H1D4IHS0234
Cooperative Agreement
Overview
Grant Description
SDPI Community Directed Grant - Riverside-San Bernardino County Indian Health, Inc. (RSBCIHI) is applying for the SDPI Community Directed Grant after successfully participating since its inception in 2000 (Grant Number H1D1IHS0212-18-01). RSBCIHI is a non-profit tribally controlled and managed health care organization, established to meet the medical and health needs of American Indians/Alaska Natives living on or near nine (9) reservations in rural, medically underserved areas of Southern California (www.rsbcihi.org).
We have seven health clinics and one outreach site across a 400-mile radius in Riverside and San Bernardino Counties. According to 2022 Government Performance and Review Act (GPRA) data, our user population is 16,482. There are 1233 active AI/AN patients with a diagnosis of diabetes for a prevalence rate of 7.5%. The diabetes registry tracks 1035 active AI/AN users as of September 2022.
There will be no delay in implementing the grant as the current diabetes program is fully functioning with highly qualified staff, adequate facilities, laboratory requirements, equipment, and educational materials. RSBCIHI also has data expertise with both the NextGen system, population health software, and a mechanism for feedback from the community through a diabetes workgroup that meets quarterly.
The RSBCIHI required best practice will focus on glycemic control with the target group being diabetics aged 18+ with an A1C>8. The proposed project will include robust clinical interventions that combine community outreach with a patient-centered care engagement that includes all members of the interdisciplinary health care team. The adoption of the patient-centered medical home (PCMH) model by the organization facilitated the changes that allow for the introduction of the glycemic control project. These changes include the integration of the diabetes team to work in the clinical setting, with offices onsite, placing our staff member in direct contact with other members of the health care delivery team.
The purpose of the glycemic control best practice will be to decrease complications in diabetics that have ravaged the Native American community. Activities that will support the glycemic control best practice include population management tools such as NextGen PopHealth (population management), NextGen Care Outcomes Program that allow timely follow-up, provider and health care team education and engagement, pharmacy medical management, self-management education and patient engagement, and specialty care through tele-endocrinology.
The amount requested is $1,075,100.00, which will be used to implement the required best practice, but also the objectives of educating the community about diabetes and prevention of diabetes. These activities will include youth and adult prevention programs, community outreach, and telemedicine. The RSBCIHI diabetes program has extensive experience implementing diabetes and community activities and besides the Community Directed Grant has also been a Healthy Heart Grant beneficiary. Combined, these two grants have served over 1,000 diabetics and planned or participated in close to 300 community events and multiple educational classes during the grant periods.
We have seven health clinics and one outreach site across a 400-mile radius in Riverside and San Bernardino Counties. According to 2022 Government Performance and Review Act (GPRA) data, our user population is 16,482. There are 1233 active AI/AN patients with a diagnosis of diabetes for a prevalence rate of 7.5%. The diabetes registry tracks 1035 active AI/AN users as of September 2022.
There will be no delay in implementing the grant as the current diabetes program is fully functioning with highly qualified staff, adequate facilities, laboratory requirements, equipment, and educational materials. RSBCIHI also has data expertise with both the NextGen system, population health software, and a mechanism for feedback from the community through a diabetes workgroup that meets quarterly.
The RSBCIHI required best practice will focus on glycemic control with the target group being diabetics aged 18+ with an A1C>8. The proposed project will include robust clinical interventions that combine community outreach with a patient-centered care engagement that includes all members of the interdisciplinary health care team. The adoption of the patient-centered medical home (PCMH) model by the organization facilitated the changes that allow for the introduction of the glycemic control project. These changes include the integration of the diabetes team to work in the clinical setting, with offices onsite, placing our staff member in direct contact with other members of the health care delivery team.
The purpose of the glycemic control best practice will be to decrease complications in diabetics that have ravaged the Native American community. Activities that will support the glycemic control best practice include population management tools such as NextGen PopHealth (population management), NextGen Care Outcomes Program that allow timely follow-up, provider and health care team education and engagement, pharmacy medical management, self-management education and patient engagement, and specialty care through tele-endocrinology.
The amount requested is $1,075,100.00, which will be used to implement the required best practice, but also the objectives of educating the community about diabetes and prevention of diabetes. These activities will include youth and adult prevention programs, community outreach, and telemedicine. The RSBCIHI diabetes program has extensive experience implementing diabetes and community activities and besides the Community Directed Grant has also been a Healthy Heart Grant beneficiary. Combined, these two grants have served over 1,000 diabetics and planned or participated in close to 300 community events and multiple educational classes during the grant periods.
Funding Goals
NOT APPLICABLE
Grant Program (CFDA)
Awarding Agency
Funding Agency
Place of Performance
California
United States
Geographic Scope
State-Wide
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 223% from $1,075,100 to $3,475,300.
Riverside-San Bernardino County Indian Health was awarded
SDPI Grant: Diabetes Control & Community Education - RSBCIHI
Cooperative Agreement H1D4IHS0234
worth $3,475,300
from the HIS Office of the Director in January 2022 with work to be completed primarily in California United States.
The grant
has a duration of 5 years and
was awarded through assistance program 93.237 Special Diabetes Program for Indians Diabetes Prevention and Treatment Projects.
The Cooperative Agreement was awarded through grant opportunity Special Diabetes Program for Indians.
Status
(Ongoing)
Last Modified 4/4/25
Period of Performance
1/1/23
Start Date
12/31/27
End Date
Funding Split
$3.5M
Federal Obligation
$0.0
Non-Federal Obligation
$3.5M
Total Obligated
Activity Timeline
Transaction History
Modifications to H1D4IHS0234
Additional Detail
Award ID FAIN
H1D4IHS0234
SAI Number
H1D4IHS0234-2796528080
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Indian/Native American Tribal Government (Federally-Recognized)
Awarding Office
75A1HS IHS Office of Management Services/Division of Grants Management
Funding Office
75GA00 IHS OFFICE OF THE DIRECTOR
Awardee UEI
V356G2KG7BJ5
Awardee CAGE
3NKG9
Performance District
CA-90
Senators
Dianne Feinstein
Alejandro Padilla
Alejandro Padilla
Budget Funding
| Federal Account | Budget Subfunction | Object Class | Total | Percentage |
|---|---|---|---|---|
| Indian Health Services, Indian Health Service, Health and Human Services (075-0390) | Health care services | Grants, subsidies, and contributions (41.0) | $1,075,100 | 100% |
Modified: 4/4/25