Access to care



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PDA Position Statements

ACCESS TO CARE
HD 00-12: That the PDA is cognizant of barriers that arise from time to time which

hinder access to dental care by Pennsylvanians, and that the PDA

continue to exercise leadership in the design and implementation of dental health programs to facilitate access to quality dental care for all Pennsylvanians.
HD 03-32: That the Pennsylvania Dental Association strongly support improving the

access to care for children enrolled in the Children’s Health Insurance

Program (CHIP) by recommending to the appropriate agencies the

authorization of any dentist to treat CHIP patients without being required

to participate with any other related dental insurance plan.
HD 12-20: That the Pennsylvania Dental Association encourage all Pennsylvania

dentists to participate with Head Start Programs in their respective

communities.

DENTAL ASSISTANTS
HD 04-29: That it be the position of the Pennsylvania Dental Association that dental

assistants should be allowed to place rubber dams and matrix bands.


HD 07-27: That it is the position of the Pennsylvania Dental Association that

legislation and/or regulations concerning the practice of dental assistants

shall include the following: dental assistants would be permitted to perform

dental coronal polishing for children up to the age of 17 under the direct

supervision of the dentist. Dental assistants would be permitted to

perform fluoride treatments (including fluoride varnish) under the direct

supervision of the dentist.

DENTAL CARE FOR THE HANDICAPPED PATIENT
HD 01-33: That the Pennsylvania Dental Association encourages its members to support dentist-provided or dentist-supervised charitable dental services.

DENTAL HYGIENISTS
HD 85 18: That the PDA is opposed to the establishment of an independent state board of dental hygienists.
HD 94-28: That the position paper on “Separate Board of Dental Hygiene” be

adopted as a position of the Pennsylvania Dental Association.


HD 94-29: That the position paper on “Accreditation of Schools of Dental Hygiene” be

adopted as a position of the Pennsylvania Dental Association.


HD 94-31: That the amended position paper on “Independent Practice of Dental Hygiene” be adopted as position of the Pennsylvania Dental Association.

DENTAL LABORATORY INDUSTRY
HD 88 54 That the Pennsylvania Dental Association adopt the position statement on licensure of the dental laboratory industry.
PENNSYLVANIA DENTAL ASSOCIATION POSITION STATEMENT ON DENTAL LABORATORIES
The Pennsylvania Dental Association affirms that the dental laboratory industry is an allied member of the dental health team, operating under the direction and professional responsibility of the treating dentist. The integrity of the dental treatment plan must necessarily be maintained by dental laboratory services being rendered exclusively to the treating dentist, who provides the laboratory with authorization for the processing of prosthetic or other dental appliances, and who ultimately is responsible for the quality of dental health services rendered to the patient.
As the dentist's licensure privilege in Pennsylvania holds him/her accountable for the services of the dental laboratory industry, duplicate licensure of the dental laboratory industry is unnecessary and would not be in the best interest of the public.

DENTAL PRACTICE ACT
HD 89 28: That the Pennsylvania Dental Association supports the Dental Practice Act which prohibits diagnosis, treatment, planning and writing of prescriptions by dental hygienists and additionally the Pennsylvania Dental Association adopts the position that only licensed dentists are qualified to diagnose patients for the presence or absence of oral pathosis.
DIVERSITY
HD 06-05: That the Pennsylvania Dental Association urge district and local societies

to develop strategies that will result in delegations to the House of

Delegates that are representative of membership diversity.

EXPANDED FUNCTIONS DENTAL ASSISTANTS
HD 92-17: That the comprehensive policy statement of dental auxiliaries be adopted as the official position of the Pennsylvania Dental Association.

FLUORIDE VARNISH
HD 09-15: That the PDA support the Physician Fluoride Varnish Program for children

four years of age or younger. Physicians should obtain a basic knowledge

of oral health conditions associated with dental disease and the use of a

caries risk assessment tool. A written referral should be immediately

made to a dentist for all children determined to be a high risk for the

development of dental disease.


Be it further resolved that a copy of this resolution be forwarded to the

Department of Public Welfare which will oversee the program and which

will, with the PDA, continue to advocate for optimal oral health for all

children within the commonwealth.


Be it further resolved that the fluoride physician program is not a substitute

for comprehensive dental care and the establishment of a dental home

with a licensed dentist.

INFECTION CONTROL
HD 00-39: That it be the position of the Pennsylvania Dental Association (PDA) that a

treating dentist has the discretion to submit for accurate diagnosis of all oral lesions for biopsy to a pathologist and/or oral pathologist of his/her choice without limitation or interference from insurance companies or managed care entities.



