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Indian Health Services Overview

Indian Health Services (HIS) requires “proof of Indian descent” to access their services. A child can be of “Indian descent” even if the child has insufficient blood quantum to be a tribal member. “Indian descent” can be shown by providing one of the following:

  1. Certificate of Degree of Indian Blood (CDIB) card for the child;
  2. Certificate of Degree of Indian Blood (CDIB) Card of a parent;
    • The child’s name does not have to appear on this card. There may be a limitation on the amount of time IHS or the tribal clinic will continue to provide services to a child not listed on a CDIB card. This limitation could vary among tribes;
  3. Tribal ID card / Certificate of Citizenship, or; and
  4. A letter issued by the tribe confirming eligibility of the parent and/or child. The Bureau of Indian Affairs (BIA) does not necessarily issue CDIB cards for all tribes. There are some tribes outside of Oklahoma with other types of documents to denote Indian descent.
Important Note: If there is no document with the child’s name, the child’s birth certificate, showing his/her relationship to the person who is listed on the tribal documentation must be included to establish Indian descent.

The Child Support Services (CSS) auditors review from Oklahoma State Information System (OSIS) and may look at the paper file. Therefore, in order to get credit for the work performed, the Child Support (CS) Specialist must make updates to the appropriate screens in OSIS, which may include making an entry on CSLOGA.

Make sure the entry is easily identifiable, such as having a tagline on the first line of the entry. The auditors need to be able to determine the documentation exists in the file showing the child is eligible for IHS. This may include:

Proof of Indian Descent

  • The child’s name does not have to appear on the documentation;
  • There must be additional documentation linking the child to the parent if the child’s name does not appear; and
  • Documents accepted are:
    • Certificate of Degree of Indian Blood (CDIB) Card of a parent;
    • Tribal ID card;
    • Card issued by Bureau of Indian Affairs (BIA), or; and
    • A letter issued by the tribe confirming eligibility.

Tribe confirms IHS eligibility through letter, statement or e-mail documented in the file.

If CSS has verified that IHS is available and if it is accessible or the parents agree to exceed the 60 mile requirement, CSS can consider the IHS sufficient to meet the medical support requirement. If IHS is provided, cash medical should not be ordered. The court can order insurance in addition to IHS if insurance is available and custodial person (CP) requests it.

The CS Specialist should send a copy of the documentation of IHS eligibility to the Employer Services Center (ESC) with the request that POLA or CPOLA be updated. The CS Specialist must indicate the name of the child covered by IHS and the tribal member through whom benefits are provided (NCP, CP, BP or Other).

If the information provided to ESC only indicates the parent is a tribal member but does not indicate the child is covered, ESC will enter the information on the parent, but will not link the coverage to the child. This means the district office will not receive credit for obtaining coverage for the children if the case is audited. In addition, the Office of Child Support Enforcement (OCSE) 157 report would not indicate coverage is being “provided as ordered” for this child.