Workforce Shortage News
MnDHA has been involved with and monitoring activity surrounding the shortage of allied dental providers, particularly dental assistants.
Additions to the scope of practice for unlicensed dental assistants have been
added to Minnesota rules (radiographs, digital impressions, intra- and extraoral
photos).
The Board of Dentistry and other stakeholders have worked to improve the pass
rate (20% increase) for the exam (DANB) required for graduates from CODA
accredited dental assistant programs to become licensed.
More proposals exist to add more to the scope of practice for unlicensed dental
assistants including administering and monitoring nitrous oxide, coronal
polishing, and placement of sealants (office training).
MnDHA does not support these additions.
Quality of care is jeopardized by office training; public safety could be at risk.
Competency based on dentist attestation.
Coronal polishing is esthetic, does not treat caries or periodontal disease; just a monetary benefit.
These new proposals will be detrimental to existing dental assistant CODA accredited programs and likely decrease the applicant pool.
The passage of new rules for these services could also affect the current salary of licensed dental assistants and decrease demand.
This could set a precedent that may someday involve the dental hygiene profession.
Posted here are documents for your review:
“Dental Workforce Shortages: Data to Navigate Today’s Labor Market”, ADA
Health Policy Institute, October 2022.
The Minnesota Dental Association formal proposal to the Board of Dentistry.
October 2023.
The Minnesota Board of Dentistry will begin discussion on these proposed rules at the
policy committee meeting; date to be announced. To receive notices about this meeting,
sign up on their website. We need your voices.
https://mn.gov/boards/dentistry/
Questions? Contact Jeanne Anderson
ander006@umn.edu
Advocacy
Minnesota has always been a progressive state in advancing the dental professions. There are exciting potential changes to come for dentistry, dental hygiene, dental assisting, and now dental therapy. The goal for MnDHA is to help educate the public, as well as dental professionals, of the changes going on in the MN legislature, which could create new beginnings in the field of dentistry. Please check this page often for informative news updates!
June 2023 Advocacy Updates
MnDHA Legislative report 2023
The Minnesota Dental Hygienists Association (“MnDHA”) had a rather quiet but
successful legislative session. MnDHA followed and supported efforts to expand access
to dental care and laid the groundwork for a 2024 push in support of a new dental
hygienist licensure compact. The dental and dental hygiene licensure compact bill was
introduced but not heard in committees this year. We anticipate its passage in 2024 as
key stakeholders all support this initiative.
The MnDHA routinely offered written testimony and letters of support for proposals
relating to public program reimbursement, clinical infrastructure, and access to care. In
the end, the restoration of a comprehensive adult dental benefit set for individuals on
Medical Assistance is likely a hallmark accomplishment of the session. The following is
an overview of the components of the Omnibus bill MnDHA supported.
Omnibus Health and Human Services Finance Bill (dental components)
Critical Access Dental Infrastructure Program: The bill appropriated $2.5 million in
one-time funding in FY 24 to support a new Critical Access Dental (“CAD”)
Infrastructure Program. The program will provide grants and forgivable loans to CAD
providers for the purposes of supporting the preservation and expansion of their clinical
capacity. The funds can be used to support the construction of new clinics, the
expansion or renovation of existing clinics, or the acquisition of dental equipment
(including that used for mobile and/or tele-dentistry).
Restoring MA Coverage for Adult Dental Services: The bill included language
restoring a comprehensive dental benefit set for adults on Medical Assistance, finally
undoing a cut implemented in response to a series of budget deficits during the
Pawlenty Administration in the early 2000’s. The adult benefit is estimated to cost $30
million in the FY 24-25 biennium and approximately $47.7 million in the FY 26- 27
biennium.
Adding Dental Professionals to the Rural Health Advisory Committee: The bill
includes language that would add an allied dental professional to the Rural Health
Advisory Committee. Larkin Hoffman and the MnDHA worked with the Minnesota Dental
Association on this language in response to a proposal from the Minnesota Department
of Health that would have converted the existing position dedicated to dentists to a
position for either a dentist or an allied dental professional.
