Special interests attempt to disrupt state of Montana and tribal partnership to improve access to care and provide services to underserved rural areas
The Gros Ventre and Assiniboine (Aaniiih and Nakoda) Tribes of the Fort Belknap Indian Community
Carried by Representative Jonathan Windy Boy, HB 599, Allowing for the (CHAP) for tribal facilities, increases access to providers, and therefore services, in the service areas of dental health, behavioral health, and community health. It is based on sovereignty and self-determination and allows the Indian Health Service to train persons to become community health aides, develop a curriculum for the training of community health aides, and create and maintain a Federal Community Health Aide Certification Board, by which individuals who complete the training curriculum are certified to provide services through Community Health Aide Program.
Although there have been concerns from the special interest groups that the Community Health Aide Program allows for untrained and uncertified individuals to perform irreversible surgical procedures without a mechanism for training and licensure, advocates and tribal leaders are calling the statements “erroneous and scurrilous.” They maintain that the Community Health Aide Program will not result in lower quality healthcare and will not place Native communities at risk of receiving substandard medical, dental, or behavioral health care because of the strict certification requirements. Further, the Indian Health Service conducts a statutorily mandated system to evaluate community health aides to assure that quality health care, health promotion, and disease prevention services are being provided to the target population.
The services which would be available through the Community Health Aide Program are currently being provided minimally or not at all due to the lack of providers willing to work in isolated reservation areas. Preventing the Community Health Aide Program would further inhibit needed services to rural communities. Seven other states have passed Community Health Aide Program legislation.
“This bill allows tribes to take charge of our own health care by providing a Native-led, community-based solution to address multiple issues regarding Native health care,” said President Andrew Werk of the Fort Belknap Indian Community Council. “All services provided under the Community Health Aide Program are 100 percent billable under Medicaid. It brings in federal dollars to the state, saves money by addressing health issues before they become costly problems later, promotes partnership between tribal, state, and federal governments, and doesn’t cost the state anything. It’s good for everyone.”
HB 599 made it through the House of Representatives and is scheduled for hearing in Senate Public Health, Welfare, and Safety on Monday, March 18th, 3:00 pm.