Initiatives: Reducing Diabetes Disparities in American Indian Communities
The Wind River Reservation in Wyoming has launched efforts to:
Integrate public health and tribal health care systems. A coalition of health care providers, including the Tribal Health Directors for the Eastern Shoshone and the Northern Arapaho tribes and representatives from the Wind River Indian Health Service, local health department, cooperative extension service and the State of Wyoming, have come together to implement comprehensive health system changes. The goals of the changes are to pool resources, share patient data and better coordinate care for tribal members, particularly those at high-risk of diabetes complications.
Secure Medicaid reimbursement for diabetes outreach workers. The Wind River coalition is seeking Medicaid reimbursement through the State of Wyoming for diabetes outreach workers. A current policy barrier they are facing is a set of stringent requirements for certification of outreach workers.
Implement diabetes self-management classes in casinos, homes, work sites and other venues and obtain insurance coverage for such classes. The Wind River coalition has implemented non-traditional DSME classes with flexible schedules and at locations such as casinos, work sites and in the homes of diabetes patients. A standardized process for casino nurse referrals has been initiated and the group is exploring both public and private insurance reimbursement for classes.