MAY 2008
VOLUME 9, ISSUE 5
AVAILABLE ONLINE AT TDA.ORG
TDA House Deliberates Workforce Issues Ralph Waldo Emerson once stated, “Nothing great was ever achieved without enthusiasm.” This is truly the hallmark of the Texas Dental Association (TDA) and its ongoing focus on workforce issues. Once again, the members of the TDA have demonstrated their passion for their profession and respect for their policy-making process with their deliberations during the 138th Annual Session held May 1–4, 2008, in San Antonio. As the TDA’s governing body, the House of Delegates has final authority on all policy matters and carefully deliberated a number of important issues facing the profession of dentistry in Texas. The most recent House actions on proposed workforce resolutions followed a five-year research and development effort and validated the integrity of the TDA’s policy development process. The following is a brief summary of these efforts as well as the actions of the House.
History
Workforce model development is a direct product of TDA’s strategic plan, TDA 2009. A complete copy of the current TDA 2009 is available online at www.tda.org. The process began in 2003 with a retreat wherein a diverse group of TDA members met to develop the strategic goals and objectives for the Association. Under the Manpower goal, the Council on Dental Education, Trade & Ancillaries was charged to develop future workforce models, including gathering all available and pertinent information. Data gathering consisted of national scientific research, as well as surveys and presentations from various stakeholders. At the 2007 Annual Session, the House requested that TDA provide the membership with regular updates on workforce development. To that end, TDA published a monthly “Dental Workforce Update” in the TDA Today that detailed current workforce research and development efforts and encouraged members to contact TDA with their thoughts and feedback. TDA also developed a dedicated page on TDA’s website that included state and national scientific articles and research about workforce issues. TDA president Dr. A. David May, Jr. and members of the TDA Board of Directors traveled across the state and met with 24 of the 26 component societies to facilitate workforce forums where members were able to review the latest research and information, as well as to voice their opinions regarding future workforce models. As in all policy matters, the ultimate decisions lie with the House. At the first session of the House on Thursday, May 1, 2008, delegates heard presentations on the latest workforce efforts, including a summary of research and the recent membership-wide survey on expanded duties for allied personnel. Following standard protocol, the House adjourned, enabling TDA Reference Committees to hear testimony and make recommendations on all policy resolutions. Workforce related resolutions were referred to Reference Committee C which, upon request of the House, was moved to a large ballroom to accommodate all persons wishing to testify or listen to the reference committee testimony. Following the testimony of approximately 40 individuals, Reference Committee C met in executive session to deliberate and draft their report for presentation to the House.
House of Delegates Action
At the second session of the TDA House on Saturday, May 3, the House met in an open session to hear all Reference Committee reports regarding all resolutions before the House. In addition to testimony provided during reference committee hearings, delegates were able to present information as they deliberated the reference committee recommendations on the various workforce resolutions. The actions of the House on each of these resolutions are listed below. The House’s deliberations and actions regarding policy on workforce resolutions are the result of a professionally executed, inclusive, and thorough policy development process that elicited enthusiastic response and debate from both the membership and the House. Important Note: Changes in TDA policy are not changes to the Dental Practice Act. In general, only the Texas Legislature can amend the Dental Practice Act to change scope of practice.
You are encouraged to contact your component society’s delegates for more information and details about the discussion on these issues.
2008 Workforce Resolutions Submitted by: Council on Dental Education, Trade & Ancillaries Strategic Plan Goal: Manpower RESOLUTION 123-2008-H Resolved, that the Texas Dental Association support a change in law and regulations to allow Texas licensed dentists to delegate to a properly-trained, registered dental hygienist the administration of local anesthetic by infiltration under direct supervision of the dentist, and be it further Resolved, that a position paper be prepared detailing the change in policy of the Texas Dental Association regarding the delegation to a properly-trained, registered dental hygienist the administration of local anesthetic by infiltration under direct supervision of the dentist, and be it further Resolved, that Resolution 69-1997-H, which reads as follows: “Resolved, that the Texas Dental Association opposes dental hygienists administering local anesthesia by injection,” be rescinded, and be it further Resolved, that Resolution 109-1997-H, which reads as follows: “Resolved, that the following position paper be accepted as the policy of the Texas Dental Association regarding Injection of Local Anesthesia by Dental Hygienists .…” be rescinded. House Action: DEFEATED The House requested a paper ballot vote that resulted in a final vote count of 35 For and 80 Against.
