Midlevel Provider Update. June 21, 2018

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2 Midlevel Provider Update June 21, 2018

3 Midlevel Provider Process Following the 2015/2016 legislative session, MDS Board of Trustees approved a task force to evaluate midlevel providers and whether or not MDS should support a version of it MDS Board approved a comprehensive oral health bill that included the creation of a new type of dental provider First state dental society to submit legislation to create a version of a midlevel provider

4 Midlevel Provider Process Cont. September 2017 MDS approached by Representatives Kate Hogan and Smitty Pignatelli to discuss midlevel providers with Pew Charitable Trusts April 2018 Following months of discussions, MDS Board agrees to compromise legislation (H.4454) First state dental society to compromise with Pew or Kellogg (national proponents of Dental Therapy)

5 Midlevel Provider Process Cont. April 2018 Following several discussions with Senate leadership, President Chandler agrees to support H.4454 without changes June 2018 The legislation is currently before the House Committee on Ways and Means

6 An Act to improve oral health for all Massachusetts residents H.4454 BILL PROVISION Licensure Reciprocity Name of Provider Yes Dental Therapist Proposal Dentist Licensure Requirements Licensed practicing dentist AND accepting MassHealth patients Reporting Requirements An employer of a dental therapist must submit quarterly reports to BORID that provide information concerning the makeup of the DT s patient panel, including the percentage of underserved patients

7 BILL PROVISION Current Legislation Number of Providers per Dentist Proposal 3:1 maximum of 2 DTs under general supervision Number of Hours of Direct Supervision 2,500 hours or 2 year, whichever is longer Educational Institution CODA accredited Length of Education Completion of a graduate level program

8 BILL PROVISION Proposal Current Legislation Permitted Procedures All acts of an PHDH All CODA procedures Reimbursement Cannot be directly reimbursed Competency for Treating Special Population Training on treating patients with special, i.e., developmental disabilities, complex medical problems, physical limitations, etc. Dual Licensure Upon graduation, is eligible to be licensed as both RDH and Dental Therapist

9 BILL PROVISION Current Legislation Supervision Practice Setting and Population Limitations Proposal Direct, then general except irreversible procedures BORID may change supervision level of irreversible procedures 50% of the DT s patient population must be underserved, i.e., MassHealth, Social Security Disability eligible, live in DHPSA, nursing home resident, receive benefits at public health settings, etc. ADDITIONAL COMPONENTS Oral Health Training for CHWs Dental Director Office of Oral Health CWF Educational Seminars Public School Oral Health Mandate Requires Community Health Workers receive oral health training prior to licensure or renewal Responsible for increasing the delivery of preventative services DPH must conduct seminars annually Notification on importance of oral health screenings

10 Irreversible Procedure Supervision - Pathway 1/1/2020 Assessment by BORID & DPH begins 12/1/2022 Recommendations by BORID & DPH Following the recommendations, BORID shall make a determination. If one or more procedures remain under direct supervision, DPH & BORID must re-evaluate annually.

11 Questions?