Chapter C2 – Article 20. Community Health Aide and Practitioner Training and Education Requirements, Competencies
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Chapter C2 – Article 20. Community Health Aide and Practitioner Training and Education Requirements, Competencies

Sec. C2.20.100. Community Health Aide I Training and Education Requirements.

A person meets the training and education requirements to be a certified community health aide I upon successful completion of:

  1. a Board approved Presession, or its equivalent, unless waived under section C4.10.060 [trainees selection process] by the CHA/P Training Center prior to admission to the Session I training course required under section C2.20.100(c) [CHA I training and education requirements];
  2. an EMT or ETT training course approved by the State of Alaska, or its equivalent as determined by the Board;
  3. Session I training course provided by a CHA/P Training Center; and
  4. Field Training Requirements including:
    1. Approved field work after completion of training center component of Session I;
    2. a minimum of 20 patient encounters;
    3. Practice skills on Post Session Practice Checklist; and
    4. Post Session Learning Needs (PSLN), if indicated.

Sec. C2.20.110. Community Health Aide I Competencies.

A certified community health aide I must successfully demonstrate and maintain:

  1. an understanding of the topics addressed in the CHA/P Curriculum for Session I, which generally include problem-specific complaints (acute care) for adults and children of the following body systems:
    1. eye,
    2. ear,
    3. respiratory,
    4. digestive,
    5. skin;
  2. competency in the following subjects to the level of performance required after meeting the requirements of section 20.100 [CHA I training and education requirements]:
    1. role of the community health aides and practitioners, dental health aides, and behavioral health aides and practitioners in the village;
    2. community health aide’s and practitioner’s general scope of work;
    3. medical ethics, including patient confidentiality and patient rights;
    4. community health aide’s and practitioner’s medical-legal coverage;
    5. State of Alaska reporting requirements;
    6. consent for treatment issues;
    7. introductory interviewing skills;
    8. general health/wellness and disease processes;
    9. infection and communicable diseases;
    10. introductory anatomy and function of the human body;
    11. introductory medical vocabulary/abbreviations;
    12. importance of thorough documentation of patient encounter;
    13. grief, loss, dying and death;
    14. introductory mental health issues, including suicide and other emergencies and self-help;
    15. emergency care (to reinforce ETT or EMT training), including primary and secondary survey, bleeding control, airway management, BLS, shock, abdominal injury, altered level of consciousness, facial trauma, spinal protection, serious chest pain, acute orthopedic injuries, burns, cold injuries (including hypothermia), drowning, uncomplicated emergency delivery, poisoning and identification and treatment of severe allergic reactions; medevac, serial monitoring and documentation.
  3. satisfactory performance of the following skills:
    1. use of the CHAM;
    2. problem-specific history taking;
    3. physical examinations of:
      1. vital signs of infant:
        1. apical pulse,
        2. brachial pulse,
        3. respiration,
        4. pulse oximetry (Sp02),
        5. rectal temperature,
        6. axillary temperature,
        7. length,
        8. weight,
        9. head circumference;
