The Community Health Aide Program is the Indian Health Service's answer to to the provision of care to 45,000 Alaska Native people living in remote areas of the state. Community health aides are local people who live and work in their villages. They offer health services from emergency to preventative care with the help of their referral physician, who may be up to 1,300 miles away. Nurse practitioners play an important role in the training and supervision of community health aides. This article gives an overview of the program, its successes and problems, with implications as a health care delivery model for care in other underserved areas of the United States.