§1616l Community health aide program

Summary

The Secretary must set up and run a Community Health Aide Program in Alaska. The program must train Alaska Natives to be health aides or community health practitioners. Those aides must give health care, promote health, and help prevent disease for people in rural village clinics. The program must also create teleconferencing in clinics near those villages. Trainers approved by the program must teach a mix of classroom lessons and supervised hands-on experience that covers emergency and acute care, health promotion, disease prevention, and running clinic pharmacies, supplies, equipment, and facilities. The program must have a certification board, offer continuing education, provide close supervision, and regularly review the aides’ work. For dental care, dental health aide therapists may do pulpal therapy (but not pulpotomies on baby teeth) or pull adult teeth only after a licensed dentist consults and says it is a medical emergency that cannot be handled with palliative care; they are strictly barred from other oral or jaw surgery, though simple extractions are not treated as oral surgery. The Secretary must also create a neutral panel of clinicians, economists, community practitioners, oral epidemiologists, and Alaska Natives to study dental health aide therapist services. The panel must check whether these services meet community needs, whether care quality is adequate or needs more training or oversight, and whether safer or cheaper options exist. The panel must consult Alaska tribal organizations and report its findings to the Secretary and to Congress committees. The Secretary may expand the program nationally but cannot cut funding for the Alaska program and must exclude dental health aide therapist services except when an Indian tribe in a State (not Alaska) where state law allows those services chooses to include them; the Secretary must help with such an election. A dental health aide therapist cannot be hired to fill a certified dentist vacancy. Nothing here prevents the Service, tribes, or tribal organizations from joining other federal programs or offering other services allowed by law.