2011 Legislative Session – Update 1 (January 20)

ASDA Government Affairs and the 2011 Legislative Session

The Arkansas State Dental Association is a leader in the healthcare community with an effective outreach to ensure that its members have a collective and influential voice in state government. ASDA’s grassroots efforts have championed many political issues for its members, including issues related to water supply fluoridation, insurance coverage and scope of practice. The ASDA maintains constant vigilance to defeat harmful legislation and regulation, while working toward solutions to problems related to Medicaid, low-income access, auxiliary education and insurance reform.

ASDA applies the following CORE VALUES (within the existing political climate of the legislature) to determine its advocacy strategy:

  • QUALITY: Ensure that the best and highest level of dentistry is provided in a clinically-appropriate setting by a team of trained professionals led by the dentist.
  • ACCESS: Belief that all Arkansans are entitled to the same quality of dental care regardless of their socioeconomic status or geographic location.
  • PREVENTION: Belief that it is far better to prevent disease rather than treat disease.

For many years, you’ve trusted ASDA to protect the practice of dentistry, and we are asking you to trust us to protect your interests in considering the dentistry-related bills pending in the current legislative session.

There are several driving forces behind three of the bills, including the Arkansas Department of Health (ADH), the Arkansas Center for Health Improvement (ACHI), and The Pew Charitable Trust (Pew). The ADH identified oral health as one of the top four problems in our state, the ACHI identified oral health as its number one priority, and Pew issued a report in February 2010 entitled, The Cost of Delay: State Dental Policies Fail One in Five Children, in which Arkansas was assigned a failing grade in the area of dental health. In its report, Pew assessed and graded states and the District of Columbia on whether and how well they are employing eight proven and promising policy approaches at their disposal to ensure dental health and access to care for disadvantaged children. Arkansas received an F, and was identified as one of only nine states that “have not yet implemented proven, cost effective policies that could dramatically improve disadvantaged children’s dental health.”

The ASDA has concerns with the Pew report, but it has been widely publicized and distributed, is embarrassing to the Arkansas dental profession, and is the main impetus behind three bills pending in the 2011 legislative session. It is imperative that we demonstrate, on behalf of dentists statewide, that we are engaged and committed to improving access to dental care. To this end, the ASDA has worked with Senator David Johnson of Little Rock in drafting three bills that are a direct result of the Pew report and the high priority assigned to oral health by ADH and ACHI.

For twenty years, the ASDA has encouraged these groups to get together to talk about dental care in the state but only now, because of the Pew report, are they recognizing the importance of oral health. It is imperative that we demonstrate support of legislation that seeks to improve access to oral health care, as long as it does so in a manner that will not negatively affect the practice of dentistry. To this end, and in keeping with its Core Values, the ASDA supports the following bills pending in the 2011 legislative session:

Collaborative Hygiene (SB42)

Although in the past the ASDA has opposed bills of this nature, in order for us to be fully responsive to the challenges at hand, the ASDA has worked with the Arkansas State Dental Hygienists Association to create this bill. The Collaborative Hygiene bill would permit hygienists to provide certain services in public schools and other public settings and in nursing homes and facilities serving disabled adults.

There are several key provisions of the bill, without which the ASDA would not be able to support it. These provisions protect the dental profession, while improving access to important preventative care in our state:

  • Dentists will remain in full control of all services provided
  • Hygienists will only be permitted to provide services that they are currently authorized to provide
  • Hygienists may only provide services through an agreement with a collaborative dentist
  • Dentist and hygienist must both hold a Collaborative Permit from State Board of Dental Examiners in order to collaborate
  • A dentist may not collaborate with more than three hygienists

At all times, the hygienist will have to determine whether or not the patient already has a dental home. If they do, the hygienist is not to interfere with that relationship. But if the patient has no dental home, the hygienist can provide preventative care services that the patient is otherwise not likely to receive. If the patient needs restorative care and has no dental home, the hygienist will refer the patient to the collaborative dentist.

If a hygienist renders services for which payment is available (whether through Medicaid or some other means), payment is made directly to the collaborative dentist, who may then provide some payment to the hygienist based on the terms of their collaborative agreement.

Under this legislation, the ADH will develop of system of prioritization for underserved populations that would benefit the most from collaborative services, and attempt to direct services to those communities.

The ASDA supports this bill because it promotes one of our core values—PREVENTION over TREATMENT—while doing nothing to diminish the dentist’s level of control over dental services.

Application of Fluoride Varnish by Pediatricians (SB43)

This bill is another direct result of the Pew report, and would permit pediatricians, after proper training (including dental caries risk assessment and fluoride varnish application), to apply fluoride varnishes to a patient who does not have a dental home. The ASDA supports this legislation after meeting with the Arkansas Academy of Pediatricians, who agrees that some level of additional training needs to be provided to physicians before allowing them to provide the services.

Water Fluoridation (Bill No. Unassigned)

The Water Fluoridation bill, if introduced, would mandate fluoridation of the state’s community water supplies that serve populations of 5,000 or more. Pew has weighed in on this particular bill, having hired a lobbying firm to support it. This bill, which is the most controversial, is also a direct result of the Pew report. This legislation is proposed in the shadow of a very recent report from the EPA that recommends a reduction in the amount of fluoridation contained in water supplies. The ASDA is depending on the solid science demonstrating that community water fluoridation and placement of sealants is a good formula to prevent the majority of dental decay in our younger population, and is vitally important in underserved areas.

Dentistry historically has always brought solutions to problems, and we continue to do so. Supporting this bill proves that, once again, we are willing to come to the table to offer solutions rather than simply complain about problems. The ASDA supports this bill in its belief, based on science, that fluoridation is crucial to the oral health of young Arkansans.

Non-Covered Services (Bill No. Unassigned)

This bill would prohibit dental insurance companies from limiting fees for services not included in dental benefit plans. This issue has been a battle on a nationwide level, but this bill has the support of most of the affected parties in Arkansas (Delta Dental, Arkansas State Chamber of Commerce, and the majority of insurance groups, including anticipated support by Blue Cross/Blue Shield). This is an issue of great import to the practice of dentistry, and the ASDA is actively supporting this bill to protect its members.

Other Legislation

The ASDA also supports proposed legislation that would ensure adequate funding for additional dental student positions at the University of Tennessee, and would ensure that the loan program for our dental students remains intact and fully-funded.

If you have questions, concerns or would like additional information, contact Billy Tarpley, ASDA Executive Director, by e-mail at billy@arkansasdentistry.org or by telephone at (501)834-7650.

Comments on this entry are closed.