Links

Nutrition
Long-Term Supports & Services (LTSS)
Health Promotion & Disease Prevention
Substance Abuse
Dementia & Alzheimer’s
Transportation
Caregiving
Grant Opportunities
Affordable Care Act
Housing
Women
Children
Disabilities
Elder Justice
Diversity
Medicare
Fall Prevention
Aging and Disability Resource Center
Disaster Prep/Dealing with Emergencies
Veterans
Death and Dying
Aging
Violence
Stress
Wellness

 

Nutrition

Links

Still Tasty
How long will your favorite food or beverage stay safe and tasty?  What's the best way to store it?  Get the answers for thousands of items.

Save the Food
Twenty Percent of the Food we each  buy never gets eaten. The good news: There's something we can do. 

Further with Food
Find and Share information on this website about proven solutions and innovative new approaches to reducing food loss and waste.

National Resource Center on Nutrition
Designed to assist the national aging network, including local nutrition programs, national associations, tribes, states and regional agencies involved with aging, in the implementation of the national portions of the Older Indians Act.

Recipes for Healthy Kids: Cookbook for Homes
The recipes in this USDA cookbook feature foods both children and adults should consume more of: dark green and orange vegetables, dry beans and peas, and whole grains. All of these healthy recipes are low in total fat, saturated fat, sugar and sodium. With fun names like Porcupine Sliders, Smokin' Powerhouse Chili, and Squish Squash Lasagna, these kid-tested, kid-approved recipes are sure to please children and be an instant hit!

Food Insecurity by County
Food insecurity exists in every county and congressional district in the country. But not everyone struggling with hunger qualifies for federal nutrition assistance. Learn more about local food insecurity and the food banks in your community by exploring data from Feeding America’s annual Map the Meal Gap project. Food security, as defined and measured by the U.S. Department of Agriculture, means “access by all people at all times to enough food for an active, healthy life.” Overall, more than 42 million people, or 13.4% of the population, were considered food-insecure in the year 2015, the last year for which data are available.  The highest rate was in Mississippi, where 21.5% are food insecure. Rates of food insecurity are generally higher in rural households than urban.

Alaska Traditional Foods Movement  The Alaska Food Code allows the donation of traditional wild game meat, seafood, plants, and other food to a food service of an institution or a nonprofit program with the exception of certain foods that are prohibited because of significant health hazards. Examples of facilities that can accept these donations include residential facilities, school lunch programs, head starts and elder meal programs.

Nutrition.gov Resources for Seniors
Nutrition.gov provides a comprehensive list of resources for seniors who are looking for information on nutrition.

Food Distribution Program on Indian Reservations
The Food Distribution Program on Indian Reservations (FDPIR) is a Federal program that provides USDA foods to low-income households, including the elderly, living on Indian reservations, and to Native American families residing in designated areas near reservations and in the State of Oklahoma. This article discusses eligibility, how to apply, resources, and contact information.

Seeds of Native Health
Extreme poverty and the loss of traditional foods have caused many Native Americans to suffer from inadequate diets and have led to widespread, chronic health problems. Many grassroots practitioners, researchers and advocates are already working to restore healthful diets. But a national campaign is needed to encourage broader strategies to improve Indian nutrition now and in the future. Seeds of Native Health is a multifaceted national campaign to improve Native American nutrition and is supported by the Shakopee Mdewakanton Sioux Community. The effort includes grant-making, sharing of best practices, capacity-building, sponsored research, and educational initiatives.

Feeding Ourselves (PDF)
This report explores the complex historical and contemporary challenges to Native American healthy food access, childhood obesity, and health disparities. Feeding Ourselves encourages its readers to take the first step toward a solution – becoming aware of the extent of the problem of Native health disparities and its deep interconnections to U.S. Indian policy, poverty, historical trauma and food systems. This includes building awareness of the complex historic and present-day situations of Native peoples, innovative models, and how systemic and long-term changes may be supported by policy changes at the tribal, federal, and philanthropic levels.

Rights of Mother Earth: The enactment of the Yurok Tribe Genetically Engineered Organism Ordinance
On December 10, 2015, after several months of committee drafting and opportunity for public comment, the Yurok Tribal Council unanimously voted to enact the Yurok Tribe Genetically Engineered Organism (“GEO”) Ordinance. The Tribal GEO Ordinance prohibits the propagation, raising, growing, spawning, incubating, or releasing genetically engineered within the Tribe’s territory and declares the Yurok Reservation to be a GMO-free zone. While other Tribes, such as the Dine’ (Navajo) Nation, have declared GMO-free zones by resolution, this ordinance appears to be the first of its kind in the nation.

Native Food Systems Resource Center
We recognize that accessing healthy food is a challenge for many Native American children and families. Without access to healthy food, a nutritious diet and good health are out of reach. To increase access to healthy food, First Nations supports tribes and Native communities as they build sustainable food systems that improve health, strengthen food security and increase the control over Native agriculture and food systems. First Nations provides this assistance in the form of financial and technical support, including training materials, to projects that address agriculture and food sectors in Native communities.

Food Safety and Nutrition
Some changes with age affect hunger and eating. Some of these changes are normal. Some of these changes are caused by diseases that are common with aging. The link lists some of these changes.

Long-Term Supports & Services (LTSS)

Links

NICOA Resources
Click here to see some fact sheets on AI/AN Health Disparities, Creating a Welcoming Facility, and Cultrually Competent Healthcare

Updates to CMS database of LTSS programs in Indian Country
This month, CMS update 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 pictrue of where LTSS programs are available in Indian Country and provides insight into where certain types of LTSS services are offered.

Tribal Pathways to Sustainable Long-Term Care: Capturing Medicaid reimbursements through Aging Services Webinar
Elaina Seep from Aniwahya Consulting Group presented great examples and explanations of funding sources for home and community based services including caregiving support, nutrition services, and transportation.  Download the webinar slides and cheat sheet which outlines steps to work with medicaid reimbursements for the long-term services that you already provide.

