Minnesota s New Oral Health Practitioners. Dental Therapist and Advanced Dental Therapist

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Andra Lee
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1 Minnesota s New Oral Health Practitioners Dental Therapist and Advanced Dental Therapist 1

2 Ten Years of Development 2000 and 2003: Surgeon General Reports 2004: Draft competencies by ADHA 2005: Metropolitan State University and Normandale Community College partnered 2006: Program approved by MnSCU 2007: Advisory committee formed 2009: Program began 2

3 Responding to an Access Need Of all the forms of inequality, injustice in health care is the most shocking and inhumane. Martin Luther King Jr.,

4 Minnesota Trends Access problem for people on public programs is getting worse Majority receive no oral health services Average age of dentists is 55, 59 in rural 60% of dentists expected to retire in yrs Long waiting lists to receive treatment in community clinics and FQHC clinics 4

5 Minnesota Goals For the Mid-level Practitioners Improve access by filling gaps where there are not enough dentists Dentists are vital to the model Designed NOT to replace or compete with dentists Part of a broader strategy to improve access Not the silver bullet 5

6 Politics and Policy 9

7 The Major Players Proponents Minnesota (MN) Mid-Level Alliance: Safety Net Coalition, safety net providers MN Dental Hygienists Association Nursing homes and long-term care orgs Head Start programs Health insurance plans State government Disability organizations and advocates 10

8 Politics Initially strong opposition activities: Grassroots Lobbying Media campaign Pressure on dentists Proponents had less money but were well organized and had support from many health care and advocacy groups 11

9 2008 Law Skeleton framework for oral health practitioner established Work Group established Work Group recommendations reported in December

10 Legislatively Mandated Workgroup 10

11 2008 Law Answered the question of whether to establish a mid-level practitioner Did not answer the how questions Legislature created a work group, which recommended the how but this did not end the controversy 14

12 2009 Session Two bills were introduced: 1. MDA/U of M: physician assistant model with dentist on site to do diagnosis and supervise treatment and only the School of Dentistry could train/educate 2. Safety Net Coalition: nurse practitioner model to provide treatment under the direction of a CMA where no dentists are available 15

13 Minnesota s Dental Therapist Law Chapter 95 - Enacted May

14 Compromise 1. Proposals merged: single practitioner, two levels 2. Only basic procedures 3. Supervising dentist requirements strengthened 4. No diagnosis 5. No prescribing authority, but may provide 6. Clinical practice required before advanced practice 7. Educational institutions not specified 16

15 Dental Therapist Licensed by the Board of Dentistry Two levels: basic and advanced practice Education programs approved by the BOD Basic: Baccalaureate degree Advanced: Masters degree Supervised by a dentist through CMA Practice limited to underserved patients and populations 17

16 State Law Parameters Dental Therapist (basic) Services allowed under general supervision Services allowed under indirect supervision Baccalaureate Degree Advanced Dental Therapist All DT services under general supervision Additional services allowed under general supervision with a CMA Masters Degree 18

17 Master of Science (M.S.) Oral Health Care Practitioner Program Curriculum leads to Dental Therapy licensure and certification in Advanced Dental Therapy 17

18 MnSCU Minnesota State Colleges and Universities 18

19 Program Overview MS: Oral Health Care Practitioner Curriculum leads to dental therapy licensure and certification in advanced dental therapy 19

20 Minnesota trains first class of dental therapists Midlevel providers aim to provide simple care in rural areas By CHRIS WILLIAMS - Associated Press Posted: January 13, :00 am MINNEAPOLIS ---- As a hygienist at the only nonprofit dental clinic in a wide swath of southern Minnesota, Jodi Hager sees close-up what limited care means: children from poor families with decay in every tooth, and adults weary from driving two hours to a place that will take their state insurance. Dental hygienists Jodi Hager and Heather Heathcote testing at Normandale Community College in [Bloomington], MN. Hager and Heathcote are two of seven hygienists at the college studying to become dental therapists. (AP Photo/Dawn Villella) 20

