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Minnesota Dental Association, with ADA support, musters opposition to hygiene practitioner bill

St. Paul, Minn.—The debate over the establishment of the Advanced Dental Hygiene Practitioner continues in Minnesota's state Senate.

The ADHP is loosely modeled on the American Dental Hygienists' Association workforce model that drastically expands the scope of dental hygiene duties to include restorations and extractions.

Since its introduction, proponents have amended the term ADHP to "oral health practitioner" and added a clause that requires OHPs to practice in settings for low-income, uninsured or underserved patients. The Minnesota Dental Association is vigorously opposing the proposal (SF 2895) due to its potential to compromise patient safety.

"The MDA continues to strongly oppose this new dental hygienist position as proposed," said MDA President Jamie Sledd. "Though the bill has recently been amended by the Senate author, there are still significant flaws in the language that potentially compromise patient safety and fail to provide comprehensive solutions to the dental access problem in our state. The MDA is currently supporting an amended version that calls for a collaborative effort among all stakeholders to seek a solution that makes best use of the entire dental team."

MDA has initiated a strong grassroots initiative to help defeat the bill, added Dr. Sledd.

"We are extremely pleased with the response of MDA members throughout the state," she said. "The MDA has sent out dozens of legislative alerts, electronic newsletters and special bulletins to members requesting their assistance in contacting their legislators to oppose this controversial and experimental proposal.

"Hundreds of members have responded by calling or writing their legislators, sending letters to editors of local papers and attending town hall, Chamber of Commerce and other local meetings," said Dr. Sledd. Students from the University of Minnesota School of Dentistry were also active participants in grassroots activities.

"This collective effort has helped influence some key legislators' votes so far and we hope to continue these powerful grassroots efforts throughout the session," said Dr. Sledd.

The ADA is supporting the Minnesota Dental Association in its efforts to oppose the new practitioner. "Rest assured that all is not lost and there are a number of activities being undertaken," said ADA President Mark J. Feldman.

"The ADA is providing significant lobbying and public relations assistance to the Minnesota Dental Association via our State Public Affairs program," said Dr. Feldman. "These efforts include public relations assistance, increased lobbying capacity and coordination of member communications. ADA representatives have worked with the MDA Board and consultants to assess the situation and help them develop their next strategic moves."

A key success for MDA came in persuading the author of the ADHP bill in the state House of Representatives to withdraw the bill from further consideration. The measure is now dead in that chamber. The Senate, however, is an entirely different story.

On March 25, the sponsor of SF 2895 offered the amendment that was adopted in a Senate finance subcommittee that revises the term for ADHP and tacks the bill onto an omnibus Senate supplemental appropriations bill. The amendment included a pilot study for the oral health practitioner but takes a step backward from an earlier amended version that would have required that the new practitioner only perform extractions during the first year of the practice if a supervising dentist was on the premises.

The amendment also moves authority for regulation of this model during the pilot study from the state dental board to the Commission of Health. The intent of the pilot study is to authorize 15 OHPs to enter practice in 2011 and another 15 in 2012. The licensure of additional OHPs would be contingent on additional authorization from the legislature.

However, this action does not sunset those licenses after any period of time so cannot be truly understood to be a pilot project. This would create 30 OHPs without a provision for expiration after a study period, pending further authorization. The MDA has advised grassroots members to let their state senators know this end run around the process is counterproductive and that the proposal still is unacceptable.

On March 13, a Senate finance subcommittee approved SF 2895 in a 5-3 vote. That subcommittee included the sponsor, who severely limited the Minnesota Dental Association's opposition testimony during the hearing.

It was in that hearing that proponents of the bill offered the amendment requiring ADHPs to work on site with a dentist during their first years of practice while performing extractions. The bill's sponsors also sought to mischaracterize the MDA's position during the March 13 hearing—claiming that the MDA had agreed to numerous concessions in discussions regarding the bill, which is untrue. The MDA and ADA have emphasized that they will continue to oppose this bill as long as it includes unsupervised surgical procedures.

The omnibus bill is expected to be heard on the Senate floor in the upcoming weeks.