Health Disparities Among American Indians/Alaska Natives, Arizona, 2017— November 30, 2018

Compared with other racial/ethnic groups, American Indians/Alaska Natives (AI/AN) have a lower life expectancy, lower quality of life, and are disproportionately affected by many chronic conditions. Arizona has the third largest population of AI/AN in the United States (approximately 266,000 in 2017), and is home to 22 federally recognized American Indian tribal nations. View the analysis of 2017 behavioral risk factor surveillance system data from Arizona here.

35th Anniversary of National Alzheimer’s Disease Awareness Month— November 20, 2018

November 2018 marks the 35th anniversary of National Alzheimer’s Disease Awareness Month. In the 35 years since the original call to build awareness of the disease, we have learned a lot about people living with Alzheimer’s disease and related dementias (ADRD) and caregiving. The Administration for Community Living continues to advance the dementia capability of states and communities through its grant programs and the work of the National Alzheimer’s and Dementia Resource Center (NADRC). Each year the NADRC develops resources to support grantees and the general community in their work with individuals living with Alzheimer’s disease and related dementias and their caregivers.

The fundamental principle ACL was created around is that all people, regardless of age or disability, should be able to live independently and fully participate in their communities. We are pleased to announce the following available resources:

Disaster Planning Toolkit for People Living with Dementia is written to help people living with dementia, their family members, and their caregivers understand what to expect in the event of a disaster and how to prepare for it. The toolkit is made up of seven tip sheets and checklists for persons living with dementia, their families, and others who interact with them, including friends and neighbors.

Handbook for Helping People Living Alone with Dementia Who Have No Known Support provides practical guidance as well as tools for helping a person living alone who does not have informal supports, including people with dementia who have a caregiver that cannot provide support. The handbook includes practical strategies for identifying people who are living alone without support, assessing risk, building trust, identifying family and friends willing to help, determining decision-making capacity, options for helping the person maintain their independence, and the basics of guardianship or conservatorship.

Working Together: How Community Organizations and First Responders Can Better Serve People Living with Dementia This guide helps community organizations collaborate with first responders to better serve people living with dementia, a need increasingly recognized by first responder agencies. This guide explains why this issue is gaining attention, provides strategies for building successful partnerships, and describes the types of programs that can benefit people living with dementia. Also included are resources such as training materials, sample policies, tip sheets and more.

ACL Launches Redesigned Eldercare Locator Website— November 5, 2018

The Administration for Community Living is pleased to launch our newly redesigned Eldercare Locator website. Located online at, the updated website makes it easier for older adults and their caregivers to find essential aging resources. New features include:

• A mobile-optimized design to easily access the Eldercare Locator on a computer, phone, or tablet

• A geographical search bar allows visitors to search for local aging resources from any page on the site

Caregiver Corner with answers to the most frequently asked questions the Eldercare Locator Call Center receives from caregivers

• A new “Learn More About” section that provides information on popular topics like transportation, support services, elder rights, housing, health, and insurance and benefits

• A centralized location that enables older adults and caregivers access Eldercare Locator brochures on topics important to their health and well-being

To view more information click here.

Newsletter from VA’s Office of Tribal Government Relations (OTGR) May/June/July 2018 - Summer 2018

To view the VA’s Office of Tribal Government Relations Summer 2018 Newsletter click here.

New VA Resource Aims to Address Unique Needs of Veterans— July 16, 2018

The Older Veteran Behavioral Health Resource Inventory provides an overview of resources for health and social service professionals interested in enhancing their outreach and support for older veterans who have or are at risk for behavioral health conditions.

The inventory, as well as other useful resources for professionals working with veterans, are available through the VA Community Provider Toolkit.

This resource was created as part of a partnership on meeting the mental health needs of aging Veterans. This partnership included the:

• Veteran Benefits Administration (VBA)
• Administration for Community Living (ACL)
• Center for Medicare and Medicaid Services (CMS)
• Office of Minority Health (OMH)
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• National Council on Aging (NCOA)

MIPPA Technical Assistance— June 15, 2018

The National Council on Aging (NCOA) held a technical assistance call this week to offer a glimpse of some of the myriad changes that will likely be coming to Medicare in 2019.  NCOA is preparing fact sheets and future webinars that review some of these changes in more detail.  NCOA is a great Medicare resource, so don’t forget to check their website for educational information for your MIPPA events.  Their information would also be useful to your Tribal Health Benefits Coordinators and Health Educators.  They have uploaded a recording from the MIPPA TA call from yesterday to:

2018 CMS National Training Program— June 14, 2018

At the 2018 CMS National Training Program (NTP) Workshops, you can expect 2½ days of tailored training to meet a variety of learning needs. Whether you’re building a foundation of basic Medicare knowledge, or you want to expand your expertise, there’s something for everyone. Day 1 provides the basics, Day 2 has cross-cutting, and Day 3 provides a deeper dive into more advanced topics.