The No Wrong Door
The No Wrong Door (NWD) System, including Aging and Disability Resource Centers (ADRC), represents a collaborative effort of the U.S. Administration for Community Living (ACL), the Centers for Medicare & Medicaid Services (CMS), and the Veterans Health Administration (VHA), to support state efforts to streamline access to Long Term Services and Supports (LTSS) options for all populations and all payers.

Elder Abuse and Prevention - The Arizona on Aging provides great resources on Elder Abuse and Prevention of Elder Abuse

Tip Sheet: Engaging American Indian/Alaska Native Adults in Chronic Disease Self-Management Education
View this tip sheet for an overview of health disparities in chronic diseases among American Indians/Alaska Natives (AI/AN) and a list of effective strategies for increasing access to chronic disease self-management education (CDSME) programs to improve overall health.

Overview of the Menominee Indian Tribe of Wisconsin’s Model of Long-Term Care (PPT)
This presentation provides information on why tribal waivers are important, and how the Menominee Indian Tribe has used the waiver to improve health and mortality, maintain a culturally competent service delivery system, and provide a trusted alternative that improves access to care and health care utilization.

LTSS for Native Veterans
Long-term care needs among Native Veterans are high, and tribal LTSS programs can help connect Veterans with care. The resources below describe the care needs of Native Veterans and offer program planning considerations for improving access to care for Veterans.

Health Promotion & Disease Prevention (HP-DP)

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Health Honoring Newsletter
Honoring Health: Resources for American Indians and Alaska Natives is a quarterly e-newsletter that features a different health topic in each issue and highlights resources, events, training, and grants and funding opportunities. It is produced by the NIAMS on behalf of the National Institutes of Health, the Indian Health Service, and the Administration for Community Living’s Administration on Aging. Subscribe to receive the newsletter. 

National Resource Center on Native American Aging: Well-Balanced (Wise Elders Living Longer)
WELL-Balanced is a group program designed specifically for Native American elders. The program uses exercise, information, and social interaction to help elders remain active and independent in their own homes as long as possible.

Let’s Move!
Over the past three decades, childhood obesity rates in America have tripled. Obesity is more than two times more common among American Indian/Alaska Native children (31%) than among white (16%) or Asian (13%) children. This rate is higher than any other racial or ethnic group studied.

National Indian Health Board Health Broadcast
Monthly National Indian Health Board (NIHB) alerts and announcements including upcoming events and news.

Substance Abuse

Rx Pain Medications. Know the Options. Get the Facts
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.

Office of National Drug Control Policy: Collaborating with Native Americans and Alaskan Natives
Drug abuse exacts a heavy toll among Native Americans and Alaskan Natives in the United States. In response, ONDCP is developing programs and policies tailored to Indian Country and designed to assist Tribal authorities using a balanced strategy of prevention, treatment, recovery support, and law enforcement.

Centers for American Indian and Alaska Native Health: Evidence-Based Practices and Substance Abuse Treatment for Native Americans
While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This long-standing tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding substantial promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions.

Indian Health Service- Alcohol and Substance Abuse Program
The objective of the Alcohol and Substance Abuse Program (ASAP) is to reduce the incidence and prevalence of alcohol and substance abuse among the American Indian and Alaska Native (AI/AN) population to a level at or below the general U.S. population. ASAP strives to meet the goal through the implementation of alcohol and substance abuse programs within tribal communities, including emergency, inpatient and outpatient treatment, and rehabilitation services in rural and urban settings.

Study Debunks Notions About Native Americans, Alcohol
Native Americans are more likely to abstain from alcohol than whites are, and heavy drinking and binge drinking rates are about the same for both groups, according to a UA study. Tribal Court Clearinghouse: Alcohol and Substance Abuse The following documents and hyperlinks should be of assistance to tribal court personnel, tribal law enforcement personnel, social services personnel, and others in handling alcohol and substance abuse cases. For more specific information concerning drug courts and tribal drug courts, see the Tribal Drug Courts page.

Nocturia in Older Adults
Nocturia, defined as voiding at least twice per night that interrupts sleep, is a common complaint in older adults. The prevalence among those 70 years and older is reported to be 69-93% in men and about 75% in women. Because it is so common, clinicians often dismiss nocturia as a normal consequence of aging and provide limited advice on how to deal with it.

Recognition of Advanced Illness and Impending Death
Recognition of approaching death is a critical skill required of all clinicians who provide care for patients at risk of dying. This skill enables the clinicians to consider a number of important issues. They include whether palliative care and hospice care are needed; whether to hospitalize the patient; or whether to perform cardiopulmonary resuscitation vs. allowing natural death.

Resilience in Aging
The concept of resilience in aging was born out of the “paradox of old age.” The paradox is that in spite of losses and physical declines experienced in later life, older adults report feeling content, and they have lower rates of psychopathology than the general population. Researchers have argued that this is due to resilience, and that an understanding of resilience can lead to new health promotion strategies that yield healthier, happier people and communities.

Active Aging: Gardening
It is important for older adults to stay active for as long as they can. This sheet describes how caregivers can help older adults stay active by gardening. These tips can be used at home, at a care facility, in a community garden, or other places that serve older adults.

Immunizations for Older Adults
Vaccines are among the most successful public health interventions, saving millions of lives and preventing millions of disabilities. While most vaccines are targeted at children and young adults, there are five recommended for routine use in adults aged 65 and older: influenza vaccine, two types of pneumococcal vaccine, herpes zoster vaccine, and a vaccine against tetanus and diphtheria. The latter includes the addition of pertussis protection in a vaccine (given one time) that combines tetanus toxoid, diphtheria toxoid, and acellular pertussis (Tdap). This issue of Elder Care will discuss these five vaccines.

