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LTSS webinar, July 24 – UNITE Natives 2024 Part 2 – Rezilient: Preserving Our Culture Through Z Codes




American Indian/Alaska Native Long-Term Services and Supports
SOLUTIONS
Technical assistance for culturally competent care
July 2024


CMS LTSS banner

LTSS Technical Assistance Center Visit the online LTSS TA Center [ https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/LongTermCare.html ] for videos, best practices, toolkits, a resource library, and a step-by-step planning roadmap.



Get email updates [ https://public.govdelivery.com/accounts/USCMS/subscriber/new ]

Join us on LinkedIn [ https://www.linkedin.com/groups/8271926/ ]

Follow us on X [ https://twitter.com/cmsgov ]




*Gaps in behavioral health care among elders*


Elders face many barriers to accessing behavioral health care, including stigma associated with seeking care, lack of transportation, and costs. A new report, Behavioral Health Among Older Adults: Results from the 2021 and 2022 National Surveys on Drug Use and Health [ https://www.samhsa.gov/data/sites/default/files/reports/rpt45341/2022-nsduh-older-adult-info.pdf?utm_campaign=fyi_newsletter&utm_medium=email&utm_source=govdelivery ] (PDF, 552 KB, 18 pp) highlights gaps in treatment for substance use and mental health indicators among older adults.



Sponsored by the Substance Abuse and Mental Health Services Administration, the report explores rates of substance use disorder (SUD), including alcohol use disorder, and mental and serious mental illness, including depression, among adults aged 60 and older.



Data in the report suggest that the majority of older adults with a mental health illness or SUD do not believe they need treatment.



To help break down barriers to seeking treatment, a first step is to let them know it is ok to do so, and that many older adults have. For example, the report found that 12.7 million older adults with a mental illness (16%) received mental health treatment. For more information on behavioral health options for American Indian and Alaska Native elders, check out CMS’s Behavioral Health website [ https://www.cms.gov/outreach-education/american-indian/alaska-native/behavioral-health ].



         
*Navigating access to elder behavioral health care*
             

Native elders have options to help them access behavioral health treatment and other services through Indian Health Service, tribal programs, and urban Indian health programs (ITU).

 

The CMS ITU Program Map [ https://www.cms.gov/training-education/partner-outreach-resources/american-indian-alaska-native/ltss-ta-center/information/state-resources-map ] lists ITU programs by state. ITU facilities can provide psychiatric evaluations, depression screenings and treatment, SUD screenings and treatment, and opioid use disorder screenings and treatment, among other services.

 

Check out the LTSS webinar, Seasons of Care: Assisting American Indian Elders with Health Care Access [ https://www.youtube.com/watch?v=f3GrxQtAW2I ], to learn how to support elders in accessing care. The webinar explains some of the historical and systemic conditions that influence Native elders’ access to care and culturally informed approaches to address barriers to care.

 

ITU Program Map of the United States

 

 

 



*Request for input on a national plan on aging*


Submit input by *September 15* on Aging in the United States: A Strategic Framework for a National Plan on Aging [ https://acl.gov/sites/default/files/ICC-Aging/StrategicFramework-NationalPlanOnAging-2024.pdf ] (PDF, 1.3 MB, 41 pp). This Strategic Framework, by the Administration for Community Living (ACL), defines:

 


* Opportunities and challenges with the aging population in the United States
* Goals and objectives to address critical aging issues in a national plan on aging

 

ACL convened leaders and experts across 16 federal agencies and departments to develop the Strategic Framework to inform the national plan. The intent of the national plan is to:

 


* Advance best practices for service delivery
* Build and strengthen cross-sector partnerships
* Identify solutions for removing barriers to health and independence for older adults

 

ACL is asking for insights into the national plan [ https://westhealth.org/nationalplanonagingsurvey/ ] through a short online survey.

 




*Social supports for LGBTQIA2S+ elders*


Common changes that accompany aging, such as hearing loss and limited mobility, can decrease elders’ interactions with others, which can lead to loneliness. This loneliness may impact some elders more than others. In a study conducted during the height of the COVID-19 pandemic [ https://www.lgbtmap.org/2020-covid-lgbtq-households ], nearly twice as many LGBTQIA2S+ (lesbian, gay, bisexual, transgender and or gender expansive, queer and or questioning, intersex, asexual or agender, and two spirit) elders reported feeling lonely, compared to their non-LGBTQIA2S+ peers.

 

Elder services tailored to LGBTQIA2S+ individuals can help this population avoid feelings of social isolation by encouraging them to participate in a range of activities and by protecting their rights. As hubs for engaging and supporting Indigenous elders, tribal and urban Indian senior centers can play a key role in supporting the social well-being of their LGBTQIA2S+ elders.

