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TDA

A publication of the Texas Dental Association

April 2005 • Volume 6, Issue 4 www.tda.org

T o d a y

Legislative Update

TDA

It’s Crunch Time for TDA Legislative Agenda

T o d a y April 2005 • Volume 6, Issue 4 www.tda.org

Editorial Staff: Christopher F. Anderson, D.D.S., M.S.D., Editor Edwina J. Shires, Managing Editor Paul H. Schlesinger, Communications Coordinator Stefanie Clegg, Website Manager Barbara S. Donovan, Art Director BOARD OF DIRECTORS TEXAS DENTAL ASSOCIATION President HERBERT L. WADE, JR., D.D.S.; President-elect RICHARD C. BLACK, D.D.S.; Past President PATRICIA L. BLANTON, D.D.S.; Vice President, Southeast THOMAS C. HARRISON, D.D.S.; Vice President, Southwest DAVID A. WOOLWEAVER, D.D.S.; Vice President, Northwest JAY C. ADKINS, D.D.S.; Vice President, Northeast DAN P. MCCAULEY, D.D.S.; Senior Director, Southeast MATTHEW B. ROBERTS, D.D.S.; Senior Director, Southwest JAMES W. CHANCELLOR, D.D.S.; Senior Director, Northwest DAVID A. DUNCAN, D.D.S.; Senior Director, Northeast FRANK L. HIGGINBOTTOM, D.D.S.; Director, Southeast. R. RONALD COLLINS, D.D.S.; Director, Southwest FREDERICK T. PHILIPS, JR., D.D.S.; Director, Northwest DAVID R. COX, D.D.S.; Director, Northeast JENNIFER J. BARRINGTON, D.D.S.; SecretaryTreasurer J. PRESTON COLEMAN, D.D.S.; Speaker GLEN D. HALL, D.D.S.; Parliamentarian MICHAEL L. STUART, D.D.S.; Editor CHRISTOPHER F. ANDERSON, D.D.S.; Executive Director MARY KAY LINN; Legal Counsel WILLIAM H. BINGHAM

TDA Today (USPS 022-007) is published bimonthly except in a legislative year when it is published a total of 8 times per year in the months of January, February, March, April, May, July, September, and November by the Texas Dental Association, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 4433675. 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. 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 August Directory of the Texas Dental Journal for more information. Every effort will be made to return unused manuscripts if a request is made but no responsibility can be accepted for failure to do so. Anonymous communications will receive no consideration whatsoever. 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.

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By S. Jerry Long, Chair, Council on Legislative and Regulatory Affairs

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ame Song, Second Verse. The month of May once again is make or break time for the legislative agenda of the Texas Dental Association. Despite having only two bills filed on its behalf in the 79th Session, TDA has identified and closely followed a record 100 bills that could adversely affect the practice of dentistry in Texas. The closing month is also notorious for political maneuvers, shenanigans, and surprises that could literally wreak havoc on a legislative agenda just hours before sine die. Your TDA staff, lobbyists, and Council on Legislative and Regulatory Affairs (CLRA) remain vigilant and hopeful that the 79th Legislature will be a landmark session for the legislative agenda of the Texas Dental Association. Issues Aplenty for TDA in Final 30 Days. Texas dentists and dental assistants are demanding relief from the onerous rules that govern the radiology certification process for dental assistants, and TDA believes that passage of SB 632, or HB 1432 will help ease the burdens of compliance on this issue. Nothing is perfect, but passage of either of these bills, or a compromise substitute, should go a long way in correcting many, if not all, of the shortcomings of the present system. Another issue that bears watching in the final days is an effort through HB 2706 to create a commission to study and make recommendations to the legislature on health professions’ scopes of practice. TDA opposes HB 2706 because it would establish another layer of bureaucracy for the health professions, and blur the lines of communication between our organization and members of the legislature. Additionally, the creation of this commission could lead to scope recommendations brought about by pressure to make change for change’s sake, or merely to justify the commission’s existence. Several bills still in the pipeline are concerned with expanding dental hygienists’ scopes of practice, and are opposed by TDA. The Texas Dental Hygienists’ Association is promoting this legislation to allow dental hygienists to work more independently of dentists, to administer nitrous oxide and local anesthetic, and to have a permit for limited prescriptive privileges. Your Association’s lobbyists and staff continue to follow HB 3 relating to property tax relief. Unfortunately, the present construction of this legislation includes a provision that would impose a sales tax on “elective cosmetic procedures” including cosmetic dentistry. This issue was introduced into HB 3 when a sales tax on diapers was taken off the table for political reasons, and a “cosmetic tax” was substituted to replace the revenue. The dollars lost from taxing diapers was exactly offset by the estimated dollars that would be gained from a sales tax levied on cosmetic

VoterVOICE® — A Powerful Tool

URGENT Legislative Alert Attention TDA Members: Immediate Action Needed The Texas Legislature is currently considering a bill that would impose a sales tax on “cosmetic dental services” and a business tax on all Texas businesses, including dental practices. TDA needs your help to defeat the proposed sales tax on cosmetic dental services by contacting your state senator as soon as possible. For more information about this issue and contacting your state senator, please see the article on Page 2.

