only emergent care. ODH school- based surveillance estimates that 36 percent have observable decay based on visual screenings. Actual decay rate is probably over 50 percent. School based programs could arrest decay and refer for treatment.


− 170,000+ adults are newly eligible for Medicaid including dental care. Medicaid remuneration has been increased to levels comparable to many insurance plans. The state’s ex- pectation is we will take care of these people.How?


− Federally Qualified Health Centers, especially in rural Missouri, have wait times for restorative appointments several months long. Many do not have the excess capacity to care for the newly eligible Medicaid patients.


• Governor Parson signed a record increase in dental Medicaid remunera- tion rates because he expects the oral health community will care for this population if they are paid fairly. How are we going to fulfill that obligation?


• The distribution map (previous page) of providers illustrates large areas of Missouri are classified as Dental HPSAs (Healthcare Professional Short- age Areas). All areas NOT colored blue are designated as such.How are we going to provide care?


• Within each legislative session there always is the chance a bill will come up that focuses on oral healthcare—from the MDA/oral health stakeholders or another outside group. If we don’t come up with solutions to provide ac- cess, someone else just might.


Possible Investigations/Solution Paths Identified by ODH


• Expand EFDA training and remove bottlenecks to make training more accessible. Consider converting didactic portions of EFDA training to online access. Consider apprenticeship/ mentoring training with supervising dentist with regional testing to make EFDA training and competency testing more accessible, especially for rural den- tists. The impact? EFDAs have proven to increase a facility’s productive capacity by 15-20 percent.


• Investigate funding for pilot vo-tech dental assisting programs in select high schools utilizing online training mod- ules and externships in local clinics.


• Advocate for expanding and fund- ing the tuition rebatement program for dental professionals who serve in dental HPSAs after graduation to in- clude five dentists, five hygienists and 10 dental assistants per year. This will help direct care providers to underserved areas.


• Use the planned ODH pilot project to investigate the use of teledentistry as a method for dentists to supervise hygien- ists and assistants extended into nursing homes and other underserved high-risk populations.


• Support inclusion of telehealth meth- odologies in all state supported dental education curriculums to extend the reach of graduating professionals.


• Support an increase in dental edu- cation funding for state-supported dental education programs to gradually increase the number of care providers in Missouri.


• Encourage dialog between the MDA and the MDHA on acceptable agree- ments for new a EFDA hygiene assistant to assist dentists and hygienists, and re- laxing hygiene supervision requirements to enable care to reach underserved populations.


To reinforce the urgency for dentists to proactively address access to care for underserved populations, I only need to cite Colorado. That state recently became the 14th to approve Dental Hygiene Therapists because that was the best solution presented to the Colorado legislature.


If you want to predict the future of dentistry in Missouri, I encourage you to proactively create it now by finding access to care solu- tions. Your job isn’t to keep things the same; it’s to make things better.


Contact Dr. Deyton at 573-526-3838 or guy.deyton@health.mo.gov. Use the QR code to access his previous workforce article from Issue 3, 2022 (May/June).


YOU CAN GET A DISCOUNT ON YOUR MALPRACTICE POLICY BY TAKING RISK MANAGEMENT COURSES?


  


Honest Answers / Practical Solutions / Personal Service 800-944-7550 • MDIS4DDS.COM


ISSUE 4 | JUL/AUG 2022 | focus 19


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32