Dental coalition urges Senate committee to address dental workforce shortages

A coalition of dental organizations is urging the Senate Health, Education, Labor and Pensions Committee to focus on four critical areas regarding the dental workforce: the dental team, student debt, diversity and underserved areas.

The coalition shared these priorities in a March 20 letter in response to the committee’s request for information on the health care workforce shortages.

In the letter to Sens. Bernie Sanders, I-Vt., chair, Senate Health, Education, Labor and Pensions Committee; and Bill Cassidy, M.D., R-La., ranking member, the dental groups thanked the lawmakers for their interest in workforce issues and said addressing these shortages is a top priority for the organizations.

The dental team: dental hygienists and dental assistants
To help dentists find candidates to fill dental hygienist and assistant positions, the groups asked Congress to support increases in funding for the Oral Health Workforce Development Program. The program helps build and train the oral health workforce and improves access to quality oral health care for those in need.

“Many dentists are small business owners and employers. And no dentist works alone,” wrote the coalition, which noted a January ADA HPI survey that found more than 85% of dentists found it challenging to recruit hygienists. “They are the head of a clinical team that also includes dental assistants and dental hygienists. Every member of this team plays an important role. Their work is essential to dental practice, and they also increase access to care by enabling dentists to see more patients.”

Student debt
With the average new dentist graduating with over $300,000 in debt, the coalition urged the committee to support several student loans bills, including:

• The Protecting Our Students by Terminating Graduate Rates that Add to Debt Act, which would reinstate eligibility for graduate and professional students with financial need to receive Direct Subsidized Stafford Loans.
• The Resident Education Deferred Interest Act, which would allow dental and medical residents to defer payments on their federal student loans —and delay the point at which interest begins to accrue — until after completing a residency.
• The Student Loan Refinancing Act, which would enable borrowers to refinance their federal student loans on multiple occasions to take advantage of lower interest rates.
• The Student Loan Refinancing and Recalculation Act, which would provide the opportunity for borrowers to refinance their federal student loans when interest rates are lower.
• The Student Loan Interest Deduction Act, which would double the student loan interest deduction from $2,500 to $5,000 and eliminate the income limits that prevent those with higher incomes from reaping the benefit.
• The Indian Health Service Health Professions Tax Fairness Act, which would allow dentists participating in the Indian Health Service Loan Repayment Program to exclude interest and principal payments from their federal income taxes, as well as certain benefits received by those in the Indian Health Professions Scholarships Program.
• The Dental Loan Repayment Assistance Act, which would allow full-time faculty members participating in the Dental Faculty Loan Repayment Program to exclude the amount of the loan forgiveness from their federal income taxes.
• The HIV Epidemic Loan-Repayment Program Act, which would offer up to $250,000 in educational loan repayment to dentists and other health care professionals in exchange for up to five years of service at Ryan White-funded clinical sites and in health profession shortage areas.

The groups recommended several ways to increase diversity in the dental profession, including:

• Reducing the student loan burden of dentists.
• Providing additional support for dental schools at Historically Black Colleges and Universities or those seeking to expand their curriculum to include a dental degree.
• Increasing funding for career and technical training programs at community colleges and trade schools for dental hygienists and dental assistants.
• Funding and supporting programs at elementary, middle, and high schools in underserved and diverse communities that aim to attract people to the dental profession at a young age.

Underserved areas
The groups asked the committee to help draw dentists to underserved areas through:
• Funding programs such as the National Health Service Corps that forgive student debt in exchange for service in underserved areas. “These programs need to be well funded, easy to navigate, and expanded to include shorter time commitments or fewer mandatory weekly hours worked,” they noted.
• Tax relief.
• Small business grants.
• Attractive loan terms for purchasing or building a new dental practice in communities of need.

The coalition also urged the lawmakers to look at the way health professional shortage areas are defined, noting the current model is “sorely outdated and inflexible.”

“When shortage areas are incorrectly defined, human and capital resources are improperly disbursed, policy is improperly focused, and bad proposals move forward,” they wrote. “Thus, those most in need are likely left behind in favor of others who may not need as much help. With an updated, technology-driven approach, we can better allocate resources to enact responsive policy that meets the unique needs of each community. We ask that the committee consider using a revised health professional shortage area algorithm, like that used by the ADA Health Policy Institute, that utilizes geomapping to locate beneficiaries, providers (with a particular focus on those accepting new patients), travel options, and times to care.”

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