Legislation

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STANDARD OCCUPATION CLASSIFICATION FOR DENTURISTS
It Is Needed And Should Happen
SUMMER 2017

The National Denturist Association has been seeking a reversal of the Federal Bureau of Labor Statistic’s (BLS) denial of a separate Standard Occupation Classification (SOC) for denturists. The BLS has denied denturists a separate classification using the argument that the sample size for denturists is too low in most states for them to collect and report data on that occupation. Without the ability to collect data, side effects there cannot be a separate occupation listing.

Many denturists asked local officials and sent letters themselves arguing that while the sample sizes for data collection may be low in some states, in states where Denturists are licensed the numbers are more significant and would be clustered in a way to make the data easily identifiable. There would be no confusion in collecting this data from households because a licensed denturist is a distinct profession with certifications and training so a household member would be very clear that they are a denturist. The data could be easily segregated.

The NDA did some research with several agencies in licensed states about the importance of being able to separate denturists from dentists and other dental professions. All have said that any separate identification would give them greater ability to segregate data and would be beneficial – especially since state tax and regulatory systems often treat occupations differently based on training and duties. This data collection could be helpful to states in the following areas:

  • Comparing patient safety and health data between care given by a dentist to that given by a denturist. According to Washington State Department of Health staff, “Having distinct data assists us in identifying profession growth rates, fee setting and long range planning to assur e access to care.”
  • Clearer assignments of occupational duties for state workers’ compensation systems.
  • More appropriate tax rate assignment for levying of state business and occupation taxes.
  • More accurate reflection of the labor market for training development purposes.

In addition, the ability for insurance companies to better compare service provided by denturists versus the same service provided by a dentist would help with patient affordability for those services.

State Senator Karen Keiser, from Washington State, went a step further an initiated communication with the Bureau of Labor Statistics. She recently received a response similar to the one previously received stating that there was not enough data for a separate Standard Occupational Classification. However, she was informed that the decision regarding 2018 SOC codes has not been finalized and she urged us to continue the push.

It is time for denturists across the country to contact their US Representatives and US Senators to ask them to urge the Bureau of Labor Statistics to create a separate Standard Occupational Code for Denturists. It is needed and should happen now.

By Carolyn Logue, Lobbyist for the Washington Denturist Association
CA Logue Public Affairs
6514 78th Avenue, NE
Olympia, WA 98516
Carolyn.logue@comcast.net
360-789-3491

DENTURIST ISSUES GETTING DISCUSSION BUT NO SOLUTIONS YET THIS SESSION
SPRING 2017

The Washington Denturist Association knew this would be a difficult year. With many new legislators and huge budget issues, asking for help with fees would be a heavy lift. Sure enough, although we had a simple bill and a great hearing, SB 5538, did not make it out of the Senate Health Care Committee by the cut off date to be kept alive for this session.

The bill would have required the state auditor to do a performance audit of the Department of Health’s health provider fee setting and also would have reduced the amount of indirect agency costs that could be applied to the Denturist program. The second part would have cut about $200 from Denturist fees. Special thanks goes to Senator Randi Becker (R -2nd District) and the other bi-partisan sponsors for bringing this forward. All is not lost however. WDA is working with legislators and the Department of Health to see what else might be done to reduce Denturist fees and we hope to see some results soon.

WDA has also been exploring how to tackle the problems some denturists have with insurance payments. While many of the issues are actually resulting from federal law and policy, there potentially are some changes that can be made at the state level. One method for finding a solution could be passage of SHB 1316 by Rep. Michele Caldier (R – 26th District). This bill would create require stand alone dental plans to come under state utilization review provisions and protect dental providers from being denied payment if a preauthorization was approved for coverage. It also would protect dental providers from being subject to audits if they file an appeal on behalf of a patient. Finally the bill would require the Office of the Insurance Commissioner to convene a workgroup to look at current dental insurance practices pertaining to coverage of benefits and the explanation of those benefits to covered persons. This bill is moving through the state House of Representatives currently and is expected to move to the Senate. The Washington State Legislature also passed, and the Governor has signed, SSB 5079. This bill allows Dental Health Aide Therapists to practice on tribal lands. The bill does not amend the Denturist statute but does provide the ability for dental services to be provided on tribal lands by this new provider type. A link to the bill is here. WDA is committed to continuing to work on these issues throughout the remainder of the 2017 Legislative Session and into the interim.

