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Dental Therapy inArizonaKristen BoiliniPivotal Policy ConsultingDental Care for ArizonaAugust 1, 2018
TIMELINE COR Hearing: December 2016 Spring of 2017: Building Support COR Hearing: November 2017 2018 Legislative Session 2018 Success General Effective Date: August 3, 2018
Dental Care forArizona Coalition American College of OB-GYNs-AZ Section Goldwater Institute Americans for Prosperity Inter-Tribal Association of Arizona Arizona Advisory Council on Indian Health Care Arizona American Indian Oral Health Initiative Arizona Hispanic Chamber of Commerce Native American Connections Arizona Dental Hygienists Association Navajo Nation Arizona Community Action Association Pew Charitable Trusts Arizona Farm Bureau Southern Arizona Oral Health Coalition Arizona Free Enterprise Club Tohono O’odham Nation Arizona Rural Health Association Tucson Hispanic Chamber of Commerce Asian Pacific Community in Action Valle del Sol (FQHC) Chicanos Por la Causa Community Health Centers Alliance
National momentum
Arizona law Broad, flexible, and statewide model Focus on underserved populations Broad scope; aligns with and goes beyond CODA
licensureWho must be licensed? Anyone practicing as a dental therapist in Arizona, must be licensed throughAzBODEXException: Persons not required to be licensed (ARS 32-1231) nor regulated byAzBODEX (paraphrased): A dental therapist, whether or not they are licensedby the State, may practice dental therapy without falling under the licensurerequirements or practice restrictions contained in Arizona Law, Chapter 296when practicing under the following conditions:A.In the discharge of official duties on behalf of the United Statesgovernment, including the U.S. Department of Veterans Affairs the U.S.Public Health Services, and the Indian Health Service.B.While employed by tribal health programs authorized pursuant to PublicLaw 93-638 or Urban Indian Health Programs.
Models for dentaltherapy practice1. Under direct supervision of a dentist Direct supervision means that a licensed dentist is presentin the office and available to provide treatment or care toa patient and observe a dental therapist’s work.2. Under a Collaborative Practice Agreement (CPA) Dentists may supervise up to 4 CPA DTs. The dentistincludes standing orders for the DT that include: Where/when the DT can practice The types of patients the DT can see The medications a DT may dispense (antibiotics, antiinflammatories, analgesics) and Any restrictions within the scope of practice.
Educationalrequirements Must be licensed as a dental hygienist (no requirementsto maintain hygiene license) Must graduate from a “Recognized Dental TherapySchool” (CODA accredited, includes initialaccreditation) No degree level specified in statute
Licensurerequirements Graduation from Recognized School Pass Western Regional Examining Board DT ClinicalExam (or equivalent) Pass Dental Jurisprudence Exam 1,000 hours preceptorship-applies to CollaborativePractice Agreement only
Other states See handout
Scope of practice CODA (a floor, not a ceiling)Plus: Extractions of certain permanent teeth (Direct supervisiononly under CPA) Suturing Space Maintainers Fabrication of athletic mouth guards *Root planning- full hygiene scope is incorporated into DTscope.
Where can dentaltherapists practice? IHS, Urban Indian Health Programs, Tribal 638’s Community Health Centers: FQHCs, Look-A-Likes Non-Profit Practices/Clinics that provide care to lowincome individuals(e.g. CPLC, St. Vincent de Paul, Brighter Way, CASS) Private Practice Dental Offices who treat CHC patientsof record
What do we stillneed to do? Immediate Opportunities The bill passed in May The effective date is August 3 Tribes can immediately begin using dental therapists Tribes can begin to consider existing training programsfor current or new dental professionals.
What do we stillneed to do? Education 8 CODA Accredited dental hygiene programs in Arizona:-Rio Salado Community Colleges-Phoenix College-Mesa Community College-Pima Community Colleges-Mohave Community College-Northern Arizona University-Carrington College-Fortis College
What do we stillneed to do? Examination & Licensure No national/regional Dental Therapy exam, yet WREB or equivalent (clinical exam for dental students) BODEX licensure requirements Process Documentation of preceptorship
What do we stillneed to do? Reimbursement Statewide Plan Amendment (AHCCCS) Employment AHCCCS Health Plans CHC’s & Non-Profit Clinics
Thank youKristen Boilinikristen@pivotalpolicyconsulting.com
Aug 01, 2018 · Models for dental therapy practice . 1. Under direct supervision of a dentist Direct supervision means that a licensed dentist is present in the office and available to provide treatment or care to a patient and observe a dental therapist’s work. 2. Under a Collaborative Practice
