The Omnibus Oral Health Bill: Answers to Frequently Asked Questions
As 2008 winds down, S.2819 - An Act to Improve, Promote, and Protect the Oral Health of the Commonwealth, remains before the House Committee on Ways and Means. This bill was bundled by legislative leaders, including Senate President Therese Murray and Senator Harriette Chandler, who are interested in oral health and are committed to seeing progress on this issue. It was these legislators who first approached the Massachusetts Dental Society (MDS) about merging initiatives sponsored by the Society, the Massachusetts Dental Hygienists Association, and Health Care for All into an omnibus bill. By participating in this unique coalition, the MDS has been recognized as a leader on oral health issues by showing its willingness to sit at the table, participate in discussions, and work to achieve consensus. With tough economic times ahead, there can be no doubt that the political goodwill the Society has generated around this bill will benefit the MDS in other ways in the future.
This legislation, referred to as the Omnibus Oral Health Bill, was passed unanimously by the State Senate at the end of July. As we await possible action in the House during informal session, it is important that MDS members have a complete understanding of what this legislation will (and will not) do. Please take a moment to read through these frequently asked questions on S.2819, the Omnibus Oral Health Bill.
Will current dental assistants be required to take additional courses before registration?
No. There is no mandate that dental assistants pursue career paths or that dentists must hire expanded-function dental assistants. Dental assistants currently working alongside dentists in Massachusetts will not be required to complete additional educational requirements, but after a six-month grace period they will be required to register. S.2819 simply allows the Board of Registration in Dentistry (BORID) to create new regulations for expanded-function dental assistants. This bill also protects on-the-job training for dental assistants, a standard that has been threatened by previous initiatives sponsored by other groups seeking to impact the composition of the dental team.
Why is the MDS in support of giving a vote on BORID to a dental assistant?
Dental assistants have already been nonvoting members of BORID for more than 20 years, during which time they have been influencing board discussions regarding regulations and licensure. S.2819 simply formalizes the dental assistant position on BORID. Furthermore, organized dentistry has long supported a dental team approach in providing oral health care. By requiring dental assistants to register, we are recognizing their valuable contribution to the practice of dentistry and, therefore, should provide them with a vote on BORID.
Why is the MDS supporting the creation of a public health dental hygienist?
It is important to realize that BORID is already in the process of creating regulations for a Public Health Dental Hygienist (PHDH). Through S.2819, the MDS is trying to influence the parameters of the final regulations. For example, language in S.2819 specifically limits the procedures performed by the PHDH to those currently allowed in private practice under general supervision (procedures that do not require the dentist to be present). Furthermore, the PHDH must enter a collaborative agreement with a dentist and can only bill MassHealth and Commonwealth Care, ensuring that the PHDH is not operating independently and is focused on providing access to care to low-income patients. Finally, S.2819 requires that the Department of Public Health submit reports to the legislature on whether or not the PHDH has improved access to care and "sunsets" the designation after five years.
Will dentists be required to enter into collaborative agreements or see additional patients?
No. S.2819 requires that the PHDH enter into a written collaborative agreement with a dentist or state agency in order to provide care in public health settings. There is absolutely no mandate that any dentist in the Commonwealth accept such an agreement.
The Omnibus Oral Health Bill also requires that the PHDH inform patients that they have not received an oral exam and that they should see a dentist within 90 days. Again, this is not a mandate for dentists to see the patient, but rather a requirement that the patient be informed that seeing a PHDH is not a substitute for the care provided by a dentist. Some dentists, however, may wish to enter into collaborative agreements with a PHDH so that they may receive the referral of those patients, but that is a strictly personal choice.
What other changes does S.2819 facilitate?
The Omnibus Oral Health Bill creates a full-time dental director to lead the Office of Oral Health. The state director will be a licensed dentist in the Commonwealth with public health experience. Currently, a dental hygienist holds the top dental position within the Office of Oral Health. The state dental director will oversee and implement public oral health prevention and education programs. S.2819 also creates a full-time dental director at MassHealth, a position that is currently only part-time.
How does this bill benefit dentists?
The Omnibus Oral Health Bill allows highly trained and educated dental assistants to perform routine procedures so that general dentists will be able to focus more on diagnosis and treating complex cases. The legislation gives BORID the authority to create new categories of dental assistants and determine the expanded duties that they can perform under the supervision of a dentist. The resulting increase in efficiency and capacity will be invaluable to the dentists practicing in the Commonwealth.
While these questions are the most frequently asked, we understand that you may have individual concerns as well. For more information on S.2819, you can call us at (800) 342-8747, ext. 225, or send an email to firstname.lastname@example.org. You can also click here to download the full text of the bill.