A Call to Congress for Continued Support of Mandatory Funding for Special Diabetes Program for Indians (SDPI) and Permanent Authorization of SDPI

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TITLE: A Call to Congress for Continued Support of Mandatory Funding for Special Diabetes Program for Indians (SDPI) and Permanent Authorization of SDPI

WHEREAS, we, the members of the National Congress of American Indians of the United States, invoking the divine blessing of the Creator upon our efforts and purposes, in order to preserve for ourselves and our descendants the inherent sovereign rights of our Indian nations, rights secured under Indian treaties and agreements with the United States, and all other rights and benefits to which we are entitled under the laws and Constitution of the United States, to enlighten the public toward a better understanding of the Indian people, to preserve Indian cultural values, and otherwise promote the health, safety and welfare of the Indian people, do hereby establish and submit the following resolution; and

WHEREAS, the National Congress of American Indians (NCAI) was established in 1944 and is the oldest and largest national organization of American Indian and Alaska Native tribal governments; and

WHEREAS, AI/AN adults are 2.3 times more likely to have diagnosed diabetes compared with non-Hispanic whites; and

WHEREAS, the death rate due to diabetes for AI/ANs is 1.6 times higher than the general U.S. population; and

WHEREAS, the Balanced Budget Act of 1997 established the Special Diabetes Program for Indians (SDPI) for “the prevention and treatment of diabetes in American Indians and Alaska Natives (AI/AN) for five years; and

WHEREAS, SDPI has been authorized as mandatory appropriations, creating program stability and insulated it from funding cuts, sequestration or reallocations by the Indian Health Service (IHS); and

WHEREAS, SDPI provides grants for diabetes treatment and prevention services to over 330 IHS, Tribal, and Urban Indian health programs in 35 states and funds Community Directed Grant Programs; and

WHEREAS, the SDPI has been incredibly successful in reducing the rates of diabetes in Northwest tribal communities and reducing health complications with End Stage Renal Disease associated with diabetes by 54%; and

WHEREAS, SDPI has had positive clinical and community outcomes, including: the average blood sugar level (A1c) decreased from 9.0% in 1996 to 8.1% in 2010 and has held steady at this improved average for 7 years; the average LDL (“bad” cholesterol) declined from 118 mg/dL in 1998 to 95 mg/dL in 2010; and more than 80% of SDPI grant programs now use recommended public health strategies to provide diabetes prevention activities and serves for AI/AN children and youth; and

WHEREAS, the President’s FY 2019 Budget Proposal for the Indian Health Service proposes to move SDPI and other health programs out of mandatory funding and into discretionary funding without a rationale or a path toward sustainable funding; and

WHEREAS, the impact could lessen SDPI as a priority compared to other IHS programs leading to decreased funding and program instability; and

WHEREAS, NCAI supports continued mandatory funding for SDPI to uphold the trust responsibility and treaty obligations between the United States and tribes; and

WHEREAS, SDPI was authorized for FY 2018 and FY 2019 under the Bipartisan Budget Act of 2018 (P.L. No. 115-123) at $150 million and has not received an increase; and

WHEREAS, NCAI supports permanent authorization of SDPI and an increase from $150 million to $250 million annually with medical inflation rates thereafter.

NOW THEREFORE BE IT RESOLVED, that the National Congress of American Indians (NCAI) calls on Congress to continue to support mandatory funding for the Special Diabetes Program for Indians; and

BE IT FURTHER RESOLVED, NCAI calls on Congress to support permanent authorization of SDPI funding with an increase from $150 million to $250 million per year with medical inflation rate increases thereafter; and

BE IT FINALLY RESOLVED, that this resolution shall be the policy of NCAI until it is withdrawn or modified by subsequent resolution.


The foregoing resolution was adopted by the General Assembly at the 2018 Midyear Session of the National Congress of American Indians, held at the Marriott Kansas City Downtown, June 3-6, 2018, with a quorum present.

Jefferson Keel, President

Juana Majel Dixon, Recording Secretary