Pathways To Respecting American Indian Civil Rights August 8 & 9 Denver Colorado Presentation by Susan A Raymond, State and Tribal Liaison, Region VIII Administration for Community Living U.S. Department of Health and Human Services

Older Americans Act of 1965 as amended Congress declared that in keeping with the traditional American concept of the inherent dignity of the individual in our democratic society, the older people of our Nation are entitled to, and it is the joint duty and responsibility of the Federal, State, Tribes and local government to assist older people to obtain: Adequate income in retirement Best possible physical and mental health Obtain and maintain suitable housing at costs they can afford

Restorative services for those who need institutional care; comprehensive long term care services; community based services; family and caregiver support Employment free of discriminatory practices Retirement in health, honor, and dignity Participation in meaningful activity; civic, cultural, educational, training and recreational opportunities

Efficient community services including transportation Immediate benefit from proven research which sustains and improves health Freedom, independence and free exercise in planning and participation in services and programs that benefit them and protect against abuse, neglect and exploitation.

Introduction of the Administration for Community Living “For too long, too many Americans have faced the impossible choice between moving to an institution or living at home without the long-term services and supports they need. The goal of the new Administration for Community Living will be to help people with disabilities and older Americans live productive, satisfying lives.“ ~ Secretary Kathleen Sebelius April 16, 2012

Administration for Community Living Mission To develop a comprehensive, coordinated and cost-effective system of long-term care that helps elderly individuals to maintain their dignity in their homes and communities. Our mission statement also is to help society prepare for an aging population.

Administration on Aging Overview Better Health/Quality of Life: Older Americans Act Title III and VII Discretionary grants: Evidence-based Prevention Program (CDSMP, falls, mental health, physical activity, care transitions grants ) Senior Community Services Employment Program Caregiver Better Care: Single point of entry AAA’s and ADRCs Participant-directed programs that support community living: Money Follows the Person (MFP) and Veterans-Directed Home and Community- Based Services (VDHCBS) Lower Costs: The Senior Medicare Patrol (SMP) State Health Insurance Program (SHIP) and Benefit Enrollment Centers

Organizational Structure

Office for American Indian, Alaska Native, and Native Hawaiian Programs The Office for American Indian, Alaska Native, and Native Hawaiian Programs was established in 1984 and is charged to serve as an advocate on behalf of Native American elders in relation to all Federal policies affecting elders. And to advocate with the States to promote the enhanced delivery of services and implementation of programs to older Native Americans.

The Office has oversight of grants to Tribes; chairs the Interagency Task Force on Older Indians; develops research plans and conducts research on Native American aging; and collects and disseminating information on problems experienced by Native American elders. This includes elder abuse, long-term care, health, and other issues unique to Native Americans.

Under Title VI of the OAA, AoA awards grants directly to Tribes and Tribal organizations and native organizations for nutrition services (including congregate and home delivered meals), information and assistance, transportation, and in-home supportive services. In 2000, as part of an amendment to the Older Americans Act, the Native American Caregiver Support Program was established to assist caregivers of Native American elders who are chronically ill or have disabilities.

History of Title VI

1975: Older Americans Act Amendments authorized grants under Title III to Indian Tribal organizations. Transportation, home care, legal services, and home renovation/repair were mandated as priority services. Two events happen in 1978: 1.Creation of Title VI 2.The recognition of Tribal Sovereignty The purpose of Title VI was to promote the delivery of supportive and nutrition services to American Indians and Alaska Natives that are comparable to service offered to other older people under the Title III program in establishing this new Title, Congress identified findings about the needs of older Indians. Although Title VI became a part of the OAA in 1978, funding for the programs were not available until 1980.

Separate Appropriation for Title VI In 1981, Congress Amended the OAA to establish a separate appropriation for Title VI. Congress reminded states that older Indians must be counted as part of the state’s total older population, and thus continued to be eligible for all services Two events happened: 1.Tribes had to meet the 60+ eligibility to apply for Title VI funds. 2. Tribes could decide the age for Title VI services. Most Tribes elected an age below sixty years old.