Clinical Dental Education Innovation Grant Program: The final bill includes $1.18
million per year in ongoing funding for the Clinical Dental Education Innovation Grant
Program. These dollars generally replace funds from the Medical Education and
Research Costs (MERC) fund that were deemed no longer available for this use. The
dollars support the clinical training of dental professionals in certain patient care
settings.
On May 22, 2023, the Senate passed S.F. 2295 by a vote of 34-32 and the House of
Representatives followed suit later in the day, passing the bill on a vote of 69-64. Gov.
Walz signed the bill into law on May 24, 2023.
The Oral Health Home Pilot Project funding and the Medical Assistance Dental
Rebasing bills did not pass this year.
In 2024 we will be asking for your support in contacting legislators on issues important
to dental hygiene. Also, please save the date, February 20, 2024 for our in-person Day
at the Capitol!
Jeanne Anderson, Advocacy Chair
ander006@umn.edu
June 2022 Advocacy Updates
The Legislature 2022:
1. Dental:
a. Our bill for collaborative practice changes passed but in the process was
stripped of several important changes due to opposition. Excluded were
provisions for dental hygienists to get paid directly and other protocols for
medicaments. Money was required to have the Department of Human
Services collect data on the services provided by collaborative practice
dental hygienists and no budgetary provisions were considered. We worked
diligently on this bill during a difficult legislative climate.
b. The Dental Homes Project funding did not get passed this year. No money is
allocated at this time.
c. Licensure by credentials for dental therapy passed.
2. A large mental health package of over $90 million passed and includes many
provisions.
3. As the result of redistricting approximately 1 in 5 of lawmakers will be leaving office
voluntarily. 22 lawmakers were paired in districts with other incumbents so one of
them either had to retire, move to another district with an open seat or go head-to-
head against a sitting colleague of the same party. That will mean after the fall
elections, your legislators may not be the same.
Jeanne Anderson,
MnDHA Advocacy Council Chair
Consultant to the Board of Dentistry
2021 Advocacy Updates
Results of the 2021 Minnesota Legislative Session
The regular 2021 Minnesota Legislative Session and the special session in June have ended resulting in the passage of dental provisions in both the Senate and House Omnibus health bills. These changes to the laws are the best news that dentistry in this state has had for a very long time! With the hard work of our lobbyist, Tara Erickson, members of our Association, and a coalition of dedicated organizations committed to improving oral health in our state, these changes to the Medicaid programs are certain to improve access and increase the numbers of providers who see people on public programs while improving the process.
Here are the highlights:
- Reimbursement base rate increase of 98% (last one from 1989).
Previous three add-ons were eliminated (This means instead of getting add on money for seeing more Medicaid patients and being in a certain location the base rate applies to all who see Medicaid patients) However, the rate to critical access providers goes down to 20% extra but will still reward these providers for treating more Medicaid patients.
- Mandated fee schedules from all managed care organizations (MCOs) and their third party administrators. (In the past one MCO did not allow providers to know what they will be paid for services per their contract)
- Creates a Dental Homes Advisory Committee of 15 members (MnDHA will have one member!) which is a committee of the Department of Human Services to develop and make recommendations for a dental home pilot project. They report back to the legislature at the end of this year.
- Managed care organizations must meet certain benchmarks based on Healthcare Effectiveness Data and Information Set (HEDIS) which is based on utilization and access and is a national standard on if enrollees are getting a dental visit. If they do not meet the benchmarks, potentially the DHS could go to a single administrator.
- MCOs will have to file a yearly dental utilization report with DHS letting them know the percentage of enrollees that received an appointment and also give the average reimbursement for provider by county.
- Establishes uniform dental credentialing by 1/1/22. Dentists now must go through credentialing to be a provider which can take months before they can begin seeing patients. This has taken 8 years of work to achieve.
- AND reimbursement for periodontal root planing and scaling once every two years for all quadrants and payment for routine periodontal maintenance !
The Minnesota Dental Hygienists Association is very pleased to have been a part of this success. Again, we are working hard for you! Your membership makes this possible.
Thank you!
