MONTANA – Governor Steve Bullock today joined Fort Belknap Indian Community Tribal leaders and state legislators to celebrate a new law that will allow Montana tribes to set up Community Health Aide Programs to improve access to health care for Native Americans living in reservation communities.
“I am thankful to the Fort Belknap community and tribal leaders who recognize that a great opportunity lies ahead for Native American communities and that doors to access can be opened with this legislation,” Governor Bullock said. “This is the innovative leadership that can lead to ensuring every single Montanan has the health care they deserve. When Indian Country succeeds, all of Montana succeeds.”
"We are proud to have worked with Governor Bullock, Senator Small, and Representative Windy Boy along with other tribal leaders and advocates to pass this monumental legislation to build the tribe’s capacity to train and provide primary or preventative healthcare to our people,” said Andrew Werk, President of the Ft. Belknap Indian Community Council. "This is a great example of tribes leading solutions to the unique challenges we face and of working government to government while maximizing our sovereignty to care for our community's health."
House Bill 599, sponsored by Rep. Jonathan Windy Boy, passed during the 2019 legislative session and was signed into law by Governor Bullock to eliminate barriers by allowing Montana tribes to set up Community Health Aide Programs. This is an innovative way to employ local, indigenous people to provide basic primary and preventative care in remote communities.
The legislation provides for the Indiah Health Services to establish a community health aid program in the state of Montana and maintain a certification board to adopt standards and set the scope of practice. Aides will be part of an established team-based or referral network that includes physicians, primary care clinics, and regional hospitals. Aides will have a personal tie to the community they serve.
Care provided can include traditional services such as limited physician, behavioral, and dental health care, as well as health screenings, in-home care, and prescribing eyeglasses. More innovative services to remove barriers to accessing care include providing transportation to appointments, helping patients understand a treatment plan, ensuring patients know how to take medications, and education on suicide prevention.
CHAP will bring federal dollars to the state, requiring no cost to the state, and will help save money on healthcare costs by helping to address health issues early on and preventing costly complications down the road. This model will also help to promote partnerships between tribal, state and federal governments.
CHAP is modeled after an Indian Health Services Program that utilized local indigenous people in Alaska to distribute medicines during a tuberculosis epidemic in the 1950s. The program evolved over the last 50 years with aides offering basic primary and preventive services in 170 rural Alaska villages.
There is a growing interest at the national level in community health workers. Last week, Governor Bullock announced a pilot program in six Montana communities to expand EMS services to non-emergency, preventative care in a patient’s home. The Governor’s Council on Healthcare Innovation emphasized the potential value of community health workers in its 2016 report. A growing body of research has demonstrated that community health workers can improve chronic disease management, enhance disease prevention and screening, promote positive lifestyle behavior changes and more.