Chapter B2 – Article 30. BHA/P Competencies: Knowledges and Skills
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Chapter B2 – Article 30. BHA/P Competencies: Knowledges and Skills

Sec. B2.30.010. Behavioral Health Aide and Practitioner Knowledge, Skills, and Scope of Practice.

  1. Minimum Knowledge and Skills. In addition to meeting all other requirements of sections B2.20.100 [BHA I training, practicum, and experience requirements], B2.20.200 [BHA II training, practicum, and experience requirements], B2.20.300 [BHA III training, practicum, and experience requirements], and B2.20.400 [BHP training, practicum, and experience requirements], as applicable to the level of certification for which the individual is applying, the BHA/P must understand and successfully demonstrate and maintain the knowledge and skills listed in subsection (b) [knowledge and skills] of sections B2.30.100 [working with others] through B2.30.145 [professional development] at the applicable level of performance described in subsection (a) [level of performance] of each of these sections.
  2. Scope of Practice. Except as provided in section B2.10.100(b)(4) [supervision of BHA/Ps; levels of supervision; individualized protocols], a certified BHA/P must limit their scope of practice to performing only those activities described in subsection (b) [knowledge and skills] of the sections listed in subsection (a) [minimum knowledge and skills] of this section at the applicable level of performance described in subsection (a) level of performance] of each of these sections.

Sec. B2.30.100. Working with Others.

  1. Level of Performance. A BHA/P must demonstrate the knowledge and perform the skills and competencies described in subsection (b) [knowledge and skills] as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a BHA I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a BHA II utilizes the knowledge or skill consistently and recognizes when to seek assistance;
    3. a BHA III utilizes the knowledge or skills consistently as a means toward meeting treatment goals; and
    4. a BHP applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of BHA I, BHA II, and BHA III.
  2. Knowledge and Skills. Working with others is a skill that requires a BHA/P to:
    1. Communicate effectively as demonstrated by:
      1. Engaging in active and reflective listening;
      2. Speaking clearly and slowly enough to be understood;
      3. Using non-judgmental words and behaviors;
      4. Communicating directly with the client’s family and significant other (with client consent);
      5. Using “person centered/person first” language; and
      6. Using technical language correctly, including clinical terminology; and
    2. Build positive relationships as demonstrated by:
      1. Demonstrating warmth, empathy, and genuineness;
      2. Showing respect and concern for others through words and actions;
      3. Focusing on and respecting the concerns and preferences of the client and family;
      4. Providing support and encouragement to colleagues and clients;
      5. Collaborating with colleagues and clients to complete tasks and solve problems; and
      6. Maintaining appropriate boundaries in all relationships.

Sec. B2.30.105. Cultural Competency and Individualizing Care.

  1. Level of Performance. A BHA/P must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a BHA I recognizes issues and provides general information to clients and the community that incorporates that recognition;
    2. a BHA II recognizes symptoms, condition, or characteristics and responds therapeutically with support from the supervisor;
    3. a BHA III applies knowledge in interaction with a client in the assessment and treatment of that client; and
    4. a BHP applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of BHA I, BHA II, and BHA III.
  2. Knowledge and Skills. Cultural competency and individualizing care is a skill that requires the BHA/P to:
    1. Deliver culturally relevant services as demonstrated by:
      1. Recognizing and adapting to different cultures, including the varied Alaska Native tribes and communities;
      2. Recognizing and respecting diversity, differences, and cultural traditions, including among different Alaska Native tribes and communities;
      3. Assessing and managing one’s own personal biases;
      4. Being aware of the traditions of the community;
      5. Demonstrating awareness of and sensitivity to the client’s’ degree of involvement in their traditions, values, and community;
      6. Adapting services to the unique characteristics and preferences of the client and family;
      7. Applying knowledge of gender expression, gender identity, sexual orientation, life span development, financial status, religion, disability, and intergenerational differences in delivering services;
      8. Promoting empowerment as a goal and desirable treatment outcome for Alaska Native/American Indian people by fostering client and family decision-making, problem-solving, and self-determination;
      9. Effectively discussing cultural issues and differences with clients;
      10. Using cultural views of health and family when assisting in providing services;
      11. Utilizing cultural resources and traditional practices when providing services (e.g., storytelling, talking circles, and deferring to elders);
      12. Identifying and addressing issues of difference to reduce conflict between individuals and groups; and
    2. Obtain consultation on cultural issues as demonstrated by:
      1. Routinely considering and discussing cultural issues in supervision and team meetings; and
      2. Consulting with elders or traditional healers in the community.