Advocacy Update 2020
The 2020 Legislative Session
The Minnesota Dental Hygienists Association had a very successful Day at the Capitol in February with approximately 140 attendees. Thanks to all who made the day memorable. However, the legislative session 2020, like everything else, was interrupted by the COVID-19 pandemic. Our lobbyist, Tara Erickson, continued to update us on any significant issues facing oral health.
The Blue Ribbon Commission in 2020
In review, the 2019 legislature and Governor Tim Walz created the Blue Ribbon Commission (BRC) to develop a plan to transform the health and human services system to be more efficient, identify cost saving measures and build better health outcomes for Minnesotans. The Commission asked for input from the public on how to accomplish these goals. Your Minnesota Dental Hygienists Association (MnDHA) submitted a proposal to improve Collaborative Dental Hygiene Practice by allowing 1) reimbursement for risk assessments and oral assessments and, 2) collaborative practice dental hygienists to be a direct pay-to-provider for Medicaid recipients. This proposal was one of over 200 strategies under consideration. Two other separate proposals for oral health came from the Minnesota Department of Health (MDH) and the Minnesota Department of Human Services (DHS).
In the summer of 2020, it was brought to the attention of the BRC that the oral health proposals had been overlooked. At that time, the three organizations were asked to combine their strategies into one. MDH and MnDHA collaborated on merging their two strategies. The combined proposal added an oral health component to the existing Whole School, Whole Community, Whole Child model (WSCC) utilizing collaborative practice dental hygienists as regional coordinators and providers into this state-wide coordinated school-based program. The proposal included our reimbursement strategies to strengthen collaborative practice.
Representatives from MnDHA and the MDH presented this combined proposal to the BRC which voted to include this strategy in their final report to the Legislature! At this time, we do not know which of the many strategies the BRC gave to the legislature will be chosen to be funded and implemented.
As a result of months of work, MnDHA truly increased our visibility as an integral partner in the future of oral health in our state! Many thanks to Deb Jacobi, Colleen Brickle, Clare Larkin and Jeanne Anderson for their work on this project. Also, thanks to Tara Erickson for helping us through the submission of our proposal and this process.
Access these websites for more information on the BRC and the WSCC Model:
https://mn.gov/dhs/assets/DHS-7367-ENG-MN-HHS-Blue-Ribbon-C
https://www.cdc.gov/healthyschools/wscc/index.htm
For more information contact Jeanne Anderson at ander006@umn.edu.
MnDHA Legislative Session 2019
Periodontal- initiative to add root planing for nonpregnant adults to Medicaid (Medical Assistance) benefits
MnDHA sent letters of support for the bills in the House and Senate. The House included the language in their HHS Omnibus bill; the Senate did not. Ultimately the provision was cut during negotiations and did not move forward
this session.Proposal to eliminate all dental benefits
The Senate Omnibus bill included a proposal to eliminate dental and vision coverage for all able-bodied adults on Medical Assistance and MinnesotaCare. We worked to get an editorial in the Star Tribune and articles around the state. Also, a Twitter campaign was started and received thousands of impressions. We are pleased to report that this provision was not included in the final bill and was opposed by Governor Walz and DHS Commissioner Lourey. This put a halt to advancing any expansion of dental benefits this year. Again, the MnDHA Advocacy Council led a letter writing campaign opposing this.Provider Tax
The 2% provider tax on dental services was to sunset (end) at the end of 2019. During legislative compromises, instead of eliminating it all together, it was reduced to 1.8%. The revenue from this tax supports MNCare, a portion of Medicaid and other programs through the Minnesota Department of Health. MnDHA was concerned that the sunset would have resulted in inadequate funding for these programs.
Critical Access Dental (CAD)
There was a proposal to eliminate the CAD program which reimburses dentists (safety net providers) who treat patients with state dental insurance. Although the numbers of safety net providers have doubled, patients receiving a dental appointment have not increased significantly. We anticipate that an alternative funding model will be developed in the future to support safety net providers.
Thanks to all who contributed by writing to their legislators. Your voice makes a difference. The MnDHA Advocacy Council will continue to support you and your patients.