Services for Native Americans (OAA Title VI)
Authorizing Legislation: Sections 613, 623 and 631 of the Older Americans Act of 1965, as amended
The Purpose of the Programs and How They Work
Services for Native Americans programs were first established in 1978 with the provision of nutrition and supportive services, and in 2000 expanded with the addition of caregiver support services. They provide grants to eligible Tribal organizations to promote the delivery of home and community-based supportive services, including nutrition services and support for family and informal caregivers, to Native American, Alaskan Native and Native Hawaiian elders. These programs, which help to reduce the need for costly institutional care and medical interventions, are responsive to the cultural diversity of Native American communities and represent an important part of the communities’ comprehensive services.
Criteria used to Determine Eligibility for Grants
Formula grants for the Services for Native Americans programs are allocated to Tribal organizations based on their share of the American Indian, Alaskan Native, and Native Hawaiian population aged 60 and over in their services area. To be eligible for funding, Tribal organizations of federally-recognized Tribes must represent at least 50 Native American elders age 60 and over. There is no requirement for matching funds. Separate formula grant awards are made for Nutrition and Supportive Services and Caregiver Support Services.
Tribal Organizations Given Flexibility on Allocation of Resources
After meeting program requirements, Tribal organizations have flexibility to allocate resources among the various activities funded by each program. Tribes may also decide the age at which a member is considered an elder and thus eligible for services. In FY 2011 grants for Nutrition and Supportive Services were awarded to 254 Tribal organizations (representing over 400 Tribes) and two organizations serving Native Hawaiian elders.
Native American Nutrition and Supportive Services
Grants provide funding to tribal organizations to fund a broad range of services to older Native Americans, including:
- Congregate and home-delivered meals
- Information and referral
- Personal care
- Health promotion and disease prevention
- Other supportive services
Native American Caregiver Support Services
Grants assist American Indian, Alaskan Native and Native Hawaiian families caring for older relatives with chronic illness or disability and grandparents caring for grandchildren. The program offers a variety of services that meet a range of caregivers’ needs, including information and outreach, access assistance, individual counseling, support groups and training, respite care, and other supplemental services.
Tribal organizations coordinate with other programs, including the Volunteers In Service To America (VISTA) program, to help support and create sustainable caregiver programs in Native American communities (many of which are geographically isolated). A core value of the Native American Caregiver Support Services, as expressed by Tribal leaders, is that the program should not replace the tradition of families caring for their elders. Rather, it provides support that strengthens the families’ caregiver role.
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Data Highlight Extensive Services Provided to Native American Elders and Their Caregivers
FY 2009 output data give details on the units of service that have been provided through funding for this program:
- Transportation Services provided approximately 894,376 rides to meal sites, medical appointments, pharmacies, grocery stores, and other critical daily activity locations.
- Home-Delivered Nutrition Services provided more than 2.4 million meals to over 20,000 homebound Native American elders, as well as critical social contacts that help to reduce the risk of depression and isolation experienced by many home-bound elders.
- Congregate Nutrition Services provided over 2.0 million meals to nearly 50,000 Native American elders in community-based settings, as well as an opportunity for elders to socialize and participate in a variety of activities, including cultural and wellness programs.
- Information, Referral and Outreach Services provided approximately 1.0 million hours of outreach and information on services and programs to Native American elders and their families. Thus services empowered them to make informed decisions about their care needs.
- In-Home Services provided nearly 1.2 million units of service to assist Native American elder.
- Caregiver Counseling and Support Group Services provided over 30,000 units of counseling and support group services to caregivers caring for elders or grandparents caring for grandchildren.
- Caregiver Respite Services provided close to 90,000 units of respite services to Native American caregivers caring for elders or grandparents caring for their grandchildren.
To obtain more information about the services provided to Native American elders and their caregivers, visit the AGing Integrated Database (AGID), an on-line query system based on AoA-related data files and surveys, and includes population characteristics from the Census Bureau for comparison purposes. The system allows users to produce customized tables in a step-by-step process and output the results in print or spreadsheet form. Information on Title VI Services by Tribal Organization is available through this database.”
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Funding for the Services for Native Americans programs during the past four years is as follows:
Funding Allocations to States and Tribal Organizations
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Resources and Useful Links
The AoA is currently funding three Resource Centers for Older Indians, Alaska Natives, and Native Hawaiians. These centers provide culturally competent health care, community-based long-term care, and related services. They serve as the focal points for developing and sharing technical information and expertise for Native American organizations, Native American communities, educational institutions, and professionals working with elders.
University of North Dakota: Since 1994 the AoA has funded the National Resource Center on Native American Aging, University of North Dakota. A culturally sensitive staff and national steering committee govern the Resource Center. The resource center provides education, training, technical assistance, and research. It also assists in developing community-based solutions to improve the quality of life and the delivery of related support services to the Native elderly population. A major project of this Resource Center has been the development of an elderly needs assessment tool to assist Tribes in planning for elder care services.
University of Alaska-Anchorage: AoA funded the National Resource Center on Native American Aging at the University of Alaska-Anchorage in 2003. Initially, this Center will: 1) empower Native communities to incorporate traditional and contemporary health practices that have the potential to effectively support and treat elders within community health care systems; 2) provide technical information to promote culturally sensitive and functionally appropriate services to maintain social well-being; and 3) provide an arena for discussions about the increasing problems of elder abuse to help Native communities in developing their own plans to reduce and control occurrences.
University of Hawaii: The National Resource Center for Native Hawaiian Elders was established in 2006 under a grant from the Administration on Aging to the University of Hawaii School of Social Work. With the nation’s largest enrollment of Native Hawaiian students, the University of Hawaii has as its mission the development and transmission of knowledge for the betterment of all Native Hawaiians. The National Resource Center for Native Hawaiian Elders seeks to continue this commitment with a focus on improving the well-being of Native Hawaiian elders by forging stronger collaborative relationships between the University, Native Hawaiian and gerontology communities.
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Other Federal Programs
Indian Health Services Elder Care Initiative: The goal of the Elder Care Initiative is to promote the development of high-quality care for American Indian and Alaska Native elders by acting as a consultation and liaison resource for IHS, tribal, and urban Indian health programs.
Centers for Medicare & Medicaid Services: Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) play a critical role in determining the type and quality of healthcare received by American Indians/Alaska Natives (AI/AN). This site will provide information on these programs and highlight aspects of specific interest to AI/AN.
Administration for Native Americans: The Administration for Native Americans (ANA) is a division of the Administration for Children and Families. The mission of ANA is to promote economic and social self-sufficiency for American Indians, Alaska Natives, Native Hawaiians, and other Native Pacific Islanders. ANA provides community-based project funding to improve the lives of Native Children and Families thereby reducing long-term dependency on public assistance. Funding for community-based projects is provided through three (3) competitive discretionary grant programs to eligible Tribes and non-profit Native American organizations.
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