Northwest Community and Behavioral Health Aide Expansion

The Community Health Aide Program (CHAP) is an Indian Health Service (IHS) system of health care delivery offered by mid-level behavioral, community, and dental health professionals.

Through CHAP, IHS aims to alleviate the health care provider shortfall many tribal communities face. CHAP began in rural Alaska Native communities. Since 2016, IHS has undertaken efforts to expand CHAP throughout the nation in partnership with tribal leaders from the 12 IHS service areas.

The Northwest Portland Area Indian Health Board (NPAIHB) is the lead entity coordinating CHAP expansion efforts in the Portland IHS region (Washington, Oregon, and Idaho). In this role, NPAIHB communicates with tribal leadership and IHS regarding CHAP expansion and is creating pathways to education and licensure for community and behavioral health aides in the Portland Area.

In the first phase of JBA’s work, we developed a crosswalk comparing the proposed service scope of community and behavioral health aides with existing comparable medical and behavioral health providers currently serving tribal communities in Washington State. This included—

• Reviewing background documents and resources
• Detailing each provider’s scope of practice under specified service categories
• Identifying unique aspects of the proposed community and behavioral health aide service scope
• Developing a final crosswalk and accompanying narrative

We also assessed the need for additional mid-level providers and services among tribal and urban Indian medical and behavioral health clinics in Washington. Tasks included—

• Carrying out a tiered, mixed-methods data collection strategy that entailed reviewing existing quantitative data and subsequently conducting key informant interviews with clinic administrators and project stakeholders
• Developing a report describing gaps in medical and behavioral health services in Washington tribal and urban Indian communities
• Collaborating with NPAIHB to present the report to stakeholders

In the second phase of our work on this project, we developed a visual crosswalk of the information gathered during phase 1 and expanded it to include Oregon and Idaho.