LTSS Program Examples

The Cherokee Elder Care Program, started in 2008, is a unique initiative providing comprehensive care for elderly individuals through a team of diverse health providers. It aims to improve the quality of life for seniors by enabling them to remain in their homes as long as possible. Notably:

• It’s one of only 15 rural PACE sites in the U.S. and the first in Oklahoma, as well as the first sponsored by a Native American tribe.
• Led by a primary care physician, it offers a range of services such as home health aides, hospice care, meals, prescriptions, therapy, and assistance with tasks like bathing.
• It assists with processes like case management and Medicaid applications.
• Eligibility requires individuals to be 55 or older, able to live safely at home within the program’s service area and certified as needing nursing home-level care.
• Funding primarily comes from Medicare and Medicaid, with participants either being reimbursed or making monthly payments. The program worked with the State of Oklahoma to be included in the Medicaid plan.

In essence, the Cherokee Elder Care Program provides vital support to elderly individuals, allowing them to receive comprehensive care while staying in their homes.

In 1994, the Oneida Nation made a deal with Wisconsin to improve access to state and Medicaid services for its tribe members. They’re part of Wisconsin’s Community Option Program (COP), which lets them offer home- and community-based services to eligible Native Americans. The tribe did a study to make sure this plan would work.

The Oneida Nation runs a program called COP-Waiver (COP-W) to help frail elders and people with disabilities. They used to get some money from the state and mostly from federal Medicaid funds. But since 2007, they convinced the federal government to cover all costs, so they don’t rely on state funds anymore.

They provide various services directly, like job coaching and physical therapy. They also help with things like Medicaid applications and finding eligible services. Some services are outsourced to other providers.

Currently, the program serves only the Oneida Nation Reservation, but they want to expand to nearby areas. The tribe worked closely with the state for over a year to make this happen, showing them how it could save money and benefit everyone involved. Eventually, Wisconsin agreed to let the Oneida Nation administer the waiver services for tribal members.

The Pueblo of Zuni has various programs aimed at providing long-term care for elders in the community. These programs work together to offer comprehensive support:

1. Zuni Adult Day Center: Started in 1998 by volunteers, this center provides respite care and activities for tribal members with dementia. It now has its own facility and is supported financially by various programs.
2. Zuni Home Health Services: This program offers skilled nursing care and home health aide services, catering to those needing assistance with daily activities. It’s federally qualified and funded through Medicaid and Medicare.
3. Zuni Senior Center: Offering a range of services including companionship, health promotion activities, meals, transportation, and more. The center also administers several programs for elders.
4. IHS Hospital’s Elder Care Program: This program evaluates and addresses the needs of elders, collaborating with other community groups and services.
5. Elderly Services Coordinating Committee: Formerly known as the Elder Task Force, this committee oversees the coordination of all elder services and meets quarterly to address any gaps in support.

These programs collectively ensure elders in the Pueblo of Zuni receive comprehensive care and support.

All content on this page was originally posted on the CMS.gov website here.