CHR Impact Stories
Community Health Representatives (CHRs) are a special and important part of health care, disease prevention, and education in Indian Country. CHRs are essential to Tribal community health services because CHRs come from and share tribal cultural competencies with their communities. CHRs provide health education and support that reduces the severity and impacts of medical conditions, lessens hospital admissions, and contributes to lower mortality rates. Their dedicated work allows healthcare services to more fully meet the needs of the people they serve.
Stories have been edited and condensed for clarity.
Read Chickasaw Nation CHR impact stories.
Read OST CHR impact stories.
Catherine Jeffries, Director, Oglala Sioux Tribe Rapid City CHR/CHW Program (OST-RC CHR/CHW)
I've worked my way up from Data Entry/Administrative Assistant in 2007, and have a Bachelors in Business Administration. I was selected as the Director in January of 2020. Our competencies include: Basic Life Support/automated external defibrillators (AED), BASIC training, First Aid, Suicide Prevention, Mental Health First Aid, and Vitals training. Our core roles are: Case Management, Transportation, Medication Deliveries, and health education. We work mainly with Elders but also high risk clients which include: High risk pregnancies, Dialysis and Mental Health to name a few. We work with both Native Healing and Native Women's Health Care, part of three Master Health programs under the Oglala Sioux Tribe here at Sioux San, Rapid City, SD. We are moving toward Mental Health First Aid which we trained for and later this year, Peer to Peer training. In FY 20/21 we worked with a Waiver Grant with the South Dakota Division of Medical Services. I wrote a Policy and Procedure Manual linking Prenatal, and Behavioral Health, and Substance Use Disorder for CHW work to bill for services. I was the first in the State of South Dakota to do so and it was approved by the State. In the Manual, I put in what a CHR does and what a CHW can do for billing.
We are always monitoring patients. We screen calls for urgent care to make sure they don't need an ambulance instead. We have three fluent Lakota Speakers. Transportation is the biggest concern for the community. We buy transit tickets for the able-bodied, and Dial-A-Ride tickets or provide taxi rides for dialysis patients. It is a big help for our program. We have limitations on what medications we can deliver, otherwise, we have to take the client to pick up their medications, especially controlled substances. Prior to Oyate Health Center, we worked with IHS extensively. There was a committee who met twice a month to staff high-risk, mostly Elders in the Community. Key players were: DSS LTSS, Fire Department, IHS Social Services, IHS Mental Health, PHN, Health Educator and the CHR program, it was dissolved after it was taken over by OHC. The CHRs were usually tasked with following up and case managing high-risk clients, especially the ones who had issues with alcohol.
Tosha Andrews, CHR Specialist, OST-RC CHR Program
I have worked for the CHR program since May 2020, with clients of all ages and needs. My first CHR/CHW client is a middle-aged female who was a dialysis patient, blind, amputee, and a severe diabetic. A dialysis social worker reached out to us for resources on transportation, med pickup and case management. During our first home visit, I met with her and her two teenage children. I immediately started working with the family on making appointments to establish primary care here in RC. The daughter and mother both needed appointments for diabetes medications and supplies. Her son was in dire need of dental care for an infection, and also to be checked for diabetes. I accompanied each to their appointments and helped fill out all paperwork and forms for the mother who is completely blind. I have worked on teaching healthy meal ideas, food alternatives, and ways to avoid infection. When she is low on food I take her to food drives and find resources to help with necessities. For over a year we provided transportation to and from dialysis 3 times a week. I help coordinate appointments and advocate for mom and children. My client is very dependent on her children for her everyday care such as cooking, cleaning and bathing, which sometimes puts a strain on their relationship and makes it hard on her emotionally and mentally. I have had the pleasure of being able to listen to the family and support them during these hard days and times and to offer advice and words of encouragement. I also helped her daughter acquire a State ID. The program is vital to my client and her family as well as others in the community. She always expresses great gratitude for what our program has done for them.
Debbie Charge On Him
I have been with the CHR program since May 2010, and am the Data Entry and Billing Specialist for OST/RC/CHR/CHW. I train the CHRs in PCC coding and Trip Reports. I started billing for transportation in July 2020 during the pandemic, when everybody stayed home. Our transportation numbers went down a lot and so did the billing.
Jennifer Floor, Psy.D., LCP, Director of Behavioral Health
The Mid-Atlantic Service Unit (MASU) is located in Richmond, VA and we are in the early stages of developing direct care services for our patient population through the development of two healthcare facilities and three mobile health units. As such, we are a growing staff and that includes our Community Health Technician (CHT) program. Our CHTs are in the tribal communities providing the highest quality of services in several core competency areas including health education and counseling, developing relationships and monitoring community needs, health promotion and disease prevention, and transportation/deliveries. As our service unit grows, we envision a broader scope of services for the CHT program and they will function as an integral part of our newly established healthcare team.
In the past year, the CHTs have been active in the tribal communities engaging in various community health activities. For instance, the CHTs were heavily involved in MASU vaccine clinics. They served many roles in this process including assisting with developing plans, coordinating with the tribes to ensure successful outcomes, advertising the program, setting up the clinics, assisting patients and the medical staff during clinics, and conducting satisfaction surveys. To date, they have participated in more than 10 successful vaccine clinics aimed to vaccinate Virginia tribes against flu, COVID-19, and shingles.
The CHTs have also participated in a wealth of other community health activities. They provide health education and disease prevention information during vaccine clinics and deliveries; deliver personal protective equipment, such as masks, sanitizer, and COVID test kits; pick up and deliver prescription medications and healthcare equipment to community members who have barriers to transportation; conduct routine calls to elders in the community to provide support and address health needs as appropriate; provide patient tours of our mobile health units and educate the community about services; and many more.
More exciting CHT projects are on the way. The CHTs have taken the lead on creating MASU’s first quarterly newsletter highlighting health education information, IHS and community resources, and our growing team to keep our tribal communities informed and up to date on the latest health information. They are also in the planning process for implementing mini health fairs for our tribal communities. These efforts and their presence in the communities have initiated positive working relationships with the tribes in Virginia and we look forward to their ongoing efforts in promoting health across Native communities.
