LTSS Newsletter—February 2026

Centers for Medicare & Medicaid Services (CMS) sent this bulletin at 02/24/2026 02:19 PM EST

LTSS webinar, February 25: Heartbeat of the Earth – Music Therapy in Indigenous Communities
American Indian/Alaska Native Long-Term Services and Supports

Technical assistance for tribal health care
February 2026
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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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Promoting discussion of brain health

Many people assume that changes in memory, thinking, or behavior are a normal part of aging—but such changes could be dementia symptoms.

To help elders broach the topic of cognitive challenges with a health care provider (HCP), the International Association for Indigenous Aging offers:

 

Discussing patterns of brain health changes with one’s HCP creates opportunities to consider diagnostic testing and explore options to stay safe while aging in place.

 
     
   

Fostering dementia-friendly communities

  
       
   

The International Association for Indigenous Aging (IA2) is a trusted provider of resources aimed at fostering dementia-friendly tribal communities.

 

For an overview of those resources, visit the TA Center’s LTSS and Dementia page and watch a series of brief videos about efforts by IA2 to:

 

  • Educate communities about what dementia is and how it affects people
  • Help people recognize the early signs of dementia
  • Increase awareness of the challenges of providing care for a loved one who has dementia
  • Spur creation of dementia-specific tribal laws, plans, and policies

 

  

New reports on LTSS

Several new reports from CMS summarize trends in use and expenditures for home- and community-based services (HCBS) under Medicaid. Key findings include:

 

  • In 2023, a majority (87.1%) of LTSS users received HCBS, and nearly two thirds (63.8%) of Medicaid LTSS expenditures went toward HCBS.
  • Between 2022 and 2023, the number of people receiving HCBS increased by 7.5%, and HCBS expenditures increased by 12.8%.

 

Additionally, a recently released 2024 report to Congress, Best Practices in the Money Follows the Person (MFP) Demonstration (PDF, 1.6 MB, 71 pp), notes that:

 

  • Between 2008 and 2023, more than 127,000 people transitioned from institutional care to community living through MFP.
  • Between 2020 and 2023, MFP transitions increased dramatically (77%).
  • In 2022 and 2023, most of those who transitioned to community living were older adults and people with physical disabilities.

 

Age-friendly care
The 4 Ms of Age-Friendly Care poster features a tree rooted in Indigenous knowledge, language, land, sovereignty, culture, traditions, history, and community.

Recently, the International Association for Indigenous Aging collaborated with tribal organizations, brain health advocates, and experts to develop culturally relevant resources about age-friendly care.

 

The resources support efforts to make sure Native elders receive the best care possible and are satisfied with the care received. At the core of such efforts is the 4Ms Framework, which references:

 

  • What Matters Most – Aligning care with each elder’s specific health outcome goals and care preferences
  • Memory, Mood, and Thinking – Keeping an elder’s mind strong and healthy
  • Movement – Helping maintain an elder’s physical strength and mobility
  • Medicine – Using traditional medicine and prescription medications that are necessary and safe and do not interfere with the other 3Ms

 
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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

Heartbeat of the Earth – Music Therapy in Indigenous Communities

Wednesday, February 25

Music therapy is a highly effective, non-pharmacologic intervention for both Native and non-Native people living with dementia. During this month’s webinar, the presenters will explain how the brain responds to sound and how the Absentee Shawnee Tribal Health System’s music therapy program harnesses the power of music to restore balance, harmony, and well-being.

 

Objectives:

 

  • Provide a brief overview of how the brain responds to music
  • Understand the neurologic basis of music therapy for people with dementia
  • Gain insight into the value of music and culture-based interventions

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

 

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

Register now.
Atheda Fletcher.

Atheda Fletcher
Grant Project Principal Investigator
Little Axe Health Center
Dr. Raphael Francisco.

Dr. Raphael Francisco
Indian Health Geriatric Scholars Program Participant
Specialist in Internal Medicine and Endocrinology
Absentee Shawnee Tribal Health System
Caregiver's corner

Connecting family caregivers with LTSS

To help develop and strengthen caregiver services and supports, USAging has released a series of action guides for organizations that serve elders and their families.

