office, but this is the beauty of having control of our own domain within our own practice walls.
I want to be very clear: I, nor any changes the workforce committee is discussing, support a mid-level or dental therapist type of provider (such as those that have come about in Minnesota, Alaska and Colorado).
Rather, what I am suggesting is the scope discussions we surveyed members about in November 2020 are steps we can take to help dental practices and patient care by allowing trained and educated dental professionals to work at the top of their scope, under supervision, and prevent ideas like mid-level providers or dental therapists from becoming reality in our state. I recognize some of the survey re- sults do not have overwhelming support, but there is meaningful support of the aforementioned survey results.
The mission statement of the MDA is helping all members succeed. Are we really supporting our members when we have 50 percent or more supporting certain concepts, yet we have position statements against?
While some of these ideas and potential changes do not sit well some members, we need to have healthy discussion of how we are going to move forward. The old way has worked, but the dam is cracking. This article is not put forth to instill fear of change, but rather as a real- ity of what is happening around us. Dig- ging in our heels is not going to produce a healthy outcome. We are still captains of our ships; let’s open our thoughts so we can continue to run our vessels.
Opinions expressed in My View are that of the author’s and do not represent an official position by the MDA. Contact Dr. Wilkerson rwilker82@gmail. com or 573-265-8402.
REFERENCES 1.
https://leg.colorado.gov/
sites/default/files/2022a_219_signed.pdf
2. MDA Dental Team Scope of Practice, Results from a Survey Conducted by ADA Health Policy Institute on behalf of the MDA, November 2020
3.
https://www.sos.mo.gov/cmsimages/adrules/ csr/current/20csr/20c2110-2.pdf#page=3
Who / What / When
The Missouri Dept of Health and Senior Services (DHSS) convened a healthcare workforce committee for all healthcare disciplines. It’s purpose is to develop recommendations for Governor Parson to address healthcare workforce shortages in Missouri. The MDA and Office of Dental Health (ODH) have given input for consideration along with other recommendations that may be presented to the Governor.
The following chart relates to Dr. Deyton’s article about groups discussing dental workforce issues and outcomes.
WHO ARE THE GROUPS HAVING DISCUSSIONS? DHSS Workforce Group
Workforce Ad Hoc
A Workforce Ad Hoc Committee consisting of representatives from each of the three major Missouri oral health stakeholders (MDA, MO Dental Hygienists’ Association and MO Primary Care Association). The Committee was tasked with understanding the oral healthcare workforce shortages and recommending solutions. Dr. Guy Deyton, ODH and Brian Barnett, Dental Board executive director, facilitated four meetings in May and June.
WHAT COULD THE NEXT STEPS BE FOR THE GROUPS? DHSS Workforce Group
Workforce Ad Hoc
This group called for all recommendations to be submitted by June 17, which will be reviewed with the decision made by August 1 as to what to pass on to Governor Parson. The Governor will review the recommendations and decide what will be included in his legislative agenda for 2023.
This committee established a list of topics that will be taken to the respective associations’ governing boards and annual meetings for discussion and possible action. If agreement on workforce initiatives can be reached by the associations, they will collaborate on legislative proposals to be considered in the 2023 legislative session.
Outside Entities
The history of oral healthcare workforce revisions in other states often involves advocacy from interest groups outside the state, like the PEW and Kellogg foundations. These outside groups fund advocacy when they perceive there is political feasibility to change the care delivery systems to improve access to care. Recently in Colorado, a consumer advocacy group aligned with the Colorado Medical Society to support and pass a Dental Therapist bill.
Outside Entities
The effort to convene representatives from each of the major oral healthcare associations to recommend workforce and access to care recommendations is an effort to have Missouri dental healthcare providers find solutions for Missouri dental healthcare issues without undue influence from outside entities.
WHEN WILL PROCESSES INVOLVED WITH POSSIBLE NEXT STEPS HAPPEN?
DHSS Workforce Group | Any workforce solutions that require state appropriation or statutory change must be presented to the legislature. Governor Parson will decide what he wishes to include in his 2023 agenda.
Workforce Ad Hoc | Any workforce initiative that proposes the state underwrite all or a portion of the cost requires a legislative proposal to be considered and passed. Some workforce changes discussed by the committee could be accomplished by rule changes at the Dental Board level. A good example might be streamlining the EFDA training process to make it more accessible. If there is agreement at the Dental Board level, a rule change can be affected in 6-8 months. Some workforce changes discussed by the committee would require a change in statutes. Examples might be creation of a new EFDA Hygiene Assistant and changes that may allow hygienists and assistants to be extended to nursing homes supervised by dentists using teledentistry. As a general rule, statutes can be passed if there is agreement and support by the major stakeholders and the fiscal note is palatable. Statutes passed take effect August 28, after the close of the legislative session. If rules are necessary subsequent to a statute, then the normal Dental Board rule making process would follow.
Outside Entities | Uncertain, but other states have models of mid-level provider and dental therapist legislation, that, if are the only solution or perceived best solution, could be considered by state entities/legislatures.
ISSUE 4 | JUL/AUG 2022 | focus 21
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