      2. vital signs of child and adult:
        1. radial pulse,
        2. apical pulse,
        3. respirations,
        4. pulse oximetry (Sp02),
        5. oral temperature,
        6. blood pressure, manual auscultation,
        7. height,
        8. weight,
        9. orthostatic vital signs;
      3. systems:
        1. general appearance,
        2. ear,
        3. eye, including Snellen,
        4. nose,
        5. throat,
        6. neck, including nodes,
        7. lungs,
        8. heart,
        9. abdomen,
        10. skin;
      4. sick child,
      5. screening physical exam on adult,
    4. performance and interpretation of the following lab tests and procedures:
      1. general lab technique and documentation (CLIA, etc.),
      2. blood glucose,
      3.  hemoglobin,
      4. rapid strep,
      5. urine dipstick;
      6. urine pregnancy test;
    5. performance only of the following lab tests and procedures:
      1. finger stick,
      2. capillary tube,
      3. newborn bloodspot screening test,
      4.  venipuncture,
      5. centrifuge/separate blood,
      6. adult clean catch urine specimen,
      7. infant (bag, urine specimen),
      8. throat culture,
      9. specimen collection for infection (for example: nose, nasopharynx, ear, wound);
    6. assessment, including:
      1. use of the CHAM,
      2. use of assessment lists,
      3. use of assessment charts,
      4. listing multiple assessments,
      5. plan for each assessment;
    7. medicines:
      1. dose calculations,
      2. reconstitution: oral,
      3. reconstitution for IM or SQ injection,
      4. label reading and making,
      5. oral (swallowed, muscosal and sublingual),
      6. drops for eye,
      7. drops for ear;
      8. injections:
        1. intramuscular hip,
        2. intramuscular upper arm (deltoid),
        3. intramuscular infant thigh,
        4. subcutaneous (upper arm, thigh, abdomen);
        5. intradermal injection;
      9. inhaler/spacer,
      10. nebulizer,
      11. rectal (including suppositories),
      12. vaginal suppository/creams,
      13. transdermal,
      14. topical (including sterile application);
    8. patient education, including:
      1. explaining assessment,
      2. use of patient education sections,
      3. use of patient education handouts,
      4. CHAM Medicine Handbook for medicine instructions;
    9. the following treatments and procedures:
      1. ear:
        1. irrigation,
        2. suction,
        3. remove foreign body,
        4. remove drainage,
        5. curette outer canal,
      2.  eye:
        1. irrigation (including use of topical anesthetic, if available),
        2. fluorescein stain,
        3. eyelid eversion,
        4. small foreign body removal,
        5. eye patches,
      3.  nose:
        1. compression and nasal packing for bleeding;
      4.  respiratory:
        1. peak flow
      5. wound care:
        1. evaluation,
        2. irrigation/cleaning,
        3. skin closure strips,
        4. suture,
        5. suture removal,
        6. staple removal,
        7. debriding blisters,
      6. intravenous fluid therapy;
      7.  orthopedics:
        1. elastic bandage,
        2. hot/cold packs,
        3. splinting,
        4. reducing dislocated joints (including shoulder, “nursemaid’s elbow”, elbow, patella, ankle, finger,
      8. other:
        1. oxygen,
        2. oral suction,
        3. stabilization of impaled object,
        4. 12 lead EKG;
      9.  prevention:
        1. hand washing,
        2. clean/sterile technique,
        3. standard precautions,
        4. mailing hazardous substances,
      10. reporting; and
      11. recording

