Illinois citizens deserve benefits of
collaborative practice
Kimberly K. Benkert, RDH, BSDH, MPH, COM, IDHA Legislative Co-Chair
IDHA Hygiene Herald August 2010
Posted 8/12/2010

What is “collaborative practice?” Collaborative practice is a means to increase access to care in Illinois without changing the basic scope of dental hygiene practice through enabling a partnership to exist between dental hygienists and dentists within their own community. Under collaborative practice or collaborative care, a licensed dental hygienist would be able to see a patient and provide oral preventive services without a prior examination of a dentist based on a written collaborative agreement between the hygienist and dentist. The agreement would serve as a relationship document, covering the full spectrum oral health care services that would be available to individuals treated under the agreement and with established protocols for how care is handled, billed and referred. Collaborative practice agreements provide the opportunity for a hygienist to refer directly into several dental practices or to a particular dentist. That referral system allows the hygienist to provide preventive services utilizing the full licensed scope of functions in the practice act. It also allows the registered dental hygienist to go out and create and/or initiate practice situations to help ensure that each individual to whom they provide services has a dental home for an annual dental examination by a licensed dentist and a treatment facility for their followup care. This will help address the disparity of care existing in many public health, nursing home, hospital and school-based settings where preventive services are not always linked to a dentist to provide the follow-up care needed to achieve full oral health. Minnesota, Wisconsin, New Mexico and several other states have collaborative practice (care) in place. You may visit each state’s website to review their individual scopes of practice. You may also go to the ADHA website at www.adha.org to learn more about collaborative practice models of care. The Illinois Dental Hygienists' Association Board of Trustees believes it is time to bring collaborative practice to Illinois. A bill for collaborative practice will be submitted during the next full legislative session to create changes to the dental practice act to allow dental hygienists to provide preventive services which also include oral cancer screenings utilizing current technologies, a dental hygiene examination and a dental screening assessment. States with collaborative practice (care) will affirm that reducing barriers to preventive oral health services is a true benefit to the public.

Currently, the public must have a prior dental examination to legally receive dental hygiene services in Illinois. We know that in private practice this is not usually the case as the dental hygienist is typically the point of entry for preventive and restorative services in the general dental practice. In public health settings, individuals are denied the basic right to even receive preventive services when a dentist is not present. Residents of nursing homes, long term care facilities and hospital settings cannot utilize dental hygienists directly due to not having a dentist do an examination prior to the RDH providing treatment. The current 90 days in the statute allowing a dental hygienist to function under an examination is not working as a practical means to provide treatment. All too often, the 90 days runs out prior to even being able to complete the planned preventive maintenance or dental hygiene services. It is inefficient and ineffective. Illinoisans deserve to have access to preventive services in all settings, without the added expense of a dentist examination, prior to receiving preventive care. A licensed dental hygienist is more than adequately educated, trained and prepared to determine who is an appropriate candidate to receive preventive services. New technologies can assist in determining if dental decay (caries) are present or if an individual tooth is at higher risk and should be referred dierctly to a dentist for services. Individuals who currently are not a patient of record in private dental practice need a point of entry into the oral health care system. The same is true for individuals in long term care facilities who cannot receive the preventive maintenance appointments they need due to lack of access. The ability of a dental hygienist to provide care for individuals in those situations is a potential the IDHA wants to help realize for the people of Illinois. We need your help to bring collaborative practice to Illinois. It will take all our efforts. Talk to your colleagues and spread the word about the benefits of collaborative practice to your community leaders, legislators, nursing homes, local hospitals and schools. Please contact IDHA or me at kbenkert@sbcglobal.net if you are interested in helping with our campaign. We need every licensed RDH in Illinois to help us move this effort forward!

Congress Passes Sweeping Health Reform Containing Significant Oral Health Provisions
Posted 3/31/2010

President Obama signed the Health Care Reform Bill on March 23, 2010. In addition to reforming the healthcare system, there are also provisions allowed in this legislation for for oral health care.

