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Tribal leaders, providers urge Montana to remove CHAP sunset and expand community health aides
Summary
Senate Bill 170 would eliminate the termination date for the Community Health Aid Program, proponents told the Health and Human Services committee, arguing CHAP builds a local health workforce for reservation and rural communities; DPHHS said federal certification/licensing requirements remain unresolved.
Senator Jonathan Windiboy opened the committee hearing on Senate Bill 170, which would eliminate the termination (sunset) date for the Community Health Aid Program (CHAP) and authorize the department to pursue federal authorization steps such as a state plan amendment to Centers for Medicare and Medicaid Services as required.
Multiple tribal leaders and advocates testified in strong support. Lance Forstar submitted a letter from the Montana American Indian Caucus urging a due pass. Alyssa Snow, representing the Blackfeet tribe and other tribal communities, said CHAP empowers ‘‘grow‑your‑own’’ midlevel providers who already live and work in tribal communities and can address critical access gaps in reservation service deserts. Keaton Sunchild of Western Native Voice framed the bill as an affirmation of tribal self‑determination that creates career pathways for behavioral, dental and mental health aides.
Stacy Anderson noted the bill’s legislative history: CHAP versions previously passed the House and Senate by large margins and proponents said tribal partners have since developed program regulations and training. Joel Rosette (Rockwood Health Center) and other tribal health leaders told the committee tribal CHAP programs are operational in Montana and that tribal providers receive 100% federal reimbursement (FMAP) for CHAP services according to testimony.
DPHHS testimony from Mary Lemieux clarified federal constraints. Lemieux said the department has not yet submitted federal authority for the CHAP services because federal law required a national certification board to establish education and licensing standards; that national board has not completed its work and DPHHS has no timeline to submit a state plan amendment (Lemieux said it would be a state plan amendment, not a waiver). Committee members asked whether the department could proceed; Lemieux said it cannot submit the SPA until the national board finalizes its standards.
Senator Windiboy closed urging a due pass and arguing Montana should not wait indefinitely for federal action to move the program forward locally. He described CHAP roles (dental health aides, behavioral health aides and mental health aides) as a proactive, school‑ and community‑level approach to early detection and access.
The hearing record shows broad proponent support and informational DPHHS testimony about federal certification and the SPA process; no opponents were recorded in the hearing.