surgery and dentistry. Despite this fortuitous coincidence for our lawmakers, TDA opposes a tax on cosmetic dental services. HB 2678 is backed by TDA and would prohibit professional liability insurance companies from denying coverage to dentists whose practices include a large percentage of Medicaid patients. If this practice is allowed to continue, access to care among the indigent population would be severely affected. Also in the pipeline is HB 3271, allowing insurance companies to market dental PPO plans in a way that could discourage patients from seeking care from out-of-network dentists. TDA opposes any changes to the dental PPO laws in Texas. SB 196, introduced by Sen. Jane Nelson of Lewisville on behalf of the TDA, has already passed the Senate, and would authorize the Texas State Board of Dental Examiners (TSBDE) to waive license fees for dentists whose practices are limited to providing charitable care without compensation. Retired Texas dentists, who have previously had to leave the U.S. to provide dental care to the underserved, will be able to treat needy Texans if SB 196 becomes law. Additionally, the TDA legislative team is working to increase Medicaid dental fees, to restore dental benefits to the Children’s Health Insurance Program (CHIP), to seek solutions to improving the oral health of nursing home residents, and as an advocate for our three Texas dental schools. The Texas Dental Association truly believes that dentistry is healthcare that already works, and that the current Dental Practice Act effectively protects the public by ensuring that all dental care in this state is either performed by a dentist or performed under a dentist’s direct or general supervision. Our legislative agenda and strategies are based on defending this traditional practice model, as well as preserving the dental team/dental home concept of care that has worked so effectively for our citizens. An adverse outcome on many of the bills outlined above could jeopardize these time-honored principles. Of course, the Association’s legislative efforts are consistent with TDA policy as established by our House of Delegates. And What Can You Do? Be alert, be informed by logging on daily to www.tda.org’s Legislative Page, and be ready to contact your legislators and other elected officials when TDA needs your help during this last month of the session. If member dentists make the effort to tell our story and express their opinions, the voice of dentistry in Texas will be received with respect and credulity. After all, we are the Texas Dental Association! ★

By Herbert L. Wade, Jr., DDS, TDA President

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old onto your hat and hang on tight — we may be in for a wild roller coaster ride between now and the end of the 79th Legislature on May 30. In this legislative session, our dental assisting bill and the taxation bill are primary concerns, but the TDA legislative team is tracking 100 bills that could directly affect dentistry. In these last days of the legislature, everything happens very quickly, and we may need your voice at a moment’s notice. To help us stay involved in the latest legislative events on an up-to-the-minute basis, the TDA has a powerful tool — VoterVOICE®. It is an online software program that gives TDA the power to mobilize its massive grassroots network of dentists at the drop of a hat. Through fax or e-mail, dentist-constituents can be called on to deliver a time-sensitive message to an individual legislator, a legislative committee, the House or the Senate, the Governor, Lieutenant Governor, Speaker of the House, or the entire Texas Legislature. The system also is available for use with the Texas congressional delegation. Here’s how it works. The zip code of every TDA member’s residence and office is matched with every member of the Texas Legislature. This means that if there is a critical legislative issue that needs immediate attention, then in just minutes you can receive an e-mail or fax alert asking you to contact your representative, senator, or committee member about the issue. The issue will be both critical and urgent, and you will be provided with a script and talking points, as well as the e-mail address and telephone number to communicate with your senator or representative. In too many instances, turning a key vote on a bill or

stopping a bad amendment depends on precious minutes and even seconds. VoterVOICE® is there to help us beat the clock in the legislative process when it matters most to our patients and profession. Why is this so important? As you can tell by the focus of this TDA Today issue, we must stay vigilant around the clock to stay abreast of all legislation being considered. The vast majority of bills will pass in the final days of the 79th Texas Legislature. It is all about the “end game.” We will be calling on you as the legislative calendar winds down. When we do, we will arm you with the information you need to influence your legislators on the issues confronting our profession: dental assistant education; taxation of dental practices and cosmetic dentistry; and revisions to the Dental Practice Act, including scope of practice and funding for Medicaid, CHIP, and our Texas dental schools. VoterVOICE® will be as effective as we make it. It is only a tool; you are the tool master. Each VoterVOICE® message you receive will be urgent. The message may give you an hour or less to make contact with your legislator, either by e-mail or by telephone. In either case, your immediate response will be vital to our cause. Never have we had a tool that has allowed us to be so responsive so quickly in the legislative process, but you will be the key to its success. Remember, there is no such thing as neutral legislation. Every bill tracked by our legislative team will have a positive or negative effect on our profession. The TDA is working to be proactive; we need you to be willing to react when the call comes! The choice is yours. ★


Attention TDA Members: Immediate Action Needed

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he Texas Legislature is currently considering H.B. 3, which includes a provision imposing a 7.25% sales tax on “cosmetic dental services.” If HB 3 passes in its current form, Texas dentists will be required to collect and report this tax for the first time, imposing financial and administrative burdens on their practices. A tax on cosmetic services today can easily become a tax on restorative and preventive services tomorrow. The Texas Senate Finance Committee will consider HB 3 the week of April 25th, and the full Senate will consider a revised version of the bill in early May.

