Jeremy Crandall, Senior AssociateThe Pew Dental Campaign

Dental Therapy:Background

& FQHC Impact

Deamonte DriverDied Feb 25 2007

$80 filling

20+ calls to dentists

$250,000 hospital bill

– “For Want of a Dentist”

Why the Pew Dental Campaign?

What we do…

Why Massachusetts?

26% 35%

0%20%40%60%80%

100%

Dentistsbilling

$10K/yr

Dentiststreating aMassHealth

patient

What is Dental Therapy?

Dental practitioner trained to provide preventive and limited restorative care

Dental Therapists go

to where care is needed

Nursing Homes

Public Health Clinics

Group Homes

SchoolsWorks under dentist supervision and can extend reach of dental team into community settings

Provider EducationRequirement

Number of Billable Procedures in Scope

Dentist Bachelor’s Degree + 4 years of dental school

~600

Dental Hygiene Practitioner

Associate or Bachelor’s Degree + additional training*

~80

Dental Hygienist Associate or Bachelor’s Degree

~40

What is Dental Therapy?

* Legislation requires that a therapist training program meet the Commission on Dental Accreditation’s (CODA) dental therapy standards. CODA requires a

training program include at least three academic years of instruction.

B. Edelstein, “Training New Dental Health Providers in the U.S.,” W.K. Kellogg Foundation (2009), 12.

Dental Therapy Nationally…

5 dentists, 3 limited license5 hygienists, 0 DasTacoma facility building new operatory in

space opening this fallSalaries and benefits

Kennedy Health Center Economic Study

Appointment schedules, supplies and equipmentAverage $ reimbursed/ visitClinical, administrative, care and supervision time by clinic staffRange and volume of patient complexity

Kennedy Health Center Economic Study

Scenario Productivity Net Revenue

Year OneWith one-time cost of new operatory

8 additional appointments/day (1920/year)

-$2,280

Year TwoNo fixed costs

8 additional appointments/day (1920/year)

+$60,720

Analysis conducted by the Pew Charitable Trusts, 2015.

The Bill…

Sen. Majority Leader Harriette Chandler

(Worcester)

Rep. Smitty Pignatelli

(Berkshires)

Passed Senate 39-0 as amendment to Senate budget (May ‘16)

Key provisions include: Hygiene-based practitioner Educated at CODA-accredited

institution 500 hours of direct supervision

training before practicing Training on treating special needs

patients Limit four practitioners per

supervising dentist

30+ organizations endorse the bill: AARP, ARC, Commonwealth Care, Harvard Dental School, Health Care for All, MA Hospitals, NAMI, MA Senior Action

“This model would work perfectly for our health center! We’d hire them tomorrow.”-MA FQHC Executive Director

“We already have limited license dentists. I don’t see how DTs would work in our practice.”-MA FQHC Executive Director

“Our limited licensure dentists have not been an ideal fit. Dental therapists could really help us fill existing gaps.”

-MA FQHC Executive Director

“I have two kids with significant developmental disbailities. There is NO access to care for them, and I have the means to pay. What about the families who don’t?”

-Head of MA advocacy group

“They told me it would be 12-16 months before my daughter would be seen at *********** Health Center. Instead I have to take her to ********* Hospital.”

-Head of MA advocacy group w/ child on MassHealth

What we’ve heard…

Conclusions…

THANK YOU!!!