care, demonstrations and initiatives such as the SDPI Diabetes Prevention Initiative, which built on the findings of an earlier clinical trial at NIH, the diabetes audit which collects data on diabetic care provided by grantees to track outcomes, dissemination of diabetes treatment algorithms and standards of care, and ongoing educational programs such as webinars, periodic meetings and conferences, and consultations with health professionals that have expertise in diabetes. Since its implementation, the incidence of diabetes-related kidney failure among AI/AN populations decreased by over 40 percent between 2000 and 2015, resulting in lower spending for programs that cover the costs of AI/AN ESRD care.36 The SDPI and related efforts have also contributed to improvements in other diabetes-related outcomes, including childhood obesity trends,37 hospitalizations for uncontrolled diabetes,38 and diabetic retinopathy.39 Find more information on the SDPI at: https://www.ihs.gov/sdpi ▶ The CDC’s National Diabetes Prevention Program (National DPP) is a partnership of public and private organizations working together to build a nationwide delivery system for a 12-month lifestyle change program proven to prevent or delay onset of diabetes.40 Congress specifically authorized the National DPP in 2010 because of previous research—including the NIH-funded Diabetes Prevention Program (DPP) and the DPP Outcomes Study—that demonstrated the potential of the CDC-recognized lifestyle change program to prevent or delay the onset of type 2 diabetes. The National DPP is founded on four key pillars: 1) a trained workforce of lifestyle coaches; 2) national quality standards supported by the CDC Diabetes Prevention Recognition Program; 3) a network of program delivery organizations sustained through health benefit coverage; and 4) participant engagement and referral. CDC also supports states’ efforts to make the NDPP and other diabetes management interventions available to high-burden populations and communities. These efforts include strengthening community-clinical linkages to screen, test, and refer people with prediabetes to CDC-recognized organizations offering the National DPP lifestyle change program; providing support to enroll and retain participants in the program; and supporting pharmacist-patient care processes that help people with diabetes better manage their medications. Find more information on the CDC’s National DPP at: http://www.cdc.gov/diabetes/prevention Page 12 | Advancing American Kidney Health ▶ The NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) promotes an integrated health system model of team-based clinical care based on the pragmatic experience of the IHS’ Kidney Disease Program. NIDDK has developed new clinical tools and educational programs that improve the care of people with kidney disease in primary care settings. NIDDK works in collaboration with government, nonprofit, and health care organizations to raise awareness about screening for individuals at risk for kidney disease; educate individuals about how to manage their disease; provide information, training, and tools that help health care providers; and support important health systems changes. Find more information on the NIH NIDDK at: http://www.niddk.nih.gov ▶ The Innovation Center’s Medicare Diabetes Prevention Program (MDPP) expanded model is a structured behavior change intervention that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries with an indication of prediabetes. This model is an expansion of the Diabetes Prevention Program model test under the authority of section 1115A of the Social Security Act. Find more information on the MDPP at: https://innovation.cms.gov/initiatives/medicare-diabetesprevention-program/ Looking forward, HHS will continue to support these programs and look for known and innovative ways to scale their adoption, in partnership with communities. ▶ In late 2017, CDC announced a new five-year cooperative agreement to scale up the National DPP in underserved areas and populations including Medicare beneficiaries, men, African Americans, Asian Americans, Hispanics, American Indians, Alaska Natives, Pacific Islanders, and noninstitutionalized people with visual impairments or physical disabilities. ▶ In late 2019, CDC will update its Hypertension Control Change Package for Clinicians (HCCP) to include tools and resources to support CKD screening and early diagnosis among persons with hypertension. This effort, part of CDC’s broader Million Hearts® initiative,41 will better support clinician efforts to end the pernicious cycle between CKD and hypertension. Find more information on the Hypertension Control Change Package for Clinicians at: https://millionhearts.hhs.gov/files/HTN_Change_Package.pdf Find more information on the Million Hearts initiative at: https://millionhearts.hhs.gov ▶ CDC has begun a collaboration with local health departments to develop innovative approaches to increase the reach and effectiveness of public health strategies for diabetes, heart disease, and stroke, including the use of clinical decision support tools within EHRs to promote early detection of kidney disease. ▶ HHS supports continued funding for the SDPI, as reflected in the President’s Fiscal Year (FY) 2020 budget that proposes