Kentucky: A testing ground for state licensure
By: Heather Wright, Marketing & Communications Coordinator
Kim DeCoste, RN, MSN, CDE, MLDE said the diabetes educator state licensure process in Kentucky was “The biggest learning curve of my life.”
The state licensure initiative’s main goal is to protect people with diabetes (PWD), with the idea that requiring a license to practice diabetes education will ensure qualified diabetes educators- the primary providers of diabetes education, have a standard minimum knowledge and skill-set. This means better service for PWD and professional protection for the “diabetes educator” title. Without this, a person can call him or herself a diabetes educator, without having appropriate training or credentialing.
DeCoste and Deborah Fillman, RD, MS, LD, CDE, MLDE, the AADE President at the time, helped to spearhead the state’s licensure bill. Before its introduction, there was not a defined scope of practice for diabetes educators, as there was for doctors, nurses, dietitians and many other healthcare providers. Kentucky was the first state to pass licensure for diabetes educators. In 2014, Indiana passed a state licensure bill for diabetes educators, but it has not yet been implemented, DeCoste noted.
AADE volunteers and staff met with AADE members in Kentucky and other constituents or stakeholders to talk about scope of practice and the importance of licensure. Member volunteers began to talk to legislators about bringing this bill forward. DeCoste said there were some people who voiced concern about parts of the language proposed in the bill after it had passed.
“We started completely from scratch.” DeCoste said, “It’s taken awhile for it all to gel. Even when the law was approved, we had to go back and revise it.”
The diabetes educator license, DeCoste explained, broadens her scope of practice as a person practicing diabetes education. It allows her to offer all of the services needed to help a person successfully self-manage diabetes. In Kentucky, those without a license from the state cannot legally call themselves diabetes educators, or practice diabetes education.
For legislation to be amended, it must go through the legislative process, which includes passage by separate House and Senate committees. The public then has an opportunity to comment on the proposed bill by appearing at the committee meeting. After approval by the legislative committees, the bill must be passed by both the Kentucky House and Senate. Since 2011, this legislation has been amended twice.
Betty Bryan, RNC-AWHC, BSN, CDE, began working on the bill after its first revision with the Kentucky Coordinating Body (CB) (formed after the bill passed in 2011). Janice Haile, RN, BSN, CDE, MLDE, worked with AADE on state licensure for a while before the CB formed. They offer advice for future states considering, or currently working on state licensure.
“You have to know about your Legislative Research Commission (LRC) and how your bill will go through the legislature,” Bryan said, stressing the importance of communication between the licensure board, lobbyists, constituents, AADE and the CB.
Bryan and Haile made note of an “exemption clause,” which says the state licensure law will not apply to those already “licensed, certified or registered…including but not limited to physicians, nurses, pharmacists, dietitians and nutritionists” (309.327 (2)
). In addition, they spoke of a need for more defined terms in the original language of the bill. They stressed more detail on the following: who is eligible to be a licensed diabetes educator, how that person can prove their diabetes competency, what coursework and content areas a person needs to accomplish to receive a license, clearer definitions of scope of practice, as well as who should sit on the licensure board.
“People have said after, ‘We are better positioned in a lot of places’ to really protect people with diabetes and protect our profession[s],” DeCoste said, emphasizing, “We are most concerned about the people we serve.”
DeCoste believes it is still too soon to measure the full impact of the bill in Kentucky, but she noted the state is starting to get a stronger workforce, especially in the more rural areas.
“Kentucky paved the way. Other states are [now] more aware of diabetes education licensure as an issue,” DeCoste said.
After the bill passed, the licensure board set a goal of 250 licenses for the first year. Their actual number of people licensed was around 600. The second year, they saw 580 people licensed, and the renewal rate was 80%. DeCoste noted that this number is higher than typical renewal for other licenses in their second year.
“We are positioning some people, where before there were barriers, to make sure they can offer a more quality service,” DeCoste said, “There are now Licensed Diabetes Educators (LDEs) in all parts of the state, where there weren’t people before.”
DeCoste, RN, MSN, CDE, MLDE was the first LDE in Kentucky and is a chairperson on the Kentucky Board of Licensed Diabetes Educators, representing registered nurses.
Bryan, RNC-AWHC, BSN, CDE, works at Hardin Memorial Hospital as part of the Diabetes Management Program and is the Finance Leader and Legislative Alternate for the Kentucky CB.
Haile, RN, BSN, CDE, MLDE is part of the state staff for the Kentucky Department of Public Health with Kentucky Diabetes Prevention and Control Program, and is the Web Administrator for the Kentucky CB. Learn more
about AADE’s state licensure efforts, and how to get involved with efforts in your state.