Dementia & Alzheimer’s

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End-of-life Planning for People with Dementia
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 symptopms progress can help caregivers and care providers learn their patients' preferences before the patient is unable to share them. 

Get Tools and Training for your practice
The Alzheimer's Disease Education and Referral Center, part of the National Institute on Aging (NIA) of the Department of Health and Human Services (HHS), has free resources to help health professionals identify, diagnose, and care for people with Alzheimer's and Dementia. Resources include things such as tools for assessment, diagnosis, treatment and management, disease-specific information, professional training and cirrcula, patient and caregiver information and much more.

Six Alzheimers/ Dementia Plain Language Fact Sheets
These fact sheets were developed by Alzheimer's Greater Los Angeles as part of an AOA grant

Inaugural National Conference on Alzheimer's: Disease/Dementia in Native American Communities (PDF)
The incidence of Alzheimer’s disease and related dementias (ADRD) among Native Americans is largely unknown and many tribes lack vocabulary to describe dementia. The growth of Native American elders is at a historical high number, and age is by far the greatest risk factor for developing dementia. Cultural differences, access to care, along with limited training of health and social service providers may result in inadequate reporting, recognition, diagnosis and treatment of ADRD in this population.

Providing Culturally Sensitive Dementia Care (PDF)
How to incorporate Cultural Sensitivity into the caregiver patient dynamic.

Alzheimer's Disease Underdiagnosed In Indian Country
About 5.3 million Americans have Alzheimer's disease, the latest statistics suggest, and it's probably about as common on Native American reservations as anywhere else. But a diagnosis in Indian Country is rarer, say mental health workers. That's likely at least partly because of a cultural belief — many Native American communities don't recognize dementia as a disorder.

The Alzheimer's Association – 10 Warning Signs
The Alzheimer's Association is the leading voluntary health organization in Alzheimer's care, support and research. We work on a global, national and local level to enhance care and support for all those affected by Alzheimer’s and other dementias. We are here to help. As the largest nonprofit funder of Alzheimer's research, the Association is committed to accelerating the global progress of new treatments, preventions and ultimately, a cure. The Association is also the leading voice for Alzheimer's disease advocacy, fighting for critical Alzheimer's research, prevention and care initiatives at the state and federal level.

Elders at Risk: New Study Finds Higher Dementia Rates for Natives
More than one third of American Indians/Alaska Natives over age 65 can expect to develop dementia before age 90, according to a new study published online by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The research project is the first to look at the incidence of Alzheimer’s, vascular dementia and non-specific dementia in AI/AN populations and Pacific Islanders.

Dementia in the Native American Cultural Context
ADRD are not being diagnosed early enough for them to benefit from locally available care and support services. It is important to receive a timely diagnosis to enable family to plan and coordinate the management of medical services

Wandering
People with dementia may wander. They get confused about where they are or where they want to go, and they walk away or get lost. Sometimes people with dementia will try to go find a place they once were or look for something that they don’t own any more. Or, sometimes they just walk somewhere because they are bored or unhappy. Anyone with memory problems can wander.

When May it Be Time to Stop Treatment?
At some point, people with dementia will be unable to care for themselves. They may not take medicine. They may not feed themselves. They may not eat or drink at all. They may become inactive. Some people with dementia want to live as long as possible, even if they are bedbound and can’t think. Others may wish to stop treatment when they cannot function on their own. Everyone has the right to decide what treatment is right for them.

Transportation

Links

Tribal Transportation Program (TTP)
The Tribal Transportation Program (TTP) is the largest program in the Office of Federal Lands Highway. Established in 23 U.S.C. 202 to address the transportation needs of Tribal governments throughout the United States, the program receives $450,000,000 annually to provide safe and adequate transportation and public road access to and within Indian reservations, Indian lands, and Alaska Native Village communities. A prime objective of the TTP is to contribute to the economic development, self-determination, and employment of Indians and Native Americans.

More Transportation Funds Head to Indian Country
A bipartisan highway bill that President Barack Obama signed into law earlier this month brings more federal funds to Indian Country. H.R.22, the Fixing America's Surface Transportation (FAST) Act, reauthorizes the Tribal Transportation Program for five years. The additional money will help tribes fix crumbling roads, bridges and other infrastructure.

Tribes Transportation: Policy Challenges and Opportunities (PDF)
Transportation infrastructure development is critical to economic development, job creation, and improving living conditions for individuals and families in American Indian/Alaska Native communities, and the millions of Americans who travel through our reservations every day. Construction of transportation systems that allow for safe travel and promote economic expansion will help tribal governments strengthen Native communities and make valuable contributions to much of rural America. Surface transportation in Indian Country involves thousands of miles of roads, bridges, and highways. It connects and serves both tribal and non-tribal communities.

DOT: Resources for Tribes and Tribal Governments
Under the leadership of Secretary Foxx, we are committed to improving existing tribal transportation resources. This webpage serves as a portal to assist tribes and tribal governments find the information and contacts they need at the Department.

Native American Transportation Issues: Information Resource Center
This website provides a gateway to information and resources pertaining to research and practice pertaining to transportation issues on or near tribal lands and communities or affecting tribal historical or cultural properties wherever located.

Addressing Commuting as a Public Health Issue: Strategies Should Differ by Rurality
Car commuting is a known risk factor for poor health, by contributing to sedentary behavior and air pollution; prevention efforts to reduce car commuting—especially long, solo commutes—are important to improving public health. This brief estimates the rate of solo car commuting and long (greater than 30 minutes) solo car commutes by rurality and urban adjacency and identifies differences in socio-demographic factors that relate to commuting behavior by geographic location.

Rural Transportation: Challenges and Opportunities
Transportation, as it relates to health and health care, is widely acknowledged to have unique features in rural communities, but there is limited research on specific challenges and potential policy interventions to alleviate them. This policy brief uses survey data from 113 key informants across all fifty states to describe challenges and opportunities related to rural transportation.

