AACDP Annual Symposium on Local Dental Programs Dental Workforce Changes, Access, and State Prac7ce Acts: What s New? Ann Ba&rell, MSDH Execu3ve Director American Dental Hygienists Associa3on April 25, 2010 Presenta3on Overview: Dental Hygiene Workforce, Educa3on, and Prac3ce Informa3on State Policy Trends Federal Policy Trends 1
The Dental Hygiene Profession and Access to Care Effec3ve and trusted messengers of the importance of oral health Providers of primary care oral health services Strong advocates for increased dental insurance coverage and public health infrastructure Collabora3ve partners with dental and health care stakeholders The Dental Hygiene Workforce 152,000+ licensed dental hygienists in U.S 130,000 ac3ve prac33oners 25% hold licenses in more than one state Clinical Employment SeXngs: Private dental office Community/public health clinics Schools Hospitals Head Start Programs Nursing Homes Resource: ADHA Master File Survey of Dental Hygienists in the U.S. 2007 2
Dental Hygiene Prac>ce 31 states: Public has Direct Access to dental hygiene services 15 states: Direct Reimbursement under Medicaid Preven>ve Services: Prophylaxis Sealants Fluoride Treatments Pa3ent educa3on Nutri3on counseling Screenings, assessments, exams Therapeu>c & Restora>ve Services Local anesthesia 43 states & DC Nitrous oxide 25 states & DC Temporary restora3ons: 37 states & DC hbp://www.adha.org/governmental_affairs/prac>ce_issues.htm Dental Hygiene Educa>on 313 Entry level (AS, AAS, BS) Programs Entry level program in each state 1 22/state Approximately 6,000 graduates per year 55 Degree Comple3on (BS) 20 Master of Science (MS) Entry level programs accredited via CODA CODA does not accredit Degree Comple3on or Masters programs hbp://www.adha.org/downloads/edu/dh_program_stats.pdf 3
The Dental Hygiene Workforce Dental Hygiene is one of the fastest growing professions in the country Occupa>onal Title Dental Hygienists Change, 2008 18 SOC Code Employment, 2008 Projected Employment, 2018 Number Percent 29 2021 174,100 237,000 62,900 36 U.S. Dept. of Labor, Bureau of Labor Sta3s3cs Occupa6onal Outlook Handbook: Dental Hygienists Projec3ons data from the Na3onal Employment Matrix h&p://www.bls.gov/oco/ocos097.htm Dental Workforce Projec>ons employment of den6sts is not expected to keep pace with the increased demand for dental services. Occupa>onal Title Den>sts SOC Code Employment, 2008 Projected Employment, 2018 29 102 0 141,900 164,000 Change, 2008 18 Number Percent 22,100 16 U.S. Dept. of Labor, Bureau of Labor Sta3s3cs Occupa6onal Outlook Handbook: Den3sts Projec3ons data from the Na3onal Employment Matrix h&p://www.bls.gov/oco/ocos072.htm 4
Policy Drives Prac>ce Trends State and federal policy changes drive efforts to increase access to care Supervision Collabora3on Pa3ents can more directly access services outside of the private dental office Policies facilitate new dental delivery models Direct Access to Dental Hygienists: Many forms collabora3ve prac3ce, public health supervision, limited access permit, etc. Dental hygienist can ini3ate pa3ent care Care administered in sexng outside of private dental office Rela3onship/collabora3on among dental hygienist and den3st vary by state Oregon now allows RDHs to work in NP and physicians offices 5
Direct Access 2010: 31 States Will insert updated side to include Kentcuky Direct Reimbursement under Medicaid Dental hygienist has provider number Dental hygienist bills directly for services delivered 6
Medicaid Reimbursement 2010 15 States Policy Drives Prac>ce Trends Health reform and CHIPRA more eligible for dental benefits than ever more Importance of oral health widely recognized by policymakers Policies facilitate new dental delivery models support state interest in innova3on 7
Health Reform Workforce $60 million for Alterna3ve Dental Health Care Provider grants Tests new and emerging workforce models Advanced prac3ce, public health, and independent dental hygienists eligible for grants Grants to support the expansion and educa3on of dental providers Dental hygienists eligible for grants CHIPRA GAO study due in mid 2010 Will explore the feasibility and appropriateness of dental mid level providers Health Reform Preven>on and Oral Health Literacy School-based health clinics grants Oral Health Prevention and Education Campaign School-based sealant programs Oral health surveillance and infrastructure development 8
Other Federal Efforts Stimulus funding (ARRA) $200 million for National Health Service Corps $500 million for community health center operations Two HRSA-funded oral health studies at IOM Oral Health Access to Services An Oral Health Initiative American Dental Hygienists Associa>on 444 N. Michigan Ave., Suite 3400 Chicago, IL 60611 312 440 8900 www.adha.org ADHA Resources Dental Hygiene Educa3on: hbp://www.adha.org/careerinfo/index.html Prac3ce Issues: hbp://www.adha.org/governmental_affairs/prac>ce_issues.htm ADHA Policies hbp://www.adha.org/aboutadha/index.html 9