RESOLUTION 124-2008-H Resolved, that the Texas Dental Association support a change in law and regulations to allow Texas licensed dentists to delegate to a dental assistant, who holds a pit and fissure sealant certificate, the placement of pit and fissure sealants under direct supervision. House Action: ADOPTED RESOLUTION 125-2008-H Resolved, that the Texas Dental Association support a change in law and regulations to allow Texas licensed dentists to delegate to a dental assistant, under direct supervision, who holds a coronal polishing certificate, the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces, utilizing an appropriate rotary instrument with rubber cup or brush and polishing agent. HOUSE ACTION: ADOPTED RESOLUTION 126-2008-H Resolved, that a Texas licensed dentist may delegate to a properlytrained dental assistant interim treatment of an emergent dental condition, under general supervision, providing that the treatment is rendered to a patient of record and that the dentist has been contacted and has delegated treatment prior to treatment being rendered. Interim treatment is that which is considered reversible and does not require cutting hard or soft tissue. HOUSE ACTION: ADOPTED RESOLUTION 127-2008-H Resolved, that the Texas Dental Association support a change in law and regulations to allow a Texas licensed dentist to delegate the performance of radiologic procedures to a properly-trained, registered dental assistant under general supervision. House Action: ADOPTED
Breaking News Medicaid Applications Online!
Inside MK’s House Notes TDA Executive Director’s Summary of House actions Mission Road Trip Charitable dentistry on the way to Annual Session TDA Smiles Foundation 2008 Healthy Smiles Golf Classic raises record revenue 2008 TEXAS Meeting Report Photos and events from Annual Session TSBDE Rule Update Information on fluoride varnish
June Journal News Leadership Addresses given at 2008 House of Delegates Dr. A. David May, Jr. TDA President Dr. John S. Findley ADA President-Elect Dr. S. Jerry Long ADA 15th District Trustee Dr. Hilton Israelson TDA President-Elect
Around the State June 21: Component Society Presidents and Presidents Elect Leadership Conference Austin, Texas July 11: TDA Council, Committee and Affiliate Training Austin, Texas
Click & Connect Online CE Verification texasmeeting.com TEXAS Meeting Photos texasmeeting.com/estore Volunteer for ’08 ADA tda.org/volunteerada08
111-2008-H Approved the amended goals, objectives, and metrics of the TDA 2009 strategic plan.
MK’s House Notes Mary Kay Linn, TDA Executive Director Below is a summary of actions of the TDA House of Delegates during the May 2008 meeting, with Speaker of the House Dr. Glen D. Hall, presiding. Dental workforce resolutions are on pages 1 and 2.
REFERENCE COMMITTEE A: Administration, Budget, House of Delegates, and Membership 32-2008-BS (2/3 Vote) Defeated addition of new sentence to Chapter IV. House of Delegates, Section 140. Rules of Order, Subsection A. Standing Rules and Reports, Paragraph a. to read: “Action may not be taken on any resolution derived from information in any report not included in the House Book until the delegates and alternate delegates have had opportunity to review the report in its entirety.” 73-2008-H (2/3 Vote) Strategic Plan Goal: Organizational Excellence Adopted a $50 per year dues assessment for 4 consecutive years to retire debt on purchase of building adjacent to the TDA central office at 1920 S. IH-35 in Austin.