Established Part B of Title VI – 1991 In 1991 Amendments to the OAA established a new Part B for Title VI that provided programs and funding for Native Hawaiians.

Title VI, Part A Federally Recognized Tribes to include American Indians and Alaska Natives Comparable to services provided under Title III Direct funding to Tribal Organizations Addressing nutrition and supportive services to include information and assistance

Title VI, Part B Public or nonprofit private organization representing Native Hawaiian elders; Native Hawaiian means any individual any of whose ancestors were native of the area which consists of the Hawaiian Islands prior to 1778 Serves at least 50 individuals age 60 and over in the identified service area; Demonstrates the ability to deliver supportive services, including nutritional services; Comparable to services provided under Title III.

Part C – NA Caregiver Program Eligible if a Title VI, Part A or B applicant Five Required Services: Information Assistance Individual counseling, support groups, training Respite – elder meets the definition of frail and services are temporary and intermittent Supplemental services – on a limited basis to caregivers caring for frail elders

Title VI Caregiver Program The program assists caregivers through: A network of Community Resource Providers to help them locate resources and services Referrals to appropriate service providers to meet their specific needs Providing health information Support groups, one-on-one counseling, and training sessions Providing a Resource Directory, Training Manual, and video library for Caregiver training Providing Respite Care to temporarily relieve caregivers of their caregiving responsibilities Lending libraries

Reasons for Coordination Provides expanded program services to meet the needs of Tribal Elders Improves quality of life for Tribal Elders Increases awareness and expands community support for the Tribal Elders Program Supports family efforts to care for loved ones at home and in their community Reduces duplication of services Develops partnerships to address unmet needs Informs community about services available to benefit Tribal Elders Expands resources including funding, staff training, facilities, equipment, etc.

GOOD NEWS! Health Promotion and Disease Prevention Works  Longer life  Reduced disability  Improved mental health  Lower health care costs

Evidence-Based Health Promotion and Disease Prevention Programs for Older Adults A Matter of Balance Active Choices Active Living Every Day EnhanceFitness EnhanceWellness Fit & Strong! Healthy IDEAS Healthy Moves Medication Management PEARLS Prevention and Management of Alcohol Problems in Older Adults Stanford Chronic Disease Self- Management Programs Stepping On Strong for Life Tai Chi

CDSMP Participants - Chronic Conditions

Additional Information For further information about ACL AoA please contact: Regional Support Centers – Title VI Lead Staff Region I: CT, MA, ME, NH, RI, VT Gene Brown (lead for both Regions I & II) John F. Kennedy Bldg., Rm Boston, MA Phone: Fax: Regions II: NY, NJ, PR, VI, DC, DE, MD, PA, VA, WV Barry Klitsberg 26 Federal Plaza, Rm New York NY Phone: Fax: Region IV: AL, FL, GA, KY, MS, NC, SC, TN Joyce Robinson-Wright Atlanta Federal Center 61 Forsyth Street, SW - Suite 5M69 Atlanta, GA Phone: Fax: Region V: IL, IN, MI, MN, OH, WI Sam Gabuzzi 233 N. Michigan Ave., Suite 790 Chicago, IL Phone: Fax: Region VI: AR, LA, OK, NM, TX Larry McClendon 1301 Young St., Rm. 736 Dallas, TX Phone: Fax: Region VII: IA, KS, MO, NE Sam Gabuzzi 601 East 12th Street Kansas City, MO Phone: Fax:

Additional Information continued Region VIII: CO, MT, UT, WY, ND, SD Susan Raymond th Street, South Terrace, Ste 496 Denver CO Phone: Fax: Region IX: CA, NV, AZ, HI, GU, CNMI, AS Anna Cwirko-Godycki (shared responsibility for California Tribes) Anna (415) Darrick Lam (shared responsibility for California Tribes) Darrick (415) Dennis Dudley (Arizona and Nevada Tribes) Dennis (415) th Street, T-8100 San Francisco, CA Phone: Fax: Region X: AK, ID, OR, WA Terry Duffin (AK & OR) Jeanette Burkett (ID & WA) Blanchard Plaza, RX-33; Rm Sixth Avenue Seattle, Washington Phone: Fax:

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