WASHINGTON STATE DENTURISTS
PREPARE FOR THE UPCOMING SESSION

Although education funding will dominate the 2017 Legislative Session in Washington State, the Washington Denturist Association is hoping to see some changes on two fronts – insurance and fees. In the insurance arena, we are exploring whether or not we can apply greater certainty that denturists will be included in the networks of in-state, stand alone dental plans to provide greater assurance of payment. We are working with the Office of the Insurance Commissioner to ensure that any legislative change in this arena will benefit denturists as a whole and not create problems. Getting paid by insurance companies can be frustrating for denturists, particularly since many of the problems are from nationally based plans which the state Insurance Commissioner has no control over. If we can ensure that Washington state law specifies that licensed denturists are required to be in dental plan networks that may help. But we don’t want to see those networks limited to only a few. In addition, with Denturist fees being some of the highest provider fees in the state, we have embarked upon a search for ideas to help stabilize or reduce these fees. First, we have been working with the Department of Health. Second, we may pursue budget language to try and reduce the amount of “indirect fees” (those not related specifically to the Denturist program). For each Denturist, these fees equate to about $500 yet are supposed to be shared among all provider groups. Other individual providers pay far less. We are hoping the Department of Health and the Legislature will help us find a way to reduce this amount specifically. Other issues we expect to be working on include : “RAP Back,” and FBI fingerprinting program that would require all health care providers to have fingerprints and background checks on file; protecting reserves in our health care provider account from raids as legislators look for more money to fund education; and, mid level dental therapist legislation.

Washington State Elections Result in Status Quo

As usual it took a few extra weeks to get all of the ballots counted, but in the end the party balance in the Washington State Legislature will remain the same as the past two years. This means that the status quo will continue on budget and other issues as well. The Washington State Senate will remain a Republican majority even though they lost a seat in the election (Senator Steve Litzow was defeated by Lisa Wellman in the 41st Legislative District). Democratic Senator Tim Sheldon votes with the Republicans to give them the edge when it comes to selecting committee chairs. In the House, the Democrats will retain a narrow 50-48 majority over the Republicans. Governor Jay Inslee easily won his re-election which means that the Department of Health will continue with the same leadership. Insurance Commissioner Mike Kreidler also won re-election which will leave the leadership in that agency intact. For Washington State Denturists, the election means little change as far as policy goes. With split control, the chance of large tax increases is minimized. Rep. Eileen Cody is likely to continue to chair the House Health Care Committee. In the Senate, current Health Care Chair Senator Randi Becker is moving to take over a higher leadership position in the caucus so we will expect an announcement regarding a new chair soon.

-by Carolyn Logue, Lobbyist for the Washington Denturist Association
CA Logue Public Affairs, 6514 78th Avenue NE, Olympia, WA 98516 – Carolyn.logue@comcast.net

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DENTURIST LEGISLATION

“Never doubt that a small group of thoughtful committed citizens can change the world; indeed, it’s the only thing that ever has.” Margaret Mead, the famous cultural anthropologist spoke from experience; she influenced an entire cultural idea.”

The National Denturist Association, USA exists to raise public awareness of the denturist profession, to be the focal point for communication and to address unjust legal restrictions on the profession. This injustice affects, not only the professional denturist , but also those individuals who could greatly benefit from denturist services. The National Denturist Association, USA provides educational opportunities, publishes The National Denturist, USA magazine, provides public advocacy, organizes national and international conferences as well as a sundry of other activities.

Many people are not aware that a denturist is the only professional legislated “exclusively” to serve individuals with removable dental prosthetics. The denturist’s entire required curriculum of study focuses on the oral health of those in need of dental prosthetics and the actual fabrication of that appliance.

Since there is a critical dental need in the U.S. to serve the edentulous that is not being met by traditional dentistry, there is a legitimate concern to put denturists on the front line alongside other healthcare professionals providing prosthetics.

This article in The Journal of Prosthetic Dentistry reinforces this need:

“ …..there was much speculation among dental educators that the need for complete dentures will decline markedly in the future and that complete denture training should be removed from the dental curriculum. Estimates based on national epidemiologic survey data indicate that edentulism has declined by 10% every decade and that only 90% of edentulous adults obtain and wear complete dentures. However, when the number of adults in each specific age group is multiplied by the percentage who need a complete maxillary or mandibular denture, the results suggest that the adult population in need of 1 or 2 complete dentures will increase from 33.6 million adults in 1991 to 37.9 million adults in 2020. The 10% decline in edentulism experienced each decade for the past 30 years will be more than offset by the 79% increase in the adult population older than 55 years. The clinical implications of these findings are twofold: First, practicing dentists will find that a sizable minority of the patient population will continue to need complete denture services; and second, if training in complete denture prostheses is eliminated from the dental education curriculum, millions of patients will be forced to seek denture services from alternative providers.” (J Prosthet Dent. 2002 Jan;87(1):5-8.; Will there be a need for complete dentures in the United States in 2020; Douglass, Shih, Ostry).

