CONTENTS • TDA Smiles Foundation Healthy Smiles Golf Classic
• DENPAC • President’s Statement • Meet the Staff - Billy Callis, TDA Smiles Foundation
• Member Spotlight
AVAILABLE ON TDA.ORG
The Annual Session of the Texas Dental Association May 1-4, 2014 • San Antonio, TX
dentistry doesn’t stand still… Our profession is constantly evolving to better meet the needs of both patients and practitioners. The TDA continues to support the growing demand of continuing education to keep our members informed on the latest scientific research, tools, techniques, and business practices.
• TDA Perks
VOLUME 15, ISSUE 3
- Rene Rosas, DDS
• TSBDE Rule Update
March Texas Dental Journal 2013 Financial Report, 2015 Proposed Budget
Whether your goal is to meet state licensure requirements, add a new treatment option, or expand your practice, the TEXAS Meeting has a continuing education program that supports the entire team. Join us in San Antonio, May 1-4, 2014, for the 144th Annual Session of the Texas Dental Association, The TEXAS Meeting. REGISTER TODAY — Avoid additional onsite fees and receive your materials in advance, by registering before April 3, 2014. Hands-on workshops have limited space, so secure your seat today! HOTEL RESERVATIONS — We are excited to partner with the Grand Hyatt San Antonio as the TDA Headquarters Hotel, conveniently located adjacent to the convention center. Take advantage of TDA special hotel rates at some of the most beautiful hotels in downtown San Antonio. Don’t delay booking your hotel room, the April 9, 2014, deadline is quickly approaching. ONE-STOP SHOPPING — The 2014 exhibit hall promises to be the biggest and best ever. Take advantage of special pricing on the latest supplies and services to enhance your practice, and receive 1 hour of CE credit when you visit the exhibit hall. We look forward to seeing you in San Antonio!
Around the State April 4-5 Board of Directors Austin
Please visit texasmeeting.com to register and book your hotel accommodations. The TEXAS Meeting I MAY 1-4, 2014 I Henry B. Gonzalez Convention Center I San Antonio, TX
TSBDE Rules for Relocating Offices
May 1-4 TDA Annual Session San Antonio
Q: I am going to relocate my office in the next few months. Which TSBDE guidelines do I need to follow as far as sending notifications to all of my patients?
May 9 Texas State Board of Dental Examiners Austin
A: The Texas Dental Board rule relating to patient abandonment provides that a dentist shall not abandon a dental patient without reasonable cause (22 Texas Administrative Code § 108.5). While presumably a dentist who is relocating does not intend to discontinue treatment of current patients, to ensure that patients are able to continue treatment with the dentist after the relocation, the dentist should notify all current patients of the relocation. In order to comply with the patient abandonment rule when relocating an office, a dentist should give any patient who is currently being treated by the dentist written notice of the relocation a reasonable time before the relocation occurs. The notice should include the effective date of the relocation, the new address, and the new phone number (if applicable). The notice should be either hand-delivered to the patient or sent certified mail, with the dentist retaining a copy of the notice in the patient’s file along with proof of service.
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A relocating dentist should also remember that the Dental Practice Act requires a dentist to notify the Board of any change of address of the person’s place of business, any change of employer, and a change of mailing address. This notification must be made not later than the 60th day after the date the change occurs (Texas Occupations Code § 256.105; 22 Texas Administrative Code § 108.10). A change of address form is available on the TSBDE website (www.tsbde.state.tx.us). A relocating dentist should also be aware that Board rule requires that a dental practice website contain office addresses and contact information (22 Texas Administrative Code § 108.59), so website information should be updated upon relocation. If a dentist is relocating a practice and entering into a written transfer of records or a written agreement for the maintenance of records, the dentist should review the rule relating to recordkeeping (22 Texas Administrative Code § 108.8).
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Texas Dental Program Medicaid/CHIP
Children with Special Health Care Needs Dr Dale Ellison, Medical Director, Policy and Program Development Branch Manager, Department of State Health Services
Dentist Incentive Plans
The Texas Department of State Health Services needs your help serving children with special health care needs.
