Denny Chan: All proper, let’s get began. Welcome to immediately’s webinar, everybody. At present’s webinar is Justice for Tribal Elders, A Useful resource Roundup. I am Denny Chan and I am the managing director for Fairness advocacy right here at Justice in Getting old, and I am joined by my colleague Shahar Takshi. So thanks a lot for becoming a member of immediately’s webinar and we’re very excited to current to you info vital to the wants and the packages that serve tribal elders. Subsequent slide. So earlier than we dive into the nuts and bolts of immediately’s webinar, I might wish to go over some logistics. Once more, welcome to all of you for coming. You’re all on mute, however we welcome your participation in immediately’s presentation via the Q&A operate on the Zoom management panel. Additionally accessible in that very same management panel is the CC button, which permits closed captioning do you have to want it.
I will be anticipating questions as they arrive in all through the webinar immediately. And so I may also uplift these questions and high-level themes via the Q&A phase on the finish of immediately’s presentation. Unanswered questions via the webinar immediately shall be addressed through e mail following the conclusion of our presentation. And you may as well at all times request technical help via the Q&A operate on Zoom and our group right here will do our highest to help you want all Justice in Getting old webinars, our webinar immediately is being recorded, and after the conclusion of this webinar, the slides and the recording shall be accessible on our web site. You must also see a part of that dropped into the chat and it’ll even be emailed to all registrants. We’d very a lot admire your participation in a post-webinar survey that may pop up in your display following the shut of the webinar. Subsequent slide.
And a bit about us right here at Justice in Getting old. We’re a nationwide authorized advocacy group devoted to utilizing the facility of regulation to combat senior poverty. We deal with healthcare, financial safety, and courts for older adults with restricted sources. We have been round for effectively over 50 years and our efforts actually have centered on these communities of older adults who’ve been marginalized and excluded from justice, resembling ladies, folks of coloration, LGBTQ people, and older adults with restricted English proficiency. Subsequent slide. Our dedication to advancing justice right here at Justice in Getting old, we’re dedicated to advancing justice for low-income older adults within the [inaudible 00:03:05] areas that we work in. We wish to be sure that all folks have entry to what they want as they age, since growing old is a common expertise, with out discrimination and no matter their private and social identities. And we advocate for insurance policies that may be sure that these experiencing the best obstacles to packages and companies can train their rights and totally entry the companies that they want.
All proper. Subsequent slide. If you need to affix us right here at Justice in Getting old, we produce a wealth of data like immediately’s webinar and you will get that together with reality sheets, situation briefs, alerts, and different supplies that preserve you updated on essential developments. As you all know, that is an space coverage has been altering rather a lot and so if you need the most recent, you possibly can be happy to affix our community, and for those who aren’t a member of our community, you possibly can go to our web site, join or ship an e mail to data@justiceinaging.org. Subsequent slide. All proper. And so with that I’ll hop off rapidly and cross it over to my colleague, Sahar, to take us via the start of the presentation.
Sahar Takshi: Thanks a lot, Denny, and thanks all for being right here immediately. Earlier than we bounce into the substance of our presentation, I wish to give a little bit of an summary about what we’re speaking about. So our agenda for immediately, we simply went via our introductions and housekeeping, thanks to Denny. Subsequent we’ll be diving into the content material of the presentation and we’ll shut out by sharing a couple of further sources after which opening it as much as Q&A. I wish to start by speaking concerning the reasoning behind not simply placing on this webinar, however Justice in Getting old’s dedication to tribal elders and advancing fairness for tribal elders. As Denny talked about within the introduction, our group at Justice in Getting old has at all times been centered on the connections between older adults and others in marginalized communities and drawing the intersection between age and different identities. This effort was reiterated in 2021 with the event of our strategic initiative to advance fairness, which actually helped our workers hone in on what these intersections appear to be and the way we will greatest serve older adults.
And it was this strategic initiative that we have been known as to develop a undertaking space particular to tribal elders, which I am excited to inform you extra about immediately. The primary impetus for us was via the usage of our fairness advocacy instrument, which is an inner framework that we use to assist us floor our advocacy and our litigation in fairness. And considered one of our colleagues in utilizing our fairness advocacy instrument got here to us and famous that we had some alternatives to study extra about tribal elders. At across the identical time, our fairness advisory council got here to us with the same thought. Our fairness advisory council is a gaggle of exterior companions who’re equally dedicated to advancing fairness for older adults with a deal with many various populations of older adults. And one of many members, Larry Curley, who’s the previous government director of the Nationwide Indian Council on Getting old and a long-time advocate for tribal elders, got here to us once more reiterating that we had room to study extra and that we may actually assist in advancing fairness for tribal elders. And that’s how we received began.
