Behavioral Health

Providing a variety of mental health services for adults, adolescents, and children.

Eligibility

ELIGIBILITY GUIDELINES
Revised April 2016 with updates on February 2020, July 2020, November 2020, April 2021, April 2022, September 2022, January 2023, March 2023, December 2023, July 2024. The Choctaw Nation Health Services Authority (CNHSA) will provide health care services at the Choctaw Nation Health Care Center, Talihina, and all field Clinics according to the following guidelines:

NATIVE AMERICANS
A Native American with a CDIB card, a Membership card, or letter of descendancy from a federally recognized tribe is eligible for services as described in the following guidelines. A Social Security card is required. If 18 or older, a Photo ID is also required.
Please Note: In order to be eligible for Choctaw Referred Care, the patient must show proof of residency in Atoka, Choctaw, Haskell, Latimer, Leflore, McCurtain, Pittsburg, Pushmataha, or Bryan counties of Oklahoma. Residency must be for a time period of 180 days or more. Proof of residency consists of Oklahoma driver’s license or OK state issued identification with an address listed within the 9 covered counties and the following: tax returns, Oklahoma driver’s license, vehicle registrations, utility bills, bank statements, school enrollment, and physical address (no P.O. Box). The burden of proof is on the patient.
NATURAL CHILDREN
Natural Children, under the age of 19 years, of an eligible parent are eligible for services. If a child has his/her own CDIB, State birth certificate and Social Security card are required. (Required by age one)
If a child does not have his/her own CDIB, eligibility will be determined through the parents ONLY. A copy of the parent(s) CDIB, State birth certificate and Social Security card is required. (Required by age one) Grandparents, other relatives, or friends may verify the child’s eligibility by providing the aforementioned documents in addition to the letter from either parent authorizing medical care for the child. In certain instances, as determined by the Administrator, care may be rendered without producing a CDIB. Individuals will be required to provide documentation by their next visit. Failure to comply will result in billing for services rendered and ineligibility for further care.
ADOPTED, STEP, AND FOSTER CHILDREN
An adopted child, stepchild, foster (i.e. placement) child, legal ward, or orphan under the age of 19 years of an eligible parent is eligible for services except for Diabetes Wellness Center services. A stepchild is required to live in the home of the Native and recertification is required once per year. The following documents must be provided to document eligibility.
1. Marriage license of parent
2. Birth Certificate of child
3. CDIB, membership card or letter of descendancy of eligible parent
4. Proof of dependency to establish permanent residency (i.e., divorce papers, tax forms, adoption papers, ICW/DHS papers, custody agreement, court orders, minor child affidavit) Note: school records can be used to show the address where the child lives.
5. The eligible parent MUST come in and complete an affidavit of acknowledgement of
  dependency form once a year. (stepchild) (if signed outside the facility must be
  notarized)
6. Choctaw Nation Health Services Authority does not recognize common-law marriages. Stepchildren from these circumstances are not eligible for care.
NON-ELIGIBLE SPOUSES
Non-eligible spouses can be seen at the Choctaw Nation Health Care Center in Talihina ONLY.
Non-eligible spouses are eligible for limited services on a fee basis. (With insurance, must have a third (3rd) party payer) non-eligible spouses can use Laboratory Services, Radiology, Surgery Clinic, Women’s Clinic, Family Practice, Emergency/Urgent Care, and In-Patient Services ONLY.
Non-eligible spouses are responsible for deductibles and paying the remaining balance after the third (3rd) party payer has been billed.
The following documents must be provided to determine eligibility:
1. Marriage license
2. CDIB, membership card, or letter of descendancy on eligible spouse
3. Proof of Insurance: Medicare, Medicaid, or Private Insurance card
4. Current Photo ID
5. In the event of the eligible spouse’s death, services will continue until the non-eligible spouse remarries
NON-ELIGIBLE SPOUSES PREGNANT WITH AN ELIGIBLE CHILD
Non-eligible spouse will be eligible for services at Talihina Hospital ONLY (with the exception of prescriptions related to pregnancy, as determined by physician, which will be available at any outlying clinic) until released by the provider.
Non-eligible spouses that are pregnant with an eligible child: ALL services related to pregnancy are covered (to be determined by physician). The following documents must be provided to determine eligibility:
1. Marriage license
2. CDIB, membership card, or letter of descendancy
3. Proof of pregnancy (positive test from the Health Department)
4. Current Photo ID
Please Note: If individuals are not married, paternity papers must be completed at the hospital during the first prenatal visit. The eligible party must be present for signature at that time. Individuals must submit a picture ID with a signature. This includes all types of paternity such as Denial of Paternity.
