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DHAT amendment withdrawn in Senate

Washington—Sen. Al Franken (D-Minn.) withdrew an amendment to extend the Alaska dental health therapist model to other states as the Senate Indian Affairs Committee took testimony from the American Dental Association and other witnesses on "expanding dental health care in Indian country."

Dr. Ron Tankersley, ADA president, told the committee, "We are opposed to Congress expanding the Alaska therapist model." 

The committee passed legislation reauthorizing the Indian Health Care Improvement Act, with language prohibiting DHAT expansion, after Sen. Franken told Sen. Byron Dorgan (D-N.D.), committee chair, "Given your commitment to work with me over the next few weeks, I withdraw my amendment. You can understand my desire and passion about this issue." He asked for and received approval to enter into the hearing record a list of organizations supporting his withdrawn amendment.

Sen. Dorgan said that his colleague's request for the dental health care hearing "prompted a discussion that is long overdue. This discussion will be helpful going forward and I thank Mr. Franken for requesting this hearing."

Dr. Tankersley thanked the committee for reauthorizing the Indian Health Care Improvement Act, "which contains so many important provisions to improve the health of American Indians and Alaska Natives (and) is long, long overdue." The last reauthorization expired in 2000. The House of Representatives approved a reauthorization earlier this year, also without DHAT extension authority.

"To us, it's not a matter of whether similar providers exist in other countries," Dr. Tankersley told the Senate committee.

"The United States has higher educational requirements than many other countries," the ADA president testified. "Currently in this country, surgical services are not delegated to any healthcare providers with just two years of post-high-school training. Even nurse practitioners, with six years of education and training, are not given surgical privileges."

Sen. Franken sharply questioned the Association testimony. "Shouldn't everyone have access to dental care?" he asked. "We believe they should," Dr. Tankersley replied.

Sen. Franken challenged the Association's assertion that "with one more year of recruiting success, the shortage of dentists in the Indian Health Service could be eliminated."

"Your numbers don't make sense to me," the senator said. "I don't see how 70 new recruits can possibly eliminate the shortage. It just bothers me. I think people need dental care and I applaud the dentists for doing this, but we have a model that would do a lot of people a lot of good. It doesn't seem to me that your testimony is convincing at all."

Sen. Lisa Murkowski (R-Alaska) asked for information on professional opportunities for Alaskan Natives and American Indians, and the Association promised a response for the hearing record. "So much of our problem is not that there are not enough dentists but our ability to get them into these remote places," Sen. Murkowski said.

"Dr. Tankersley, I so appreciate what the ADA is doing in their efforts to get more dentists into rural America, and I applaud you on that."