HB 3 Also Imposes a Business Tax on Dental Practices In addition to the sales tax on cosmetic dental services, HB 3 would require all Texas businesses (corporations, LLC's, professional associations, partnerships with one or more employees, and sole proprietorships) to pay either 1.15 percent of payroll or the current franchise tax, which is 4.5 percent of earned surplus or 0.25 percent of capital assets. If paying the payroll tax, businesses with more than 15 percent of revenues from Medicare and Medicaid can credit 40 percent of those revenues against the tax.

What Can You Do to Help? Please call your state Senator immediately regarding HB 3 and let them know that TDA opposes a sales tax on any dental services, including cosmetic dental services. You can locate contact information for all your elected officials on the Internet at any time by going to www.capitol.state.tx.us and clicking on "Who Represents Me?" If you have questions about this legislative alert, please contact Jenny Young at jyoung@tda.org, or Jay Bond at jbond@tda.org, or call (512) 443-3675. ★

MK’s Board Notes

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By Mary Kay Linn, TDA Executive Director Below are summaries of actions of the Texas Dental Association (TDA) Board of Directors during meetings in November 2004, February 2005, and April 2005 with TDA president Dr. Herbert L. Wade, Jr., presiding.

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November 2004 TDA Board Meeting • • • • • • • • • • • •

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Appointed Texas Dentists for Healthy Smiles board members: Dr. Ron C. Auvenshine (Houston) and Dr. David S. Wilbanks (El Paso). Appointed a TDA Building Committee member to fill the unexpired term of Dr. Robert Dixon (deceased): Dr. Karen E. Frazer (Austin). Appointed TDA representative to the Texas Department of State Health Services’ Head Start and Early Head Start Pilot Project: Dr. Jose L. Cazares, Jr. (McAllen). Appointed TDA representative on Texas Department of Health Services’ Statewide Oral Health Coalition’s Steering Committee: Dr. Michael D. Vaclav (Amarillo). Approved awards for TDA component society presidents presented during TDA presidential visits. Authorized formal recognition of dental team members with 25 or more years or service in a dental office, presented during the 2005 Texas Meeting. Approved purchase of a TDA reserved table for the January 22, 2005 Baylor College of Dentistry’s Celebration of the Century Gala. Authorized an increase in TDA travel reimbursement rates related to per diem, taxis, out-of-state and in-state automobile rental, and surface transportation. Authorized purchase of VoterVOICE®, an online, Internet-based system for mobilizing and evaluating participation of grassroots networks for use during the 2005 legislative session. Approved additional support to an existing Relief Fund recipient for medical and living expenses. Amended Section 120 of the Bylaws so that the House of Delegates considers a resolution effecting a change in the dues of active members only after all other resolutions with financial implications have been disposed of. Approved mandatory assessment language for the 2005 TDA dues statement, as follows: Mandatory Assessment — From the TDA Constitution and Bylaws, Chapter I, Section 70.N.: All dues paying members of the Texas Dental Association may be annually assessed an amount not to exceed $50 dedicated to TDA’s legislative efforts. Resolution 175-2004-H passed at the 2004 TDA House of Delegates, activating the assessment for the 2005 membership year. Log in at www.tda.org and click on “Current issues,” then click on “Mandatory Dues Assessment.” Approved sending all TDA members an explanation of the TDA peer review process and a dental office sign with contact information for disputes. Approved the TDA legislative agenda, as prepared by the Council on Legislative and Regulatory Affairs, for use during the 79th Session of the Texas Legislature. Accepted the ADA’s State Action Plan for Amalgam Wastewater, and referred two items to the Council on Legislative and Regulatory Affairs for evaluation. Approved design for Smile Texas Style specialty license plates (authorized by HB 2971, 2003 Texas Legislature) for purchase by dentists, allied dental personnel, and the general public. Adopted TDA 2009 action plans to document implementation strategies, activities, and metrics related to strategic planning. Authorized dissolution of the Diversity Committee and approved adding a consultant on cultural issues to the Council on Membership. Authorized restructure of the tripartite membership process in Texas, including: New interim member category while component societies complete the selection process; No requirement for two TDA active member signatures on application form; Applications submitted to TDA for determination of component society and appropriate dues quotation; Immediate processing (no Judicial Committee review) for newly licensed dentists within 6 months of having received DDS or DMD; Tripartite dues payments made to the TDA with application for interim membership; TDA staff to perform routine verification of licensure and send applicant a copy of TDA Constitution & Bylaws, and Principles of Ethics and Code of Professional Conduct; Active membership is contingent upon certification by the component society secretary and the TDA secretary; and Component society Judicial Committee review is completed 30 days after receiving notice of application from TDA. Approved discontinuing “News Now” in the Texas Dental Journal, because TDA Today publishes current news, January through November.

