U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Contract Health Services

Requirements: Contract Health Services Delivery Areas (CHSDA)

The residence requirements are applied to determining eligibility for contract health services. The intention of Congressional appropriated funds is the general support of the health program of the Indian Health Service to provide health services for Indians who live on or near Indian reservations. The contract health services delivery area (CHSDA) 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.

In general: You must be an Indian from a federally recognized tribe. You must reside on or near an Indian reservation within a contract health service delivery area, i.e. a county containing all or part of a reservation or sharing a boundary with a reservation, or in Alaska, Nevada or Oklahoma.

An excerpt of the CHSDA Federal regulation is provided; CFR at Title 42, Section 136.22: Subpart C-Contract Health Services ยง 136.22 Establishment of contract health service delivery areas.

  1. In accordance with the congressional intention that funds appropriated for the general support of the health program of the Indian Health Service be used to provide health services for Indians who live on or near Indian reservations, contract health service delivery areas are established as follows:
    1. The State of Alaska;
    2. The State of Nevada;
    3. the State of Oklahoma;
    4. Chippewa, Mackinac, Luce, Alger, Schoolcraft, Delta, and Marquette Counties in the State of Michigan;
    5. Clark, Eau Claire, Jackson, La Crosse, Monroe, Vernon, Crawford, Shawano, Marathon, Wood, Juneau, Adams, Columbia, and Sauk Counties in the State of Wisconsin and Houston County in the State of Minnesota;
    6. With respect to all other reservations within the funded scope of the Indian health program, the contract health services delivery area 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.
  2. The Secretary may from time to time, redesignate areas or communities within the United States as appropriate for inclusion or exclusion from a contract health service delivery area after consultation with the tribal governing body or bodies on those reservations included within the contract health service delivery area. The Secretary will take the following criteria into consideration:
    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 contract health services.
  3. Any redesignation under paragraph (b) of this section shall be made in accordance with the procedures of the Administrative Procedure Act (5 U.S.C. 553).

The updated CHSDA listing by Tribe and Counties/State published in the Federal Register, Volume 21, issued on June 21, 2007 is provided in the Other Resources- Regulations.

Federal Register CHSDA [DOC-325KB]

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