1.   Kansas, MO: July 31–August 2, 2018

2.   New York, NY: August 6–8, 2018

3.   Seattle, WA: August 14-16, 2018

4.   Atlanta, GA: September 5-7, 2018

5.   Denver, CO: September 10-12, 2018

Food Safety for First Nations People of Canada: A Manual for Healthy Practices— May 29, 2018

Food safety is important. Food that hasn't been properly handled, and that is contaminated by bacteria, viruses and parasites can make you and your family sick.

The Food Safety for First Nations People of Canada: A Manual for Healthy Practices is intended to raise awareness on the safe handling, preparation, and storage practices of traditional and store-bought foods, in order to reduce the incidence of foodborne illnesses.

The manual covers a variety of topics from microbial and chemical hazards to the safe handling, preparation and storage of foods, and aims to promote the consumption of traditional foods and their high nutritional value, while, at the same time increase awareness about potential public health risks (e.g., microbial and chemical contamination) that may be associated with methods of handling.

To view the manual, please click here.

VA Office of Tribal Government Relations Newsletter~ March/ April 2018— May 2, 2018

Tribal Health Programs (ITU) trainings for health care providers held in Denver, CO, Sacramento, CA, Gallup, NM, and Albuquerque, NM.   Additionally, on the health care front, the VHA Community Care Office along with the Indian Health Service Office of Urban Indian Health Programs hosted a webinar for Urban Indian Health Programs interested in becoming providers VA uses to refer Veterans to care in the community.

See the Newsletter Here.

CMS Publishes New Tribal Nursing Home Directory— April 23, 2018

CMS recently released an updated directory of tribal nursing homes. LTSS in Our Community: Tribal Nursing Home Directory(PDF, 725 KB, 10 pp) lists contact information for the 18 nursing homes in Indian Country that offer long-term services and supports (LTSS). It includes details about certification, the number of beds, and each facility’s ombudsman and Quality Innovation Network–Quality Improvement Organization.

Culturally Sensitive Care in Tribal Nursing Homes— April 23, 2018

Strong connections to culture and traditions enhance the quality of life for AI/AN elders as they age.  Many tribal nursing homes and assisted living facilities have developed strategies for provideidn culturally sensitive care to their residents. A new report from CMS (PDF, 11 pp, 4.1MB) describes how four tribal long-term care facilites provide culturally sensitive care for elders.  The report highlights recommendations other tribal program can follow to provide care that honors individual lifeways and preferences. The report outlines tips for honoring tradition, coordinating cultural activities, incorporating spiritually into care, and training staff to be culturally sensitive.

To see the report, click here.

Advocacy 101: Gaining Congressional Support for Tribal Public Health— April 13, 2018

Last week, the National Indian Health Board (NIHB) celebrated National Tribal Public Health Week. Learn more about the resources NIHB shared as part of the celebration! For example, see the diagram below about how a bill becomes a law, from our webinar, Advocacy 101: Gaining Congressional Support for Tribal Public Health.

To view the slides, Click Here. To watch the recording, Click Here.

Title VI (FY2017) Online Reports are available for submission!— April 4, 2018

REMINDER: The (12 month) SF 425 for Period Ending March 31, 2018 is due by July 30, 2018.

· For Title VI, Parts A/B, C, and NSIP-- (NSIP awards only; no indirect cost allowed for NSIP program)

· SF 425 financial reports can be submitted in Title VI Online Reporting System:


If you need help to access the online system, contact Cecelia Aldridge (202) 795‐7293 or

BUDGET Period:          04/01/2017 – 03/31/2018 (12-month report)

PROJECT Period:        04/01/2017 – 03/31/2020

Meal Delivery Programs Reduce the Use of Costly Health Care in Dually Eligible Medicare and Medicaid Beneficiaries— April 4, 2018

Delivering food to nutritionally vulnerable patients is important for addressing these patients’ social determinants of health. However, it is not known whether food delivery programs can reduce the use of costly health services and decrease medical spending among these patients. We sought to determine whether home delivery of either medically tailored meals or nontailored food reduces the use of selected health care services and medical spending in a sample of adults dually eligible for Medicare and Medicaid. Compared with matched nonparticipants, participants had fewer emergency department visits in both the medically tailored meal program and the nontailored food program. Participants in the medically tailored meal program also had fewer inpatient admissions and lower medical spending. Participation in the nontailored food program was not associated with fewer inpatient admissions but was associated with lower medical spending. These findings suggest the potential for meal delivery programs to reduce the use of costly health care and decrease spending for vulnerable patients.