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April 2005 TDA Board Meeting • • •

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February 2005 TDA Board Meeting • •

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Approved TDA policy briefs on preferred provider organizations, dental hygienist scope of practice, reform of dental assistant exams, charitable licensure for retired dentists, taxation, and access to care. Authorized TDA Council on Legislative and Regulatory Affairs and legislative team to use Texas Medicaid: The Oral Health Crisis (PowerPoint presentation), and Improving Access to Dental Care for Children in Texas (booklet) to support strategies to improve Medicaid provider rates and address children’s oral health issues. Directed that all dentists who participated should receive a Give Kids a Smile! namebadge ribbon recognizing their support at the 2005 TDA Annual Session. Approved a TDA letter responding to Health and Human Services Commission Request for Information #529-05-061 regarding a Universal Services Card for Medicaid client authentication. Directed the Task Force on Charitable Foundations — Drs. Hilton Israelson (chair), Robert V. Walker, W. Kurt Loveless, William H. Gerlach, David F. Nichols, Edward H. Sauer, and Richard M. Smith, and TDA legal counsel as consultant — to oversee uniting Texas Dentists for Healthy Smiles and the Texas Dental Foundation into a single entity, including development of new bylaws, board structure, and operating procedures. Directed that TDA create an umbrella entity to explore a unified strategy for all annual meetings in Texas (report in February 2006), with members to include two dentist representatives and one staff each from the TDA Council on Annual Session, the Southwest Dental Conference, and the Star of the South Conference. The TDA president-elect will be a non-voting ex-officio member and serve as chair.

Approved the East Texas Dental Society’s constitution and bylaws and code of ethics as reviewed by the TDA Council on Constitution and Bylaws. Adopted Campaign Rules. Adopted Caucus Manual for divisional caucuses regarding identification and duties of chair; identifying eligible voters; quorum and lack of quorum; appointment of sergeant-at-arms and tellers; order of business; nominations (speeches, questions, closing); voting (positions considered separately, ballot method, majority votes, late arrivals, vote tally); compliance (oversight, conflict of interest, violations); and conformity (appeals regarding rules violations). Authorized $5,000 for Sen. Florence Shapiro’s “Governor for a Day.” Approved 10 line items over budget: Auditing, Board Meetings, Central Office Maintenance, Ethics and Judicial Affairs, House of Delegates Headquarters, Legislative and Regulatory Affairs, Lobbying, Printing, Texas Reception, and Website. Authorized allocation of TDA Relief Fund interest, 2004 ($2,943.50 each) to Dentists Who Care and Texas Dentists for Healthy Smiles, with TDHS monies dedicated to equipment purchase. Approved the TDA Budget Committee recommendation for use of the 2004 Surplus allocation of $506,340. This amount includes unexpended surplus amounts of $6,055 from 2004; $1,926 from 2003; and $6,055 from 1998. Allocation for 2005 expenditures is as follows: ADA Speakers Bureau, 2004 Annual Session ($4,981); Leadership Development Program ($1,500); Direct Reimbursement Program for TDA staff ($3,051); Legal Reserve Fund ($50,000); development of Dental Practice Model ($10,348); TDA travel reimbursement policy ($41,125); update of Ethics and Judicial Manual ($7,500); staff incentive bonus/related benefits ($9,375); Operating Reserve Funds ($110,000); cash carry over for 2006 ($204,585); and funding for future projects ($63,514). Approved the 2006 proposed TDA budget of $5,071,040. Approved a new leave policy for TDA staff. Referred to the TDA Resolutions Committee (report in April 2005) consideration of a resolution to the ADA House of Delegates to support entities seeking to repeal the McCarren-Ferguson Action of 1945. Referred to Task Force on Medicaid (report in April 2005) authorizing TDA to ask each component society to appoint an individual or a committee to recruit dentists to participate in Head Start programs within their districts. Referred to TDA Council on Dental Care Programs and Community Oral Health (report in April 2005) a response to the ADA concerning community health centers. Referred to the TDA Council on Dental Care Programs and Community Oral Health (report April 2005) investigation of TDA and component societies partnering with child identification program organizations.

