Explorer January 2019

President’s Message:

Annual Session Review

Changes On the Horizon for the Federal and State Level

Deb Astroth, Chair Council on Regulation and Practice

On Wednesday, November 28th , Congress sent HR 2422, the Action for Dental Health Act, to President
Trump’s desk for his signature. The Action for Dental Health Act allows more organizations to qualify for
Health and Human Services (HHS) grants to improve oral health through education and dental disease
prevention. The grants will also be used to develop and expand outreach programs establishing dental
homes for children and adults, including the elderly, blind and disabled.
On December 3 rd the Department of Health and Human Services, the US Treasury and the US
Department of Labor released their report to President Trump entitled “Reforming America’s Health
Care through Competition and Choice.” There are numerous recommendations, however, several are
pertinent to the dental hygiene profession.

• States should consider changes to their scope of practice statutes to allow all healthcare
  providers to practice to the top of their license, utilizing their full skill set.
• The federal government and states should consider accompanying legislative and administrative
  proposals to allow non-physician and non-dentist providers to be paid directly for their services
  where evidence supports that the provider can safely and effectively provide that care.
• States should consider eliminating requirements for rigid collaborative practice and supervision
  agreements between physicians and dentists and their care extenders (e.g. physician assistants,
  hygienists) that are not justified by legitimate health and safety concerns.
• States should evaluate emerging healthcare occupations, such as dental therapy, and consider
  ways in which their licensure and scope of practice can increase access and dive down consumer
  costs while still ensuring safe, effective care.
• States and the federal government should explore legislative and administrative proposals
  modifying reimbursement policies that prohibit or impede alternatives to in-person services,
  including covering telehealth services when they are an appropriate form of care delivery. In
  particular, Congress should consider proposals modifying geographic locations and originating
  site requirements in Medicare fee-for-service that restrict the availability of telehealth services
  to Medicare beneficiaries in their homes and in most geographic areas.
•  States generally should consider allowing individual healthcare providers and payers to mutually
  determine whether and when it is safe and appropriate to provide telehealth services, including
  when there has not been a prior in-person visit.
• Congress and other policymakers should increase opportunities for license portability through
  policies that maintain accountability and disciplinary mechanisms, including permitting licensed
  professionals to provide telehealth service to out-of-state patients.

On the state level, the Department of Regulatory Agencies (DORA) is in the midst of a recodification
project that will be presenting a bill to the Legislature in January that takes out all of the general
provisions that apply to all of the regulatory boards from each of the professions under DORA and puts them in one general provision statute. What will remain in each professions’ statute are those aspects
that are specific to the professions. In essence for dentistry and dental hygiene, licensees will need to
be aware that they may need to consult both the General Provisions statute and the Dental Practice Act.
In the past our statute was 12-35-XXX which will change and become 12-220-xxx. CODHA is working
with CDA to propose legislation that will reorganize the Table of Contents of the Dental Practice Act to
make it more user friendly for licensees.

CODHA has also signed on with a group of stakeholders to request a Declaratory Order of the Colorado
Dental Board regarding the Boards’ rule on Silver Diamine Fluoride. The inclusion of requirements
around a dentist’s “diagnosis, treatment plan, and instructions to apply silver diamine fluoride” hinders
patient care in telehealth settings by delaying eligible patients’ prompt access to permitted, evidence-
based care when they must wait for a dentist’s review. These requirements are not in the authorizing
statute.This will be addressed at the January meeting of the Colorado Dental Board.On December 13th , CODHA hosted a webinar with our lobbyists to prepare members to participate in
Capitol Day on February 27th from 12:00-3:00 pm at the state Capitol. We will be hearing a panel of
legislators as well as having a tour of the Capitol.

The Council is having a rebuilding year. We will concentrate on identifying individuals in each
component that would like to learn more about the regulatory and legislative arena so that they can act
as a resource for the members in their component. We will also be reviewing the current CODHA
Legislative Policy statements and proposing policies for the House of Delegates to consider. In addition
we will be starting the discussion to identify issues to address in the Special Interest Survey that is
distributed to Colorado dental hygienists three years prior to our Sunset in 2025. We need members
especially from Boulder, Northern Colorado, Southeastern Colorado and Colorado Springs.
The Sunset Task Force is focused on preparing for the 2021 Sunset of the Interim Therapeutic
Restoration and Silver Diamine Fluoride sections in the statute as well as the 2025 Sunset of the entire
Dental Practice Act. The Council will also be following the legislation to include dental benefits through Medicaid for pregnant women.

