Alberta

  • The Alberta Dental Association and College have been actively working to empower a hospital based dental committee to look in a forward direction to planning the care provisions and access for those persons with challenges (physical, mental and developmental).

  •  The Calgary area has had the pleasure of having a new regional chief hired.  Dr. Graham Cobb, an oral surgeon, will now oversee three programs (children’s hospital, adult hospital care for those with complex medical care requirements and the public dental health services).

  •  The fluoride debate continues and has become a polarizing subject within all the major cities in Alberta as the anti-fluoridation group work to sway our politicians on the negatives of fluoride.

  •  A large number of pediatric dentists have moved to Alberta; their presence will help optimize the provision of care for the children and special needs persons in Alberta.


Arizona

  • The AMA is seeking support from the AZDA to increase Medicaid reimbursement to at least the 2009 fee schedule. The rates were decreased three times to help decrease the budget during the recession.  This is currently on the AZDA CGA agenda. The legislative session will open on the second week in January 2020.

  • The Board of Dentistry is forming a subcommittee to evaluate and update sedation guidelines. Dr. Kirk Robertson, current AZDA president and pediatric dentist, is applying for inclusion into the subcommitee.


British Columbia

  • In June 2019, Vancouver hosted the IADR and several members of the chapter attended the successful conference.

  •  Dr. Geoff Grant and five other BCSPD members are in the process of planning and organizing the CAPD meeting in Whistler in September 2020.


California

Sugar Sweetened Beverage Bills:

  • AB 138 (Bloom) California Community Health Fund

This bill creates a fee on sodas and other sugary beverages and uses the new revenue to offset health and economic costs associated with over-consumption of sugar.

Status: Stalled in the Committee on Revenue and Taxation due to cancellation of hearing at request of author

CSPD Position: Under consideration

Comment: This bill would establish the California Community Health Fund in the State Treasury, where monies in the fund shall be used to diminish the human and economic costs of diabetes, obesity, and heart and dental disease in California. It is also the intent of the Legislature that monies in the fund support health, education, and wellness programs designed to prevent and treat diabetes, obesity, and heart and dental disease, thereby reducing the burden of health conditions related to the over-consumption of sugar-sweetened beverage products.

  • AB 764 (Bonta) Sugar Sweetened Beverages

This bill would prohibit a soda company from offering a manufacturer’s coupon to their partnering manufacturing, distributor or retailer.

Status: Failed to advance to an Assembly Floor vote in May and cannot be further considered in this legislative session

CSPD Position: Support

  • AB 765 (Wicks): Healthy Checkout Aisles for Healthy Family Acts

The bill prohibits placement of sugar-sweetened beverages near the checkout counter at supermarkets, larger grocery stores, supercenters, and warehouse clubs.

Status: Failed to advance from the Assembly Health Committee, where it was removed from consideration by the author, and will be held in committee until the 2020 legislative session

CSPD Position: Support

  • AB 766 (Chiu): Unsealed Beverage Container Portion Cap

This bill bans the sale of unsealed beverages larger than 16 ounces at food service establishments, including restaurants with self-service soda fountains.

Status: Failed to advance from the Assembly Health Committee, where it was removed from consideration by the author, and will be held in committee until the 2020 legislative session

CSPD Position: Support

  • SB 347 (Monning): Sugar Sweetened Beverages: Safety Warnings

This bill requires a warning label on sugar-sweetened beverages to help educate consumers as they make purchasing decisions.

Status: Failed to advance from the Assembly Health Committee, where it was removed from consideration by the author, and will be held in committee until the 2020 legislative session.

CSPD Position: Under Consideration

Other Bills:

  • AB-316 (Ramos) Medi-Cal Benefits: Beneficiaries with Special Dental Care Needs

This bill is intended to improve access to care for children and adults with chronic medical, mental, behavioral or developmental conditions and disabilities that complicate their dental care, by increasing compensation for providers who treat them. This bill would require the department to implement a special needs treatment and management benefit that would be provided for 4 visits in a 12-month period for a Medi-Cal dental program beneficiary with special dental care needs, as defined. The bill would require a Medi-Cal dental program provider to document specified information, including the need for additional time to treat a Medi-Cal dental program beneficiary with special dental care needs, for purposes of reimbursement.

Status: Failed to emerge from the Assembly Appropriations Committee and will not be further considered this year

CSPD Position: Under Consideration

  • AB 954 (Wood): Dental services: Third-party Network Access

This bill would require dental benefit plans to be more transparent about the common practice of “leasing” access to their network of contracted dentists to a separate third-party benefit plan.

Status: Under active consideration by the legislature at the time of publication of the CSPD bulletin

CSPD Position: Under Consideration

  • Silver Diamine Fluoride Benefit

This bill would make the application of silver diamine fluoride, as a caries-arrestment agent, a Denti-Cal program benefit for children age six and under, persons with disabilities, and adults in assisted living arrangements. It includes provisions requiring specific informed consent and that the service is part of a comprehensive patient treatment plan.

Status: Currently active at the time of publication of the CSPD Bulletin; If the bill reaches the Governor’s Desk, CSPD will actively support signing of the bill

CSPD Position: Support


Hawaii

  • The Hawaii Academy of Pediatric Dentistry along with the Hawaii Dental Association’s Legislative Committee has been working with the Board of Dentistry to create a category for dental assistants and register them.  At the present time, they are not registered and have no requirements (eg., BLS/OSHA, ethics, CE, etc.).

