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Volume 1, No. 69, July 7, 2020

ADEA Advocacy in Action
This feature will appear 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.
 
Lost Clinic Revenue—Provider Relief Fund
May 1 – Joint letter [ [link removed] ] with the Partnership for Medicaid on fund reimbursement for Medicaid providers.
April 30 – Joint letter [ [link removed] ] with ADHA on availability of reimbursement from Fund.
 
Other COVID Issues
May 28 – Joint letter [ [link removed] ] with the American Council on Education regarding liability protection shields.
May 18 – Joint letter [ [link removed] ] with ADA and AADR in support of funding COVID-19 research.
 
Dental School COVID Related Capital Needs
June 1 – ADEA letter [ [link removed] ] to Sen. Lamar Alexander regarding reopening guidelines
May 13 – ADEA letter to Speaker Pelosi [ [link removed] ] and Rep. Frank Pallone [ [link removed] ] (D-NJ) about infrastructure improvements and modernization funds for dental schools,
 
2019 Graduate Licensure
April 9 – ADEA letter [ [link removed] ] to National Governors Association.
 
For a full list of ADEA Letters and Policy Memos, click here [ [link removed] ] .

CDC Releases Updated Re-Opening Dental Settings Guidance
 
The Centers for Disease Control and Prevention (CDC) released updated guidance for dental settings [ [link removed] ] . This guidance addresses resuming non-emergency dental care during the COVID-19 pandemic and includes three updates:
 • The recommendation to wait 15 minutes after completion of clinical care and exit of each patient without suspected or confirmed COVID-19 to begin to clean and disinfect room surfaces has been removed to align with CDC Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings.
 • The time period recommended for patients to inform the dental clinic if they develop symptoms or are diagnosed with COVID-19 following a dental appointment has been changed to two days to align with the CDC’s Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure Guidance.
 • Clarifying language has been added to Engineering Controls.

Oklahoma Passes Medicaid Expansion Referendum
 
On June 30, voters in Oklahoma narrowly passed [ [link removed] ] a ballot measure that requires the state to expand Medicaid eligibility under the Affordable Care Act. The referendum will add a provision to the state constitution that requires the state to expand Medicaid to individuals who earn up to 138% of the federal poverty level.
 
Similar measures have been passed in other states in recent years, but in some states, legislators and governors have attempted to limit the expansion by implementing work requirements [ [link removed] ] or reducing the income cap [ [link removed] ] on covered populations. By enshrining Medicaid expansion in the state constitution, however, it is unlikely changes will be made to the plan in Oklahoma.
 
One of the biggest questions facing the state between now and implementation is how the state will fund its share [ [link removed] ] for coverage of the expansion population. The federal government will provide 90% the funds for the expansion population, but the state currently lacks a plan for providing its 10% share. Gov. Kevin Stitt (R) has stated that cuts will need to be made in other areas of the state’s budget, as he will not raise taxes.
 
Thirty-five states [ [link removed] ] have now expanded Medicaid under the Affordable Care Act, and Nebraska is currently working toward implementing an expansion of its program. Voters in Missouri [ [link removed] ] will have the opportunity to vote on a similar referendum in August.

U.S. House Passes Enhancements to the Affordable Care Act
 
The U.S. House of Representatives passed H.R. 1425 [ [link removed] ] , the Patient Protection and Affordable Care Enhancement Act. The bill makes a variety of enhancements, some of which were:
 • Continuous eligibility for Medicaid and Children’s Health Insurance Program (CHIP) recipients,
 • Postpartum Medicaid eligibility for one year (instead of the current 60 days),
 • A pay increase for Medicaid primary care providers,
 • Permanent funding for CHIP and
 • Allow states to cover children whose family incomes exceed eligibility thresholds.

The manager’s amendment also added $2 billion in funding for innovation projects at the National Institutes of Health.
 
The bill’s Medicaid provisions would include enhanced federal funding for states that expand their programs to cover the newly eligible adult population under the Affordable Care Act, and reduce administrative funds for those that don’t. These provisions are intended to incentivize the 14 states that have not yet expanded their Medicaid programs to do so.
 
One of the more contentious provisions in the bill extended exchange eligibility, including financial subsidies to help cover the cost for health insurance plans to individuals covered by the Deferred Action for Childhood Arrivals (DACA) program.
 
Finally, the bill also allows the federal government to negotiate drug prices for certain drugs. The drug negotiation provision had previously passed the House; however, the provision was not taken up in the Senate.
 
Though Progressive Caucus members had initially threatened to oppose the bill due to the lack of the inclusion of a public option, the bill passed largely along party lines, with just one Democrat voting against the bill and two Republicans crossing party lines to support the bill.

North Carolina Debates Number of Dental Hygienists a Dentists Should be Allowed to Oversee
 
Dentists across the country are facing a backlog of patients as they begin to reopen following shutdowns due to the COVID-19 pandemic. That is no different in North Carolina, where the state’s Board of Dental Examiners recently debated allowing dentists to oversee three dental hygienists, instead of two, to help dentists deal with the backlog. According to an article in North Carolina Health and News [ [link removed] ] , board members representing larger practices tended to be more in favor of the expansion, while at least one member who owned a smaller practice stated that there was a shortage of hygienists and he was concerned that small practices would not be able to compete with larger practices if they were permitted to hire more dental hygienists. Another board member also brought up safety concerns and his belief that having more people in a dental office during the pandemic could be dangerous.
 
A decision on the matter was tabled until July. ADEA Advocacy and Government Relations will continue to monitor and provide updates as the story develops.

Iowa Governor Signs Licensure Portability Bill
 
On June 25, Iowa Gov. Kim Reynolds (R) signed a new law [ [link removed] ] that requires licensing boards in the state to issue an Iowa license to any resident or spouse of an active-duty member of the military stationed in the state, who has held a license issued by another jurisdiction that is in good standing for at least one year. The new law is similar to laws passed in Arizona [ [link removed] ] in 2019 and in Missouri [ [link removed] ] earlier this year, and may represent a trend among state legislatures as similar legislation [ [link removed] ] was introduced in Oklahoma, Ohio and Idaho.
 
The Iowa law does allow licensing boards to require applicants to pass an examination specific to the laws of the state, and establishes some minimum requirements to qualify for portability. Under the law:
 • A license must have been obtained in a jurisdiction that establishes minimum educational requirements and, if applicable, work experience, clinical supervision requirements and the passage of an examination.
 • A license must have been obtained in a jurisdiction with a substantially similar scope of practice.
 • A person must not have a complaint, allegation, investigation pending or have faced other specified disciplinary actions in the past.

ADEA State Calendar [ [link removed] ]

ADEA Washington Calendar [ [link removed] ]

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

Key Federal Issues [ [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.
 
©2020
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
202-289-7201, 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
 
[email protected] [ mailto:[email protected]?subject=State%20Update%3A%20 ]

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