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Directed that all policy resolutions indicate the policy’s relationship to the TDA strategic plan. Endorsed the “declared moot” determination by the Speaker of the House for a TDA resolution to the ADA advocating repeal of the McCarren-Ferguson Act of 1945. Existing ADA policy already addresses such insurance issues. Approved TDA offering online continuing education for members (dentist side of site) and for the dental practice team (public side). Content will follow guidelines of the ADA’s Continuing Education Recognition Program (CERP), and fees to support production and development will be reviewed annually. Determined additional rules for election of officers in TDA Rules for Caucus Procedures, Nominations, and Elections to include determination of speaking order, initial introduction of all candidates by the Speaker of the House as moderator of the forum, and only one candidate at a time in the room to speak for 10 minutes and answer questions for 10 minutes. Alternatively and with approval of all candidates, a 30-minute question and answer session could be held with all candidates in the room to answer each question in turn. Approved a revised TDA Judicial Manual. Directed that TDA send a list of Head Start Programs to each component dental society with a request to appoint a liaison or committee to ensure that dentists are available to perform the federally required dental exam for all children entering the program in each component society. Approved new indemnification requirements for component society peer review and judicial committees so that each component society certifies annually that its chair has attended a TDA training session within the last 4 years and that each chair certifies annually that each committee member has attended a TDA training session within the last 8 years. Referred to the Council on Dental Care Programs and Community Oral Health (report in August 2005) the feasibility of TDA forming partnerships with organizations sponsoring child identification programs with scientifically demonstrated and valid dental-related components. Directed that the TDA Future Focus Committee, a standing committee of the TDA Board, include the current TDA president-elect and another board member as two of the four members; that the TDA president appoint the chair; that the Committee coordinate implementation and measure strategic plan progress; and that the Committee meet with the board and an outside facilitator as needed to monitor and adjust the plan. Directed that the TDA Assets Management Committee (as of May 2005) be chaired by the TDA secretary-treasurer with four TDA Board members appointed by the TDA president to include one director, one senior director, and two vice presidents. Appointments will be based upon experience, knowledge, and willingness to serve up to 3 years. After 2005, the TDA president will appoint one director and one vice-president each May to maintain the balance and experience of members as the remaining two members advance one year in seniority. Approved a $2,000 contribution to the Dr. Stephen F. Schwartz campaign for ADA second vice president (election in October 2005). Authorized a $50 mandatory assessment for the 2006 membership dues year to be used for legislative efforts (lobbyist, consulting firm, public relations, etc.) and holding the monies in a designated Legislative Assessment Fund. Approved a letter to the Texas Workers’ Compensation Commission supporting the proposed new Rule 134.303, which updates reimbursement guidelines for dental services. Authorized Service Recognition Awards at the 2005 Annual Session for Dr. Ronald L. Rhea (Communications Committee chair) and Dr. William D. Steinhauer (Medicaid Task Force and legislative hearings witness). Directed the Council on Ethics and Judicial Affairs and the Council on Peer Review to explore ways to transfer to the TDA central office more of the ethics and judicial work of component societies that cannot or will not function as needed (report in November 2005). Referred to TDA legal counsel for a recommendation (report in June 2005) whether the TDA board liaison may participate in Council on Ethics and Judicial Affairs ongoing discussions. ★

April 2005 / TDA Today / 2


Under the Dome with Team TDA By Jenny Young, TDA Director of Public Affairs

Legislative Team TDA

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ith less than 60 days remaining in the 79th session of the Texas Legislature, TDA’s legislative team is in high gear, pushing propatient/pro-dentistry legislation, supporting favored budget items, impacting the debate on business taxation, and fending off numerous attacks on the Dental Practice Act. TDA’s legislative team includes three contract lobbyists, four full time staff, and an attorney. Dr. David Sibley, an oral surgeon and Texas senator for 12 years, leads our team, which has more than 125 years of combined legislative experience. Susan Ross served as TDA’s public affairs director for 3 years prior to becoming one of our legislative consultants. TDA also places great confidence in Nora Del Bosque who has represented TDA for several sessions. Our TDA staff team includes Jay Bond, director of policy; Diane Rhodes, public policy associate; Leigh Ann Montague, DENPAC manager; Kelly Whitebread, legislative intern; and myself as director of public affairs. Bill Bingham is TDA’s general counsel, providing the team with legal services. The team receives additional support from TDA staff including help with Legislative Day, frequent website updates, and other valuable support. Our TDA legislative team works at the direction of the Council on Legislative and Regulatory Affairs (CLRA), chaired by Dr. Jerry Long, and ultimately reports to the TDA Board of Directors. On any given day in the Capitol, the legislative team is lobbying individual members of the legislature for votes on dental legislation, covering legislative committee hearings on multiple bills affecting dentistry, working with bill authors to amend legislation, interacting with the legislative leadership to insure passage of dentistry’s agenda, providing information to members of the Governor’s policy team, assisting legislators who are authoring TDA bills, and responding to questions about dental health policy from any of 181 legislative offices. The lobby messages delivered on behalf of dentistry are carefully crafted by our staff experts and CLRA members using position papers based on TDA policy as established by its House of Delegates. With almost 98 bills to track, the legislative team works around the clock, promoting legislation to strengthen the practice environment for dentistry while standing guard to protect critical legislative statutes, such as the insurance code and Dental Practice Act. Six bills have been filed to expand the scope of practice for dental hygienists and at least one bill deals directly with dental PPO’s and would allow health plans to discount fees for non-contracting dentists. In these instances, our team must work respectfully and shrewdly to oppose the bills, knowing that on another day, the bill author’s vote may be the one we need to succeed on another issue. On a typical day, one of our lobbyists can easily walk 10 miles or more traveling the four floors of the main Capitol and the maze of hallways and corridors in the underground Capitol extension. TDA’s lobbyists are a clear and visible presence to the legislators, staff, and lobbyists representing our foes. TDA lobbyists are present at every key hearing and throughout the day are moving swiftly from office to office, carrying TDA’s message on behalf of Texas dentists and their patients. In the 140 days of the legislative session, 5,000 or more bills may be considered by dozens of legislative committees. The legislative team monitors every key committee meeting, anticipating the need for amendments to legislation and for TDA testimony for or against bills. Key Committees and Issues • Senate Finance and House Appropriations — Medicaid, Children’s Health Insurance Program (CHIP), and dental school funding. • Senate Health and Human Services and House Public Health — dental assistant education reforms and any legislation related to the Dental Practice Act including dental licensure issues and scope of practice. • Senate State Affairs and House Insurance — for liability issues and legislation covering third party payors. • House Ways and Means and Senate Finance — taxation. • Senate Education and House Higher Education — for dental school funding through tuition revenue bonds.

