Community Health Representatives (CHRs)
Who are CHRs?
CHRs are tribally employed, and function as the oldest and only federally funded CHW workforce in the country.
Nationally, the CHR workforce consists of approximately 2,000 CHRs representing 264 Tribes. Of the 22 Tribes in Arizona, 19 operate a CHR Program and employ approximately 275 total CHR/supervisors–which is equivalent to 30% of the total CHW workforce in Arizona estimated at 1,000 CHWs.
The 2020 CHR Workforce Assessment produced by the Center for Health Equity Research, in collaboration with the AACIHC, found that CHRs serve as “the backbone of healthcare delivery in Native American communities” and are at the forefront of tribal communities’ response to COVID-19, providing essential services such:
- Contact tracing
- Home wellness visits
- Disease prevention
- Management education
- Vaccination deployment
As part of their mission to “advocate for increasing access to high-quality health care programs for all American Indians in Arizona,” the Arizona Advisory Council on Indian Health Care (AACIHC), an agency within the Arizona Medicaid System, has consistently engaged Tribal CHR programs to increase CHR workforce capacity and advocate on a state level for greater integration of CHRs into health systems.
CHR WITH uS! (Community Health Representative Workforce Integration in Tribal Health Systems to Address COVID-19)
AACIHC, in partnership with eight Tribes and CHER, was awarded a three-year, $6 million grant from the Centers for Disease Control and Prevention (CDC) to strengthen community-based responses to COVID-19.
The award provides $2 million annually to fund CHR WITH uS! , which supports the training and deployment of CHRs in their efforts to prevent the spread of COVID-19, build their communities’ resilience to public health emergencies, and promote health equity for American Indians across the state.
CHR WITH us! involves eight tribally operated CHR programs:
- Cocopah Indian Tribe
- Colorado River Indian Tribes
- Gila River Health Care
- Hopi Tribe
- Hualapai Tribe
- Navajo Nation
- Salt River Pima-Maricopa Indian Community
- White Mountain Apache Tribe