1. Demonstrates initiative in implementing a plan for effectively managing a diabetes education program 2. Implements care using the typical strategies and resources available for problem-solving
3. Collaborates with all members of the healthcare team to provide for needed changes in the patient’s plan of care
4. Uses evidence to guide the delivery of diabetes care and education
5. Assists with the development, selection, or evaluation of diabetes-related resources 6. Identifies patterns of behavior among staff requiring conflict management
Business Management
1. Works with other agency staff to evaluate safety, effectiveness, and cost relative to diabetes-related materials and equipment
2. Uses expertise in application of sound judgment to decisions related to resource acquisition and use
In closing we hope that the responses provided and the supplemental documents paint a better picture of why there is a need to ensure that persons with diabetes need access to quality diabetes self-management training and that those providing it are adequately trained, educated and credentialed.
We look forward to hearing your recommendations and will take them in high regard as we move forward in this effort.
Respectfully,
Heather Denise, RD CD CDE CPT HCA, WADE Coordinating Body Chair, Poulsbo, WA Patricia Haldi, MSN RN CRRN CDE, WADE State Legislative Coordinator, Liberty Lake, WA Carrie Swift, RD CDE BC-ADM MS, WADE Coordinating Body, Richland, WA
Cindy Brinn, MPH RD CDE BC-ADM, WADE Immediate Past Chair, Bellingham, WA Prepared by:
James E. Specker, State Advocacy Manager, AADE, Chicago, IL
Kim DeCoste, RN MSN CDE, Chair, Kentucky State Licensing Board for Diabetes Educators, Richmond, KY Patricia Haldi, MSN RN CRRN CDE, WADE State Legislative Coordinator, Liberty Lake, WA
CC:
Charles J. Macfarlane, FACHE, CAE, Chief Executive Officer, AADE, Chicago, IL Martha L. Rinker, JD, Chief Advocacy Officer, AADE, Washington, DC
Works Cited
American Association of Diabetes Educators . (2010). Competencies for Diabetes Educators. Retrieved from http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/general/Competencies2011.pdf American Association of Diabetes Educators. (2007). What is Diabetes Education? Retrieved August 19, 2013, from
AADE: http://www.diabeteseducator.org/DiabetesEducation/Definitions.html
American Association of Diabetes Educators. (2011 ). AADE Practice Advisories. Retrieved August 14, 2013, from Diabetes Educator:
http://www.diabeteseducator.org/export/sites/aade/_resources/pdf/research/PRACTICE_ADVISORY_Tel ehealth.pdf
Linda Haas, M. M. (2012). National Standards for Diabetes Self-Management Education and Support. The Diabetes Educator, 619 - 630 .
Mayo Clinic Staff. (n.d.). Pre-diabetes: Risk Fators. Retrieved August 16, 2013, from Mayo Clinic: http://www.mayoclinic.com/health/pre-diabetes/DS00624/DSECTION=risk-factors
July 19, 2013
Sherry Thomas, Policy Coordinator Washington State Department of Health Health Systems Quality Assurance
PO Box 47850, Olympia, WA 98504-7850 Dear Ms. Thomas:
It is my pleasure to write a letter in support of state licensure for diabetes educator.
As a person living with diabetes for the past 24 ½ years I know I would not be where I am at without the support I received from my CDEs (Certified Diabetes Educators) back in 1988. I was given such a great start with my diabetes that I went on to become a Diabetes Educator 5 years later and earned my own CDE in 1994, by sitting for the exam, which I’ve sat for a total of 3 times and most recently renewed by CE of 75 hours over 5 years . I am very proud to carry the credential of CDE.
What I am now very concerned about is that anyone can say they are a health educator or life coach and teach patients about diabetes without having the credential of CDE or the
knowledge and experience a CDE carries. I have personally worked with dietitians and other health care providers who “claim” to have the same knowledge as I have in regards to
diabetes management and care. However, when I see patients who have been in the care of these “counterfeit” diabetes educators I find patients with diabetes so out of control and disillusioned about their own abilities to manage their diabetes, I have to start back at the beginning. I frequently hear “if I had this information when I first got started, I would be in better health today”. (Research has shown that when patients get their diabetes in control and maintain control for the first 10 years, they can delay/prevent complications by 20 to 30 years.)
The following is an example of what I am most concerned about. I saw a patient with type 2 diabetes about 4 years ago (for the first time). She had previously seen a RD upon her diagnosis of diabetes. At our first visit I asked her how her blood sugars were. She stated she had not started checking her blood glucose as she was told all she needed to do was lose some weight and it wasn’t time to start checking yet. I got her monitoring her blood glucose that day and her BG was > 250 mg/dl and was having a very difficult time staying awake during our appointment. Her A1C was around 11%. After seeing me for 3 months and monitoring her A1C had come down to around 7% and she felt much better and alert during our entire appointment. Now 4 years later my patient has neuropathy in her feet and has a fair amount of pain related to the neuropathy.
This RD has told people she is a diabetes educator yet she does not have the credentials of CDE, and despite my encouraging her to take the exam she has refused to go the extra mile for her patients. I have seen several patients in the recent past previously seen by this RD
and everyone of them I go back to the basics on blood glucose monitoring and daily
management routines ( eating 3 balanced meals/day with snacks as needed, how to take their medications, the importance of activity, coping with diabetes, reducing the risks for
complications and problem solving).. This RD is a danger to our community with diabetes if she continues to give them information that does not move them into self-management mode for their diabetes. One reason for licensure would be to keep this particular RD from doin
g
to other patients what she has done to the particular patient.
Licensure will assure the public that the education and training provided by a licensed professional will be accurate and safe. Licensure will set standards of care provided by professionals who are at the front line of the war against the epidemic of the most costly chronic disease our generation faces. In 2012, the cost for diabetic medical expenses in Washington totaled $5.11 billion, and indirect expenses totaled over $1.36 billion. The current lack of standards in the training and education provided to those with a diagnosis of pre-diabetes and/or diabetes contributes to poor self care management that more than often results in diabetes complications i.e., improper foot care leading to financial, physical and emotional effects of amputation.
In conclusion, I fully support the efforts of WADE as they seek legislation for licensure for diabetes educators. I personally see this action as a vital move in the fight against a serious and costly epidemic that poses a major public health problem. If we are to make advances against this devastating disease we must improve health care education and providing licensure for diabetes educators will do just that.
Sincerely,
Leslie Merklin-Barber BSN, RN, CDE
206 431-5370 Work Phone 253 228-1607 Cell Phone