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Content provided by the Catalog of Federal Domestic Assistance
93.237 Special Diabetes Program for Indians_Diabetes Prevention and Treatment Projects




Balanced Budget Act of 1997, Public Law 105-33; Consolidated Appropriation Act 2001, Public Law 106-554.
To promote improved health care among American Indians/Alaska Natives through special diabetes prevention and treatment services projects with objectives and priorities determined at the local level.


Project Grants.
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To fund primary, secondary, and tertiary diabetic prevention and treatment and related data collection. The award amount will include both direct and indirect costs. Grant funds may not be used for any other purpose. Funding may not be used as matching funds for other Federal programs.


Applicant Eligibility:   The Public Health Service Act, as amended, states that the following groups are eligible to apply for grants: Indian Health Service (IHS) entities: Indian tribes or tribal organizations who operate an Indian Health program. This includes program under a contract, grant, cooperative agreement or compact with the IHS under the Indian Self-Determination Act; and Urban Indian organizations that operate an urban Indian Health program. This includes programs under a grant or contract with the IHS under Title V of the Indian Health Care Improvement Act.

Beneficiary Eligibility:   American Indians/Alaskan Natives will be the ultimate beneficiaries of the funded projects through either prevention or direct treatment services.

Credentials/Documentation:   Costs will be determined in accordance with OMB Circular No. A-87, "State and Local Governments," or OMB Circular No. A-122, for nonprofit organizations.

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Pre-application Coordination:   Not applicable. This program is excluded from coverage under E.O. 12372.

Application Procedure:   This program is subject to the provisions of either 45 CFR 92 or 45 CFR 74, depending upon the type of applicant organization. Information on the submission of applications may be obtained from the Grants Management Officer, Grants Management Branch, Division of Acquisition and Grants Management, 801 Thompson Avenue, Suite 120, Parkway, Rockville, MD 20852. Telephone: (301) 443-5204. Applications will be reviewed by the Grants Management Branch in Headquarters East, Indian Health Service, for eligibility and compliance with the announcement. Chief Medical Officers (CMOs) and Area Diabetes Consultants (ADCs) in IHS Area Offices will be responsible for programmatic review, addressing the soundness of the proposed services, compliance of proposed service with the legislation, and recommending the proposed costs. Applications will be rated not ranked. Grants will be awarded based on CMOs and ADCs acceptance of the applications.

Award Procedure:   After review and approval, a notice of this grant award is prepared and processed along with the appropriate notification to the public.

Deadlines:   Contact the Grants Management Officer, Headquarters Office for information regarding application deadline dates. Deadline dates are also noted in the grant announcement.

Range of Approval/Disapproval Time:   Funds are expected to be awarded no later than 45 days after complete applications are received. Awards could be delayed for applications not meeting initial approval.

Appeals:   None.

Renewals:   The 1997 BBA Public Law 105-33 project period is currently up to 5 years with non-competitive renewals projected annually. The HR 4577 Public Law 106-554 project period is projected to be 3 years with non-competitive renewals projected annually.


Formula and Matching Requirements:   This program has no statutory formula or matching requirements. IHS will distribute the Balanced Budget Act (BBA) of 1997 (Public Law 105-33) funds of $150 million for a 5-year period based on the following formula: 1) $1.5 million is set aside for urban programs; and 2) $30.2 million is available to IHS entities, Indian tribes, or tribal organizations that operate an Indian Health program. IHS will distribute the Consolidated Appropriation Act 2001 (Public Law 106-554) funds based on the following formula: 1) $70 million in 2001; 2) $70 million in 2002; and 3) $100 million in 2003 to IHS entities, urban programs, Indian tribes, and tribal organizations that operate an Indian health program. Funds will be utilized to address diabetes prevention and treatment activities. The actual distribution formula and methodology for these funds is currently pending IHS tribal consultation recommendations.

Length and Time Phasing of Assistance:   The Public Law 105-33 project is limited to 5 years (total) with annual budget periods. The Public Law 106-554 project is projected to be 3 years with annual budget periods.


