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.

Specialized Care

Provides care by culturally competent & respected members of their community

Improved Care

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

Enhanced Care

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

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.

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.

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

Medical Histories
Physical Exams
Vital Signs
Basic Specimen Collection for Labs
Medication Management
Acute Care
Wound Care

Chronic Wound Care
Adolescent Health
Family Planning
Prenatal Care
Postnatal Care
Newborn Care
Well-Child Care

Sick Child Care
Reproductive Health
Chronic Care of Major Systems
Clinical Management
Team Leadership
Mentorship & Support to All CHA Levels

Medical Histories
Physical Exams
Vital Signs
Basic Specimen Collection for Labs
Medication Management
Acute Care
Wound Care
Chronic Wound Care
Adolescent Health
Family Planning

Prenatal Care
Postnatal Care
Newborn Care
Well-Child Care
Sick Child Care
Reproductive Health
Chronic Care of Major Systems
Clinical Management
Team Leadership
Mentorship & Support to All CHA Levels

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/

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.

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.