

   Record source categories:

   Subject individual, IHS health care personnel, references supplied by the subject individual, professional societies or associations, specialty boards, colleges and universities attended by the subject individual, former employers, health facilities or health providers with which the subject individual was associated, liability insurance carriers, organizations providing cardiopulmonary resuscitation (CPR) training to the subject individual, state and local health and health care licensing or certifying organizations, and organizations which serve as repositories of information on health care professionals.

   Systems exempted from certain provisions of the act:

   None.

   Appendix 1: System Managers and IHS Locations Under Their Jurisdiction Where Records are Maintained

   Director, Aberdeen Area Indian Health Service, Room 309, Federal Building, 115 Fourth Avenue, SE., Aberdeen, South Dakota 57401 Director, Cheyenne River Service Unit, Eagle Butte Indian Hospital, P.O. Box 1012, Eagle Butte, South Dakota 57625 Director, Crow Creek Service Unit, Ft. Thompson Indian Health Center, P.O. Box 200, Ft. Thompson, South Dakota 57339 Director, Fort Berthold Service Unit, Fort Berthold Indian Health Center, P.O. Box 400, New Town, North Dakota 58763 Director, Carl T. Curtis Health Center, P.O. Box 250, Macy, Nebraska 68039 Director, Fort Totten Service Unit, Fort Totten Indian Health Center, P.O. Box 200, Fort Totten, North Dakota 58335 Director, Kyle Indian Health Center, P.O. Box 540, Kyle, South Dakota 57752 Director, Lower Brule Indian Health Center, P.O. Box 191, Lower Brule, South Dakota 57548 Director, McLaughlin Indian Health Center, P.O. Box 879, McLaughlin, South Dakota 57642 Director, Omaha-Winnebago Service Unit, Winnebago Indian Hospital, Winnebago, Nebraska 68071 Director, Pine Ridge Service Unit, Pine Ridge Indian Hospital, Pine Ridge, South Dakota 57770 Director, Rapid City Service Unit, Rapid City Indian Hospital, 3200 Canyon Lake Drive, Rapid City, South Dakota 57701 Director, Rosebud Service Unit, Rosebud Indian Hospital, Rosebud, South Dakota 57570 Director, Sisseton-Wahpeton Service Unit, Sisseton Indian Hospital, P.O. Box 189, Sisseton, South Dakota 57262 Director, Standing Rock Service Unit, Fort Yates Indian Hospital, P.O. Box J, Fort Yates, North Dakota 58538 Director, Trenton-Williston Indian Health Center, P.O. Box 210, Trenton, North Dakota 58853 Director, Turtle Mountain Service Unit, Belcourt Indian Hospital, P.O. Box 160, Belcourt, North Dakota 58316 Director, Wanblee Indian Health Center, 100 Clinic Drive, Wanblee, South Dakota 57577 Director, Yankton-Wagner Service Unit, Wagner Indian Hospital, 110 Washington Street, Wagner, South Dakota 57380 Director, Youth Regional Treatment Center, P.O. Box 68, Mobridge, South Dakota 57601 Director, Sac & Fox Health Center, 307 Meskwaki Road, Tama, Iowa 52339 Director, Santee Health Center, 425 Frazier Avenue, Main Street 2, Niobrara, Nebraska 68760 Director, Alaska Area Native Health Service, 4141 Ambassador Drive, Suite 300, Anchorage, Alaska 99508-5928 Director, Albuquerque Area Health Service, 5300 Homestead Road, NE., Albuquerque, New Mexico 87110 Director, Acoma-Canoncito-Laguna Service Unit, Acoma-Canoncito- Laguna Indian Hospital, P.O. Box 130, San Fidel, New Mexico 87049 Director, To-Hajille Health Center, P.O. Box 3528, Canoncito, New Mexico 87026 Director, New Sunrise Treatment Center, P.O. Box 219, San Fidel, New Mexico 87049 Director, Albuquerque Service Unit, Albuquerque Indian Hospital, 801 Vassar Drive, NE., Albuquerque, New Mexico 87049 Director, Albuquerque Indian Dental Clinic, P.O. Box 67830, Albuquerque, New Mexico 87193 