About

The Community Health Aide Program (CHAP) is a multidisciplinary system of mid-level behavioral, community, and dental health professionals working alongside licensed providers to offer patients increased access to quality care in rural Alaskan areas. In 2016, The Indian Health Service (IHS) consulted with Tribes on expanding the program, and in 2018, formed the CHAP Tribal Advisory Group (CHAP TAG) to expand CHAP to the lower 48 states.

Benefits of Health Aide Providers

The Community Health Aide program is a sovereign right of every federally recognized tribe within the United States to create a custom healthcare model specifically tailored to each individual tribal community’ needs. It is a multi-disciplinary approach to filling the gaps in tribal communities’ healthcare needs, including access to culturally competent care and lack of healthcare providers.

1

Specialized Care

Provides care by culturally competent & respected members of their community

2

Improved Care

Provides unique opportunities for Tribes to improve current health & education systems

3

Enhanced Care

Improves continuity of care, alleviate recruitment & retention in tribal health care systems

4

Careers in Care

Provides education & career advancement in workforce

What is a CHR?

The Community Health Representative (CHR) Program is a unique concept for providing health care, health promotion, and disease prevention services. CHRs have demonstrated how they assist and connect with the community, and their work has become essential to the spectrum of Tribal community-oriented primary health care services. CHRs are great advocates, in part, because they come from the communities they serve and have tribal cultural competence. Their dedicated work has assisted many to meet their healthcare needs. The health promotion and disease prevention efforts that CHRs provide have also helped people from the community improve and maintain their health. By providing health education and reducing hospital readmissions, CHRs have contributed to lowering mortality rates. The demand for CHRs continues to grow. 

A female nurse checking the schedule on a tablet.

CHR is a great place to start if you are hoping to advance towards a Community Health Aide, Dental Health Aide, or Behavioral Health Aide. 

Nurses and doctors.

What is a CHA/P?

The Alaska CHAP model consists of roughly 550 Community Health Aides/Practitioners (CHA/Ps) in more than 170 rural villages. These CHA/Ps operate within the guidelines of the 2006 Community Health Aide/Practitioner Manual that outlines the assessments of treatments and protocols. They have an established referral relationship with Advanced Practice Providers (APPs), Physicians, and the Alaska Medical Center. CHAP Physicians will make visits to the rural communities they oversee whenever possible in collaboration with the local CHA/Ps who are in the communities full-time.

In Oregon, Washington, and Idaho, CHA/Ps are community members of American Indian/Alaska Native communities who attend educational programs approved by the Portland Area CHAP Certification Board and work within the tribal health and human systems.

Although the lower forty-eight states may have different geographical needs than Alaska, the southern plains area still experiences significant gaps in healthcare coverage for our Native American populations due to rurality, lack of healthcare providers secondary to location and compensation limitations, as well as cultural and trust implications to seeking care. CHAP pioneers have partnered with national stakeholders to share their knowledge and lessons learned along the CHAP journey to help improve CHAP implementation efforts for all federally recognized tribes who are willing and able to bring this culturally specific healthcare model to our own communities.

General Scope of Practice

General Scope of Practice

What is a DHA/T?

A dental health aide is a dental provider practicing under a licensed dentist who can provide a range of common dental procedures to support tribal community dental health with a tiered scope of work. A dental health aide therapist’s scope is just under that of a dentist. It will be operational on a state-by-state basis dependent on current and future legislation and state plan amendments supporting tribally regulated DHAT as a sovereign right of federally recognized tribes as seen in precedent with other state’s tribes currently operating a DHAT provider. For more information on where DHATs can currently practice and more, visit the National Partnership for Dental Therapy at https://www.dentaltherapy.org/

Dental Health Aide

Alaska’s Tribal Health System educates and employs four levels of Dental Health Aides. Primary Dental Health Aides provide patient education and preventative services such as fluoride and oral hygiene education. They can also be trained to be a dental assistant, take radiographs, provide cleanings, complete atraumatic restorative treatment, and place sealants. Expanded Function Dental Health Aides can be educated to either place restorations or provide cleanings. Dental Health Aide Hygienists must hold a state license as a registered dental hygienist. Dental Health Aide Therapists/Practitioners (DHAT/DHATPs) receive three academic years of education through the Iḷisaġvik College/ANTHC Alaska Dental Therapy Educational Program or another Commission on Dental Accreditation accredited program. DHATs can provide diagnosis and treatment planning, cleanings, sealants, fillings, and extractions. All Dental Health Aides earn certification from the Alaska Community Health Aide Program Certification Board.

A woman holding another woman's hand to comfort her.

What is a BHA/P?

