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Tribal Consultation

DOH & FCS Tribal Programs

DHSS works with Alaska’s Tribal Health Organizations (THOs) through a variety of ongoing programs. This list provides an overview of the department’s ongoing Tribal partnerships, activities and programs, organized by DHSS division.

Commissioner’s Office

  • Provide assistance on Tribal consultation policies.
  • Participate quarterly in the State Tribal Medicaid Task Force (MTF) to collaborate on Tribal Medicaid reimbursement and policy issues. 
  • DHSS directors and the MTF participate biannually in the Alaska Native Health Board Mega meeting.
  • Partner with Tribal Behavioral Health Directors and the Tribal Community Health Aide Program on an ongoing basis to establish codes, reimbursement and service delivery models statewide.
  • Partner with Tribal travel entities to create, implement and operationalize travel offices at Alaska Native Tribal Health Consortium (ANTHC), Yukon-Kuskokwim Health Corporation (YKHC) and Tanana Chiefs Conference (TCC).
  • Meet quarterly with THOs on Tribal Medicaid Administrative Claiming to reimburse THOs for Medicaid eligibility enrollment and outreach efforts across the state. Federal match provides 50 percent reimbursement for administrative roles.
  • Partner with THOs and Division of Public Assistance (DPA) to maintain and oversee a DPA staff member at Alaska Native Medical Center (ANMC) to process hospital presumptive eligibility, pregnant woman and medical emergency applications.
  • Partner with THOs on capital projects, such as Long Term Care (LTC) in Kotzebue and Bethel, enhanced capacity with residential housing at ANMC and enhanced service capacity in orthopedic surgeries, NICU, OB and ophthalmology.
  • Support THOs for bond bank requests such as YKHC hospital and TCC projects.

Health Care Services

  • The Section of Tribal Health currently partners with 18 THOs to verify referrals for services provided to American Indian/Alaska Native (AI/AN) members by non-Tribal providers. This effort is part of the ongoing Tribal Refinancing initiative to reclaim additional federal funds based on a recent clarification from Centers of Medicare and Medicaid Services (CMS) regarding services “received through” an Indian Health Service (IHS)/Tribal facility.
  • The Tribal Health section partners with the Alaska Native Tribal Health Consortium (ANTHC) to educate non-Tribal providers about Tribal Refinancing and to encourage non-Tribal providers to sign the care coordination agreement (CCA). Currently, there are over 1,500 CCAs signed which includes the participation of 18 THOs and 143 non-Tribal providers.
  • Tribal behavioral health units at six THOs, the DHSS Division of Behavioral Health and Qualis Health collaborate to ensure THOs are involved in the referral process for children placed in out-of-state residential treatment facilities. The process being developed also guarantees that the AI/AN child will be connected back to the THO once they are discharged from the out-of-state residential facility. This assists DHSS in reclaiming additional federal funds.
  • Tribal Health, ANTHC, Southcentral Foundation (SCF) and Providence Extended Care LTC Tribal Claiming Work Team work together to streamline and solidify care coordination, referral and exchange of records, between agencies.

Division of Alaska Pioneer Homes

The Division of Alaska Pioneer Homes has two official Tribal Partnership agreements:

  • Care Coordination Agreement with Alaska Native Tribal Health Consortium (ANTHC). This agreement simplifies continuity of patient care and the timely transfer or referral of elders and record sharing between the facilities.
  • The Ketchikan Pioneer Home is home to the community’s Indian Education Preschool Program, which is administered through the Ketchikan Gateway Borough School District.  This successful intergenerational program has been a model for others like it since 2004 and continues to offer opportunities for the children and elderly “grandparents” to interact in meaningful ways. 

Other Pioneer Homes across the state have other informal working relationships and activities with Alaska Tribes that benefit and enrich the lives of elders.

Division of Behavioral Health

DBH works with Tribal Behavioral Health Departments to increase rural behavioral health services so individuals can receive care closer to home. The DBH Tribal Liaison has also worked closely with all Tribal Behavioral Health Departments on DBH Medicaid Regulations and billing assistance so Tribal Behavioral Health Departments can increase Medicaid revenue. 

The DBH Tribal Liaison works closely with the ANTHC Behavioral Health Aide Program, sits as a non-voting member on the Behavioral Health Aide Review Committee and is working on the implementation of the Behavioral Health Aide State Plan Amendment. The DBH Tribal Liaison attends quarterly Tribal Behavioral Health Director meetings and the quarterly Medicaid Task Force Meetings.