  •  The Hawaii Academy of Pediatric Dentistry has joined the Hawaii Oral Health Coalition to support their efforts in legislation to ban flavored tobacco products and bring oral health awareness to children/middle school children who are vaping.


Idaho

  • Some members of ISPD leadership board have been working closely with ISDA and Idaho Department of Health and Welfare to help determine which types of services mid-level providers working with tribal dental clinics can perform with direct supervision, which with indirect supervision, etc. ISPD is also trying to help state leaders understand that there is not an access to care issue in most parts of the state but the underlying issue is low reimbursement to existing dental providers.

  •  ISPD is in the process of recruiting members, who would be willing to represent ISPD in Idaho Oral Health Alliance Organization. As of July, 2019, reimbursement increased (5-10%) for some ADA treatment codes (pediatric treatment codes).


Nevada

  • Medicaid reimbursement:

The Medicaid program in Nevada (medical) decreased surgery center reimbursement rates specifically for general anesthesia fees for dental cases in 2018. This fee was cut in half compared to previous years, which has made dental cases at the outpatient surgery centers and hospitals not profitable. Thus, surgery centers are now denying dental cases all over the state of NV and has severely limited access to care. We have been working to restore this fee to what it used to be. Medicaid officials have heard our complaints and promise to work on a solution, however, it will be a slow process. Also, over the last year, Nevada’s Medicaid program was contracted with Liberty Dental plan and has been undergoing changes. They met in early 2019 to discuss decreasing reimbursement fees for dental procedures, with many of them affecting codes used by pediatric dentists. They decided to NOT go through with the new fee schedule.

  • Dental therapy:

A new dental therapy bill was proposed to legislation in Nevada for this year. This bill will allow for dental therapists to provide dental treatment to individuals in the state without direct supervision of a dentist. The NDA worked with a lobbyist to try and get the legislatures to vote “no” on this bill, however, it was passed in June 2019.


 Oregon

  • On November 8th, 2018, the Oregon Health Authority – Dental Pilot Project Program received a request from Northwest Portland Area Indian Health Board’s (NPAIHB) for modification to the approved Scope of Practice for trainees under Dental Pilot Project #100. It was proposed that trainees be allowed to administer (start the flow of) Nitrous Oxide after completing and adhering to certain criteria (which included being required to maintain a current BLS for Healthcare Providers certificate or its equivalent, and being required to complete a training course of at least 14 hours of instruction in the use of nitrous oxide from a CODA accredited dental school or dental hygiene program amongst other requirements). The OAPD issued a letter strongly recommending denial of this modification and expansion of scope. The letter was included as public comment during the March 4, 2019 Advisory Committee for Dental Pilot Project #100.

  •  The Oregon Association of Pediatric Dentistry collaborated with the state chapters of other recognized dental specialty organizations (OMFS, Endodontics, Periodontics) to draft legislature that would formalize restricting providers who represent themselves or advertise as dental specialists to only those who have completed a CODA accredited specialty program recognized by the ADA. The proposed bill SB835 was drafted with the goal of relieving the Oregon Board of Dentistry (OBD) from legal liabilities as a regulatory body, and to protect the public by keeping the standards of claiming oneself as a specialist consistent with our longstanding precedents and laws.  By making this an Oregon state statute, the various general dental organizations will not be able to attack the state boards or individual members and the OBD can take action toward those who violate this precedent. After several months of hearings, which included testimony presented by all involved specialties, Governor Kate Brown signed SB 835 into law on June 13, 2018.

  • The Oregon state legislature approved a bill that adds the prescription and administration of vaccines into a dentist’s scope of practice. House Bill 2220 received overwhelming bipartisan support and passed the Oregon Senate on April 25; on May 16, 2019, Gov. Kate Brown signed the bill into law. Under the bill, dentists providing vaccinations are required to take an additional continuing education training course and must meet current state mandated vaccine storage and reporting requirements. The Oregon Dental Association announced it will work with Oregon Health and Sciences University and the Board of Dentistry to create training programs for dentists who wish to provide vaccinations in their practice.


Utah

  • The inaugural Continuing Education-Business meeting is being planned with the primary children’s hospital, to be held in the fall of 2020.

  • There have been a few issues with MCNA not paying claims.

  • Intermountain Health Care, the largest health care provider in the state, has started to open dental clinics and has purchased a portion of a large pediatric dental chain in the state.

  • The Governor has proposed a tax on services, which may include dental care.


 Washington State

  • At the beginning of 2019, the state was preparing to switch to Managed Care for Medicaid. In a last minute change, the legislature denied the switch and asked for a report by November 2019 outlining the possible ways to administer Medicaid in the state of Washington. The WSAPD, along with WSDA, is working with the HCA as much as possible on that report, to ensure that effective ways to provide care for patients are found.


Wyoming

  • State leadership continues to battle poor insurance and Medicaid reimbursements.

  • Thanks to a few new pediatric dentists moving to Wyoming, dental coverage for most rural communities is now available, making access to care not nearly the concern it was years ago.

  • The state leadership hopes to establish a formal state pediatric society in the near future.

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