Transportation to Support Rural Healthcare
Transportation is an important social determinant of health in rural communities. The availability of reliable transportation impacts a person’s ability to access appropriate and well-coordinated healthcare, purchase nutritious food, and otherwise care for him or herself. 

 

Caregiving

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Care Partner Information: Caregiver Stress
Taking care of an older adult can be stressful. Adults can live many years with a chronic disease. Over time, these diseases can make it hard for older adults to do things for themselves. It is a lot of work to help someone with basic care and disease care when they are not able to take care of them self.

Elder Care: Resilience in Aging
The concept of resilience in aging was born out of the “paradox of old age.” The paradox is that in spite of losses and physical declines experienced in later life, older adults report feeling content, and they have lower rates of psychopathology than the general population. Researchers have argued that this is due to resilience, and that an understanding of resilience can lead to new health promotion strategies that yield healthier, happier people and communities.

Caregiver Support in Indian Country (PDF)
Providing long-term care for a family member with a chronic illness or disability is an important and challenging endeavor. Caregiving can become overwhelming and place strain on an individual’s health and wellbeing. To alleviate these challenges and the accompanying stress, families may choose to utilize caregiver support services. Caregiver support includes a number of services, such as counseling, respite care, transportation, caregiver training, case management, support groups and adult day care.

Native Elder Caregiver Curriculum: Caring for Our Elders
The Native Elders Caregiver Curriculum is a tool to assist family and community members, as well as CHRs, who have the responsibility of caring for their elders. It is dedicated to these caregivers and their values of respect, generosity, compassion, and fortitude. We hope it will empower these special people with some of the information they need to carry out their sacred work.

The Savvy Caregiver in Indian Country, Trainers Manual (PDF)
The Manual is designed for use by all American Indian and Alaskan Native people caring for an elder with memory loss and thinking problems, referred to as dementia.

National Family Caregiver Support Program
The National Family Caregiver Support Program (NFCSP), established in 2000, provides grants to States and Territories, based on their share of the population aged 70 and over, to fund a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible.

Financial Steps for Caregivers (PDF)
The National Resource Center on Women and Retirement Planning serves as a national clearinghouse of tools and information on retirement planning and related financial materials, such as consumer fraud and prevention. The goal of the Center is to assist women, especially middle and low income women, women of color and women of limited English-speaking proficiency, to advance their capacity to and expand their choices for planning for their economic security later in life.

Family Caregiver Alliance
On an airplane, an oxygen mask descends in front of you. What do you do? As we all know, the first rule is to put on your own oxygen mask before you assist anyone else. Only when we first help ourselves can we effectively help others. Caring for yourself is one of the most important—and one of the most often forgotten—things you can do as a caregiver. When your needs are taken care of, the person you care for will benefit, too.

Caregiver tool box
A list of Public and Federal resources for Caregivers.

Picking a Culturally Sensitive Caregiver
Many older people, due to their cultural backgrounds, have firm views on caregiving. These may include:

  • A sense that the family should provide all facets of care for their loved one.
  • Resistance to medical intervention, medical professionals and any nonfamily caregivers.
  • Wariness about any arrangement that could distance the care recipient from his or her family.

Elder Care: Anxiety in Older Adults - Pharmacotherapy
Anxiety disorders are common among older adults and associated with poor quality of life, increased disability, and cognitive impairment. Studies indicate that early treatment targeting full cessation of anxiety symptoms has considerable benefit for older adults. Despite this, anxiety disorders in late life are understudied and underreported, and patients are often under-treated. A variety of behavioral and pharmacological approaches are used to treat anxiety disorders. This edition of Elder Care will focus on evidence-based pharmacotherapy for treating anxiety in older adults

Caregiver Strees
Taking care of an older adult can be stressful. Adults can live many years with a chronic disease. Over time, these diseases can make it hard for older adults to do things for themselves. It is a lot of work to help someone with basic care and disease care when they are not able to take care of them self.

Fit to Fly? Older Adults and Air Travel
As more older adults travel on commercial airliners, it is important to recognize and help prevent air travel-related medical complications. While the vast majority of older adults travel without incident, clinicians should consider several key issues when providing care for jet-setting older adults (Table 1). Those with recent hospitalization, injury, or surgery should seek medical consultation at least 10 days before flying. For those with complicated cardiopulmonary problems or planning foreign travel, referral to a travel medicine specialist may be helpful.

Making the Most of a Doctor Visit
It is important for older adults and their care providers to prepare for a health care visit. Most visits are short, and it is easy to forget to talk about something important. Some people like to bring a family member or friend to the visit to help remember what to say, and what the doctor says. It is important that the patient gets to talk with the doctor, not just the care partner. Be sure to plan who is going to say what.

Elder Care: Hyponatremia in Older Adults – Therapeutic Considerations
This Elder Care sheet, “Hyponatremia in Older Adults – Therapeutic Considerations” provides best practice approaches for treating this common electrolyte abnormality.

Caregiver Respite
This Care Partner sheet, “Caregiver Respite,” describes the different types and sources of respite available to caregivers of older adults. All of our Care Partner sheets are available in English and Spanish.

Grant Opportunities

Links

Native One-Stop
Benefits.gov, the official benefits website of the United States, launched a portal of resources for Native American, Alaskan Native, and tribal populations. The portal, Native One-Stop, provides information about the services that are available through the Federal government. Native One-Stop conveniently houses any service that these populations may need with topics ranging from assistance for populations with severe disabilities to congressional internships for Native Americans.

Rural Tribal Health Funding & Opportunities
The Rural Tribal Health hub is your guide to improving health for rural residents—we provide access to current and reliable resources and tools to help you learn about rural health needs and work to address them.

Foundation Funding for Native American Issues and Peoples (PDF)
Foundation Center is the leading source of information about philanthropy worldwide. Through data, analysis, and training, it connects people who want to change the world to the resources they need to succeed. Foundation Center maintains the most comprehensive database on U.S. and, increasingly, global grant makers and their grants — a robust, accessible knowledge bank for the sector.

