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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 310. Oklahoma State Department of Health |
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Chapter 590. Diabetes Supplies, Equipment, and Education Covered by Insurance |
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Subchapter 3. Service Provisions |
SECTION 310:590-3-5. Standards for diabetes self-management training
Latest version.
- When deemed medically necessary and prescribed by a physician or health care provider with prescribing authority working under the supervision of a physician diabetes self-management training shall be covered by individual and group health insurance policies as defined by statute. The diabetes education process for self-management training shall include the following standards.(1) Needs assessment. The licensed health care provider/diabetes educator shall conduct an individualized educational needs assessment with the participation of the patient, family or support systems to be used in the development of the educational plan and interventions. The educational needs assessment shall include, but is not limited to the following:(A) Health history;(B) Medical history;(C) Previous use of medication;(D) Diet history;(E) Current mental health status;(F) Use of health care delivery system;(G) Life-style practices such as occupation, education, financial status, social, cultural, religious practices, preventive behaviors;(H) Physical and psychological factors including age, mobility, visual acuity, hearing acuity, manual dexterity, alertness, attention span, and ability to concentrate;(I) Barriers to learning such as education, literacy level, perceived learning needs, motivation to learn, and attitude;(J) Family and social support; and(K) Previous diabetes education, including actual knowledge and skills.(2) Education plan. The licensed health care provider/diabetes educator shall develop a written education plan from information obtained in the needs assessment and that includes the following:(A) Desired patient outcomes;(B) Measurable, behaviorally stated learner objectives; and(C) Instructional methods.(3) Education intervention. The licensed health care provider/diabetes educator shall create an educational setting conducive to learning with adequate resources such as space, teaching and audio-visual aids to facilitate the educational process and use a planned content outline. The content outline shall be provided based on the needs assessment:(A) Diabetes pathophysiology;(B) Stress and psychological adjustment;(C) Family involvement in disease management;(D) Medical nutrition therapy;(E) Exercise and physical activity;(F) Medications;(G) Blood glucose monitoring and use of results;(H) Diabetes management which is the relationship between nutrition, exercise, medication, and blood glucose levels;(I) Prevention, detection and treatment of acute complications;(J) Prevention, detection and treatment of chronic complications;(K) Foot, skin, and dental care;(L) Behavior change strategies, goal setting, risk factor reduction, and problem solving;(M) Benefits, risks, and management options for improving glucose control;(N) Uses of health care systems and community resources; and(O) Preconception care, pregnancy and gestational diabetes.(4) Evaluation of learner outcomes. The licensed health care provider/diabetes educator shall review and evaluate the degree to which the person with diabetes is able to demonstrate diabetes self-management skills as identified by behavioral objectives.(5) Plan for follow-up for continuing learning needs. The licensed health care provider/diabetes educator shall review the educational plan and recommend any additional educational interventions to meet continuing learning needs.(6) Documentation. The licensed health care provider/diabetes educator shall completely and accurately document the educational experiences provided.