Support for Dental Health Aide Therapist Programs in Indian Country

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TITLE: Support for Dental Health Aide Therapist Programs in Indian Country

WHEREAS, we, the members of the National Congress of American Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants the inherent sovereign rights of our Indian nations, rights secured under Indian treaties and agreements with the United States, and all other rights and benefits to which we are entitled under the laws and Constitution of the United States, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise promote the health, safety and welfare of the Indian people, do hereby establish and submit the following resolution; and

WHEREAS, the National Congress of American Indians (NCAI) was established in 1944 and is the oldest and largest national organization of American Indian and Alaska Native tribal governments; and

WHEREAS, American Indian and Alaska Native (AI/AN) people have a higher prevalence of dental caries and untreated tooth decay in all age groups compared to the general United States population, with many AI/AN children experiencing dental caries before the age of two, yet there are few dental caries prevention programs that target AI/AN children and other oral health issues persist for the AI/AN population; and

WHEREAS, these disparities are directly attributed to a lack of dental health professionals in the Indian health system in which IHS dental providers have a patient load of 2,800 patients per provider, while general population providers have approximately 1,500 patients per provider and the IHS experiences a very high dental provider vacancy rate, with estimates that 26 percent of the dental positions within the IHS are vacant, which contributes to the lack of access to dental health services; and

WHEREAS, the Alaska Native Villages determined the most expedient and successful approach to resolving their dental crisis was to send their Members to New Zealand to learn how to provide dental care to their communities as Dental Health Aide Therapists (DHATs) and presently provide DHAT training through the two-year educational program managed by the Alaska Native Tribal Health Consortium; and

WHEREAS, the Commission on Dental Accreditation (CODA) directed the formation of a Task Force on New Dental Team Members to develop standards for dental therapy that seeks to restrict Dental Therapist training to a four-year training program, even though the Alaska DHAT Program has been found in several research studies to be highly successful based on the two-year training program; and

WHEREAS, it is the desire of tribal leaders to support a two-year training model as demonstrated by the Alaska DHAT and would like to express their views by nominating a tribal representative to serve on the CODA; and
WHEREAS, the U.S. Senate Health, Education, Labor and Pensions Subcommittee held a hearing on the national dental crisis on September 12, 2013, where testimony was offered noting the interest of tribal governments to expand the DHAT program nationally; and

WHEREAS, that the Indian Health Service has adopted an unofficial policy decision (Christopher G Halliday Memorandum dated February 20, 2009) that IHS does not support expansion of the DHAT program beyond Alaska and the American Dental Association has used this memorandum to undermine tribal government efforts to expand the DHAT program; and

WHEREAS, tribal governments are seeking to expand the oral health workforce to address unmet needs.

NOW THEREFORE BE IT RESOLVED, that NCAI does hereby support a two-year standard for dental therapy education as demonstrated by the Alaska Native DHAT Program; and

BE IT FURTHER RESOLVED, that NCAI requests that the Indian Health Services Director immediately rescind the letter dated February 20, 2009 addressed to the American Dental Association informing them that the IHS is not supportive of an initiative to expand the Dental Health Aide Therapist Program beyond the Alaska Area; and

BE IT FURTHER RESOLVED, that NCAI supports a demonstration program on training and employment of alternative dental health care providers for dental health care services under the Indian Health Service; and

BE IT FINALLY RESOLVED, that this resolution shall be the policy of NCAI until it is withdrawn or modified by subsequent resolution.



The foregoing resolution was adopted by the General Assembly at the 2013 Annual Session of the National Congress of American Indians, held at the Cox Business Center from October 13 - 18, 2013 in Tulsa, Oklahoma with a quorum present.


Recording Secretary