Fall 2011 Vol. 4, No. 1
Preventing and Controlling Diabetes
Approximately 25.8 million Americans live with diabetes. This number more than doubled during the past two decades, and researchers expect diabetes to become more prevalent in coming years. Researchers attribute approximately 10 percent of all U.S. health care spending to diabetes. According to the Centers for Disease Control and Prevention (CDC), people with diagnosed diabetes, on average, have medical expenditures that are 2.3 times higher than people without the disease. Diabetes can also lead to painful and costly health complications, including nervous system damage, heart disease, stroke, blindness, and kidney disease. To address the increasing burden of diabetes, and disparities in health care coverage for the condition, CDC funds state-based diabetes prevention and control programs in all states, the District of Columbia, and eight territories. Several of these programs encourage Medicaid reimbursement for patients’ education on the self-management of diabetes. This kind of education is intended to help people with diabetes lead healthier lives by better controlling their diabetes, preventing complications and reducing costs. New York and Texas have both recently expanded diabetes self-management education.
In 2009, for example, legislators amended New York’s Social Services law to give the state’s nearly 300,000 Medicaid beneficiaries with diabetes the opportunity to learn how to self-manage the disease. After the law passed, New York’s diabetes program staff worked closely with the Office of Health Insurance Programs to publicize this benefit to New York’s Certified Diabetes Educators and to increase health care clinicians’ referrals for its use. Data from the first year of benefit use were analyzed to consider whether to extend the benefit to other practitioners. In January 2011, the state’s existing policy was expanded to allow additional accredited diabetes self-management education programs to obtain reimbursement for their services through Medicaid.
The Texas Diabetes Prevention and Control Program and the Texas Diabetes Council collaborated on changes to public policy to ensure that all people with diabetes have access to diabetes self-management education. The Texas diabetes program worked with statisticians at the Texas Health and Human Services Commission to collect data on Medicaid recipients with diabetes. Data collected by the program provided a resource for legislators who enacted legislation in 2009 to create a pilot program for about 2,000 people with diabetes that allows at least 10 hours of self-management education to be covered by Medicaid, with the option for follow-up education.
Under the pilot, participants have access to diabetes self-management education that meets state and national standards. The Texas diabetes program and partner organizations are monitoring the progress of the project, and information learned will shape future efforts to make the service available to all Medicaid recipients with diabetes in Texas. In addition, Texas legislation enacted in 2011 requires a report by Dec. 1, 2012, estimating the annual direct and indirect costs, both public and private, of preventing and treating diabetes in Texas; and an assessment every two years of state-administered diabetes programs including number of people served, areas where diabetes services are unavailable and number of diabetes treatment providers under state programs.
CDC 2011 National Diabetes Fact Sheet
Upcoming Events and NCSL Resources
Fall Forum, Nov. 30- Dec. 2, 2011, in Tampa, Fla. Come learn about key state issues, and help tackle difficult policy concerns such as budget gaps, health care coverage, education affordability, transportation funding, energy costs and many others. NCSL's Standing Committees will also meet at Fall Forum to share state concerns and the effect of federal actions. The Committees saved states billions of dollars over the years as they work to fight unfunded federal mandates.
NCSL produces a series of brief reports about a variety of topics contained in the federal health reform legislation, known as the Accountable Care Act of 2010(ACA). The briefs are intended to help legislators and legislative staff understand better various provisions of the ACA and to provide resources for additional information.
NCSL can provide testimony to legislatures on chronic disease prevention; health promotion; preventing injuries and violence; reducing health disparities; access to health care; community health centers; and other health policy topics. Contact Alise Garcia at Healthemail@example.com.
LegisBrief: State Approaches to Prevent and Control Diabetes
Diabetes Overview Page
Diabetes in Health Reform
Diabetes in State Budgets
Diabetes Health Coverage: State Laws and Programs
Diabetes - State Legislation Overview
In the News
Leadership for Healthy Communities has released Obesity Prevention on a Budget: Low- and No-cost Policy Options to Increase Healthy Eating and Active Living, which outlines budget-conscious policy approaches to reduce obesity rates by increasing opportunities for healthy eating and physical activity.
On June 28, 2011, the Institute of Medicine of the National Academy of Sciences released a report, “For the Public's Health: Revitalizing Law and Policy to Meet New Challenges,” that reviews how statutes and regulations prevent injury and disease, save lives and improve public health.
An article released in the New England Journal of Medicine on September 1, 2011, shows that physician practices using electronic health records have significantly increased care standards and improved diabetes care than practices using paper-based records.
On September 13, 2011, Secretary Kathleen Sebelius of the U.S. Department of Health and Human Services (HHS) outlined Million Hearts, a $200 million initiative aimed at preventing 1 million heart attacks and strokes in the next five years by encouraging life-saving choices such as using aspirin, controlling blood pressure control and cholesterol, and not smoking.
On September 14, 2011, with support from the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention, the Public Health Accreditation Board launched the first national accreditation program public health departments. The goal of the accreditation program is to protect and improve the health of communities by advancing the quality and performance of all state, local, territorial and tribal health departments.
On October 6, 2011, HHS released a report, “Healthy People 2010 Final Review,” discussing the nation’s health goals over the past decade. The U.S. reduced cholesterol levels and smoking rates contributing to an overall drop in deaths from heart disease and stroke. Efforts to reduce health disparities and the obesity rate were not reached.
The CDC Alcohol Program developed an online tool, Alcohol-Related Disease Impact (ARDI), that provides access to national and state estimates of alcohol-related health effects, including deaths attributable to alcohol and years of potential life lost because of premature death related to alcohol.
On August 25, 2011, HHS awarded $137 million in ACA funded grants to 49 states, two territories and the District of Columbia to strengthen successful public health programs supported through the CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA). The grants aim to protect the public's health and prevent costly health problems by improving tobacco cessation services and laboratory and immunization services, preventing healthcare-associated infections and providing comprehensive substance abuse prevention and treatment.
On August 31, HHS awarded $40 million in ACA grants to strengthen public health workforce and public health services delivery by increasing education and training opportunities in areas such as environmental health, public health leadership, nutrition and cultural competency.
Public Health Project Partner News
NCSL collaborates with the Centers for Disease Control and Prevention and other national organizations—including the National Governors Association, the Association of State and Territorial Health Officials and the Society for Public Health Education—on public health projects. Recent resources available from partner organizations on public health topics include the following.
CDC Releases New School Health Profile Survey Results
The CDC Division of Adolescent and School Health released the report, School Health Profiles 2010: Characteristics of Health Programs Among Secondary Schools in Selected U.S. Sites that includes survey results from 49 states, 19 large urban school districts, 5 territories, and 2 tribal governments showing how states compare in school health policies and practices.
CDC Report: Strokes Rising Among Teens and Young Adults
A new CDC report from the Division of Heart Disease and Stroke Prevention shows strokes are rising among teens and young people. The increase may be due to more young people, ages 15 to 44, who have diseases such as obesity, high blood pressure and type 2 diabetes.
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