This year, DentaQuest and MCNA Dental will be unveiling dentist incentive plans (DIPs) with the goal of reducing oral health disparities by incentivizing the delivery of preventive services to clients enrolled in the Texas Dental Program. As a part of both DIPs, it is very important for contracted dentists to review their patient panels, identify patients that have not been into their office, and contact those patients to schedule an appointment. The Office of Inspector General confirmed that informing patients in a dentist’s panel about needed preventative services appears to fall within the exceptions outlined in Government Code § 531.02115. However, dentists must be aware of the limitations of such communication detailed in Government Code § 531.02115 (c) (B) (i-iv). Namely, the dentist must limit such communication to the following: • • • •
providing an appointment reminder; distributing promotional health materials; providing information about the types of services offered by the provider; or coordinating patient care.
Porcelain Crown Medicaid Policy Change The Health and Human Services Commission (HHSC) announced a change in Medicaid policy pertaining to onlay restorations and porcelain crowns effective January 1, 2014. According to the December 20, 2013, Texas Medicaid & Healthcare Partnership (TMHP) banner message, the age band for porcelain crown procedure codes D2740, D2750, D2751, and D2752 is expanded for Medicaid clients who are 13 through 20 years of age to include all permanent premolar and anterior teeth. The previous age band was 17 through 20 years of age. The identified codes for dental onlay restorations and crowns will be limited to once per client, per tooth every 10 years. HHSC is requiring the dental plans to comply with the policy change. For comprehensive information about the policy change, please refer to the Medicaid/CHIP webpage on the TDA’s website.
Training at the 2014 TEXAS Meeting The Texas Dental Association’s Committee on Access, Medicaid & CHIP is sponsoring two education courses during the TEXAS Meeting. Class size is limited, so reserve your spot today by visiting www.texasmeeting.com. The Impact of Fraud, Waste, and Abuse on Medicaid/CHIP Dental in Texas Friday, May 2, 2014 9:00 am to 12:00 pm Linda Altenhoff, DDS Chief Dental Officer HHSC Office of Inspector General
Our clients need providers for • general and preventive dental services, and • specialty services such as orthodontia.
Who We Are
The Children with Special Health Care Needs (CSHCN) Services Program is a comprehensive health-care program for eligible children from birth through 20 years of age and people of any age with cystic fibrosis. CSHCN Services Program clients include people with cerebral palsy, diabetes, orthopedic disabilities, and cleft lip/palate. The CSHCN Services Program is not a Medicaid program. Unlike Medicaid, the CSHCN Services Program did not change to managed care organizations (MCOs) for its dental services.
You may be providing services to clients who are eligible for CSHCN Service Program benefits. By enrolling as a service provider, you can submit claims for the services you provide to our clients. When clients are eligible for both Medicaid and CSHCN, being a provider allows you to submit claims for services that are not a benefit of Medicaid—such as dental services for adults, and if a client loses Medicaid eligibility, you may submit claims to our program. Enrolling in the CSHCN Services Program is easy and now only a click of the mouse away! Go to tinyurl.com/TMHPProviderEnrollment to begin the enrollment process. If you are already a Medicaid provider, the process to become a CSHCN Services Program provider is even easier. To get more information about becoming a CSHCN Services Program dental-service provider, call or write to: Texas Medicaid & Healthcare Partnership Attn: Provider Enrollment PO Box 200795, Austin, TX 78720-0795 1-800-568-2413, Option 2 CSHCN Services Program Inquiry Line: 1-800-252-8023 Children with Special Health Care Needs Services Program Department of State Health Services, MC 1938 P.O. Box 149347, Austin, TX 78714-9347 1-800-252-8023 — Toll Free 512-776-7355 — Local 512-776-7417 — Fax Email: email@example.com
TDA Perks Amps Up the Fun at TEXAS Party 2014 TDA Perks Program’s popular red carpet and green screen photo opportunities are returning to TEXAS Party. But this year, 3 new stops will join the entertainment lineup for unprecedented fun: car racing simulators, a longest drive golf challenge, and a TapSnap™ photo booth! It’s all possible thanks to Perks’ 2014 TEXAS Meeting Gold Sponsors. For more information regarding TDA Perks Program, visit tdaperks.com, or call 512-443-3675.
happy healthy smiles... that’s our mission! 2014 Healthy Smiles Golf Tournament Don’t forget to register for the annual Healthy Smiles Golf Classic during the TEXAS Meeting! This fun, charity golf tournament, which benefits the TDA Smiles Foundation (TDASF), is Friday, May 3, 2014, at the Quarry Golf Club in San Antonio, with a shotgun start at 7:00 am.
