2012 Legislature: Regular Session Adjourns, Special Session Begins

Last Thursday, March 8, marked the end of the 2012 60-day legislative session. The regular session proved to be very eventful but the Legislature failed to pass a supplemental budget to close the $500 million shortfall in state’s current two year operating budget. As a result, Governor Chris Gregoire convened a special legislative session focused on passing a supplemental budget and other large budget issues. Special legislative sessions carry restrictions that do not exist during regular legislative sessions. Therefore, the Legislature can only focus on budget issues during this special session and cannot deliberate on other policy issues. Here’s a breakdown on what happened on the major legislation that WSDA followed during 2012 regular session:

What Passed:

SB 5620
SB 5620 authorizes the creation of certified dental anesthesia assistants (CDAA). CDAAs will be allowed to assistant oral surgeons will patient monitoring, initiate and discontinue intravenous lines, administer emergency medications, and perform are duties under direct verbal command. The Dental Quality Assurance Commission will now begin writing rule for the new law.

SB 6131
SB 6131 was a minor technical amendment to Washington’s bulk mercury law which takes effect in June. SB 6131 clarifies that dental amalgam and other commercial devices containing mercury (such as switches used in airplanes) are not included in a ban on the sale, purchase, or distribution of bulk mercury. SB 6131 was supported by the Department of Ecology, WSDA, and several business groups.

HB 2319
HB 2319 is Governor and Insurance Commissioner requested legislation for implementing the federal affordable care act in Washington. HB 2319 clarifies the responsibilities of the Washington Health Benefit Exchange Board of Directors, what health benefits must be included in health plans, and market rules for health plans offered inside and outside of the exchange. Under federal law, pediatric dental benefits must be offered in health plans offered in the exchange but HB 2319 requires that all dental plans must be offered separate from medical plans to ensure that consumers can more easily compare dental insurance options. WSDA will continue to monitor how the affordable care act will be implemented in Washington and advocate for the best interests of the profession and dental patients.

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WSDA Dentists Respond to ER Reports

WSDA President Dr. Rod Wentworth and Snohomish County Dental Society President Dr. Stephen Lee jointly wrote an editioral piece in the Everett Herald last Friday. The piece was written in response to an Everett Herald editorial about utilization of hospital emergency rooms for dental care.

The entire piece is included below or can be read here:

Education, state aid are essential

The Herald's editorial "Sign of a system in crisis" brings attention to the importance of oral health and the use of hospital emergency rooms by people with dental problems. The solution is seemingly simple: good oral health practices can prevent costly emergency room visits.

As dentists, we see two key barriers to this solution: lack of knowledge about the importance of oral health and Washington's fractured dental safety net. We believe finding cost effective solutions to these problems will reduce dental related emergency room visits and improve the overall health of our residents.

Low oral health literacy is one of the most significant barriers to dental care. Dentists cannot provide care unless patients see a need for treatment. Even among people with dental insurance, less than 60 percent visit the dentist for regular preventive care. Laws and regulation will not change this, but education can. The Washington Oral Health Foundation, the charitable arm of the Washington State Dental Association, works throughout the state in schools and community centers to educate people about the importance of oral health. Only when we address issues like fear, cultural and language barriers, and lack of knowledge will we begin to solve real problems for many Washingtonians.

Unfortunately, programs that provide dental care for low-income people have been severely cut in Olympia. That penny-wise, pound-foolish decision will result in more pain for patients and more expense for taxpayers. Washington dentists are doing their part, providing charity care to more than 100,000 patients in 2011 alone. However, charity care is not a sustainable health care system.

Some, like the Pew Foundation, suggest that a lesser trained person with no real supervision should treat the most vulnerable. As dentists we know that, instead of lowering the quality of care to those most in need, the better answer is dramatically ramped up prevention and oral health education programs -- prevent the problem before it becomes an emergency.


Dr. Rod Wentworth, president
Washington State Dental Association
Dr. Stephen Lee, president
Snohomish County Dental Society

All Mid-Level Practitioner Bills are Dead for 2012

SB 6126 and HB 2226, the dental practitioner bills supported by the Kellogg Foundation and the Children’s Alliance, are now dead. HB 2226 died in the House Health Committee two weeks ago and SB 6126 will not pass out of the Senate Rules Committee. The WSDA appreciates our members' strong efforts and we're especially thankful for the leadership from the Board, committees, grassroots advocates and lobbyists. If you have received positive responses from your local legislators on WSDA’s position, please send them a thank you for supporting our concerns about patient safety and our continuing efforts to reduce barriers to oral health care. 

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Dental Practitioner Proposals Pose Considerable Health, Financial Risks

Pierce County Dental Society President Dr. Sammy Pak penned an editorial last week in the Tacoma News Tribune. The piece was in response to an editorial written in support of SB 6126 which would allow midlevel providers to perform surgical procedures without the on-site supervision of a dentist. Here's the piece:

Re: “Our state’s dental system is letting too many patients down” (Viewpoint, 1-29).

Anita Rodriguez recently argued on this page for a new category of mid-level dental provider authorized to practice independently from a dentist.

Rodriguez explained that many dentists oppose this proposal because of concerns for safety and quality of care. She also argued that such practitioners are much the same as the nurse-practitioners of 50 years ago – a profession once opposed by the establishment and now embraced by it.

I wanted to provide some clarity on many dentists’ views on this matter.

Rodriguez is writing in particular about two bills that are currently being considered by our Legislature. Both would create practitioners who, with an unspecified amount of training after high school, could perform irreversible procedures that include drilling and extractions without the on-site supervision of a dentist.

We have three concerns with these bills.

 • We are concerned about the seriousness of the procedures these mid-level practitioners could perform. The measures would allow dental therapists to do surgical procedures including pulpotomies (root canals on primary teeth), drilling for cavity preparation and extractions.

These procedures are irreversible and could be performed by an individual with a GED, an unspecific amount of training and no competency testing. There is no precedent for this mid-level practitioner anywhere else.

To Rodriguez’s point about nurse practitioners: Nurse practitioners cannot perform surgical procedures, and in our state they are required to receive a master’s or doctoral degree.

 • We are concerned about fracturing the dental home for patients. Under the structure of these bills, a patient with complications from a practitioner’s procedure would need to rush to a dentist to address the issue or wait for the dentist to come to him or her. Nearly every dentist can tell a recent story of a procedure that was more complicated than he or she expected.

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