Stumbling Blocks in the Pursuit of PA State Licensure for Diabetes Educators
Lisa Laird, RN, BSN, CDE
State Grassroots Coordinator for the Pennsylvania Coordinating Body of AADE
Jenni Catron presented at a women’s leadership meeting recently sharing that “leadership, defined as the power to affect others, is sacred work”. You love and lead people every day. The sphere of influence you affect reaches far beyond your home and loved ones into the community and state.
Protecting people with diabetes from misguided, misinformed care without evidence was our goal in licensure. Safety was and is our goal. Awareness was and is our goal. When I shared with a friend with a child with type 1 diabetes that the diabetes educator was not licensed in diabetes care, she was astounded. She assumed the person caring for her child in a nationally ranked hospital had credentials in diabetes. No, certainly the caregivers were licensed registered nurses and licensed registered dietitians, and some even voluntarily certified diabetes educators (CDE), but not licensed or acknowledged by the Commonwealth of Pennsylvania as having a scope of practice specific to the diabetes education we give.
A diabetes educator, as defined by the American Association of Diabetes Educators, is a health care professional who specializes in teaching people to manage their diabetes. They are generally employed in hospitals, physician offices, managed-care organizations, home health care and other settings. Diabetes self-management education and support (DSMES) is a collaborative process through which people with, or at risk for, diabetes gain the knowledge and skills needed to modify behavior and successfully self-manage the disease and its related conditions. DSMES, which once required a diabetes educator, no longer holds that standard. Programs are credentialed by the ADA or the AADE based on the curriculum taught aligning with national standards of care. A multidiscipline approach to education is employed by licensed health care providers, none of whom are required to be specialists in diabetes.
On behalf of AADE in Pennsylvania as well as the national office, a Sunrise Evaluation Report was submitted to the Pennsylvania Department of State in support of licensure for diabetes educators in September 2016 and again in January 2017. The Professional Licensure Committee Executive Director, Wayne C. Crawford, has reviewed the request and reported a license such as this today would cost approximately $750 per applicant in order to process. The State Board of Nursing is also governed by this committee. Our nursing license renewals are currently $65 every two years. AADE members in Pennsylvania had an expectation to hold the cost of licensure to something similar.
Clearly, the cost associated with a diabetes educator license would be prohibitive for AADE members in Pennsylvania.
Therefore, it was decided to cease active pursuit of licensure until the spring of 2019. After the gubernatorial election, monies may be available to supplement this professional licensing board and reduce the $750 cost of licensure. Until then, we will keep the request to license and the benefits to license and define scope of practice before our legislators.
Diabetes is pandemic. Over a million residents of Pennsylvania have diabetes and over 3.5 million have prediabetes. Let us not lose focus. We are effective in delivering diabetes education and supporting life-long habits and care delivery for a vulnerable population facing decreased quality of life and reduced life expectancy. This comes at both a personal loss and significant impact to our economy.
Over the next couple of years, let’s stay motivated to help others, prolong life, and improve the quality of life. Bring the strategy and vision forward in your sphere of influence to let others know you care.
Lisa Laird