News and Activities:
AADE Award Winners Announced at AADE15
Congratulations to the AADE 2015 award winners, representing some of the most engaged and talented diabetes educators in the field. Winners were announced at AADE15 in New Orleans. The full press release is below:
The American Association of Diabetes Educators (AADE), the national premier association dedicated to advancing the field of diabetes education, announces this year’s winners in our 2015 Awards Recognition Program. The awards were presented at the AADE 2015 Annual Meeting in New Orleans earlier this month.
Lifetime Achievement Award: Ann Albright, PhD, RD
Dr. Albright, diagnosed with type 1 diabetes at age 9, has had a life-long commitment to improving the lives of people affected by diabetes. She was the first diabetes educator, non-physician to hold the position of director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention in 2007. She has held executive positions at the Institute for Health and Aging, the University of California San Francisco (UCSF) and the California Department of Health Services. Albright has served in key leadership roles with AADE; the American Diabetes Association; the American College of Sports Medicine and the American Academy of Nutrition and Dietetics.
Allene Van Son Distinguished Service Award: Marcia “Marcie” Draheim, RN, CDE and Patti Geil, MS, RD, FADA, CDE
This award, granted posthumously, recognizes Marcie Draheim and Patti Geil for their outstanding contribution and service to AADE. Marcie Draheim was a longtime AADE member and 2009 president. She served on various American Diabetes Association committees and received the St. Luke’s Hospital Nursing Excellence Award for her work as a clinical diabetes educator.
Patti Geil began her involvement with AADE in 1998 and continued her dedication to the association the remainder of her life, including serving as the 2013 Annual Meeting Planning Committee program chair. She was actively involved in several organizations including the American Diabetes Association and authored or co-authored 12 books.
MY AADE NETWORK Award: Missouri Coordinating Body
Among this group’s many achievements were their outstanding efforts in volunteer recruitment and participation in leadership activities. They are excellent users of MY AADE NETWORK posting blogs, announcements and spurring very active discussion forums.
Advocacy Award: Bridget Jennings, RN, BAS, CDE
Selection of this award is based on engagement and participation of an individual member or stakeholder, who works towards advancing AADE’s advocacy efforts. Bridget has worked closely with AADE staff and her fellow Floridians to explain state licensure for diabetes educators. She expanded her knowledge of advocacy on a federal level, working with the AADE Coordinating Body leaders to provide updates.
Rising Star Award: Lynn Fletcher, PharmD, BC-ADM
Based on numerical scoring, this award recognizes a diabetes educator who has less than three years of diabetes education experience and has demonstrated leadership and commitment in their practice. Lynn rose to the top of the applications through her ability to foster connections in the community and leadership qualities.
Innovative Use of Media and Technology Award: Anastasia Albanese O’Neil, PhD, ARPN, CDE
This award recognizes the development and/or implementation of an innovative concept that utilizes technology to advance diabetes education. Dr. O'Neil created a prototype mobile web application called mDAD: Mobile Diabetes Advice for Dads to encourage dads to participate in the diabetes education of their children.
Public Comment Period Open: Revised Competencies for Diabetes Educators
A draft of the revised competencies for diabetes educators and diabetes educator associates are available here for your review and comment.
The revised competencies are intended to be a general guideline regarding the roles and responsibilities of diabetes educators and diabetes educator associates. We encourage you to take the opportunity to review the draft and to provide your input. The public comment period runs until September 20, 2015.
New CGM White Paper and Other Practice Documents Available
AADE has recently posted a number of new practice documents on our website. A new white paper was posted that is based on a thought leader summit devoted to continuous glucose monitoring (CGM). It identifies best practices for managing and educating patients through the use of CGM. Read more
Three new Practice Synopses:
The Healthy Eating Practice Synopsis summarizes key messages about healthy eating, describes the role of the diabetes educator as it relates to this behavior, provides some recommendations for practice, and shares essential resources and references. Read more
Community Health Workers in Diabetes Management and Prevention Practice Synopsis discusses the roles and competencies of community health workers as well as the role of the diabetes educator. Read more
Cultural Considerations in Diabetes Education Practice Synopsis provides information and resources on incorporating culturally relevant diabetes education. Read more
Harvard Law School White Paper on DSME Cost Sharing Released
The white paper, Reconsidering Cost-Sharing For Diabetes Self-Management Education: Recommendation for policy reform is now available. As technical assistance for the Together on Diabetes initiative, which was funded by the Bristol Myers Squibb Foundation, AADE requested this DSME cost-sharing white paper from the Harvard Law School.
