The W.K. Kellogg Foundation (WKKF) applauds the Indian Health Service’s (IHS) announcement to expand Alaska’s successful Community Health Aide Program (CHAP), which includes dental therapists, to tribal communities throughout the United States. Community health aide workers are critical to expanding access to much-needed health care and dental health services that so many tribal citizens have long had to do without. IHS will now consult with tribal leaders on the proposed plans and will be accepting public comments on the proposal through July 29, 2016.
CHAP began in the 1960s as a tribal solution to make primary care services available to Alaska Natives in remote communities in Alaska. In the CHAP program, Alaska Natives have been trained to serve as primary care, non-physician providers, which includes behavioral health, nursing and dental health aides.
Communities value and embrace these providers who overwhelmingly return to practice in the villages and surrounding areas in which they grew up. They offer high-quality, culturally competent care and a deep understanding of the community, its traditions and cultures, as well as its health needs.
Having traveled to Alaska just last week, I had a chance to see this front-line initiative operating in real time. Prior to joining WKKF, I oversaw the public health system in Boston for a number of years, and I have seen many innovative initiatives as a prior vice chair of the Big Cities Health Coalition Alumni Council, which is a project of the National Association of County and City Health Officials. I was impressed with the rigor of the community dental health aide therapist program in Alaska. It is clearly making an immense difference in promoting health equity and improving the overall health of tribal members and their communities. What I saw confirmed the findings from a national RTI study, “Evaluation of Dental Health Aide Therapist Workforce in Alaska,” which reports that dental health aide therapists provide high-quality, safe and effective care to people in their own communities. Equally important, it found patients were highly satisfied with the care they received.
Today, the Alaska Native Tribal Health Consortium’s Dental Health Aide Therapist (DHAT) Program is providing regular dental care to 45,000 people living in remote Alaska Native villages and oral health is improving.
The IHS recognition of the vision of tribal leaders in adding these professionals to health and dental care teams is the first step toward making a national federally-funded CHAP program a reality.