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Welcome to CDHP's Health Policy Dental Check-up! We are excited to provide a
regular update on what is happening on Capitol Hill related to oral health policy. We look
forward to providing you with the information we hear and to hearing from you. |
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About CDHP
Founded in 1997, the Children's Dental Health Project is a national
non-profit organization with the vision of achieving oral health for all children to ensure that they reach their full potential. Children's Dental Health Project (CDHP)
designs and advances research-driven policies and innovative solutions
by engaging a broad base of partners committed to children and oral
health, including professionals, communities, policymakers and
parents.
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ACA Appropriations Update
Before leaving for the August recess, the Senate and House
appropriations subcommittees on Labor, Health and Human Services, Education,
and Related Agencies passed their respective versions of the FY 2011
appropriations bill. Although the oral health funding levels requested by
nearly 200 public health organizations and oral health advocates fell short,
both chambers clearly recognized the need to address oral health funding in the
coming year despite a very tight budget. While the members of the subcommittees should be applauded for their
effort to address oral health funding, it is important for them to fully
understand the implications of not funding many of the new initiatives
authorized by the Affordable Care Act (ACA), particularly those designed to
enhance cost effective prevention based activities. For example, it
is encouraging to see an increase in infrastructure dollars to the CDC Division
of Oral Health but the value of that investment will be far from realized
without the complementary CDC programs targeting disease management or public
education. While the workforce numbers are more robust, we need to ensure
that HRSA and the states have sufficient guidance and flexibility to diversify
their workforce and have a strong foundation for addressing the oral health
demands in states. The committee reports display a much welcome acknowledgment
of the importance of oral health and some incredibly important oral health
initiatives now stand to receive initial or increased funding when the
appropriations process moves into conference some time after the recess. Advocates should remain vigilant in
expressing their support for these provisions and in particular, supporting the
Senate's overall approach to oral health funding.
Some of the Senate subcommittee's proposed funding levels
worth mentioning are: - $47.982
million for primary care dentistry training and workforce improvements
- $3
million for the National Health Workforce Commission
The committee
report encourages agency and program directors to utilize funding specifically
for oral health and prevention within the context of more general
appropriations. The full reports can be viewed online at the Senate
and House
appropriations websites. |
Contact Your Representatives
While advocates should be pleased to see the attention paid
to oral health by the appropriations committees thus far, many essential oral
health provisions are being left off the table for FY 2011. The oral health provisions in ACA are necessary to
effectively support the pediatric dental benefit and enhance existing oral
health infrastructure. It is important that advocates continue to put pressure on
their representatives so that every new oral health program receives the seed
money necessary to make an impact. When
speaking with your representatives, we encourage you to use the following
talking points adapted from the sign on letter sent to Senator Harkin and
Congressman Obey in May: General ACA Oral Health Information - Benefit: Thank you for passing a bill with a
strong dental benefit. Although dental caries (tooth decay)
is preventable, it remains the #1 chronic disease in childhood. Making the commitment in ACA to ensure
that all children receive dental coverage through medical and stand-alone
plans in the exchanges is a necessary step in the right direction.
- Funding
other ACA provisions: Almost 20
additional oral health provisions in ACA need funding. These essential
provisions dealing with access, prevention, infrastructure, training, and
research are essential in supporting the dental benefit and create a
system-wide change to end childhood tooth decay.
Prevention - Message
of Prevention: Dental caries,
the disease that causes cavities, is an infectious, transmittable, but
preventable disease. By focusing on
prevention, thousands of lost school days and millions of dollars can be
saved. Low-income
children who have their first preventive dental visit by age one are not
only less likely to need subsequent restorative or emergency room visits,
but their average dentally related costs are reduced by almost 40%.
- CDC
Oral Health Prevention Public Education Campaign ($5 million):
Public education is a broad reaching and inexpensive strategy to minimize tooth
decay similar to what has been done to address other chronic diseases
(such as diabetes and heart disease).
This campaign will focus on promoting good oral health among those
who stand to benefit most, especially children, pregnant women, and
underserved and at risk populations.
- Dental
Caries Disease Management grants ($8
million): Dental caries is entirely a manageable disease. However, unlike many other chronic
conditions like diabetes and cardiovascular disease dental treatment lags
far behind in utilizing effective disease management. These grants will help demonstrate how to
close the knowledge gap among insurers, health professionals, and
communities, so they can invest earlier, smarter, and with more targeted
interventions.
- School-based Dental Sealants Program ($15 million): Among high-risk
children, sealants applied to permanent molars have been shown to avert
tooth decay over an average of 5-7 years. Funding for this program will allow for the effective
targeting of schools with large numbers of underserved children across the
nation.
- CDC
Oral Health Infrastructure grants ($25
million): In order to
effectively address the oral health needs of communities, there needs to
be leadership and a strong infrastructure in place. CDC's investment in a limited number of
states has proven incredibly effective to date and must be expanded to all
50 states for communities to fully benefit from federal support related to
program guidance, surveillance and above all, building a more efficient
oral health delivery system at every level.
Workforce - ACA
significantly expands Medicaid, which will undoubtedly add new challenges
to the existing dental workforce. There simply are not enough dental
professionals, particularly in rural and impoverished areas, The workforce
provisions in ACA aim to meet the increasing need.
- Alternative
Provider Demonstration grants ($15
million): In addition to investing in the current workforce, ACA
supports states that want to expand their dental workforce, specifically
by training or employing new mid-level dental providers. This provision is targeted at supporting
underserved communities.
- Primary
Care Training Programs ($30
million): Expanded funding
for primary care training program is yet another strategy to addressing
the maldistribution and shortage of dental providers in the country. Providing training and loan forgiveness
to serve in shortage areas will provide immediate care in communities in
addition to a long-term investment in a future workforce with the
knowledge and skills to serve the underserved.
Surveillance &
Monitoring - National
Oral Health Surveillance ($5
million): In order to adequately address the
oral health needs, data collection is necessary to measure the current
status in addition to identifying any measurable changes.
Multiple federal data and surveillance systems provide the full
oral health picture including pregnant women and at-risk populations is
integrated into the Pregnancy Risk Assessment Monitoring System (PRAMS),
the National Health and Nutrition Examination Survey (NHANES), the Medical
Expenditures Panel Survey (MEPS) and the National Oral Health Surveillance
System.
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