Director, Alamo Navajo Health Center, P.O. Box 907, Magdalena, New Mexico 87825 Director, Jemez PHS Health Center, P.O. Box 279, Jemez, New Mexico 87024 Director, Santa Ana PHS Health Center, P.O. Box 37, Bernalillo, New Mexico 87004 Director, Sandia PHS Health Center, P.O. Box 6008, Bernalillo, New Mexico 87004 Director, Zia PHS Health Center, 155 Capital Square, Zia, New Mexico 87053 Director, Santa Fe Service Unit, Santa Fe Indian Hospital, 1700 Cerrillos Road, Santa Fe, New Mexico 87501 Director, Santa Clara Health Center, RR5, Box 446, Espanola, New Mexico 87532 Director, San Felipe Health Center, P.O. Box 4344, San Felipe, New Mexico 87001 Director, Cochiti Health Center, P.O. Box 105, 255 Cochiti Street, Cochiti, New Mexico 87072 Director, Santo Domingo Health Center, P.O. Box 340, Santo Domingo, New Mexico 87052 Director, Southern Colorado-Ute Service Unit, P.O. Box 778, Ignacio, Colorado 81137 Director, Ignacio Indian Health Center, P.O. Box 889, Ignacio, Colorado 81137 Director, Towaoc Ute Health Center, Towaoc, Colorado 81334 Director, Jicarilla Indian Health Center, P.O. Box 187, Dulce, New Mexico 87528 Director, Mescalero Service Unit, Mescalero Indian Hospital, P.O. Box 210, Mescalero, New Mexico 88340 Director, Taos/Picuris Indian Health Center, P.O. Box 1956, 1090 Goat Springs Road, Taos, New Mexico 87571 Director, Zuni Service Unit, Zuni Indian Hospital, Zuni, New Mexico 87327 Director, Pine Hill Health Center, P.O. Box 310, Pine Hill, New Mexico 87357 Director, Bemidji Area Indian Health Service, 522 Minnesota Avenue, NW., Bemidji, Minnesota 56601 Director, Red Lake Service Unit, PHS Indian Hospital, Highway 1, Red Lake, Minnesota 56671 Director, Leech Lake Service Unit, PHS Indian Hospital, 425 7th Street, NW., Cass Lake, Minnesota 56633 Director, White Earth Service Unit, PHS Indian Hospital, P.O. Box 358, White Earth, Minnesota 56591 Director, Billings Area Indian Health Service, P.O. Box 36600, 2900 4th Avenue North, Billings, Montana 59101 Director, Blackfeet Service Unit, Browning Indian Hospital, P.O. Box 760, Browning, Montana 59417 Director, Heart Butte PHS Indian Health Clinic, Heart Butte, Montana 59448 Director, Crow Service Unit, Crow Indian Hospital, Crow Agency, Montana 59022 Director, Lodge Grass PHS Indian Health Center, Lodge Grass, Montana 59090 Director, Pryor PHS Indian Health Clinic, P.O. Box 9, Pryor, Montana 59066 Director, Fort Peck Service Unit, Poplar Indian Hospital, Poplar, Montana 59255 Director, Fort Belknap Service Unit, Harlem Indian Hospital, Harlem, Montana 59526 Director, Hays PHS Indian Health Clinic, Hays, Montana 59526 Director, Northern Cheyenne Service Unit, Lame Dear Indian Health Center, Lame Deer, Montana 59043 Director, Wind River Service Unit, Fort Washakie Indian Health Center, Fort Washakie, Wyoming 82514 Director, Arapahoe Indian Health Center, Arapahoe, Wyoming 82510 Director, Chief Redstone Indian Health Center, Wolf Point, Montana 59201 Director, California Area Indian Health Service, John E. Moss Federal Building, 650 Capitol Mall, Suite 7-100, Sacramento, California 95814 Director, Nashville Area Indian Health Service, 711 Stewarts Ferry Pike, Nashville, Tennessee 37214-2634 Director, Catawba PHS Indian Nation of South Carolina, P.O. Box 188, Catawba, South Carolina 29704 Director, Unity Regional Youth Treatment Center, P.O. Box C-201, Cherokee, North Carolina 28719 Director, Navajo Area Indian Health Service, P.O. Box 9020, Highway 264, Window Rock, Arizona 86515-9020 Director, Chinle Service Unit, Chinle Comprehensive Health Care Facility, P.O. Drawer PH, Chinle, Arizona 86503 Director, Tsaile Health Center, P.O. Box 467, Navajo Routes 64 & 12, Tsaile, Arizona 86556