The report draws the conclusion that insurers should provide coverage of DSME with little or no cost-sharing in order to both improve patient health and curb costs.
Review more advocacy tools and resources.
Thinking About Retirement? Keep AADE in Mind
Did you know that AADE has a Retired Member option? Stay connected with the diabetes educator community after retiring by continuing as an AADE Retired Member. To be eligible, you must be an active member of AADE for at least three consecutive previous years, be retired from your position and no longer employed. Retired Members have all the same privileges and benefits of Active Members except the right to stand for a national elective office or to hold a member-elected directorship position.
To learn more and become a Retired Member, please call 800.338.3633.
Diabetes Educators Make News with Eating Disorder, Monitoring &
Being Active Messages
In the past weeks, diabetes educators have made headlines for the role they play in helping people with diabetes live healthy, active lives. As part of AADE’s Professional and Public Outreach Campaign, media interest in diabetes education climbed thanks in part to AADE15 and other diabetes education news:AADE15: Media coverage of AADE’s annual meeting brought attention to important issues such as eating disorders and benefits of blood sugar monitoring for people with type 2 diabetes. Diabetes educators and AADE members Lorraine Platka-Bird, PhD, RD, Marcia Meier, RN, CDE, and Dana Brackney, PhD, RN, CDE, BC-ADM, were featured in multiple outlets, including Doctor Radio on Sirius XM, Endocrine Today and Endocrine Web. Coverage of the meeting resulted in reaching nearly 7 million people, raising awareness of diabetes educators and AADE. Active Living and Diabetes: As an expert in diabetes and active living, AADE Executive Board Member Karen Kemmis, PT, DPT, MS CDE, FAADE, is featured in an EveryDayHealth.com article about tips for people living with diabetes to get more activity. Karen discusses realistic ways to introduce activity into day-to-day life and the benefits of doing so.
These are just some of the examples of how the Professional and Public Outreach Campaign helps advance diabetes educators’ mission. Links to more media coverage are posted on AADE’s Facebook
pages. Feel free to share the articles with your networks to help spread the news of all of the important work diabetes educators do. And, join AADE’s campaign to reach prescribers and people with diabetes by emailing firstname.lastname@example.org
. You’ll receive free brochures and access to other campaign materials.
New Study Toolkit for BC-ADM Exam
2015 has been a busy year for the BC-ADM exam. The exam blueprint was restructured into four domains and the practice exam was updated to include results that identify any areas in need of improvement. Plus, the candidate handbook, a free resource, was revamped. Now, AADE has released a new study toolkit to help guide BC-ADM candidates in their preparation.
The toolkit includes four easy steps to prepare for the exam:
Step 1. Verify you are eligible to sit for the exam.
Step 2. Review the four study sheets, one for each domain.
Step 3. Focus on areas for improvement and review the resource list.
Step 4. Take the practice exam.
Click here to access eligibility and pricing information plus much more.
Weren't Able to Attend the Coordinating Body & Community of Interest Networking Reception?
If you were not able to join us at this AADE15 event in which attendees met their state Coordinating Body (CB) leaders, and learned more about the educational programs, activities and local groups available to them as AADE members- it’s not too late to become part of your CB. Don’t miss out on connecting with your AADE member colleagues close to home - become part of the discussions in your state.
Not familiar with AADE’s Communities of Interest (COIs) and did not have a chance to meet the leaders of these groups at the networking reception? Learn more about this invaluable resource to respond to your practice concerns along with tips and updates on diabetes education materials- all provided by diabetes educators just like you! Join these practice online discussions and participate in over 17 COIs-- all free to AADE members.
Fall CORE Concepts® Courses
If you're preparing to earn or renew your CDE® this fall, now is the time to start preparing. Register for a three-day, intensive CORE Concepts Course to jump-start your studies.
Dive into the world of diabetes education through case studies, interactive discussion and hands-on activities led by experts in the field. Brainstorm new ideas and share best practices with fellow healthcare professionals while earning up to 24 CE.
We have added some new features for 2015 attendees: Online CDE® exam test-taking strategies module Access to online study materials and CDE® exam practice questions
Access to online version of slide sets.
Register for an upcoming course:
October 15-17 | Washington, DC
*The use of AADE products does not guarantee successful passage of the CDE® exam. CDE® is a registered mark owned by NCBDE. NCBDE does not endorse any preparatory or review materials for the CDE® exam.
November DSME Workshop Expands to 1½ days
A successful diabetes education program implements the National Standards for Diabetes Self-Management Education and Support while navigating reimbursement, documentation and the importance of implementing a thorough follow-up plan. But what about educating patients with type 2 diabetes on prevention?
