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Power Point presentation of issues

  1. 1. A G reat D entist Goes to Washington Review of Federal Issues for Hill Visits
  2. 2. Federal Issues <ul><li>Title VII Health Professions Programs </li></ul><ul><li>Access to Care / Health Care Reform </li></ul><ul><li>Legislation: </li></ul><ul><ul><li>Meth Mouth Prevention and Community Recovery Act (S. 450) </li></ul></ul><ul><ul><li>Dental Emergency Responder Act (H.R. 903) </li></ul></ul><ul><ul><li>Essential Oral Health Care Act (Not yet introduced) </li></ul></ul>
  3. 3. Title VII Health Professions Programs – Background and Overview <ul><li>Programs authorized by Title VII of the Public Health Service Act </li></ul><ul><li>Eight (8) major programs in total </li></ul><ul><li>Provide grants to support health professions workforce enhancement </li></ul>
  4. 4. Title VII Health Professions Programs – Background and Overview <ul><li>Two Title VII Programs of interest to dentistry: </li></ul><ul><ul><li>Training in Primary Care Medicine and Dentistry (TPCMD) Program </li></ul></ul><ul><ul><li>Public Health, Preventive Medicine, and Dental Public Health Program </li></ul></ul>
  5. 5. Training in Primary Care Medicine and Dentistry – About the Program <ul><li>Supports health professions training for five (5) disciplines </li></ul><ul><li>“General and Pediatric Dentistry” is one of the disciplines supported by the TPCMD program </li></ul><ul><ul><li>Provides grants or contracts to dental schools or other approved programs to support the planning, development, and operation of residency programs in general and pediatric dentistry </li></ul></ul>
  6. 6. Training in Primary Care Medicine and Dentistry – Historical Funding Levels <ul><li>Last reauthorized in 1998 </li></ul><ul><li>Annual funding has decreased from nearly $90 million annually to under $50 million annually from FY 2005 – FY 2008 </li></ul><ul><li>To address declining overall TPCMD Program, FY 2007 and FY 2008 Labor-HHS-Education Appropriations bills carve out $5 million for general dentistry and $5 million for pediatric dentistry </li></ul>
  7. 7. Training in Primary Care Medicine and Dentistry – FY 2009 & FY 2010 Funding <ul><li>FY 2009 Labor-HHS Appropriations – carve out of $5 million for general dentistry and $5 million for pediatric dentistry </li></ul><ul><li>American Recovery and Reinvestment Act </li></ul><ul><ul><li>$200 million in FY 2009 and FY 2010, total, for Title VII and Title VIII (nursing) </li></ul></ul><ul><ul><li>Joint Explanatory Statement indicates that funding shall be used to increase funding for the TPCMD program </li></ul></ul>
  8. 8. Training in Primary Care Medicine and Dentistry – The AGD Ask <ul><li>Thank you for carve out of $5 million in Labor-HHS Appropriations bill for general dentistry and for $200 million in ARRA for Title VII and VIII </li></ul><ul><li>Please continue to carve out specific funds for general dentistry and support continued funding for all Title VII programs at the increased level in FY 2011 and subsequent years </li></ul><ul><li>Reducing funding will: </li></ul><ul><ul><li>Be disruptive to general dentistry residency programs </li></ul></ul><ul><ul><li>Reverse gains made from the ARRA funding </li></ul></ul><ul><ul><li>Limit the number of general dentists available to serve residents of Dental Health Professional Shortage Areas </li></ul></ul>
  9. 9. Public Health, Preventive Medicine, and Dental Public Health Programs – Background and Overview <ul><li>Support various training and residency programs aimed at enhancing public health workforce development </li></ul><ul><li>The Residency Training Program in Dental Public Health: </li></ul><ul><ul><li>Provides support to assist accredited dental public health programs in: </li></ul></ul><ul><ul><ul><li>Developing new training programs </li></ul></ul></ul><ul><ul><ul><li>Maintaining or improving existing residency training programs </li></ul></ul></ul><ul><ul><ul><li>Providing financial assistance to trainees enrolled in such programs </li></ul></ul></ul>