Sec. B2.30.110. Professional and Ethical Practice.

  1. Level of Performance. A BHA/P must demonstrate the knowledge and perform the skills and competencies described in:
    1. subsections (b)(2) [ethics], (b)(3) [consent], and (b)(4) [confidentiality and privacy] as provided in paragraphs (A) through (D) of this paragraph, as applicable:
      1. a BHA I demonstrates the skill, applies it as directed, and routinely seeks assistance;
      2. a BHA II utilizes the skill consistently and recognizes when to seek assistance;
      3. a BHA III consistently applies the principles to specific client and community situations; and
      4. a BHP applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of behavioral health aides I, II and III; and
    2. Knowledge and Skills. Professional and ethical practice is a skill that requires a behavioral health aide or practitioner to:
      1. Fulfill responsibilities and commitments as demonstrated by:
        1. Minimizing absences, arriving on time, and completing a full work day;
        2. Completing assigned duties in a timely way and following through on instructions received, reasonable requests, and promises made;
        3. Acting professionally in interactions with the client, family, community and other professionals;
        4. Working within the limits of assigned duties and role;
        5. Recognizing personal limits of knowledge and skills;
        6. Seeking additional supervision or consultation when uncertain about what to do or when concerned about the performance of others; and
      2. Practice ethically as demonstrated by:
        1. Complying with the BHA Code of Ethics;
        2. Complying with laws, regulations, and agency policies;
        3. Effectively managing personal and professional boundaries with clients, families, and the community;
        4. Modeling appropriate personal and professional behavior;
        5. Respecting client and family rights; and
      3. Obtain client consent as demonstrated by:
        1. Providing information and obtaining informed consent
        2. Complying with special rules and procedures related to consent for: involuntary commitment; mandated reporting; minors; or individuals unable to consent, under guardianship, or subject to a court order; and
      4. Maintain confidentiality and privacy as demonstrated by:
        1. Complying with laws, regulations, and agency policies regarding confidentiality and privacy (e.g., HIPAA, Federal Privacy Act, 42 C.F.R, Part 2);
        2. Complying with the procedures regarding disclosure of confidential information (e.g., mandated reporting, duty to warn, client authorized releases of information);
        3. Maintaining the physical security of confidential information (electronic and hard copy);
        4. Educating clients and families about confidentiality, privacy, and their limits;
        5. Assisting clients with decisions and process to release confidential information;
        6. Maintaining the confidences and privacy of clients and families, even when not required by law, regulation or policy;
        7. Protecting client and family anonymity when providing information for statistical information and research;
        8. Assisting in ensuring that other individuals providing services comply with the laws, regulations, and policy on confidentiality and privacy; and
      5. Manage stress and maintain personal health as demonstrated by:
        1. Recognizing signs of personal stress; and
        2. Using self-care strategies to manage stress, maintain health, and prevent burnout.

Sec. B2.30.115. Documenting.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a behavioral health aide I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a behavioral health aide II utilizes the skill consistently and recognizes when to seek assistance;
    3. a behavioral health aide III consistently applies the skills to specific client and community situations; and
    4. a behavioral health practitioner applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of behavioral health aides I, II and III.
  2. Knowledge and Skills. Documenting is a skill that requires a behavioral health aide or practitioner to:
    1. Complete required documentation as demonstrated by:
      1. Completing all required documentation (e.g., screening and assessment, intake, service plans, progress notes, discharge summaries);
      2. Producing documentation that is objective, accurate, and legible with correct language, grammar, and spelling;
      3. Completing documentation in a timely manner; and
    2. Respond to client requests to view records as demonstrated by:
      1. Reviewing client documentation with clients when they request to do so and when approved by the agency; and
      2. Demonstrating sensitivity when assisting clients in understanding their documentation during a records review
    3. Follow all documentation requirements as demonstrated by:
      1. Having knowledge of organization documentation policies;
      2. Having familiarity with insurance payer requirements, including the Center for Medicare and Medicaid Services (CMS), and
      3. Having knowledge of the documentation requirements of accrediting bodies.