 



The cover of the report, The Disproportionate Impacts of COVID-19 on LGBTQ Households in the U.S.

The report, The Disproportionate Impacts of COVID-19 on LGBTQIA2S+ Households in the U.S., from the Movement Advancement Project



Here are several steps that senior centers can take to promote social well-being among LGBTQIA2S+ elders.

 


* *Revise intake forms* to ask about gender identity and sexual orientation and to make sure phrasing is inclusive of LGBTQIA2S+ elders
* *Train staff* on understanding and responding to the needs of LGBTQIA2S+ elders
* *Build relationships with local organizations* that serve LGBTQIA2S+ elders and collaborate with them on programming and events
* *Update policies* to safeguard the well-being of LGBTQIA2S+ elders, such as by specifically noting sexual orientation and gender identity within the non-discrimination policy
* *Offer LGBTQIA2S+-themed programming* that is inclusive of LGBTQIA2S+ elders and acts as an educational opportunity for other community members

 

View more information from the National Council on Aging [ https://www.ncoa.org/article/how-can-senior-centers-better-support-lgbtq-older-adults ] about how to support the social well-being of LGBTQIA2S+ elders.

 

Visit the National Resource Center on LGBTQ+ Aging [ https://www.lgbtagingcenter.org/ ] for guidance on how to:

 


* Develop inclusive policies and services [ https://www.lgbtagingcenter.org/resources/resource.cfm?r=487 ]
* Respectfully gather data on gender identity and sexual orientation [ https://www.lgbtagingcenter.org/resources/resource.cfm?r=601 ]
* Provide inclusive programming [ https://www.lgbtagingcenter.org/resources/resource.cfm?r=705 ]

 




LinkedIn Tribal Affairs Group

 

Join the conversation on LinkedIn

Want to learn more about or discuss LTSS in Indian Country? Looking to connect with others working in the same field?

Join the Tribal Affairs Group [ http://cms.us9.list-manage.com/track/click?u=c0033d065eadb44cbd20725a3&id=116fe94e25&e=8f57678a0b ] on LinkedIn.





Upcoming webinar


*UNITE Natives 2024 Part 2 – Rezilient: Preserving Our Culture Through Z Codes*


* Wednesday, July 24 *

The evolution of post-acute care has challenged providers to reach beyond their individual care settings to better support relationships across the health care spectrum. This shift is evidenced in current CMS Quality Reporting Program (QRP) measures related to supporting effective care transitions and the recently allowed flexibility to provide care via telehealth and remote therapeutic/physiologic monitoring. During this presentation, elders will share their perspective on how the social determinants of health (SDOH)-related Z codes impact their health.

 

*Objectives:*

 


* Define current skilled nursing facility QRP measures related to discharge from post-acute care and 30-day post-discharge readmissions
* Explain how telemedicine and remote therapeutic/physiologic monitoring can increase the likelihood of successful care transitions for Native elders
* Suggest common-sense approaches to engagement with acute care partners, including collaborative use of clinical pathways and outcomes sharing
* Discuss the role of SDOH-related Z codes in quality improvement initiatives


Register [ https://kauffmaninc.zoom.us/webinar/register/WN_uwQm9JeqTsWsk4ii_fXI1A#/registration ]

*Please note your *

*location's call-in time:*

 

8 a.m. Hawaii

10 a.m. Alaska

11 a.m. Pacific

12 p.m. Mountain

1 p.m. Central

2 p.m. Eastern




 

Have questions for our presenters? Let us know before the webinar by emailing ltssinfo@kauffmaninc.com.

_Register now [ https://kauffmaninc.zoom.us/webinar/register/WN_uwQm9JeqTsWsk4ii_fXI1A#/registration ]_.



*Presenters*


Dr. Kendall Brune

*Dr. Kendall Brune*
UNITE Board Member
Adjunct Associate Professor
Meharry Medical College

Travis Le Duc

*Travis Le Duc*
UNITE Board Member
Director of Operations & Communications
Tohono O’odham Nursing Care Authority

Brandi Hodges

*Brandi Hodges*
UNITE Secretary
Administrator
White River Health Care Center

Joseph Ray

*Joseph Ray*
Elder Care Advocate
UNITE Board Member
Laguna Rainbow Corporation




Caregiver's corner


*Finding no-cost respite care options*


According to the National Indian Council on Aging [ https://www.nicoa.org/connected-elders/for-caregivers/ ] (NICOA), more than 75% of caregivers in the United States are family members. Results of NICOA’s 2019 survey for caregivers of older adults [ https://www.diverseelders.org/wp-content/uploads/2020/10/What-Providers-Should-Know-About-American-Indian-Family-Caregivers-May-2020.pdf ] (PDF, 179 KB, 2 pp) found that:

 


* 44% of Indigenous caregivers are the only person who provides care for their loved one
* 22% have no support from other family members, friends, or neighbors

 

Everyone needs regular breaks from the demands of caregiving for their own well-being. This need is where respite care comes in. However, given the demands of caregiving and the cost of respite caregiving, many caregivers struggle to find the time and the finances to secure a respite caregiver.

