Community Health Aide Program (CHAP) Introduction and History

The Community Health Aide Program (CHAP) was developed in the 1960s in response to a number of health concerns, including the tuberculosis epidemic, high infant mortality, and high rates of injury in rural Alaska. In 1968, CHAP received formal recognition and congressional funding. The long history of cooperation and coordination between federal and state governments as well as Native tribal health organizations has facilitated improved health status in rural Alaska.

CHAP now consists of a network of approximately 550 Community Health Aides/Practitioners (CHA/Ps) in more than 170 rural Alaska villages. CHA/Ps work within the guidelines of the 2006 Alaska Community Health Aide/Practitioner Manual, which outlines assessment and treatment protocols. There is an established referral relationship that includes advanced practice providers (APP’s), physicians, regional hospitals, and the Alaska Native Medical Center. In addition, providers such as public health nurses, physicians, and dentists make visits to villages to see clients in collaboration with the CHA/Ps.

The Alaska Area Native Health Service (AANHS) has the responsibility of providing medical and health-related services to Indian Health Service beneficiaries residing in Alaska. These services are provided by tribal organizations within the Alaska Native Health Care System. The village-based CHA/Ps are a vital link in the delivery system.

Community Health Aides (CHAs) are selected by their communities before receiving training. Training centers are located in Anchorage, Bethel, Nome, and Fairbanks. Traditionally, there are four sessions of CHA training, each of which lasts three to four weeks. Currently, there are distance learning opportunities for session training limiting time spent away from their communities. Between sessions, CHAs work in their clinics completing a skills list and practicum. After completing the four-session training curriculum and a clinical skills preceptorship and examination, the CHA qualifies as a Community Health Practitioner (CHP). CHA/Ps at any level of training may obtain certification by the Community Health Aide Program Certification Board (CHAPCB).