Sec. C2.20.200. Community Health Aide II Training and Education Requirements.

A person meets the training and education requirements to be a certified community health aide II upon successful completion of:

  1. all requirements under sections C2.20.100 [CHA I training and education requirements] through C2.20.110 [CHA I competencies];
  2. current ETT or EMT certification or its equivalent, as determined by the Board;
  3. Session II training course provided by a CHA/P Training Center; and
  4. Field Training Requirements:
    1. 200 hours of approved field work after completion of training center component of Session II, including:
    2. a minimum of 60 patient encounters;
    3. Practice skills on Post Session Practice Checklist; and
    4. Post Session Learning Needs (PSLN), if indicated.

Sec. C2.20.210. Community Health Aide II Competencies.

In addition to meeting the requirements of section C2.20.110 [CHA I competencies], a certified community health aide II must successfully demonstrate and maintain:

  1. understanding of the topics addressed in the CHA/P Curriculum for Session II, which generally includes problem-specific complaints (acute care) for adults and children of the following body systems:
    1. mouth and teeth,
    2. eye,
    3. ear,
    4. respiratory,
    5. circulatory,
    6. digestive,
    7. urinary,
    8. male reproductive,
    9. female reproductive,
    10. musculoskeletal,
    11. nervous,
    12. endocrine,
    13. skin,
    14. sick child care,
    15. introduction to prenatal care;
  2. competency in the following subjects to the level of performance required after meeting the requirements of section C2.20.200 [CHA II training and education requirements]:
    1. dental health and prevention;
    2. mental health issues, including self-help, mental illness, substance abuse and dependency, and grief, loss, dying and death;
    3. clinic management;
    4. management of medicines in the village;
    5. introduction to tuberculosis disease;
    6. introduction to sexually transmitted infections and sexually transmitted infection issues;
    7. HIV disease and issues;
    8. emergency care review, including medical evacuation, primary and secondary survey, bleeding control, airway management, BLS, shock, spinal protection, splinting, cold injuries;
  3. satisfactory performance of the following skills:
    1. physical examinations of the following systems:
      1. mouth and teeth,
      2. circulatory,
      3. heart,
        1. pulses (including carotid, radial, femoral, posterior tibialis, dorsalis pedis);
      4. back/costal vertebral angle (CVA),
      5. genitals:
        1. male,
        2. female: external/cervical motion;
      6. external anus,
      7. return prenatal exam,
      8. extremities,
      9. musculoskeletal,
      10. nervous system,
      11. mental status;
      12. complete physical exam;
    2. performance and interpretation of the following lab tests:
      1. purified protein derivative (PPD),
      2. fecal occult blood,
    3. perform the following lab tests and procedures:
      1. venipuncture,
      2. heelstick,
      3. newborn bloodspot screening test,
      4. non-clean catch urine specimen,
      5. urine culture,
      6. stool for ova and parasites,
      7. sputum for TB testing,
    4. medicines;
      1. topical,
      2. giving IM and SQ immunizations;
    5. the following treatments and procedures:
      1. eye:
        1. review section C2.20.110(c)(9)(B) [CHA I competencies; eye];
      2. wounds:
        1. review section C2.20.110(c)(9)(E) CHA I competencies; wound care];
        2. splinter removal,
        3. ring removal,
        4. fishhook removal;
      3.  orthopedics:
        1. crutch fit/walk,
        2. splinting;
      4. intravenous fluid therapy;
      5. dental prevention:
        1. tooth brushing,
        2. flossing,
        3. disclosing tablets,
        4. fluoride application;
      6. performing 12 lead ECG.

Sec. C2.20.300. Community Health Aide III Training and Education Requirements.

A person meets the training and education requirements to be a certified community health aide III upon successful completion of:

  1. all requirements under sections C2.20.100 [CHA I training and education requirements] through C2.20.210 [CHA II competencies];
  2. current ETT or EMT certification or its equivalent, as determined by the Board;
  3. Session III training course provided by a CHA/P Training Center; and
  4. Field Training Requirements, including:
    1. 200 hours of approved field work after completion of training center component of Session III;
    2. a minimum of 60 patient encounters;
    3. Practice skills on Post Session Practice Checklist;
    4. Post Session Learning Needs (PSLN), if indicated.

Sec. C2.20.310. Community Health Aide III Competencies.

In addition to meeting the requirements of sections C2.20.110 [CHA I competencies] and C2.20.210 [CHA II competencies], a certified community health aide III must successfully demonstrate and maintain:

  1. an understanding of the topics addressed in the CHA/P Curriculum for Session III, which generally include:
    1. male reproductive health;
    2. female reproductive health;
    3. adolescent health;
    4. well child care;
    5. sick child care;
    6. newborn care;
    7. urinary; and
    8. problem-specific complaints (acute care) of the following body systems:
      1. male reproductive;
      2. female reproductive;
      3. breast;
    9. competency in the following subjects to the level of performance required after meeting the requirements of section C2.20.300 [CHA III training and education requirements]:
      1. women’s reproductive health issues;
      2. men’s reproductive health issues;
      3. sexually transmitted infections and sexually transmitted infection issues;
      4. family planning issues;
      5. prenatal care;
      6. mental health issues, including substance abuse during pregnancy, family problems, domestic violence, sexual abuse, and rape;
      7. fetal alcohol syndrome;
      8. labor and delivery, including the importance of avoiding village deliveries;
      9. post-partum issues;
      10. newborn care issues;
      11. well child care issues;
      12. adolescent healthcare issues;
      13. immunization issues;
      14. nutrition; and
      15. emergency care review, emphasizing infants, children, and special considerations for pregnant patients.
    10. satisfactory performance of the following skills:
      1. history taking:
        1. return prenatal visit;
        2. well child;
      2. physical examination of:
        1. breast system;
        2. prenatal revisit;
        3. well child;
      3. medicines:
        1. immunizations;
      4. the following treatments and procedures:
        1. wounds:
          1. review section C2.20.110(c)(9)(E) CHA I competencies; wound care];
          2. abscess care.

