HEALTH
GUIDELINES FOR USING
CONTRACT HEALTH
The Contract Health Service Program is Federally
funded under P.L 93-638 by Congress for the Confeder
ated Tribes of Grand Ronde to assist eligible tribal
members with payment of eligible medical and dental
services. All services must be pre-authorized by the
Contract Health Service Program based upon available
funds and based upon medical priority.
POLICIES
ELIGIBILITY: for members enrolled in the Confeder
ated Tribes of Grand Ronde and their minor depend
ents who:
A) Are an enrolled member of or dependent of an
enrolled member of the Confederated Tribes of Grand
Ronde and reside witnin our established service delivery
area. Enrolled Confederated Tribes of Grand Ronde
members who must reside within Oregon counties of
Polk, Yamhill, Marion, Tillamook, Washington and
Multnomah. Have applied for Contract Health Services
and received official notification of approval from, the
Confederated Tribes of Grand Ronde Contract Health
Services Program.
B) Are an enrolled member of a Federally Recognized
Tribe and reside within the service area and maintain
"close social and economic ties" are eligible for Con
tract Health Services. Have applied for Contract Health
Services and received official notification of approval
from the Confederated Tribes of Grand Ronde Contract
Health Services Program.
PREAUTHORIZATION: is required for all NON
EMERGENCY SERVICES and follow-up visits. All
EMERGENCY SERVICES provided after normal
office hours must be reported to the Contract Health
Staff within 72 hours of service.
ALTERNATE RESOURCES: Contract Health will
not authorize payment when alternate resources are
available and accessible such as: Medicare, Welfare
(Medicaid), or Private Insurance for the provision of
necessary health services. Refusal to apply and com
plete the application process does not mean the re
sources are not accessible or available. Any person
refusing to or not applying for alternate resources will
be denied assistance. "
PRIVATE INSURANCE; When an eligible mdividual is
enrolled in a private insurance plan, the Contract Health
Service Program will normally pay the deductible and
or balance of the bill for eligible services in which the
insurance carrier participated. PROVIDING the
Contract Health Service is notified of the service and all
other rules have been met.
PAYMENTS RECEIVED FROM ALTERNATE
RESOURCES: When patients receive checks for
payment of partial payment of medicaldental bills, and
do not apply the entire amount to the bill, then the
Contract Health Service will not be responsible for that
portion of the bill. It will be the patients responsibility
. for payment.
PHARMACY: Payment for medication prescribed by
the private provider (doctordentist) will be paid by the
Contract Health Services when the service is preauthor
ized. EMERGENCY ROOMS: All visits to the emergency
rooms will be reviewed very carefully, and in those cases
where a true emergency did not exist, such a problem
which could have been handled during normal clinic
office hours, will be denied for payment for the visit.
MADATORY IHS CLINIC USE: If you reside within
30 minutes (25 miles from the Chemawa IHS clinic), you
are required to utilize those services. When the IHS
provider refers you out for specialized services or
because there is an existing backlog of appointments, the
Contract Health Services will make payment for author
ized services. REMINDER, it is your responsibility to
call the Contract Health Services Program when you
have been referred by the IHS provider.
SERVICES PROVIDED BY THE CONTRACT
HEALTH SERVICE PROGRAM WHEN PRIORI
TIES ALLOW.
STERILIZATION: may be paid for when the Federal
-, guidelines have been followed and a consent form is
completed and sent to Contract Health Service showing
compliance with Federal guidelines.
ABORTIONS: are provided only for those circum
stances which are medically determined to be life
endangering to the mother if the fetus were carried to
term.
MEDICALDENTAL PROGRAM: will be established
as recommended by area-wide Indian Health Service
guidelines, and based on budget and the need of service
delivery area.
EYEGLASS PROGRAM: The Tribal operation has
implemented an eyeglass program based on the recom
mended Indian Health Service guidelines, which at
. present is limited to children up to age 18, full-time
students, female senior citizens age 62 and older, male
senior citizens age 65 and older, and visually handi
capped people with certain specified serious eye disor
ders, (near and far-sightedness are not serious disorders).
FOR MORE INFORMATION CALL THE CON
TRACT HEALTH SERVICES OFFICE AT: (503)
879-5211. Toll free within Oregon State: 1-800-422-0232,
or write Contract Health Services Program,
Confederated Tribes of Grand Ronde, P.O. Box 178,
Grand Ronde, Oregon 97347. '
CONTRACT HEALTH SERVICES
1-800-422-0232
NATIVE AMERICAN STUDENT UNION
University of Oregon
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20TH ANNUAL
SPRING POW-WOW
MAY 13-14, 1988
MAC ARTHUR COURT
Featuring:
Wilfred Jim, Sr, Warm Spring, Oregon
Master of Ceremonial
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Nallvt American Student Uniua
UA Era Memorial Uniua
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NEW HEALTH SERVICES
Beginning Friday, April 8th, Indian Health Services will
be offering Therapeutic Massage, Body Therapy and , , ,
Physio-Theraphy each Friday between 1:00 and 4:30
p.m. except for prearranged dates. Their new volunteer,
Cloud (Dawn Faith Cloud, LMT) will be providing these
clinical therapies for Tribal members who have injuries,
disabilities, chronic pain, TMJ syndrome, postural mis
alignment, stress over load, recent grief and life adjust
ments (death of a loved one, divorce, job loss, and drug,
alcohol, nicotine, sugar, and food withdrawls, etc.).
Cloud is a 'Licensed Massage Technician' and holds
current state licenses in Oregon and Florida. She had
been in private practice as a BodyMind Therapist since
1981 and works out of "Common Ground Healing
Center in Portland on TuesdayWednesdayThursday.
Cloud has a background in Humanistic Psychology and
Human relations, as well as extensive training in many
different Body Therapy modalities. She specializes in
Trager Therapy, developed and taught by Dr. Milton
Trager. Trager is a gentle shaking, rocking, stretching of
the joints, muscles and tendons; to loosen & free painful
areas of the patient's body. It is a subtle, deceptively
gentle, yet very powerful, and is especially effective on
disabled and injured patients. Some of the other
therapies that Cloud is trained in are: Neuromuscular
(Deep Tissue), Swedish, Esalen, Sports-massage,
Reflexology, Reiki, Accupressure and Polarity.
"I am very pleased to be able to offer this nurturing,
healing experience to my Grand Ronde friends. I sense
that I was sent to Mother Earth not just to take but to
give back something. The greatest gift that I can offer is
my Self."
Appointments may be made, in advance, by calling
Grand Ronde Tribal Health, 879-5211, and ask for Mary
BrickelT. Home visitations are available (within a 20
mile radius) for Elders, disabled, or injured patients who
are unable to be transported to our Tribal Center.