G-2306-18469

The Northwest Portland Area Indian Health Board (NPAIHB) is a non-profit tribal organization serving 43 federally recognized tribes in Oregon, Washington, and Idaho. Their mission is to eliminate health disparities and improve the quality of life of American Indians and Alaska Natives by supporting Northwest tribes in their delivery of culturally appropriate, high-quality healthcare.

Over this past grant year, NPAIHB participated in the Washington Dental Access Campaign, which succeeded in authorizing dental therapy’s use in safety net settings outside of tribal land and continued its leadership in the advocacy work to expand the Community Health Aide Program (CHAP) to tribes in the lower 48 states. In Oregon, NPAIHB’s policy work has also been successful with dental therapy legislation and implementation well underway and informing the organization’s technical assistance to Washington. Dental therapists in Oregon have received state licenses and tribes are employing licensed dental therapists, however, Indian Health Services (IHS) and other federal processes continue to delay broader employment of dental health aides (DHAs). Finally, to ensure that tribal communities and safety net providers are prepared to pursue licensure as dental therapists or dental health aides, NPAIHB has created an Introduction to Health Careers course that is currently presented in two tribal high schools with plans for broader dissemination, to share opportunities and collect data about the DHA/T career options. NPAIHB's progress in advancing dental therapy's authorization and implementation on and beyond tribal lands was rewarded with IHS formally recognizing the Portland Area CHAP Certification Board (PACCB) as a federal certification board. While the Board cannot yet certify CHAP providers due to federal processes, this is a significant milestone for the profession and the organization's overall advocacy efforts.

The proposed project is a multifaceted approach to develop and implement a Northwest Tribes-specific DHA program, while also working to ensure that the state and federal policies surrounding it are supportive. To do this NPAIHB will support groups like the CHAP Tribal Advisory Group and Dental Academic Review Committee (DARC) to support efforts to authorize the PACCB as a certification provider to DHAs. NPAIHB’s project also aims to support the implementation of dental therapy in Washington state, and this entails serving as an expert voice to support the rulemaking process and assisting FQHCs, including Urban Indian clinics, to prepare to employ dental therapists. Finally, NPAIHB will continue to refine and multiply educational pathways for AI/AN individuals in the Pacific Northwest that are culturally relevant for Tribal communities and will promote a representative oral health workforce. To accomplish this goal, the organization will intentionally build partnerships with Oregon Health & Science University (OHSU), Idaho State University, and tribal clinics to promote DHA and dental therapy training opportunities.

This proposal is being recommended for a grant of $200,000, in alignment with CareQuest Institute’s historical support to NPAIHB. The organization continues to lead the advocacy efforts around expanding CHAP and is an exemplar for other tribal communities across the country that may be interested in pursuing the authorization of dental therapy and/or dental health aides. If funded, this grant would make up less than 1% of the organization’s overall budget and would support NPAIHB’s proactive efforts to position dental therapy and AI/AN communities for success as responsive solutions to historically poor oral health access and care for these communities.