2009 Legislative Priorities

The following issues have been adopted by the Registered Dental Hygienists of Texas as their legislative priorities for the 2009 Session of the Texas Legislature

1. Improve access to long-term, consistent oral health care by expanding Section 262.1515

Expand Section 262.1515 of the Dental Practice Act to increase locations dental hygienists can enter to include Head Start Centers, Community Health Centers, and any other Texas State Board of Dental Examiners approved facility, and to increase the number of times a dental hygienist can provide preventive services to a patient in one of these facilities during a one year period.

1. Administration of Local Anesthesia under Supervision

Legislation to allow a dentist to delegate to a certified, registered and licensed  dental hygienist the administration of local anesthesia for management of treatment-related pain. This bill would give a Texas dentist the option and authority to delegate to a properly trained dental hygienist the administration of local anesthesia under supervision.

For further information regarding the 2009 Legislative Priorities of the TDHA, please contact:

Beth Stewart, RDH
President
Texas Dental Hygienists’ Association
B.Stewart@texasdha.org
432-413-8843

Legislative Update 9/1/2009

We had a very successful Legislative session this year. We did a lot of preparation before the session which allowed both of our bills to be pre-filed and sponsorship secured very early, obtaining low bill numbers and companion bills.

SB97/HB456 expands the current law allowing a hygienist to provide preventive services in long term care facilities, school based centers and Community Health centers for a period of 6 months before an exam by a dentist is required. We had originally asked for a period of one year, but compromised with TDA on this, as well as other issues. This will go into effect September 1, 2009.

SB 536/HB 168 regarding local anesthesia was once again defeated. Heavy opposition from organized dentistry and much mis-information was presented in hearings. Rep. Lois Kolkhorst, Chair of the House Public Health Committee, was not comfortable with the provisions in the bill and decided to not vote the bill out of Committee. She did mention possible plans for an interim study to provide additional data and information regarding the safety of hygienists performing this procedure.

HB 3670 (filed by TDA) allows a Registered Dental Assistant to apply pit & fissure sealants, fluoride varnish and coronal polishing under direct supervision. TDHA was successful in removing language that would allow coronal polishing to be billed as a prophy and requiring additional educational requirements before permits to perform these duties are issued. “Legislative Intent” was established, meaning the TSBDE was given direction to write Rules & Regulations regarding the performance of these duties. While the law becomes effective Sept. 1, 2009, the Rules must be written, published, opened for public comment, revisions made if necessary, and republished before they can be in effect. This process can take several weeks and until it is completed, it is NOT permissible for these duties to be performs by a dental assistant in any office! This bill also allows for a Registered Dental Assistant to provide “interim emergency care” under general supervision. TDA was required to add more restrictive language as part of the compromise, regarding a dentist’s liability. This will also be addressed by the TSBDE in the Rules.

TDHA will be offering guidance, mentoring and continuing education to facilitate the process of hygienists’ moving forward in our expanded practice settings. While these bills may be considered “baby steps” in the future of our profession, they are steps in the right direction. At our Annual Session in September, in Houston, we will be revisiting our Legislative priorities for 2009-2015. We welcome your input and comments. If you have any questions regarding the bills passed this session or the future direction of Legislation, please contact Kris Potts, RDH, Legislative Chair, GFWDHS.

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IN OTHER NEWS

You also need to be aware of invitations from ADA to become an “associate” member of their professional organization. To make an informed choice, you should be aware of the full picture of the story.

The Illinois Story - The CDA (Chicago Dental Assoc.) refers to the allied professional member category with the Illinois State Dental Assoc. as a successful example of including dental hygienists and laboratory techs in the dental association. To make an informed choice, you should be aware of the full picture.   In 1999-2000, at the well known Chicago Midwinter Dental Meeting, there was a $25 membership fee for hygienists and lab techs to join the Illinois State Dental Association. Benefits such as discounts on CE were offered. Many signed up.   The Dental Association continued to encourage their dentist members to sign up their hygiene staff and to discourage their staff from joining the hygiene assoc. citing benefits and a lower cost. It was reported that many hygienists did not know that they were being “signed up” by their employers.   In legislative hearings, the Dental Assoc. claimed their hygiene membership exceeded that of the Illinois Dental Hygienists’ Association. The Dental Assoc. also utilized the testimony of two Dental Assoc. hygienist members claiming to be representative of hygiene in the state. The Dental Assoc. in Illinois used the allied membership activity as an effort to drive a wedge among dental hygienists. Fortunately, the state legislators saw the attempt for what it was and decided in favor of local anesthesia and general supervision for dental hygienists in spite of it.   In California, they are calling the allied membership an Associate Dental Health Provider, ie; ADHP. Sound familiar? Many hygienists will mistake this for the ADHA’s ADHP initiative and undoubtedly sign up.   Let’s not duplicate the Illinois experience in Texas. Let’s encourage hygienists to join their own association to speak on their behalf about matters affecting dental hygiene.  

