A cultural care accreditation framework for tribal health.
ICHAS is a cultural care accreditation framework developed with Richard Moves Camp, Lakota medicine man and advisor to IHA. Sixty-six standards, 208 elements, ten domains. Built to sit alongside AAAHC and IHS GPRA, not to replace them.
A cultural care supplement. Not a replacement.
Existing accreditation bodies do essential work. AAAHC measures clinical quality and ambulatory operations. IHS GPRA measures Indian Health Service performance against federal targets. Neither framework was built to measure whether a clinic is culturally accountable to the tribal community it serves.
ICHAS fills that gap. It is a structured set of standards, grounded in specific Indigenous teaching relationships, that a tribal clinic can use to self-assess, train staff, and demonstrate cultural accountability to its community and its board. It does not replace AAAHC or GPRA. It adds the measure those frameworks were never designed to carry.
What ICHAS measures.
Cultural competence
Staff training, recruitment, and evaluation practices that produce a workforce able to deliver care inside tribal communities, not just near them. Assessed at the program level, not by individual attestation.
Traditional medicine integration
Structural integration of traditional medicine practitioners and practices into clinical operations, on terms set by the tribal community. Assessed by how the clinic makes space for this work, not by prescribing what it looks like.
Community accountability
How the clinic reports to, listens to, and is governed by the tribal community it serves. Assessed on the presence and quality of community feedback loops, not on surface compliance.
The ten domains extend these core axes into practical areas of clinic operation. Full domain list and scoring rubric available to tribal programs evaluating ICHAS adoption.
Three ways tribal programs use ICHAS.
Self-assessment
Tribal programs use the framework internally to identify strengths, gaps, and priorities for cultural care investment. No external review. Lowest-friction entry point.
Facilitated review
IHA walks a program through the framework with the clinical and cultural leadership team. Produces a written assessment, scored against the 208 elements, with prioritized recommendations.
Accreditation pathway
For programs seeking formal ICHAS designation. Includes facilitated review, remediation, site visit, and cultural advisory board engagement. Requires longer timeline and deeper commitment.
Who ICHAS is built for.
- Tribally-owned clinics and FQHCs serving federally recognized tribes
- Urban Indian health programs operating under Title V
- 638 contracted and compacted programs wanting a cultural accountability measure alongside federal performance metrics
- Non-tribal health systems with tribal patient populations, as a structured way to assess and improve cultural responsiveness
ICHAS is not a substitute for tribal consultation, tribal governance, or Indian preference hiring. It sits alongside those structural commitments as one measurement tool among many.
Framework in final review.
ICHAS is currently in final review before broader release. IHA is accepting expressions of interest from tribal programs and academic partners for the initial cohort of facilitated reviews.
Development of the framework is led by Richard Moves Camp, Lakota medicine man working with IHA in an advisory engagement, with contributions from IHA leadership and tribal advisors. Attribution and release terms will accompany any public publication of the framework.
Evaluating cultural accountability?
Whether you are a tribal program scoping self-assessment or a non-tribal system trying to measure cultural responsiveness, start with a scoped conversation.
Book a discovery callWant to understand the grounding?
ICHAS is grounded in specific Indigenous teaching relationships. The cultural foundation page describes how that grounding threads through IHA's work.
See our cultural foundation