Division of Juvenile Justice

The Division of Juvenile Justice (DJJ) has several existing partnerships with Tribes throughout Alaska:

  • Six month prevention mini-grants through RurAL CAP funding, which support local Tribes and communities to provide youth leadership and cultural camps; 
  • Tribal Diversion Agreements to create an opportunity for DJJ and tribes to work together to address delinquency referrals for youth;
  • Memorandum of UnderstandingPDF
  • Cultural programming and community activities for youth in DJJ custody that increase access to cultural foods, stories, traditions, and elders. 
  • For more information:  

Division of Office of Children’s Services

  • Transforming Child Welfare Outcomes for Alaska Native Children: Strategic Plan 2016-2020: This five-year strategic plan, funded and supported by the Casey Family Programs and Clarus Consulting group, is aimed at transforming outcomes for Alaska Native children. It is the result of collaborative work by the department, First Alaskans Institute, Tribal leaders, partners, elders, advocates, legal representatives, and child welfare representatives.
  • Alaska Tribal Child Welfare Compact: The Compact is a government-to-government agreement between the State of Alaska and Alaska Tribes and Tribal Organizations. It recognizes Tribes’ inherent sovereign authority to serve their citizens as they have since time immemorial. It provides definition of the services to be carried out by Tribes and Tribal Organizations in a defined jurisdiction or service area. This is Alaska’s first Tribal-state compact and opens the door to create other government-to-government agreements in other service areas beyond child welfare and DHSS.
  • Knowing Who You Are (KWYA), an Indian Child Welfare program: KWYA provides a framework for participants to identify and explore racial and ethnic identity and to understand how one’s race and ethnicity impacts both personal and professional interactions. The three-part training includes participating in a pre-workshop teleconference (about 1 hour), completing a participant handbook (about 2-3 hours), and attending and participating in a two-day in-person workshop. KWYA is open to state and Tribal child welfare workers, child advocates, foster parents, juvenile justice staff, educators, law enforcement, service providers, and other community partners. For a list of upcoming trainings, visit the ICWA webpage.
  • Tribal State Collaboration Group: The Tribal State Collaboration Group (TSCG) is a partnership of representatives from Tribes, Alaska Native community partners and the Office of Children's Services who meet to collaborate on issues pertaining to Alaska Native or American Indian families and youth. The focus on this group is to strengthen ICWA compliance, promote healthy racial and ethnic identity, and develop strong working relationships.
  • Strengthening Families is a research-informed, strength-based approach to helping families reduce stress, address risk factors, and promote healthy development.  The overarching goal is the promotion of child and family well-being. It is based on engaging families, programs and communities to build five protective factors that help families succeed and thrive, even in the face of risk and challenges.  Alaska was selected in 2005 by the Center for the Study of Social Policy to pilot this approach and continues to work with programs and communities in implementing this framework.

Division of Public Assistance

  • The Low Income Home Energy Assistance Program (LIHEAP) is administered by the state and 13 Tribal agencies who are directly funded by the federal Administration of Children and Families. This program provides training and guidance on LIHEAP. DPA also has a memorandum of agreement with several Tribes to use its EIS eligibility system to verify income and expedite application processing.
  • Tribal TANF: Seven tribal agencies (AVCP, BBNA, CCTHITA, CITC, KANA, Maniilaq, TCC) operate their own Temporary Assistance for Needy Families (TANF) programs.  These tribes receive federal and state general funds to operate the program in their area. Tribal TANF also facilities communication with the Alaska Child Support Services Division (CSSD). Tribal entities provide household information and benefit amounts; CSSD provides TANF the amount collected and pass through information.
  • Work Services: DPA has agreements with the Metlakatla Tribe and Kawerak to provide work services in their area.  This includes adult basic education and job development. 
  • FDPIR: The Food Distribution Program on Indian Reservations is a federal program that provides food boxes instead of SNAP benefits.  The DPA field services unit works with the Alaska Native Tribal Health Consortium to coordinate benefits with 18 tribal entities.
  • Child Care Program Office: The DPA Child Care Program Office collaborates and coordinates with Alaska Tribal Organizations on licensing; Child Care and Development Block Grant (CCDBG) and related funding requirements; on-site health and safety inspections; training; and more.

