The clock is ticking once again toward the expiration of funding for the Special Diabetes Program for Indians, or SDPI.

The latest in a string of short term funding appropriations expires Dec. 11.
SDPI serves more than 300 Tribal and urban Indian communities across the country, including the Seminole Tribe of Florida. Congress created it in 1997 in response to a diabetes epidemic among American Indians and Alaska Natives. The program provides funds for diabetes treatment and prevention to IHS, Tribal, and Urban Indian health programs across the U.S.

Officials say the continued short-term extensions combined with the Covid-19 pandemic has severely complicated matters.

The National Indian Health Board estimates that nearly 1 in 5 SDPI programs have experienced employee furloughs since March – the majority of those directly linked to the economic impacts of the pandemic.

In addition, NIHB estimates that roughly 1 in 4 SDPI programs have reported delaying essential purchases of medical equipment to treat and monitor diabetes due to funding uncertainty, and nearly half of all programs are experiencing or anticipating reductions in the availability of services.

On Sept. 11, the NIHB sent a letter with 17 signatories to the leaders of Congress urging a fully funded, five-year extension of the program – which encompasses a variety of other health services for Indian Country, including SDP – the Special Diabetes Program – which generally focuses on type-1 diabetes.

“In order to prevent additional interruptions in patient access to vital public health services, interruptions in medical research, and to mitigate additional threats to medical training programs and health care provider placements during a national pandemic, it is essential that Congress approve a five-year reauthorization of these key programs and consider proposed increases requested during the 116th Congress,” the NIHB letter reads.

Continued strain

In just over 12 month’s time, the SDPI has gone through five short-term extensions – some lasting only a few weeks.

The most recent authorization was Sept. 21 – part of a short-term budget resolution in the House of Representatives to avoid a federal government shutdown.

Stakeholders say the short term extensions put undue strains on long-term budgeting and planning and result in cuts to essential public health services for medically underserved patients; cuts to type-2 diabetes prevention, treatment, and management services; delays in research to treat, prevent, and ultimately find cures for type-1 diabetes; setbacks to provider recruitment and retention in high need areas; and even the closing of residency programs training the next generation of health care professionals.

The NIHB said in its letter that without the stability and security of a long-term reauthorization, many Community Health Centers (CHCs) would not have the resources to accommodate growing populations.

“We remind you that millions of Americans rely on these public health programs to receive their health care services, diabetes services, medical trainings, and potential cures,” the letter said. “Each of these programs is integral to our national Covid-19 response efforts and for protecting the public health and safety of our communities.”

Further, the letter stressed that Congress has supported SDPI and related programs in a bipartisan manner for many years.

NIHB officials said it’s unclear if a long-term reauthorization can be achieved before Dec. 11, and could hinge, in part, on the outcome of the November election.