This month's CB Corner is brought to you by Kathy Jackson. She is currently one of our CB At-Large-Members as she is the Chair of MADE, one of our 3 LNGs. Kathy also won the Rising Star award from AADE last year.
So what do we know about licensure for Credentialed Diabetes Educators? We know that currently, Kentucky and Indiana have licensure and that Washington State had legislative changes to aid reimbursement, but hasn't move fully to licensure yet.
One piece that Beth Silvers, our CB's Legislative Rep, would also like us to remember about licensure is that this is/would be a budget neutral bill. This means it will not increase the budget. The money is already allocated for diabetes education and was not used due to recognized programs not having enough clients to request the education.
Should North Carolina consider licensure? Why are some states taking the time and effort to work on licensure for Diabetes Educators? What is all this about??
AADE has learned a few things while working on legislation to gain Medicare provider status for the Credentialed Diabetes Educators. Number one is that there is no legal definition of the diabetes education provider which makes it very difficult to get that legislation. Why do we need Medicare provider status? REIMBURSEMENT – how we get paid for our services! I don’t think I need to go into detail about how difficult our current healthcare crisis is to diabetes educators. Although diabetes is now considered “pandemic”, outpatient diabetes centers have seen sharp declines in patients due to economics.
So the first step, especially in the current health care arena, is to nail down this definition. Legislators look at our legal definition, which is the scope of practice from our license. They do not look at our certifications. This is one of the reasons that many can “practice” as diabetes educators without a certification. If someone has some sort of medical license, RN, RD, MD, PhD, LPN, etc. then they can give medical instruction. This is another issue that we see all the time – misinformation given to patients by well meaning providers who do not have expertise in diabetes. But a definition of a qualified diabetes educator then needs a license to practice because of the need for a legal definition.
Although our diabetes certification qualifies each of us to talk to patients about Right now here is what each of us is qualified to do LEGALLY per our license in the 7 Elements of DSMT:
- Healthy Eating RD
- Being Active RD
- Monitoring RN, Pharmacist
- Taking Medication RN, Pharmacist
- Problem Solving RN, LSW
- Reducing Risks RN
- Healthy Coping LSW
Now our CDE has qualified each of us to do all seven, but that is not our legal standing. What protects us legally is our job description, which needs to reflect all seven of these elements. However, when legislation is made, legislators only look at license not credentials.
When I began to understand that I became more open to the idea of licensure for diabetes educators. A requirement for licensure for diabetes educators will also:
} Provide a much needed element of protection for the patient
} Establish a legal Scope of Practice for the diabetes educators
} Set the minimum standards of care
} Establish an ethics and practice review procedure
} Establish educational and clinical training requirements
} Recognize diabetes educators as the qualified health care professionals they are
} Increase access for the person with diabetes to proven diabetes self-management training programs
} Help reduce the costly health complications associated with the disease and reduce the overall prevalence
Everything written here is from what I learned through AADE. To get more information go to the AADE website, on the main page at the top there is the advocacy center, under the advocacy center is the state licensure initiative.
Kathy Jackson, MS, RN, CDE
For more information about the State Licensure Initiative, please look at: http://www.diabeteseducator.org/PolicyAdvocacy/State_Licensure_Initiative.html