Resolution 2018-07: Advocacy and Support for Permanent Reauthorization and Compact Funding for Special Diabetes Program for Indians (SDPI)

WHEREAS, the Special Diabetes Program for Indian (SDPI) was established by Congress in 1997 to combat the diabetes epidemic among Alaska Natives and American Indians; and

WHEREAS, the Special Diabetes Program for Indians is grant funded through the Indian Health Service and requires re-authorization by Congress every couple of years, with an annual nation-wide budget of $150 million that has not seen any increases or inflation corrections in at least 10 years;and

WHEREAS, this grant funding mechanism is not stable or permanent within the health care system that offers diabetes care to qualifying Alaska Natives and American Indians. Furthermore, every time the U.S. Congress funds Federal Programs through Continuing Resolution in the years that the SDPI funding requires reauthorization, there is significant concern whether the SDPI funding will be included or not, which leads to destabilization of workforce and significant concern and anxiety among patients regarding continued availability of treatment and prevention services; and 

WHEREAS, on February 9,2018 the President signed bill H.R. 1892, which extends funding for the federal government until March 23, 2018. Attached to this bill is a provision to fund the Special Diabetes Program for Indians (SDPI) at $150 million per year for fiscal years 2018 and 2019, again without inflation correction; and

WHEREAS, the Indian Health Services staff indicated that they have proposed and requested to move SDPI funding into the discretionary side of the budget in FY2019; and

WHEREAS, the Tanana Chiefs Conference Special Diabetes Program for Indians is a concerted effort by TCC Health Services to reduce diabetes through the interior of Alaska, especially among Alaska Natives and American Indians; and

WHEREAS, the burden of diabetes in the Tanana Chiefs Conference region is significant, as 5.6% of the Alaska Native Population in the Interior had a diagnosis of diabetes in 2014, slightly below the 5.8% prevalence rate of diabetes among the US – White population. The crude prevalence of diabetes among Alaskan Native/American Indian people increased 28% between 2008, from a crude prevalence rate of 38.7/1000, to a crude prevalence of 49.5/1000, in 2013; and

WHEREAS, there has been an increase in the number of patients with prediabetes, from around 600 Alaska Native / American Indians in the Interior of Alaska in 2008 to over 1100 in 2017; and

WHEREAS, Tanana Chiefs Conference is a non-profit organization, with a membership of Native governments from 42 Interior Alaska communities. TCC successfully manage and operates many programs and State and Federal grants and follows all required and applicable reporting requirements which includes, but not limited to tracking and reporting outcome measures, as well as performing annual fiscal audits, conducted by a qualified outside agency; and

WHEREAS, Tanana Chiefs Conference Health Programs are accredited through AAAHC and CARF, have successfully gone through HRSA audits and State audits and other program reviews; and

WHEREAS, Tanana Chief Conference is also a co-signer to the Alaska Tribal Health Compact since its inception, and Tanana Chiefs Conference provides numerous successful health programs for the benefit of Alaska Natives and American Indians through Compacting; and

WHEREAS, SDPI funding allocation through a grant-mechanism is contraire to self-governance and compacting; re-occurring grant applications, monitoring and reporting requirements continue to apply and are unnecessarily burdensome; grant terms limit co-signers’ flexibility to redesign the activities to best suit local needs. This system is administratively inefficient, and it unnecessarily limits the flexibility of co-signers to utilize these funds in the most effective manner possible; and

WHEREAS, Tanana Chiefs Conference supports resolutions and letters from the Alaska Native Health Board (ANHB) and the National Indian Health Board (NIHB) in previous years, requesting permanent reauthorization of the Special Diabetes Program for Indians, as well as requests for legislative language changes to change SDPI funding mechanism from a grant process to re-occurring funding through compacting.

NOW THEREFORE BE IT RESOLVED that the Tanana Chiefs Conference Full Board of Directors stipulates the Special Diabetes Program for Indians should be funded through Compacting and Government-to-Government negotiations and not grants; and

BE IT FURTHER RESOLVED that the Tanana Chiefs Conference Full Board of Directors directs staff to continue to advocate for permanent reauthorization of the SDPI Funding and for legislative language changes allowing SDPI funds be compacted and made reoccurring; and

BE IT FINALLY RESOLVED that the Tanana Chiefs Conference Full Board of Directors mandates that this resolution become a standing resolution until such time as the SDPI will be reauthorized permanently and funding will be compacted.

Submitted by: Tanana Chiefs Conference Regional Health Board


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