2016 LEGISLATIVE REVIEW
The 2016 legislative session will commence on Jan. 11, 2016 and is scheduled to last only 60 days. Given that the last legislative session was the longest in state history and that many lawmakers will be running for re-election this summer, legislators are anxious to return home on time. Moreover, many complicated policy issues remain or have developed over the interim that will demand the attention of lawmakers. These issues include the Supreme Court sanctioning the state for not adequately funding basic education (this refers to what is called the McCleary Decision), and another Supreme Court ruling threatening charter schools in Washington.
Given that the Legislature will face many competing priorities in a very short amount of time, WSDA’s Committee on Government Affairs determined it was best to narrow the WSDA’s 2016 legislative agenda. A smaller legislative agenda during a short session better positions WSDA for legislative success. In 2016, WSDA will be pursuing three legislative priorities: protecting patient safety and maintaining ownership of dental practices; expanding dental residencies; and defending against midlevel providers.
Protecting patient safety, maintaining dentist ownership of dental practices
State and federal law ensures decisions about a patient’s dental care remain between the patients and their dentist, helping to ensure patient safety. Legislation introduced last session by the Association of Dental Support Organizations (ADSO) would have fundamentally changed the definition of dentistry in Washington and opened the door to nondentist ownership and control of a dental practice. This legislation was not passed by the Legislature, but it was a very difficult debate.
To better position itself in 2016, WSDA drafted its own legislation that acknowledges the role of DSOs in the marketplace, but places parameters around these agreements in order to protect patient safety. As Dr. Bryan Edgar laid out in his column on page 5, the proposed legislation ensures:
• Licensed dentists and their patients will make decisions regarding the services required for quality dental care that puts the best interests of patients first
• Dentists continue to have choices regarding what outside businesses they contract with for clerical services
• Agreements with outside companies are consistent with fair market value for the services provided and are devoid of direct or indirect payments for patient referrals or business generated between outside companies and dentists
The ADSO also drafted new legislation for 2016 that again seeks to redefine our state’s definition of dentistry. We remain opposed to any changes in Washington’s definition of dentistry that could result in nondentist ownership of a dental practice.
Expanding dental residencies
Dental residencies are a powerful tool for bringing care to traditionally underserved communities – at no ongoing cost to the state. They are fully funded by Medicare’s Graduate Medical Education program. In 2016, WSDA will work to expand dental residencies in our state with both a policy proposal and a construction budget request.
The greatest barrier to expanding residencies is building the facility itself. That’s why we’re requesting the state provide $800,000 to round out private funding that will create a residency program at St. Peter Medical Center in Olympia. This new program is expected to serve an additional 10,000 patient visits annually.
Secondly, as adopted in HD-16-2015, we will introduce legislation that allows all graduates of GPR and AEGD residency programs in Washington to be eligible for licensure in lieu of the regional board exams. Currently, this is only an option for graduates of residency programs located in Health Professional Shortage Areas, which excludes King County, or community health centers. WSDA’s proposed legislation will remove the current location restrictions, encouraging more graduates to seek residency opportunities while attracting the most qualified candidates from across the nation.
Defending against midlevel providers
The 2016 legislative session is the second year of the biennium. This means that all bills introduced in 2015 remain active in 2016, and we will again face five midlevel provider bills. Two of these bills resemble the traditional model WSDA has opposed for the past six years, while the other three bills sanction the use of midlevel providers on tribal land. Tribes are sovereign nations and are able to determine how healthcare is delivered to their members. The bills being considered by the Legislature would allow for work provided by midlevel providers to be reimbursed by Medicaid. We remain opposed to the creation and sanctioning of midlevel providers.
WSDA remains committed to having a dialogue with tribes across our state about their barriers to care, so that solutions to improve the oral health of tribal members can be identified. However, we remain opposed to threatening the quality of care that a patient receives. The bills before the Legislature would create a system in Washington where patients in tribal communities would receive dental care from providers with a fraction of the education and experience of a licensed dentist or hygienist, while patients in every other community in our state would have access to healthcare professionals with more training.
Other legislative issues
While WSDA’s legislative priorities are shorter than last year’s, we continue to work on issues important to our membership in arenas outside of the Legislature. Last session, WSDA introduced House Bill 1712 ,which sought to reform the current Medicaid audit process in our state. This legislation was met with opposition from the Washington State Health Care Authority (HCA) because it placed a significant burden on HCA, rather than focusing on the contract auditors performing the audits. During the interim, WSDA has had productive conversations with HCA staff, and we are working together to address our members’ concerns with the manner in which Medicaid audits are being conducted. WSDA is confident that several necessary Medicaid audit reforms can be accomplished outside the Legislature.
Dental Action Day
The 2016 legislative session could fundamentally change the delivery of oral health care in Washington. That’s why it’s important that practitioners get involved. Your voice is vital as state legislators weigh the decisions before them. Please join us at Dental Action Day on Jan. 29, 2016. REGISTER TODAY
If you have any questions, contact Anne Burkland, WSDA’s VP of Government Affairs, at firstname.lastname@example.org.