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'All hands on deck': Indian Country diabetes program faces loss of funding again

WASHINGTON, D.C. -- A successful program that helps tribes address high rates of diabetes in their communities is once again in danger of expiring despite widespread and bipartisan support among lawmakers in the nation's capital.

The Special Diabetes Program for Indians provides $150 million in grants every year for treatment, prevention and awareness initiatives in tribal communities. Following its authorization by Congress in 1997, rates for disease among Native youth have not increased in more than 10 years, while rates among Native adults have remained steady for much of the past decade.

"It is one of the most impactful and successful public health programs ever implemented -- not just in Indian Country," Shervin Aazami, the director of Congressional relations for the National Indian Health Board, said at a gathering of Indian educators in Washington, D.C., on Tuesday.

Yet funding for the program will run out on May 22 unless Congress takes action. So tribal health advocates are once again calling on Indian Country to lobby their lawmakers to keep it going.

"It needs to be an all hands on deck approach," Aazami said during a meeting of the National Indian Education Association, held at a hotel just a few blocks from the U.S. Capitol.

Indian Health Service: Changing the Course of Diabetes in Indian Country

When the Special Diabetes Program for Indians was about to expire last year, an overwhelming number of lawmakers, Republicans and Democrats alike, voiced support for it. More than 80 percent of the members of the U.S. House of Representatives and more than two-thirds of the U.S. Senate signed onto letters that called for its reauthorization.

"SDPI has proven to be effective and we need to further invest in the program to continue to build on its success," Rep. Markwayne Mullin (R-Oklahoma), who is a citizen of the Cherokee Nation, wrote in an opinion published on Indianz.Com in August.

Advocates are hoping to build on the bipartisan backing as they head to Capitol Hill next week for two days of hearings before the House Committee on Appropriations, the legislative panel that writes the federal government's spending bill. Extending the diabetes program has always been a frequent issue of the annual affair.

"SDPI works because it is consistent, broad-based funding that reaches a significant amount of tribes each year," Victoria Kitcheyan, a council member from the Winnebago Tribe who serves as president of the National Indian Health Board, told members of the committee last year.

A number of Democratic candidates for president are also getting on board. Pete Buttigieg, a former mayor of South Bend, Indiana, who has been in a leading position in the the party's first nominating vote of the year, and Elizabeth Warren is the senior U.S. Senator from Massachusetts, are promising to find ways to permanently authorize the program, in order to prevent tribes and their advocates from having to repeatedly ask Congress to renew it.

"It has been so successful because it stands on tribal sovereignty," Aazami said of the Special Diabetes Program for Indians at NIEA's Capitol Hill event. "It is a tribally-directed and tribally-implemented. That's why it's so successful."

Mullin, Haaland and Rep. Tom Cole (R-Oklahoma), the fourth tribal citizen in Congress, are co-sponsors of H.R.2680, the Special Diabetes Programs for Indians Reauthorization Act. The bipartisan bill would extend the program for five years and increase the level of funding to $200 million a year. Tribes have not seen an increase in grant levels despite increases in the costs of providing health care to their communities.

Participants in a health and wellness walk are cheered on during the National Congress of American Indians 76th annual convention in Albuquerque, New Mexico, on October 23, 2019. Photo by Kevin Abourezk

NIEA's event continues on Wednesday with presentations from key lawmakers, including Rep. Deb Haaland (D-New Mexico) and Rep. Sharice Davids (D-Kansas), who are the first two Native women in Congress. The conference, during which Indian educators are advancing a number of their priorities on Capitol Hill, wraps up on Thursday.

The House Appropriations Subcommittee on Interior, Environment, and Related Agencies will be holding its American Indian and Alaska Native hearings on Tuesday and Wednesday of next week. Witness lists have not bee released but the hearings typically draw several dozen tribal and Indian leaders.

House Committee on Appropriations Notices
American Indian and Alaska Native Public Witness Day 1 (February 11, 2020)
American Indian and Alaska Native Public Witness Day 2 (February 12, 2020)

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