10.20.060 Eligibility.
(1) IHS Manual Requirements. To be eligible for PRC Services, a person must:
(a) Be a Samish citizen; and
(b) Meet one of the following residency requirements:
(i) Reside in the PRC Service Area; or
(ii) Be a student (undergraduate or graduate, vocational, technical, or other academic education) whose permanent residence is within the PRC Service Area, but who is temporarily absent from that residence for the purpose of their education; or
(iii) Be a transient (a person who is in travel or is temporarily employed, such as seasonal or migratory workers), during their absence from their place of residence within the PRC Service Area; and
(c) Meet any other eligibility requirement listed in the Indian Health Service manual or 42 CFR 136.12.
(2) Other Categories/Conditions of Eligibility.
(a) A Samish citizen child who is placed in foster care outside the PRC Service Area by order of a court of competent jurisdiction and who is eligible for Samish PRC at the time of the court order shall continue to be eligible for Samish PRC while in foster care.
(b) A woman who is not a Samish citizen but is pregnant with an eligible Samish citizen’s child, who resides within the PRC Service Area, is eligible for Samish PRC Services during pregnancy through post-partum (usually six weeks). If unmarried, such a woman is eligible for Samish PRC if an eligible Samish citizen provides the results of paternity testing that shows that he is the father of the unborn child, or such is determined by order of a court of competent jurisdiction. This provision is intended to ensure health services to the unborn Samish child.
(c) A person who is a member of an eligible Samish citizen’s household within the PRC Service Area is eligible for Samish PRC if it is determined by a physician that services are necessary to control a public health hazard or an acute infectious disease that constitutes a public health hazard.
(3) A person who is otherwise eligible for Samish PRC but leaves the PRC Service Area and is neither a student nor a transient will be eligible for PRC for a period of up to 180 days from date of departure.
(4) It is the responsibility of the PRC enrollee to notify PRC immediately whenever there is a change of address, employment, or family composition. No appeal will be allowed if a failure to notify PRC of these events results in a denial for payment of service. [Res. 2020-10-013 § 2, 2020.]