Division of Public Health

  • Section of Chronic Disease Prevention and Health Promotion
    • The Play Every Day public education campaign, which helps Alaska children maintain a healthy weight, collaborates with ANTHC to develop messaging that resonates with Alaska Native families; ANTHC also contributes funding.
    • The Tobacco Prevention and Control Program funds 23 grantees statewide; many of these are THOs. The program is also working specifically with ANTHC and several Tribal health organizations to develop improved systems with Alaska’s Tobacco Quitline.
    • Health System Collaboration unit staff work with the Alaska Primary Care Association to improve control of hypertension, increase referrals to diabetes self-management programs, and increase screenings for cancer in in Federally Qualified Health Centers (FQHCs) by providing Quality Improvement training and ongoing coaching to change policies and adopt evidenced-based protocols. Many of the FQHCs involved are Tribal health organizations. Read about their success.
    • The Diabetes Prevention and Control program works with statewide partners, many of them Tribal health organizations, to develop and maintain capacity for chronic disease self-management and lifestyle change programs, including Diabetes Self-Management Education/Support, and the National Diabetes Prevention Program.
    • The Comprehensive Cancer Control Program collaborates with statewide partners, including many Tribal partners, to educate the public and providers, support patient navigation, and increase access to screenings for colorectal cancer, one of the leading types of cancer in Alaska. As a result, 65.9 percent of all Alaska adults now meet the colorectal cancer screening guidelines and 61.4 percent of Alaska Native adults meet those same guidelines. This represents a 19 percent increase since 2008 for all Alaskan adults and 30 percent increase for Alaska Native adults, a group that has a significantly higher risk for colorectal cancer.
    • CDPHP staff have partnered with the Alaska Native Tribal Health Consortium to lead the Alaska Statewide Violence and Injury Prevention partnership and develop and implement the FY18-22 Alaska Statewide Violence and Injury Prevention Plan.
    • The Obesity Prevention and Control Program is working with ANTHC to improve the availability of healthy foods and beverages on the Alaska Native Health Campus in Anchorage. Staff are also working with birthing facilities, including tribal health organizations, to improve breastfeeding practices, and with child care providers, including tribal child care organizations, to implement physical activity and nutrition standards in child care settings.
    • The Behavioral Risk Factor Surveillance System collaborates with the Alaska Native Tribal Health Consortium to oversample rural regions to ensure the availability of regional data.
  • Section of Epidemiology
    • The HIV/STD Program works in close collaboration with Tribal Health and other key partners during the quarterly HIV/STD Advisory Task Force to address issues related to disease trends, program activities, and strategic planning for statewide coordinated HIV/STD services.
      • ANTHC is a sub -recipient of DHSS HIV Prevention grant funds to prevent the spread of HIV. 
      • The STD Program collaborates with ANTHC on the "Wrap it UP" campaign for STD Prevention (www.iknowmine.org)
      • The HIV/STD Program created a partnership with Tribal Health to publish annual data on STD rates and case reports by Alaska Native Regional Health Corporation Regions.
  • The Alaska Immunization Program Manager routinely coordinates with ANTHC’s Immunization Program and Tribal Health Vaccine Coordinators on tribal vaccine supply, which includes leading quarterly multi-agency meetings.
  • The Alaska Tuberculosis Program works closely with tribal health providers, public health nurses, and community health aides to control TB in villages, which includes assisting with medical consultation, providing medication for TB patients, performing contact investigations, and delivering provider and community outreach.  
  • The Alaska Hepatitis Prevention Program facilitates a Hepatitis Advisory Working Group (HAWG), which involves active participation by ANTHC staff.
  • The ANTHC Epidemiology Center and Alaska Section of Epidemiology, along with the other stakeholder agencies, have collaborated successfully in implementing several activities for assessment, prevention, and control of intentional and unintentional death.  Activities have included co-authorship of Epidemiology Bulletins, participation on scientific advisory committees and injury prevention workgroups, and hosting joint projects for students and fellows.
  • The Environmental Public Health Program (EPHP) partners with Tribal Health Organizations to increase blood lead screening and public awareness of lead poisoning prevention throughout all of Alaska.
  • EPHP partners with THOs to address contamination concerns, such as those from contaminated sites or from naturally occurring sources. For example, EPHP partnered with THOs and tribes in Southwestern Alaska on a project to collect additional information on mercury levels using Hair Mercury Biomonitoring.
  • EPHP partners with THOs to assess subsistence food safety and develop fish consumption guidelines for Alaskans; this process involves an assessment of the health benefits and risks of subsistence food consumption.
    • Alaska Native Tumor Registry and the Alaska Cancer Registry work together to streamline reporting of cancer cases and reduce duplicate work between cancer registries to improve incidence measures.
    • All Tribal hospitals voluntarily report to the Health Facilities Data Reporting program.

Division of Senior and Disabilities Services

Senior and Disabilities Services coordinates with the Division of Health Care Services on Tribal consultation policies, and manages grant programs in which Alaska Tribes are the grant recipient.