OBJECTIVE To design a health care program that allows Alaska Natives to receive culturally appropriate health services in their homes, thus avoiding the trauma of institutionalization and significantly increasing the quality of the patient's life during the course of the treated illness. METHODS Utilizing the culturally appropriate sensitivity that is found within Tribal Health Corporations, Southcentral Foundation is designing a federally based community health care model to bring health support services into the patient's home. Health Aides and Community Health Representatives play an important role in extending this model into an urban community setting. The cost of care is significantly reduced, as it is more cost-effective to keep patients in their own home environments rather than in institutions. RESULTS Major outcomes for patients are increased cultural sensitivity to their needs, personal comfort, dignity, and care in their own home surroundings. Outcomes for the federal care system are significant savings and more efficient personalized health care.