In growing this undertaking space, it was actually essential to us to be constructing very significant and powerful partnerships with tribal leaders, tribal organizations, older adults who’re American Indian or Alaska Native, and different advocates who’ve been dedicated to this work for a really very long time. I want I may listing each one who has lent their time to us, however I’ve listed a couple of of them on the display right here. People on the Nationwide Indian Council on Getting old, the Native American Elder Justice Initiative, Michigan Indian Authorized Providers, and extra not too long ago people from the Cash Follows the Individual Tribal initiative who’ve been so beneficiant in serving to us to know the wants of tribal elders from the angle of oldsters who’ve direct expertise.
We’ll be speaking quite a bit about numerous packages that tribal elders may use, however I needed to start out simply by speaking about who tribal elders are. By some estimates there are over 1 million American Indian and Alaska Native people who find themselves age 65 or older residing within the US. There are 574 federally acknowledged tribes within the US. And so whereas on this webinar we’ll be speaking about tribal elders as one inhabitants. I do wish to emphasize that there’s great variety by way of the historical past, the traditions and tradition in addition to the geography and even a few of the obstacles that may be confronted by numerous tribes relying on the a part of the nation and their particular historical past. Okay. We’re going to launch our first ballot query for our viewers. I am curious to study what you’re most excited by studying about immediately. Is it A, greatest practices for participating with tribal elders, B, packages focused to tribal elders, C, navigating authorized points and authorized exceptions for tribal elders, or D, the entire above. We’ll depart that open for an additional 30 seconds.
I believe we will go forward and finish the ballot and I’ll share the outcomes. I am unsure if people are in a position to see the outcomes, however in case you are not, appears that 17% have been on the lookout for greatest practices. One other 17% trying to find out about packages, 8% navigating authorized points, and the overwhelming majority, 58% on the lookout for the entire above. Subsequent we’ll be speaking about cultural issues. I wish to begin the part off with this quote from the Nationwide Congress of Indian Individuals. The quote says, “Tribal sovereignty is a authorized phrase for an abnormal idea, the authority to self govern.” Tribal sovereignty is an idea that’s central to tribal governance and to tribal tradition and their interactions with the assorted packages that we’ll be speaking about immediately.
So what’s tribal sovereignty? Tribal sovereignty is one thing that has been repeatedly affirmed via treaties, via Supreme Court docket rulings, via statements by congressional and government leaders over many, a few years. And tribal sovereignty affirms that tribes inside the US retain their inherent powers of self-governance. So what does this imply? Which means that in dealings between the US federal authorities and tribal nations, these are thought-about government-to-government relationships. Our companions have emphasised to us repeatedly that any options referring to tribal communities, together with tribal elders, do must middle tribal sovereignty, together with in the best way that packages are arrange, in the best way that tribal nations have been consulted in selections affecting them and so forth.
One other theme that’s central to our work round tribal elders has been cultural responsiveness. As I discussed earlier, there may be great variety amongst completely different tribes by way of their historical past, their geography, their tradition, but in addition by way of the obstacles or inequities that may impression their group. So for outreach and repair supply to be impactful and significant in tribal communities, people must contemplate focused approaches to the actual tribal inhabitants, to the actual geography that’s at situation. So I’ll discuss via a couple of examples of these. So one consideration in relation to focusing on round language may be that some tribal elders could know their native language and should admire supplies in that language, whereas others could not comprehend it as a result of historical past of oppression and Indian boarding faculties, people could not have had the chance to study the language. Equally, religious practices and traditions and celebrations are important to many tribal elders’ well-being.