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CDHC - ADA’s Workforce study on creating the Community Dental Health Coordinator position

On March 27, 2007 ADA President Kathy Roth testifies as part of a hearing entitled “Insuring Bright Futures: Improving Access to Dental Care and Providing a Healthy Start for Children” before the Subcommittee on Health of the Committee on Energy and Commerce, US House of Representatives.  As part of the ADA’s written and oral remarks, they are advocating for “some assistance from Congress” with their CDHC proposal. Dr. Roth described the CDHC provider as “….essentially a social worker with some clinical oral health skills…”.   Rep. Gene Green (D-TX) posed a question asking if the provider would be an …”oral health provider in addition to a social worker and whether the CDHC would be a state-licensed position?”   Dr. Roth directly answered the question with, “No, the CDHC will not be a state-licensed position – I would like to make that very clear…It will basically be a social worker with some clinical oral health skills…”   The exchange in the committee clarifies two important points.   First, although we have suspected the ADA was lobbying Congress trying to secure funding for a CDHC demonstration/pilot project – Dr. Roth’s mention of the CDHC on several occasions confirms that suspicion.   Secondly, although nothing has been said that the CDHC would be licensed, the statements on that day made it clear that licensure for the CDHC is off the table.   In the state of Texas, a Social Worker must be licensed and hold the equivalent of a Bachelor’s Degree for an entry level position and a Master’s for specialization, but a CDHC would be allowed to scale subgingivally, administer local anesthetic, carve and place restorations among other duties that are currently denied to a degreed, licensed Registered Dental Hygienist in Texas. To have it unregulated and unlicensed is a direct threat to the public’s safety without ensuring an individual administering direct patient care meets a minimum standard of competence.   In addition, the proposed CDHC as someone to provide direct access to the public is contradicted (with the exception of oral health education) as all the proposed duties would require the direct supervision of a dentist.   These are very real, very immediate threats to our profession and is something ADHA and TDHA is very much on top of, working for you!

Thanks to all of you who testified either verbally or in writing, and all of you who worked behind the scenes making phone calls, sending emails, and faxes, and contacting legislators. That is what gave us the power to attain hearings this session.   Without your efforts this would not have happened. Access to Care is becoming a big issue, not only for dental care but for health care in general. We were able to capture the attention of Legislators that hygienists were not only willing, but capable of meeting some of these needs were it not for the restrictions imposed upon us in the Practice Act.

Each session brings us little closer to our legislative goals, until then, we learn, we adapt, we overcome.  As our esteemed TDHA President Jones said, “The best way to eat an elephant is one bite at a time.”

Anyone got a recipe for Elephant Stew?

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TEX HY-PAC

In 1978, the TDHA voted to support the formation of Texas Dental Hygienists’ Political Action Committee (Tex Hy-Pac). Its purpose is to encourage dental hygienists and other interested persons to inform legislators of current dental hygiene issues. This voluntary, non-profit committee supports the goals of TDHA, but operates independently and autonomously.  Tex Hy-Pac is not affiliated with any one political party but supports candidates who have demonstrated an interest in excellence in dental hygiene, and to persuade other candidates to hear our voice.This committee donates money to endorse candidates, provides information to hygienists on current legislative issues including those candidates whose views are consistent with a positive impact for dental hygiene.  The synergy of dozens and hundreds of dental hygienists working together is what it takes for our collective voice to be heard.

To find out more about what bills are before our Legislature: www.capitol.state.tx.us