Education Recognition Program

Recognition Requirements

Any entity that provides DSMES is eligible to apply for Recognition of their DSMES service when and as long as it has demonstrated that the education services meet the  National Standards for Diabetes Self-Management Education and Support (NSDSMES). Eligibility for ADA Recognition status is only for diabetes education services in the non-acute setting, including Licensed Home Health agencies.


 

The 2022 National Standards for Diabetes Self-Management Education and Support are the framework for the  11th Edition ADA Education Recognition application requirements.

a) The education process reflected in the intitial comprehensive DSMES cycle must be established and docuemented for all participants of a DSMES service seeking Recognition and maintained for the full 4- year recognition period:

  1. Receiving a referral (if insurance requires a referral )from a provider managing the participant’s diabetic condition.
  2. *Assessing  the participant  to establish her/his diabetes education and support need(s).  
  3. *Formulating an education plan that  involves  the participant and is based on her/his assessed  concerns and need(s).
  4. *Educating  the participant in the area(s) of assessed  need(s) and documenting education outcomes (see scale at the top of the page)
  5. *Assisting the participant in setting at least one behavioral goal
  6. *Following up on the selected behavioral goal/s achievement.
  7. *Following up on other participant outcomes that the DSMES service is tracking.
  8. *Communicating with  the participant’s referring provider or other healthcare team  members outside of the DSMES service including summary of education plan or education provided, and outcomes.

    * Samples and templates are available on the ERP homepage

c) In support of the process and as a main tool for guiding education, the DSMES service must have a evidence based curriculum with the 9 topic areas, with the following elements:

  1. Content outline     
  2. Participant learning objectives
  3. Identified methods of delivery that is tailored/individualized and involves interaction
  4. Identified strategies for evaluating participant  learning

d) DSMES Service Evaluation:

    (I) There must be an identified process in place for the DSMES service performance improvement (CQI) based on participant or service delivery or process outcomes.

    (II) At least 2 outcomes must be tracked* as a measure of service success:

  1. Participant defined goals and measure of goal attainment
  2. Other participant outcome (metabolic, clinical, quality of life) with  measure of attainment

*The tracking may be done within an EMR or manually in Excel

e) DSMES service identified Reporting Period:

Original Applications: (new services) the reporting period can start up to 6 months prior to the online application submission date and be 1 month up to 6 months in length.

Renewal Applications: The reporting period can start up to 12 months prior to the online application submission date and needs to be a required 12 months in length.

All Applications:  There can be no more than 3 months from the end of the reporting period to the date of the online application submission.  A minimum of 1 participant must have completed the initial comprehensive DSMES cycle during the specified reporting period at each of the service’s multi-sites. 
 

f) Support Documentation & Payment:

  1. Support Documenation Checklist
  2. Payment (if paying by check; the check number will be required for completion of the online application, if you do not have a check number you may enter your DSMES service ID number).

*The support package must be received in the ADA office within 14 calendar days of the date of the online application submission. The support documentation must be uploaded within the online application or faxed to the fax number below. DSMES Service ID number must be the cover page of the documentation submitted when submitting via fax.

E-mail: ERP@diabetes.org
Phone: 1-888-232-0822
Fax: 1-703-991-9120

Payment Address:           

American Diabetes Association - ERP
Po Box 7023
Merrifield, VA 22116

  1. Applications are entered in the review queue once the three application elements are received.
    1. Online application is submitted
    2. All support documents are received in the ERP office
    3. Payment is received in the ERP oofice
  2. All applications are entered in the same review queue: original, renewal, additional site applications.
  3. Application review can take up to 30 days.
  4. Applications requiring additional information and or corrections during the review process may take longer than 30 days to complete review and the application to pass.
  5. Communications regarding application review and status will be done through the ERP portal (where your online application was submitted.)
  6. Quality coordinators will be notified via email when the application has been either approved or returned for additional documents.
  7. Notifications of certificate packet mailings will go out with approved application notifications.

It is the responsibility of the DSMES service to maintain adherence to the National Standards for Diabetes Self Management Education and Support (DSMES) as outlined by the American Diabetes Association 11th Edition Interpretive Guidance and Checklist all timeduring the 4-year Recognition period.

  1. The quality coordinator will be required to complete an on-line Annual Status Report (ASR) the anniversary month of the Recognition to confirm that the DSMES service continues to meet the National Standareds for DSMES. The coordinator will receive email notification of when the ASR is due.  ERP also conducts a monthly ASR conference call walks through how to complete the ASR and allows call particpants to ask questions.   Register for these free calls at:   www.diabetes.org/erpqa
  2. It is the responsibility of the DSMES service to display the Concerns Poster in an area where DSMES service participants can see it.  The Concerns Poster is sent with the Recognition certificate packet.  This poster provides contact information for the ADA Education Recognition staff so participants who have concerns about the education they receive can contact ADA.  The DSMES service may make as many copies of the poster as needed for all Recognized sites.  If the poster is lost, a new copy can be requested by the coordinator.  The coordinator may request a copy by sending an email to erp@diabetes.org with the DSMES service ID# and Concerns Poster in the subject line.
  3. Changes in DSMES quality coordinator or service status (i.e. site/program closure) should be submitted to ERP within 30 days of the change if possible.  The electronic Change of Information form   is available on the ADA/ERP website. at: www.diabetes.org/erpupdate
  4. ADA staff provides a regular report to the Centers for Medicare and Medicaid Services (CMS) and regularly updates the listing of Recognized DSMES services on the ADA website
  5. Five percent, or up to a total of 70, of all Recognized DSMES services will receive an on-site audit annually.  The DSMES services to be audited are selected randomly from among all active Recognized services.  A DSMES service may be selected any time during the 4 years of Recognition.  The Coordinator will be notified 10 business days prior to the audit for a selected DSMES service

*Please note that audit dates are non-negotiable and refusal of an audit will result in immediate loss of Recognition. Completion and submission of the on-line application constitutes an agreement to this random audit process.

  • Documentation and items that support the application will be reviewed during an on-site audit.  Current documentation and items to confirm that the DSMES service continues to meet the Standards will be required as well.
  • All documents used by the auditors can be found in the Maintaining Recognition section at www.diabetes.org/erp.
  1. Recognition must be renewed every FOUR years by submitting a renewal application. It is the responsibility of the DSMES service quality coordinator to know when Recognition will expire and to submit a timely application for renewal.
  2. A renewal notice will be emailed to the quality coordinator 6 months prior to the current Recognition period expiring.  At this point the coordinator can begin the application and see the randomly selected paper audit item.  The application can be started, saved and entered as many times as needed.  It is imortan to select “save” to save all application entries.
  3. Reminders will be available in the ERP DSMES service management system for up to 90 days prior to Recognition expiration.

It is recommended that DSMES services submit renewal applications at least 60 days prior to the current expiration date.

The American Diabetes Association (ADA) is the longest standing of the two Centers for Medicare and Medicaid (CMS) DSMT National Accrediting Organizations that I\identifies quality diabetes self-management educationl and support (DSMES) services that meet the National Standards for Diabetes Self-Management Education and Support. Benefits of ADA Recognition include:


 

Visit the ADA website – www.diabetes.org

Visit the Professional ADA Website - www.diabetes.org/pro

Contact your local ADA office – this can be found on www.diabetes.org

Call 1-800-Diabetes (1-800-342-2383)

VIII. How can I get information about Medicare regulations?

Information is available on the Education Recognition portion of the ADA website under Resources – Organizations, Publications, and CMS Reimbursement Contacts. Updates to DSMT reimbursement can also be found on the CMS website: www.cms.gov

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