Administration for Native Americans – Funding Opportunities
ANA project funding is available in short-term development terms of 12, 24, and 36 months. All ANA community projects must be completed by the end of the project period or supported by alternative funds. Training and technical assistance is available to applicants for project and proposal development and to grantees for project implementation and reporting.

Funding Opportunities for Tribal Green Building
Green building, also known as sustainable design, can assist tribal communities to reduce the impact of construction on the environment while protecting the health, livelihood and culture of tribal residents.

Across the Board Increases for Obama’s Indian Country Budget
President Barack Obama submitted his Fiscal Year 2017 proposal to Congress, and the budget has increased funding and support across the board for Indian country.

Affordable Care Act

Links

How Does the Affordable Care Act Impact American Indians and Alaska Natives?
The Affordable Care Act provides more than 500,000 uninsured American Indians and Alaska Natives an opportunity to get affordable health insurance coverage. The following gives an overview of the coverage and benefits available to American Indians and Alaska Natives.

The Affordable Care Act Helps American Indians and Alaska Natives (PDF)
Historically, American Indians and Alaska Natives have faced significant barriers to accessing affordable health insurance and these barriers have contributed to significant health disparities.” The Affordable Care Act includes substantial new benefits for American Indians and Alaska Natives across the country. See how health reforms are already making a difference in Indian Country.

Medicaid and American Indians and Alaska Natives
This brief provides an overview of the health needs of American Indians and Alaska Natives, discusses the role of Medicaid and the potential impact of the Medicaid expansion for this population, and summarizes new guidance from the Centers for Medicare and Medicaid Services (CMS) that expands the scope of Medicaid services provided to American Indians and Alaska Natives that may qualify for 100% federal match.

CMS Outreach & Education Resources
The Center for Medicare and Medicaid Services (CMS) Division of Tribal Affairs is responsible for creating and disseminating informational materials to American Indian Alaska Native beneficiaries, providers, and relevant health professionals on CMS programs. This includes multimedia (video & radio), printed materials, webinars and training materials. Many of these materials were developed in collaboration with HHS (Intergovernmental External Affairs), the Indian Health Service, the CMS TTAG, and national Indian organizations. These materials can be downloaded from this page or ordered from the CMS warehouse. Click on below links to access materials.

Medicaid Coverage and Access to Care for American Indians and Alaska Natives Under the Affordable Care Act
In this issue of JAMA Internal Medicine, Frean and colleagues find Medicaid coverage gains among American Indians and Alaska Natives in states that expanded Medicaid under the Affordable Care Act (ACA) Medicaid expansion. They also find that, among AIANs living near reservations, most gaining Medicaid utilize Indian Health Services (IHS) for care. These findings suggest important strides forward for the 5 million individuals who self-identify as AIAN. Medicaid coverage gains will increase their access to care and enhance capacity among IHS and Tribal health care providers.

Aaron Payment: Affordable Care Act boosts Indian Country health
American Indians and Alaskan Natives have long been recognized as having the highest poverty rates of any ethnic group. The passage of the Affordable Care Act (ACA) marks an opportunity for all Americans, even those of us who are the most poor, to obtain health care coverage. Thanks to the ACA, American Indians and Alaska Natives now have better access to medical care than ever before. This article reviews many of the ways the ACA has positively impacted Indian Country.

Coverage exemptions for American Indians, & Alaska Natives, and others eligible for services from Indian health programs
American Indians and Alaska Natives as well as other people eligible for services through the Indian Health Service, tribal programs, or urban Indian programs (like the spouse or child of an eligible Indian) do not have to pay the fee for not having health coverage. This is called having an Indian health coverage exemption. Find out how to apply for the Indian exemption in two easy ways.

ACA and You
Alaska Native and American Indian people have special protections and benefits when it comes to the Affordable Care Act (ACA). One of the most important things for Alaska Native and American Indian people to know about the ACA is, even if you don’t buy insurance, you and your family will still be able to get health care services at your Tribal health facility. The health care services provided at IHS/Tribal health facilities are not changing. Read more to find out about exemptions, special benefits and FAQ.

Insurance Marketplace Sponsorship Calculator for American Indians and Alaska Natives
Tribes interested in a premium sponsorship program can estimate the costs and benefits of buying insurance using the insurance marketplace sponsorship calculator. A user tutorial provides step-by-step instruction on how to use the calculator.

Housing

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Housing Needs of American Indans and Alaska Natives Tribal Areas Report
HUD's comprehensive assessment of Housing Needs of American Indians and Alaska Natives - findings of three new comprehensive reports of tribal housing needs released January 2017 by the U.S. Department of Housing and Urban Development (HUD) and the Urban Institute.

The Green House Project
The Green House Project e-Newsletter provides thought leadership, innovative practices, and updates from developing and operating Green House homes across the country.

Office of Native American Programs (ONAP)
HUD's Office of Native American Programs (ONAP) administers housing and community development programs that benefit American Indian and Alaska Native tribal governments, tribal members, the Department of Hawaiian Home Lands, Native Hawaiians, and other Native American organizations.

Rural Home: Federally Recognized Indian Tribes and Resources for Native Americans (PDF)
Over 500 Native American tribes reside in disparate locations across the United States, and Native American lands can be found in all regions of the United States. While geographically diverse, these communities are the product of a common set of historical and political actions.

HUD Grants to Support Native American Housing Totals $660M
The grants, known as Indian Housing Block Grant allocations, are distributed each year to eligible Native American tribes or their tribally-designated housing entities for a range of affordable housing activities. Section 184 Indian Home Loan Guarantee Program The Section 184 Indian Home Loan Guarantee Program is a home mortgage specifically designed for American Indian and Alaska Native families, Alaska Villages, Tribes, or Tribally Designated Housing Entities. Section 184 loans can be used, both on and off native lands, for new construction, rehabilitation, purchase of an existing home, or refinance.

