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Education and Training

The Indian Health Service (IHS) created a robust hybrid (web-based and onsite) education and training program to: support the role of the Community Health Representative (CHRs); promote CHR core competencies; meet the demand for CHR training; and reduce travel costs incurred by Tribal and IHS CHR Programs. The long-range goal of the IHS National CHR Program is to meet Area (State) requirements to support Tribal and IHS CHR Program capacity to bill for CHR services.

The IHS National CHR Education and Training program is similar to other State Promoters and Community Health Workers (CHWs) training that use web-based training formats. The IHS converted the IHS CHR Basic Training onsite curriculum to web-based modules with the aim to: support CHRs life-long learning needs and support the CHR’s knowledge, skills and competencies to advocate for individuals, families and communities through service coordination, providing direct health care services and by providing health promotion and disease prevention education. The primary objective of the IHS CHR web-based training program is to provide CHRs with the educational tools necessary to competently accomplish their jobs. It is the responsibility of the local Tribal CHR Program to define CHR services to meet the needs of the Tribe and the tribal community.

IHS-sponsored CHR onsite training programs are available to Compacted/Self Governance (Title III) tribes if: (1) class space is available, and (2) if they pay the costs of training. Admission is based on equitable treatment to all eligible tribes. The need for onsite training and core competencies is established by the Area Office Coordinators (AOC) through consultation with their Tribal constituents.

IHS provides web-based training for tribes in the IHS system and those tribes who have opted for Title I (AFA) shares and Compacted/Self Governance (Title III) tribes. To be eligible to take the IHS CHR web-based training modules, the CHR must have completed a 6 month probationary period and required pre-requisites i.e.; Basic Life Support Certification (BCLS) and first aid training.

Online Training

The IHS National CHR Program training and education components are:


IHS strongly advises that tribal programs ensure CHR candidates meet the following qualification guidelines:

  • CHR Online Training Modules - MedCom Trainex
    1. Basic Training (web-based) -To provide CHRs with general health education to build and support an integrated sustainable CHR workforce with the aim to promote health and prevent disease and disability in AI/AN communities. CHRs are required to successfully complete the CHR web-based modules within one year of employment.
    2. Advanced Training (web-based) -To increase CHRs health knowledge on a variety of public health related topics designed to improve outreach capacity to meet Tribal health system and IHS national goals. CHRs must have completed three years of continuous service as a CHR to be eligible to take the advanced modules.
    3. Specialized Training (Onsite) -To provide CHRs with specialized training to expand the CHRs knowledge base and to promote culturally competent mediators (health brokers). Health brokers work with providers as team members and with members of the community by linking patients to community resources, help to avoid unnecessary hospitalizations and to improve outcomes for community members. Examples of specialized training include but are not limited to: Motivational Interviewing, Case Management, Maternal Child Health, Mental Health, Health Promotion and Disease Prevention, Emergency Preparedness, Emerging Public Health Threats and CHR documentation
    1. Director National IHS/CHR Program Office - To be responsible for the overall management of the CHR Program.
      • Curriculum Review Committee - Utilize subject matter experts as required for review and analysis of CHR curricula.
      • Contractors/Grantees - Ensure that CHRs are provided training commensurate with their duties under the awarded instrument.
    2. Area CHR Coordinators - Assess, update, and evaluate the training needs of CHR’s in their respective areas and provide this information for use in policy formulation.
      • Implement policies and procedures pertaining to CHR training.
      • Ensure that each CHR receives and satisfactorily completes the online CHR Training modules.
      • Coordinate training and educational training activities for CHRs to include other disciplines associated with the Area CHR Program(s).
    • submit fingerprints for and pass background and criminal history checks, especially for applicants who will be in contact with children, the elderly or disabled
    • pass a drug test prior to hiring as well as randomly scheduled drug screenings
    • be physically able to carry out needed tasks
    • possess CPR certification
    • complete a first aid training course
    • possess a valid driver's license
    • be at least 18 years old (determined by tribal personnel regulations)
    • meet Tribal requirements for employment i.e.; Indian Preference, Veterans’ Preference, etc.