142-2007-BS-H Encouraged dentists and their staffs to be trained in proper use of Automated External Defibrillators in dental offices across the state.
REFERENCE COMMITTEE C: Dental Education, Dental Health, and Dental Care Programs 51-2008-H Strategic Plan Goal: Advocacy Approved support of the concept of the “Lighthouse” project, which primary care providers can access when referring children to a dentist to establish a dental home. 135-2008-HR-RCCS-H Strategic Plan Goal: Manpower Approved investigation of the Community Dental Health Coordinator (CDHC) concept by the appropriate TDA entity with a report to the TDA Board in March 2009. 136-2008-HR Strategic Plan Goal: Manpower Defeated a resolution calling for a new, mini survey of the TDA membership to ask specifically if they are in favor of delegation of dental anesthesia to a qualified dental hygienist. A subset of questions would determine members’ preferences regarding (a) block and infiltration and/or (b) infiltration only. A preface to the question would address historical political concerns of the TDA House; and the House would review the survey before it is distributed to members.
REFERENCE COMMITTEE D: Legislative, Legal, and Governmental Affairs
85-2008-H Referred to the appropriate TDA entity for further study the provision of per diem and hotel room reimbursement for TDA action team leaders attending the annual ADA Leadership Conference.
34-2008-H Strategic Plan Goal: Advocacy Directed the appropriate TDA entity to investigate possible solutions to problems associated with dental tourism.
87-2008-H (2/3 Vote) Adopted the TDA 2009 budget as proposed with a financial implication of $6,397,913.
72-2008-RCDS-H Approved TDA support for Federally Qualified Health Centers (FQHCs) and other community health centers as part of TDA’s ongoing efforts to increase access to oral health care; a cost/ benefit analysis of expanding dental services at existing FQHCs in Texas; working with Texas Association of Community Health Centers to promote efforts in Texas; continue support of the National Health Service Corps and the Dentist Education Loan Repayment Program; support a new state loan assistance program to comply with the Frew v Hawkins agreement by recruiting more dentists via loan forgiveness for dentists who treat Medicaid patients in underserved areas.
88-2008-H (2/3 Vote) Authorized increase in TDA active member dues annually from $410 to $455. 122-2008-H Ratified acquisition of building and real estate adjacent to TDA central office building and authorized execution of all promissory notes, bank loan documents, closing statements, lease agreements, and other real estate-related documents necessary to borrow funds and acquire titles.
REFERENCE COMMITTEE B: President’s Address, Miscellaneous Matters, Membership, Component Societies, Subsidiaries, Strategic Planning, and Annual Sessions 71-2008-H Determined that all TDA councils, committees, and affiliates should hold initial meetings of the year in conjunction with the annual TDA council, committee, and affiliate training session. 100-2008-H Amended the TDA Guidelines for Statewide/At-Large Elections of Officers requiring a Candidates Forum to be published in the Texas Dental Journal at least two months (instead of four months) prior to the election of officers. 108-2008-H Allotted eight pages per year in the Texas Dental Journal for the TDA Smiles Foundation at no charge. 110-2008-H Authorized the TDA Editor to include an announcement in TDA Today requesting notification from TDA component societies regarding about any new dental hygiene education programs under consideration or development.
84-2008-H Strategic Plan Goal: Advocacy Directed the appropriate TDA entity(s) to investigate pertinent regulatory requirements regarding proper disposal of discarded patient documents and other items from dental offices. 117-2008-H Strategic Plan Goal: Advocacy Authorized the TDA Board ask TDA district dental societies to hold meetings to recruit members to serve as Medicaid providers, ask that the meetings include representatives of the Department of State Health Services, Texas Health Steps, and Texas Medicaid Healthcare Partnership representatives, as well as one or more local dentists who accept Medicaid patients. 119-2008-H Strategic Plan Goal: Advocacy Because TDA is opposed to the bleaching of teeth in a non-dental setting without a dentist’s supervision, directed that TDA shall provide guidance to component societies to pursue all legal remedies including prosecution; to petition the Texas State Board of Dental Examiners to follow through with cease and desist orders for non-dental bleaching of teeth; and to encourage enforcement of the Texas Dental Practice Act by the State of Texas through its attorneys general, district attorneys, and/or county attorneys.