The patient will be seen up to six weeks postpartum for routine medical care related to pregnancy and for eight weeks for sterilization procedures. If a condition continues after the pregnancy, care can be established with an outside provider.
NOTE:
If a stepchild and/or non-eligible dependent presents herself as being pregnant, the patient will be eligible for all services related to pregnancy until six weeks post-partum. After a stepchild and/or non-eligible dependent has delivered the baby then that individual becomes emancipated. (Emancipated means being considered as being an adult.) Additionally, the baby born at Choctaw Nation Health Care Center to the stepchild and/or non-eligible dependent (mother) will receive care for six weeks post-partum.
NON-ELIGIBLE EMERGENT CARE
CNHCC will assess/treat any emergency with the potential of loss of life or loss or limb (CNHCC complies with all laws governing emergency services). Non-eligible patients presenting with a non-emergent complaint will be assessed to determine the necessity of treatment. (An attempt will be made to stabilize the patient before a transfer is made to another facility.) In questionable cases, the administrator on call will make a determination concerning admission or transfer. These individuals will be required to pay for the Episode of Care.
A supply of medications will not be dispensed. If the provider determines it to be a medical necessity and an alternate source for obtaining medication is unavailable, the provider may give a one (1) time dose or a one-day dosage to start initial treatment.
NON-ELIGIBLE EMPLOYEES (SEE NON-ELIGIBLE EMPLOYEE POLICY IN HR SECTION)
ACTIVE-DUTY NON-INDIAN MEMBERS OF THE ARMED SERVICES INCLUDING SPOUSES AND DEPENDENTS- THIS INCLUDES COMMISSIONED CORP.
Active-duty non-Indian members of the Armed Services are eligible for all services except Diabetes Wellness Center, Choctaw Referred Care, and Pharmacy on a fee basis.
Non-eligible spouses and dependents (under age 18) of non-Indian Active-Duty members of the Armed Services are eligible for Laboratory, Radiology, Emergency, or Urgent Care ONLY on a fee basis. Talihina only
ACUTE INFECTIOUS DISEASE
Non-Indian family members dwelling in the house of an eligible where an acute infectious disease has been diagnosed will be assessed/treated for the disease.
SPECIALITY SERVICES
All patients seen by specialty services provided by CNHSA must meet the following guidelines:
1. BIOLOGIC MEDICATIONS – Limited to CRC/Choctaw only (must be living in and have lived in 10 1⁄2 counties for at least the past three (3) years; OR if patient does not meet these criteria, must have third-party insurance coverage of these medications).
2. CARDIOLOGY – 18 y/o+; Echo 18 y/o+; Holter Monitor 18 y/o+- Limited to CRC only (any tribe living in 9 counties) Limited to CRC/Choctaw only (living in 10 1⁄2 counties).
3. DENTAL PEDIATRIC (Ages 2-10 y/o) – Limited to CRC/Choctaw only (must be living in 10 1⁄2 counties).
4. DERMATOLOGY – CDIB holders (direct, any tribe living anywhere), any patient with consult, and non-eligible health care employee spouses and dependent children with a third-party payer.
5. ECHO – 18 y/o+; CDIB holders (direct, any tribe living anywhere), OB patients
  pregnant with eligible child.
6. EEG – Limited to CRC/Choctaw only (living in 10 1⁄2 counties), ordered by Neurologist.
7. Endocrinology- CDIB holders (direct, any tribe living anywhere), includes pediatric and FNA.
8. Endodontic -14 y/o+ – Limited to CRC/Choctaw only (Living in 10 1⁄2 counties)
9. ENT Talihina (incl Surgery) 2 y/o+- Limited to CRC only (any tribe living in 9 counties) Limited to CRC/Choctaw only (living in 10 1⁄2 counties)
10. ENT- Durant- CDIB holders (direct, any tribe living anywhere)
11. GASTROINTESTINAL – CDIB holders (direct, any tribe living anywhere).
12. NEUROLOGY – Limited to CRC/Choctaw only (living in 10 1⁄2 counties), will see patients aged 2 y/o+. (For migraines, must have two (2) failed therapies. Will see for any other serious neurological issue).
13. OPHTHALMOLOGY CATARACT SERVICES – Limited to CRC/Choctaw only w third party payer (living in 9 counties)
  Exception: IN HOUSE cataract surgery only, NOT CRC
  - Any Tribe in the 10.5 Counties
  - CDIB cardholders
  - May or may not have 3rd party
  - Choctaw tribal members in or outside the counties are eligible
  - Any patient who requires extraction to treat Diabetic Retinopathy, as determined by the Retina Clinic.
  - Same Criteria for Blepharoplasties and Pterygium removal.
14. ORTHO MID-LEVEL – Limited to CRC only (any tribe living in 9 counties), Limited to CRC/Choctaw only (living in 10 1⁄2 counties).
15. ORTHOPEDIC SURGEON – Limited to CRC/Choctaw only (living in 10 1⁄2 counties).
16. PT-EMG/NCVS- Limited to CRC/Choctaw only (living in 10 1⁄2 counties)
17. PULMONARY 18 y/o+- Limited to CRC only (any tribe living in 9 counties), Limited to CRC/Choctaw only (living in 10 1⁄2 counties)
18. RHEUMATOLOGY – Limited to CRC/Choctaw only (living in 10 1⁄2 counties) Patients must be age 18 y/o+.
19. SLEEP LAB – Limited to CRC/Choctaw only (living in 10 1⁄2 counties) Patients must be age 18 y/o+.
