Table 1. Examples of Diabetes Self-Management Education and Support Activities Implemented by State Health Departments, 2012–2014.

Strategy Driver	Example Activities
ADA-recognized or AADE-accredited DSMES programs established (primary or satellite sites)	The Alabama Department of Public Health created an advisory group to work with department staff members to identify existing DSMES programs, areas of the state underserved or unserved by DSMES programs, and organizations interested in becoming providers of accredited or recognized programs, and to determine which strategies should be pursued in which areas to increase access and referrals to and use of DSMES programs.
	Arizona Department of Health Services staff members provided technical assistance and training to 3 organizations in Arizona to obtain AADE accreditation (eg, capacity building within each organization, curriculum development, credentialing compliance, training of staff on evidence-based strategies).
Insurance coverage for DSMES	The Illinois Department of Public Health engaged with Medicare/Medicaid Alignment Initiative Health Plans to discuss DSMES coverage for patients/members with diabetes.
	Staff members of the Indiana State Department of Health provided live webinars on DSMES reimbursement for 20 hospital-based and 4 pharmacy-based DSMES programs.
Referral policies and practices in place in the health system to efficiently connect people with diabetes to DSMES programs	Members of the Nevada Diabetes Education Stakeholder group, created by the Nevada Department of Health and Human Services, used a DSMES academic detailing toolkit to educate health care providers on ways to increase self-care options for patients and make referrals to ADA-recognized or AADE-accredited DSMES programs.
	Maryland Department of Health and Mental Hygiene staff members designed and built an online self-management referral website that allows the public to search for DSMES classes and health care providers to refer patients to DSMES programs.
Awareness, capacity, and willingness of people with diabetes to attend DSMES programs when other drivers are in place	Michigan Department of Health and Human Services staff members expanded media promotion of recognized or accredited DSMES programs through their diabetes program website and a statewide radio public service announcement.
	The New York State Department of Health’s diabetes program partnered with the state’s arthritis program to develop a digital media campaign to promote DSMES among women aged 40 or older in 2 counties.

Abbreviations: ADA, American Diabetes Association; AADE, American Association of Diabetes Educators; DSMES, diabetes self-management education and support.