Tribal Health Programs in the Office of Medicaid and Health Care Policy

Created in 2002, the Tribal Health Program within the Department focuses on Medicaid services provided through Tribal Health Organizations (THO) statewide.  Tribal Health Program staff collaborate across divisions to ensure Tribal Health Organizations are active participants in Department discussions regarding the delivering of health care services to the Alaska Native Medicaid population.  The program has two full-time dedicated staff located in Juneau and Anchorage, and is assisted by several other program staff within the Division of Health Care Services.

The Tribal healthcare delivery system is complex and unique.  Each THO is a valued Medicaid provider, offering a wide range of services including hospital, behavioral health, dental, long-term care, targeted case management, and community health aides. Given the breadth of services, THOs delivering services to Medicaid beneficiaries interact with numerous programs and divisions within the Department. In the past, division specific programs focused on one service area, creating gaps in service and coordination with providers and/or key staff outside of the specific program. This process failed to accommodate the uniqueness of the tribal health system and often resulted in conflicting rules and regulations.

To improve consistency and ensure a concerted focus on the tribal delivery system, Tribal Health Program staff act as liaisons to the Tribal Health Organizations across the state, and to each division and program within the Department.  These staff are instrumental to ensuring all programs and divisions are actively collaborating to eliminate conflicts between programs affecting THOs and are developing and refining program policies that support THOs in their delivery of services to Medicaid beneficiaries. The Alaska Medicaid program partners with other state agencies in the operation of mental health, substance abuse and home and community based waiver services. Tribal Health Program staff work diligently to help support the development of tribal infrastructure in these areas. Current projects include developing a behavioral health system for rural Alaska, and combining the resources of mental health and substance abuse programs into a consolidated structure.

Tribal Health Program staff are also at the forefront of emerging issues.  To address a growing concern regarding the need to more fully support the health care needs of tribal elders, Tribal Health Program staff are also working to support tribal development of nursing facilities in Kotzebue and Bethel, as well as increasing community based care options in other Alaskan villages.

With new federal opportunities for innovation through waivers and other policy options, and new state-level budget restrictions, creating an affordable, sustainable health care delivery system will require strong partnerships in order to move forward.  The State fully recognizes the valued contribution of the THOs and the services they provide to Alaskans throughout the state.  Partnerships, like those cultivated by the collaboration between the tribes and the Tribal Health Program, are critical to ensuring Alaska has a sustainable health care system all Alaskans can depend on.