REFERENCE COMMITTEE E: Constitution, Bylaws, Ethics, and Peer Review 118-2008-H (2/3 Vote) Determined the duties of the TDA Council on Dental Economics.
Charitable Dentisty … On The Road When Dr. Jason White was planning the visit to San Antonio with his staff for the TEXAS Meeting, he came up with a unique idea. Along the way on the 687 mile drive from Lubbock, Dr. White and his assistants stopped their van in various towns to distribute free toothbrushes and toothpaste to surprised but grateful residents. They report that, at 13 gas stations, two take-out restaurants and a Wal Mart parking lot among other stops, the doctor and his seven staff members gave away 1200 toothbrushes, 200 tubes of toothpaste, and 50 Oral-B electric toothbrushes. They also answered questions regarding oral health care and encouraged people to see their local dentists. People from Tahoka and Lamesa to Big Spring and San Angelo to Eden, Menard and Fredricksburg were beneficiaries of the odyssey of Dr. White and his group. Jessica Gutierrez of O’Donnell received an electric toothbrush after naming three things you shouldn’t put into a baby bottle. She said, “Thank you so much. My four boys depend on me to take care of their teeth!” Dr. White says of the project, ““It’s a great feeling to step back from the fast paced world of dentistry and give back to the community by simply giving away toothbrushes and dental fun Top, from left: Trey Owen, Lubbock Christian University; Corina Gomez; facts. As dental health practitioners, it is our Dr. Jason White; Mechelle Heibert, RDH; Mindy Weaver. Bottom, from left: Barrett Brashier, Texas Tech University; Sunshine Ruedo; Mary Fran Johnson. obligation to serve the public.” May 2008 / TDA Today / 2
2008 Healthy Smiles Golf Classic Though the sun was hot and the humidity high, 120 golf enthusiasts and friends of the Texas Dental Association Smiles Foundation helped raise more than $26,000 at the 2008 Healthy Smiles Golf Classic on Friday, May 2, in San Antonio. The event was held at the Pecan Valley Golf Course in conjunction with the TEXAS Meeting. Funds from the tournament will be used to support the TDA in educating the public and profession about oral health, improving the public image of dentistry, and improving access to dental care for the citizens of Texas. Thanks to the presenting sponsor Nobel Biocare, Class One Orthodontics, and Orthogensis, volunteers and staff will continue to provide dental care for thousands of Texans who otherwise do not have access to treatment. In addition to our host group, the Texas Association of Orthodontists, this success would not have happened without the following individuals: Drs. Moody Alexander, James Archambeau, Lee Clitheroe, Clark Colville, Jeff Genecov, Bill Gerlach, Lynne Gerlach, Kurt Loveless, Bryan Taylor, and Ed Wentz. It isn’t too early to register for next year’s tournament. Call (512) 4482441, extension 100, or e-mail kslimp@tda.org for sign-up information.