Tribal Technical Assistance Program for Transportation— March 30, 2018

The Federal Highway Administration (FHWA) Office of Innovative Program Delivery’s Center for Local Aid Support recently established a national Tribal Technical Assistance Program (TTAP) as a one-stop transportation resource for tribal communities across the country.

The TTAP Center provides comprehensive transportation training and technical assistance to tribal communities, building skills and expertise to ensure the safety and maintenance of tribal roads and the continuous professional development of tribal transportation workforces. To visit the site, click here.

Get Ready for New Medicare Cards— March 29, 2018

Between April, 2018 and April, 2019, the Centers for Medicare & Medicaid Services (CMS) will mail new Medicare cards to all people with Medicare.  The new cards will have a new unique Medicare Number instead of a Social Security Number.  Medicare will automatically mail the new cards to the beneficiary address on file with the Social Security Administration.

CMS will mail the new cards in waves.  Starting in April 2018, people with Medicare will be able to check the status of card mailings in their area on Medicare .gov. The first wave of cards will be mailed between April and June to people with Medicare in the following 11 states and territories:

• Alaska
• American Samoa
• California
• Delaware
• District of Columbia
• Guam
• Hawaii
• Maryland
• Northern Mariana Islands
• Oregon
• Pennsylvania
• Virginia
• West Virginia

After receiving a new card, people with Medicare are advised to take 3 steps to make it harder for someone to steal their information and identity:

1.  Destroy your old Medicare card.

2.  Use your new card right away. Doctors, other health care providers, and plans approved by Medicare know that Medicare is replacing the old cards and are ready to accept the new cards.

3.  Beware of people contacting you about your new Medicare card and asking you for your Medicare Number, personal information, or to pay a fee for your new card. If you think someone is trying to steal your identity or otherwise commit fraud related to the new Medicare cards, you can report them to your local Senior Medicare Patrol (SMP).

Information and resources for partners and providers related to the roll-out of the new cards is available from

Social Security's American Indian Alaska Native (AIAN) Geospatial Map— March 28, 2018

This map presents data on tribal information, Social Security Video Service Delivery (VSD) sites, and Social Security Field and Resident Station locations to assist with American Indian and Alaska Native (AIAN) outreach. Please use the navigation keys on our map + / - to zoom in and out of this map. Symbols on the map will appear, as you zoom in on the map. Click on any of the symbols to find SSA Video Service Delivery (VSD) sites, field offices, or resident stations, closest to your tribe or reservation locations. To view the map, click here.

Resources for Justice- Involved Veterans: A Guide for Tribal Justice Systems— March 19, 2018

This Guide will describe several efforts currently underway to address the need for treatment and other services among Veterans in the criminal justice system.  Veterans Treatment Courts (VTC) are an example of one approach, although not the only one, and will receive particular attention.  The Guide will discuss the components common to most VTCs and suggest the steps a tribal government may take to implement a certain piece of the model.  One purpose of this Guide is to provide interested tribal governments with a breakdown of how VTCs work and identify the movable parts of various programs that would allow tribal governments to choose the parts it wants to explore using in its tribal justice system.  No less important, the Guide is intended to identify resources available to justice-involved Veterans, regardless of whether their communities have adopted the VTC model.

Click here to read the Guide.

Rx Pain Medications. Know the Options. Get the Facts— February 26, 2018

The Centers for Disease Control and Prevention and SAMHSA have developed a series of fact sheets entitled Rx Pain Medications. Know the Options. Get the Facts.  These fact sheets are designed to increase awareness of the risks associated with prescription opioid use and misuse, as well as to educate patients who are prescribed opioids for pain about the risks and to provide resources on methods for alternative pain management.

Many of these fact sheets are relevant to older adults, and we will be sharing these fact sheets with you periodically this year.  The first fact sheet that we are distributing as part of this effort focuses on alternative pain management methods such as acupuncture, cognitive behavioral therapy, and meditation.

