COVID-19’s impact on dentistry remains a top advocacy priority for CDA, and a new bill that CDA is co-sponsoring with the California Medical Association would help to safeguard health care providers’ financial stability during future state emergencies like the current pandemic.
CDA is also sponsoring legislation by Assemblymember Jim Wood, DDS, (D-Santa Rosa) that would give dentists permanent authority to independently prescribe and administer the COVID-19 and flu vaccines.
Increasing access to oral health care for Medi-Cal beneficiaries continues to be a major focus.
CDA will be advocating for stabilization of the Medi-Cal dental provider network by seeking reimbursement for the cost of increased PPE through the state budget process. Another effort seeks to improve dental utilization in Medi-Cal by partnering with registered dental hygienists in alternative practice to break down medical-dental silos. RDHAPs would provide oral health education, basic preventive services and care coordination to Medi-Cal-enrolled children and pregnant people in medical office settings.
Rounding out CDA’s legislative priorities for 2021 is an effort to eliminate the statewide ban on cities’ and counties’ ability to enact local taxes on sugar-sweetened beverages. Local governments that enacted such taxes before the ban have put the tax revenues toward nutrition and other programs to improve their residents’ health.
CDA and more than a dozen major state and national health organizations are co-sponsoring legislation to end the ban.
Requiring plans to support provider networks during state emergencies
The COVID-19 pandemic has revealed that dental and medical plans and insurers have made record profits by taking in premiums but not paying claims while patients were not receiving care. Many patients are still not receiving care: Only 43% of practices surveyed in the ADA’s Health Policy Institute poll for the week of Jan. 18 reported patient volume to be “business as usual.”
And providers are suffering a double whammy: Not only are they experiencing a reduction in patient volume, but they are also incurring significantly increased costs for purchasing and using additional required personal protective equipment.
To assist health care providers in future state emergency situations, CDA and CMA are pursuing a legislative path and co-sponsoring AB 454 by Assemblymember Freddie Rodriguez (D-Pomona). The bill would give the director of the Department of Managed Health Care or the Insurance Commissioner of California the authority to require dental and medical plans or insurers to support providers and, in turn, help maintain access to care for members of those plans.
Plans’ support could take the form of grants, reimbursement rate increases, forgivable no-interest loans, supplemental payments or reimbursements for the additional costs of implementing mandatory infection-control measures in the practice.
CDA also strongly supports Senate Bill 242 (Newman, D-Fullerton), which is a companion bill to AB 454. SB 242 addresses the urgent, near-term need to reimburse providers for PPE and infection control supplies related to the COVID-19 pandemic while AB 454 focuses on future public health emergencies and natural disasters.
“Requiring the plans and insurers to support their provider networks during a public health emergency would improve access to care for their members,” said CDA President Judee Tippett-Whyte, DDS. “This bill would help physician and dental practices stay open and continue to be available to treat Californians.”
Giving dentists authority to prescribe, administer COVID-19, flu vaccines
The Department of Consumer Affairs’ emergency waiver issued Jan. 4 allows dentists to administer COVID-19 vaccines temporarily ― during the current public health emergency ― to individuals age 16 and older provided the dentists complete a required Centers for Disease Control and Prevention training course. (Learn more about the current vaccine administration landscape in CDA’s COVID-19 Vaccine Information Toolkit.
Legislation by Assemblymember Jim Wood, who is a forensic odontologist, would amend the Dental Practice Act to give dentists permanent authority to independently prescribe and administer the COVID-19 vaccines as well as flu vaccines to individuals age 3 and older. Three states have already expanded their dental practice acts to permit dentists to administer vaccines, and 21 states have temporarily expanded their vaccinating workforce by allowing dentists to administer COVID-19 vaccines.
AB 526 would also align the California Department of Public Health laboratory registration with federal law so that dentists can obtain the appropriate state licensure to be able to conduct COVID-19 rapid tests for their patients and dental team members.
Restoring municipalities’ power to address local health, funding needs
Former Gov. Jerry Brown in 2018 signed legislation that prohibited California cities and counties from enacting new taxes on soda until 2031.
Now, CDA is co-sponsoring legislation to end that ban and restore local governments’ ability to address the health inequities in their communities and direct their own economies, including by instituting a tax on sugary beverages.
The 2018 legislation was covered nationally as a compromise to keep a Big-Soda-funded measure off the November 2020 ballot; the measure, had it qualified and passed, would have devastated city and county budgets by requiring them to obtain a supermajority vote of their citizens before raising any taxes ― not just soda taxes.
San Francisco, Oakland and Berkeley implemented soda taxes before the ban took effect in 2019 and those taxes remain in place. All three cities are directing tax revenues toward school and nutrition programs.
The bill’s author, Assemblymember Adrin Nazarian (D-Van Nuys), said in a news release announcing the bill, “Special interests should not be dictating policy in our cities. This bill gives power back to the people.” San Francisco is raising $15 million annually for its residents, according to the news release.
Other major organizations co-sponsoring the bill include the American Diabetes Association, the California Black Health Network, Public Health Institute and the American Cancer Society.
Facts about the effects of sugary drinks on health and the effectiveness of sugary-drink taxes are available on the Californians for Less Soda website.
Improving access to care by allowing RDHAPs to work in medical settings
Low utilization of dental services has been a longstanding problem in the Medi-Cal program. Before the pandemic, less than half of all Medi-Cal-enrolled children visited the dentist at least once annually. And although dental offices have reopened, the Department of Health Care Services recently reported that utilization rates have not recovered to pre-pandemic rates.
CDA together with the California Dental Hygienists Association is sponsoring a collaborative effort to help improve access to dental care for Medi-Cal Dental beneficiaries without a dental home.
The goal of Assembly Bill 733 (Chiu, D-San Francisco) is to expand access to oral health care for Medi-Cal enrolled children and pregnant people by allowing registered dental hygienists in alternative practice to partner with medical professionals in medical settings to provide fluoride treatments and oral health education and to coordinate care with dental providers and the dental care system.
The effort builds upon CDA’s work to ensure that Medi-Cal beneficiaries, especially children, are fully utilizing their dental benefits. CDA has supported the virtual dental home model, for example, which allows the dental team under the supervision of a dentist to reach patients outside the traditional four walls of a dental practice.
CDA, CDHA and other stakeholders will be using the successes of recent pilot programs through the state’s Dental Transformation Initiatives that utilize new technology solutions to better integrate medical and dental settings. Pilot programs have successfully placed RDHAPs in medical office settings to improve oral health education and dental care coordination.
The new proposal could be especially successful given that utilization of medical services is much higher than dental services within Medi-Cal: Nearly 84% of Medi-Cal-enrolled children visit a physician annually.
Expanding the RDHAP settings to include medical offices in the Medi-Cal system “can help increase utilization of dental services by Medi-Cal beneficiaries and ensure they are connected to permanent and stable dental homes,” CDA and CDHA stated in a joint-release fact sheet on the bill.
CDA will share more details about the four bills as they make their way through the Legislature.