So for instance, a tribal elder residing in a nursing facility could actually need the workers to know that they’ve a sacred object or a celebration that they wish to attend in order that they are often enabled to speak with their group in that means. People who’re collaborating with tribes would wish to find out about indigenous values, which regularly focus across the collective and round sharing knowledge with youthful generations. And these are issues that may impression the best way selections are made. After which after all, as I’ve talked about a couple of occasions, geographical issues and even digital issues may fluctuate for tribes. So for instance, people who dwell on extra distant components of a reservation or extra distant reservations could face problem in attending to one thing like a well being clinic or a discipline workplace. Equally, digital obstacles may be a priority for some. If broadband web isn’t tremendous accessible in part of the nation, you wish to be thoughtful as such for those who’re speaking with tribal communities.
I needed to share this graphic that I believe actually highlights the view of elders in tribal communities. It is from a article that was printed simply this yr, and as you possibly can see on this graphic, as I discussed, the view round elders and tribal group isn’t essentially associated to 1’s chronicle age, one’s numerical age, however has so many different elements that make up elderhood. So a few of these may be an elder’s contributions to the group and the best way they supply care, it may additionally be an elder’s recognition for realizing and residing and educating conventional experiences and transmitting that to subsequent generations. It can also embody the elders who present a imaginative and prescient and who floor the group in traditions. Okay. We’re going to launch our subsequent ballot query for immediately. Our subsequent ballot query is, have you ever had any coaching on cultural competency referring to American Indian or Alaska Native communities? The responses are sure, considerably, or no. We’ll depart this open for an additional 15 or 20 seconds.
I believe we will finish the ballot and we’ll share our outcomes. About 34%, or break up fairly evenly, about 34% mentioned sure, 32 mentioned considerably, and 34 mentioned no. Thanks. Okay. So we’ll dive into our subsequent part centered on healthcare. So earlier than we start, I wish to emphasize that we’ll be speaking about sources of healthcare, however there are various, many points impacting tribal communities in relation to healthcare that we may cowl and I’ll level to a few of our sources on the finish of the presentation that speak about them. What’s essential to notice is that American Indian and Alaska Natives within the US face a few of the largest well being disparities of any inhabitants, and that is significantly true within the areas of persistent sicknesses resembling diabetes, but in addition by way of different situations together with psychological well being situations in addition to a considerably shorter lifespan.
And that is after all significantly regarding and putting given the tribal sovereignty that tribal nations are alleged to have and the duty of the US authorities to supply healthcare companies to tribal nations. I’ve listed a couple of of the obstacles that contribute to a few of these well being inequities, however after all this can be a few bullets of what may very well be a for much longer listing. I additionally wish to emphasize that the basis of many of those obstacles is as a result of legacy of many, many centuries of oppression, of displacement and genocide, after which after all steady underfunding of well being care companies directed at tribal communities. However a couple of trendy obstacles that impression tribal communities’ entry to healthcare protection embody problem in getting details about eligibility and enrollment and simply the challenges that include navigating these tough processes. We have heard from a lot of our companions that the restricted variety of suppliers on reservations and in different rural areas the place tribal elders may dwell is sort of a priority.
And lastly, limitations in accessing culturally competent care. So for instance, care that’s offered by someone who’s from the group or people who’ve the suitable coaching for that. Subsequent I’ll be speaking about some sources of healthcare and healthcare protection that tribal elders can entry. And the primary of those is the Indian Well being Providers or IHS. IHS is a federal program that gives healthcare via 45 hospitals and 780 clinics throughout the US, serving over 2.5 million American Indian and Alaska Natives within the nation. And IHS is a really important supply of care. It’s a bodily place that individuals who belong to federally acknowledged tribes can go to get care, nevertheless it does include a few of its personal gaps. Specifically funding restrictions restrict the variety of IHS services which might be accessible. And so for people that dwell in geographically distant areas, it may be very difficult to get to an IHS facility. These funding restrictions additionally impression the supply of suppliers, together with specialists.
Constructed into IHS is a course of known as Bought and Referred Care. So if someone must go outdoors of the IHS community to see a supplier, for instance, if they do not dwell near a facility or if their facility does not have the type of specialists or equipment that they want, they will use the Bought and Referred Care course of to get a referral to go outdoors of the IHS community. Sadly, Bought and Referred Care isn’t entitlement, which means it’s not assured. So someone can submit a request for a referral and it may not get licensed relying on funding or different issues. IHS does additionally function what are known as City Indian Well being Applications that present companies for people that dwell off of the reservation. So I simply needed to flag that as effectively.
