At the TDA Annual Meeting in San Antonio in May of this year, TDA passed four resolutions that could affect the future of your profession. (Italics are mine)
1. To allow Texas licensed dentists to delegate to a dental assistant, who holds a pit and fissure sealant certificate, the placement of pit and fissure sealants under direct supervision. Currently, CDA’s with proper certification that are employed in a Medicaid provider office are the only CDA’s allowed to place sealants.
2. To allow Texas licensed dentists to delegate to a dental assistant the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces, utilizing a rotary instrument with rubber cup or brush and polishing agent (coronal polishing). Currently, CDA’s with proper certification that are employed in a Medicaid provider office can polish the surface of a tooth in preparation for the placement of a sealant or an orthodontic bracket. This new resolution, if signed into law would enable a CDA in any dental office to polish and remove stain from any and all tooth surfaces and potentially bill the patient for a prophy.
3. To allow a Texas licensed dentist to delegate to a properly-trained dental assistant interim treatment of an emergent dental condition under general supervision. The definition of “emergent care” is “relief of pain, bleeding or infection”. Draw your own conclusions.
4. To allow a Texas licensed dentist to delegate the performance of radiologic procedures to a properly-trained, registered dental assistant under general supervision. See above.
In addition, after a lengthy presentation (which included many inaccuracies) on the threat of the ADHA Workforce Model of the ADHP, the resolution to support the administration of local anesthetic by a dental hygienist, was defeated. Keep in mind, these resolutions are just that, resolutions and are not binding changes to our Dental Practice Act. Yet.
The ADA Workforce Model of the CDHC (Community Dental Health Coordinator) is still a very present obstacle. In Oklahoma, after a large donation to the University of Oklahoma, the ADA and ODA have plans to begin their “Pilot Program: of the CDHC this fall. Students in a “Distance Learning” environment, in just 18 short months of course work, with weekend clinical training once a month for the second half of the program, would be able to scale Type I Periodontal patients, scale supragingivally and spoon excavate decay with no anesthetic. They plan was pitched to provide access to care on federally funded and operated facilities, but some have the idea that school and church based programs would benefit also. There is no faculty in place and the proposed curriculum was presented to the Oklahoma State Board for their “eyes only” upon the direction of ADA. Not one of the 14 notebooks was opened, but the OSB voted to “support” the curriculum that wasn’t even read! Can the move for the CDHC in private practice be far behind?
We plan to forge ahead with our planned bills in the upcoming session in Austin for local anesthetic and expanding practice settings for the dental hygienist to allow for better access to oral healthcare to all Texans. February 22-23, 2009 we will have our Legislative Awareness Day in Austin. Please make your plans to attend. Your donations to Tex HY PAC are so important, now more than ever! The future of your profession as you know it is at stake. For more information on any of the issues mentioned here, feel free to contact me.
Kris Potts, RDH
Legislative Chair
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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
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