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   Director, Rock Point Field Clinic, c/o Tsaile Health Center, P.O. Box 647, Tsaile, Arizona 86557 Director, Pinon Health Station, Pinon, Arizona 86510 Director, Crownpoint Service Unit, Crownpoint Comprehensive Health Care Facility, P.O. Box 358, Crownpoint, New Mexico 87313 Director, Pueblo Pintado Health Station, c/o Crownpoint Comprehensive Health Care Facility, P.O. Box 358, Crownpoint, New Mexico 87313 Director, Fort Definance Service Unit, Fort Definance Indian Hospital, P.O. Box 649, Intersection of Navajo Routes N12 & N7, Fort Defiance, Arizona 86515 Director, Nahata Dziil Health Center, P.O. Box 125, Sanders, Arizona 86512 Director, Gallup Service Unit, Gallup Indian Medical Center, P.O. Box 1337, Nizhoni Boulevard, Gallup, New Mexico 87305 Director, Tohatchi Indian Health Center, P.O. Box 142, Tohatchi, New Mexico 87325 Director, Ft. Wingate Health Station, c/o Gallup Indian Medical Center, P.O. Box 1337, Gallup, New Mexico 87305 Director, Kayenta Service Unit, Kayenta Indian Health Center, P.O. Box 368, Kayenta, Arizona 86033 Director, Inscription House Health Center, P.O. Box 7397, Shonto, Arizona 86054 Director, Dennhotso Clinic, c/o Kayenta Health Center, P.O. Box 368, Kayenta, Arizona 86033 Director, Shiprock Service Unit, Northern Navajo Medical Center, P.O. Box 160, U.S. Hwy 491 North, Shiprock, New Mexico 87420 Director, Dzilth-Na-O-Dith-Hle Indian Health Center, 6 Road 7586, Bloomfield, New Mexico 87413 Director, Teecnospos Health Center, P.O. Box 103, N5114 BIA School Road, Teecnospos, Arizona 86514 Director, Sanostee Health Station, c/o Northern Navajo Medical Center, P.O. Box 160, Shiprock, New Mexico 87420 Director, Toadlena Health Station, c/o Northern Navajo Medical Center, P.O. Box 160, Shiprock, New Mexico 87420 Director, Teen Life Center, c/o Northern Navajo Medical Center, P.O. Box 160, Shiprock, New Mexico 87420 Director, Oklahoma City Area Indian Health Service, Five Corporation Plaza, 3625 NW. 56th Street, Oklahoma City, Oklahoma 73112 Director, Claremore Service Unit, Claremore Comprehensive Indian Health Facility, West Will Rogers Boulevard and Moore, Claremore, Oklahoma 74017 Director, Clinton Service Unit, Clinton Indian Hospital, Route 1, Box 3060, Clinton, Oklahoma 73601-9303 Director, El Reno PHS Indian Health Clinic, 1631A E. Highway 66, El Reno, Oklahoma 73036 Director, Watonga Indian Health Center, Route 1, Box 34-A, Watonga, Oklahoma 73772 Director, Haskell Service Unit, PHS Indian Health Center, 2415 Massachusetts Avenue, Lawrence, Kansas 66044 Director, Lawton Service Unit, Lawton Indian Hospital, 1515 Lawrie Tatum Road, Lawton, Oklahoma 73501 Director, Anadarko Indian Health Center, P.O. Box 828, Anadarko, Oklahoma 73005 Director, Carnegie Indian Health Center, P.O. Box 1120, Carnegie, Oklahoma 73150 Director, Holton Service Unit, PHS Indian Health Center, 100 West 6th Street, Holton, Kansas 66436 Director, Pawnee Service Unit, Pawnee Indian Service Center, RR2, Box 1, Pawnee, Oklahoma 74058-9247 Director, Pawhuska Indian Health Center, 715 Grandview, Pawhuska, Oklahoma 74056 Director, Tahlequah Service Unit, W.W. Hastings Indian Hospital, 100 S. Bliss, Tahlequah, Oklahoma 74464 Director, Wewoka Indian Health Center, P.O. Box 1475, Wewoka, Oklahoma 74884 Director, Phoenix Area Indian Health Service, Two Renaissance Square, 40 North Central Avenue, Phoenix, Arizona 85004 Director, Colorado River Service Unit, Chemehuevi