INSURANCE
HD 07-20: That the Pennsylvania Dental Association opposes the merger of any

insurance companies or the creation of pay-for-performance programs that

would result in reduced competition in the Pennsylvania marketplace and/or

the concomitant reduction to the quality of care.


Be it further resolved that the PDA contact other professional associations

with the goal of forming a coalition to accomplish the above and to lobby

legislators to pass legislation to mandate that any health insurance made

available in any part of Pennsylvania must be available in the entire commonwealth.


LEGISLATION
HD 86 45: That PDA support legislative efforts that would prohibit the use of smokeless tobacco in the schools of Pennsylvania.
HD 03-23: That the PDA shall support legislation to limit non-economic damages in medical liability settlements.
HD 04-31: That the Pennsylvania Dental Association would support legislation to

make it a criminal offense for an individual to misrepresent their medical

history to a health care professional.
HD 07-24: That the Pennsylvania Dental Association endorse the American Dental Association’s alternative workforce models that include Community Dental Health Coordinators and Oral Preventive Assistants as part of the dental team. PDA’s support for these dental auxiliaries will be conveyed to policymakers as an alternative to independent hygiene practice.
HD 08-11: That PDA lobby the Pennsylvania Departments of Education and Health to pursue regulations that would require the state to include

oral health education in curriculum for students in kindergarten, third, seventh and eleventh grades.


HD 10-25: That PDA advocate for the passage of assignment-of-benefits

legislation in the Pennsylvania General Assembly.


HD 10-26: That PDA advocate for the passage of legislation in the Pennsylvania

General Assembly that prohibits insurers from capping non-covered

services provided by participating providers.
HD 12-21: That the Pennsylvania Dental Association adopt the following position

Statement:


That the Pennsylvania Dental Association (PDA) support legislation requiring a tax on

smokeless tobacco products as a percentage of wholesale price as a means to discourage the

use of all tobacco products. PDA supports this tax as long as the revenue does not become a

part of the general fund and rather is used for programs to reduce the morbidity and mortality

associated with tobacco-related diseases, especially oral diseases.

LICENSURE BY CREDENTIALS
HD 89 22: That the Pennsylvania Dental Association strongly supports the concept of licensure by credentials.

NURSING HOMES
HD 92-23: That the House of Delegates adopt the Policy Statement on Dental Care in Nursing Homes as a position of the Pennsylvania Dental Association.

OWNERSHIP OF DENTAL PRACTICES
HD 85-9: That the Pennsylvania Dental Association adopt the following position statement on the ownership of dental practice.
OWNERSHIP OF DENTAL PRACTICES

Dental practice acts are an exercise of the police power of the state to protect the health and safety of its citizens. These acts define the practice of dentistry, and forbid dental practice except by those natural persons who are duly qualified and licensed by the State Board of Dental Examiners. Dental care is the sum total of the diagnostic, preventive, remedial and restorative services provided to dental patients by practitioners legally authorized to perform these services. Under state dental practice acts, it is the dentist who is professionally and legally responsible for diagnosis, treatment planning and patient services. The dentist is uniquely qualified for this responsibility through professional training and licensure. In carrying out this responsibility, the dentist also makes decisions on the most effective use of dental auxiliaries within established provisions for such utilization. Because the health interests of patients are best protected when dental practices and other private facilities for the delivery of dental care are owned and controlled by members of the dental profession, all states should limit the right of ownership operation or control of a dental practice to duly licensed practitioners.



It is within the police power of the state to control and regulate the ownership and operation of a dental practice, to prescribe the qualifications of those who engage in the practice of dentistry, and to insist upon the personal obligation of individual practitioners. If persons or business entities without the requisite skill and character were permitted to own, manage or operate a dental practice, then the statutes regulating the practice of dentistry would be of no effect. The standards and ethics of dental practice, the quality of care and the cost of care would be controlled by an owner or manager who is not duly licensed or qualified to practice dentistry. The lay owner or manager would be doing indirectly what he could not do directly, and would function without the regulation of the State Board of Dental Examiners.
To protect the public health and safety, the law does not divide the practice of dentistry into professional or business components. Either one may extend into the domain of the other in ways that make such a division impractical if not impossible. Therefore, the subject is treated as a whole. If the professional and business aspects of a dental practice were divided, the proprietor of the business could be guilty of gross misconduct in its management and violate all standards which a licensed dentist would be required to observe, and yet stand immune from any regulatory supervision whatsoever. The licensed dentist, as an employee, could also be immune from discipline on the grounds that he was only an employee and was not responsible for his employer's misconduct.
If purely commercial enterprises, whose directors are not dentists, are permitted to operate, it is they who ultimately control dental practice. In this situation, the professional loyalties of the employed dentist would be shared between the employer and the patient. As a result, patients would lose the important privacy of the doctor-patient relationship. In addition, hiring practices, use of auxiliaries, advertising and other important matters would be dictated by commercial advantage rather than standards of professionalism and quality of care. Corporate profit factors could eventually influence treatment planning and other dental health considerations.
On grounds of public policy, conditions which compromise the quality of health care delivery must not be tolerated. In each state, restrictions on the ownership or control of a dental practice have been or should be enacted to protect the health, safety and welfare of the public. This end cannot be attained if purely commercial interests are permitted to weaken or destroy the protections of a dental practice act.
HD 85 10: That the Pennsylvania Dental Association affirms it belief that the health interests of patients are best protected when dental practices and other private facilities for the delivery of dental care are owned and controlled by dentists licensed in Pennsylvania.

