Transcript ADHA Today and Into the Future

AACDP Symposium
Local Dental Programs: Wear
Your Wetsuit!
National Oral Health Conference
April 30, 2006
Ann Battrell, RDH, MSDH(c)
ADHA Executive Director
ADHA Mission Statement
To improve the public's total health, the mission of
the American Dental Hygienists' Association is to
advance the art and science of dental hygiene by
ensuring access to quality oral health care,
increasing awareness of the cost-effective benefits
of prevention, promoting the highest standards of
dental hygiene education, licensure, practice and
research and representing and promoting the
interests of dental hygienists.
Dental Hygiene Projections
•
U.S. Department of Labor, Bureau of Labor Statistics:
– Occupational Outlook Handbook
– Dental hygienists noted within the top 10 fastest growing
occupations and occupations having the largest numerical job
growth from 2004-2014
– Noted by level of education and training
– http://www.bls.gov/oco/ocotjt1.htm
• (retrieved 12.21.05)
Oral Health Workforce
U.S. Dept. of Labor, Bureau of Labor
Statistics: DENTISTS (general)
Industry
Total employment, all
workers
2004 employment
Projected 2014
employment
Number
Number
Number
128,000
145,000
17,000
Change, 2004-2014
%
13.5
http://data.bls.gov/
Retrieved 12.21.05
Oral Health Workforce
U.S. Dept. of Labor, Bureau of Labor
Statistics: DENTAL HYGIENISTS
Industry
Total employment, all
workers
2004 employment
Projected 2014
employment
Number
Number
Number
158,000
226,000
68,000
Change, 2004-2014
Percent
43.3
http://data.bls.gov/
Retrieved 12.21.05
Dental Health Professional Shortage
Areas (D-HPSAs)
• Critical issue
– Distribution of dental workforce
– Eliminating oral health disparities
• Pockets of underserved areas
– Rural
– Inner city
• DHPSAs increased to:
– 3296 (792 in 1993)
– 45,620,457 people affected
*SOURCE:03/06/06, Shortage Designation Branch, National Center for Health Workforce
Analysis, Bureau of Health Professions, Health Resources and Services Administration
ADVANCED DENTAL
HYGIENE PRACTITIONER
ADHA HOD RESOLUTIONS,
June 2004
• That the ADHA advocates the creation of an advanced
dental hygiene practitioner who provides diagnostic,
preventive, restorative and therapeutic services directly to
the public.
• That the ADHA supports a standardized educational
curriculum developed by the American Dental Hygienists’
Association, for the advanced dental hygiene practitioner.
ADHA HOD RESOLUTIONS,
June 2004
• That the following definition of Advanced
Dental Hygiene Practitioner be adopted:
– A dental hygienist who has graduated from an
accredited dental hygiene program and has
completed an advanced educational curriculum,
approved by the American Dental Hygienists’
Association, which prepares the dental hygienist
to provide diagnostic, preventive, restorative and
therapeutic services directly to the public.
ADHP Vision Statement
• The advanced dental hygiene
practitioner will improve the
underserved public’s health and
access to quality, cost-effective
oral health care and appropriate
referrals within multidisciplinary
healthcare teams.
Historical Perspective
Why is ADHA pursuing this?
– Access to oral health care crisis in the U.S.
– Heightened awareness for the need for a “midlevel practitioner”
– Compliments the ADHA’s commitment to resolve
health care disparities
– Workforce Supply, Demand and Distribution
Advanced Dental Hygiene
Practitioner
• Why Dental Hygienists?
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–
–
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Projected growth in workforce
Projected growth in educational programs
Market forces creating advanced practice
Advanced education already in place
• 15 MSDH Graduate programs in place
– Avoid duplication in education and training
– Potential for cost-savings in cross training
– Opportunity to revise efficiency in delivery of
oral health care
The ADHP …
• Follows the Rapid Practice Changes in the DH
Profession:
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Affiliated Practice (AZ)
Registered Dental Hygienist in Alternative Practice (CA)
Extended Care Permit RDH (KS)
Public Health Permit (ME)
Collaborative Practice RDH (MN)
Limited Access Permit with Public Health Supervision (MT)
Public Health Supervision (NH)
Collaborative Practice RDH (NM)
Public Health Endorsement (NV)
Public Health Supervision (IA)
Limited Access Permit (OR)
School Sealant Programs (WA)
The ADHP would …
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Provide primary oral health care.
•
Be competent in working with populations with special needs:
– children
– medically compromised
– adolescents and geriatric populations.
•
Be able to evaluate oral health needs of populations with limited
access to care.
•
Develop, implement and monitor dental hygiene care programs for
these populations.
•
Participate as a member of a comprehensive health care team.
The ADHP…
• From the clinical perspective:
– Including but not limited to:
• cavity preparation, performing pulpotomies and competency in
atraumatic restorative therapy (a temporary filling) among other
preventive and restorative therapies.
• From the health promotion perspective:
– Including but not limited to:
• Designing nutritional interventions, implement and evaluate
smoking cessation programs and evaluate health promotion and
disease prevention programs for specific populations.
Advanced Dental Hygiene
Practitioner (ADHP) Draft
Curriculum
Educator’s Forum – Wednesday,
June 22, 4:00-6:00 p.m.
Association Activities Forum – Friday,
June 24, 10:30-12:30 p.m.
ADHP Draft Curriculum
DOMAINS:
I.
Provision of Primary Oral Health Care
II.
Healthcare Policy and Advocacy
III.
Management of Oral Care Delivery
IV.
Translational Research
V.
