ABSTRACT
Special Diabetes Program for Indians
FY2023 Community Directed Grant Program
H1D1IHS0406
The Indian Family Health Clinic (IFHC) is an urban Indian Health Service (IHS) clinic located in Great Falls, Montana. The clinic serves American Indian/Alaska Natives and their families in the community and surrounding areas. It is less than two miles from the nearest IHS service unit and approximately 120 miles from the nearest tribal clinic. The local AI/An population includes many who are Little Shell. Little Shell has, within the last year, received Federal Recognition. With this, Little Shell is in the process of getting its clinic fully operational. IFHC is committed to assisting Little Shell with their tribal members for care such as diabetes screening and care.
The Indian Family Health Clinic is a small facility with limited staff and cannot offer comprehensive pharmacy, specialist services on-site, or inpatient care. There are many obstacles the patients and providers must overcome to have complete healthcare. Most of the patient population at IFHC struggle financially. They will go weeks to months with medications and often avoid seeking services and primary care because help is too far away or unaffordable. It is known that medical expenditures are three times greater in people with diabetes than in non-diabetics, making preventative care of utmost importance in decreasing costly complications for IFHC patients.
The Diabetes Program at IFHC was launched in October of 2000 and is currently in its twenty-second year. IFHC SDPI efforts during FY2023 will focus primarily on promoting preventative healthcare through fitness centers vouchers; flu shot clinics, retinavue eye exams, referrals to partners for annual eye exams, and comprehensive foot exams with vouchers for foot care. The 2022 Diabetes Audit revealed:
• 58% of the clinic's diabetic patients have a body mass index (BMI) of >30; this is a drop from our submission in 2016 of 72%. This does indicate that obesity is an issue. By promoting the clinic's fitness center through the distribution of vouchers and contact from the fitness center staff to diabetic patients, IFHC will continue decreasing the obesity rates in this population.
• 53% of IFHC's patients received their flu vaccine last year. This dropped 3% from IFHC 2016 submission. Staff will target this population during flu season and evaluate the effectiveness of flu vaccination education with a short questionnaire before receiving the vaccination. A flu vaccination clinic will also be held during the fall to promote the flu vaccine.
• 70% of IFHC's diabetic patients received a foot exam. This is up 21% from 2014. Staff will continue encouraging and giving reminders for diabetic foot exams at every clinic visit.
• 42% of patients received their eye exams. This is up 11% from 2016. Staff will refer our partner for eye exams and help with the cost of eyeglasses.
The Indian Family Health Clinic must give all patients the best preventative care and resources available. In recent years, IFHC has demonstrated success in community outreach and education, such as Health Native Hearts and Diabetes support group. In addition, we continually strive to avoid duplication of services that may already be available to the larger community by developing partnerships with local organizations and participating in community-based health initiatives.