25 U.S.C. § 1616l — Community health aide program

(a) General program. Under 25 U.S.C. § 13, the Secretary^*, through the Service^*, must operate an Alaska Community Health Aide Program that trains Alaska Natives as health aides or community health practitioners, uses them to provide health care, health promotion^*, and disease prevention^* to Alaska Natives in rural villages, and establishes teleconferencing in or near those villages’ clinics.

(b) Requirements. Through the program, the Secretary must use accredited trainers to provide high-quality training; create a curriculum combining health-care theory with supervised practice and covering acute and emergency care, health promotion, disease prevention, and efficient clinic pharmacy, supply, equipment, and facility management, while promoting the objectives in 25 U.S.C. § 1602(2); certify successful trainees or people with equivalent experience through a Community Health Aide Certification Board; identify continuing-education needs and provide programs; maintain close supervision; review and evaluate work for quality; and ensure that pulpal therapy (except pulpotomies on baby teeth) or adult-tooth extraction occurs only after a licensed dentist determines it is a medical emergency that palliative treatment cannot resolve. Dental health aide therapists may not perform other oral or jaw surgery; uncomplicated extractions are not treated as oral surgery under this section.

(c) Review. (1) The Secretary must establish a neutral panel appointed from clinicians, economists, community practitioners, oral epidemiologists, and Alaska Natives. (2) The panel must study whether dental health aide therapist services are adequate and appropriate. The Secretary, consulting interested parties including professional dental groups, sets the study parameters. The study must decide whether the services meet Alaska Natives’ dental needs, what quality, training, improvement, or oversight is needed, and whether safer, less costly alternatives exist. The panel must consult Alaska tribal organizations about accuracy and adequacy. (3) The panel must report results to the Secretary, Senate Committee on Indian Affairs, and House Committee on Natural Resources, including its determinations and tribal-organization comments.

(d) National program. (1) Except as paragraph (2) provides, the Secretary may establish a national program consistent with this section. (2) Subject to paragraphs (3) and (4), the Secretary may not reduce funding for Alaska’s program and must exclude dental health aide therapist services. (3) That exclusion does not apply when a tribe or tribal organization^* outside Alaska elects to use those services or midlevel dental-provider services, and State law authorizes them; the Secretary must facilitate the elected services. (4) The Service may not fill a certified-dentist vacancy with a dental health aide therapist.

(e) Other authority. This section does not limit the Service, a tribe, or a tribal organization from joining a program or providing a service authorized by another Federal law.