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Improving Long-term Care for American Indians in Region VIII

A Workshop for Tribal and State Health Officials

The following summary reflects the discussions among participants of a User Liaison Program (ULP) workshop held July 21-23, 2003, in Bismarck, North Dakota, for Tribal and State officials in U.S. Department of Health & Human Services (HHS) Region VIII. The workshop, which was co-sponsored by the Administration on Aging (AoA), the Centers for Medicare and Medicaid Services (CMS), the Indian Health Service (IHS), and the National Resource Center on Native American Aging at the Center for Rural Health, University of North Dakota School of Medicine and Health Sciences, was designed to help Tribal and State policymakers better understand American Indian long-term care needs and develop policies and programs that meet those needs.

About the Workshop Sponsor.


As American Indians age or develop chronic conditions that affect their ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs), the need for services that support families and provide direct care has risen. American Indians have higher rates of disability and health conditions than other Americans and fewer resources to serve those with long-term care (LTC) needs.

There are special considerations in developing programs that meet the long-term care needs of American Indians, including:

  • Addressing cultural issues in care delivery.
  • Supporting families in their caregiving roles.
  • The sovereign nation status of tribes.
  • The role of IHS, Tribal governments, and State programs in delivering care.
  • The lack of infrastructure, particularly in very rural areas such as many of the reservations in Region VIII.

Summary of Key Workshop Themes


What is long-term care?
Who needs long-term care and what services do they need?
Who pays for long-term care?
How are long-term care services delivered to American Indians in Region VIII?

Assessing American Indian LTC Needs

What types of long-term care needs exist in American Indian communities and how are they being met?
What resources are available to help tribes identify elders' long-term care needs?
What role does culture play in long-term care?
Who are informal caregivers and what are their needs?

Using Health Promotion and Disease Prevention

How can American Indian communities improve elders health through disease prevention and health promotion?

Meeting American Indian LTC Needs

How can programs and funding sources be combined to provide a range of long-term care services?
What resources are available to help American Indian communities develop their long-term care systems?
How can a single entry point help elders access long-term care services?
How can Medicaid be used to finance the long-term care services provided to American Indians?
How can personal care services be provided?
How can tribes and States work together to meet American Indian long-term care needs?

AHRQ's User Liaison Program (ULP) disseminates health services research findings in easily understandable and usable formats through interactive workshops. Workshops and other support are planned to meet the needs of Federal, State, and local policymakers, and other health services research users, such as purchasers, administrators, and health plans.

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