Medicaid & The Children’s Health Insurance Program (CHIP) Friday, May 2, 2014 2:00 pm to 5:00 pm Linda Altenhoff, DDS, Monica Anderson, DDS, Brenda Walker, Carlos Garcia, DMD
Help TDASF improve access to dental care for thousands of your fellow Texans in need, and have a great time doing it! Lunch will be provided and the tournament will also offer fun contests, prizes, and awards.
Playing at the 2013 TDA Smiles Foundation Healthy Smiles Golf Tournament are (L-R) Dr Larry Herwig of Dallas, Dr Arlet Dunsworth of Dallas, Troy Jones of Burkhart Dental Supply, Dr Chris Miller, and Dr Bill Gerlach of Plano.
MARCH 2014 • TDA Today • 2
To register as a player, foursome, or become a sponsor, please contact the TDASF office at 512-448-2441 or email TDASF Director Judith Gonzalez at firstname.lastname@example.org.
President’s S tatement
David A. Duncan, DDS, TDA President
TDA: The Next Generation We’re getting old. There’s no question to it. We, the older generation, are getting just that. Older. But, with age comes wisdom and knowledge and leadership. More than half of TDA’s members are aged 50 and older. That means retirement is not that far off or is a reality for many of us. It is important that we, the older generation, pass the torch onto the new generation, which includes the Generation Xers and the Millennials, those currently in dental school. Membership recruitment efforts are happening now at the 3 Texas dental schools. In March, TDA staff and University of Texas Health Science Center at San Antonio Dental School faculty coordinated Freshman Day to introduce incoming dental school freshman to TDA and organized dentistry. Maybe they were just there for the free pizza, but maybe, just maybe, we planted a seed that will grow. Year after year, they’ll hear more about the benefits of TDA, its legislative outreach, policy information, and CE and charitable care opportunities. In April, ADA National Signing Day is scheduled at the University of Texas School of Dentistry at Houston. We have the opportunity to build TDA and continue its growth. “The best time to plant a tree is 20 years ago. The second best time is now.”
Where did you grow up? I grew up in and around Cincinnati, Ohio, the home of Pete Rose, John Boehner, and Jerry Springer.
TDA S lly Callis mil Missio es Foundati o ns Coo rdinat n or
What is one thing about you that might surprise people? I have trouble distinguishing blue from purple, and green from brown, and certain shades of aqua from grey and pink. I am very mildly colorblind. This does not mean I can’t see, appreciate, or use colors. In fact, since 2002, my photography and other artwork have been displayed at 5 galleries in 4 states. I prefer color photography over black and white. What is your favorite thing about the job? At other nonprofit organizations, I worked on the demand side, with clients who were trying to meet their own needs using limited resources. Now, I get to work on the supply side, with people who donate their own time and resources to heal others. The thing that inspires me most is the dedication of TMOM volunteers. I am blown away by the devotion people show in working with us for months or years to plan a successful TMOM event, pulling their communities together to serve those in need. Where did you go to school? I earned my bachelor’s from Kenyon College, a small liberal arts college in rural Ohio. I share my alma mater with Paul Newman. Why did you decide to come to the Texas Dental Association? My wife was starting a PhD program at UT, so I came with her to Austin, and I applied for jobs that would utilize my background in nonprofit work. TDA offered me a chance to work with a fantastic group of people, and make a real difference.