Sec. B2.30.120. Community Education and Advocacy.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a behavioral health aide I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a behavioral health aide II utilizes the skill consistently and recognizes when to seek assistance;
    3. a behavioral health aide III consistently applies the skills to specific client and community situations; and
    4. a behavioral health practitioner applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of behavioral health aides I, II and III.
  2. Knowledge and Skills. Community education and advocacy is a skill that requires a behavioral health aide or practitioner to:
    1. Provide education as demonstrated by:
      1. Educating clients, families, and the community about behavioral health conditions and their prevention and treatment;
      2. Providing information to destigmatize people with mental health and substance use conditions; and
    2. Participate in prevention activities as demonstrated by:
      1. Using community gatherings to encourage healthy behaviors;
      2. Serving in community workgroups focused on prevention and early intervention with behavioral health conditions;
      3. Working with community leaders to develop supports for individuals and families at risk;
      4. Engaging and providing support to individuals and families at risk;
      5. Educating clients and families about strategies for improving physical and mental health;
      6. Assisting in assessing community needs and readiness for prevention and early intervention activities; and
    3. Provide advocacy as demonstrated by:
      1. Providing information to clients and families about their rights and responsibilities;
      2. Supporting individual and family goals and wishes within the agency and with other organizations;
      3. Helping clients and families to participate in service planning meetings; and
      4. Referring clients and families to peer and family support activities and advocacy organizations.

Sec. B2.30.125. Screening and Assessment.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a behavioral health aide I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a behavioral health aide II utilizes the skill consistently and seeks additional intervention or assistance as needed to achieve the purpose of the interaction; and
    3. a behavioral health aide III engages the client more effectively based on an understanding of the client’s information or behavior; and
    4. a behavioral health practitioner performs the skill independently, subject to applicable restrictions, and applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of the skill in behavioral health aides I, II and III.
  2. Knowledge and Skills. Screening and assessment is a skill that requires a behavioral health aide or practitioner to:
    1. Gather information using multiple sources as demonstrated by:
      1. Obtaining information from providers knowledgeable of the client and family;
      2. Collecting demographic, psychological, social, and medical information through interviews of the client and family;
      3. Summarizing all information verbally or in writing;
      4. Demonstrating sound judgment in evaluating and using the information collected; and
    2. Use screening and diagnostic tools as demonstrated by:
      1. Assisting clients in completing screening tools on substance use and mental health conditions;
      2. Scoring and interpreting the results of screening tools correctly; and
    3. Assess and identify strengths and needs as demonstrated by:
      1. Assessing clients’ preferred method of communication and language barriers;
      2. Identifying client and family strengths and resources;
      3. Identifying barriers to engage in services and providing solutions;
      4. Identifying client and family goals;
      5. Assessing clients’ motivation and readiness to participate in services;
      6. Identifying client problems, mental health and substance use conditions, and stressors;
      7. Identifying signs of abuse and neglect;
      8. Assessing level of risk for harm to self or others;
      9. Determining whether additional assessment is required and arrange if necessary;
      10. (BHA II, III, BHP only) Assessing physical and psychological risk associated with acute intoxication, overdose, withdrawal, detoxification, and co-occurring mental health and substance use disorders;
      11. (BHA II, III, BHP only) Applying the criteria in the current version of the Diagnostic and Statistical Manual for Mental Disorders (DSM) in assessing clients’ behavioral health conditions; and
      12. (BHA II, III, BHP only) Applying the American Society of Addiction Medicine (ASAM) patient placement criteria to guide treatment planning and recommend a level of care.

