The Alaska Native Tribal Health Consortium (ANTHC) received funding from the Indian Health Service to assess the health status and long term care needs of Alaska's Native elders. The project approaches the needs from a systems and service delivery perspective. The objectives are to determine what services are needed, what services are currently available, and where and how the system can develop services for elders that are culturally appropriate and close to home. This report includes a description of long term care services, estimates of current and future numbers of elders needing services, and recommendations for service development in each region of the state.