Executive Committee Introduction

Mediation May Save Your License to Practice

By Simon Mole

Written: November 29th, 2018

Denver, CO – Recently enacted HB-1224 has given DORA licensed professionals the right to insist on mediation with a mediator of their choice in any action to suspend or revoke their certification.  Even out of court, mediation is good business practice. It can help resolve conflict within a business, but it can be especially valuable in defusing complaints from customers, so that they never escalate to action before the Colorado Dental that controls licensure for dental hygienists.

Our legislature has observed that “mediation typically achieves a resolution in a matter of hours.  Taking less time means expending less money on hourly fees and costs.” At the heart of HB-1224 is a requirement that the hearing officer or administrative law judge shall order mediation.  At the licensee’s request, the judge must allow a public or private mediator chosen by the licensee.

The many of the cases before the Board are relatively minor in the sense that their ultimate resolution involves a continuing education requirement only.  However, some cases are initiated by members of the public, and lead to loss of RDH licensure. These are the kinds of cases that should prompt an early recourse to mediation, i.e. before DORA is ever involved.  A patient may complain to DORA about your professionalism. Perhaps the record-keeping and payments are at issue, or the patient has been difficult to deal with. It is precisely when everyone is mad at each other, that you should think to mediate.   Successful early mediation can protect more than your license, it can protect a business relationship and your wider reputation in social media and elsewhere.

About Mediation

Mediation is a process that brings parties together to resolve their differences through discussion and problem-solving. The goal is to achieve “win-win” solutions. The mediator is a neutral third party who helps facilitate the dialogue but is not the final decision-maker or judge. Mediation can resolve disputes quickly and effectively without the anxiety of litigation.

By offering a safe environment for parties to express their needs and interests, discuss options and reach a mutually agreeable resolution, mediation can preserve important relationships. Mediators assure the fairness of the process, facilitate communication, and maintain the balance of power between the parties.

Mediation sessions are confidential and voluntary for everyone.  Even when mediation is court ordered, all that is really being asked is that parties make a good faith attempt to resolve the issues in dispute. The process typically involves one or more meetings between the disputing parties and the mediator. It may also include one or more confidential sessions between individual parties and the mediator (a “caucus”). Either party may withdraw at any time. Generally, a signed agreement is binding; in some cases, court approval may be necessary.

During mediation you may choose to be represented by an attorney. Mediators may not give legal advice or interpret the law. If parties arrive at a mutually satisfactory resolution, mediators may assist in drafting settlement agreements or “Memorandums of Understanding.”  These set down the terms to which everyone has agreed. If mediation is unsuccessful and an agreement cannot be reached, it is as if mediation never happened: parties may still pursue all legal remedies.

About the Mediation Association of Colorado

Since 1983, the Mediation Association of Colorado (theMAC) has been the largest statewide, private non-profit organization dedicated to the promotion of the mediation profession, and to the use of mediation as a positive alternative to litigated dispute resolution.

With approximately 200 members across Colorado, theMAC offers the public and the courts access to experienced mediators.  All are bound by a code of professional ethics and practice.

Use the Find-A-Mediator tool on our website ( www. coloradomediation.org ) to search for a mediator based on name, area of practice, language spoken, county, or city.  You can also just see a list of all of our Professional Member mediators.  Schedule your mediation directly with the mediator that you select.

Contact

To learn more about mediators and mediation, please contact:

Simon Mole, President of the Board of Directors

Mediation Association of Colorado

4 Dry Creek Circle, Suite 100

Littleton, CO 80120

303-818-6787

Email simon@coloradomediation.org

Visit: coloradomediation.org

Invite to Strategic Planning Meeting

Do you have thoughts about how CODHA can better support Hygienists and promote the profession?

Do you love your job and want to have a voice in shaping our priorities for the future?

Do you feel burned out or frustrated with the profession and want to help make a difference?

Please consider joining the Strategic Planning Meeting Saturday, Feb 9^th!

We will meet in the Community Room at the Louisville Alfalfa’s (785 E South Boulder Rd, Louisville) on Saturday Feb 9, from 8-10 AM. Light refreshments will be provided, so please RSVP so we plan the right amount of food! RSVP to President–elect@CODHA.org by Feb 1.

Together we will brainstorm, ideas for our next Strategic Plan. We’ll review wins from our current Strategic Plan and discuss areas of growth opportunities.  It is an exciting time to be a Dental Hygienist, and Colorado is well positioned to be a leading state in medical/dental integration and improved access to care. We want voices from all facets of Dental Hygiene Represented!