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American Dental Education Association


Volume 3, No. 3, June 13, 2023

Federal Budget and Oral Health Funding Outlook
 
President Biden and the Congress reached an agreement to extend the federal debt limit through Jan. 1, 2025. To implement the extension and set the stage for the funding parameters on next fiscal year’s budget, Congress passed and the President signed the Fiscal Responsibility Act (FRA) [ [link removed] ] (H.R. 3746) on June 3.
 
As part of the agreement there will be enforceable discretionary budget caps on federal funding for fiscal years (FY) 2024 and 2025. The increase between FY 2024 and FY 2025 is 1%. However, the non-defense discretionary (a.k.a., domestic discretionary) spending limits decreased by $43 million from the current FY 2023 levels. Between now and the start of FY 2024 on Oct. 1, the Committees on Appropriations in the U.S. House of Representatives and Senate will decide where those cuts will occur. Much of that burden may fall on the departments, agencies and programs funded by the House and Senate Labor, Health and Human Services, Education Subcommittees, which fund oral health training programs, dental and craniofacial research and higher education. No programs will be immune from possible reductions. Moreover, both Houses will be pressured to provide additional funds for VA Health Care, which is a discretionary program, and support for humanitarian needs at the southern U.S. border.
 
In the coming months, ADEA will actively make the case for funding oral health workforce and dental and craniofacial research needs, and it will need ADEA members’ help. Please watch for requests to contact your Members of Congress!

Biden Announces NIH Director and CDC Director
 
President Biden recently nominated two women to head major federal health care agencies. The President nominated Dr. Monica Bertagnolli [ [link removed] ] to lead the National Institutes of Health (NIH), succeeding Dr. Francis Collins, who served as NIH Director for more than a decade.
 
Dr. Bertagnolli is a surgical oncologist and cancer researcher who is currently Director of the National Cancer Institute (NCI), the first woman to serve in this role. At NCI, Dr. Bertagnolli has worked to further President Biden’s Moonshoot Cancer Initiative. Previously, she served as the Richard E. Wilson Professor of Surgery in surgical oncology at Harvard Medical School, a surgeon at Brigham and Women’s Hospital, and a member of the Gastrointestinal Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute, all in Boston.
 
She has also served as group chair of the Alliance for Clinical Trials in Oncology, a National Clinical Trials Network member organization, and was CEO of Alliance Foundation Trials, LLC, a not-for-profit corporation that conducts international cancer clinical trials and focuses on the inclusion of rural communities in clinical studies. Dr. Bertagnolli awaits Senate confirmation.
 
President Biden also plans to nominate Dr. Mandy Cohen [ [link removed] ] , an internal medicine physician, to lead the Centers for Disease Control and Prevention, replacing Dr. Rochelle Walensky, who is stepping down on June 30. Since January 2022, Dr. Cohen has been CEO of Aledade Care Solutions and Executive Vice President of Aledade Inc., a primary care network. Prior to Aledade, she served as North Carolina's Secretary of Health and Human Services starting in 2017. During her five years at the agency, she shepherded the state through the COVID-19 pandemic, implemented the state’s Opioid Action Plan and helped pass Medicaid expansion in the state.
 
Dr. Cohen has held senior positions at the Centers for Medicare & Medicaid Services during the Obama administration, including Chief Operating Officer and Chief of Staff at the agency, and served as Acting Director of the agency’s Center for Consumer Information and Insurance Oversight.

U.S. Supreme Court Upholds Medicaid Beneficiaries’ Right to Sue
 
Last week, the Supreme Court ruled [ [link removed] ] 7-2 to protect the right of private individuals’ right to sue state and local actors for violations of their federal civil rights under Section 1983 [ [link removed] ] . Specifically, in Health and Hospital Corporation of Marion County v. Talevski, the court held that Medicaid nursing home residents can seek relief in federal court under Section 1983 when state officials do not meet a certain quality of care established by statute. This case reaffirms and preserves federal Medicaid guarantees as privately enforceable legal rights.
 
The case centered around Gorgi Talevski, who resided in a nursing facility owned by Health and Hospital Corporation of Marion County where he was both physically and chemically restrained and later involuntarily moved to a different facility. Mr. Talevski’s family sued the nursing facility’s owners under Section 1983 for depriving him of his federal rights guaranteed by Medicaid’s Federal Nursing Home Reform Act (FNHRA). FNHRA is a 1987 federal law governing nursing homes that receive federal funding. The law includes a provision that prohibits nursing homes from using physical restraints or chemical restraints for nonmedical reasons.
 