PUBLIC INFORMATION
HD 60: The Association encourages any program to interest young people in dentistry as a career.
HD 00-31: The Pennsylvania Dental Association opposes the marketing of soft drink beverages in all elementary and secondary schools in the State of Pennsylvania. Studies have indicated that the consumption of soft drinks increases the risk of dental caries and promotes nutritional adjustment detrimental to general health. The Pennsylvania Dental Association discourages all school districts from entering into any pouring rights contracts with soft drink companies.

RADIOGRAPHY
HD 00-42: That it be the position of the Pennsylvania Dental Association that Section 33.302 of the Dental Regulations should be interpreted to allow developing of radiographs by a dental auxiliary as a procedure not needing x-ray certification.

REFERRALS AND REFERRAL SERVICES
HD 93-6: That it be the position of the Pennsylvania Dental Association that all dental referral sources which require a fee to be paid by the practicing dentist should prominently indicate in their advertising that such a fee has been paid.


STANDARD SCHOOL DENTAL RECORD
HD 09-13: That PDA support the adoption of a standard Pennsylvania school dental

record and report form.



STATE BOARD OF DENTISTRY
2/98BT136: That the Pennsylvania Dental Association believes that the public and the

profession of dentistry are best served by a state board of dentistry that includes members of the dental professions. The Pennsylvania Dental Association therefore opposes the concept of the elimination of all state licensing boards and the consolidation of the board’s powers and duties within the Bureau of Professional and Occupational Affairs.



THIRD PARTY PAYERS
HD 76 4: That the completion of a dental insurance claim form gives any third or fourth party all information necessary to determine benefit payments; and be it further resolved
That when a third or fourth party makes benefit determinations on such a claim form for services, other than those prescribed or provided by an attending dentist, by invoking "least expensive but adequate treatment" contract language, such action shall constitute an unwarranted intrusion into diagnosis and treatment; and be it further resolved
That such an intrusion into diagnosis and treatment is not in the best interest of the public for the following reasons:
1. It allows a third or fourth party to escape liability for insurance benefits which were legitimately and in good faith purchased by the patient;
2. It allows a third or fourth party to make diagnostic and treatment decisions of the sole purpose of reducing claims liability;
3. It undermines the confidence of the public in their attending dentists, who have been educated and licensed to serve as providers of dental care;
4. It will lower the quality of care provided to citizens of the Commonwealth, and be it further resolved

HD 76 26: That the Pennsylvania Dental Association recognizes that it is neither unethical or improper for appropriate charges to be made when a dentist completes a claim form, a narrative report, or other paper work requiring secretarial, clerical and professional time.


HD 01-31: That in order to assure a patient's freedom of choice of a dentist, and to

prevent third party discrimination of insured patients, the PDA is opposed

to a reimbursement differential based on a provider’s participation status. And be it further resolved that the PDA shall encourage legislative and or regulatory action to make this kind of discrimination unlawful.
HD 00-34: That the Pennsylvania Dental Association support the concept of health care provider joint negotiations or any legislation that would allow dentists to negotiate with third party payers.
HD 03-32: That the Pennsylvania Dental Association strongly support improving the

access to care for children enrolled in the Children’s Health Insurance

Program (CHIP) by recommending to the appropriate agencies the

authorization of any dentist to treat CHIP patients without being required



to participate with any related dental insurance plan.
HD 13-15: The position of the PDA is that the auditor working on behalf of the third party payers reviewing dental claims possess the same degree of training and ADA recognized specialization as the healthcare provider being audited.


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