Moving towards An Integrated Chronic Disease Workforce: CVD Certification for RI Diabetes Outpatient Educators

Objective:Cardiovascular disease (CVD) is a concern for adults with diabetes and an independent public health problem. RI is providing expanded practice opportunity in CVD management for the Certified Diabetes Outpatient Education (CDOE) workforce. This will provide more comprehensive education to persons with diabetes, begin to build a workforce that can provide education to persons with CVD, and better sustain the workforce by increasing skills and reimbursement potential.

Methods: Since 1980 the CDOE program of 211 certified nurses, dietitians and pharmacists has been a sustained initiative under the auspices of the RI DPCP. A 26-member CDOE Board provides policies/procedures for diabetes education, certification program, continuing education programs and quality oversight. CDOEs serve approximately 6,000 persons with diabetes annually (about 10% of adults with diagnosed diabetes). The CDOE program is self-sustaining and a 1997 legislative mandate requires reimbursement for diabetes education. A CVD sub-committee was created in 11/2008 to establish objectives, curriculum and certification requirements.

Results: The CDOE Board approved a CVD CDOE program in 9/2009. In 10/2009, 40 CDOEs took the 14-hour Certified CVD Outpatient Education Course and 2- hour certification exam. This was self-funded with CDOEs paying $100 for the training and the DOE Board paying for the speakers’ honorarium. The CDOEs who obtain CVD certification are poised to provide CVD education to persons with diabetes and/or CVD and to become care managers for RI’s multipayer patient centered medical home initiative.

Conclusion: Expanding an existing self-sustaining diabetes professional workforce to other chronic diseases is possible in an integrated chronic care system.