This paper, based on experiences at the physical rehabilitation center at Jiqi (磯崎), a multi-ethnic Indigenous community, explores how the health initiative sought community empowerment and self-determination through utilization of internal resources , social relations, deep understanding, and flexible deployment of local knowledges, in connection with support from external medical institutions. Building on ethnographic work and expanding on the concept of 'cultural sovereignty', the paper reveals how elderly care grounded in daily local cultures challenges existing health promotion policies and practices. To increase compatibility between policy and local implementation, this paper proposes two directions worth considering for Indigenous health policy-making: 1) highlight structural differences for resource allocation and program operation while reducing reliance on quantitative and indicative evaluation and, 2) release decision-making and operation capacities to local cultural translators with both mainstream and Indigenous knowledges.