The following supply of healthcare protection that’s accessible to tribal elders is Medicare. Medicare is the federal medical health insurance program that’s accessible to anybody who’s over the age of 65 or who has sure disabilities, and this consists of tribal elders who’re over the age of 65 or meet these definitions of incapacity. Medicare is extraordinarily essential and it could assist to fill in a few of the gaps that may be left by IHS. Nevertheless, Medicare does have price sharing that may be excessive for the person relying on their scenario. So there are the prices of premiums and co-pays and deductibles. The nice factor is there are packages which might be accessible that may assist decrease these prices, and I’ve listed a couple of of them on the display right here. These can embody the Medicare Financial savings Program that helps with premiums, the Certified Medicare Beneficiaries program that helps with deductibles and co-pays and the Medicare Low-Earnings Subsidy that helps with the price of pharmaceuticals.
One other medical health insurance program that’s accessible to tribal elders is Medicaid. Medicaid is a joint federal and state medical health insurance program that’s accessible for folks with low earnings. As a result of it’s a joint program with states, the earnings and asset limits for who can qualify will fluctuate by state, however there are federal carve outs within the regulation that may make it just a little extra accessible for tribal elders, for people who find themselves members of federally acknowledged tribes to qualify for Medicaid. So for instance, sure forms of earnings associated to the sources on a reservation may be accepted.
Medicaid is one other technique to complement healthcare for those that qualify as a result of it not solely helps make the price of Medicare extra inexpensive, a few of these price sharing items that we simply talked about, nevertheless it additionally supplies some companies that aren’t coated by Medicare. And I might say the chief amongst these is residence and community-based companies, that are what permit older adults and other people with disabilities to stay of their communities versus going to an institutional setting like a nursing facility.
So taken all collectively relying on their age, incapacity, their membership to a federally acknowledged tribe and their earnings and property, a tribal elder may be eligible for all three of those sources of healthcare, each Medicare, Medicaid, and Indian Well being Providers. And I emphasize this as a result of as we have been speaking, you might have seen every of those packages does have its personal gaps and limitations, however after all taken all collectively a person might need entry to a extra sturdy supply of care. Okay, I’m going to cross it to Denny for this subsequent part.
Denny Chan: Thanks, Sahar. And I ought to have talked about originally, this was my oversight, however we known as this a useful resource roundup as a result of since 2023 once we began trying on the points impacting tribal elders extra intently, we have been releasing plenty of sources. And so that is meant as an summary of a few of these sources and to attach you to these sources as effectively. So we’ll be, and we now have been dropping hyperlinks within the chat to these sources and there is additionally a slide on the finish of the presentation with these sources as effectively. However I’ll discuss just a little bit about financial safety. So subsequent slide. Much like what Sahar highlighted within the healthcare house, the identical forms of inequities that tribal elders expertise actually at the next proportion in financial safety as effectively. So native elders expertise poverty at twice the speed of all older adults on this nation.
The speed is 3 times as a lot as the speed that White folks expertise and that goes even greater for these tribal elders who’re residing on reservations. This after all, is tied to and comes from most of the elements that Sahar already highlighted in a few of her content material, however it’s made even worse by points with healthcare protection, price of residing, caregiving tasks, all proceed to push tribal elders additional into poverty. A lot of these elements being common, that many older adults expertise, and a few of them actually coming from the discrimination and the lengthy legacy of discrimination that Native American communities on this nation have skilled. Subsequent slide.
So in mild of these financial inequities, what packages and what sources can be found to tribal elders to actually assist them make ends meet? And the primary actually is a program that’s accessible to many others, however together with tribal elders, social safety. So social safety lifts thousands and thousands of older adults together with tribal elders out of poverty yearly. And the final eligibility necessities are that you need to be 62 and older, you need to have labored a sure variety of quarters, roughly 10 years, so as to be eligible to obtain social safety retirement advantages. After which a fast word right here that people who find themselves the partner, ex-spouse, minor baby, or disabled grownup baby of a deceased eligible beneficiary can obtain survivor advantages. Subsequent slide.
