LTSS Newsletter—June 2019


Funding opportunities, news, events, and resources for tribal LTSS programs
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Upcoming webinar, June 26: Reclaiming Indigenous Food Relationships—Improving Health with Culture
Long-Term Services and Supports

Technical assistance for culturally competent care
June 2019
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End-of-life care in tribal communities

Beliefs about the end of life are personal, sacred, and rooted in culture. End-of-life care provided by tribal and urban Indian programs helps ensure that services are culturally appropriate.

The CMS infographic on end-of-life care in Indian Country offers tips on how tribal communities can develop their own hospice or palliative care programs.

Caring for those nearing end-of-life

Several tribal nations and urban Indian organizations offer end-of-life care programs tailored to the people they serve. Learn more about what works for these programs.


Palliative care resources


There are two types of end-of-life care:


  • Hospice care, which aims to provide comfort for patients who are no longer seeking a cure
  • Palliative care, which patients may receive while also in treatment for a serious illness

Visit the CMS LTSS TA Center for an overview of hospice and palliative care in Indian Country.


You can also review and share these resources on palliative care: 




Summer heat and mail-order medicine

Medicine capsules and a thermometer

Mail-order medication delivery options are often necessary to improve access to medical treatment, especially for rural tribal communities that may not have nearby pharmacies. But the heat of summer warrants a few extra precautions for this delivery option.

For example, many medications must be kept cool to stay effective. Medicine that sits outside in the sun, rain, or humidity after delivery could become less effective. Leaving medicine in a hot vehicle can also lower its effectiveness.

What caregivers can do:

  • If you will be unable to bring the medicine inside soon after delivery, have someone you trust bring it in for you
  • If the home becomes too hot, keep the medicine in a temperature-controlled container
  • Check with the pharmacy or the company selling the medicine to see if they use temperature-controlled packaging
  • Check with the mail carrier to see if they use temperature-controlled vehicles

If you think medicine has been affected, speak with the pharmacist, insurance company, or the medication manufacturer to get a replacement.

Upcoming Event: National Title VI TTA Conference

August 13–16, 2019
Minneapolis, MN

The National Title VI TTA Conference will cover Medicaid billing, menu planning, sustainable programming, and more. The agenda also includes a training session for new directors. Register now or view the draft agenda.


June is National Aphasia Awareness Month

National Aphasia Awareness Month aims to educate the public about aphasia, a disorder that causes problems with speaking, reading, writing, and/or understanding what others say.


National Aphasia Association logo

Stroke is the most common cause of aphasia, which varies in severity. Many people with aphasia are unable to clearly communicate their needs or express discomfort. As a result, they feel isolated and powerless. Such feelings can lead to difficult behavior, mood swings, and depression.

People with aphasia may feel less isolated when caregivers:

  • read or talk to them at a normal pace and volume, even if they cannot respond or fully comprehend what is being said,
  • listen to music or watch funny videos with them,
  • use pictures to communicate, and
  • pay special attention to facial expressions and body language.

Find more information on communicating with someone who has aphasia.

Disaster preparedness for people living with dementia

Many parts of the country have already begun to experience extreme summer weather conditions, such as wildfires. To prepare for weather-related or other emergencies, caregivers of people with dementia should make special preparations.


The Administration for Community Living developed a disaster planning toolkit for people with dementia to support caregiver planning. The toolkit provides information on the following topics:


The cover of the Disaster Planning Toolkit for people living with dementia

  • Considerations for planning for a disaster, with tips for people with dementia who live alone
  • Worksheets to fill in important contacts, medical conditions, and care needs
  • An emergency supplies checklist
  • Planning tips for after a disaster
  • Tips for communication and responding to dementia symptoms

Additionally, in a best practices report from CMS, 5 tribal nursing homes explain what they do to prepare for emergencies.

Funding opportunity

Tribal LTSS Resource Center

Application deadline: July 5

View the Tribal LTSS Resource Center funding opportunity

The Administration for Community Living will fund a national resource center to help tribal communities develop and implement culturally appropriate LTSS programs.


The center will be required to create a network of LTSS navigators and an LTSS toolkit. Federally recognized tribal governments and tribal organizations are encouraged to apply.

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 on LinkedIn.

Upcoming webinar

Reclaiming Indigenous Food Relationships—Improving Health with Culture

Wednesday, June 26

Prevention strategies rooted in customs and cultural traditions are proving to be promising practices for elevating the health of American Indian and Alaska Native (AI/AN) people.

In this webinar, learn how to use the American Indian Cancer Foundation's (AICAF) latest resource, Reclaiming Indigenous Food Relationships: Improving Health with Culture (PDF, 5.5 MB, 12 pgs.). This framework recognizes cultural foodways as central to life. It is a valuable tool for integrating culture into efforts to restore health for AI/AN people.


Please note your
location's call-in time:

9 a.m. Hawaii
10 a.m. Alaska
11 a.m. Pacific
12 p.m. Mountain
1 p.m. Central
2 p.m. Eastern


Participants will:

  • learn about the AICAF and its history
  • understand how to use the Reclaiming Indigenous Food Relationships framework to implement comprehensive healthy eating initiatives by applying a Culture is Prevention model
  • hear innovative success stories of how the framework has advanced healthy Native foods initiatives
  • learn about potential partnership areas.

Have questions for our presenter? Let us know before the webinar by emailing

Register now.

Daanis Chosa

Daanis Chosa 
Bois Forte Band of Chippewa
Prevention and Policy Coordinator
American Indian Cancer Foundation

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About the Newsletter

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 Indian Health Service Administration for Community Living