Support for the Community Health Representatives and Health Education Programs

WHEREAS, the National Indian Health Board (NIHB), established in 1972, serves all Federally recognized American Indian/Alaska Native (AI/AN) Tribal governments by advocating for the improvement of health care delivery to AI/ANs, as well as upholding the Federal government’s trust responsibility to AI/AN Tribal governments; and

WHEREAS, The Community Health Representatives (CHR) Program was established in 1968, under the authority of the 1921 Snyder Act (25 U.S.C. 13); and

WHEREAS, the Community Health Representative is a trusted member of the community who is well aware of cultural sensitivities and traditions and provides health care, health promotion, and disease prevention services; and

WHEREAS, CHRs provide services like in-home patient assessment of medical conditions, providing glucose testing or blood pressure tests to determine if the patient should seek further care, and providing transportation for medical care. They also help interpret prescriptions which is critical to patient safety; and

WHEREAS, by providing health education and reducing hospital readmissions, CHRs have contributed to lowering mortality rates; and in short, CHRs are part of the direct provision of health services, especially for the most vulnerable AI/ANs; and

WHEREAS, On February 12, 2018 the President released his fiscal year (FY) 2019 Budget Request to Congress. The budget would eliminate the Community Health Representatives program (currently funded at $60 million) and the health education program (currently funded at $19 million); and

WHEREAS, today, the CHR the program is funded through contracts, grants, or cooperative agreements based on the Indian Self-Determination and Education Assistance Act (P.L. 93-638) and program serves as the largest Tribally contracted and compacted program with more than 95% of CHR programs being directly operated by Tribes under P.L. 93-638 of the Indian Self Determination and Education Assistance Act, as amended; and

WHEREAS, There are more than 1,600 CHRs representing over 250 tribes in all 12 IHS