Sec. B2.30.130. Planning Services.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a behavioral health aide I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a behavioral health aide II utilizes the skill consistently and identifies when additional intervention or assistance may be needed to achieve the purpose of the interaction; and
    3. a behavioral health aide III engages the client more effectively based on an understanding of the client’s information or behavior; and
    4. a behavioral health practitioner performs the skill independently, subject to applicable restrictions, and applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of behavioral health aides I, II and III.
  2. Knowledge and Skills. Planning services is a skill that requires a behavioral health aide or practitioner to:
    1. Identify recommended goals and services as demonstrated by:
      1. Identifying recommended short-term and long-term service goals;
      2. Identifying service options based on experience and research;
      3. Evaluating eligibility and insurance coverage or ability to pay for recommended services; and
    2. Support client and/or family member decision-making in developing the plan of care as demonstrated by:
      1. Communicating outcome of the screening and assessment to the client and family;
      2. Assisting the client and family in understanding the client’s conditions and effects;
      3. Discussing recommended goals and services with client and family and alternate options;
      4. Assisting client in communicating their needs to others;
      5. Negotiating and finalizing a plan of care with the client and family based on their preferences; and
    3. Assist clients in developing personal plans as demonstrated by
      1. Assisting the client in developing a safety plan, as needed;
      2. Supporting the client in developing wellness and recovery plans.

Sec. B2.30.135. Linking to Community Resources.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a behavioral health aide I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a behavioral health aide II utilizes the skill consistently and identifies when additional intervention or assistance may be needed to achieve the purpose of the interaction;
    3. a behavioral health aide III applies knowledge and skills to increase access to resources and engages the client more effectively based on an understanding of the community and the client’s information or behavior; and
    4. a behavioral health practitioner performs the skill independently, subject to applicable restrictions, and applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of behavioral health aides I, II and III.
  2. Knowledge and Skills. Linking to community resources is a skill that requires the behavioral health aide or practitioner to:
    1. Identify recommended resources as demonstrated by:
      1. Maintaining information on a range of community resources (e.g., service, medical, financial, housing, spiritual, volunteer);
      2. Maintaining information on traditional support and intervention resources (Elders, traditional healers);
      3. Identifying recommended resources and traditional supports for the client and family based on need and eligibility;
      4. Identifying resources outside of the community that may need to be brought into the community; and
    2. Support client and family member decision-making in selecting resources as demonstrated by:
      1. Discussing resource recommendations and options with the client and family;
      2. Motivating the client and family to access and use resources;
      3. Negotiating a plan with the client and family about accessing resources based on their preferences; and
    3. Connect individuals and families to community resources as demonstrated by:
      1. Making a referral and actively connecting the client or family to selected resources;
      2. Ensuring that the referral was accepted and client or family is receiving services;
      3. Making an alternate referral if the initial referral was unsuccessful; and
      4. Drawing on individuals in the community to offer support to the client and family.