A behavioral health aide (BHA) is a community-based mental health/substance use disorder provider who is employed by a Tribal Behavioral Health Program to support the mental health needs of all community members. They provide services within the community under the supervision of a licensed provider with a tiered scope of practice based on an intense BHA Program. The program requires completion of a curriculum and a specific number of practicum hours to be eligible for certification. At this time there are two curriculum options within the lower forty-eight states. Both are in the Northwest Portland area. Learn more on enrolling in these education programs here:

Northwest Indian College (NWIC) – Online Course

Heritage University – Hybrid Course (online/in-person)

The Behavioral Health Aide (BHA) Program grew out of Alaska’s statewide “counselor-in-every village” initiative to provide behavioral health prevention, treatment, and recovery services in rural Alaska. The BHA program was founded by the Alaska Native Tribal Health Consortium (ANTHC) in 2009 and modeled after the Community Health Aide Program (CHAP), which was established to assess and provide emergent, acute, and chronic medical care to residents in rural communities.

Questions About the
Community Health Aide Program?

The Team

Julie Seward, RDH, MEd
Julie Seward, RDH, MEd
Program Manager

Julie is a Registered Dental Hygienist from Checotah, OK and a citizen of the Cherokee Nation. Julie is a Program Manager at the Southern Plains Tribal Health Board (SPTHB). The Southern Plains Tribal Health Board (SPTHB) is a non-profit organization based in Oklahoma City that provides a unified voice on tribal public health needs and policy for the 44 federally recognized tribes located in the states of Kansas, Oklahoma, and Texas. Julie practiced clinical dental hygiene in general and periodontal practice settings for over 10 years. She served as dental hygiene faculty for 3 years at Houston Community College. At the SPTHB, Julie serves as the program lead for multiple programs including the Community Health Aide Program (CHAP), Oklahoma Shared Clinical and Translational Resources, and the Native Oral Health Network (NOHN). Julie previously served as the Grassroots Representative for Oklahoma and on the National Oral Health Connection Team (NOHCT) through the Oral Health Progress and Equity Network (OPEN), the vice-chair of the Oklahoma Oral Health Coalition and the Public Health Chair of the Oklahoma Dental Hygienists' Association. Julie currently serves on the Dental Hygiene Advisory Committee to the Oklahoma Board of Dentistry. In 2020, she was the recipient of the Oklahoma Public Health Association’s Exceptional Merit award and in 2023 was the recipient of the Delta Dental of Oklahoma Foundation’s Distinguished Service Award.

Kimberlee Burgess
Kynsington Cochran
Public Health Specialist

Kynsington Cochran is a proud member of the Kiowa Tribe of Oklahoma. She obtained her bachelor’s degree in psychology from Oklahoma State University. Currently, Kynsington holds the position of Public Health Specialist for the Community Health Aide Program at Southern Plains Tribal Health Board (SPTHB).

Kynsington Cochran
Kimberlee Burgess

Kimberlee is a proud mother of 3 children, two boys and a girl, and wife to lifelong friend and husband, Aria. She is a Registered Nurse (RN), receiving her Associate of Applied Science from Northern Oklahoma College in 2014, and recently obtained her Bachelor of Science in Nursing from Northeastern State University in Tahlequah, OK. She is a proud descendant of the Otoe Missouria Tribe. Kimberlee is a program coordinator at the Southern Plains Tribal Health Board (SPTHB). SPTHB is a non-profit organization based in Oklahoma City that provides a unified voice on tribal public health needs and policy for the 44 federally recognized tribes located in the states of Kansas, Oklahoma, and Texas. Kimberlee has spent many of her 10 years as a RN providing service to rural, underserved, and Native American communities. After a short stretch in the intensive care unit for Ponca City Hospital, Kimberlee provided home health nursing care to residents all over Oklahoma. She worked her way from field nursing up the leadership ladder to becoming a regional manager for the Homecare company. When the pandemic hit, she was called to provide service within tribal communities and started as a Public Health Director for the Ponca Tribe of Oklahoma; creating the Public Health Department, creating COVID-19 protocol, and establishing an award winning vaccine program that would ultimately help vaccinate thousands of patients including multiple public schools throughout Kay County as well as colleges, businesses, and factories who couldn’t gain access to the vaccine. Kimberlee’s path eventually led her to work for her people as the Director of Health Services for Otoe Missouria Tribe where she discovered Alaska’s Community Health Aide Program (CHAP) and became intrigued with the idea of bringing the program to communities in Indian Country. She believes in Chap and wants to be a part of bringing it to Oklahoma area and was called to apply to serve the CHAP program. At the SPTHB, Kimberlee currently serves as the program coordinator for the Community Health Aide Program (CHAP), a program she is truly passionate about and aims to serve communities in Indian Country in every way possible.