Sec. C2.20.400. Community Health Aide IV Training and Education Requirements.

A person meets the training and education requirements to be a certified community health aide IV upon successful completion of:

  1. all requirements under sections C2.20.100 [CHA I training and education requirements] through C2.20.310 [CHA III competencies];
  2. current ETT or EMT certification or its equivalent, as determined by the Board;
  3. Session IV training course provided by a CHA/P Training Center; and
  4. Field Training Requirements, including:
    1. 200 hours of approved field work after completion of training center component of Session IV;
    2. a minimum of 60 patient encounters;
    3. Practice skills on Post Session Practice Checklists; and
    4. Post Session Learning Needs, if indicated.

Sec.  C2.20.410. Community Health Aide IV Competencies.

In addition to meeting the requirements of sections C2.20.110 [CHA I competencies], C2.20.210 [CHA II competencies], and C2.20.310 [CHA III competencies]; a certified community health aide IV must successfully demonstrate and maintain:

  1. an understanding of the topics addressed in the CHA/P Curriculum for Session IV, which generally include long-term care complaints (chronic care) of the following body systems:
    1. eye,
    2. ear,
    3. respiratory,
    4. circulatory,
    5. digestive,
    6. musculoskeletal,
    7. nervous,
    8. endocrine,
    9. skin; and
  2. competency in the following subjects to the level of performance required after meeting the requirements of section C2.20.400 [CHA IV training and education requirements]:
    1. management of tuberculosis in the village;
    2. introductory environmental health issues, including food/water borne disease, rabies, and injury prevention;
    3. chronic disease;
    4. introductory cancer issues;
    5. pharmacology;
    6. emergency care review;
    7. adult health surveillance;
    8. approach to elder healthcare;
    9. substance abuse and dependency concepts;
    10. introduction to smoking cessation training; and
  3. satisfactory performance of the following treatments and procedures:
    1. postural drainage;
    2. peak flow;
    3. diabetic foot exam;
    4. wound:
      1. review section C2.20.210(c)(5)(B) CHA II competencies; wound care]; and
      2. abscess care.

Sec. C2.20.500. Community Health Practitioner Training and Education Requirements.

A person meets the training and education requirements to be a certified community health practitioner upon successful completion of:

  1. all requirements under sections C2.20.100 [CHA I training and education requirements] through C2.20.410 [CHA IV competencies];
  2. a preceptorship, reviewed and approved by a CHAP training center, including:
    1. at least 30 hours of supervised direct patient care experience;
    2. a minimum of 15 patient encounters as primary provider; and
    3. the Preceptorship Critical Skills List;
  3. the statewide written Alaska Community Health Aide/Practitioner Program Credentialing Exam with a score of 80 percent or higher on each section;
  4. the statewide Medical Math Exam with a score of 100 percent; and
  5. an evaluation of the applicant’s clinical performance and judgment by the applicant’s direct supervisor or other approved evaluator.

Sec. C2.20.510. Community Health Practitioner Competencies.

A community health practitioner must successfully demonstrate and maintain the ability to meet all of the requirements of sections C2.20.110 [CHA I competencies], C2.20.210 [CHA II competencies], C2.20.310 [CHA III competencies], and C2.20.410 [CHA IV competencies].

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