To get the fact sheets, please click here.

Protecting Nursing Home Residents During Emergencies— February 23, 2018

Many tribal nursing homes have developed emergency preparedness plans to safeguard elders in the event of a flood, fire, or other emergency.

A new best practices report from CMS describes how 5 tribal nursing homes prepare for emergencies. It shares their recommendations on partnerships, funding, and staff training that other LTSS facilities can use in their own planning.

CMS Emergency Preparedness rule: CMS now requireed health care facilities that participate in Medicare and Medicaid, including nursing home, to have emergency preparedness plans in place to protectthe wellbeing of their patients and staff.  More information about the emergency preparedness rule available on

Rx Pain Medications: Know the Options Fact Sheet— February 8, 2018

Although prescription pain medications can be effective at treating certain types of pain, there are different treatment options and therapies available. Whether one approach is safer and more effective than another will depend on your unique situation.

To access the fact sheet, Click Here.

Webinar Recording Available: Strategies to Combat Opioid Use in Rural Communities— January 23, 2018

The opioid epidemic is an ongoing problem in rural areas. Rural youth, young adults, women experiencing domestic violence, and people living in states with large rural populations suffer from higher rates of opioid use than their urban counterparts. Opioid overdose deaths are growing faster in rural counties than urban counties. This presentation by John Gale, MS, of the University of Southern Maine focused on a wide range of strategies that communities can use to combat the opioid problem. In particular, it discussed cost-effective, evidence-based prevention, treatment, and recovery programs that have been successfully implemented in rural communities. It concluded by describing community organizing strategies to engage a wide range of local stakeholders to reduce the burden of opioid use.

To access the recorded webinar, presentation, and transcript, click here.

NIEJI Announces 2018 Elder Abuse Innovation Award Recipients— January 11, 2018

Eight tribes from eight states were awarded a total of $150,000 from the National Indigenous Elder Justice Initiative (NIEJI) Innovation Program to address elder abuse in their communities. NIEJI is part of the Center for Rural Health (CRH) at the University of North Dakota School of Medicine and Health Sciences. The CRH works with tribal communities to help improve the health and well-being of American Indians. The grants are funded by an award from the Administration for Community Living.

To read more, click here.

Tribal Climate Health Champions: Spotlight on the Village of Wainwright— January 11, 2018

The National Indian Health Board (NIHB) funds three Tribal climate health projects as part of the  Climate Ready Tribes Project with support from the Centers for Disease Control and Prevention (CDC). NIHB is currently highlighting each of these Tribes and their climate health efforts through email spotlights. You can view the previous email in this series here. Also look for updates coming soon to the NIHB climate page to share information about all of the awardees and their projects.

Today's spotlight highlights work in Alaska, the largest and one of the least populated states in the US. The Village of Wainwright (VOW) is located in the northern Alaskan Arctic, on the shores of the Chukchi Sea. It is situated within a region commonly referred to as the North Slope, which begins in the interior just north of the Brooks Range and stretches down to the Chukchi and Beaufort Seas. Wainwright is approximately 70 miles southwest of the hub city of Barrow and three miles northeast of the Kuk River estuary. The Kuk is a 35-mile-long stream that discharges to the Chukchi via the Wainwright Inlet. Wainwright is itself situated on a wave-eroded coastal bluff of a narrow peninsula that separates the Wainwright Inlet from the Chukchi Sea. Wainwright received its contemporary moniker from the Inlet, which was given its English name in 1826 by Captain F.W. Beechey in honor of his officer, Lt. John Wainwright (North Slope Borough, 2014).To read the full article, click here.

Stress and Health Disparities Report— January 8, 2018

There are well-documented disparities in health by socioeconomic status and race and ethnicity (National Center for Health Statistics, 2012.) Stress has been identified as one of the top 10 determinants of disparities in health (World Health Organization [WHO], 2008). This report presents a state-of-the-science overview of research examining stress as a driver of disparities in health. Stress occurs when individuals experience demands or threats without sufficient resources to meet these demands or mitigate the threats (Lazarus & Folkman, 1984). We document disparities in stress exposures; explore biopsychosocial mechanisms that may link stress to health, with a particular focus on disparities in depression, cardiovascular disease, and cancer; and identify interventions on the individual, family, community and national levels that may reduce stress and the effects of stress on health among health disparity populations. The aim is to identify actions that APA and others can take to reduce stress and stress-related health disparities.

To read the full report, click here.