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Cherokee people are beneficiaries of a pre-paid, public health care system which has developed as a result of many federal action, treaties and laws. This system is administered throughout the United States by the Indian Health Service (IHS). It addresses the needs of over 300 federally recognized Indian tribes and more than 200 Alaskan Native villages. An agency of the U.S. Department of Health and Human Services, the IHS was established in 1955, and followed the U.S. Department of War and the U.S. Department of Interior (Bureau of Indian Affairs ) as agencies responsible for dealing with Indian health issues. Today, IHS is responsible for the nationwide development and administration of the "Indian health care," which is a part of the public trust created when native people of this continent exchanged, with and without choice, their land and natural resources for certain protection and services.
Funds for operating all "Indian hospitals" or "Indian clinics" are appropriated by Congress. Some of the facilities are run directly by the IHS, some are run by tribes with IHS funding. This funding is allocated through the IHS to a particular tribe or the IHS Area headquarters in the given geographic region (See "Area Office"). The Area Office is then responsible for further distribution of funding for facilities and programs not yet under direct tribal management based on what are referred to as "tribal shares".
Within the Cherokee Tribal Jurisdictional Service Area (See "TJSA"), there are six outpatient clinics and two hospitals where beneficiaries can access basic health service. The Cherokee Nation Health Service operates the outpatient clinics located at Jay (Delaware county); Muskogee (Muskogee county); Nowata (Nowata county); Salina (Mayes county); Sallisaw (Sequoyah county); and Stilwell (Adair county); and, the IHS operates the two hospitals at Tahlequah (Cherokee county); and Claremore (Rogers county) Oklahoma. The hospitals also offer ambulatory (outpatient) care. (See "CRHN")
Eligibility for basic services from any of these facilities is based on membership in any federally recognized tribe (See "Eligibility"). This is why, although only about half of the enrolled Cherokee tribal membership resides within the tribal service area, more than 254,000 patients are registered to receive service from this network of rural health facilities. Specialty care is provided to any eligible patient when it is available through direct care at the Indian health facility. However, when it is necessary to refer a patient outside the system for a specialized service or tertiary care, authorization for payment of these services is based on established medical priority and the availability of funds for contracted care. (See: Program Profiles: Office of Managed Care/Contract Health Services.)
From time to time, through Self-governance agreements with various entities, monies will become available from the tribe's general accounting fund for specialty health care services. For example, funds referred to as "fuel-tax revenues" were appropriated by the Tribal Council in 1997-8 for eyeglasses, dentures and cancer treatment. Through the terms of an agreement with the state of Oklahoma, tax monies collected for fuel sold from tribally owned gas stations on tax-exempt lands are rebated to the tribe on an annual basis. The Tribal Council then allocates these proceeds based on requests/recommendations from the administrators of the direct service programs, including Health. Fuel tax revenues are independent from the facilities operations revenue (received through IHS from the Congress) and are distinct from program revenues (received from their various funding sources, public and private)(See Programs/Services and Program Profiles). It is, nevertheless, considered to be a part of the Health Services annual budget and is used for the specific purposes assigned to it by the Council. Each year that purpose will vary, so each year the eligibility criteria for services funded with these proceeds will vary. For example, if the monies are designated by the Council to be used for cancer treatment, the criteria for deciding what treatment can be provided to which patients will be based on the medical priorities already established to govern the administration of service from the Managed Care Office.
The Cherokee Nation Heath Service management makes every effort to stay abreast of changes in federal, state and tribal policies, which dictate our program operations, and to clarify all guidelines regulating the usage of our health care system. Because they are affected by continuously changing legislation and the diverse needs of many tribes, Indian health care issues can be complicated, making it difficult to keep tribal members and the public at large informed on the benefits and expectations of the system. Meanwhile, certain rights and responsibilities are dictated by common sense and informed judgement. These we recognize as intrinsic. Thank you for your interest in the Cherokee Nation Health Service.
Question on any of these matters may be directed to the:
Office of the Executive Director of the Cherokee Nation Health Service Health Communications:
918-453-5580
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