 

The National Volunteer Caregiving Network [ https://nvcnetwork.org/wp/index.php/program-map-2/#/ ] can help quickly locate local volunteer caregivers. This network comprises about 1,000 caregiving organizations across the United States, and services vary widely, ranging from transportation to companionship to dementia care and more.

 





Funding opportunities


*Housing self-sufficiency supports for Indian housing residents*


*Applications due: September 30*
Learn more about the housing self-sufficiency funding opportunity [ https://www.grants.gov/search-results-detail/354625 ]

 

Through this funding opportunity, the U.S. Department of Housing and Urban Development anticipates awarding 130 discretionary grants of up to $816,750 per grantee to tribal and public housing authorities, federally recognized tribal governments, and nonprofit organizations. The goal of this funding is to support residents of public and tribal housing in attaining financial and housing self-sufficiency.

 





Upcoming events


*Webinar on PCTI*


*July 24, at 1 p.m. Eastern*
Register for the webinar, Foundations of the PCTI Approach [ https://form.jotform.com/241556407558968 ]

 

The Jewish Federations of North America Center on Holocaust Survivor Care and Institute on Aging and Trauma will host the webinar, Foundations of the Person-Centered, Trauma-Informed (PCTI) Approach.

 

During the webinar, presenters will share actionable steps to incorporate the Substance Abuse and Mental Health Services Administration’s PCTI principles at the organizational level and with program participants. Presenters will also share real examples of PCTI approaches to care.

 



*Webinar on aging in place*


*July 25, at 1 p.m. Eastern*
Register for the American Society on Aging’s webinar, Empowering Older Adults: Maximizing Independence through Aging in Place [ https://asaging.org/web-seminars/empowering-older-adults-maximizing-independence-through-aging-place ]

 

This webinar will share innovative strategies and technologies to empower older adults to maintain their independence and safety at home as they age. The presenter will explore challenges older adults face when aging in place and discuss how home modifications, smart technologies, and community resources can help address these challenges.

 



*All Tribes Consultation Webinar: OPPS Rule*


*July 25, at 3 p.m. Eastern*
Register for the All Tribes Consultation Webinar [ https://kauffmaninc.zoom.us/webinar/register/WN_92m8XwGNQRCJjUrSaZ5lGA ]

 

The CMS Division of Tribal Affairs and Center for Medicare will hold the All Tribes Consultation Webinar, Medicare Provisions for IHS and Tribal Facilities in the Outpatient Prospective Payment System Rule [ https://public-inspection.federalregister.gov/2024-15087.pdf ].

 

This webinar will provide an overview of two provisions within the proposed rule that are relevant to Indian Health Service and tribal programs, including services provided outside of the four walls, telehealth services, and behavioral health services. The comment period on the Outpatient Prospective Payment System (OPPS) proposed rule is open through *September 9.*

 



*Webinar on family dynamics in caregiving*


*August 7, at 1 p.m. Eastern*
Register for the American Society on Aging’s webinar, Addressing Challenging Family Dynamics in Caregiving [ https://asaging.org/web-seminars/addressing-challenging-family-dynamics-caregiving ]

 

This webinar will explore challenges experienced by people who provide care for family members. Those challenges include differences in opinions, varying levels of involvement, and communication hurdles.

 

The webinar will also share strategies and resources to help families navigate and cope with these challenges.

 



*2024 National Ryan White Conference on HIV Care & Treatment*


*August 20–23*
Washington, DC, and hybrid
Register by *August 16* for the 2024 National Ryan White Conference [ https://ryanwhiteconference.hrsa.gov/register/?utm_campaign=enews20240607&utm_medium=email&utm_source=govdelivery ]

 

Registration is open for the 2024 National Ryan White Conference on HIV Care & Treatment, presented by the Health Resources and Services Administration. This conference will share best practices and innovative strategies to continue implementing a national response to end the HIV epidemic in the United States.

 





Send us your news

Do you have news to share about LTSS in Indian Country? Send it to ltssinfo@kauffmaninc.com for possible inclusion in an upcoming newsletter. Contact us with other comments or feedback, too.

 

About the newsletter

American Indian/Alaska Native Long-Term Services and Supports Solutions is published monthly by the CMS Division of Tribal Affairs to share information, funding opportunities, and resources with LTSS planners, tribal leaders, and supporters.




Centers for Medicare & Medicaid Services [ http://cms.gov ] Indian Health Service [ http://ihs.gov ]Administration for Community Living [ http://acl.gov ] [ http://ihs.gov ]



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