IHS Seeking Written Feedback from UIOs on the Use of $70 Million in Special Diabetes Program for Indians Funding

On July 13, 2026, IHS released a Dear Tribal Leader and Urban Indian Organization Leader to initiate Tribal Consultation and Urban Confer to request feedback and recommendations regarding the use of approximately $70 million in Special Diabetes Program for Indians (SDPI) funding ($50 million associated with the Fiscal Year (FY) 2026 SDPI funding increase and $20 million in one-time unobligated SDPI funding).

This follows the agency’s May 21 announcement of administrative grant supplements for all current grantees and a commitment to Tribal Consultation and Urban Confer on additional funding.

IHS is seeking written responses to the following questions:

1. Current SDPI grant recipients will receive a Calendar Year 2026 administrative grant supplement totaling 25% of their annual SDPI grant award using one-time, unobligated funding.
   1. What IHS flexibilities do you suggest to help current grantees fully spend the additional supplemental SDPI funds within the grant period?
   2. What educational resources or technical assistance would your SDPI program request to fully spend supplemental SDPI funds by December 31, 2027?
   3. What is the best way to distribute the additional SDPI funds to improve current efforts in treatment, prevention, and care coordination within existing SDPI scopes of work?
2. How should the IHS prioritize the use of $70 million to achieve the greatest impact?
3. What are the most significant diabetes risk factors affecting your community that could be addressed through a prevention-focused SDPI initiative?
4. What recommendations do you have for structuring a prevention and wellness program that supports Tribal sovereignty, cultural practices, local decision-making, and community-defined health priorities?
5. How can the IHS best support prevention efforts that focus on children, youth, and families to improve long-term health outcomes and prevent type 2 diabetes and related chronic diseases?
6. What are your recommendations for the future direction of SDPI, including opportunities to strengthen the program’s impact, flexibility, sustainability, and responsiveness to Tribal and Urban Indian community needs?

Comments due to IHS by August 12, 2026. Email Urban Confer comments to: urbanconfer@ihs.gov (SUBJECT LINE: SDPI Funding)

According to the letter, the IHS Tribal Leaders Diabetes Committee (TLDC) will review the input received through Tribal Consultation and Urban Confer and provide IHS with final national recommendations.

Background on SDPI

The Consolidated Appropriations Act, 2026 (P.L. 119-75), signed into law in February 2026, reauthorized SDPI at $200 million per year, a $41 million increase above the prior funding level and the highest authorization in program history. The law also provided $50 million for the first three months of FY 2027, extending authorization through December 31, 2026. Thirty-one Urban Indian Organizations (UIOs) are among the 310 current SDPI grant recipients.

• Learn more about SDPI funding on NCUIH’s blog: Special Diabetes Program for Indians Faces Funding Cliff Without Congressional Reauthorization (May 22, 2026).

IHS Tribal Leaders Diabetes Committee

The IHS TLDC is charged under IHS Circular 25-11 with making recommendations to the IHS Director on the distribution of SDPI funds and broad-based policy and advocacy priorities related to diabetes in American Indian and Alaska Native (AI/AN) communities. The TLDC has been actively engaged with IHS on SDPI funding administration. NCUIH serves as a technical advisor to the TLDC, representing the needs of urban AI/AN communities and the UIOs that serve them.