Jenny Young

Dr. Jerry Long

Dr. David Sibley

While the legislative team can carry dentistry’s agenda far in the legislative process, it takes the activism of practicing dentists to win at the “end game,” or final days of the legislative session when most key issues are decided. We ask that you remain on high alert between now and the end of the session on May 30. Watch for and respond quickly to TDA legislative action alerts. And, know that the interests of your patients and your profession are being aggressively advocated, day in and day out, under the dome. ★

79th Texas Legislature: Status of Selected Legislation, April 14, 2005 HB 3: Relating to property tax relief and protection of taxpayers, taxes and fees, and other matters relating to financing public schools. AUTHOR: Rep. Jim Keffer (R-Eastland) Current Status: 3/22/05: Referred to Senate Finance Committee. COMMENTS: This bill would reduce property taxes and reform the state tax system. The version passed by the House includes a provision that would impose sales taxes on “elective cosmetic procedures” (but not “reconstructive” procedures), including “cosmetic” dentistry. The TDA legislative team is working to eliminate the tax on cosmetic dentistry from the final version of the bill. HB 682: Relating to a dental services pilot program in border-region counties. AUTHOR: Rep. Jim Solis (D-Harlingen) Current Status: 2/8/05: Referred to House Committee on Public Health. COMMENTS: This bill, which is identical to SB 814 by Sen. Eddie Lucio (D-Brownsville), would establish a pilot program to provide dental services in border-region counties. Rep. Solis passed an identical bill in 2001, but it was never funded. HB 1432: Relating to the regulation of dental assistants who make dental x-rays. AUTHOR: Rep. Jodie Laubenberg (R-Parker) Current Status: 3/16/05: No action taken in House Committee on Public Health. COMMENTS: Action on this bill in the House Committee on Public Health has been deferred pending consideration of a related bill, SB 632, which has passed the Senate and been referred to the committee. HB 2543: Relating to authorizing the issuance of revenue bonds for the University of Texas Dental Branch at Houston at the University of Health Science Center at Houston. AUTHOR: Rep. Peggy Hamric (R-Houston) Current Status: 4/12/05: Left pending in the House Higher Education Committee. COMMENTS: This bill would authorize the University of Texas system to issue $45 million in tuition revenue bonds to build a new facility for the University of Texas Dental Branch at Houston. HB 2678: Relating to a prohibition of the use of certain information for professional liability insurance for physicians and health care providers. AUTHOR: Rep. John Smithee (R-Amarillo) Current Status: 4/4/05: Left pending in the House Committee on Insurance. COMMENTS: This bill would address concerns raised by TDA about the use of a dentist’s status as a Medicaid or CHIP provider to deny or limit professional liability insurance coverage. HB 2706: Relating to the establishment of the Health Professions Scope of Practice Review Commission. AUTHOR: Rep. Dianne White Delisi (R-Temple) Current Status: 4/14/05: Posting rule suspended. COMMENTS: This bill, which TDA opposes, would create a new state agency to review proposed changes in the scope of practice for health professionals in Texas. Dr. Long

testified against creating such a commission when the bill was heard in the House Committee on Public Health.

ments for audits of Medicaid providers, including dentists (same as Rep. Yvonne Gonzalez Toureilles’ HB 3418).

HB 2874: Relating to regional and state dental services advisory committees under the Medicaid program. AUTHOR: Rep. Jim Solis (D-Harlingen) Current Status: 3/17/05: Referred to the House Committee on Public Health COMMENTS: This bill would require the state Health and Human Services Commission (HHSC) to establish Medicaid dental services advisory committees at the state and regional levels.

