James Specker is the Federal and State Advocacy manager for the American Association of Diabetes Educators. AADE Advocacy is responsible for maintaining a national network of diabetes educators to support activities that affect persons with diabetes and public policy related to diabetes education and care.
On Tuesday the American Association of Diabetes Educators kicked off our Annual Meeting & Exhibition in Indianapolis with a state advocacy training for our members who serve as state legislative coordinators. This training covered a number of legislative issues, include a visit to the Indiana State Capitol, a meet and greet with Indiana State Representative David Frizzle and a historical tour of the Lilly Diabetes campus.
The bulk of the training, however, focused on the Supreme Court's ruling on the Affordable Care Act (ACA) and what effect that has on the diabetes educator.
A major component of the ACA is the Essential Health Benefits Package (EHB). The EHB is a comprehensive package of items and services which covers ten broad areas including "prevention and wellness and chronic disease management." Insurance policies must cover these benefits in order to be certified and offered in Exchanges, and all Medicaid state plans must cover these services by 2014.
One key factor that we have discovered in our conversations with state advocacy groups is under the EHB the power to determine who the qualified providers of these services are will be given to the states. The states' will base it on the provider's license and legal scope of practice. Currently there is no legal definition or legal scope of practice (license) for the diabetes educator.
Without this "legal" definition, diabetes educators will continue to be self-defined. While payors may continue to reimburse for the diabetes education service (DSMT), they may not recognize (reimburse) the true provider of these services - the qualified diabetes educator. Possessing a credential alone does not allow permission for the individual to manage diabetes beyond the limitations of their individual primary professional license or registration.
How are we responding? Under the direction of the AADE Board of Directors and in an effort to gain recognition for the qualified diabetes educator we have embarked on a state licensure initiative.
We believe that it is imperative that diabetes health care professionals be well educated and appropriately credentialed to ensure that those who are qualified are providing care. Licensure of the diabetes educator will provide consumer protection, professional recognition and setting quality guidelines for the profession.
The new regulations stemming from the ACA and EHB should expedite the need for states to seriously consider pursuing licensure as a means to meet the demand for qualified diabetes educators, combat the growing prevalence of diabetes, and protect the profession and practice of diabetes education.
All questions regarding this initiative can be directed to James Specker, Advocacy Manager, AADE at firstname.lastname@example.org