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IHS worker says closing diabetes program could hurt progress


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Tim Leeds Havre Daily News [email protected]

A federal employee said that the closure of the diabetes prevention program at the Fort Belknap Indian Reservation could set back work done by the program. “Temporarily closing the program halts current efforts and activities.,” Carol Strasheim, diabetes consultant with Indian Health Services in Billings, said in an e-mailed response to questions. “Changes in the availability of a communitybased program are difficult for a small community to navigate through, and progress is likely to be temporarily affected.” Strasheim said the protocol of Indian Health Service is that all questions must be submitted in writing. Her supervisor, Susan Fredericks, forwarded Strasheim's response to questions from the Havre Daily News Friday afternoon. The Fort Belknap government confirmed last week that its Diabetes Prevention Program was being terminated effective Friday. The federal funding for the program, through an Indian Health Service grant program, expired Sept. 30 and applications for the next grant cycle are not due until this week. Loren “Bum” Stiffarm, chief administrative officer at Fort Belknap, said Friday morning that a representative from the Fort Belknap health department would call to discuss the closure of the program. As of deadline this morning, the health department had not responded to the Havre Daily's request for comments. Members of the program's staff last week said they were concerned that many of the programs would lose ground, including trust the staff members have built up with the local schools and residents of the reservation. They also said they do not know that, if the program starts again if new funding is approved, they will be hired back to do their jobs again. They also expressed concern that the Fort Belknap government did not step in to keep the program running until the next grant application process is complete. Strasheim wrote that the grant cycle sometimes does not fall to set new funding when the old grant runs out. Often the tribe steps in to keep the program running until the grant is awarded, although there is some risk to the tribe in Doing so. If the grant is not awarded, the pre-award costs to the tribe, which are allowed pending prior approval by the funding agency, cannot be recovered. Strasheim wrote that, because of the past success in the diabetes program, it has a good chance to be awarded a grant to fund its efforts again. Criteria considered in awarding the grants will include program planning and evaluation, program reporting involving community needs assessment, leadership reporting, previous accomplishments and budgetary information. “Fort Belknap has a strong list of accomplishments with their program providing diabetes prevention, education and services to the community,” Strasheim wrote. One of the benefits of the program has been providing screening which finds people who have diabetes or are at high risk of contracting it early, she wrote. “The awareness of diabetes symptoms and the screening activities have made it easier for newly identified patients to receive care earlier,” she wrote. Strasheim said the program has successfully worked to improve the understanding of and treatment for diabetes, including using cultural aspects of traditional life at the reservation. The program has implemented fitness activities for youth and screening for risk factors for diabetes, foot care for elderly patients with diabetes, support of dialysis, nutrition programs and outreach to patients with diabetes. “They have supported community wellness by incorporating cultural aspects of caring for oneself,” Strasheim added.


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