American Rescue Plan Act: Tribal Long-Term Care System Enhancements

Investing in home and community-based services

Tribal nations in Wisconsin received more than $22 million in federal American Rescue Plan Act (ARPA) funds to improve and enhance home and community-based services (HCBS) for their members who are aging or have a disability. The funding supports home, service facility, and infrastructure improvements. Each Tribe can also hire a dedicated Aging and Disability Resource Specialist (ADRS).

Home improvements to support independence

Home improvements make it possible for Tribal members to stay in their homes as they age. Common HCBS home improvements include:

Roofing
Siding
Heating and plumbing repair

Ramps
Mold removal
Window and door replacements

To qualify, they must get HCBS services now or be at risk of needing them in the future. They must also be 55 or older and have at least one functional need. "At risk" means they have a medical diagnosis that may keep them from living on their own.

Infrastructure and facility improvements

These improvements will help deliver specialized care and services to the Tribal community. Durable medical equipment is one example. Many Tribes maintain a supply of wheelchairs, walkers, crutches, hospital beds, and more. With this funding, they can repair or replace equipment so it's ready when needed. Other common investments include:

Generators. Power outages, often caused by severe weather, can cause serious health complications. Medical devices, like oxygen or home dialysis equipment, need electricity to function.
Air conditioners and refrigeration appliances. In the summer heat, people with respiratory issues need air conditioning, and refrigeration is often needed to store insulation and other medications.

More significant capital investments to enhance and strengthen HCBS include:

Renovating, expanding, or building facilities. This will ease overcrowding and better accommodate the demand for services.
Purchasing a shuttle and paving parking lots for improved transportation.
Investing in technology such as tablets and laptops to improve communication and promote telehealth.

Aging and disability resources

An Aging and Disability Resource Specialist (ADRS) answers questions and helps members who are aging or living with a disability apply for programs and benefits. This ARPA funding allows Tribal nations to hire their own Tribal Aging and Disability Resource Specialist or partner with an Aging and Disability Resource Center (ADRC). Tribal ADRS:

Create awareness of Tribal ADRS services within the tribal communities through marketing and outreach.
Counsel Tribal members on community resources available to meet their individual needs.
Promote health and wellness activities.
Create and maintain a loan closet program for durable medical equipment.
Assess community needs.
Use technology and other equipment to enhance and support educational and programming services.
Collaborate with the ADRC to provide services to members in their community

The funding may also cover vehicles, technology, and other equipment to support ADRS educational and programming services.

Impact highlights

All 11 Tribal nations:

Are committed to using these ARPA funds to provide more support and services to aging Tribal members or members living with a disability.
Have or will hire a dedicated ADRS.
Will stock durable medical equipment (DME) to loan to members as needed.
Are investing in technology such as hotspots and tablets. These tools will make it possible for members to get telehealth appointments. They can also access virtual presentations and other center-based activities.

In addition:

More than 100 members have completed needed home improvements.
Tribes that lack adequate transportation are planning to buy shuttle buses or other vehicles to expand access to programs.
Culturally-appropriate initiatives are underway to reduce social isolation and increase health and well-being. Examples include educational programs, walking trails, traditional native medicine gatherings, and more.