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Public Health Policy & Programs Director

Posted: June 29, 2016

NIHB and NPAIHB Tribal Only Call on the Creation of National IHS Community Health Aide Program (CHAP)

The National Indian Health Board and the Northwest Portland Area Indian Health Board (NPAIHB) will be hosting a Tribal Only call on the Creation of a National Indian Health Service Community Health Aide Program (CHAP) on Thursday, July 7, 2016 at 4:00PM ET to discuss the proposed comments and provide input on the creation of a national Indian Health Service Community Health Aide Program (CHAP). Comments on the Creation of a National Indian Health Service CHAP are due to IHS no later than July 29, 2016. NIHB and NPAIHB will work collaboratively to develop a template Tribal comment letter to assist Tribes in making their own comments. NIHB and NPAIHB have created a briefing paper on CHAP for Tribes. Please contact Devin Delrow ([email protected]) for call-in information.



Posted: June 2, 2016

Tribal Exemption from Employer Mandate

The Tribal Employment and Jobs Protection Act (H.R. 3080) was considered in a Full Committee Markup of the U.S. House of Representatives House Ways and Means Committee:
H.R. 3080 was reported favorably by the Committee on a vote of 24 (yes) - 13 (no)

This legislation, introduced by Representative Kristi Noem (R-SD), seeks to exempt Tribes and Tribal employers from the employer mandate under the Patient Protection and Affordable Care Act (ACA). It would prevent fines that Tribal employers would incur under the employer mandate and ensure that the U.S. federal government lives up to its trust responsibility to federally recognized Tribes.

As the House Ways and Means Committee Chairman Kevin Brady (R-TX) said today in his opening statement, "Congresswoman Noem's legislation brings relief from Obamacare's employer mandate to Tribally owned businesses...by advancing these bills today, we can demonstrate that we are serious about addressing major challenges in child welfare and health care."

The legislation will now move to be considered by the full House of Representatives. NIHB will continue to monitor and provide updates on this important legislation. If you have questions or feedback regarding this issue, please contact Mr. Devin Delrow, NIHB Director of Federal Relations, at (202)-507-4070 or [email protected].



Posted: June 2, 2016

Indian Health Service Seeking Tribal Consultation on the Catastrophic Health Emergency Fund (CHEF) Proposed Rule

Yesterday, the Indian Health Service (IHS) released a Dear Tribal Leader Letter to provide an update on the proposed rule for the Catastrophic Health Emergency Fund (CHEF). Several Tribes and Tribal Organizations, including the National Indian Health Board (NIHB), submitted comments and expressed concerns about the provisions and requested Tribal consultation before finalizing the rule. In response, IHS is listening to Tribes and will not move forward with the proposed rule until Tribal consultation has taken place, which will include two telephone consultation sessions and an in-person consultation session at the National Congress of American Indians (NCAI) Convention scheduled for October 9-14, in Phoenix, Arizona...

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Posted: June 1, 2016

Indian Health Service Seeking Tribal Consultation on Draft Policy to Expand Community Health Aide Program

Today the Indian Health Service (IHS) released a Dear Tribal Leader letter requesting Tribal Consultation on a draft policy statement detailing the planned national expansion of the Community Health Aide Program (CHAP, including the creation of a national certification board.

The national expansion of the CHAP would mean an increase in paraprofessionals and workers providing services for health education, communicable disease control, maternal and child health, dental health, behavioral health, family planning, and environmental health. Community health aide is an encompassing term that includes behavioral health aides, nursing aides, and dental health aides. Many Tribal communities are likely familiar with a community health aide program already in place: the IHS Community Health Representative (CHR) program. The CHR deploys trained and medically guided health care workers that provide medical services, including health education, case management, patient transport, and patient advocacy.

Tribal communities in Alaska also benefit from the Dental Health Aide Therapist (DHAT) program, which brings dental education and routine dental services to rural Alaska Native communities. DHATs provide dental services to 40,000 Alaska Native people since 2004. Many rural Alaskan Native villages also have Community Health Aides (CHA). CHAs serve as a primary provider for many individuals, providing emergency first aid, patient examinations and follow-ups in conjunction with the treating physician, and carrying out treatment recommendations, education and instruction, and conducting preventive health programs. Behavioral Health Aides (BHA) work within Tribal communities to address behavioral health needs, including substance abuse and mental health problems. BHAs address these needs by serving as counselors, health educators, and advocates.

With a low access to care in many Tribal communities and tremendous success in existing programs, the Indian Health Service is committed to expanding the Community Health Aide Program. In the draft policy statement Mary Smith, Principal Deputy Director of the IHS, states, "Not only do CHAPs contribute to the overall health care team, but the additional advanced training they receive often leads to improved health and quality of life for the communities they serve. CHAPs are proven partners in health, and the IHS is committed to seeing them expand outside of the State of Alaska."

In the coming weeks, NIHB will be reaching out to Tribes and Tribal organizations for their input on what they would like to see in the policy. Based on this input, NIHB will create a template comment and briefing memo for Tribes to use in submitting their own comments. If you would like a copy of these materials or more information, please contact NIHB’s Director of Federal Relations, Devin Delrow at 202-507-4072 or [email protected].

Comments are due to IHS on Friday, July 29, 2016.

Comments may be submitted to [email protected], with the subject IHS Expansion of Community Health Aide Program Draft Policy Statement Consultation.

Mail your comments to:
Alec Thundercloud, M.D.
Director, Office of Clinical and Preventive Service
Indian Health Service
5600 Fishers Lane Mail Stop: 08N34-A
Rockville, MD 20857
ATTN: IHS Expansion of Community Health Aide Program Draft Policy Statement Consultation



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