Along with social safety retirement, there’s additionally social safety incapacity. So that is related for people with disabilities together with tribal elders with disabilities who even have the requisite work historical past can entry social safety incapacity advantages. They’ve to satisfy the federal government’s definition of incapacity. And the requisite work historical past is usually 5 out of the previous 10 years. Subsequent slide. There’s additionally Supplemental Safety Earnings, in any other case generally known as SSI. That is accessible to people who’re 65 and older, together with tribal elders or these with a incapacity who’ve low earnings and property. So there are eligibility necessities right here that relate to earnings. A fast word and flag as an summary that there are carve-outs for eligibility necessities that exclude sure forms of property for members of federally acknowledged tribes. In the event you do meet the eligibility necessities, then SSI supplies a modest month-to-month cost that basically is vital for low-income tribal elders.
The utmost quantity which you can get in 2025 is $967 a month. And naturally any earnings or items that the person receives will get subtracted from that quantity. And I’ll drop within the chat our hyperlink to a short that we launched earlier this yr, I believe, on supporting tribal elders via social safety, which talks extra about a few of these carve-outs and the methods during which these packages may also help tribal elders meet their prices. Subsequent slide. And I believe with that, that wraps up our financial safety portion. I’ll flip issues again to Sahar who will discuss via another points round diet, caregiving, and authorized companies assist.
Sahar Takshi: Thanks, Denny. In order Denny talked about, I’ll be speaking about some diet, caregiving, and authorized companies, and particularly I’ll be speaking concerning the Older Individuals Act or OAA. The OAA is the cornerstone piece of federal laws that addresses the wants of older adults. The OAA does many, many issues together with establishing federal and state businesses that oversee packages impacting older adults, packages for older adults. It is also establishes Space Companies on Getting old, also referred to as AAAs, which administer these packages on the native stage. The OAA supplies authority for a lot of completely different sorts of companies to be offered for older adults within the US. These embody diet companies resembling congregate meal websites and meal supply companies, in addition to senior facilities, assist companies for caregivers resembling Respite. And it additionally establishes the long-term care ombudsman program.
There’s a lot that the Older Individuals Act does, however immediately I’ll focus particularly on Title III and Title VI of the Older Individuals Act. So Title III of the OAA is the half that authorizes funding to the states for residents of that state and the state can use these funds to supply companies for anyone who’s in that state and is 60 or older. There are a selection of companies which might be accessible via the Older Individuals Act. I listed a couple of of them on the slide earlier than, however there are others as effectively, resembling authorized companies. And whereas the Title III, Older Individuals Act companies can be found to anyone in that state who’s age 60 or older, there are not any earnings necessities. The state is required to focus on these companies and that outreach to individuals who have the best social and financial wants.
Then again, Title VI of the Older Individuals Act supplies funding on to tribes or members of federally acknowledged tribes. Not like Title III, the tribes are allowed to set the age restrict for which an older grownup can entry Title VI funds. Many tribes have chosen age 50 or 55 because the age during which an elder can entry Title VI companies. Nevertheless, Title VI companies are extra restricted. The authority for that’s particular to diet companies, caregiver helps, and supportive companies which might embody issues like transportation, case administration, and outreach packages. In order you possibly can think about, there is a world during which a tribal elder can entry companies via Title VI, however as a result of they dwell in a selected state, they may additionally be capable of entry Title III companies, proper? In the event that they meet the age necessities and if they’re resident of that state, they may be capable of entry each. And in reality, the regulation does require coordination between Title III and Title VI to maximise the companies which might be accessible to tribal elders throughout the nation.
So one instance of what that coordination may appear to be and the way these funds can be utilized to raised serve tribal elders is a Title III fund for use to supply companies to tribal elders which might be 65 and older whereas Title VI funds are reserved for people who find themselves in that youthful vary. Different examples of coordination embody a AAA, a Title III program offering funding or contracting with a Title VI program. It may imply a AAA establishing a task of a tribal liaison, someone whose job it’s to go meet with tribes to supply companies and trainings and to report again.
It may additionally appear to be the Title VI program and the Title III program recurrently assembly collectively, exchanging info, perhaps co-hosting programming collectively. Primarily based on the newest survey of Title VI packages within the nation, about 70% of Title VI packages have famous that there’s some stage of collaboration between the Title VI program and the Title III program of their state. Nevertheless, lower than 18 of these are monetary coordination items and are extra centered on conferences and co-hosting. Okay, I believe we will launch our final ballot query of the day. And the query is, what has been your expertise with reference to coordination between state or county businesses and tribes? And this does not need to be particular to Older Individuals Act, this may very well be different forms of coordination. We’ll depart it open for an additional 25 seconds or so.
