NATIONAL KIDNEY FOUNDATION OF ARIZONA - TOHONO OODHAM 2017.PDF

Last updated: 05/06/2017
General information
Organization National Kidney Foundation of Arizona
Contact First name James
Contact Last name Ivie
Contact e-mail jivie@azkidney.org
Contact phone number 6028401644
Address
Street 360 E. Coronado Rd., Suite 180
City Phoenix
State AZ
ZIP Code 85004
From what tribe is the Tohono O’odham Nation
organization requesting the
grant?
Total grant amount request 25,000
1 / 1


Funding Proposal / Request for $25,000
Tohono O’odham Nation 12% Gaming Distribution for Fiscal Year 2018
Explain the perceived need and explain how the proposal will address that need:
The Nutritional Support for Patients with Kidney Failure Program is a continuing project that is a
joint effort of the National Kidney Foundation of Arizona (NKF AZ), the Arizona Council for
Renal Nutrition, and Arizona Nephrology Social Workers. The program is designed to identify
kidney failure patients who are on dialysis and who are contending with one of the following
three conditions: 1) they are new to dialysis and are failing to thrive, 2) they have been on
dialysis for more than three months and are malnourished as evidenced by abnormal labs and/or
weight loss, or 3) their poor oral health/dentition prevents consumption of the high protein meats
and other foods they need. Patients who exhibit these conditions can apply to NKF AZ for
grocery assistance, a copy of our “Cookbook: A Guide for Renal Nutrition,” protein
supplements, and/or dental care to restore a healthy nutritional status.
The purpose of our Program is to prevent malnutrition, enhance consistency in patient education,
facilitate adherence to diet recommendations, and improve health outcomes. These goals meet
the Tohono O’odham Nation’s funding priorities in both health and education. Diet restrictions
for dialysis patients limit and regulate the intake of fluid, sodium, phosphorus, calcium, and
potassium while encouraging the use of protein-rich foods. Many dialysis patients are diabetic
and must contend with the requirements of a diabetic diet as well. Adjustment to the logistical,
dietary, financial, and emotional challenges of dialysis can be daunting and the first three months
can be the hardest of all.
The needs that the Program aims to fulfill are threefold:
1) For patients who are new to dialysis and failing to thrive, there is often a need for more
individualized nutritional education and financial assistance. There is a learning curve for
patients over the first few months of dialysis as they adjust to diet restrictions and the impact on
their grocery budget. Dialysis facility dietitians can apply to NKF AZ for a grocery store gift
card and a Cookbook. When an application is approved and a grocery store card is issued, it is
the dietitian who receives it at the dialysis facility. The card is then given to the patient in the
context of a nutritional education presentation that includes a review of what foods conform to
the renal diet; what foods need to be avoided; a list of the current week’s grocery store specials
that are rich in protein, low in sodium, low in phosphorus, low in calcium and low in potassium;
and a selection of recipes from the NKF AZ Cookbook: A Guide for Renal Nutrition that makes
use of recommended foods. The patient is then assigned “homework” to use the grocery store
card to purchase food items listed in the recipes and to prepare healthy meals. The patient is
instructed to report back to the dietitian on how they completed the assignment and what they
learned. Our Cookbook is a tool for nutritional counseling and meal planning that reduces the
“guess work” involved when advised to control the intake of protein and other nutrients.
2) For patients who have been on dialysis for more than three months and who are
malnourished as evidenced by abnormal labs and/or weight loss, there is a need for protein
supplements (liquids, powders, gelatins, and bars) to prevent cachexia (severe loss of weight,
muscle atrophy, fatigue, weakness, and significant loss of appetite). It is well established that
dialysis patients whose blood laboratory values show low protein levels have significantly higher
rates of mortality. This protein malnutrition is often due to the inability to consume adequate

protein because of poor physical or oral health, social and cultural practices and/or financial
barriers. The availability of protein supplements offers the opportunity to reverse the risk of
cachexia nutritionally.
3) For patients with poor oral health/dentition, there is a need for assistance with the cost of
cleanings, fillings, extractions, crowns, and dentures in order to eliminate pain or infections and
to restore the ability to chew solid high-protein foods. The Program can prevent periodontal
diseases from contributing to malnutrition or becoming a source of systemic inflammation for
patients with kidney failure.
Describe the population who will benefit from the proposal if approved:
The Program serves dialysis patients throughout the entire state of Arizona. There are currently
over 9,000 dialysis patients statewide and their numbers continue to grow. Historically, our food
assistance, nutritional supplements, and dental care programs have been used by up to 10% of
the kidney failure population, which represents several hundred people. It is projected that over
700 patients could be served by the Program in the coming year.
There are over 120 dialysis facilities in Arizona and all of them can refer patients to the Program.
The dialysis facilities are owned by several different companies, such as Fresenius, DaVita,
Southwest Kidney Institute, U. S. Renal Care, Dialysis Centers Inc., and American Renal
Associates. Applications for assistance are received on a continuous basis through renal
dietitians and social workers who identify patients in need. The timetable for implementation of
the Program encompasses the whole of fiscal year 2018, which spans from July 1, 2017 through
June 30, 2018.
List any other funding requests that have been made for this or substantially related proposals
and provide the status of those requests:
A substantially related proposal was submitted to the Ft. McDowell Yavapai Nation in March
2017. A decision on that application is not expected until the end of August.
Indicate whether the entity has already received a 12% distribution from the Tohono O’odham
Nation or other Arizona tribes, along with the amount and date awarded:
NKF AZ has not received a 12% distribution from the Tohono O’odham Nation. Three years
ago, NKF AZ was awarded $180,000 by the Gila River Indian Community to fund our
transportation assistance program over a span of two years. That funding ended in June 2016.
Identify a designated contact person and alternate contact person for follow-up, including e-mail
address, phone number, mailing address, and fax number for these persons:
James Ivie, PhD, LCSW / Director of Patient Services
National Kidney Foundation of Arizona / 360 E. Coronado Rd., #180, Phoenix, AZ 85004
jivie@azkidney.org / (602) 840-1644 / FAX: (602) 845-7955
Alternate contact person: Jeffrey Neff / CEO / same address
jeffreyn@azkidney.org / (602) 840-1644 / FAX: (602) 840-2360
Indicate which priority area (from the above list) the proposal falls under:
This proposal addresses the priority areas of health care and education.

If the proposal is from a non-profit organization, include the name of the city, town, or county an
agreement will be made with if funds are granted. A letter from the governmental entity
acknowledging its agreement to work with the non-profit is not necessary for the initial proposal.
However, it is necessary for those non-profits selected to receive grant funding.
Maricopa County has agreed to be the fiscal agent if we are awarded a grant.
Include a budget of the requested funds, with the total amount requested clearly annotated:
PROJECTED PROGRAM BUDGET
Program Category Amount Requested Total Program Projected Numbers of
from Tohono O’odham Budget Patients Helped
Dental Care $14,000 $68,000 100
Protein Supplements $9,500 45,000 500
Food & Cookbook $1,500 7,000 110
Total: $25,000 $120,000 710