Historically, the courts have recognized Section 1983 as a vehicle for private citizens, including beneficiaries of public welfare programs such as Medicaid, to protect their federal rights when state governments or actors violate them. Mr. Talevski’s family won their case at the federal appeals level. However, the nursing facility asked the Supreme Court to overturn this decision. The nursing facility claimed FNHRA, and statutes like it, act as common contracts and that under common contract law, the contractual obligations are between the federal government and fund recipients—in this case the state Medicaid program—and that third-party beneficiaries of these contracts, like nursing home residents, cannot enforce these contracts under Section 1983. The court rejected the nursing facility’s argument and through its ruling made it clear that Section 1983 continues to be a mechanism through which private citizens can protect their federal rights when state governments or actors violate them.

Ohio House Passes Dentist and Dental Hygienist Compact
 
On May 31, the Ohio House of Representatives passed a bill that would allow the state to join the Dentist and Dental Hygienist Compact [ [link removed] ] . The bill has been sent to the state Senate for consideration.
 
Once enacted by seven states, the compact will create a pathway to licensure portability for dentists and dental hygienists who are licensed in member states. Licensees who live in states that are compact members can apply for a “compact privilege” that will allow them to practice in another member state. Under the current draft [ [link removed] ] of the model compact that was written by The Council for State Governments, license holders will be granted the opportunity to apply for compact privilege if they do the following:
 • Hold a license as a dentist or dental hygienist;
 • Graduate from a Commission on Dental Accreditation-accredited program;
 • Successfully complete a clinical assessment for licensure, with “clinical assessment” currently defined as an examination or process required for licensure as a dentist or dental hygienist, as applicable, that provides evidence of clinical competence in dentistry or dental hygiene;
 • Have passed a National Board Examination of the Joint Commission on National Dental Examinations or another examination accepted by rule as a requirement for licensure;
 • Meet any jurisprudence requirements;
 • Complete a criminal background check;
 • Submit an application and pay applicable fees; and
 • Comply with requirements to submit specified information for administrative purposes.

Iowa [ [link removed] ] became the first state to join the compact on April 27. Washington [ [link removed] ] state and Tennessee [ [link removed] ] became the second and third states, respectively. To date, the bill has been introduced in eight states [ [link removed] ] .

Nevada Legislature Sends Bill to Governor That Would Impact Dental Hygienists and Expanded Function Dental Assistants
 
The Nevada Legislature will send a bill [ [link removed] ] to Gov. Joe Lombardo (R) that makes multiple changes for dental hygienists and also creates licensure for expanded function dental assistants.
 
If signed into law, the bill would create requirements for the licensure and regulation of expanded function dental assistants. The bill lists procedures expanded function dental hygienists would be permitted to perform under the authorization of a licensed dentist and defines “expanded function dental assistance” as “the performance of educational, preventative, therapeutic, palliative and restorative treatment of intraoral or extraoral procedures.”
 
Additionally, the legislation would permit a public health dental hygienist to authorize an expanded function dental assistant or a dental assistant to perform specified tasks as part of an approved program of public health dental hygiene.
 
The bill would also allow a licensed dental hygienist who has successfully completed a course on restorative dental hygiene to apply for a special endorsement that would allow them to practice restorative dental hygiene. Dental hygienists who hold this special endorsement would only be permitted to practice restorative dental hygiene under the authorization of a licensed dentist.
 
Finally, the bill would also allow dental hygienists who meet specified qualifications and are issued a certificate by the state board of pharmacy to prescribe:
 • Topical or systemic prescription drugs other than controlled substances for preventative care,
 • Fluoride preparations for which a prescription is not required,
 • Topical antimicrobial oral rinses and
 • Medicament trays or mouthguards.

ADEA Advocacy in Action
This appears weekly in the ADEA Advocate to summarize and provide direct links to recent advocacy actions taken by ADEA. Please let us know what you think and how we might improve its usefulness.
 
Issues and Resources
 • ADEA report [ [link removed] ] on teledentistry
 • ADEA report [ [link removed] ] on the Impact of the COVID-19 Pandemic on U.S. Dental Schools
 • ADEA policy brief [ [link removed] ] regarding overprescription of antibiotics
 • For a full list of ADEA memos, briefs and letters click here [ [link removed] ] .

Key Federal Issues [ [link removed] ]

ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]

Key State Issues [ [link removed] ]

The ADEA Advocate [ [link removed] ] is published weekly. Its purpose is to keep ADEA members abreast of federal and state issues and events of interest to the academic dentistry and the dental and research communities.
 
©2023
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
Tel: 202-289-7201
Website: www.adea.org [ [link removed] ]

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B. Timothy Leeth, CPA
ADEA Chief Advocacy Officer
 
Bridgette DeHart, J.D.
ADEA Director of Federal Relations and Advocacy
 
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
 
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
 
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