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Dear Pennsylvania Diabetes Educators,

The PA Coordinating Body has voted to move forward in pursuit of licensure. From legislation, a passed bill will move through a regulatory process. The regulatory process is often one of compromise involving multiple stakeholders. Listed below is the intent what we are putting forward in the Sunrise Evaluation Report to be submitted to the Department of State outlining our vision of licensure.

Please be informed. Please ask questions or for clarification while the process is evolving. I believe licensure will offer professional recognition.

Best regards,

Lisa Laird RN, BSN, CDE

Chair, PA CB

Your Right to Practice

If Licensure of Diabetes Educators Passes in Pennsylvania

1. Licensed Diabetes Educators are poised to become an essential part of expanding roles of healthcare professionals participating in the Patient Protection and Affordable Care Act (PPACA) turning our focus from “sick” care to “primary prevention”. Roles and responsibilities expanding are: health promotion, primary prevention, chronic disease state management, and business management. (Mary Ann Hodorowicz, 2015).
2. Licensed Diabetes Educators will have a defined scope of practice expanding the practice of diabetes related skills to those skilled and equipped beyond traditional discipline boundaries. Without this “legal” definition tied with licensure, diabetes educators will continue to be self-defined (KBLDE – Kentucky, FAQ).

We will continue evidence based practice in combination with training and experience in our subspecialties. Example: As an RN, CDE, I have never provided renal nutrition therapy nor am I qualified to do so as a licensed diabetes educator for the patient with diabetes and renal failure. I will teach the effect of CHO on blood glucose and other diabetes related issues.

1. The healthcare provider teaching the use of medications and diabetes care practices within their own scope of practice at various points of care such as in the hospital and in homecare. They will continue their work just not under the name of “diabetes educator” if that is the licensed terminology. The healthcare provider teaching DSME/S may continue to do so but not under the title of “diabetes educator”.
2. The Licensed Diabetes Educator will be the legally identified provider of diabetes education effecting change through DSME/S and in the emerging role in primary care. Attend our PA State 5^th Annual Conference April 21-22, 2016 in Harrisburg to learn more. Patient Centered Medical Homes (PCMH) and Accountable Care Organizations (ACO) are emerging as two main models of healthcare delivery. Patient self-management of chronic diseases, and BMI and BP screening including follow-up care will be required. Meeting composite scores of diabetes or at-risk populations will be rewarded (A1C, LDL-C, and BP).
3. The Licensed Diabetes Educator will provide a safe haven of quality diabetes information delivered in dialogue that effects behavior change as directed by the individual patient’s desires in appropriate timing along the continuum of care.
4. The Licensed Diabetes Educator designation will not permit billing to third party payers for services outside a credentialed education program through AADE or ADA at this point in time. Payment and reimbursement models are changing. Bonus payments and bundled payments rewarding better outcomes will expand our opportunities for future reimbursement. The ACA mandates a licensed HCP be the provider of care.
5. The Licensed Diabetes Educator practices according to an ethical standard of care in a truthful and non-misleading manner providing health promotion and disease state prevention effectively lessening co-morbidities.

Your Expenses

If Licensure of Diabetes Educators Passes in Pennsylvania

1. Your expense – If you already hold the CDE or BC-ADM credential, you will be required to pay the state mandated licensure fee every two years. It is our intent to keep it at a minimum such as the RN or RD licensure. Perhaps the Diabetes Educator Licensure will be assigned to the Nursing Board or the Medical Board allying further costs.
2. Your expense – If you do not already hold the CDE or BC-ADM credential, you may sit for a licensure examination. AADE and NCBDE are discussing the use of the CDE examination for this purpose. The AADE and the NCBDE are working together to support qualified healthcare providers of diabetes education.
3. Other criteria for licensure will include but not be limited to (since it does not exist yet and will be determined by regulatory committee) 250-300 practice hours. It will be necessary to complete continuing education hours in biological and social sciences, communication, counseling and education in order to position yourself to pass the qualifying exam but they will not be structured or required.
4. Renewal of licensure will be every two years and inclusive of a fee and continuing education hours.