SB 632: Relating to dental assistant x-rays. AUTHOR: Sen. Jane Nelson (R-Lewisville) Current Status: 4/04/05: Referred to House Committee on Public Health. COMMENTS: The current version of this bill, which has already passed the Senate, would replace the current standalone radiology certification exams with a single, comprehensive course that includes an exam. It would require the course and exam to be developed and administered by CODA-accredited dental schools or dental assisting programs, as well as “dental professional organizations.” It would allow dental assistants to fulfill their CE requirements through Board-approved self-study, interactive computer courses or lecture courses, and expand the approved curriculum to cover “dental assistant duties.”

HB 3271: Relating to dental care insurance benefit plans. AUTHOR: Rep. Bill Keffer (R-Dallas) Current Status: 4/18/05: Scheduled for public hearing in House Committee on Insurance. COMMENTS: This bill, which TDA opposes, would amend the Insurance Code to allow employee benefit plans or health insurance policies to use certain terms in marketing their dental insurance products. It would also ease dependent coverage requirements for such plans or policies. HB 3336: Relating to dental hygiene services or procedures provided under the medical assistance program. AUTHOR: Rep. Bryan Hughes (R-Mineola) Current Status: 3/22/05: Referred to the House Committee on Public Health. COMMENTS: This bill, which TDA strongly opposes, is identical to last session’s HB 2715. It would allow Medicaid patients to select a dental hygienist to provide care that is covered by Medicaid and within the hygienist’s scope of practice. HB 3342: Relating to certain anesthesia services provided by dental hygienists. AUTHOR: Rep. Bryan Hughes (R-Mineola) Current Status: 3/22/05: Referred to the House Committee on Public Health. COMMENTS: This bill, which TDA strongly opposes, would allow dental hygienists to administer local anesthesia and nitrous oxide. SB 196: Relating to the provision of voluntary charity care by certain retired dentists. AUTHOR: Sen. Jane Nelson (R-Lewisville) Current Status: 3/23/05: Referred to the House Committee on Public Health. COMMENTS: This bill, which has already passed the Senate and is awaiting action in the House, would authorize the Texas State Board of Dental Examiners (TSBDE) to waive licensing fees for retired dentists whose practice is limited to providing charitable care without compensation. SB 610: Relating to the regulation of the practice of dentistry. AUTHOR: Sen. Jane Nelson (R-Lewisville) Current Status: 3/23/05: Referred to the House Committee on Public Health. COMMENTS: This “housekeeping” bill for the Texas State Board of Dental Examiners has already passed the Senate and is awaiting action in the House. SB 630: Relating to audits of providers in the Medicaid program. AUTHOR: Sen. Leticia Van de Putte (D-San Antonio) Current Status: 3/29/05: Left pending in Senate Committee on Health and Human Services. COMMENTS: This bill would establish specific require-

April 2005 / TDA Today / 3

SB 726: Relating to the authority of a dental hygienist to prescribe and administer fluoride varnish. AUTHOR: Sen. Bob Duell (R-Greenville) Current Status: 4/14/05: Reported engrossed. COMMENTS: As passed by the Senate, this bill would require the Texas State Board of Dental Examiners to issue “limited fluoride varnish permits” to allow dental hygienists to administer fluoride varnish without supervision by a dentist. It would require the TSBDE to set educational and proof of competency requirements in consultation with the Dental Hygiene Advisory Committee.

Susan Ross

Nora Del Bosque

Bill Bingham

SB 814: Relating to a dental services pilot program in border-region counties. AUTHOR: Sen. Eddie Lucio (D-Brownsville) Current Status: 3/10/05: Referred to the Senate Committee on Health and Human Services. COMMENTS: This bill, which is identical to HB 682 by Rep. Jim Solis (D-Harlingen), would establish a pilot program to provide dental services in border-region counties. Rep. Solis passed an identical bill in 2001, but it was never funded.

Jay Bond

SB 1163: Relating to the authority of a dental hygienist to provide services in certain facilities and schools. AUTHOR: Sen. Eddie Lucio (D-Brownsville) Current Status: 3/21/05: Referred to the Senate Committee on Health and Human Services. COMMENTS: This bill, which TDA opposes, would allow dental hygienists to provide “unsupervised preventive and therapeutic dental hygiene services” in long-term care facilities, schools, Head Start centers, day-care facilities, or other institutions approved by TSBDE rule.

Diane Rhodes

SB 1188: Relating to the medical assistance and children’s health insurance programs. AUTHOR: Sen. Jane Nelson (R-Lewisville) Current Status: 4/12/05: Voted favorably from committee as substituted. COMMENTS: This bill includes a provision that would require the Health and Human Services Commission to develop a fee schedule for dental care provided in longterm care facilities. The Texas Association for Long Term Care Facility Dentistry worked with Sen. Nelson’s staff to add language setting parameters for the fee schedule, and requiring appointment of a work group that includes dentists and long-term care advocates to develop it. ★

