dental mid level bills an overview and discussion...mar 22, 2017 · dental mid level bills an...
TRANSCRIPT
Dental Mid Level Bills
An Overview and Discussion
Shannon Wells, MSW
Oral Health Affairs Manager
March 22, 2017
Oral Health Affairs Manager
You May Have Heard…
What's Going On
The PEW Charitable trust has filed Senate, No. 1169 An
Act authorizing dental therapists to expand access to oral
health which opens up and expands the role of a dental
hygienist.
The Mass Dental Society has come out with their version
of a mid-level provider bill Senate, No. 142 known as An
Act relative to graduate education for certain professionals.
What's in the Scope from MDS Bill
A licensed public health dental practitioner may perform all acts of a registered dental hygienist at the same supervision level as a registered dental hygienist and may perform the following acts under direct supervision of a licensed dentist:
identify oral and systemic conditions requiring evaluation and/or treatment by dentists, physicians or other healthcare providers, and manage referrals
dispensing and administering via the oral and/or topical route non-narcotic analgesics, anti-inflammatory, and antibiotic medications
fabricating athletic mouth guards
emergency palliative treatment of dental pain limited to the procedures in this section
preparation and placement of direct restoration in primary and permanent teeth
fabrication and placement of single-tooth temporary crowns
preparation and placement of preformed crowns on primary teeth
indirect and direct pulp capping on permanent teeth
indirect pulp capping on primary teeth
removal of space maintainers
What's not in Scope in the MDS
The bill removes procedures permitted by CODA, specifically extractions and
minor repairs on removable prostheses. No extractions are allowed even
under direct supervision.
What’s Allowed Under Scope in the PEW
Must complete 500 hours, or 1 year of residency, under direct supervision before practicing under general supervision
• Under general supervision, DT may perform the following w/out dentist prior exam:
All public health DH procedures;
All acts as defined by CODA, plus:
Interpret radiographs;
Place space maintainers;
Pulpotomies on primary teeth
oral evaluation/assessment and develop treatment plan, and
Nonsurgical extractions of erupted, badly diseased permanent teeth with +3 mobility
Major DifferencesMDS PEW
Practice Area FQHCS & Health
Provider Shortage
Area
No restrictions or limitations
Education
Requirements
Completion of a
graduate level public
health dental
practitioner program
accredited by CODA
of at least 2
academic years
Completion of a DT program that meets
CODA standards; or NEASC accredited
school that meets CODA standards; or
certified by the Indian Health Service (IHS).
Training with developmental disabilities,
mental illness, cognitive impairment,
complex medical problems, physical
limitations, and vulnerable elderly
Supervising
Dentist
Licensed dentist
practicing full time
and accepts
MassHealth patients
May supervise up to
2 PHDPs at a time
Licensed dentist who enters into a
Collaborative Agreement with a DT
May enter into CMAs with up to 4 DTs
MDS PEW
Reimbursement No direct reimbursement to
the DH.
Reimbursed for services
covered by Medicaid and
other-third party payers-
appears to be direct to the
DH.
Licensure No licensure reciprocity
allowed of DTs licensed in
other states or certified through
the IHS
Licensure reciprocity
allowed of DTs licensed in
other states or certified
through the IHS
Dental Assistants No mention Can supervise DA
Impact Review practitioner must maintain
session log and patient care log,
DPH to report- safety,access…
DPH to establish Public Health
Dental Hygiene Coordinator at
the OOH
BORID will complete 5
year impact review patient
safety, costs, access
Adds on in the MDS Bill
• Community Health Worker training on Oral Health for licensure/renewals
• New Public Health Hygiene Coordinator at DPH Office of Oral Health
• DPH conducts 6 annual Water Fluoridation Seminars
• Mandatory School oral health screening for kindergartners and school annual reporting to DPH
Things to Discuss & Consider
• This isn’t going away anytime soon
• If our state opens up a new provider level- what’s in the best interest of the CHCS?
• Is your CHC going to use either one, why or why not?
• Does the CEO/CFO feel differently then you?
• What is the potential impact this will have on salaries and staff structure?
• Limited license dentists?
• What do you like in these bills?
• What do you not like?
Next Steps & Questions
• Do we formally support one over the
other?
• Do we let individual CHCS decide?
• Do we come up with an alternative bill?