NON-SPECIALTY SERVICES
1. 24 Hour Event Monitors- CDIB holders (direct, any tribe living anywhere)
2. 30 Day Event Monitors- Limited to CRC only (any tribe living in 9 counties)
3. ACC (anti-coagulation clinic)- CDIB holders (direct, any tribe living anywhere)
4. Audiology-Hearing Test/Exam- CDIB holders (direct, any tribe living anywhere)
5. Audiology-Hearing Aids/Batteries- Choctaw tribal members in or outside the counties are eligible every three years through EDH program.
6. Behavioral Health- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, crisis only, Talihina only), Non-Eligible Health Care Employee & Commission Corp. (Bariatric, with CNO Insurance).
7. Chi Hullo Li- (Female)- CDIB holders (direct, any tribe living anywhere)
8. Choctaw Referred Care (CRC)- Limited to CRC only (any tribe living in 9 counties)
9. Community Health Nurse- CDIB holders (direct, any tribe living anywhere) (Immun). Limited to CRC only (any tribe living in 9 counties) (NB)
10. Dental- – CDIB holders (direct, any tribe living anywhere)
11. De-Sat Monitors- CDIB holders (direct, any tribe living anywhere)
12. Diabetic Educator- CDIB holders (direct, any tribe living anywhere)
13. Dietician- CDIB holders (direct, any tribe living anywhere)
14. DWC (Diabetic Wellness Clinic)- CDIB holders (direct, any tribe living anywhere)
15. Emergency Care- CDIB holders and any non-eligible
16. Employee Health – All Employees, spouses and children, Non-eligible Health Care employee spouse and dependent children, ALL CNO Employees. Insurance not required.
17. Eye clinic – CDIB holders (direct, any tribe living anywhere)
18. Family Practice- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with Insurance, and Non-eligible Health care employee spouse and dependent children with insurance.
19. Imaging (excluding MRI)- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, and Non-eligible Health care employee spouse and dependent children with insurance.
20. In-Patient Services- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, and Non-eligible Health care employee spouse and dependent children with insurance.
21. Laboratory- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouses and dependent children with insurance.
22. MRI- CDIB holders (direct, any tribe living anywhere), non-Eligible Health Care Employee & Commission Corp. with insurance, Non-eligible Health care employee spouse and dependent children with insurance.
23. Nutrition Therapy Counseling- CDIB holders (direct, any tribe living anywhere), Non-Eligible Health Care employee & Commission Corp. (Bariatric, with CNO Insurance).
24. Nutrition Therapy Supplement-Limited to CRC/Choctaw only (any tribe living in 10 ½ counties)
25. OB (obstetrics)- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouse and dependent children with insurance.
26. OMT (osteopathic manipulation therapy)- Limited to CRC/Choctaw only (living in 10 ½ counties).
27. Ophthalmology-Retinal- CDIB holders (direct, any tribe living anywhere)
28. OR (operating room)- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouse and dependent children with insurance.
29. OT (occupational therapy)- CDIB holders (direct, any tribe living anywhere)
30. Pediatric- CDIB holders (direct, any tribe living anywhere), Non-eligible Health care employee dependent children with insurance.
31. Pharmacy- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only)
32. Physical Therapy- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), Breast program), non-eligible spouse with insurance (Talihina only), non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee, spouses, and dependent children with insurance (Talihina only), only), Non- Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouse and dependent children with insurance (Talihina only)..
33. Podiatry- All ages- CDIB holders (direct, any tribe living anywhere)
34. Recovery Center- (Male)- CDIB holders (direct, any tribe living anywhere)
35. Respiratory Therapy- Direct (Any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouses and dependent children with insurance.
36. Social Service- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee, spouse, and dependent children with insurance.
37. Specialty Transport- CDIB holders (direct, any tribe living anywhere)
38. Speech Therapy- CDIB holders (direct, any tribe living anywhere)
39. Surgery- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum, 8 wks. For sterilization procedures. (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouse and dependent children with insurance.
40. Talihina Community Clinic- CDIB holders (direct, any tribe living anywhere), non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non- Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouse and dependent children with insurance.
41. Women’s Health- CDIB holders (direct, any tribe living anywhere), Non-Eligible Pregnant with an Eligible child up to 6 wks. post-partum, 8 wks. for sterilization procedure (pregnancy related, Talihina only), non-eligible spouse with insurance (Talihina only), Non-Eligible Health Care employee & Commission Corp. with insurance, Non-eligible Health care employee spouses and dependent children with insurance.