Leigh Ann Montague

Kelly Whitebread


A

t various times each year, the Texas State Board of Dental Examiners (TSBDE) amends various rules that govern the practice of dentistry in Texas. To help TDA members keep up with these periodic changes, please use the links below to access a list of amendments to TSBDE rules adopted in 2005 as well as an explanation of those changes. TSBDE 2005 Adopted Rule Changes: http://www.tsbde.state.tx.us/documents/rules/2005%20Adopt%20Rules%20Explanation.pdf TSBDE 2005 Adopted Rules Explanation: http://www.tsbde.state.tx.us/documents/rules/FY%202005%20Adopted%20Rule%20Changes.pdf Use the following link to access the current version of the complete set of TSBDE rules: http://www.tsbde.state.tx.us/rules.htm ★

Texas Mission of Mercy, Dallas Serving the Greater Dallas Area, Touching Hundreds of Lives

News you can use

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or the eighth time, a multitude of volunteers gathered collective talents to hold a Texas Mission of Mercy (TMOM) on February 12–16, 2005, the second such event held in Dallas at the Science Place in Fair Park. The partnership of the Texas Dental Association, Texas Dentists for Healthy Smiles, Dallas County Dental Society Foundation, and Baylor College of Dentistry-TAMHSC enabled this Dallas TMOM to see 669 patients at a value of $237,393 in delivered charitable care. Media exposure for TMOM events continues to improve. There were television interviews from several networks. TMOM also had coverage in The Dallas Morning News, where Linda Stewart Ball reported, “They [TMOM patients] were missing teeth or had dark holes in their front teeth. They were embarrassed and reluctant to smile because they didn’t have the money to fix the problem. Although there are many nonprofit dental clinics in North Texas, including two in Collin County, they’re often difficult to get into because the need is so great. The temporary Mission of Mercy — which has treated nearly 6,000 people in eight missions across the state since 2001 — helped fill that void.” Thank you to the many volunteers that made this event possible. To see a complete list of the TMOM Dallas volunteers, go to www.tdhsmiles.org. ★

Dr. William H. Gerlach, TDHS chair, introduces Dallas Mayor Laura Miller to the TMOM project.

in folder — 04-05NYCUoutlinescmyk.eps

From left: Dr. William H. Gerlach, TDHS chair; State Rep. Roberto Alonzo; and Dr. Larry D. Herwig, TMOM Dallas co-chair.

Errata Texas Dental Journal, April 2005, pages 370-375

In the chart, “Texas Dental Association 2006 Proposed Budget,” the four column headers across the top of each page should read from left to right as follows: 2004 Actual

2004 Budget

2005 Budget

2006 Proposed

Contact the TDA Board: ✽ WADE: (979) 776-8100, hwade@tda.org ✽ BLACK: (915) 592-5853, rblack@tda.org ✽ BLANTON: (214) 559-4670, pblanton@tda.org ✽ HARRISON: (281) 492-6064, tharrison@tda.org ✽ WOOLWEAVER: (956) 425-7744, drwoolweaver@tda.org ✽ ADKINS: (806) 793-3556, jadkins@tda.org ✽ MCCAULEY: (903) 572-3981, dmccauley@tda.org ✽ ROBERTS: (936) 544-3790, mroberts@tda.org ✽ CHANCELLOR: (210) 653-4410, jchancellor@tda.org ✽ DUNCAN: (806) 355-7401, dduncan@tda.org ✽ HIGGINBOTTOM: (214) 827-1150, fhigginbottom@tda.org ✽ COLLINS: (281) 983-5677, rcollins@tda.org ✽ PHILIPS: (361) 992-9871, fphilips@tda.org ✽ COX: (817) 596-7782, dcox@tda.org ✽ BARRINGTON: (972) 923-0374, jbarrington@tda.org ✽ COLEMAN: (210) 656-3301, jcoleman@tda.org ✽ HALL: (325) 698-7560, ghall@tda.org ✽ STUART: (972) 686-8828, mstuart@tda.org ✽ ANDERSON: (806) 792-5111, canderson@tda.org ✽ LINN: (512) 443-3675, marykay@tda.org ✽ BINGHAM: (512) 495-6000, bbingham@mcginnislaw.com

TDA T o d a y

April 2005 • Volume 6, Issue 4 www.tda.org

TDA INTERNET

Cafe

Check out the TDA Internet Café located in the registration area! Check your e-mail Sign up for a Personal Web Page Sign up for a FREE E-mail Alias Check out the TDA website Look up directions

TDA web manager Stefanie Clegg will be there to answer questions, show you what’s new on TDA’s website, how to register online for next year’s TEXAS Meeting, and where to look online for highlights from this year’s TEXAS Meeting.

TDA's Internet Café is brought to you by Susan Gunn of Gunn Consulting.

Purchase photos from the TEXAS Meeting! 4 x 6 photo = $5 5 x 7 photo = $7 8 x 10 photo = $10 E-mail photo = $3

TEXAS Meeting Photos!

TDA's photographer will be taking candid photos during the TEXAS Meeting. The photos will be available the next day at the Internet Café located in the registration area. *Photos taken on Saturday will be available online after the meeting.

All photos will be available for purchase on TDA's website after the meeting at www.texasmeeting.com/estore.


TDA Today April 2005