Emerging LTSS Issues
Guidance for three LTSS topics and related issues within Indian Country, including LTSS funding for home- and community-based services, adult family homes, and Alzheimer’s and dementia.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 14, 2019
This page includes research on several key LTSS issues, including:
- Home- and community-based care funding
- Adult family homes
- LTSS for adults who have disabilities
- Tribal assisted living facilities
- Diabetes and LTSS
See an overview of three emerging issues:
- Report—Emerging LTSS Issues in Indian Country (PDF) (588 KB, 3 pp): Reviews LTSS funding for home- and community-based services, adult family homes, and dementia
The resources below include information on HCBS funding and adult family homes. (See LTSS and dementia for more information on providing long-term care for people with dementia.) Additional emerging issues discussed in the resources on this page include LTSS for people with disabilities, assisted living facilities, diabetes and LTSS, Alzheimer’s and other dementias, cognitive assessments, and caregiver training.
Home- and community-based care
- Report—Emerging LTSS Issues in Indian Country: Rebalancing LTSS Funding for HCBS (PDF) (PDF, 1.05 MB, 16 pp): Reviews current information on efforts to rebalance LTSS funding for HCBS in Indian Country that breaks down Medicaid funding information and provides insights from two current programs
- Report—Offering and Funding Home- and Community-Based Services in Indian Country (PDF) (473 KB, 17 pp): Reviews ways that AI/AN communities provide home- and community-based care, including common funding sources, five program profiles, and recommendations from program administrators
- Report—Emerging LTSS Issues in Indian Country: Adult Family Homes (PDF) (777 KB, 10 pp): Discusses adult family homes as a viable home- and community-based care option for providing culturally appropriate, affordable, long-term care to elders or others in need of such services while keeping tribal members in the community
LTSS for people with disabilities
- Report—Improving Care for Adults with Disabilities in Indian Country - Highlights from the Field (PDF)(1 MB, 9 pp): Describes several programs working to enhance long-term care for people with disabilities in Indian Country
- Report—Improving Care for Adults with Disabilities In Indian Country - Highlights from the Literature (PDF) (1.5 MB, 10 pp): Discusses the benefits of HCBS and trauma-informed care for people who have disabilities and the importance of listening to their voices
- Report—Emerging LTSS issues in Indian Country: Disability and Housing (PDF)(726 KB, 14 pp): Examines the issues AI/AN people face in seeking housing assistance and outlines the efforts of a tribal housing program that is working to address those needs
- Report—LTSS in Indian Country: Issues Affecting American Indians and Alaska Native Consumers with Disabilities (PDF)(798 KB, 23 pp): Discusses the challenges AI/AN people with disabilities face in seeking LTSS and highlights three tribal LTSS programs that serve people with disabilities
Assisted living facilities
- Report—Emerging LTSS issues in Indian Country: Assisted Living (PDF) (1.2 MB, 17 pp): Examines the approaches of tribes who have established their own assisted living facilities
Diabetes and LTSS
- Literature review—Emerging LTSS Issues in Indian Country: Diabetes in Indian Country (PDF)(818 KB, 34 pp): Provides background information about diabetes in Indian Country and discusses the heightened LTSS concerns of older AI/ANs with diabetes and approaches to providing care for those with diabetes.
Alzheimer's and dementia
- Report—Emerging LTSS Issues in Indian Country: Alzheimer’s and Dementia (PDF) (888 KB, 10 pp): Highlights current information about Alzheimer’s disease and dementia in Indian Country, barriers that prevent diagnosis, and recommendations for tribal communities to take proactive measures to address challenges
Cognitive assessments
- Report—Best Practices: Cognitive Assessment Tools (PDF) (687 KB, 8 pp): Shares cultural considerations for cognitive assessments and example cognitive assessment tools
- Literature review—Emerging LTSS Issues in Indian Country: Cognitive Assessments (PDF) (962 KB, 13 pp): A literature review on the need for cognitive assessments in Indian Country, challenges with them, and promising cognitive assessment tools
Caregiver training
- Report—Emerging LTSS issues in Indian Country: Caregiver Training (PDF) (775 KB, 14 pp): Describes the need for caregiver training in Indian Country, recommendations, and a program profile
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