CDC Recognition and Sustainability

CDC Recognition and Sustainability

Obtaining CDC recognition increases the visibility and credibility for your Extension Diabetes Prevention lifestyle change program.  This can boost participant enrollment and strengthen referral relationships with health care providers and organizations.

Program recognition is managed by the CDC Diabetes Prevention Recognition Program.  Before considering applying for recognition, we strongly recommend reviewing and being familiar with the CDC DPRP Standards and Operating Procedures. This document (contents listed here) provides all of the requirements for recognition.

The National Diabetes Prevention Program Customer Service Center is a source of technical assistance for organizations planning to or currently delivering the National Diabetes Prevention Program. A specific section has been developed with resources to help you learn about receiving and maintaining CDC recognition.

Applying for CDC Recognition

The on-line application for CDC recognition is available at: https://dprp.cdc.gov/.

Your Extension organization must be ready to start offering sessions within 6 months after your effective date (the first day of the month immediately following CDC approval of its application).  Data must be submitted every 6 months and must include at least 5 new eligible participants.

If your Extension organization wants to use different modes of program delivery, separate applications are required for each mode either in-person only, online only, distance learning, or combination.

After submitting the application, you will receive a confirmation email. If you are using a CDC-approved curriculum you will normally be notified of the results of the CDC review within 15 working days.  Once your application is approved, you will receive a welcome letter granting your organization Pending recognition with a unique organization code and all of the details for program delivery and data submission.  Your organization will be listed on the DPRP Registry, the publicly available program locator.

Models for Program Coordination

The lifestyle change program can be coordinated by state Extension Services in many ways, depending on the specific situation within the state. An Extension organization may choose to coordinate the program statewide, regionally, or locally.

Statewide

  1. Statewide coordination involves the state specialist or other representative serving as the program leader. In this case, the state lead applies for CDC recognition for the whole Extension organization and all coaches and program sites report through the same organization code(s) through the state office.
    1. For example, at the University of Georgia, all county lifestyle coaches (extension agents) submit their data to the state office, and the State Specialist submits all data to the CDC under the organization code for that delivery mode.
    2. CE-NDPP States that have statewide coordination: Georgia, Arizona, Virginia, and Tennessee 
    3. Benefits to statewide coordination:
      1. more sites means more data to contribute toward achieving recognition
      2. Allows lifestyle coaches the opportunity to take a break from program delivery, so long as at least one cohort is conducted in the state each year
      3. Can be helpful for having substitute coaches in the event of employee turnover, transition, or absence
    4. Drawbacks of statewide coordination:
      1. One really poor performing location can bring down the average

Regional

  1. Regional coordination usually involves an Extension educator serving as the program coordinator for several sites in an area or region. In this case, each region would have their own organization code(s) for CDC recognition. In this case, a state may have several Extension organizations registered with the CDC.

Local

  1. Local coordination involves each county or local Extension site functioning as its own CDC recognized provider and program coordinator
    1. For example, at University of Florida and Washington State University Extension all counties have their own organization codes and report to CDC independently.

Data Reporting and Management

Each CDC-recognized organization is required to submit evaluation data to the Diabetes Prevention Recognition Program (DPRP) every six months from the effective date of their application.  In each data submission, your organization must include data for at least 5 new eligible participants.

Data submissions are made through the DPRP Data Submission Portal (https://dataPortaldprp.services.cdc.gov/samsinfo ). Using the Portal requires Secure Access Management System (SAMS) registration.

If you have not completed your SAMS registration, please submit a National DPP Technical Assistance Request by logging in to the National DPP Customer Service Center.

The NDPP Customer Service Center provides resources and guidance on the CDC-recognized organization’s data submission process. You will find information about reporting timelines, steps to complete the data collection spreadsheet, instructions for uploading the file to the CDC’s DPRP data submission website, and understanding your evaluation report.

These three resources are very helpful for becoming familiar with the data requirements:

DPRP Standards and Operating Procedures Data Entry Webinar

The DPRP Data Entry Webinar focuses on questions most frequently asked of CDC for mandatory data reporting. The purpose of the DPRP Data Entry Webinar is to review the DPRP Data Entry and Collection Process in alignment with the updated DPRP Standards and Operating Procedures. This session also provides guidance to CDC-recognized organizations on how to submit data through the DPRP Data Submission portal.

The Data Entry Excel Spreadsheet

The top of the spreadsheet has a list of variable names that correspond to the Data Dictionary within the DPRP Standards.  Even if you use a data management system like DAPS or DPP Express, you should be familiar with this CDC standardized spreadsheet.  This format MUST be used when submitting data using the DPRP Data Submission portal. The data management systems will export your data into a Excel csv file that matches the format of the CDC requirement for the data report spreadsheet. 

