Public Health Committee
JOINT FAVORABLE REPORT
AN ACT REQUIRING A STUDY OF MEANS TO IMPLEMENT RECOMMENDATIONS OF THE DIABETES ADVISORY COUNCIL.
Joint Favorable Substitute
SPONSORS OF BILL:
REASONS FOR BILL: This bill requires DPH, in consultation with DSS and the insurance department, to study ways to implement the recommendations of the diabetes advisory council to:
1. Secure Medicaid coverage for diabetes self-management education;
2. Devise a plan and seek financial support to increase the state's pool of diabetes educators who represent at-risk populations;
3. Modify cost-sharing of diabetes self-management, including ensuring that such education is not subject to insurance deductibles or copayments; and
4. Build the capacity for a state-wide diabetes self-management education program with an emphasis on culturally and linguistically appropriate standards and improved access.
The bill requires the DPH commissioner, by January 1, 2019, to report on the study and related recommendations. Legislation in 2016 established, within available appropriations, a diabetes advisory council in DPH.
RESPONSE FROM ADMINISTRATION/AGENCY:
Raul Pino, Commissioner Department Of Public Health (DPH): This legislation amends statues to (1) secure Medicaid coverage for diabetes self-management education programs accredited by the American Diabetes Association or the American Association of Diabetes Educators, (2) devise a plan and seek financial support to increase the states pool of lay and professional diabetes educators who represent at-risk populations including, but not limited to minorities and those residing in lower socioeconomic and rural areas, (3) modify cost-sharing of diabetes self-management education by reforming insurance plans to decrease barriers and ensure that such education is not subject to insurance deductibles or copayments, and (4) build the capacity for a state wide diabetes self-management education program with an emphasis on culturally and linguistically appropriate standards and improved access. As long as federal funds are available for the implementation of (2) and (4) The DPH can work with stakeholders to achieve that end. Provisions (1) and (3) do not fall under the purview of DPH and the Department asks the committee to consult with The Department of Social Services and Insurance regarding the fiscal impact of these provisions. Diabetes self-management education (DSME) is an evidence base program to educate those with diabetes to better manage and live with their conditions. On average DSME saves $1,445 per patient per year in insurance cost. This proposal will improve health disparities of priority populations.
Department of Insurance: This legislation will require health insurers to cover certain diabetes supplies and training without cost sharing. In addition to modifying cost-sharing requirements this legislation will affect the metal tiers on the health exchange. If the benefits proposed in the bill are to be covered with no cost sharing, this would increase the cost of health insurance for all Connecticut residents. This will also create issues with actuarial vales of plans and may throw off metal tiers on the exchange, creating barriers for individuals in the insurance market.
NATURE AND SOURCES OF SUPPORT:
John Cattelan, Connecticut Alliance of YMCA's: Request the addition of language from HB 6245 would require commercial, state employees and Medicaid health plans for diabetes prevention programs, such as the YMCA's Diabetes Prevention Program. The YMCA's program saved Medicare $2,650 for each person enrolled during a 15 month period.
Barbara Nadolny, RN: DSME can reduce blood glucose levels significantly. In these classes individuals learn the skills needed for diabetes self-care such as monitoring, taking medications, diet, and exercise. DSME is the missing piece of diabetes care and this legislation will allow Medicaid recipients are having coverage for diabetes education.
Pamela Howard, RN, Certified Diabetes Educator at Norwalk Hospital: DSME is important because it teaches those affected on how to live with diabetes and control it on a day to day basis.
Neal Lustig, Connecticut Association of Directors of Health: Type 2 Diabetes affects 9% of the state's population and if left unchecked can cause numerous health issues. For many this disease is manageable thru diet and medication along with the appropriate education. This legislation will increase funding for prevention and control through insurance reimbursements. In the long run this will help both patients control their disease and save the health care system money.
Stephen Habbe, American Diabetes Association: This bill addresses recommendations made by The Diabetes Advisory Council. Most importantly, it addresses the critical care gap by establishing Medicaid coverage for Diabetes Self-Management Education.
Connecticut Nurses Association: individuals that receive ongoing support and education have a better quality of life and better outcomes. Implementing these recommendations is essential to the better health of the state's citizens.
NATURE AND SOURCES OF OPPOSITION: NONE
Reported by: Walter L. Morton IV