Chapter 10. ADA Accreditation Guidelines
The ADA accreditation program also is based upon the national standards for diabetes self-management education.
The initial application fee is $1,100.00  for a single, primary site. Each additional site, under a primary program, costs an additional $100.00. The duration of the initial recognition is four (4) years. A primary site can add additional sites at any time during the four (4) year recognition period. Each additional site requires the payment of another $100 fee. There is no limit to the number of additional sites but the program must show how each additional site will be managed under the existing management structure.
The DSME entity must adhere to the following standards to obtain accreditation under ADA guidelines:
- The DSME entity must have the organizational structure, mission and goals that support quality DSME to improve diabetes care.
- The entity must have an advisory group in place that ensures and promotes the quality of the services provided to participants.
- The advisory group should include healthcare providers, consumers and community stakeholders.
- The program must a conduct a review of the community’s needs, determine the target population and, ultimately, provide services that meet the needs of the priority group within that community.
- The program must have a program coordinator who provides oversight and management for the program. The program coordinator will have the academic preparation and experience to oversee a chronic disease management program.
- The program must have one or more instructors who participate in the diabetes education provided. Instructors must have recent education and experience in diabetes management education. The instructor is not required to be a Certified Diabetes Educator. At least one of the instructors has to be a registered nurse, dietitian, or pharmacist. Program staff must have documentation of all licenses, CEU credits and other training for each staff member requiring these credentials.
Once the program has the essential components in place, staff can submit for accreditation from the ADA. The program must have a written curriculum that reflects currently accepted practice guidelines.
The components of an approved curriculum include the following items:
- Participant learning objectives
- Methods of delivery
- Strategies for evaluation learning
- Content outline
The program must also provide an individual assessment and education plan to address the individualized needs of each participant. This assessment and education plan must be documented in the patient’s medical record and adhered to by participating education providers. The education plan and assessment will be used to determine the outcome, evaluation measures. Each medical record requires personalized, evaluation goals as well as a follow-up plan. The plan must be developed, using a collaborative approach with healthcare providers involved in the care of the patient. The information in this collaborative plan is required to be submitted to the primary care provider as part of the continuum of care.
Lastly, the program must have a detailed evaluation program and provide quality assurance. A continuous quality improvement (CQI) program must be in place and evaluated as part of the program. Outcome measures must be reviewed and documented for each participant. However, the program’s ability to improve participant outcomes is not a requirement of ADA to obtain initial accreditation or reaccreditation.
The program must provide both participant data and program data to ADA as part of the accreditation process. The program data must cover at least a six (6) month period prior to submission for accreditation. Within this time period, the program must show that there has been a minimum of fifteen (15) participants.
ADA requires a review of the participant’s medical record to complete the accreditation process. In order to adhere to HIPAA guidelines, the program must ensure that no personally identifiable information (PII) is submitted for the medical record review. The submission of personal identification, without the individual’s consent, is a violation of the Health Insurance Portability and Accountability Act (HIPPA).
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The following information must be removed from all areas of the information submitted as part of the accreditation review:
- Phone number
- Social Security number
- Medicare number
- Medical record number
- Health plan beneficiary number
- E-mail address
- Account number
Items that must be submitted as part of the program documentation include the following:
- Patient chart with personal information removed as per HIPAA regulations;
- Program curriculum
- Documentation of participation of the oversight/advisory group;
- Program coordinator job description and resume of the individual serving in the position as program coordinator;
- Continuous Quality Improvement (CQI) plan and process.
To maintain accreditation under ADA guidelines, the program must submit annual status reports. In addition, program staff has to complete a process evaluation and outcome evaluation using the CQI process. The evaluation must be accompanied by an improvement plan that is used to improve the program quality.
An additional criterion for recognition is to ensure that the structure of the program has the following, minimum components:
- Documentation of an advisory group that provides input to the program;
- The priority population of the program is well defined and the need is documented;
- A qualified program coordinator is in place to manage the overall program. In addition, the program coordinator must meet the minimum qualification standards as a professional to manage the program
- Qualified instructional staff.
To obtain more information about ADA’s accreditation application and application process, please visit the website.
It is important to note that after a DSMT program receives accreditation from ADA or AADE and Medicare recognition from CMS. CMS recognized sites are subject to random program audits. CMS performs the audit and coordinates this effort with AADE and/or ADA in conducting random site selection.
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