21 MS:OHCP Dental Therapy Program Program is distinctive: Experienced dental hygienists, licensed and practicing in the profession Students have already mastered a wide range of competencies Educated to have sound public health perspective, to be competent in care management as well as perform specific oral procedures 21

22 DT/DH Combination Dual license option: Licensed as both an dental therapist and a dental hygienist Provide full scope of dental hygiene practice in addition to DT scope If credentialed, ability to provide ADT scope Valuable in communities and treatment settings without a traditional dentist office 25

23 Educational Program Degree: Master s of Science Length: 26 months* Full-time commitment expected * Additional clinical hours for ADT credential 23

24 Program Information Classes will be at: Metropolitan State University (Saint Paul Campus) Campus, on-line, web-enhanced, and/or web supported courses Normandale Community College (Bloomington) Normandale lab, clinic, and qualified faculty 24

25 Admission Criteria Application Form and Fee Official transcripts of all college coursework Baccalaureate degree Current dental hygiene licensure in good standing Three prerequisite courses required 25

26 Prerequisite Courses DENH Collaborative and Advanced Dental Hygiene Practice DENH Management of Oral Health Care Delivery DENH Restorative Functions Theory and Lab 26

27 Admission Criteria continued Goal Statement Essay Computer Proficiency Form Reference Forms Professional Portfolio 27

28 Following program acceptance, students must furnish the following documentation: Active Dental Hygiene License Work experience Pain Management certifications CPR certification Restorative Functions course documentation Immunization information Successful background check 28

29 Program Costs for Students Current tuition/fees for Metropolitan State University graduate nursing and dental courses: Approximately $360 per credit (fall 2009) Books, lab fees, and equipment are not included in the fee above $2,000 fee for the lab/clinical and externship courses (subject to change) 29

30 Background for Curriculum Development Master s Program Advisory Committee formed March 2007 Three Advisory Committee members visited the Canadian Dental Therapy Program in Saskatchewan May 2007 Reviewed other dental therapy curriculums 30

31 Curriculum Development Curriculum development was based on: ADEA Competencies for the New General Dentist ADHA Competencies for the ADHP CODA Standards for the Dental Education Programs Students enter the program having met CODA Standards and Competencies established for Dental Hygiene Education Programs 31

32 Course Sequence Summer Sessions 1 and 2 (Pre-professional Courses) Advanced Research Community-Based Intercultural Communication Fall semester Epidemiology Pharmacology Principles of Clinical Application Health Assessment and Oral Diagnostic Reasoning 32

33 Course Sequence Spring semester Management of Dental and Medical Emergencies Health Policy and Leadership Community-Based Primary Oral Healthcare I Summer Session 1 Community-Based Primary Oral Healthcare II Summer Session 2 Community-Based Primary Oral Healthcare III 33

34 Course Sequence Fall semester Community-Based Primary Oral Healthcare IV Advanced Specialty Practices Spring semester Community-Based Primary Oral Healthcare V Advanced Community Specialty Externship 34

35 Course Sequence Summer 1 Comprehensive Competency-Based Capstone Experience Licensure Examination for DT Currently seeking program approval for the addition of credits to complete clinical hours required for Advanced Dental Therapy Certification 35

36 Issues Acceptance by Practicing Professionals and the Public Support for Educational Institutions Accreditation Challenges Third Party Payors 36

37 Lessons Learned As you move forward It is about access and the underserved Focus on building coalitions and alliances Stay grounded in facts, research, and proven experience Continuous communication and education Maintain your integrity 37

38 To raise new questions, new possibilities, to regard old problems from a new angle, requires imagination and marks real advance in science Einstein 38

39 Thank you Colleen M. Brickle RDH, RF, EdD Metropolitan State University and Normandale Community College (MnSCU)

Planning and Implementation For a new oral health care practitioner to address access needs

Planning and Implementation For a new oral health care practitioner to address access needs The Minnesota Story Responding to an Access Need Of all the forms of inequality, injustice in health care is the most shocking and inhumane. Martin Luther King Jr., 1966 Dental Therapist and Advanced Dental