2008 TEXAS Meeting Report Dr. Tyler L. Pendergrass, Chair, 2008 TEXAS Meeting What a great meeting we had this year! With more than 90 clinicians and 150 sessions, the 2008 program covered the gamut of educational opportunities for the entire dental team. Included were sessions focusing on specialty areas of oral surgery, emergency medicine, endodontics, periodontics, pediatrics, and many more. Multiple “hands-on workshops” were offered each day, allowing registrants to learn and practice new skills in a small group setting under the watchful eye of a master clinician. Your annual session council and staff worked diligently to continue putting together a program that rivals any in the country — showing ever more the importance of maintaining your membership in the Texas Dental Association and continuing your attendance at the TEXAS Meeting. Our 2008 host society, Dallas County (Fifth) District Dental Society, was an invaluable member of our planning and on-site facilitation team. Many kudos to Dr. Jean Bainbridge and her team — their organizational skills and commitment were outstanding and very much appreciated. The tradition of Texas hospitality was shown throughout the whole week and hopefully all who attended felt the same. Thursday evening’s Texas Party, cosponsored by The Blaising Group, rocked the hall again with Johnny Dee and the Rocket 88’s playing favorite tunes from the 1950’s and 1960’s. Attendees enjoyed reuniting with old friends and making new ones. “Happy Hours” in the Exhibit Hall on Thursday and Friday, as well as daily cash prize drawings, continued to draw huge numbers of potential buyers!
From left: Drs. Andy Doerfler, Karen Frazer, David May, Ty Pendergrass, Bill Nance, and Roger Macias celebrate the official opening of the 2008 TEXAS Meeting Exhibit Hall.
Registration this year continued to be easier than ever with more than 66 percent registering online, which shortens the on-site registration lines many of you remember from years past. On-line CE verification has proved to be an added benefit to attendees, offering the opportunity to skip the lines at the meeting and print CE forms in the comfort of their own homes or offices. This year was the first time we reduced the registration fee for non-member Texas dentists to match the ADA’s reduced fee structure of $75. The 13 non-member Texas doctors attending last year escalated to 128 this year. We continue to support activities to increase membership in the Texas Dental Association, and to promote the value of the TEXAS Meeting year after year for all of our attendees. With your help, we will encourage those non-member Texas dentists to become a part of our profession’s organized activities! The TEXAS Meeting was again an enormous success. The support of the TDA leadership and President Dr. A. David May, Jr., is invaluable to the work of the Council on Annual Session and the many volunteers who make this meeting such a great success. The TDA staff is tremendous, working long hours over and above a typical 40-hour work week putting on this meeting. If there is anything we can do to make your meeting a more memorable experience, please don’t hesitate to contact any of the Annual Session council members or your TDA staff. We are here to expand your educational horizons and to continue the valuable traditions of your TEXAS Meeting.
Marvin H. Berman, D.D.S., Chicago, Illinois, presents “Dentistry for Children ... Are We Having Fun Yet?”
The TEXAS Meeting Exhibit Hall showcased 360 exhibiting companies, including 17 companies in the TDA Perks Program aisle.
Sarah Conroy, D.D.S., R.D.H., Colombus, Ohio, at right, presents “Obtaining Accurate Alginate Impressions and Model Pouring Techniques.”
Charles Wakefield, D.D.S., Baylor University, presents “Restorative Materials: What, Where, When, and How.”
John O. Burgess, D.D.S., University of Alabama, Birmingham, presents “Using Modern Restorative Materials Effectively.”
Announcing the New TDA Family of Logos
May 2008 / TDA Today / 3
Breaking News: Medicaid Applications Online! Effective April 1, 2008, potential and current Texas medicaid Program and Children with Special Health Care Needs (CSHCN) Services Program providers can enroll and re-enroll online at www.tmhp.com. A link to the provider enrollment application is provided on the Texas Medicaid & Healthcare Partnership (TMHP) homepage. Applicants will be prompted to register if they have not already done so. Texas Medicaid Program, Primary Care Case Management (PCCM) and Children with Special Health Care Needs (CSHCN) Services Program providers and potential providers can complete the following applications online: • • • • • •
Editorial Staff Christopher F. Anderson, D.D.S., M.S.D., Editor Edwina J. Shires, Director of Publications Nicole Scott, Publications Coordinator Barbara S. Donovan, Art Director
Initial fee-for-service enrollment (including enrollment in the Texas Health Steps [THSteps] Program for both medical and dental providers and Case Management for Children and Pregnant Women [CPW]). Fee-for-service re-enrollment. Initial Credentialing PCCM. Re-Credentialing PCCM. Initial CSHCN Services Program enrollment. CSHCN Services Program re-enrollment.