The Data Dictionary

This Data Dictionary is a summary of the data elements and the corresponding variable names and coding/valid values required for data submission for each participant in the program.  It is important to have a participant on-boarding process or intake form that collects all 24 of the data elements that will not change during the program.

For each session, you will need to report: session type, session date, participant weight, participant physical activity minutes for the past week.

Data Management Systems

For small programs, the Excel data template is a low cost, easy to use option.

The Excel spreadsheet is free, but staff time to do data entry is not.  Larger or more complex programs that cover multiple sites or counties may want to consider investing in a data management system that follows the CDC recognition requirements.  Some options include:

Data Analysis of Participants System (DAPS) 

Created by the Association of Diabetes Care Specialists and very affordable at $550/year.

DPP Express

Provided by the American Diabetes Association, pricing starts at $300/year for basic features and they do have an Educational Recognition Discount program.  A benefit of DPP Express over DAPS is the ability to plan, send and track recruitment campaigns using the platform when you purchase the Advanced Features.

Sustainability

Bringing a DPP lifestyle change program to your Cooperative Extension organization is the first step. Once you have established the program, and have successful participant outcomes, it is important that you plan how to sustain and grow your program. 

Do you want to offer it in more counties? Train new lifestyle coaches? The DPP is different from Extension programs with established sources of funding, such as EFNEP or SNAP-Ed.

There are several avenues to fund your Diabetes Prevention Program:

Charge a program fee

Determine what your program costs are, and calculate a fee that will ensure you recover your expenses. Nationally, many organizations charge a fee for the DPP. The CDC suggestion is around $500 per participant. You may also implement a sliding-scale fee in order to be inclusive of different financial challenges of potential participants.

Cost calculation resources: https://coveragetoolkit.org/cost-value-elements/

 

Insurance reimbursement

For more support on insurance reimbursement, the CE-NDPP working group has a subgroup on Insurance Reimbursement. Please contact us if interested in joining.

 

Medicare DPP

In the original DPP Research Trials, the risk reduction reported in older adults with prediabetes who made lifestyle changes was 71% (compared to 58% in all adults in the study). Therefore, the Centers for Medicare and Medicaid Services have covered the DPP lifestyle change program as a Medicare benefit since 2018. This means organizations delivering the DPP LCP can become Medicare DPP suppliers and get reimbursed from CMS for providing this program. Reimbursement is on a pay-per-performance fee schedule, shown below. Organizations must achieve at least ‘preliminary’ CDC recognition status before applying to become MDPP suppliers. Read more on MDPP here: Medicare Diabetes Prevention Program (MDPP) Basics – National DPP Coverage Toolkit Currently, Michigan State University Extension and New Mexico State University Extension are the only MDPP suppliers within Extension.

Medicaid DPP

In some states, organizations can bill Medicaid for DPP services. These reimbursement models vary by state, and more information is available here: Medicaid Agencies – National DPP Coverage Toolkit

Private insurers

Your organization may also contract directly with private insurers to provide the DPP lifestyle change program to their beneficiaries.

Third-party billers

Depending on the organization’s capacity to handle medical insurance claims, Extension DPP lifestyle change providers may choose to outsource the processing of claims submissions, invoicing, and payment. In that situation, the University would contract with a third party biller. Below are a few examples of third-party billers working with DPP reimbursement.

Solera https://soleranetwork.com/en/network-partners
Welld Health https://www.welldhealth.com
HabitNu https://www.habitnu.com/partners

State Employee Coverage

Some states offer the DPP LCP as a covered benefit to state employees. Click here to see if your state does: States with Public Employee Coverage Map

Your Extension organization can start by attempting to contract with the health insurers providing coverage to your state employees.

SNAP-Ed

Diabetes prevention is included in the USDA’s Food and Nutrition Service guidance: https://snaped.fns.usda.gov/sites/default/files/documents/FY%202022%20SNAP-Ed%20Plan%20Guidance.pdf Page 84 states, under allowable nutrition education and obesity prevention: “Diabetes prevention, education, promotion, and support that focuses on obesity prevention and is coordinated with multi-level interventions and/or public health approaches.” In many states, SNAP-Ed fund allocation and program priorities are set by the State Department of Health Services. Your Extension SNAP-Ed state coordinator can inquire about adding the DPP lifestyle change program to your state’s approved programming.

Grant Funding

Examples of agencies who have funded lifestyle change programs include county health departments, state health departments, Blue Cross Blue Shield, the Association of Diabetes Care and Education Specialists.

Employee wellness

Employers may choose to offer the DPP lifestyle change program as a wellness benefit. Your organization may pursue contracts with local employers to provide the program to their employees on a predetermined cost per participant. https://coveragetoolkit.org/commercial-plans/commercial-plans-employers/