Rene Rosas, DDS • El Paso “Gracias, doctor. Le estamos haciendo su corona en el cielo.” Loosely translated it says, “Thank you, doctor. We are preparing your crown in heaven.” Rene Rosas, DDS, says these words are music to his soul. A life member of TDA and an 81-year-young practicing dentist, Dr Rosas is Dr Rosas says that, as the chief dental officer at serving his most important role – Centro de Salud Familiar La Fe in El Paso, his time is the chief dental officer at Centro split between administrative and clinical duties. de Salud Familiar La Fe, a medical and dental community health center for the low income population in El Paso. Dr Rosas graduated from the University of Texas School of Dentistry at Houston (formerly the University of Texas Dental Branch at Houston) in 1962. He and his wife of 54 years, Irma, have 5 grown children, Rene Raul, Rob, Rick, Rochelle, and Ron. Dr Rosas grew up in El Paso, and he says he never really had any intention to further his education past high school. “I wanted to do what all the neighborhood kids did — pump gas and buy a car!” However, the football coach at what is now the University of Texas at El Paso had other plans for the young Dr Rosas, recruiting him to play football. After graduating from college, Dr Rosas followed a friend to the Naval Air Station in Pensacola, Florida. He became a pilot and served as a Marine jet fighter, stationed at Cherry Point, North Carolina. After 1.5 years in the fighter squadron, he was reassigned to the training command in Corpus Christi as an advanced jet flight instructor. There, he says he was friends with Navy dentists and would watch them work at the naval hospital. “What they were doing sparked my interest in dentistry!” This interest set him off on a “great ride” back to school for his dental degree and a career in dentistry. For 32 years, Dr Rosas was a general dentist in private practice in El Paso. He became very involved in leadership roles at TDA and the American Dental Association. He eventually retired, selling his practice to an associate. Dr Rene Rosas treats a patient at Centro de Salud Familiar La Fe, a community clinic in El Paso.
But, that retirement was short-lived. The executive director of Centro de Salud Familiar La Fe called him one day: “‘Come work for us.’ ‘But I’m retired!’ ‘That’s why I’m calling. I need someone to clean up this practice.’ ‘I’ll help for 2 years!’”
Two years turned into 20. After 2 decades of serving patients at the community health center in zip code 79901, one of the 5 poorest zip codes in the United States, Dr Rosas says the experience has been the most rewarding of his career. “Little old ladies would kiss the back of my hand. ‘Gracias, doctor. Le estamos haciendo su corona en el cielo.’ That (appreciation) comes from the heart, and that’s something money cannot buy.” He and the 5 dentists who serve under him treat an estimated 3,000 patients a month at the non-profit discount clinic, and he recruits dentists who have a servant’s heart. “If a patient is sitting in one of our chairs, we will treat them as if they were our mother with respect and dignity and deliver the best quality dental care we are capable of. Just because they’re poor doesn’t mean they don’t deserve the best care.” Dr Rosas does not envision a real retirement in the near future. “If my hand doesn’t shake, I’m still working. I have just as much energy as I did in private practice.” However, after more than a half century as a dentist, he does have advice for new graduates. He recalls a presentation given at a study club in the late 1960s, which left an impression that shaped his treatment perspective: “Get a silver dollar. Put it in front of your eye. If you let this get in between you and your patient, you’re not in it for the service.” This recurring section highlights the lives of TDA members outside of the office. If you have an interesting story about yourself, if you are working on a project that your peers might find interesting, or if you have a hobby that keeps you busy, please contact TDA Managing Editor Nicole Scott, email@example.com, 512-443-3675.
MARCH 2014 • TDA Today • 3
TSBDE Rule Update
This recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices.