Sustainable Native Communities Collaborative
The Sustainable Native Communities Collaborative (SNCC) focuses on culturally and environmentally sustainable development with American Indian, First Nations, and Indigenous communities worldwide. Through planning, architectural design, technical assistance and research, our services help tribal communities gain self-sufficiency, improve their impacts on the natural world, and develop healthy, green, culturally-appropriate communities.

American Indian Supportive Housing Initiative (AISHI)
CSH partners with Tribal Nations and American Indian organizations to develop affordable housing linked to services to end homelessness. We blend tested supportive housing models with tribal culture and traditional service approaches to build programs that work in American Indian communities.

Native American Housing Assistance and Self-Determination Act: Revisions to the Indian Housing Block Grant Program Formula
This proposed rule would revise the Indian Housing Block Grant (IHBG) Program allocation formula authorized by section 302 of the Native American Housing Assistance and Self-Determination Act of 1996, as amended (NAHASDA).

Women

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The Power of Elder Native Women
With genuine hearts, Native American women are able to lead their household in ameliorating the emotional and physical detriments that infect the Native American people. However, they had to come to a realization first. As soon as imbalance became prevalent, Native American women made it their duty to restore Hozhó (Hozhó means balance and harmony in Navajo) in their people’s way of life.

Tips for Good Health in Later Life: For Older Women
Older women are more likely than men to have chronic, or ongoing, health conditions – such as arthritis, high blood pressure, and osteoporosis. Women are also more likely to develop multiple health problems, according to a recent report from the Kaiser Family Foundation. Older women are also more likely to have memory or other “cognitive” problems, and difficulty carrying out daily activities such as dressing, walking, or bathing without help. Fortunately, there’s a lot you can do to boost your chances of staying mentally and physically healthy as you age.

Healthy Women - Aging Well
Healthy Women (HW) is the nation's leading independent health information source for women. Our core mission is to educate, inform and empower women to make smart health choices for themselves and their families. For more than 20 years, millions of women have been coming to HW for answers to their most pressing and personal health care questions. Through our wide array of online and print publications, HW provides health information that is original, objective, reviewed by medical experts and reflective of the advances in evidence-based health research.

American Indian and Alaska Native Violence Against Women
This site provides information on current events, legislation, resources, provider education, public health issues, policies and procedures, clinical tools, sexual assault, community action, cultural appropriateness and access to care.

Womens Law: Native American Services
Find contact information for national Native American service organizations, broken down by subject matter.

Children

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The National Indian Child Welfare Association (NICWA)
The National Indian Child Welfare Association (NICWA) is a national voice for American Indian children and families. We are the most comprehensive source of information on American Indian child welfare and the only national American Indian organization focused specifically on the tribal capacity to prevent child abuse and neglect.

Native Strong: Healthy Kids, Healthy Futures
Native Strong: Healthy Kids, Healthy Futures is a national program of grantmaking, technical assistance, research, communications and advocacy. Native Strong, working with a network of organizations and national partners, helps reduce the prevalence of childhood obesity and type 2 diabetes in Native communities. Native Strong believes that Native American communities have the inherent knowledge, assets and values to advance Native health. Native Strong is designed to provide tribal communities with the tools and information needed to create sustainable change in their own communities that benefit their children’s health.

Assistance for Native American Grandparents Raising Grandchildren
"A disproportionately large number of the native households we work with have a grandparent functioning as a primary caretaker," says NAPPR Tribal Home Visiting Project Director Maria Brock, Laguna Pueblo/Santa Clara Pueblo. "We want them to know they’re not alone and that programs and services are available to help. They shouldn't wait until things reach crisis proportion. Caregiver burnout is a well-known problem, but when caregivers do better, kids do better too. It’s like the advice airlines give adult passengers traveling with small children—put your own oxygen mask on first before attempting to attend to the child’s needs."

Grandparents as "Spiritual Guides"
One of your most important, and sacred, roles as a grandparent involves cultivating your grandchild’s spiritual development. This is the role of "spiritual guide," A most powerful role that can have a profound and lasting impact on the moral path your grandchild will take, and his relationship with nature and the numinous aspects of life. And because the limits of this role are boundless, if you are a stepgrandparent or if you have adopted grandchildren, you can fully serve as a spiritual guide to the young ones in your life.

Grandparenting Styles: The Contemporary American Indian Experience (PDF)
Grandparenthood is neither defined by the narrow constraints of biological and reproductive attainments nor executed solely within the parameters of cultural consensus. Rather, grandparental roles are expressed across a range of activities, purposes and levels of intensity so varied as to be identified as distinct grand parenting styles. Six grand parenting styles—cultural conservator, custodian, ceremonial, distanced, fictive and care-needing—are identified and discussed.

'We get the kids back': Native American grandmother fights to preserve families
In South Dakota, 51% of children in foster care are Native American but one woman turned de facto legal counsellor is using the law to change that.

Disabilities

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Quality Trust for People with Disabilities
Quality Trust is an independent, non-profit advocacy organization focused on improving the lives of children and adults with disabilities and their families in the District of Columbia and beyond.  We work with individuals and family members to solve problems, identify opportunities for learning and contribution and find creative ways to minimize “differences” and make the most of each person’s abilities.

Frailty – Elders At Risk
Frailty is a common geriatric syndrome associated with aging that is predictive of a decline in health. It is characterized by a loss of physiologic reserves that makes older adults more vulnerable to poor health outcomes. There is consensus by frailty experts Fried and Rockwood to define frailty as: “A medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance, and reduced physiologic function that increases an individual's vulnerability for developing increased dependency and/or death.”

Hoarding Disorder
Hoarding disorder is the accumulation of possessions and persistent difficulty discarding them, regardless of their actual value. Significant distress is associated with attempts to discard possessions, creating a large volume of items which can be associated with functional impairment and compromise the intended use of living areas.

