Tribal Community Health Provider Project (TCHPP) - Established in 1972, the Northwest Portland Area Indian Health Board (NPAIHB) is a non-profit 501(c)(3) tribally designated organization serving the 43 federally recognized tribes of Idaho, Oregon and Washington. The mission of the NPAIHB 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. The Community Health Aide Program (CHAP) model is a Tribally created and driven health program offering long-term sustainable solutions that strengthen tribal communities, tribal self-determination, tribal sovereignty, and self-governance by providing educational opportunities to become a Behavioral Health Aide/Practitioner (BHA/P), Dental Health Aide/Therapist (DHA/T), Community Health Aide/Practitioner (CHA/P), also known as a Tribal Community Health Provider (TCHP). TCHPs are mid-level health care providers, educators, and advocates who have received specialized training in culturally appropriate approaches and work under the supervision of clinical providers. Creating a workforce that comes from our tribal communities resolves issues of accessing quality care with proven benefits. CHAP was developed in Alaska in the 1960s and has evolved into a vital resource for the Alaska health care system. CHAP is community driven and noted for its role in providing primary and emergent care in remote villages, increasing access to care at their tribally managed hospitals and clinics, and village-based care. The health care system as it is today does not meet the needs of many Tribal communities. CHAP challenges structurally racist systems that, for centuries, have disadvantaged tribal communities. For these reasons, Tribal Community Health Provider Program (TCHPP), in close collaboration with the Portland Area Tribes, has engaged in CHAP implementation since 2015. Thus far, TCHPP has laid down strong infrastructure within our Northwest Tribes for a tribally run, tribally based, health provider education system that will feed into our tribal communities and provide the type of care Tribal communities in the Northwest have requested. TCHPP has built education programs with partnering higher education institutions. Additionally, TCHPP worked with tribal governments to develop regulatory infrastructure to exercise their sovereign rights and license health care providers in their own communities. Tribes from the Northwest are using their sovereignty rights to fill in the gaps of care in Tribal communities that are experiencing healthcare workforce shortages and recruitment challenges within their health systems. Through this proposed project, TCHPP will implement all Tribal Planning and Implementation areas of focus. Over the next two years, key major successes will include: CHAP clinical implementation resources; a second National CHAP Symposium; clinic staff and supervisor trainings; development and implementation of CHAP training (which includes an electronic Health Aide Manual with focused content on the electronic Community Health Aide Manual for Practice); the creation of BHA III, IV and Practitioner curricula in collaboration with Northwest Indian College and Heritage University; the development of a certification database for the Portland Area CHAP Certification Board; and continued nationwide advocacy with Tribes and federal agencies.