Sec. B2.30.140. Providing Services.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) as provided in paragraphs (1) through (4) of this subsection, as applicable:
    1. a behavioral health aide I demonstrates the skill, applies it as directed, and routinely seeks assistance;
    2. a behavioral health aide II utilizes the skill consistently and identifies when additional intervention or assistance may be needed to achieve the purpose of the interaction;
    3. a behavioral health aide III applies knowledge and skills to increase access to resources and engages the client more effectively based on an understanding of the client’s information or behavior; and
    4. a behavioral health practitioner performs the skill independently, subject to applicable restrictions, and applies knowledge to mentor and support others in the use of the skill and to participate in supervision and evaluation of behavioral health aides I, II and III.
  2. Knowledge and Skills. Providing services is a range of skills that includes case management, coordination of services, assistance with medication management, counseling, and crisis management and requires a behavioral health aide or practitioner to:
    1. Coordinate Care as demonstrated by:
      1. Arranging for assistance, if needed, with language translation or literacy;
      2. Implementing the plan of care (e.g., begin services, make referrals);
      3. Monitoring client’s condition, behavior, and progress on a continuous basis;
      4. Recognizing when progress has slowed, address barriers, and work to motivate the client;
      5. Evaluating progress and reviewing and revising the plan of care on a regular basis;
      6. Encouraging client participation in services and reaching out when the client is not engaged;
      7. Participating in developing, coordinating, and monitoring a discharge plan;
      8. Establishing working relationships and coordinating care with other providers and teams in the BHA’s agency;
      9. Establishing working relationships and coordinating care with other providers in other agencies;
      10. Assisting in establishing routine and formal working relationships with other agencies; and
    2. Assist with medication management as demonstrated by:
      1. Reviewing the list of the client’s medications and their effects and side effects;
      2. Supporting client and family education about medication effects and side effects;
      3. Coaching the client on strategies for taking medications as prescribed;
      4. Coaching the family on strategies for supporting the client in taking medications;
      5. Supporting the client’s participation in medical appointments, medical monitoring, and lab testing;
      6. Assisting the client in monitoring and reporting medication effects and side effects to the medical prescriber; and
    3. Provide individual counseling as demonstrated by:
      1. Providing emotional support, encouragement, and reassurance;
      2. Helping the client define the problem by telling their story, discussing their situation, and challenging their current perspective, when warranted;
      3. Helping the client set goals by discussing the possibilities and assisting the client to select and commit to new goals;
      4. Helping the client take action through problem-solving, education and training, reflecting on past experiences and patterns, creating an action plan, contracting, and providing feedback; and
    4. Manage crises as demonstrated by:
      1. Recognizing behavioral health crises and early warning signs of crises;
      2. Assisting in deescalating problems in their early phase;
      3. Reporting crises and seeking assistance from a supervisor or licensed behavioral health professional;
      4. Seeking assistance, as needed, from Village Public Safety Officers, other first responders, or community members;
      5. Assisting in implementing the response for an individual, family, and community crises;
      6. Communicating with the family and others about the crisis and the response;
      7. Assisting with notifications and investigations of reportable events (e.g., abuse, domestic violence, assaults, neglect, deaths);
      8. Providing support to those affected by the crisis and assisting them in accessing supportive services;
      9. Assisting the client and family in obtaining services related to the crisis (e.g., domestic violence shelter; emergency foster care);
      10. Participating in debriefing meetings to discuss the crisis and the response; and
    5. (BHA II, III BHP only) Provide family counseling as demonstrated by:
      1. Assessing family norms and roles (in nuclear and extended families, clans, biological and non-biological families);
      2. Using genograms and sociograms to assess and work with families;
      3. Identifying family dynamics, functional and dysfunctional units, and barriers to communication;
      4. Identifying the impact within the family of an individual with a mental health or substance use condition and accommodations made by the family for the individual;
      5. Identifying the impact on family functioning of stressors (e.g., medical illness, separation, divorce, abuse, financial concerns, housing issues, legal trouble);
      6. Engaging members of the family in constructive problem-solving;
      7. Assisting the family in improving its functioning; and
    6. (BHA II, III BHP only) Provide group counseling as demonstrated by:
      1. Identifying the functions, limitations, and risks of different types of groups (e.g., educational, psychoeducational, self-help, support, activity, skill development, and therapeutic);
      2. Identifying appropriate members for the different types of groups;
      3. Orienting new members to groups addressing the purpose, rules, boundaries, and levels of self-disclosure;
      4. Running groups effectively, providing adequate structure, encouraging member interaction, and maintaining safety;
      5. Assisting clients in ending participation in a group or transitioning to another group; and
      6. Managing the ending of groups.

Sec. B2.30.145. Professional Development.

  1. Level of Performance. A behavioral health aide or practitioner must demonstrate the knowledge and perform the skills and competencies described in subsection (b) in their own interaction with supervisors, mentors and trainers, in pursuing their own professional development, and as provided in paragraphs (1) through (3) of this subsection, as applicable:
    1. a behavioral health aide I or II does not perform supervision, training, or professional development of other behavioral health aides or practitioners, but a BHA I may provide peer support for a person training to be a behavioral health aide I and a BHA II may provide peer support for a BHA I;
    2. a behavioral health aide III demonstrates the skills and competencies and applies it as directed and routinely seeks assistance; and
    3. a behavioral health practitioner applies the knowledge and skills to engage, mentor and support, and participate in supervision and evaluation of behavioral health aides I, II and III, based on an understanding of the supervisee’s level of knowledge and skills, professional goals, and behavior.
  2. Knowledge and Skills. Professional development is a skill that requires a behavioral health aide or practitioner to:
    1. Seek opportunities to improve knowledge, skills and abilities as demonstrated by:
      1. Setting personal goals for professional development;
      2. Participating in employer sponsored training and other continuing education activities;
      3. Adopting best practices learned through continuing education; and
    2. Use supervision effectively as demonstrated by:
      1. Participating routinely and constructively in supervision;
      2. Using supervision, peer consultation, and self-evaluation to enhance self-awareness and improve professional performance;
      3. Using formal evaluations to improve professional performance and the quality of services provided; and
      4. (BHA II, III, BHP only) Provide guidance and mentoring to others.

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