Low Vision Aids
The National Eye Institute reported that in 2014 more than 4 million adults in the US had blindness or low vision, and the majority were over age 65. By 2030, that number is expected to increase to over 7 million. As noted in a prior edition of Elder Care, age-related macular degeneration (AMD) is the most frequent cause of irreversible blindness among older adults in the US. It affects 30% of people over 75, with 1 in 14 having serious visual impairment.

Disability & Socioeconomic Status
Although the Americans with Disabilities Act assures equal opportunities in education and employment for people with disabilities and prohibits discrimination on the basis of disability, people with disabilities remain overrepresented among America’s poor and undereducated. According to the U.S. Department of Labor’s (2017) Office of Disability Employment Policy, the labor force participation rate for people with disabilities (including physical, intellectual and developmental, sensory, and other disability categories) aged 16 and over is 20.1% as compared to 68.6% for people without disabilities of the same age. Disabilities among children and adults may affect the socioeconomic standing of entire families. In 2015, roughly 38,601,898 people in the United States had a disability (U.S. Census Bureau, 2015).

Elder Justice

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Interdisciplinary Training for those who serve Vulnerable Adults and Seniors
The Social Security Administration (SSA) is pleased to present this Representative Payee Interdisciplinary Training series.  It includes useful modules to educate individuals and organizations about the roles and responsibilities of serving as a representative payee, elder abuse and financial exploitation, effective ways to monitor and safely conduct business with the banking community, and ways to recognize the changes in decisional capacity among vulnerable adults and seniors.

The Department of Justice Elder Justice Initiative Webinar - Highlighting the role of Victim Specialists

National APS Resource Center: Putting Research Into Practice
The National Adult Protective Services Association (NAPSA), in conjunction with the National Committee for the Prevention of Elder Abuse (NCPEA) are pleased to release a new Research to Practice (R2P) Brief, titled Disrespect of Our Elders: Elder Abuse in Indian Country by Dr Jacqueline Gray. This brief is a follow-up to the webinar of this subject. The R2P series links cutting-edge research with everyday practice in adult protective services. This brief and others are available on our website.

Elder Abuse: Warning Signs
A previous edition of Elder Care (see resource list) provides details about the reporting process if elder abuse is suspected, including what information is needed to make a report, what happens after a report is filed, and common reasons why older adults sometimes fail to report abuse. This edition will focus on the different types of elder abuse, and some general (not inclusive) warning signs that healthcare professionals should know.

Diversity

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National Resource Center on LGBT Aging
The National Resource Center on LGBT Aging is the country's first and only technical assistance resource center aimed at improving the quality of services and supports offered to lesbian, gay, bisexual and/or transgender older adults. Established in 2010 through a federal grant from the U.S. Department of Health and Human Services, the National Resource Center on LGBT Aging provides training, technical assistance and educational resources to aging providers, LGBT organizations and LGBT older adults. The center is led by SAGE, in collaboration with 18 leading organizations from around the country.

Ethnic and Racial Miniorities & Socioeconomic Status
The relationship between SES, race, and ethnicity is intimately intertwined. Research has shown that race and ethnicity in terms of stratification often determine a person’s socioeconomic status (U.S. Census Bureau, 2009). Furthermore, communities are often segregated by SES, race, and ethnicity. These communities commonly share characteristics: low economic development, poor health conditions, and low levels of educational attainment. Low SES has consistently been implicated as a risk factor for many of these problems that plague communities.

Sexual Orientation, Gender Identity & Socioeconomic Status
Evidence indicates individuals who identify as lesbian, gay, bisexual, and/or transgender (LGBT) are especially susceptible to socioeconomic disadvantages. Thus, SES is inherently related to the rights, quality of life, and general well-being of LGBT persons.

Medicare

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PSAs on Medicare and Medicare Fraud
The International Association for Indigenous Aging (IA2) just released a set of audio public service announcements (PSAs) that are available for use by anyone working with American Indian and Alaska Native (AIAN) tribes or for tribes or tribal health providers use. There are four English language PSAs, 2 in Navajo and 2 in Lakota of varying lengths (:30 and :6) with accompanying scripts for each set of PSAs.

The PSAs are designed to complement a larger toolkit released earlier this year by IA2 that included a resource manual that discussed outreach to AIANs, a brochure, two PowerPoints, 4 drop-in articles about Medicare and Medicare fraud, and series of 6 fact sheets focused on Medicare as well as Medicare fraud and abuse.

The key theme for all the resource materials is “Medicare Matters.”

The resources are available for download and are free of charge. Visit the IA2 website to access the materials.

No Wrong Door
Medicaid Administrative Claiming is one avenue for sustaining and supporting a NWD System

Medicaid claiming, also known as Federal Financial Participation (FFP), represents a way in which Federal funds are used to reimburse agencies doing work that supports Medicaid programs.

The role that NWD System’s play in assisting individuals with understanding and navigating complicated long-term services and supports includes many administrative functions that are eligible for Medicaid claiming.

Federal matching funds under Medicaid are available for costs incurred by the state for administrative activities that directly support efforts to identify and enroll potential eligibles into Medicaid and that directly support the provision of medical services covered under the state Medicaid plan, when those activities are performed either directly by the state Medicaid agency or through contract or interagency agreement by another entity.

SMP, SHIP, and MIPPA Social Media Webinar
The MIPPA Resource Center partnered with the SHIP & SMP Resource Centers on a webinar to talk about their experiences with social media. Dan Hoblick, from the South Dakota SHIP, spoke about his state’s experience using Facebook grants to target outreach to people potentially eligible for benefits. Listen to other SMP, SHIP, and MIPPA representatives speak about their social media experiences and what has worked well for them.