Enrolling online promotes accurate submissions, decreases processing time, and enables immediate feedback on the status of the application. For more information, call the TMHP Contact Center at (800) 925-9126 or the TMHP-CSHCN Services Program Contact Center at (800) 568-2413.
TSBDE Rule Update This recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices. Question: Can a Texas dentist delegate to a dental assistant the application of fluoride varnish? Answer: No. Under Sec. 262.002(a)(4), Texas Occupations Code, the topical application of drugs to the surface tissues of the human mouth or the exposed surface of human teeth is part of the practice of dental hygiene. As a result, Sec. 262.002 and Sec. 262.003, which provides an exemption for certain dentists and physicians, effectively prohibit the application of fluoride varnish by anyone other than a dental hygienist, a licensed dentist, or a physician authorized to practice medicine in Texas.
The full text of Sec. 262.002 (emphasis added) follows: § 262.002. PRACTICE OF DENTAL HYGIENE. (a) A person practices dental hygiene if the person: (1) removes accumulated matter, tartar, deposits, accretions, or stains, other than mottled enamel stains, from the natural and restored surface of exposed human teeth and restorations in the human mouth; (2) smoothes roughened root surfaces; (3) polishes exposed human teeth, restorations in the human mouth, or roughened root surfaces; (4) topically applies drugs to the surface tissues of the human mouth or the exposed surface of human teeth; (5) makes dental x-rays; and (6) performs any other service, task, or procedure prescribed by board rule. (b) A person legally practicing dental hygiene does not violate state law regulating the practice of dentistry.
BOARD OF DIRECTORS Hilton Israelson, D.D.S., President Matthew B. Roberts, D.D.S., President-Elect A. David May, Jr., D.D.S., Immediate Past President Vice Presidents F. Dee Rea, D.D.S., Northeast William M. Walton, D.D.S., Northwest R. Mark Peppard, D.D.S., Southeast Rise’ L. Lyman, D.D.S., Southwest Senior Directors Arlet R. Dunsworth, D.D.S., Northeast J. Brad Loeffelholz, D.D.S., Northwest Craig S. Armstrong, D.D.S., Southeast Johnny G. Cailleteau, D.D.S., Southwest Directors Donna G. Miller, D.D.S., Northeast Kathleen Nichols, D.D.S., Northwest R. Lee Clitheroe, D.D.S., Southeast John W. Baucum, III, D.D.S., Southwest J. Preston Coleman, D.D.S., Secretary-Treasurer Glen D. Hall, D.D.S., Speaker of the House Michael L. Stuart, D.D.S., Parliamentarian Christopher F. Anderson, D.D.S., Editor Mary Kay Linn, Executive Director William H. Bingham, Legal Counsel TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S. IH-35, Ste 400, Austin, TX 78704-3698. Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental Association (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30. Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6. Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. Every effort will be made to return unused manuscripts if a request is made but no responsibility can be accepted for failure to do so. Anonymous communications will receive no consideration whatsoever. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously.
News You Can Use MAY 2008
VOLUME 9, ISSUE 5
AVAILABLE ONLINE AT TDA.ORG
Congratulations to our 2008 iPod nano Winners! Hundreds of show attendees visited the new TDA Perks Program area at TEXAS Meeting in May, and registered to win an iPod nano. Congratulations to our winners! Dr. Michael Bates.............San Antonio Ms. Sharon Buck.........................Hondo Dr. Monica Flynn.............San Antonio Dr. Brian Hale....................San Antonio Ms. Kathy Knox.........................Odessa Ms. Vanessa Rivera...................El Paso Dr. Stacie Test..............Flower Mound More chances to win in 2009!
Do you know your Perks? Visit tdaperks.com for information on discounts or benefits negotiated for TDA members.
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