DISCLAIMER: CoC (Continuum of Care) is an alternative term for LTSS (Long Term Services and Support). Please note that not all instances of LTSS have been transitioned to the new designation.
Engaging in Long-Term Services and Supports (LTSS) Initiatives: A Guide for Tribal Communities
For those eager to participate in Long-Term Services and Supports (LTSS) initiatives within their tribal communities, understanding the avenues through which tribes can contribute is paramount. This guide aims to clarify the various ways tribes can lend their support to LTSS efforts, from referral services to direct care provision.
Referral Services: Tribes can direct individuals in need towards available LTSS resources within the community.
Partnerships and Collaboration: By forging partnerships with existing LTSS service providers or community organizations, tribes can foster collaborative efforts aimed at bolstering the accessibility and efficacy of LTSS provision.
Supportive Services: Tribes may opt to provide hands-on assistance by offering supportive services such as transportation aid or assistance with daily tasks to community members requiring LTSS.
Interim Activities: During the developmental stages of a tribal LTSS program, interim activities can serve as stopgap measures to address immediate community needs while comprehensive LTSS infrastructure is being established.
Direct Care Services: For tribes prepared to assume a more substantive role, the direct provision of LTSS, encompassing housing, healthcare, and related services, constitutes a significant commitment to meeting the long-term care needs of community members.
In conclusion, tribes possess a spectrum of opportunities for involvement in LTSS initiatives, each bearing its own level of commitment and impact. By strategically aligning their resources and capacities with community needs, tribes can play a pivotal role in enhancing the accessibility and quality of LTSS within their communities.
Your tribe can refer people who need CoC services to your program or other available services in your community. The tribe might also refer members to outside CoC programs or government offices for services that your community or program does not currently offer.
An eligibility assessment means that the tribe determines what types of available CoC service options an individual is eligible for. An assessment also determines whether the person qualifies for Medicaid. Assessments are important for educating individual community members about what services are available to them and how they can finance those services.
When a tribal member contracts with a CoC agency or caregiver, the tribe can manage the care of that person. By providing case management services, tribes help their members navigate CoC services and health care systems. In addition, tribes can act as patient advocates to ensure their members receive culturally appropriate care.
If your tribe does not wish to handle case management, inquiries can be referred out to other entities.
To learn more about case management, check out these resources:
- Read Case Management, a Tribal Perspective (PDF) (webinar slides, PDF) to learn how tribes are getting involved in case management for elders.
- Learn about Home and Community-Based Services for Native Elders: Pathway to CHR Targeted Case Management at Standing Rock Sioux Tribe (PDF) (webinar slides, PDF).
If a tribe does not have the population or other resources needed to operate an CoC program itself, the best alternative may be to find another agency who can serve tribal members and set up a contract with that agency. Contracting may also be a good option if your tribe is located close to comprehensive CoC programs that already exist, and that are willing to respect AI/AN culture in service delivery.
To learn more about how tribes can successfully contract with other entities, watch Tribal Partnerships: How the Arizona Health Care System Addresses the Long-Term Care Needs of Tribal Medicaid Members.
To provide direct care, a tribe must be accredited to operate as a home care agency or facility-based CoC program. Once the program is accredited, a tribe can directly provide CoC services to its members.
For more information on tribal involvement in direct care, see these resources:
- Watch this webinar recording on the Menominee Indian Tribe of Wisconsin’s Model of Long Term Care (webinar recording, 48 min), which explains how Menominee administers a state Medicaid waiver program.
- View the Tohono O’odham Nursing Care Authority presentation (PDF) (webinar slides, PDF), which describes the development of a tribally based skilled nursing facility and hospice, certified by Medicare, by the Tohono O’odham Nation.
Elder Safety and Abuse Prevention
- Convene an elder task force to meet, identify potential problems or risks, and advise the community on elder abuse issues
- Develop an elder safety code to protect older community members from physical, mental, emotional, or other kinds of abuse
- Implement elder abuse best practices to address risk factors for elder abuse
Learn more about elder abuse prevention efforts used by different tribes through these resources:
Housing for older adults is an important need in many communities. The availability of housing resources often determines whether a person can stay in his or her own home instead of receiving care in a separate facility outside of the community.
Think about what you learned from your needs assessment. Is housing a priority need in your community? How does this need tie in with the other needs you found?
Although housing is a common CoC need, sources that fund health related CoC needs do not usually cover housing services. For example, home- and community-based services (HCBS) do not include funding for housing or home modifications.
Explore the Housing Capacity Building Initiative for Community Living Resource Center, which offers information and resources that can help you find funding solutions for housing needs.
Interim Activities for Tribes
Interested in helping out with Long-Term Services and Supports (LTSS) in your community? That’s great! But you might be wondering how your tribe can pitch in. Don’t worry, we’ve got you covered.
First off, it’s essential to understand what LTSS are needed in your community and what’s already available. Once you’ve got that info, you might be wondering how your tribe fits into the picture. Well, there are different ways tribes can help with LTSS efforts.
Let’s break it down:
Referral Services: This is the simplest way tribes can help. You can point people in the right direction to get LTSS care if they need it.
Partnerships and Collaboration: If you’re up for working with others, you can team up with existing LTSS service providers or other community groups. By working together, you can make sure everyone gets the help they need.
Supportive Services: Maybe you want to offer more hands-on help. You could provide things like rides or assistance with daily tasks for community members who need it.
Interim Activities: If you’re planning to start your own LTSS program, you might want to do some temporary stuff while you get things set up. It’s like a sneak peek of what’s to come!
Direct Care Services: This is the big one. If you’re ready to dive in, you can offer LTSS directly to your community. That means providing things like housing and healthcare right where people need it.
So, there you have it! Whether you’re just giving pointers or diving headfirst into providing care, there’s a way for your tribe to get involved in LTSS. It’s all about finding what works best for you and your community.