Home and Community Based Services for Native Americans

Across the United States, Native American communities face unique challenges when it comes to accessing healthcare and social services. Fortunately, there are programs designed to address these needs and empower individuals with disabilities and elders to live fulfilling lives within their own communities. These programs are known as Home and Community Based Services (HCBS).

Native American Population 

An estimated seven million Native Americans currently live in the United States with 574 federally recognized tribes and 63 state-recognized tribes. Native Americans make up about 2% of the US population.

What are HCBS Programs?

HCBS programs provide a range of services that allow individuals to remain independent in their own homes, avoiding the need for institutional care facilities. This can include assistance with daily living activities such as bathing, dressing, and meal preparation. HCBS can also encompass transportation services, help with managing finances, and respite care for family caregivers.

Importance of Culturally Competent Care

For Native American communities, culturally competent care is essential. HCBS programs that are designed with tribal values and traditions in mind can better serve the unique needs of their populations. This means incorporating traditional healing practices alongside mainstream medical care and ensuring that service providers have a strong understanding of the history, culture, and languages of the people they serve.

Finding HCBS Programs

The landscape for HCBS programs can vary depending on location and tribal affiliation. Here are some resources to help you find HCBS programs:

• Tribal Health Programs: Many tribes operate their own health clinics and social service agencies that offer HCBS programs. These programs are often tailored to the specific needs of the reservation community. For more information on Tribal/Urban Indian Health Centers, see Title I | Office of Direct Service and Contracting Tribes (ihs.gov) or Office of Urban Indian Health Programs | Indian Health Service (IHS).

• Indian Health Service (IHS): The IHS, a federal agency within the Department of Health and Human Services, provides a variety of healthcare services to federally recognized tribes. IHS may also offer or partner with HCBS programs.  Visit their website for more information at: www.ihs.gov.

• Administration for Community Living (ACL): The ACL funds programs that support American Indians, Alaska Natives and Native Hawaiians in the areas of nutrition, supportive services for older adults, and caregiver services.  More information can be found here Services for Native Americans (OAA Title VI) | ACL Administration for Community Living.

• State HCBS Programs: Some states have established HCBS programs that are accessible to Native Americans living on and off reservations. These programs may have specific eligibility requirements, so contacting your state’s HCBS agency is recommended. You can find more information by visiting Medicaid.gov.

Building Stronger Communities

HCBS programs, along with other available resources, are a vital part of ensuring that Native Americans have access to the care they need to live well in their communities. By prioritizing culturally competent care and collaboration between tribes, states, and federal agencies, HCBS programs can empower individuals and strengthen tribal communities for generations to come.

by Sandra Woodward
Client Engagement Manager