The need is legitimate and providers are needed desperately especially among those in lower socioeconomic areas such as Appalachia.

The National Institute of Dental and Craniofacial Research investigating the disparity of dental care and need in parts of Appalachia showed that by age 65, about 40 percent of the West Virginia’s retirees have none of their natural teeth remaining (A Look at Oral Health Disparities in Appalachia; www.nidcr. nih.gov)

Natural News reported a 2013 poll indicating that 15% of adults 18-24 years old have had a tooth extracted due to decay. Likewise, 67% of West Virginia residents 65 years or older have lost at least six teeth due to gum disease or decay. (January/2015; http://www.naturalnews.com)

The National Academy of State Health Policy and the Pew Center on the States report a Harvard Study: “Dental problems may represent the biggest unmet health care need among adults, as well…” This telling research by two Harvard researchers was published in their book, Uninsured in American. (Help Wanted, A Policy Maker’s Guide to New Dental Health Providers. The Pew Center for States, National Center for State Health Policy, WK Kellogg, Washington DC, 2009 http://www.nashp.org/sites/default/files/Dental_Report_final_Low%20Res.pdf)

Twenty-five percent (25%) (internationally) of all adults aged 60 years and older have lost all of their teeth. More specifically, 20.5% of adults in the U.S. aged 65 and older have lost all of their natural teeth due to tooth decay or gum disease. (2004 National Health and Nutrition Examination Survey, Centers for Disease Control and Prevention, www.cdc.gov; 1999-2002 National Health and Nutrition Examination Survey, Centers for Disease Control & Prevention, www.cdc.gov)

According to a government study, nearly 9,500 new dental providers are needed to meet the country’s current oral health needs However, there are more dentists retiring each year than there are dental school graduates to replace them. Accountability Office (GAO) found that less than half of dentists in 25 states treat any people with Medicaid at all.

“We need to leverage the available workforce more effectively, produce more dentists and providers of dental care and, if needed, create new provider categories to ensure that everyone has access to the care they need. We need to redesign the oral health system by further integrating dental services into nontraditional settings, such as schools. We also need to prioritize preventive strategies and education which provide important health benefits to all people. The time to strengthen the oral health care system to improve oral health and overall health for millions of Americans is now.” (DENTAL CRISIS IN AMERICA The Need to Expand Access; http://www. sanders.senate.gov/imo/media/doc/DENTALCRISIS.REPORT.pdf)

So without question the need is great and denturist will serve. In Washington State for instance, where Medicaid does include dental prosthetics, it is mostly denturists that will accept the state’s reimbursement and serve these patients. Denturists will serve in Appalachia; denturist have a heart to serve. However, this should not be the only reason denturists should find their rightful place within the healthcare community…..every citizen of the United States should have the right to access the exemplary and in many cases unparalleled services provided by these talented individuals.

Denturists have served in every province of Canada, many countries and several states for decades with exemplary service. Unfortunately, there are areas in the U.S. where denturists are not available to citizens in need of the expert service they provide. Political restraints prohibit this freedom. The National Denturist Association, USA is dedicated to undo this injustice by encouraging public awareness. This is a “people issue” and denturists have never lost in the public arena.

Our vision is to allow every individual in every state the opportunity to choose a denturist for their prosthetic dental need. To do this we need like-minded individuals like you to stand with us. Your membership will help as we work toward a better America by speaking with a unified voice for everyone that will benefit from this popular much needed profession. Membership is open to interested parties with designations for professional denturists, dentists, dental technicians, denturist students, and associate memberships.

You will have the satisfaction of knowing you are part of a historic movement. While helping denturists achieve success, you are providing access to a much needed dental service and improving the oral health of millions of Americans.

JOIN NOW…. Go to the Membership Page to join online or call: 360-232-4353 or 855-653-3688

“INDIVIDUAL COMMITMENT TO A GROUP EFFORT – THAT IS WHAT MAKES A TEAM WORK, A COMPANY WORK, SOCIETY WORK, A CIVILIZATION WORK. PEOPLE WHO WORK TOGETHER WILL WIN, WHETHER IT IS AGAINST COMPLEX FOOTBALL DEFENSES, OR THE PROBLEMS OF MODERN SOCIETY.”

Vince Lombardi

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