For the first time, AADE is adding a second half-day to the popular workshop, Building Your Diabetes Education Program- “Everything You Need to Know and More.” Mark your calendars: November 6-7 in Phoenix, AZ.
Attendees will spend the whole first day of the workshop brainstorming ways to build or improve their diabetes education programs. On the second day, attendees will now have the unique opportunity to explore the emerging realm of the National Diabetes Prevention Program. Participants will walk away with a binder full of samples to use in their own practices along with 10 CE.
Learn more about this workshop.
Remaining 2015 Live Webinar Schedule Released
Wait no more! The remaining live webinar topics for 2015 have been released. Use this monthly schedule to plan your learning in advance. Here are the upcoming topics: September 24: Medication effectiveness: How do type 2 meds compare? October 7: Managing obesity with medication October 21: Patient-centered care: The diabetes education and support algorithm
Gestational diabetes update Increasing provider referrals
Remaining 2015 Live Webinar Topics:
Behavior modification Comorbid conditions
2016 Annual reimbursement update
All topics and dates are subject to change. Download the complete schedule.
Top Comments on MY AADE NETWORK for Q1 Announced
Each quarter the most helpful, insightful, and/or eye-opening comments are voted on by our team of Online Community Contributors (volunteer members dedicated to facilitating conversations on MY AADE NETWORK) who pick two that truly stand out. Members whose comments are chosen each win a gift card and are recognized on their MY AADE NETWORK profiles with a Top Commenter badge.
Congratulations to this quarter’s winners, Linnet Steinman, RN, MSN, CDE and Tammi Boiko, MSN, RN, PHN, CDE!
Commenter: Linnet Steinman
Thread: Tricking the Glucometer
Topic: Diabetes Technology COI Discussions
“As educators and HCP, we need to be cautious about our words and actions when working with our clients living with diabetes. Using words such as ‘control,’ ‘testing,’ ‘compliance,’ even ‘management’ can invoke a sense of failure. I have given my son's logbook to his physician and they marked every blood glucose that was high or low with a red pen--then at home, as I document the next blood glucose readings, I am reminded of all the failures we had.
Many of our clients want to be ‘perfect’ to please their families and HCP, but as we know, that is not the nature of diabetes. We need to set expectations and make our offices a place for them to be honest about challenges and barriers they may face in caring for diabetes.
I have seen children with T1 obtain a number that is within range, alter the date and time on their meter and recheck again with another drop of blood. That way, they have multiple ‘good’ numbers that appear to be at different times.”
Or, they may have friends without diabetes that allow them to check. They may clean their finger with alcohol but not allow the alcohol to dry, diluting out the blood.
There is a story of a child who had been promised a new car if all her numbers were ‘good’… meter download revealed numbers in the 80-110 range… A1C in the double digits… she had been checking her dog's blood sugars.
One of the best ways to learn more about working with children with T1D is to attend a residential camp near you. The camps often need great medical staff, and it is real world!”
Read the full thread.
Commenter: Tammi Boiko
Thread: Creating a New Inpatient Role
Topic: Advanced Practice COI Discussions
I completed my MSN in Diabetes at Capella last Sept. My advice, make certain your MSN degree qualifies you as APRN in your state. In California, my MSN is not recognized as APRN, nor CNS.
I have been in your shoes, I've been the outpatient diabetes program coordinator for 8 years, and two years ago, I was asked to cover the inpatient side as a diabetes educator. After 3 months, it became apparent an advance role would be required glucose management. I do work closely with the hospitalist and have an Endo Champ, I make recommendations for treatment and care, but in Calif., unless I am a NP, I cannot officially place orders. Even my CNS cannot place orders.
My title was changed to Manager, Diabetes Service, which allowed me more wiggle room with order sets, nursing education and working with the MD's.
My Capstone addressed the need for inpatient APRN for glucose mgt. My researched demonstrated, currently in the US, on an average, only 1,000 board certified Endocrines currently practice/make rounds in the hospital setting.
Our role in glucose management is growing... we need to gain advanced privileges!
Good luck, keep us posted!”
Read the full thread.
Know someone who is giving exceptional advice, insight, or help on MY AADE NETWORK? Send us a tip along with a link to the submission, and that member’s comment will be entered into the contest for the quarter it was posted.
Get the Most out of Your AADE Membership
Make sure you’re taking full advantage of all the great benefits provided to you as a member of the leading association for diabetes educators. Whether it’s significant discounts on the Annual Meeting and local events, great savings on education courses and products, valuable patient and practice tools, or any number of other resources, AADE delivers what you need to enhance your diabetes patient care.
Visit the online member packet for more details and to ensure you’re getting the most out of your membership.