Programs & Services
Elders In-Home Support Services (MEIHSS)
Page last updated:
November 14, 2023
November 14, 2023

Muckleshoot Health & Wellness Center

17500 SE 392nd St

Auburn, WA 98092


Mon 8:00am - 5:00pm

Tue 8:00am - 5:00pm

Wed 8:00am - 5:00pm

Thu 8:00am - 5:00pm

Fri 8:00am - 5:00pm

Closed daily 12:00-1:00pm for lunch.

Program Overview

MEIHSS strives to offer excellent, culturally relevant in-home healthcare and community-based social services to individuals and families of the Muckleshoot Indian Tribe and community. We are a tribally owned and operated in-home healthcare service. An elder is qualified for services based on our assessment and may receive assistance with personal care, hygiene, cooking, cleaning, laundry, grocery shopping, mobility, nursing services, and social services.

MEIHSS provides the highest quality support for aging members of the Muckleshoot Tribe. The purpose of the Elders In-Home Support Services Program is to allow elders who qualify for services under the program guidelines to remain safely in their homes by assisting with essential activities of daily living and providing culturally appropriate care in a setting that is familiar, comfortable, and surrounded by family and community. When this option is not available, we provide bridge services within the community to ensure the elders are supported when transitioning back to their homes as safely as possible.

As the largest Tribally-Owned and Operated In-Home Care Agency of our kind in Washington State, we believe our program to be a model for Indigenous Elder health in a Reservation setting. MEIHSS works closely with Muckleshoot Adult Protective Services to be able to protect, advocate and safely provide care to our elders in their homes. We encourage healing and recognize the importance of maintaining family connections.

We are working with other Tribes in our State to share our experiences and successes. The program has gained national recognition from CMS and Washington State as one-of-a-kind “Long Term Services Support “ (LTSS) program.

Services Provided

  • Professional Nursing Case Management Oversight – Including Registered Nurses and ARNPs
  • Medical Social Services – assistance with applications, hospital discharges, case planning, Medicare,
  • Medicaid, disability questions, or other related services
  • Life Alert – Medical Monitoring Emergency System
  • Elder and Vulnerable Adult tailored Care Plans
  • Assistance with Activities of Daily Living (ADL)

ADLs: Ambulation/Positioning after transfers, Dressing, Grooming, Bathing, Personal Hygiene, Toileting, Meal Preparation, Essential Shopping, Light housework, Laundry, Medication Reminders, Transport to and from Medical Appointments, Wound Care, End of Life Support.

Eligibility for Services

Outlook for 2023

  • Policy & Procedures Restructure & Revisions
  • Leadership Development Training
  • Cultural Caregiver Training Classes: Cooking, communication, respect, arts & crafts
  • Collaboration for Assisted Living Project

Highlights of 2022

  • Certified Nursing Training Collaboration- Successfully graduating and employment of Muckleshoot Tribal Members who provide quality, culturally competent care to our elders, reducing the need for outside agency contracts.
  • Consistent Implementation of Quality Assurance Measures focused on “person-directed care” plan with emphasis on activities of daily living, training, communication, nutrition, and wellness.
  • MEIHSS strives to reconnect with clients who have care needs that were previously unavailable, and who have been misplaced due to medical conditions off the reservation and away from their family members.
  • Promotion of family engagement to increase elder support and reduce gaps in coverage. Family engagement helps care for the elder in a manner they are most comfortable with. MEIHSS believes that having family participate in the care of the elder provides quality time while fostering the passage of wisdom from generation to generation.

Tribal Employee and Leadership Development

MEIHSS believes in promoting and developing tribal members within the program. Several Staff members of the program have shown interest in making Healthcare a lifelong career, continuing to serve their elders and community. MEIHSS continues collaborations with Human Resources, focusing on engaging MIT family and community members to consider a career at MEIHSS.

Acting Assistant Director - MIT Tribal Member Adrian Markantonatos

In September 2022, MEIHSS welcomed Muckleshoot Tribal Member Adrian Markantonatos to the MEIHSS team. Adrian is currently working under the Executive Leadership Training Program. After 24 years of working at the Muckleshoot Casino, Adrian has quickly become a highly valued team member with exemplary leadership, communication, and managerial skills that make him a true asset to the program. Adrian stepped in as Acting Assistant Director and will be working to help develop the MEIHSS team and bring in tribal members. Also, he will work to enhance the overall structure of the department policy and procedures.

Adult Protection Services (APS)- Collaboration MEIHSS Investigator

This year we have had our Investigator working with APS to help elders and caregivers deal with situations in the home and resolve problems to promote a healthy and safe environment for all involved.

The MEIHSS Investigator researched and resolved 249 incident reports with positive results to make our elders safe.

New hires and promotions within MEIHSS

We are proud that we have been able to hire 43 new caregivers during 2022; 7 of whom are MIT Tribal members. This continues to be a priority as we seek to employ Muckleshoot Tribal members first. When possible we promote MIT tribal employees from within our program to new positions.

Home Care Agency Audit and Reimbursement

In August 2022, MEIHSS navigated our fourth Washington State Audit as a licensed Home Care Agency. This allows MEIHSS to get reimbursement for home care services from the State. This is essential to increasing our ability to be self-supporting, saving tax fund dollars, and being able to be sustainable in supporting our program services. This year, we received over $1.2 million dollars in State Medicaid reimbursement for in-home services we provided to the elders. Of that $1.2 million, we received $10,500 for training services provided by our Tribal employees and $44,000 in Non-Emergent Medical Transportation Reimbursement.

CNA Training Collaborations- Muckleshoot Tribal College, Muckleshoot ROW Grant

In 2022, MEIHSS partnered with the Muckleshoot Tribal College, Muckleshoot ROW Grant (Reclaiming our Wellness Grant), and Renton Technical College to train, certify and employ tribal members to work in the healthcare field providing culturally competent care to our elders and community. 23 caregivers completed the training programs offered, 4 have passed their WA state exam, and the others are in queue to be assigned a testing location.

CRR/BLS Training Program

Tribal Member Roberta Tecumseh completed her C.N.A. certification and is in process of finalizing her Adult Education Training and Basic Life Support Training Program to complete the credential requirements as a “Certified” Staff trainer for MEIHSS. Roberta has worked very hard at completing the certification process so that the Tribe is self-sufficient and non-reliant on outside contracts to maintain credentials within the program. To date, Roberta Tecumseh has completed 31 training certification classes for HHAs, Jackie Carey, also a Muckleshoot Tribal Member assisted the program by completing 15, and Diane Dea, a Lummi Tribal member supported with 22. The total CPR/BLS caregivers/staff trained and certified is 68.

Caring for the Vulnerable Adult Population

Although MEIHSS primarily supports Elders, once assessed and screened by nursing, vulnerable adults with significant medical issues can be accepted into the program and utilize services provided by MEIHSS.

Transitioning out Agency Care in Favor of MIT Caregivers

Since the program’s inception, it has always been the goal of MEIHSS to phase out external agency contracts and to promote MIT Tribal members and other Natives to provide culturally competent care. The national caregiver shortage that came about when the pandemic hit drastically affected our ability to sustain services without outside help. MEIHSS has had to rely on other Home Care agencies for CNAs, HHA’s, and locum (traveling) nurses. These agencies have allowed the program the ability to continue to care for our elders in their homes, preventing re-admissions to hospitals, Skilled Nursing Facilities, and Adult Family Homes.


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