I believe we will shut the ballot. And our outcomes, 14% mentioned there may be sturdy coordination with native tribes in my state, nearly all of folks, 62% mentioned there may be some coordination with tribes in my state, however there’s room for extra, and 24% mentioned there may be little to no coordination with tribes in my state. Thanks all. Okay. And that closes out our substantive portion of the presentation. However earlier than we transfer on to Q&A, I do wish to share a couple of of our sources. So the title of the presentation immediately is Justice for Tribal Elders, A Useful resource Roundup. Denny and our workers have kindly been placing hyperlinks to a few of the sources that we have developed within the chat as they associated to completely different components of the presentation. I am additionally itemizing them right here on this slide and the slides shall be made accessible after the presentation so you possibly can entry these hyperlinks in a while as effectively. I do encourage you to look via these and when you’ve got any questions on them later, be happy to succeed in out to us. And with that, I believe we will transfer on to Q&A.
Denny Chan: All proper. Thanks, Sahar. So I have been trying on the Q&A as they arrive in and encourage all of you who’re on to proceed typing in questions. We will give Sahar a few minutes to have a look at a few of them, however simply to kick us off, Sahar, I wish to ask two questions off the highest of the bat. The primary is to return to the slide on the three sources of protection, Medicare, Medicaid, and IHS. In the event you return to that slide, so historically once we work with advocates, we speak about how Medicaid is the payer of final resort. Medicare can be major for companies which might be coated below each Medicare and Medicaid. After which IHS now introduces a 3rd potential supply of protection slash to payer. So there is a query right here about how all that works with the triple eligibility and for those who can say extra about who’s paying when after which we will transfer on to another questions.
Sahar Takshi: Yeah, after all. And to emphasise, like Denny mentioned, it might rely upon the person’s particular scenario, their age, their incapacity, whether or not they’re a member of a federally acknowledged tribe, their earnings so as to qualify for all these packages, to be triple eligible. But when someone is triple eligible primarily based on all these elements, IHS to emphasise isn’t a medical health insurance program, it’s a healthcare supplier, primarily. These are clinics and hospitals which might be accessible to people who find themselves members of federally acknowledged tribes. And so for those who go into an IHS facility and also you do qualify for IHS companies, then IHS is the one who pays.
Nevertheless, in case your IHS hospital or clinic does not have the companies that you just want, or for those who do not dwell close to one, you may wish to go outdoors of the IHS community. As I discussed through the IHS part, there’s a course of for which you may be capable of get the IHS to pay so that you can go outdoors of that community, however that isn’t a assure, that cash isn’t at all times accessible and there are various administrative burdens related to that and that is the place Medicaid and Medicare may grow to be extremely helpful to a person as a result of they’re medical health insurance packages that may assist to cowl the associated fee for those who do not go to an IHS facility, for those who go to someone outdoors of that community. I hope that solutions that query.
Denny Chan: I believe that is a useful, extra detailed description of the way it all works behind the scenes since I do know that may get complicated and these packages are complicated sufficient. So there’s one other thread of questions actually asking about all of the modifications this yr, whether or not that pertains to the impacts of H.R.1, in any other case generally known as the OBBA, or presently the federal authorities is shut down. Are you able to say something about how any of those modifications or any of those points, whether or not it is H.R.1 or the shutdown are impacting both IHS or different packages and companies that work with tribal older adults?
Sahar Takshi: Completely, sure. There have been loads of modifications and loads of uncertainty this yr and sadly tribal elders have and shall be impacted by them. H.R.1 does speak about IHS barely, nevertheless it does not essentially minimize funding from IHS. I do advocate reaching out or trying on the sources accessible from the Nationwide Indian Well being Board on that specific subject as they’ve submitted letters that I believe actually spotlight what the problems round H.R.1 are. However simply because H.R.1 does not discuss too deeply about IHS, that doesn’t imply that tribal elders won’t be impacted by H.R.1. H.R.1 has some tremendously unfavourable potential impacts for recipients of Medicaid. And as we talked about, Medicaid may be a supply of protection for a lot of tribal elders. And in reality, relying on what sort of care they’re on the lookout for, for instance, residence and community-based care, Medicaid may truly be considered one of their solely sources of protection there. So the cuts in funding, the proposed work necessities, all of those can have a tremendously unfavourable impression for tribal elders as effectively, sadly.
