IHS Solicits Tribal Consultation on Proposed CHAP Expansion

Published on Jun 01, 2016

Indian Health Service Solicits Tribal Consultation on Proposed Community Health Aide Program Expansion

Washington, DC – In a teleconference meeting today, Indian Health Service (IHS) Principal Deputy Director Mary Smith called on tribal leaders to provide feedback and input on an IHS draft policy statement that could expand the innovative Community Health Aide Program (CHAP) beyond Alaska. The CHAP program funds nursing aides, behavioral health aides, and in some cases, mid-level dental providers called Dental Health Aide Therapists (DHAT), along with other types of community health workers, to ensure residents of rural communities have access to health services. Currently, Alaska is the only IHS service area that has the program in place.

Tribal communities in Alaska have embraced the CHAP and DHAT programs, and tribal leaders outside the state have long advocated for expansion of the programs as part of an overall strategy to improve access to care, especially in remote and rural areas facing provider shortages. The proposed new IHS policy underscores the Agency’s recognition of the CHAP and DHAT programs as effective, efficient, and culturally competent mechanisms for increasing access to high-quality health and dental care by American Indian and Alaska Native people across the nation.

“Today’s announcement is a tremendous step forward in creating the health care systems our citizens need and deserve,” stated NCAI President Brian Cladoosby. “The CHAP and DHAT programs are common sense approaches that deliver excellent care. Every tribe should be able to determine what care model works for citizens, and every tribe should be able to set up these innovative models.”

In the draft policy statement, IHS also notes Congressional support for the program as demonstrated in the Indian Health Care Improvement Act, which authorized creation of a national CHAP program.

DHATs not only provide high quality care to their patients, but also bring high levels of cultural competence to their practice settings – as most DHATs are from the communities they serve. (Nearly 80 percent of DHATs returned to their home villages to practice and the program has an 81 percent retention rate.) The Alaska program has allowed for more than 40,000 patients to be treated for the first time. A study conducted by Community Catalyst demonstrated that mid-level dental providers cost less than 30 cents for every dollar of revenue they generated.

While both DHAT and CHAP programs have won many awards since 2005 for their impact on remote and rural health, some of the most impressive accolades come from the populations being served by DHATs and CHAPs. “Children and adults too would be so scared. Every time they thought of dental, they thought of pain. I was able to build trust with them,” shared DHAT Bonnie Johnson. “Now they are excited to see me… I’m not only here to fix pain; I’m here to prevent it.” 

NCAI Executive Director Jaqueline Pata stated, “Tribal leaders have shown tremendous support for and interest in both the CHAP and DHAT programs. These are model programs that have been incredibly successful. We applaud IHS for exploring ways to scale up these programs nationally so that they can benefit all of Indian Country.”


About The National Congress of American Indians:
Founded in 1944, the National Congress of American Indians is the oldest, largest and most representative American Indian and Alaska Native organization in the country. NCAI advocates on behalf of tribal governments and communities, promoting strong tribal-federal government-to-government policies, and promoting a better understanding among the general public regarding American Indian and Alaska Native governments, people and rights. For more information visit www.ncai.org.

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