Overview of State Initiatives to Bolster the Dental Workforce

Transcription

1 Overview of State Initiatives to Bolster the Dental Workforce Tara Lubin Policy Associate Forum for State Health Policy Leadership National Conference of State Legislatures May 15, 2006 Outline Problems Shortage vs. Maldistribution Greatest need in rural areas Need for dental school faculty Lack of racial/ethnic diversity among practitioners 1

2 Outline What are states doing Expand opportunities to go to dental school Open new dental schools Loan repayment Expand role of dental hygienist Mid-level dental practitioner Shortage of dentists? American population growing as more dentists retiring and fewer new dentists graduating About 4,500 dental school graduates in 2003 down from over 6,500 annually in the 1980s Ratio of dentists (per 100,000 pop.) decreased from about 60 in 1990 to an estimated 58 now to a projected 53 in

3 Dentists per 100,000 US population Actual Projected Source: Bureau of Health Professions, HRSA, DHHS. Data from the Eighth Report to Congress and unpublished reports. Some say enough dentists, but Not enough of the right kind, or in the right places Shortage of those who treat low-income/medicaid clients Shortage in rural areas 38% of rural counties have no dentist* 61.7% less dentists in Health Professional Shortage Areas (HPSAs) than the national average *Journal of Public Health Dentistry, 2000 and NCSL,

4 Dental Health Professional Shortage Areas The federal government estimates that more than 31 million people live in dental shortage areas where there is less than one full-time equivalent dentist for 4,000 to 5,000 people over 21 million of this population are considered underserved Health Resources & Services Administration, U.S. Department of Health and Human Services, March 31, 2001 Dental school faculty Few dental students show interest in academia Most potential professors lured away by rising earnings in private practice ~275 budgeted faculty positions vacant ( ) 4

5 Number of vacant budgeted faculty positions in U.S. dental schools, % Percent U.S. Dental School First-Year Enrollment by Race/Ethnicity: % 30% 25% 5.1% 4.6% 20% 15% 10% 23.8% 5% 0% 0.5% Native American or Alaska Native Black or African-American Asian or Pacific Islander Hispanic Source: American Dental Association **Not shown: 66% White Dental School First-Year Enrollment,

6 State Approaches 6

7 Increasing enrollment in dental schools (including minorities) Early school recruitment and mentoring programs Scholarships for rural and minority dental students Financial aid to lowincome dental students New dental schools Only 56 dental schools in the country including Three new dental schools 2003 Arizona 2002 Nevada 1997 Florida Coming soon 2007 Virginia 7

8 Loan repayment programs Dentist serves in shortage area in return for funder repaying all or part of the provider s student loans Modeled on National Health Service Corps (requires 2 year commitment) states may have both but state program allows more flexibility Most state programs operate on small scale Loan repayment programs cont. Helps fill underserved area vacancies At least 27 states have their own dental loan repayment programs Downside renter s mentality Improve programs with year-to-year retention bonuses or similar 8

9 Looking to dental hygienists 19 states allow some form of unsupervised practice (AZ, CA, CO, CN, IA, KS, ME, MI, MN, MO, MT, NH, NM, NY, NV, OK, OR, TX, WA) 3 states (CA, CO, NM) allow dental hygienists to practice independently Many states also are expanding DH scope of practice Mid-level dental practitioner Alaska has been using a mid-level dental health aide for over a year positive results reaching rural, tribal areas Other states are showing interest in this model as well 9

10 Thank you for your time. Tara Lubin Policy Associate Forum for State Health Policy Leadership National Conference of State Legislatures