Denny Chan: Nice. Nice as in nice for answering the query, not a fantastic impression on the communities we care about. There’s one other bucket of questions as I type via them which might be actually coming from individuals who I believe try to do some outreach to tribal communities and who haven’t perhaps gotten the identical response or enthusiasm that they have been hoping to get. And I do know that is one thing that we have talked about. That is half and parcel to why we began off our work, actually pondering via who’re the best companions or who the companions we needed to carry on board have been. So any insights or suggestions for individuals who wish to do extra outreach however are discovering it arduous to actually get their foot within the door?
Sahar Takshi: Completely. Yeah. I believe it is nice that people are interested by this and asking these questions and there positively was a studying curve for us in constructing partnerships with tribal communities and tribal advocates as effectively. One factor I do wish to word is that relying on the tribe or the group, staffing is usually a difficulty and so simply the supply of time is just a little bit restricted. However what we discovered has been actually useful is considering native values once we’re constructing these relationships. We discovered and have been instructed by a lot of our companions on this area that issues like face-to-face communication or the chance to actually get to know each other earlier than diving into the extra nitty gritty of the work items is de facto valued in the neighborhood, constructing that private connection earlier than moving into regardless of the skilled ask may be.
We have additionally discovered that it’s actually essential to show the dedication to constructing that partnership, the dedication to that relationship versus perhaps a one or two off dialog, constructing a relationship with a tribe or with a company that you just intend to maintain for a very long time, that you just intend to collaborate with for a very long time and show what that may appear to be. We discovered that that has been actually profitable and has truly been far more informative than perhaps assembly only one or two occasions to find out about a particular subject, however permitting the connection to blossom into studying about different ways in which we would wish to collaborate as effectively.
Denny Chan: I believe one other piece to notice and perhaps, Sahar, you possibly can discuss extra about why, I believe even once we have been doing a few of our first work on this the place we hit extra partitions than we have been anticipating, the place does all that come from? And I believe why is it that persons are not experiencing the identical enthusiasm as different outreach initiatives?
Sahar Takshi: Yeah, completely. We won’t ignore the legacy of oppression and harms finished to tribal communities within the US. And I believe that does present up in generally the best way that we do outreach. I believe so many tribal nations have had unfavourable experiences with the federal authorities and even generally state governments not respecting tribal sovereignty, not respecting treaties obligations resembling offering healthcare and only a relationship that has been far more about taking than collaborating and giving. And so I actually do assume that’s generally the supply of loads of the distrust and that is why demonstrating why you is usually a reliable and long-term companion and long-term advocate is so essential.
Denny Chan: All proper. So I’ll bounce us over to the OAA items and for those who can transfer again to the Title III versus Title VI slide. There was a query right here actually simply asking you to make clear how they’re completely different and the way they are often coordinated and work in apply.
Sahar Takshi: In fact. Yeah. So Title III and Title VI are at their core, they’re simply completely different components of this huge piece of laws that’s the Older Individuals Act, however what they do is they supply completely different buckets of funding. And so these are completely different congressionally accredited quantities. Title III goes to the states and can be utilized for residents of that state who meet the age requirement and the state can resolve how they supply these companies and what companies can be found. Title VI is its personal separate bucket of funding and that goes on to tribal nations for use for members of federally acknowledged tribes. Like as proven on the display, there are a couple of variations. The age necessities are allowed to be completely different for Title VI packages and the forms of companies that these funds can be utilized for are far more restricted for Title VI than for Title III.
However that’s the reason coordination and collaboration is so essential between the 2. Proper? So a person, a tribal elder who’s perhaps a member of Navajo Nation residing in Nevada may be capable of entry each Title VI and Title III via the Navajo Nation’s Title VI program in addition to the state of Nevada’s Title III packages. That collaboration actually does fill in a few of the gaps that may be left by Title VI. As I discussed, it is a way more restricted quantity of companies. Additionally it is a way more restricted pool of funds. So it’s a lot much less cash that’s directed to tribes than to the states.