NOTE: Dependent Child refers to any child or legal ward of a CDIB holder and/or associate who is 18 years old or younger; or 19 to 26
years old and a beneficiary on their parent’s and/or legal guardian’s CNHSA sponsored UMR insurance plan.

Please note: The eligibility guidelines change frequently. As the guidelines are updated, Leadership, Executive Medical Staff and Governing Board will be presented with a cover sheet of amendments. Annually, the eligibility guidelines will be presented to these respective committees for approval.

CDIB, letter of descendancy, or tribal membership card from a federally recognized tribe (living anywhere)

How to Apply

Please call to make an appointment at any Choctaw Nation health clinic for an evaluation or counseling session. Psychiatric services will require a referral from a primary care provider.

Additional Information

Counseling services are available at the Wind Horse Counseling locations listed below unless there is not one available in that city, in which case all services will be at the clinic. Psychiatric support services will be provided at the clinics only.

Please ask for help with addiction and/or mental health. The Behavioral Health team is available. The following resources are available through the Substance Abuse and Mental Health Services Administration (SAMHSA):

The National Helpline at 1-800-662-HELP (4357) is for individuals and family members facing mental and/or substance use disorders.
The National Suicide Prevention Lifeline is available at 988 for those in suicidal crisis or emotional distress.
The text crisis line is designed for immediate help. Text INDIGENOUS to 741-741.

Services

Individual Counseling
Family Counseling
Case Management Services
Substance Abuse Counseling
Child/Partner Abuse Counseling
Psychiatric Medication (Evaluation/ Management)
Crisis Intervention
Suicide Prevention

Grants

The program aims to increase awareness about the new 988 mental health lifeline and bridge gaps in the tribal crisis continuum system. Services include inpatient discharge appointments, interim counseling, case management, Suicide Care Pathways assistance and Mobile Response Team support. To learn more, call 580-920-2100.

The program provides peer recovery assistance to incarcerated individuals and those on probation, ages 18 and older. For more information, call 918-302-0052.

The program aims to establish a tribal children’s advocacy center, catering to tribal child victims with comprehensive care through multidisciplinary teams. For more information, call 918-302-0052.

The project focuses on suicide prevention among youth aged 24 and under within the Choctaw Nation. Services include case management, Question Persuade Refer curriculum delivery, bullying prevention education and resiliency-building activities. For more information, call 918-302-0052.

The project aims to improve access to quality medical forensic care for sexual violence survivors within Choctaw Nation. It focuses on enhancing outreach, education, community resources and organizational practices. For more information, call 918-302-0052.

The program provides mental health services for Native American youth aged 10-18 within the Choctaw Nation, including counseling, case management and peer recovery support. Referrals are accepted through Choctaw Nation programs. For more information, call 539-316-2157.

These programs provide suicide prevention education and integrated care to tribal members at healthcare facilities. The grants aim to improve access to behavioral healthcare during primary care visits and educate clinics and new employees on suicide prevention. For more information, call 918-567-7000.

The project provides case management and support services to incarcerated individuals nearing release in Choctaw Nation. Services include needs assessment, aftercare planning, psychoeducation and assistance in obtaining official documents. Additionally, the project hosts Celebrating Families curriculum sessions within Leflore County to support families recovering from substance use. For more information, call 539-316-4792.

The program offers education and resources on domestic violence, sexual assault, healthy relationships and bullying prevention to community groups and individuals. Services include group sessions, self-defense seminars, school bullying prevention assemblies and case management. For more information, call 918-302-0052.

The project provides forensic interviewing and support services to child victims and families, collaborating with the Choctaw Nation Sexual Assault Response Team. The project also emphasizes community education through training and educational materials. For more information, call 918-302-0052.

The program addresses the overdose crisis in tribal communities by enhancing access to FDA-approved medications for opioid use disorder and supporting prevention, harm reduction, treatment, and recovery services. For more information, call 580-920-2100.

The program is dedicated to promoting health and wellness among Choctaw youth. It integrates Choctaw traditions, teachings, and outdoor experiences to instill cultural pride and land stewardship values. For more information, call 580-920-2100.

The program provides culturally connected holistic services to enhance mental, physical, spiritual, and emotional health, specifically focusing on veterans. Peer Support Specialists and Counselors offer case management and experiential services. For more information, call 918-302-0052.