Texas Medical Disclosure Panel The Texas Medical Disclosure Panel (TMDP) is appointed by the health commissioner at the Texas Department of State Health Services to determine which risks and hazards related to medical care and surgical procedures must be disclosed to patients by physicians, dentists, and health care providers, and to establish forms for such disclosures. For the past several years, the Texas Dental Association has worked closely with the TMDP on integrating certain dental procedures into the Panel’s disclosure and consent forms. The Panel separates medical treatments and surgical procedures into two separate lists. List A identifies treatments and procedures that the Panel determined requires a disclosure of specific risks and hazards when obtaining informed consent. List B identifies treatment and procedures that the Panel determined does not require disclosure of specific risks and hazards. The TMDP defines “informed consent” as the, “permission given by a patient to perform a medical treatment or surgical procedure after the patient has been advised of the risks or hazards that could influence a reasonable person in deciding whether or not to give permission.” Before the patient can decide whether to give or withhold consent, the patient needs information about the treatment or procedure and the risks associated with it. The Informed Consent Statute, Section 74.101 of the Texas Civil Practice and Remedies Code, specifies that a patient can only recover against a health care provider for lack of informed consent if the patient can show that the health care provider was negligent in failing to disclose the risks or hazards that could have influenced a reasonable person in making a decision to give or withhold consent. Thus, if a provider complies with the processes established by the Panel, including the List A treatments and procedures requiring disclosure, the Informed Consent Statute offers a “rebuttable presumption” that the provider was not negligent in obtaining informed consent. To prevail on the claim, the patient would then to present evidence to overcome or “rebut” the presumption that the provider fulfilled the duty to disclose risks and hazards. For List B treatments and procedures that the Panel found no disclosure is required, the same rebuttable presumption exists that the provider met the requirements of the Informed Consent Statute. The panel is required to establish the form for disclosures of risks and hazards for List A procedures. At this time, there are 4 separate consent forms available: • • • •
Disclosure and Consent – Medical and Surgical Procedures Disclosure and Consent for Radiation Therapy Disclosure and Consent for Hysterectomy Disclosure and Consent for Anesthesia and/or Perioperative Pain Management (Analgesia)
The TDA will continue working with the TMDP to establish proper forms for informed consent for dental procedures and will notify members about the availability of the TMDP forms as soon as they are available.
EDITORIAL STAFF Nicole Scott, Managing Editor Barb Donovan, Art Director Paul H. Schlesinger, Consultant Board of Directors David A. Duncan, DDS, DDS, President David H. McCarley, DDS , President-elect Michael L. Stuart, DDS, Immediate Past President Vice Presidents Jean E. Bainbridge, DDS, Northeast Gregory K. Oelfke, DDS, Southeast Yvonne E. Maldonado, DDS, Southwest David C. Woodburn, DDS, Northwest Senior Directors Jerry J. Hopson, DDS, Northeast William S. Nantz , DDS, Southeast Joshua A. Austin, DDS, Southwest Steven J. Hill, DDS, Northwest Directors William H. Gerlach, DDS, Northeast Karen A. Walters , DDS, Southeast John B. Mason, DDS, Southwest Charles W. Miller, DDS, Northwest Ron Collins, DDS, Secretary-Treasurer John W. Baucum III DDS, Speaker of the House Michael D. Vaclav, DDS, Parliamentarian Michael L. Stuart, DDS, Interim Executive Director William H. Bingham, Legal Counsel TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental Association, 1946 S IH-35 Ste 400, Austin, Texas 78704-3698, 512-443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S IH-35 Ste 400, Austin, TX 78704-3698. Copyright 2014 Texas Dental Association. All rights reserved. Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental Association (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30. Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6. Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles. Advertisements: Publication of advertisements in this publication does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made of it by its manufacturer.
In the meantime, dentists are reminded that the Texas State Board of Dental Examiners rules governing informed consent can be found in 22 Texas Administrative Code (TAC) §108.7(6) Minimum Standard of Care, General and for each level of sedation/anesthesia at 22 TAC Chapter 110 Sedation and Anesthesia. For more information, please contact TDA Policy Manager Diane Rhodes at 512-443-3675, firstname.lastname@example.org.
VOLUME 15, ISSUE 3
AVAILABLE ON TDA.ORG
TDAPerksSupplies.com leverages the group buying power of more than 7,400 TDA members. “...We’ve just received our latest order and everything was exactly as requested...I reviewed all of my orders so far, and have averaged about 30% savings over my previous supplier. Wow! Thanks again.” —Dr. William A. Sadler, DDS; Dallas, TX Get a price estimate by providing a list of items using SKU or distributor item numbers via email, phone or fax. Your ADA number is required to access TDAPerksSupplies.com or customer sevice.
What You Should Know: TDA Perks received some questions about TDA Perks Supplies and
asked the company to respond. The following is TDA Perks Supplies’ response: TDA Perks Supplies only offers products from direct manufacturers or authorized distributors. No gray market, expired, or counterfeit items are supplied. TDA Perks Supplies vendors ship exactly what a dentist orders—no alternative brands. Vendors must sell products pursuant to manufacturer guidelines. All vendors offer free ground shipping on any order—regardless of sIze.
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