And that collaboration and coordination isn’t just a pleasant factor to do, it’s a authorized requirement to occur, however the states and the tribes do have loads of flexibility in what that coordination seems like. So I believe on the following slide I listed a couple of examples of what that coordination may appear to be. And I believe the bulk, about 70% of Title VI packages do interact in some type of coordination, however as a result of restricted funding that’s given to Title VI, it could usually be an enormous burden for them to provoke that or to be those to guide what that coordination seems like. So I believe that is a chance for lots of Title III packages to step up and perhaps provoke, be those to host the assembly, to care for the schedule and issues like that.
Denny Chan: All proper. Thanks, Sahar, and hopefully that is clear to the one who requested round how they’re completely different and tips on how to coordinate. There is a query right here. So that you began the presentation speaking about a few of the values which might be essential in endeavor this work. And so there is a query about how do you combine cultural responsiveness into this work? One query, this query particularly will get on the situation round language for example, and I believe you highlighted that on considered one of your slides the place there was a scenario the place the elder was speaking and there was a miscommunication and as an alternative of being moved, which is what the elder needed in that second, the individuals who have been speaking together with her misunderstood her and as an alternative administered extra morphine, which is what they thought she was saying. So any suggestions or insights on tips on how to bridge a few of that hole by way of ensuring that there’s cultural responsiveness in working with tribal elders?
Sahar Takshi: Yeah, completely. That is a very nice query. I believe the problem of language and language entry is one that’s related for tribal elders however for a lot of different communities as effectively. I believe that is an space the place packages can take into consideration focusing on their companies just a little extra primarily based on the distinctive make-up in their very own state or of their locality. So we talked immediately about tribal elders as being this one large group, however everyone knows that no group is a monolith. There’s going to be distinctive languages, cultural expectations, traditions, issues like that primarily based on the tribe, primarily based on the world.
So I believe language is an space during which people can, if their program permits it, to discover what are the native tribes in your space. What are the languages which might be spoken? Are they generally spoken? For instance, some native languages are predominantly oral traditions fairly than written traditions. So that you may wish to know that and study that, however after all it is arduous to get it proper on a regular basis. Anyone may not, you may not know that, you may not have had the power to organize for that. I believe it is actually essential to attempt to talk with the older grownup as a lot as potential. However sometimes in tribal communities, group and household are, there’s loads of emphasis positioned on group and household. And so we have heard from loads of our companions that a person might need a group member, a member of the family, one other elder who they actually do depend on, who they do look to. And so in the event that they do give permission to speak to someone else, that may be a chance to discover whether or not you possibly can actually higher perceive what that particular person is wanting in that second.
Denny Chan: Thanks. Yeah. So that you all weren’t shy with questions and questions are nonetheless coming in through the Q&A, so I encourage you to maintain asking questions. As a reminder, the questions we’re not taking dwell, we’ll observe up over e mail to the perfect of our means and both reply them there or join you with different sources. If I zoom out and take a look at a few of the different unanswered questions, Sahar, there’s one other thread round housing and housing insecurity for tribal elders. Any sources or something that you have come throughout in your work that we will level people to on helps for tribal elders within the housing context?
Sahar Takshi: Yeah. That’s positively an space of a lot curiosity and sadly one which we do not have a ton of inner sources on, however I consider the Nationwide Indian Council on Getting old has finished fairly a bit of labor round housing and so I might say that is a very excellent spot to start out. If I am remembering accurately, they’ve a sub net web page on their web site particular to housing for tribal elders.
Denny Chan: Nice. And we simply dropped, thanks to Shelby on our group for dropping the hyperlink within the chat. We’ll additionally join with a few of our housing attorneys internally right here and see if there are different sources. Clearly to the extent that there are packages and companies, tribal elders can be eligible like different older adults for them as effectively.
Okay. So I am having a look at the remainder of the questions. I believe it most likely is sensible for us to do and to select up on one of many issues that another person has mentioned to do, perhaps an FAQ. We will attempt to flow into an FAQ afterwards with a few of the most continuously requested questions. There are some which might be most likely one-offs that we’ll attempt to reply our greatest over e mail. So with that, I’ll say thanks for becoming a member of us. Be happy to maintain these questions coming and attain out to me or Sahar over e mail. Our contact info was on that final slide there. You may get a recording and the slides after the presentation immediately. And an enormous thanks to Sahar for doing the heavy lifting on this, particularly whereas she is just a little below the climate. You most likely could not inform. However thanks, Sahar. Thanks everybody else for coming immediately and we stay up for reaching out and being in contact. So thanks very a lot.
