1. Power Point Presentation to Tribal Leaders To gain support, orientate, and as a method of Buy In of the tribal leaders a PowerPoint on the grant progress is delivered quarterly. Gaining tribal leader support Fort Belknap Indian Community

2. Montana/WyomingTribal Consortium The Special Diabetes Program for Indians funded by Balanced Budget Act 1997Prevention/Treatment of Diabetes in AIANs Administered by the IHS -2002 Reauthorization Congressional direction – develop a competitive grant program to demonstrate diabetes prevention and also address the most compelling complication of diabetes (cardiovascular disease) The Cardiovascular Disease Risk Reduction arm (Healthy Heart Project) targets individuals diagnosed with type 2 diabetes and utilizes a case management approach. Special Diabetes Program for Indians Comprehensive Evaluation, Coordinating Center

3. Program Overview Montana Tribal Consortium goal is to recruit and retain 50 type II diabetic participants over the age of 18 per year (25 per site) per year to prevent CVD. The Consortium will assess and care for the patients according to the Indian Health Services Type II Diabetes Standards of Care and through intensive case management. Budget Budget awarded for FY 2011 is $324,300.00 to be shared between three consortia sites. Personnel: The SDPI Healthy Heart Project Consortia consists of Site 1-Fort Belknap, Site 2-Rocky Boy, and Site 3-Crow Nations. Site 1 Velva Doore BSProject Manager Doreen Bell BS/MHAProject Coordinator Amber Belgard Data Coordinator Ruth Burleigh RN/BSNCVD Nurse Case Manager Site 2 Tamra Baker RN/BSNCVD Nurse Case Manager Site 3 Casaja Fritzler RN/BSNCVD Nurse Case Manager

4. Using Healthy Heart Data by Doreen Bell, BS/MHA Montana/Wyoming Tribal Consortium Site 1 – Fort Belknap As of 8/30/2011 Entered into the Excel Registry - 153 Consented in the program - 128 Receiving Intensive Case Management - 120 Site 2 – Rocky Boy Entered into the Excel Registry – 79 Consented in the Program – 79 Receiving Intensive Case Management – 79 Site 3 – Crow Nations Entered into the Excel Registry – 103 Consented in the Program – 88 Receiving Intensive Case Management – 65Overall Total Consented: 295 Three Hearts - Three Nations together serve 1424 tribal members on the diabetes registry. “This is the first attempt in the history of SDPI for consortia to share resources in providing diabetes education and healthcare through intensive case management to dense diabetic user populations over large land base.” Quote from the SDPI Spotlight Newsletter.

5. Current Fort Belknap Participant Data as of 9/6/11 Individuals in the HHP registry153 Number of consented participants128 Number with completed baseline assessments 102 Number with completed annual assessments 64 Number with completed 2-year assessments 46

6. How Are We Doing? As of January 1, 2010 National AverageFort Belknap Average 3 rd Annual Weight loss1%Gained 4lbs BMI decrease1%1.% gain Waist decrease.9%.1% decrease LDL decrease.9%.8% decrease HDL increase1.2%1.05% increase Triglyc. Decrease1%1% decrease Tot. Chol. Decrease 1%1% decrease HbA1C decrease1%1% decrese

7. Perspective A one point drop in HbA1C reduces diabetes-related complications by 40%. Over a period of nine years, the 333 community- directed grants dropped their national average by 1 point. In three years Fort Belknap’s HHP participants dropped their average HbA1C level by 1 point.