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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.
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End-of-life planning for people with dementia
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End-of-life care is a common long-term care need. The progress of dementia can make it difficult for an elder to discuss what they want for end-of-life care. Having the conversation before symptoms progress can help caregivers and care providers learn their patients’ preferences before the patient is unable to share them.
In Indian Country, end-of-life discussions should include cultural sensitivity. For example, it may be culturally appropriate to use third-person descriptions in end-of-life discussions, rather than talking about the patient’s symptoms and care needs outright.
Additionally, care providers may need to include the patient, their immediate and extended family, and a translator in end-of-life discussions. Find more information about hospice and palliative care in Indian Country (PDF, 282 KB, 2 pp) on the CMS LTSS Technical Assistance Center.
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Hospice and palliative care resources for Indian Country
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The LTSS TA Center hospice and palliative care resources offer planning guidance to help programs build or improve their end-of-life care programs with cultural sensitivity in mind.
Resources include 5 tribal program profiles, a literature review, an infographic, and two presentations that highlight culturally specific best practices, lessons learned, and financial considerations.
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RAISE Family Caregivers Act will help families of people with disabilities
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The Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act requires the federal government to develop a national strategy to address the needs of family caregivers, including those who support people with developmental disabilities.
The act, passed in January 2018, calls for the Secretary of Health and Human Services to establish a national plan within 18 months and create a family caregiving advisory council to guide the government on how to support family caregivers across the country.
The plan will address:
- person- and family-centered care in health and LTSS settings
- assessments and service planning
- education, training supports, and care coordination
- respite options
- financial security
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Funding opportunity: Paralysis Resource Centers
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The Administration for Community Living has announced two funding opportunities. The first opportunity will fund a National Paralysis Resources Center (opportunity number HHS-2018-ACL-AOD-PRRC-0287). The second opportunity will fund up to 5 Paralysis Resource Center state pilot programs (opportunity number HHS-2018-ACL-AOD-PRRC-0286). The closing date for both applications is April 17.
Tribes and tribal organizations are eligible to apply for both funding opportunities. Under both grant programs, grantees will provide sub-awards to community-based organizations to improve their available services and supports or increase their program offerings for people living with paralysis and their families and caregivers.
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Updates to CMS database of LTSS programs in Indian Country
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This month, CMS updated its ITU database, which lists Indian Health Service, tribally operated, and urban Indian health programs (ITUs) that offer LTSS throughout Indian Country.
This interactive map shows an overall picture of where LTSS programs are available in Indian Country and provides insight into where certain types of LTSS services are offered.
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Native-language videos for at-home blood pressure checks
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Depending on how it is tailored, language can serve as a barrier or a bridge to helping elders understand their health. A Crow Agency-based health outreach program, Messengers for Health, has created a set of Native-language videos that teach people how to check their blood pressure at home. The videos, released in late 2017, are published in 5 Native languages—Cree, Salish, Blackfeet, Cheyenne, and Crow—and English.
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March is National Kidney Month
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March, National Kidney Month, is a good time to review kidney health and diabetes treatment and prevention. American Indians and Alaska Natives are 50% more likely to have kidney failure than White Americans. Additionally, American Indians and Alaska Natives are twice as likely to have diabetes as White Americans, and people with diabetes have a higher risk for kidney disease.
To help prevent and treat diabetes, Medicaid, Medicare, and private insurance help pay for screening tests, monitoring supplies, treatment, and diabetes education. Indian Health Service’s Special Diabetes Program for Indians offers treatment and prevention services. Learn more in the CMS brochure Diabetes Care and Health Coverage for American Indians and Alaska Natives (PDF, 342 KB, 2 pp).
The book Using Our Wit and Wisdom to Live Well with Diabetes by Barbara Mora (Paiute/Diné) describes the author’s journey with diabetes through a Native lens. This book is useful to those living with diabetes, their family members, and health care providers. Order a copy from the IHS Division of Diabetes Education Materials and Resources webpage.
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New Medicare cards—webinar recording
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To help protect elders from identity theft, CMS is issuing new Medicare cards, which will replace Social Security numbers with Medicare numbers that are unique to each beneficiary.
A recent CMS LTSS webinar focused on why CMS is providing new Medicare cards, how the new cards will affect tribal beneficiaries, and efforts to raise awareness about the new cards. Watch the recording. On CMS.gov, you can also find:
If you have questions or comments about the new cards, you can email CMS at NewMedicareCardsSSNRemoval@cms.hhs.gov.
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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.
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Elder Abuse Prevention Resources in Indian Country: National Indigenous Elder Justice Initiative
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Wednesday, March 28, 2018
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Are you looking for ways to prevent elder abuse, neglect, and exploitation and help victims in your community? Dr. Jacqueline Gray with the National Indigenous Elder Justice Initiative (NIEJI) will discuss online resources focused on preventing abuse of American Indian, Alaska Native, and Native Hawaiian elders. Dr. Gray has worked with tribes for more than 35 years in the areas of health, education, counseling, and program development.
Learning objectives:
- Learn what resources NIEJI provides to address elder abuse in Indian Country
- Understand how to locate NIEJI resources and access technical assistance
- Identify resources on the resource locator map
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Please note your
location's call-in time:
8 a.m. Hawaii
10 a.m. Alaska
11 a.m. Pacific
11 a.m. Arizona
12 p.m. Mountain
1 p.m. Central
2 p.m. Eastern
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Jacqueline Gray, PhD
Program Director, National Indigenous Elder Justice Initiative
Associate Director and Associate Professor, Center for Rural Health, University of North Dakota School of Medicine & Health Sciences
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Send Us Your News
Do you have news to share about LTSS in Indian Country? Send it to ltssinfo@kauffmaninc.com, and we’ll include it in a newsletter. Contact us with other comments or feedback, too.
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About the Newsletter
Long-Term Services and Supports Solutions is published monthly by the CMS Division of Tribal Affairs to share information, funding opportunities, and resources with LTSS planners, tribal leaders, and supporters.
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