Webinar Links:
-Recording playback
-SMP Resource Center video: Facebook Analytics Walkthrough
-SHIP TAC video: How SHIP Helps Beneficiaries

Fall Prevention

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For Health Professionals: One risk factor for falls in older adults is rheumatoid arthritis. The attached Elder Care sheet, “Rheumatoid Arthritis” describes treatment and special considerations for older adults. All of our Elder Care sheets are available and can be found by clicking here

For Care Partners (in English and Spanish): The attached Care Partner sheet, “Falls,” provides an overview of fall risks and how to address them. All of our Care Partner sheets are available in English and Spanish.

Using a Cane
Many older adults use a cane to help with balance, injuries or mild pain. Different types of canes work better for different needs. A doctor, physical therapist or other health care provider can help pick the best cane for the person, and show them how to correctly use it. When used right, a cane can help with pain or prevent a fall. But if a cane is not used right, it can cause more problems.

Using a Walker
Many older adults need some support when walking. Different types of walkers work better for different needs. A doctor, physical therapist or other health care provider can help pick the best walker for the person’s needs, and show them how to correctly use it. Using a walker in the right way can help older adults stay mobile and prevent falls. But if a walker is not used in the right way, it can cause problems.

 

Aging and Disability Resource Center

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AARP Celebrates Native Origins
Welcome to AARP's Native Origins page, where we celebrate the lives and culture of 50-plus American Indians, Alaska Natives, and Native Hawaiians!  Here you can find recipes by Emmy-winning chef Loretta Barrett Oden, that offers a back-to-basics approach to preparing nutritious meals that are easy to make for caregivers and families. These heart-healthy dishes are sprinkled with native pride.  It also features great articles regarding Native American Health and topics influencing Native culture.

From the HCBS Conference August 30, 2017

This presentation will share strategies utilized by the Wisconsin Department of Health Service in developing successful partnerships between Tribes and the State, with the goals of expanding access to LTSS in tribal communities and delaying entry into nursing homes. Areas of discussion will include: existing Medicaid care services, waiver services, and acute and primary services currently provided by Tribes; strategies implemented to fully utilize 100 percent Federal match; coordination of service providers; the importance of identifying tribal communities’ needs and assessment of capacity for service provision; and understanding the distinctive needs of Tribal communities.

 

Disaster Prep/Dealing with Emergencies

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The National Rehabilitation Information Center, known as NARIC, produced a research brief on emergency preparedness for people with disabilities. NARIC is National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)’s library and National Information Center that serves anyone who calls them.

 

Veterans

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101 Ways to Thank a Veteran
There are many ways to thank veterans, here are 101 ways to thank a veteran.

Activities for Veterans Day
Veterans Day is an excellent occasion for schools and local communities to produce a variety of meaningful cooperative programs. Participation by veterans organizations and other patriotic groups can enhance many of the activities suggested in this guide.

 

Death and Dying

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End of Life & Socioeconomic Status
Research has highlighted several areas where SES appears to significantly affect end-of-life issues. Some areas include early detection of terminal illnesses, racial and economic disparities, and the quality of life for people diagnosed with terminal illnesses. This fact sheet aims to expand on these areas, noting the ways that SES acts as a moderator.

 

Aging

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Aging & Socioeconomic Status
The United States is facing unprecedented increases in the older adult population. Americans age 65 years and over comprise nearly 13% of the U.S. population (U. S. Census Bureau, 2010). The older adult population is projected to double between 2012 and 2060, from 43.1 to 92.0 million (U.S. Census Bureau, 2012). The older adult population is projected to double between 2012 and 2060, from 43.1 to 92.0 million (U.S. Census Bureau, 2012). As the percentage of older Americans rises, so does concern for their economic stability.

 

Violence

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Violence & Socioeconomic Status
Exposure to violence transcends age and SES, affecting all levels of income, education, and occupation. Although exposure to violence affects all SES groups, youth from lower SES backgrounds tend to have increased exposure and likelihood of suffering from detrimental future outcomes.

 

Stress

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Work, Stress and Health & Socioeconomic Status
Work is central to the psychological health and well-being of individuals and communities (Blustein, 2008). Vocational and industrial–organizational psychology have demonstrated the importance of work and how it promotes connection to the broader social and economic world, enhances well-being, and provides a means for individual satisfaction and accomplishment (Blustein, 2006; Brown & Lent, 2005; Hall, 1996; Spector, 2005).

 

Wellness

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Wellness Toolkits
American Indian and Alaska Native (AI/AN) communities have been disproportionately affected by many health issues such as diabetes, substance abuse, and sudden infant death syndrome. The National Institute of Health (NIH) is addressing the health of AI/AN communities by providing various resources available from many Institutes, Centers and Offices that can be used to promote healthier Native communities. One specific resource NIH offers is the “Our Healthiest Self: Wellness Toolkits”.These toolkits describe simple things people can do to improve their surroundings, relationships, emotional well-being, and physical health. To access the wellness toolkits, please click here.

SOAR to Health and Wellness Online Module
The SOAR (Stop, Observe, Ask, Respond) framework is a trauma-informed, culturally and linguistically appropriate response to human trafficking. It provides a quick mental reference for professionals to keep in mind the best way to help individuals who are at risk or have been trafficked. After completing the one-hour CEU credited SOAR to Health and Wellness Online module, learners will be able to:

  • Describe the types of human trafficking in the United States
  • Recognize possible indicators of human trafficking
  • Screen and identify individuals who have been trafficked
  • Assess the needs of individuals who have been trafficked and deliver appropriate services
  • Share the importance of human trafficking awareness and responsiveness with others in your work environments

Trauma-Informed Care Training Modules
As part of the National Child Traumatic Stress Network (NCTSN), the Learning Center for Child and Adolescent Trauma offers Free Online Education on trauma and trauma informed care. Anyone can experience trauma.  In these modules, presenters discuss how to recognize the signs of trauma and deliver trauma-informed care to your patients and clients. The NCTSN is funded by the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services and jointly coordinated by UCLA and Duke University. 


Last modified Nov 7, 2018