1. Oral Health Workforce The ADHA Perspective: Evolution & Revolution Ann Battrell, MSDH ADHA Executive Director August 2012

2. I.The Dental Hygiene Landscape II.Advanced Dental Hygiene Practitioner (ADHP) 2004 III.ADHA’s Role in the Development, Evolution and Advocacy of New Oral Health Providers IV.Workforce Update Framework

3. Background: The Dental Hygiene Landscape The workforce –Currently 150,000+ dental hygienists in the U.S. –One of the top 10 fastest growing health care professions 38% growth projected between 2010-2020 The educational infrastructure –334 entry level dental hygiene programs –58 degree completion programs –20 Masters programs States expanding role for Dental Hygienists –35 states allow hygienists to initiate care in community settings –15 states directly reimburse hygienists

4. Dental Hygiene Direct Access Expanding Dental hygienist initiate patient care without the presence of a dentist in settings outside of the private office Many forms – collaborative practice, public health supervision, limited access permit, etc. Utilizes the existing dental hygiene workforce to increase access Resource: ADHA’s Chart on Direct Access States: http://www.adha.org/governmental_affairs/downloads/direct_access.pdf

5. 2004

6. ADHA Policies on Workforce The American Dental Hygienists’ Association advocates the creation of an advanced dental hygiene practitioner who provides diagnostic, preventive, restorative and therapeutic services directly to the public. Advanced Dental Hygiene Practitioner 4-04

7. 2008 Minnesota & Dental Therapists

8. Minnesota Legislation: –Passed in 2008/2009 – ADHA and MNDHA supported legislation –Created two new models: Dental Therapist (DT) Advanced Dental Therapist (ADT) –ADT Masters program at Metropolitan State University is dental hygiene-based Curriculum based, in part, on the ADHP Competencies Graduates are dually licensed to provide dental hygiene and dental therapy services First class graduated in June 2011 and are currently employed

9. 2009 ADHA WORKFORCE POLICIES BEGIN TO BROADEN & INCLUDE COLLABORATION

10. The ADHA supports oral health care workforce models/providers that culminate in: –Graduation from an accredited institution –Professional Licensure –Direct access to patient care ADHA Access to Care Policy 2009 4S-09

11. COLLABORATION & COALITIONS The American Dental Hygienists’ Association affirms its support for optimal oral health for all people and is committed to collaborative partnerships and coalitions that improve access to oral health services. Access to Care 7S-09/27-74

12. 2010 ADHA Defines Midlevel Oral Health Practitioner

13. Mid-level Oral Health Practitioner: A licensed dental hygienist who has graduated from an accredited dental hygiene program and who provides primary oral health care directly to patients to promote and restore oral health through assessment, diagnosis, treatment, evaluation and referral services. The Mid-level Oral Health Practitioner has met the educational requirements to provide services within an expanded scope of care, and practices under regulations set forth by the appropriate licensing agency. Dental Hygiene Practice 2010 2-10

14. The American Dental Hygienists’ Association supports programs that inform stakeholders of the scope of dental hygiene practice and its contribution to health in collaboration with health care delivery providers Access to Care 16-10/38-82

15. ADHA’s Approach to New Providers Policies afford ADHA flexibility in considering new provider models (not just the ADHP) Consider on a state-by-state basis Work in partnership with state dental hygiene associations and numerous stakeholders Focus on developing providers who are appropriately educated, licensed & deliver safe and quality oral healthcare directly to the public Commitment to advocate in support of dental hygiene-based models

16. Why Dental Hygiene-based? The workforce is educated, licensed, prepared and available The educational infrastructure is in place Dental hygienists currently work in alternative settings to increase access Patients will benefit from a practitioner who can provide both preventive and restorative services

17. Workforce Update…..

19. Kellogg’s Dental Therapist Initiative Washington State, Kansas & Vermont –Advocating dental hygiene-based models –Dental hygiene educators are active collaborators in effort –State dental hygiene associations actively engaged in advocacy in support of models Ohio & New Mexico –Ongoing discussion about dental hygiene link in legislative efforts –State dental hygiene association and dental hygiene educators actively engaged

20. Other Legislative Proposals Connecticut –Advanced Dental Hygiene Practitioner legislation Maine –Coalition led effort to establish a dental-hygiene based model –State dental hygiene association actively engaged in advocacy effort New Hampshire –Coalition led initiative to pilot test a new provider –State dental hygiene association is an active participant in coalition

21. Pilot Programs Oregon –The Oregon Health Authority may approve pilots that teach new skills to existing dental providers and develop new providers California –Legislation pending to authorize pilots using dental assistants and dental hygienists with advanced training to provide restorative services under varying levels of supervision Michigan –University of Detroit Mercy is developing a restorative function dental hygienist pilot program

22. ADHA Moving Forward… ADHA Accreditation Study Completed –To study existing and potential options for the accreditation of programs that educate oral health providers –ADHA Board of Trustees will consider the report in September Potential Consideration of Defining Dental Hygiene Advanced Practice

23. The Momentum in Support of New Providers Affordable Care Act Grants to Pilot Test Alternative Dental Health Care Providers Continued interest from policymakers, foundations, stakeholders, the public and the media Continual data demonstrating safety and effectiveness of non-dentist providers ADHA and our state associations remain committed partners in developing solutions to increasing access

24. American Dental Hygienists’ Association 444 N. Michigan Ave., Suite 3400 Chicago, IL 60611 312-440-8900 www.adha.org ADHA Resources Dental Hygiene Education: http://www.adha.org/careerinfo/index.html Practice Issues: http://www.adha.org/governmental_affairs/practice_issues.htm ADHA Policies http://www.adha.org/aboutadha/index.html