From the Alaska Native Tribal Health Consortium
Other states considering the Alaska midlevel dental model
2014 marks the 10th anniversary of the first group of Alaska students returning from education in New Zealand to become Alaska’s, and the nation’s, first Dental Health Aide Therapists (DHATs). Those DHATs, along with the faculty, dentists, Tribal leaders and rural communities who support this program, were pioneers, the first to bring midlevel dental providers to the United States. Over the past 10 years, they have expanded much-needed access to dental care and prevention services for more than 40,000 Alaska Native people living in 81 rural, mostly remote communities across the state.
The success of Alaska’s DHATs demonstrates the benefits of adding midlevel providers to a dental team and the importance of providing care in the community in order to expand access. Today, 27 DHATs provide professional and culturally competent dental care in Alaska and 60 percent of the services they provided are preventive. A 2013 report released by Community Catalyst found that midlevel dental providers were economically viable and sustainable, costing less than 30 cents for every dollar of revenue they generated.
Candidates with strong ties to rural communities are selected for the DHAT program. They are trained to clean and fill teeth, perform simple extractions, and provide a range of prevention and education services. DHATs must meet the rigorous standards set by the federal Community Health Aide Program Certification (CHAP) Board. Nearly 80 percent of DHATs return to their home regions to practice and the program has an 81 percent retention rate.
Their accomplishments are a big step forward in combatting the decades-long epidemic of oral suffering and disease around rural Alaska and improving access to dental care for Alaska Native people. Prior to the DHAT innovation, 87 percent of 4-and 5-year–old children and 91 percent of 12-15 year olds had tooth decay.
“More than 40,000 rural Alaskans now have regular access to dental care from a DHAT – access and continuity of care that few had before,” said Andy Teuber, Alaska Native Tribal Health Consortium Chairman and President. “For the first time, we have “cavity-free” clubs in our elementary schools. This is not just change – it is a dramatic transformation from the days when teenagers graduated from high school with full sets of dentures.”
DHATs no longer have to travel across the world for training. Since 2007, the Alaska Native Tribal Health Consortium’s (ANTHC) DHAT Educational Program has prepared DHAT students with a two-year program led by award-winning staff at state-of-the-art facilities in Anchorage and Bethel. Alaska’s DHATs are trained in the DENTEX program, a partnership between the University of Washington and ANTHC. Students study for one year in Anchorage followed by a second year in Bethel.
The DHAT model has started a movement to authorize midlevel providers to operate in other states and Tribal communities. Alaska’s DHATs and ANTHC’s Educational Program are recognized as models of success for improving oral health and access to care for rural populations around the world. Providers like DHATs are now legally allowed to practice in Minnesota and Maine, and 15 other state are pursuing similar models.
ANTHC and the Federal CHAP Certification Board created Alaska’s DHAT program, with support from the W.K. Kellogg Foundation, the Rasmuson Foundation and the Bethel Community Services Foundation, to boost the number of dental providers in rural Alaska and the level of dental services available to Alaska Native people.
“Alaska’s Tribes exercised their sovereign rights to create a community-based solution to foster a better health future for their children and improve the health and well-being of their communities. It is working so well that the rest of the nation is looking to Alaska as they work to solve the oral health crisis in their own communities,” said Dr. Alice Warner, program officer at the W.K. Kellogg Foundation. “The Kellogg Foundation is honored to have been able to support their great work and will continue to stay committed to expanding access to oral health care for the millions of people, particularly children of color and low-income children, who suffer without it.”
On June 6, the Alaska DHAT program’s 2014 graduating class will receive certificates indicating successful completion of the DHAT training program. These five graduates will go on to a 400 hour preceptorship with a sponsoring Tribal health organization prior to certification as a DHAT. ANTHC will also present white coats to six first-year DHAT students transitioning to their second year of education in Bethel.
Why: Celebrating 10 years of DHATs improving access to oral health care in Alaska and the graduation of the 2014 class of DHATs.
When: 2 p.m. Friday, June 6
Where: ANTHC Consortium Office Building, 4000 Ambassador Drive, first floor, Conference Room One
Who: Five graduates will receive certificates of completion from the DHAT Educational Program.
- Angelica Afcan, Yukon-Kuskokwim Health Corporation
- Renee Cheemuk, Yukon-Kuskokwim Health Corporation
- Lauren Reed, Maniilaq Association
- Samantha Brown, Maniilaq Association
- Shawn Martin, Yukon-Kuskokwim Health Corporation
Six first-year students transitioning to their second year of training will receive their white coats.
- Sadie Green, Yukon-Kuskokwim Health Corporation
- Sabrina Manacio, SouthEast Alaska Regional Health Corporation
- Amanda Miles, Kodiak Area Native Association
- Sharon Johnson, Bristol Bay Area Health Corporation
- Charles Redfox, Yukon-Kuskokwim Health Corporation
- Carrie Tikiun, Yukon-Kuskokwim Health Corporation
About the Alaska Native Tribal Health Consortium
The Alaska Native Tribal Health Consortium is a not-for-profit Tribal health organization managed by Alaska Native Tribal governments and their regional health organizations. We provide statewide services in specialty medical care; construction of water, sanitation and health facilities; community health and research; information technology and professional recruiting. For more information, please visit www.anthc.org.
About the W.K. Kellogg Foundation
The W.K. Kellogg Foundation (WKKF), founded in 1930 as an independent, private foundation, is among the largest philanthropic foundations in the United States. Guided by the belief that all children should have an equal opportunity to thrive, WKKF works with communities to create conditions for vulnerable children so they can realize their full potential in school, work and life.
The W.K. Kellogg Foundation is based in Battle Creek, Mich., and works throughout the United States and internationally, as well as with sovereign tribes. Special emphasis is paid to priority places where there are high concentrations of poverty and where children face significant barriers to success. WKKF priority places in the U.S. are in Michigan, Mississippi, New Mexico and New Orleans; and internationally, are in Mexico and Haiti. For more information, visit www.wkkf.org.