LTSS Newsletter—December 2019

Funding opportunities, news, events, and resources for tribal and urban Indian LTSS programs
Upcoming webinar: Emergency Preparedness in Indian Country, Wednesday, December 11
Long-Term Services and Supports

Technical assistance for culturally competent care
December 2019
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LTSS Technical Assistance Center

Visit the online LTSS TA Center for videos, best practices, toolkits, a resource library, and a step-by-step planning roadmap.

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Fire safety for caregivers

According to the U.S. Fire Administration (USFA), older adults are at higher risk during a fire than the general population.

USFA developed the Fire-Safe Seniors Program to help caregivers of elders plan and implement fire safety measures. Program tools include:

  • training curricula for trainers and staff
  • an implementation guide
  • educational fact sheets and
  • stickers

Additionally, USFA's fire prevention and safety digital media library provides resources to help share fire safety tips through social media. Tools include photos, short videos, animations, social cards, hashtags, and messages.


Disaster preparedness


In September, CMS published the Emergency Preparedness Rule to create national planning requirements for care providers' response to natural and man-made disasters.

This month's LTSS webinar will also present information to help tribal communities respond to disaster and keep elders and people with disabilities safe.

The CMS report, Tribal Nursing Home Best Practices: Emergency Preparedness (PDF, 614 KB, 14 p), provides examples from tribal nursing home administrators on how they prepare for emergencies.




"The more training, the better prepared the staff are, the smoother it will go. It definitely would prevent loss of life by having people trained in the event of a real emergency."

– Sally Hutton, Colville Tribal Convalescent Center Administrator, Tribal Nursing Home Best Practices: Emergency Preparedness

Vaccinate care facility staff to protect patients

Elders, especially those in care facilities, are at high risk of dying from influenza-related complications, such as pneumonia. Care facilities can help protect patients by requiring all staff, regardless of whether they are directly involved in patient care, to receive their annual flu vaccine.

To that end, the National Adult and Influenza Immunization Summit's Influenza Working Group offers guidelines to help care facility administrators implement flu vaccination requirements (PDF, 1.4 MB, 34 pp). The document explains why vaccinating both clinical and non-clinical staff makes sense. It also lists frequently asked questions and includes links to posters and a sample policy statement.

Easing loneliness for elders

For elders living away from home, the winter months can be a time of loneliness and isolation. Here are a few ideas to share with families of elders who are staying at LTSS facilities to help them stay connected with their elders this season.

  • Visits: Families may not know what they can and cannot do at the facility while visiting with their elders. To help everyone feel at home, make sure families know where to grab a warm beverage, some games, or books to enjoy during their stay. Consider offering a list of fun conversation topics to break the ice.
  • Supporting long-distance family relationships: Help elders navigate a video chat if their family lives too far to visit in person. Share a list of fun games they can play over the phone, like Battleship or storytelling challenges, to keep the conversation going.
  • The holidays: Ask the elder about their traditions and how or if they celebrate the holidays and include these considerations in your activities. Let families know whether they can bring decorations or food, and invite them to join any holiday meals or activities.

For more ideas on how to help elders feel connected, check out 8 Ways to Ease Holiday Isolation for Older Adults.

Upcoming webinar 

Emergency preparedness in Indian Country

Wednesday, December 11

The December LTSS webinar will look at ways tribal communities can plan ahead to better position themselves to respond to emergencies and assist older adults and vulnerable community members during an emergency.

Webinar participants will learn about:

  • emergency preparedness planning and
  • related planning tools and resources

Do you have an LTSS topic you would like these webinars to cover? Email

Rhonda Schwartz

Rhonda Schwartz

Regional Administrator ‐ Region III Administration for Community Living

U.S. Department of Health & Human Services


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

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 and join the conversation.

Caregiver's corner

Signs of caregiver stress

The Centers for Disease Control and Prevention (CDC) notes that being a caregiver for an elder or someone with disabilities can be lengthy and intense. Nearly half of caregivers provide at least 20 hours of care a week, on top of other household tasks, for at least 2 years.

Caregivers are already at risk of burnout, but the holidays can pile on extra stress. Additionally, burnout can affect a caregiver's ability to properly provide care. Help caregivers recognize the signs of stress, so they know when they need to take a step back and focus on self-care. Signs of caregiver stress can include:

  • Denial
  • Anger
  • Social withdrawal
  • Anxiety
  • Depression
  • Exhaustion
  • Sleeplessness
  • Irritability
  • Lack of concentration
  • Health problems

A snippet of CDC's infographic, "Caregiving among American Indian/Alaska Native Adults"

A chart shows levels of happiness and calmness follow the same upward trends when elders participate in cultural activities

Funding opportunity

Dementia care: Home- and community-based services

Applications due: January 8, 2020

Through the National Healthy Brain Initiative, CDC will provide 6 awards to organizations that support populations with a high burden of Alzheimer's Disease and related dementias. Organizations will provide related outreach messaging to these populations and assist in the national implementation of other planned activities, to be determined with input from CDC.

Conceptual Framework for the Healthy Brain Initiative Road Map

Conceptual Framework for the Healthy Brain Initiative Road Map

About the TA Center

The LTSS Technical Assistance Center provides a roadmap for American Indian and Alaska Native communities who are planning and implementing LTSS programs to care for their elders and people with disabilities.

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.

Send Us Your News

Do you have news to share about LTSS in Indian Country? Send it to, and we'll include it in a newsletter. Contact us with other comments or feedback, too.

Centers for Medicare & Medicaid Services Indian Health Service Administration for Community Living