****
69th Legislature 2025 SB 526.1
- 1 - Authorized Print Version – SB 526
1 SENATE BILL NO. 526
2 INTRODUCED BY J. WINDY BOY, S. NOVAK, T. CROWE, S. FYANT, J. SOOKTIS, J. MORIGEAU, F.
3 SMITH, C. SPRUNGER, S. WEBBER, M. FOX, J. COHENOUR, P. FLOWERS, T. FRANCE, D. HAWK, C.
4 KEOGH, A. OLSEN
5
6 A BILL FOR AN ACT ENTITLED: “AN ACT ESTABLISHING THE COMMUNITY HEALTH AIDE PROVIDER
7 EDUCATION GRANT PROGRAM; PROVIDING ELIGIBILITY CRITERIA; PROVIDING MAXIMUM GRANT
8 AMOUNTS; PROVIDING RECIPIENT REPORTING REQUIREMENTS; REQUIRING REPORTS TO THE
9 LEGISLATURE; PROVIDING AN ALLOCATION; AND PROVIDING AN EFFECTIVE DATE.”
10
11 WHEREAS, there is a primary care crisis in Indian Country; and
12 WHEREAS, American Indian and Alaska Native people in Montana have very limited access to health
13 care services and are disproportionately affected by oral health care, primary health care, and behavioral health
14 care disparities, which are directly attributed to a lack of health care professionals in Indian communities and
15 have caused a serious access issue and backlog of many health care services for American Indian and Alaska
16 Native citizens in Montana; and
17 WHEREAS, the tribes of Montana successfully partnered to provide training and education for dental
18 health aide practitioners who will go on to serve urban and rural American Indian populations with the specific
19 purpose of improving population oral health through filling service gaps, community outreach, and offering
20 culturally responsive care; and
21 WHEREAS, tribal clinics are often the only dental clinic that accepts Medicaid-eligible patients in rural
22 areas. Increasing provider capacity at tribal clinics will benefit the entire community. Even in instances where
23 the tribe does not provide health care to nonbeneficiaries, increasing provider capacity at clinics serving
24 Medicaid-eligible individuals benefits all patients because of the overall increases in capacity; and
25 WHEREAS, many tribes in Montana have great difficulty and face challenges in recruiting and retaining
26 health care professionals in their communities, resulting in further challenges to ensure continuity and
27 comprehensive health care for all people in Montana under Article II, section 3, of the Montana Constitution;
28 and ****
69th Legislature 2025 SB 526.1
- 2 - Authorized Print Version – SB 526
1 WHEREAS, tribes in Montana are implementing the community health aide program. The Alaska
2 community health aide program has been in existence since the 1960s and is a program of the Indian Health
3 Service. The community health aide program has been an effective method for diminishing health disparities of
4 Alaska Natives and promoting access to health care services and health care provider education for Alaska
5 Natives residing in rural and remote communities. The program also provides opportunities to incorporate social
6 determinants of health; and
7 WHEREAS, the community health aide program educates providers from within tribal communities to
8 provide valued, patient-centered, and quality care. These providers understand the history, culture, and, in
9 some cases, the language of their patients and can integrate that knowledge into their care. Community health
10 aide program providers offer routine, preventative, and emergent health care through community health aides
11 and practitioners, behavioral health aides and practitioners, and dental health aides and practitioners; and
12 WHEREAS, tribes are investing in higher education, wealth generation activities, and health care for
13 their citizens, thereby incorporating social determinates of health. However, college attainment during the
14 previous 20-year period only rose 3.9% compared to 7.6% in the rest of the United States. Approximately 15%
15 of American Indian and Alaska Native adults in the northwest region of the United States have less than a high
16 school degree, and, compared to the general population, a smaller proportion have attained a baccalaureate or
17 graduate degree.
18
19 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
20
21 NEW SECTION. Section 1.
22 (1) There is a community
23 health aide provider education grant program administered by the commissioner of higher education. The
24 purpose of the grant program is to develop, implement, and maintain education programs for community health
25 aide or dental health aide providers.
26 (2) The community health aide provider education grant program must involve the development of
27 a community health aide or dental health aide provider education program that qualifies graduates to practice
28 within the scope authorized under 25 U.S.C. 1616l. ****
69th Legislature 2025 SB 526.1
- 3 - Authorized Print Version – SB 526
1 (3) A tribal college located in the state may apply for a grant to:
2 (a) expand or maintain an existing education program for community health aide or dental health
3 aide providers; or
4 (b) develop a new education program for community health aide or dental health aide providers.
5 (4) (a) It is the intent of the legislature that the commissioner award grants in the following
6 amounts:
7 (i) a one-time amount of up to $1 million to a recipient for startup costs for developing a new
8 provider education program; and
9 (ii) an amount of up to $500,000 to a recipient each year, reoccurring for up to 4 years, for the
10 ongoing maintenance of the program as well as for data collection and reporting in accordance with subsection
11 (5).
12 (b) The maximum total amount a recipient may receive under the community health aide provider
13 education grant program is $ 3 million.
14 (c) Funding preference may be given to tribal colleges with experience with either community
15 health aide or dental health aide provider education programs.
16 (5) A tribal college awarded a grant under this section shall evaluate the impact of the use of
17 community health aide and dental health aide providers on the delivery of and access to primary care or
18 primary oral health care. Grantees shall report to the commissioner on the outcomes of a program supported by
19 the grant program including, at minimum:
20 (a) the number of annual graduates of the community health aide or dental health aide program;
21 (b) the number of community health aide or dental health aide providers annually certified by the
22 appropriate federal certification board;
23 (c) the settings where certified community health aide and dental health aide providers are
24 practicing and the patient populations and tribes served;
25 (d) in collaboration with tribal health clinics, the cost-effectiveness of community health aide and
26 dental health aide providers; and
27 (e) population health data describing the effectiveness of community health aide and dental health
28 aide providers in improving access to primary care and primary oral health care, including: ****
69th Legislature 2025 SB 526.1
- 4 - Authorized Print Version – SB 526
1 (i) numbers and service categories of patients served compared to years without community
2 health aide or dental health aide providers;
3 (ii) types of health care services provided by clinics employing community health aide and dental
4 health aide providers;
5 (iii) utilization data for local emergency medical services;
6 (iv) chronic care disease management data;
7 (v) medicaid utilization;
8 (vi) numbers of new patients served;
9 (vii) clinic wait time trends; and
10 (viii) distances traveled by patients to receive care.
11 (6) The commissioner shall create and administer a grant program that meets the goals and
12 requirements of this section. The commissioner shall utilize the data reported under subsection (5) and shall
13 submit an annual report on the administration and outcomes of the program to the education interim committee
14 and to the children, families, health, and human services interim committee in accordance with 5-11-210.
15
16 NEW SECTION. Section 2. (1) There is allocated $1.5 million from the general fund to
17 the commissioner of higher education for the biennium beginning July 1, 2025, for the purposes described in
18 [section 1].
19 (2) The legislature intends that the allocation in this section be considered part of the ongoing base
20 for the next legislative session.
21
22 NEW SECTION. Section 3. The secretary of state shall send a
23 copy of [this act] to each federally recognized tribal government in Montana.
24
25 NEW SECTION. Section 4. [Section 1] is intended to be codified as an
26 integral part of Title 20, chapter 25, part 4, and the provisions of Title 20, chapter 25, part 4, apply to [section 1].
27
28 NEW SECTION. Section 5. [This act] is effective July 1, 2025. ****
69th Legislature 2025 SB 526.1
- 5 - Authorized Print Version – SB 526
1 - END -