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Roles and Responsibilities of Community
Health Representatives in Indian Country



Community health representatives, or CHRs, play an important role in every tribal health program. As the “first line of defense,” they can spot critical problems before they become serious and, if trained, can help community members as first responders in emergency situations. As a group of dedicated individuals, CHRs work to fulfill specific tribal needs and work as liaisons between the Indian Health Service (IHS) and the community. They refer patients, help health clinics gain community support and, most importantly, increase the quality of life for those that they care for.

For someone currently working as a CHR or someone looking to start a program, it’s important to understand the role that CHRs play in health clinics, the responsibilities that they have to their patients and the influence that they can have within their communities. During this class, our instructor will guide you through the daily responsibilities of a CHR and will explain how to increase the CHR’s role in the community.

T O P I C S   I N C L U D E
Indian Health Programs
  • Foundation of IHS
  • Fundamentals of health education
Creating a CHR Program
  • Program authorization
  • Purpose and method of operation
  • Starting a new program
Role of the CHR
  • Advocate
  • Liaison
  • Interpreter
  • Facilitator
  • Educator
Assessing Your Tribe’s Needs
  • Determining current problems
  • Evaluating current tribal health programs
Responsibilities of the CHR
  • Creating programs:
    • Health
    • Safety
    • Exercise and fitness
    • Nutrition
  • Representing individual patients and tribal concerns
  • Providing direct care in specialized areas:
    • Diabetes
    • Cancer
    • Vision
    • Nutrition and obesity
    • Maternity and child health
    • Elder care
    • Alcohol and drug abuse prevention and referral
    • First responder
    • Domestic violence and sexual assault
    • Delivering medications
  • Protecting themselves from lawsuits
Nutrition and Health — What a CHR Needs to Know
  • What is healthy?
  • Common health problems in Indian Country
  • Good alternatives to bad habits
  • Reaching out and educating
  • What to look for in a patient during a baseline assessment
  • Considering all of the needs of the patient — physical, emotional, spiritual
  • What the patient is not telling you
  • Acting as an advocate for the patient
  • Patient’s rights and how the CHR fits in
  • Developing confidence in dealing with professional staff — doctors, licensed nurses, etc.
  • Monitoring dietary behaviors
Developing and Implementing Programs
  • Brainstorming
  • Creating a task force
  • Presenting ideas
  • Budgeting
  • Developing material for the program
  • Planning the program
  • Implementing the program
Measuring Performance
  • Effectiveness
  • Looking at statistics:
    • Improving glycemic control of patients diagnosed with diabetes
    • Maintaining the number of patients who have achieved blood pressure control
    • Continuing to achieve baseline rates of immunizations for children
    • Maintaining rates of influenza and pneumococcal vaccinations in older patients
  • Staying within budget boundaries
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