Reports:   An annual Program Progress Report as part of the grant continuation application for year 02 through year 05 of the 1997 BBA funds is required. At a minimum, this report must include: (1) Accomplishments and challenges of the program; (2) an annual Financial Status Report (Standard Form 269 - long form) must be submitted within 90 days after the expiration of each budget period; (3) Data Report including (a) diabetes prevalence for the target site, and (b) diabetes audit results for target site or other diabetes measures (amputations, end stage renal disease, laser treatments, obesity prevalence); and (4) completion of the IHS Diabetes Program questionnaire.

Audits:   In accordance with the provisions of OMB Circular No. A- 133 (Revised, June 24, 1997), "Audits of States, Local Governments, and Nonprofit Organizations," nonfederal entities that expend financial assistance of $300,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $300,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. In addition, grants and cooperative agreements are subject to inspection and audits by DHHS and other Federal government officials.

Records:   Financial records of the grant must be retained for 3 years after submission of the final expenditure report. If questions remain, such as those resulting from an audit, pertinent records must be kept until the matter is resolved. The Secretary, the Inspector General of the Department of Health and Human Services, and the Comptroller General of the United States or any of their authorized representatives shall have the right to access all records, reports, books, documents, papers, or other records of the grantee, contractor, or subcontractor, or of any entity pertinent to the DHHS grant in order to make audits, examinations, excerpts, and transcripts. In accordance with 45 CFR 92 or 45 CFR 74, Subpart D, as applicable, grantees are required to maintain grant records for 3 years after they submit their final expenditures report. If any litigation, claim, negotiation, audit or other action involving the records have been started before the end of the 3-year period, the records must be retained until completion of the action and resolution of all issues arising from it, or until the end of the regular 3-year period, whichever is later.


Account Identification:   75-0390-0-1-551.

Obligations:   (Grants) FY 01 $100,200,000; FY 02 est $100,200,000; and FY 03 est $100,200,000. (Note: Public Law 105-33 authorizes $30.2 million each year in FY 01, FY 02, and FY 03. Public Law 106-554 authorizes $70 million each year in FY 02 and FY 03.)

Range and Average of Financial Assistance:  
No Data Available.

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In fiscal year 2001, 286 grants were awarded. It is estimated that a similar number of grant awards will be made in fiscal years 2002 and fiscal year 2003 under the Public Law 105-33 funding. It is not yet known how many grant awards will be made in fiscal year 2002 and fiscal year 2003 under the Public Law 106-554 funding.


45 CFR 92 and 45 CFR 74; Public Health Service Grants Policy Statement, DHHS Publication No. (OASH) 94-50,000 (Rev.) April 1, 1994.


Regional or Local Office:  
None. Program Contact: IHS Division of Diabetes Treatment and Prevention, 5600 Fishers Lane, Rockville, MD 20857; e-mail:; telephone: 1-844-447-3387.

Grants Management Contact: Mr. Robert Tarwater, Director, Division of Grants Management, Indian Health Service, 5600 Fishers Lane, Mail Stop 09E70, Rockville, MD 20857. Telephone: (301) 443-5204, Fax (301) 594-0899.

Headquarters Office:   Grants Policy Office 5600 Fishers Lane, Mail Stop: 09E70, Rockville, Maryland 20857 Email: Phone: 301-443-5204

Web Site Address:


Examples include primary prevention efforts to prevent the onset of diabetes in people at risk for the disease and have not been diagnosed with diabetes (such as diet and exercise programs); or secondary prevention efforts to prevent complications of diabetes such as kidney disease, eye disease, heart disease, and amputations in patients diagnosed with diabetes; and tertiary prevention efforts to prevent or delay morbidity and mortality in patients with diabetes already having complications from the disease.


Completed applications that meet eligibility criteria must address: Soundness of proposed services to be provided and prevention/treatment; compliance with proposed services with the legislation, likelihood of success in that area; and proposed costs.

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