Tribal Partnerships for LTSS Care

Long-Term Services and Supports

Technical assistance for culturally competent care

August 2016

LTSS Training and Technical Assistance Center

Visit the online LTSS TA Center for videos, best practices, toolkits, a resource library, and a step-by-step planning roadmap.

Could More Community Health Aides Expand Tribal LTSS?

Alaska’s thriving Community Health Aide Program (CHAP) uses a state-wide network of community health aides and practitioners to provide medical, behavioral health, dental, and other health services to elders, people with disabilities, and other residents across more than 170 rural Native villages. The Indian Health Service (IHS) is now consulting with tribes on a draft policy to expand CHAP into IHS and tribally operated facilities across the lower 48 states—a move intended to increase the availability of health workers in American Indian communities.

In Alaska, there are several types of aides and practitioners:

Community Health Aides and Community Health Aide Practitioners are the primary providers for many people
Behavioral Health Aides and Behavioral Health Aide Practitioners work in Native communities to address substance use and mental health problems
Dental Health Aides and Dental Health Aide Therapists provide dental education and routine dental services

All aides work within an established referral network of physicians, other health professionals, dentists, clinics, and hospitals.

Find out more:

(Note: The Deadline for tribal comments has been extended to October 27, 2016, and there will be an in-person consultation at NIHB’s National Tribal Health Conference on Sept. 19.)

A Good Time to Assess or Revisit Your LTSS Needs

IHS is currently consulting with tribes on a draft policy that could reshape the Indian health system in the years to come.

Would a redesigned Indian health system change your tribe’s existing LTSS program? Would it inspire your community to take the first steps toward developing a sustainable LTSS program?

If so, the place to start is a needs assessment—a clear look into your community’s demographics, LTSS needs, and available resources. This step is key to your program’s success because it helps you avoid investing resources into services that are unneeded or are not a good fit for your community.

The LTSS Roadmap provides detailed, step-by-step planning guidance for creating or expanding a tribal LTSS program. Step 1 of the roadmap describes how to conduct a needs assessment.

Take a short video tour of the LTSS Roadmap.

Immunizations for Elders and People with Disabilities

It’s National Immunization Awareness Month. The Centers for Disease Control and Prevention (CDC) has the following immunization and vaccination recommendations for adults:

All adults: a seasonal flu vaccine every year, and

one dose of the Tdap vaccine for adults who did not receive the vaccine as adolescents, as well as a Tdap vaccine for expectant mothers during each pregnancy, to protect against whooping cough
a Tdap booster shot every 10 years to protect against tetanus and diphtheria

Adults over 60: a Shingles vaccine to protect against shingles
Adults over 65 and younger adults with certain chronic health conditions, such as asthma, heart disease, or diabetes: pneumococcal vaccine to protect against pneumonia and other infections in the lungs and bloodstream

You’ll find additional recommendations for health care workers and people with chronic health conditions on the CDC website. The website also has printable materials and other resources you can use to promote immunizations in your community this month and all year round. Here are a few resources to get you started:

Quiz: What Vaccines Do You Need?
Handouts, posters, flyers, a video, drop-in newsletter articles, web buttons, and other materials for older adults and people with chronic health conditions.
Flu vaccination materials for American Indians and Alaska Natives

Why People Are Ashamed to Claim

Programs like Medicaid and SNAP lifted 15.5 million seniors out of poverty in 2014 alone. Yet feelings of shame and embarrassment keep many eligible elders and people with disabilities from applying for public benefits.

An End to Stigma, a new research report from the National Council on Aging, looks into what causes this stigma, discusses successful strategies to overcome it, and calls for support from policymakers and social service administrators to help more people enroll in benefit programs.

A New Definition of Health and Well-Being

Health is more than the absence of disease; however, most traditional models of health used by policymakers focus only on medical conditions. Researchers at the University of Chicago created a new model of health and well-being that accounts for a broad range of physical, psychological, and social indicators. They followed 3,000 older adults for 5 years and found that the new model did a better job of predicting the risk of incapacity and death than a medical-only model.

Poor mental health, poor sensory function and social engagement, and having a broken bone any time after age 45 are all strong markers for future health problems, while greater mobility serves as a strong predictor for well-being. These findings could potentially reshape how medical professionals and health practitioners assess and manage the quality of life and health of older adult patients.

Learn more about the study on the National Institutes of Health website.

Tour the Technical Assistance Center: LTSS Roadmap

The LTSS Technical Assistance Center offers detailed planning guidance for creating or expanding a tribal LTSS program. Watch a short video to explore many features and resources available through the Roadmap.

Take a video tour of the LTSS Roadmap (4:20).

Join the Conversation on LinkedIn

Want to learn more about or discuss LTSS in Indian Country? Looking to connect with others working in the same field? Join the Tribal Affairs Group on LinkedIn and join the conversation.

Upcoming Webinar

There is no LTSS webinar in August, but webinars will resume next month. As they say in the old song, “See you in September!”

Send Us Your News

Do you have news to share about LTSS in Indian Country? Send it to ltss@kauffmaninc.com, and we’ll include it in a newsletter. Contact us with other comments or feedback, too.

About the Newsletter

Long-Term Services and Supports Solutions is published monthly by the Tribal Affairs Division of CMS to share information, funding opportunities, and resources with LTSS planners, tribal leaders, and supporters.