Indian Health Clinic, P.O. Box 1858, Havasu Landing, California 92363 Director, Colorado River Service Unit, Havasupai Indian Health Station, P.O. Box 129, Supai, Arizona 86435 Director, Colorado River Service Unit, Parker Indian Health Center, 12033 Agency Road, Parker, Arizona 85344 Director, Colorado River Service Unit, Peach Springs Indian Health Center, P.O. Box 190, Peach Springs, Arizona 86434 Director, Colorado River Service Unit, Sherman Indian High School, 9010 Magnolia Avenue, Riverside, California 92503 Director, Elko Service Unit, Newe Medical Clinic, 400 ``A'' Newe View, Ely, Nevada 89301 Director, Elko Service Unit, Southern Bands Health Center, 515 Shoshone Circle, Elko, Nevada 89801 Director, Fort Yuma Service Unit, Fort Yuma Indian Hospital, P.O. Box 1368, Fort Yuma, Arizona 85366 Director, Keams Canyon Service Unit, Hopi Health Care Center, P.O. Box 4000, Polacca, Arizona 86042 Director, Phoenix Service Unit, Phoenix Indian Medical Center, 4212 North 16th Street, Phoenix, Arizona 85016 Director, Phoenix Service Unit, Salt River Health Center, 10005 East Osborn Road, Scottsdale, Arizona 85256 Director, San Carlos Service Unit, Bylas Indian Health Center, P.O. Box 208, Bylas, Arizona 85550 Director, San Carlos Service Unit, San Carlos Indian Hospital, P.O. Box 208, San Carlos, Arizona 85550 Director, Schurz Service Unit, Schurz Service Unit Administration, Drawer A, Schurz, Nevada 89427 Director, Fort McDermitt Clinic, P.O. Box 315, McDermitt, Nevada 89421 Director, Unitah and Ouray Service Unit, Fort Duchesne Indian Health Center, P.O. Box 160, Fort Duchesne, Utah 84026 Director, Whiteriver Service Unit, Cibecue Health Center, P.O. Box 37, Cibecue, Arizona 85941 Director, Whiteriver Service Unit, Whiteriver Indian Hospital, P.O. Box 860, Whiteriver, Arizona 85941 Director, Desert Vision Youth Wellness Center/RTC, P.O. Box 458, Sacaton, AZ 85247 Director, Portland Area Indian Health Service, Room 476, Federal Building, 1220 Southwest Third Avenue, Portland, Oregon 97204-2829 Director, Colville Service Unit, Colville Indian Health Center, P.O. Box 71-Agency Campus, Nespelem, Washington 99155 Director, Fort Hall Service Unit, Not-Tsoo Gah-Nee Health Center, P.O. Box 717, Fort Hall, Idaho 83203 Director, Neah Bay Service Unit, Sophie Trettevick Indian Health Center, P.O. Box 410, Neah Bay, Washington 98357 Director, Warm Springs Service Unit, Warm Springs Indian Health Center, P.O. Box 1209, Warm Springs, Oregon 97761 Director, Wellpinit Service Unit, David C. Wynecoop Memorial Clinic, P.O. Box 357, Wellpinit, Washington 99040 Director, Western Oregon Service Unit, Chemawa Indian Health Center, 3750 Chemawa Road, NE., Salem, Oregon 97305-1198 Director, Yakama Service Unit, Yakama Indian Health Center, 401 Buster Road, Toppenish, Washington 98948 Director, Tucson Area Indian Health Service, 7900 South ``J'' Stock Road, Tucson, Arizona 85746-9352 Director, Pascua Yaqui Service Unit, Division of Public Health, 7900 South ``J'' Stock Road, Tucson, Arizona 85746 Director, San Xavier Indian Health Center, 7900 South ``J'' Stock Road, Tucson, Arizona 85746 Director, Sells Service Unit, Santa Rosa Indian Health Center, HCO1, Box 8700, Sells, Arizona 85634 Director, Sells Service Unit, Sells Indian Hospital, P.O. Box 548, Sells, Arizona 85634 Director, Sells Service Unit, West Side Health Station, P.O. Box 548, Sells, Arizona 85634

   [FR Doc. 06-3091 Filed 3-30-06; 8:45 am]

   BILLING CODE 4165-16-M