 

One of those guides, Family Caregivers and Planning for Long-Term Services & Supports (PDF, 561 KB, 7 pp), suggests steps and resources that organizations might find useful for their work in the following areas:

 

  • Outreach to family caregivers to engage in LTSS planning – Learn how to connect with family caregivers, help them identify as family caregivers, and dispel stigma surrounding discussion of illness and death.
  • Advance care planning – Learn how to have meaningful conversations and consider available options.
  • Financial planning – Explore program examples to help caregivers understand the financial impacts of LTSS to guide their decisions.
  • Professional care options – Explore program examples to help families navigate LTSS care options.
  • Palliative care – Help caregivers better understand the palliative care services available in their area and eligibility criteria.

 
Funding opportunities

Healthcare Connect Fund Program

Applications due: April 1
Learn more about the Healthcare Connect funding opportunity

 

The Healthcare Connect Fund Program provides eligible rural health care providers with a 65% discount on broadband connectivity expenses. Skilled nursing facilities and other health care sites are eligible to apply.

 
Upcoming events

IHS Clinical and Community Workforce Summit

March 10–12
Denver, Colorado
Register for the IHS Clinical and Community Workforce Summit

 

The 2026 IHS Clinical and Community Workforce Summit’s theme is “Alzheimer’s and Elder Care: Knowledge, Compassion, and Community at Work.” The event will foster collaboration to address the unique challenges and opportunities around elder care and memory health in tribal communities.

 

CMS Quality Conference
Logo for 2026 CMS Quality Conference.

March 16–18
Baltimore, Maryland
Register for the CMS Quality Conference

 

The theme of this year’s CMS Quality Conference is “Make America Healthy Again: Innovating Together for Better Health.” Leaders, providers, researchers, advocates, and partners committed to improving health care quality and outcomes are encouraged to attend.

 

Dementia Friends Information Session

April 1 at 1 p.m. Eastern
Virtual via Zoom
Register for the next Dementia Friends Information Session

 

The International Association for Indigenous Aging invites everyone to join their next quarterly Dementia Friends Information Session for Native communities. Session participants will hear six key messages about dementia and be better prepared to support fellow community members who are living with dementia.

 

Anyone unable to make the April 1 session is welcome to join the July 1 or October 7 session. Each session begins at 1 p.m. Eastern.

 

Tribal Public Health Conference

April 7–9
Oklahoma City, Oklahoma
Register for the Tribal Public Health Conference

 

The theme for this year’s Tribal Public Health conference is “The Vision for Generational Healing, Health, and Wellness.” Attendees will explore healing and wellness across lifespans and generations.

 

The conference will cover topics such as:

 

  • Environmental health and emergency management
  • Culturally adapted public health
  • Data and epidemiology
  • Oral health
An elder securing a traditional hat on the head of her grandson who is getting a piggyback ride from his father.

 

Conference art: “Dance on My Shoulders” by Kevin Tushka

 

Tribal Self-Governance Conference

April 7–9
Chandler, Arizona
Register for the Tribal Self-Governance Conference

 

Federal partners, tribal leaders, tribal officials, and people who work closely with tribal communities are encouraged to attend this year’s Tribal Self-Governance (TSG) Conference. Note, TSG was formerly known as the Self-Governance Communication & Education Tribal Consortium.

 

American Society on Aging Conference

April 20–23
Atlanta, Georgia
Register for the American Society on Aging conference

 

Join the American Society on Aging (ASA) for their annual On Aging conference. The theme for 2026 is “The Power of Belonging: Amplifying Voices, Advancing Justice, Accelerating Connection.” Explore sessions on Medicaid enrollment benefits for American Indian and Alaska Native elders, artificial intelligence and elder care, attracting donors, and more. ASA members who sign up for a volunteer role will be offered a discounted registration rate.

 

Annual NCUIH Conference

April 27–30
Washington, DC
Early bird registration deadline: March 6
Register for the NCUIH conference

 

This year’s National Council of Urban Indian Health (NCUIH) conference will commemorate the 50th anniversary of the Indian Health Care Improvement Act. Urban Indian organization (UIO) staff, health care professionals, policymakers, community leaders, and advocates are encouraged to attend. The day before the conference, NCUIH will offer training for UIO boards of directors. Additionally, UIOs are invited to participate in Capitol Hill Day, April 30.

 

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 Indian Health ServiceAdministration for Community Living