Planning and financing long-term care services for American Indian and Alaska Native (AIAN) elders is a challenge. Institutional care (i.e. nursing homes) is not desired by most elders and has high costs for both the elders and tribal governments. In contrast, less expensive home care can provide enough assistance to keep most disabled elders in their own or their relatives’ homes, where they prefer to be. State Medicaid programs are one source of funding for home and community based long-term care services on reservations. We have compiled 20 guides that include a general overview of Medicaid in-home care programs as well as state-specific Medicaid home care details, such as services reimbursed by home and community based care programs and key contact information. These tool kits provide a road map for tribal health programs that are considering long-term care services, with a focus on personal care services for the elderly and disabled people that can be funded by Medicaid. The guides were developed on behalf of the Indian Health Services and with the assistance of numerous agency and state representatives. The tool kit provides information on a number of topics, including:

• Why Provide Medicaid Personal Care Services
• What Are Personal Care and other non-medical in-home services
• Medicaid Programs that Provide In-home Services
• How Personal Care and other in-home Services are Provided
• Tips for Developing a Plan for Delivering Medicaid Home Care Services