ADVOCACY: A Vital Role ??? !!! by Jane Pinkerton, BSN, RN-CDE
As a Diabetes Educator, how often do you stop to consider the many roles you serve? Some include teacher, learner, mentor, cheerleader, counselor, creator, innovator. In my soon-to-be 45 years in nursing, perhaps none has been more challenging than that of advocate. So what do I mean and why is this role important to each and every diabetes educator today? Why does your voice need to be heard?
Webster defines Advocate as “One who pleads for another.” Did our instructors, professors, and mentors, talk about “pleading” as we pursued our professions? For me as a pediatric nurse, it quickly became apparent that some children needed an adult voice to speak for them. How could I stand by and say nothing?---thus the intro. to advocacy which led to eventually asking “why” and “why not?” Why did our community hospital plan to drop Diabetes Education classes? Why was there not a parent support group? Why where children not introduced to the diabetes camp experiences? Why not have public school emergency protocols with Glucagon & Epipens provided by the county hospital? Why not Medicare coverage for therapeutic shoes to prevent amputations vs. only coverage for infections and amputations? The list could go on and on. I am certain you have similar experiences which raise similar questions/concerns. The challenge I pose to you is “What are you doing as an advocate to create the change that is needed?”
For me the opportunity to travel to Washington, DC for the AADE 2014 Public Policy Forum provided face-face time to advocate--”to plead for another.” This year I was not pleading for shoes or emergency protocols in schools but sharing the benefits possible if Medicare recipients receive the full coverage for Diabetes Self-Management Training (DSMT) which was established in 1997. Unfortunately, the broad legislative language of that time did not name credentialed (certified) educators as Medicare providers, thus limiting who may be reimbursed. As communities face the challenges to reach the growing numbers of those in need of DSMT such reimbursement is vital. The intent of the 1997 legislation has yet to be fulfilled due to this oversight. Yes, some portions of education are covered, but for most people with diabetes they never receive the full entitlement under Medicare!
On May 19th & 20th it was my privilege to represent South Carolina Diabetes Educators
and our residents with diabetes at the AADE Public Policy Forum. While our primary focus remains the Access to Quality Diabetes Education Act of 2013 H.R.1274/S.945 (covers the Medicare reimbursement to include credentialed “certified” educators) we were also introduced to 7 additional bills that impact those living with diabetes and those at risk of diabetes. (To learn more about these bills checkout the Diabetes Advocacy Alliance at www.diabetesadvocacyalliance.org --- AADE is a member).
With statistics and personal scenarios in hand—I made the trip to the Hill. Yes, the stats we all know too well --- 26 million people in the U.S. Living with diabetes
--- over 416,000 in SC (ranked #4 in the U.S.)
The fact that, if passed, the proposed H.R.1274/S.945 average Medicare cost savings per month per patient is $135 for those beneficiaries who complete DSMT.
Having made similar legislator visits in 2012, I was pleased to find some progress. At Sen. Lindsey Graham's office, I met with the same legislative assistant. Since my previous visit, he has attended several of the Diabetes Alliance Workshops. Yet, while he can articulate the alarming facts about the incidence and costs of diabetes in our state, I have not yet been able to obtain co-sponsorship by Sen. Graham for S.945. YOUR VOICE IS NEEDED!
Next was a visit at Rep. Jeff Duncan's office where I was the educator for a young new staffer. With pleasure, I acknowledged Rep. Duncan had joined the Congressional Diabetes Caucus since my 2012 visit---and I again asked for his co-sponsorship of H.R. 1274.
But---YOUR VOICE IS NEEDED!!
Near the end of the day came a warm welcome at the office of Sen. Tim Scott. Currently, Sen. Scott serves on the Senate Health, Labor, & Pensions Committee and the
Senate Special Aging Committee, both of which relate directly to Medicare issues. His co-sponsorship of S.945 was also requested.
Again---YOUR VOICE IS NEEDED!!!
The primary elections take place soon! Our Senators may change next year---but with their co-sponsorship now, we will be closer to an affirmative vote for this vital legislation. As educators we know the benefits to someone who learns how to proactively manage diabetes. We also know this process is enhanced when self-care decisions are based on current knowledge vs. fear. Unfortunately, too often those in Congress are not as well versed.
They need to hear your voice. They need to hear from those who can “plead for another.”
Again & Again--- YOUR VOICE IS NEEDED!!!!
Check out the new AADE Advocacy Action Center at www.diabeteseducator.org .
There are now numerous ways to easily make your voice heard –consider e-mail, facebook, tweet, etc. Share your stories from your professional experiences. Share your concerns with our SC Senators and your local Congressional Representative today.
BE AN ADVOCATE—LET YOUR VOICE BE HEARD!!
#DiabetesEd4All
P.S.
These quotes from my Mary Engelbreit May Calendar kept me going on the Hill---
“The question isn't who is going to let me; it's who is going to stop me.”
“Nothing happens, and nothing happens, and, then...EVERYTHING HAPPENS!”
“Now, get out there and do something REMARKABLE!”
LET'S MAKE H.R. 1274/S.945 HAPPEN NOW