from Washington
Legislation Update 

The 2015 August issue of the Advocacy Brief discussed S. 192, the Older Americans Act reauthorization bill. The bill, which funds critical services that keep older adults healthy and independent, includes provisions for oral health screenings which have not been previously included.

President Obama signed this bill into law on April 19, 2016.
from the states
Communities vote to keep water fluoridation

What's the issue?
An initiative to remove supplemental fluoride from the water in Marin County, California failed. Proponents of the initiative were unable to collect the 11,000 signatures needed to remove fluoride from the water.

Collier County, Florida and Downingtown, Pennsylvania also voted to continue fluoridating their water supplies.

In each community, health care professionals played a key role in advocating for the benefits of water fluoridation.

Why is this important?
As stated in ASDA's I-1 Policy, the association encourages the fluoridation of community water supplies. Patients may receive misinformation on the potential risks of community water fluoridation from internet sources or friends. As evidenced by the communities mentioned above, it is important to provide your patients with accurate information on water fluoridation to help combat efforts to remove fluoridation from water supplies.

Next step:

Massachusetts Senate approves dental hygiene practitioner budget amendment

What's the issue?
On May 25, in a 39-0 roll-call vote, the Massachusetts Senate approved a budget amendment that would create a mid-level provider level of practice. In an attempt to address policy issues within the annual spending bill, Sen. Harriette Chandler filed an amendment that would create a dental hygiene practitioner position within the dental team.

The provision will be discussed further in June during the House-Senate conference committee meeting to finalize the budget. There is no equivalent amendment in the House version of the budget.

Why is this important?
According to ASDA's C-2 policy, the dentist is the only dental provider that should perform the following functions: examinations, diagnosis, treatment planning and surgical/irreversible procedures.

The unanimous vote in the Massachusetts Senate signals that the Bay State could be the next to operate with mid-level providers. As dental students, it is important to continue to advocate for solutions that address barriers to care without creating a two-tiered system of care.

Next step:

California looks to improve Denti-Cal through the Dental Transformation Initiative

What's the issue?
As discussed in the January 2015 issue of the Advocacy Brief, children enrolled in Denti-Cal were not receiving the dental care they needed. California attributed the gap in care to low reimbursement rates, limited access to Denti-Cal providers in certain counties, and an increase in the overall number of patients eligible for Denti-Cal services.

In order to address the problem, the U.S. Centers for Medicare and Medicaid Services granted California a $740 million, five-year waiver to improve the system. This project is called the Dental Transformation Initiative (DTI) and focuses on the following four domains:
  • Domain 1: Increase preventative services utilization for children
  • Domain 2: Caries risk assessment and disease management pilot
  • Domain 3: Increase continuity of care
  • Domain 4: Local dental pilot programs
Since introducing the initiative, the California Department of Health Services released information about incentive amounts that will be paid for under domain 1. They have also provided the list of the 17 pilot counties that will be included in domain 3.

Why is this important?
Ensuring low-income residents receive the dental care they need is a complex issue. The Dental Transformation Initiative highlights the importance of developing multiple approaches to address the issue.

Next steps:

Barriers to care: By the numbers

ASDA created an infographic to spotlight issues related to barriers to care. Use this resource to inform yourself and others on some of the key metrics.
Advocacy Brief shares news about ongoing issues and legislation that are of interest to dental students and organized dentistry. Inclusion of items does not imply their adherence to ASDA policy.
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