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Letter From CDA President to Members

Letter From CDA President to Members

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Published by grahbar
Letter sent to CDA members by CDA president outlining CDA's position on SB 694
Letter sent to CDA members by CDA president outlining CDA's position on SB 694

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Published by: grahbar on Jan 28, 2012
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01/28/2012

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January 20, 2012 Dear CDA Member, As your association president, I am writing this letter to respond to discussions andcommunications about SB 694 (Padilla) taking place in the environment. This bill,sponsored by The Children’s Partnership, seeks to reinstate a dental director andauthorize a rigorous scientific study addressing safety, quality and cost-effectiveness of allowing non-dentists to perform advanced dental procedures on children only in a publichealth clinic setting. Some communications related to this bill and the House of Delegates’ resolutions providing CDA direction on the legislation appear to be designedto create distrust, fear and dissension within organized dentistry. Although I am disappointed with what feels like a deliberate campaign of misinformation, it has allowed me the opportunity to assure you that your associationleadership, including councils, the Executive Committee, Board of Trustees and House of Delegates participated in a thorough discussion on the subject of access. Thesediscussions included how best to address assertions by policy makers that the dentalworkforce is inadequate to meet the needs of a growing population of children anticipatedto receive dental coverage under the Affordable Care Act.I would be happy to discuss with any of you the thought process your leaders used inreaching the policy that came to thehouse but also the logic with which we areapproaching the legislation.  Not only would I be happy to discuss this, I invite theopportunity. Recently, a local dental society and at least one dental specialtyorganization have taken positions opposing SB 694 without providing an opportunity for dialogue with CDA leadership. The members of local dental societies and virtually allspecialists are members of CDA. This division in organized dentistry does not benefit anyof us. I am deeply disturbed that our profession, which I believe prides itself on beingscientific in thought process, has made decisions on the legislation without pursuingcomplete and accurate information. This is not informed decision making. CDAvolunteers spent three years working on the access report and nearly a year communicating this work to, and inviting comments from, the members. While somemay take issue with the process we employed, our desire was to make the most informeddecision possible. Common courtesy would dictate that CDA leadership is shown thesame respect and be included in any dialogue taking place at a local component or specialty organization. After all, we really are one membership and all care deeply aboutour profession.The current whisper campaign by some past CDA leaders that the workforce study calledfor in the Access Report and Resolution 2 is being led by CDA staff is ridiculous and aninsult to the integrity of your current volunteer leadership. Let me assure you, I am clear,as are other leaders in this association, that the role of staff is to provide background andadvice. Our role is to make decisions that we believe are in the best interest of the profession. We do not take that responsibility lightly and are offended that any member would believe we abdicate our responsibility to staff or fail to act with the highest regard
 
for the interests of the profession. You may disagree with our course of action and weshould always be prepared to discuss these differences, but questioning the motivation of leaders does a disservice to the hours of volunteer time we dedicate to serving a profession we are a part of and are deeply devoted to protecting and advancing. In supporting SB 694, CDA has been accused of supporting the creation of a new dentalworkforce position, specifically one that would experiment on underserved children or create a two-tiered system of care. To be clear, the proposed legislation does
not 
call for the creation of a new dental provider, but rather a careful scientific study of whether non-dentists can perform some expanded procedures safely and with high quality. This is notan experiment with children. The same oversight and training provided to dental studentswhen they treat patients in a learning environment would apply to the expanded duties being called for in this study. Until the results of the study are complete, any permanent changes in scope of practice or creation of a new type of dental provider will be opposed by CDA. This is entirelyconsistent with both Resolution 2RC and Resolution 24S1, as directed by thehouse.Some claim that delegates thought they were approving a study to look at other states thatare farther along in their alternative dental workforce models. This is confusing at best.The duties outlined in the report, as well as the categories recommended for study, do notall exist elsewhere. While it may be possible to study a dental therapist type provider inanother state, there are no expanded function dental assistants or hygienists allowed to perform the range of procedures recommended for study. There is no way to determinethis information without providing the additional training necessary in a carefullycontrolled environment where safety and quality outcomes can be assessed. You can findthese parameters and specifics in Section 4, page 15 of the reportcda.org/library/pdfs/access_proposal.pdf .If delegates did not understand that some formof demonstration project would need to be created to answer these questions on safetyand quality, we should revisit this issue. However, there was extensive discussion, both inthe reference committee and on thehouse floor, and I do believe most delegatesunderstood the action they took in November. If I am incorrect and delegates confirm thatthey did not understand the action they approved, I agree that the appropriate step is torevisit that decision.That said, as CDA’s ultimate policy authority, thehouse’s decisions are respected andguide CDA activity in the legislative arena. CDA’s support of SB 694 is entirelyconsistent with thehouse’s directive. Thehouse’s action – one I believe the delegates understood when they voted in November – positions this organization to be activelyengaged in legislative discussions about potential changes to the dental workforce – discussions that will occur with or without the support and involvement of organizeddentistry.It is easy to use fear to cause doubt, and I believe that is what in part is currently taking place within our ranks. This is a highly emotional and complex issue. I encourage you toask the tough questions and seek information before reaching your conclusions. All of us

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