Professionalism and Ethics
DOMAIN I: Provision of Primary Oral
Health Care
The advanced dental hygiene practitioner
demonstrates competence in providing
primary oral health care and case
management in diverse populations.
Practitioners use the process of care and
target the underserved including those
with special needs using a
multidisciplinary approach.
DOMAIN II: Healthcare Policy and
Advocacy
The advanced dental hygiene practitioner
contributes to health policies that address
disparities in oral health and access to
care for the underserved. The
practitioner supports and applies health
policy at the institutional, local, state,
regional, and national levels.
DOMAIN III: Management of Oral
Care Delivery
The advanced dental hygiene practitioner
integrates practice management, finance
principles, and health regulations to
analyze, design and develop initiatives that
will improve clinical outcomes, the quality
of care and patient safety. The practitioner
demonstrates effective leadership for
changing healthcare and practice
environments.
Domain IV: Translational Research
The advanced dental hygiene practitioner
uses sound scientific methods and
accesses evidence-based information
when making decisions and providing
client care.
Domain V: Professionalism and
Ethics
The advanced dental hygiene practitioner
demonstrates professional behavior and
clinical decision-making skills consistent
with dental hygiene parameters of care,
legal regulations and the ADHA Code of
Ethics. The advanced dental hygiene
practitioner possesses the values and
behaviors which promote service to the
public, professional involvement, and
lifelong learning.
In what settings do you expect the
ADHP to work?
• Hospitals
• Nursing homes
• Public health settings
• Community Health
Centers
• Federally Qualified
Health Centers
• Homebound
• Elementary and
Secondary Schools
• Other…
What level of education and credential
will be necessary for the ADHP?
• Point of entry for all
• Flexibility
– Potential exists for distance education
• Proven success in dental hygiene education
– Currently 58 degree-completion programs (35 designated with
some/all distance education)
• Master’s Degree
• Credentialing process
How will the ADHP differ from the dental
therapist or dental aide positions
available elsewhere?
• ADHA has and will continue to examine
related models
• Unique in design
• Oral health needs and U.S. health care
delivery system
Will this replace the entry-level position
for the registered dental hygienist?
• No.
• Answering an unmet public health
need.
• Intended to go beyond entry-level
education.
Where will the classes be taught?
• Curriculum development in process.
• Educational collaboration with universities.
• Credential offered through the ADHA.
What would it mean for an ADHP to serve
as a collaborative partner?
• Working with public health, allied health, and
medical professionals.
• Variety of practice settings.
• Patients to receive a well-rounded approach to
health services.
Coalition Building
• National Rural Health Association
• National Rural Education Association
• American Oral Health Association /Oral
Health Section
• Special Care Dentistry
ADHP Commentary
“Additional flexibility and
capacity of the oral heath
care workforce is sorely
needed.”
A National Call to Action to
Promote Oral Health, Office
of the Surgeon General, June
2000
“The APHA actively supports
innovative programs and
practices to help alleviate
the great unmet oral health
need…”
American Public Health
Association, December 2005
“The ADHP, a role comparable
to the nurse practitioner,
presents a timely and
appropriate way to explore
new approaches to oral
health care delivery…”
Oral Health Section,
American Public Health
Association, March 2006
“It is time to find a new way to
deliver oral health care
services; it is time to test
the feasibility of the ADHP
concept.”
National Rural Health
Association, January 2005
“The idea that got the broadest
support was expansion of scope
of practice to include simple
restorative procedures for dental
hygienists.”
--Policy Issues in Dental Workforce Diversity and CommunityBased Dental Education, November 2004
Legislative Success…
• 19 states without overly restrictive
supervision requirements
• 10 States with Medicaid provider status
• 43 States with general supervision
• 38 States that allow dental hygienists to
administer local anesthesia
ADHP Legislative Success
• July 2005: ADHP language is inserted into HR 3010, the
Fiscal Year 2006 Appropriations Bill for the Labor, Health
and Human Services.
– The language is considered ‘report language’ – it does not
carry the weight or law or appropriate any federal funding. It is
encouragement to the lead health agency, HRSA, to explore
development of the ADHP.
• July 2005: HR 3010 is passed by the Senate
Appropriations Committee.
• October 2005: HR 3010 passes the full Senate.
ADHP Legislative Success
• December 2005:
– HR 3010 passes the House – after passage in a
conference committee. (The ADHP language was not in
the House’s appropriations bill, so the 2 bills went into a
conference committee to negotiate differences in the 2
bills.)
• December 2005:
– President Bush signs HR 3010 into law. Specifically, the
final bill language “directs Departments and agencies to
be guided by the language and instructions set forth
therein…..”
ADHP Report Language
“The Committee is aware that dental disease
disproportionately affects our nation’s most vulnerable
populations, including many in rural America. New ways of
bringing oral health care to rural and underserved
populations are needed. The Committee encourages
HRSA to explore alternative methods of delivering
preventive and restorative oral health services in rural
America. Specifically, the Committee encourages HRSA to
explore development of an advanced dental hygiene
practitioner who would be a graduate of an accredited
dental hygiene program and complete an advanced
educational curriculum, which prepares the dental hygienist
to provide diagnostic, preventive, restorative and
therapeutic services directly to the public in rural and
underserved areas.”
No single oral health care profession, by
itself, can meet the needs of the public.
Only through collaborative effort of all of
us will the American public receive the
oral care it needs and deserves.
Next Steps …
• ADHP Task Force
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November 2005
January 2006
March 2006
3 meetings for 2006-2007
• Pilot project funding
• Advisory Committee
• ADEA Allied Education Working Group
– June 2006
• Your continued input!