Chicago, March 22, 2010—Late last night, the U.S. House of Representatives staged a series of votes on health reform legislation, thus ushering in sweeping health reform and a new era of heath care delivery in the United States. The 219-212 House vote for passage of H.R. 3950, the health reform bill, already passed by the Senate on Christmas Eve, closely followed party lines with only Democrats voting in favor of the measure. The bill now awaits President Obama's signature in order to become law, which is anticipated as early as Tuesday, the 24th. Just minutes after the vote was taken on H.R. 3590 another vote to pass a reconciliation bill, H.R. 4872, was passed by the House to amend some of the provisions contained within the health reform package. The Senate is expected to vote on the reconciliation bill later this week.

ADHA has been involved in the national dialogue on health reform for more than a year, as legislation has been drafted and debated. The association has not taken a position for or against health reform, but has been guided by ADHA’ Statement on Health Reform which asserts that if Congress undertakes comprehensive health reform, oral health provisions should be included as oral health is a vital component to individuals’ total health.

ADHA President Lynn Ramer, LDH reflected, “As a national stakeholder in oral health, ADHA has a responsibility to be engaged in the health reform debate as these issues significantly impact the oral health care delivery system and dental hygienists throughout the country. For more than a year, ADHA has advocated for the dental hygiene profession and the patients we serve by highlighting the important role dental hygienists play in the delivery of oral health care.”

HR. 3590 contains a number of oral health provisions including a mandatory oral health benefit for children (up to age 21) as part of any essential benefits package offered through health insurance exchanges called for in the bill. The legislation also recognizes dental hygienists as primary oral health providers through the inclusion of dental hygiene providers, students, and education programs as eligible entities for workforce development funds. Additionally, the legislation provides for 15 demonstration grants to train or employ alternative dental health care providers to evaluate emerging workforce models that improve access to oral health care. Public health dental hygienists, independent dental hygienists, advanced practice dental hygienists, and dental therapist models are listed models eligible for the grants.

A list of additional oral health provisions in health reform and their impact on dental hygiene is available on ADHA’s Key Oral Health Provisions in Health Reform Legislation Chart.

Efforts related to health reform do not end with the passage of H.R. 3590. As noted, the Senate is expected to take up the reconciliation bill later this week to provide some immediate amendments to the bill. None of the oral health provisions contained in H.R. 3590 are impacted the reconciliation package. Additional amending legislation will likely be introduced in the future and the implementation of health reform policies will be a long-term effort.

ADHA will continue to stay engaged in health reform and advocate on behalf of the profession as directed by ADHA policies and the Statement on Health Reform.

ADHA is the largest national organization representing the professional interests of more than 150,000 dental hygienists across the country. Dental hygienists are preventive oral health professionals, licensed in dental hygiene, who provide educational, clinical and therapeutic services that support total health through the promotion of optimal oral health. For more information about ADHA, dental hygiene or the link between oral health and general health, visit ADHA at http://www.adha.org.

Family Smoking Prevention and Tobacco Control Act Signed into Law

On June 22, 2009, President Obama signed into law the Family Smoking Prevention and Tobacco Control Act, granting the Food and Drug Administration (FDA) regulatory power over the manufacture, sale and marketing of tobacco products. This historic bill marks a turning point in the fight to keep Big Tobacco from luring kids into becoming the next generation of lifelong smokers. Click for more information

Posted 8/4/2009

GREAT NEWS!!!!!!!!!!!!!!

Minnesota became the first state in the country to pass legislation that will allow for students educated under the ADHP model to be licensed to practice. The law, passed by the Minnesota House and Senate on May 13, was signed into law by Governor Tim Pawlenty on May 16th.

Please note that there was a name change. The Advanced Dental Therapist (ADT) is the new name for the Oral Health Practitioner.

The Provider is not going to be called the ADHP but is going to be educated under the ADHP model.
The services and education outlined for the Advanced Dental Therapist in the new law are consistent with what is included in the ADHP competencies.

The press release on Minnesota and the history and time line of what transpired in the state relative to workforce models is available at this link: http://www.adha.org/media/releases/05182009_MN_mid-level.htm

This is a great leap forward for the Profession of Dental Hygiene, lets take a moment to breathe in and enjoy this sweet victory for our profession.

Posted 5/20/2009