Nooksack SDPI FY 2025 - The Nooksack Tribe is located in a rural area in the northwest corner of Washington State near the Canadian border. The tribe owns pockets of land spread out within the communities of Deming, Everson, Sumas, Nooksack and Lynden in Whatcom County, Washington. The city of Bellingham is about 10 miles away. The Diabetes Program serves the Nooksack service area. The active user population is 1742. 126 individuals have been diagnosed with diabetes. There are currently 84 active patients on the diabetes register who receive care at the clinic. The Diabetes Program started in 1998 with the creation of a Diabetes Register and hiring of a certified diabetes educator (CDE) nutritionist. The goals of the Diabetes program are to 1) promote early treatment of diabetes, 2) prevent complications in individuals diagnosed with diabetes, 3) promote early diagnosis of diabetes, and 4) prevent diabetes in tribal members who may be at risk for diabetes The Diabetes Program operates out of the Nooksack Health Clinic. The Clinic is staffed with Medical Providers - 1 DO, 1 Pediatrician, 2 ARNPs, 8 RN and LPN staff, 1 RD,CDE and a Medical Social Worker. The tribe also operates a WIC clinic. Medical Providers work closely with the Diabetes Program and are members of the diabetes team. The diabetes team meets monthly to review and update the diabetes register, review patient outcomes and assist with planning and implementing diabetes program education and prevention activities. The Program works with other health programs including dental and fitness and has support from Administrative staff who oversee our project activities and budget. Our Best Practice for 2023 is Hepatitis C Screening which we chose because recent audits revealed that the % of diabetes patients who have been screened was significantly lower than the Area and IHS %. Our activities for the Best Practice include: identify patients who are due for HCV screening, review guidelines and testing procedures for HCV screening with medical providers, educate patients on the rationale for screening and provide incentives to encourage patients to be screened. The focus of the Diabetes Program been diabetes care and education. We have been successful in providing diabetes related education to the majority of the patients on our diabetes register and have seen improvement in patient care and outcomes. We plan to continue education activities and devote a significant portion of diabetes funds to a portion of the salary for a Registered Dietitian. The Diabetes Program funds diabetes prevention activities focused on increasing physical activity and promoting healthy food choices. These include fitness/health challenges, cooking classes, food demonstrations and support for 2 community gardens. We recruit and pay registration fees for tribal members to participate in a local Jingle Bell Run and fund passes to a local Aquatic Center. Diabetes funds support a number of athletic teams with registration fees, uniforms and travel expenses for tournaments and competitions including youth basketball, adult co-ed softball, canoe clubs, and cross-fit participants. Physical activity is integral to weight management and blood sugar, blood pressure and lipid control. Helping to sustain activities that are of interest to the community helps to meet our goal of diabetes prevention and reduced risk of complications. Funds are used for assistance with eye exams, foot care supplies, dental supplies and Libre readers and sensors to help patients achieve treatment goals and meet the standards of care.