  10. 10. Residency Training Program in Dental Public Health – Funding Levels <ul><li>Approximately $450,000 in grants provided in FY 2008 </li></ul><ul><li>Specifically identified as a program to benefit from the $200 million included in ARRA for Title VII and Title VIII programs in FY 2009 and FY 2010 </li></ul>
  11. 11. Residency Training Program in Dental Public Health – The AGD Ask <ul><li>Thank you for the funding included in ARRA </li></ul><ul><li>Please maintain these increased funding levels in FY 2011 and subsequent years </li></ul><ul><li>Reducing funding will: </li></ul><ul><ul><li>Be disruptive to dental public health training programs </li></ul></ul><ul><ul><li>Reverse gains made from the ARRA funding </li></ul></ul><ul><ul><li>Limit the number of dental public health professionals </li></ul></ul>
  12. 12. Access to Care – Health Care Reform <ul><li>Top priority for President Obama and Democratically-Controlled Congress </li></ul><ul><li>President and Congressional leaders are making concrete plans, not speaking esoterically </li></ul><ul><li>The AGD needs to be prepared to engage in this debate </li></ul>
  13. 13. Health Care Reform – How it Looked at the Start of the Year <ul><li>Coverage for uninsured and under-insured: </li></ul><ul><ul><li>Expansion of SCHIP (DONE) </li></ul></ul><ul><ul><li>Increase in FMAP (DONE) </li></ul></ul><ul><ul><li>Possible New Insurance Pools </li></ul></ul><ul><ul><li>Possible Mandate </li></ul></ul><ul><li>Funding for EMR Infrastructure (DONE) </li></ul><ul><li>Cost Containment: </li></ul><ul><ul><li>Prevention and Wellness Programs (DONE) </li></ul></ul><ul><ul><li>Comparative Effectiveness (DONE) </li></ul></ul><ul><ul><li>Value-Based Purchasing - P4P </li></ul></ul><ul><li>Medicare Improvements and Enhancements </li></ul><ul><ul><li>Physician Fee Schedule Fix </li></ul></ul><ul><ul><li>Reimbursement for Providers </li></ul></ul>
  14. 14. Health Care Reform – Key Players <ul><li>President Obama </li></ul><ul><li>Senate Finance Committee Chairman Max Baucus (D-MT) </li></ul><ul><li>House Energy & Commerce Committee Chairman Henry Waxman (D-CA) </li></ul><ul><li>Others </li></ul><ul><ul><li>Sen. Edward Kennedy </li></ul></ul><ul><ul><li>Sen. Christopher Dodd </li></ul></ul><ul><ul><li>Sen. Charles Grassley </li></ul></ul><ul><ul><li>Sen. Michael Enzi </li></ul></ul><ul><ul><li>Rep. Charles Rangel </li></ul></ul><ul><ul><li>Rep. Fortney “Pete” Stark </li></ul></ul><ul><ul><li>Rep. Frank Pallone </li></ul></ul><ul><ul><li>Rep. Joe Barton </li></ul></ul><ul><ul><li>Rep. Dave Camp </li></ul></ul>
  15. 15. Health Care Reform – President Obama <ul><li>Set aside $630 billion over 10 years in his budget as a down payment on health care reform </li></ul><ul><li>Eight Principles: </li></ul><ul><ul><li>Protect Families’ Financial Health </li></ul></ul><ul><ul><li>Make Health Coverage Affordable </li></ul></ul><ul><ul><li>Aim for Universality </li></ul></ul><ul><ul><li>Provide Portability of Coverage </li></ul></ul><ul><ul><li>Guarantee Choice </li></ul></ul><ul><ul><li>Invest in Prevention and Wellness </li></ul></ul><ul><ul><li>Improve Patient Safety and Quality Care </li></ul></ul><ul><ul><li>Maintain Long-Term Fiscal Sustainability </li></ul></ul>
  16. 16. Health Care Reform – Congress <ul><li>House Energy & Commerce: Hearings </li></ul><ul><li>Senate Finance: Roundtables </li></ul><ul><li>Tentative Schedule: </li></ul><ul><ul><li>March – May: Congressional Hearings </li></ul></ul><ul><ul><li>June – July: Congressional Markups </li></ul></ul><ul><ul><li>September – October: Floor Debate </li></ul></ul>
  17. 17. Health Care Reform: What We’re Likely to See in Democratic Plan <ul><li>Universal Coverage: </li></ul><ul><ul><li>Expansion of current programs </li></ul></ul><ul><ul><li>New public insurer </li></ul></ul><ul><ul><li>Mandate for coverage / subsidy </li></ul></ul><ul><ul><li>Mandate to provide coverage / fee </li></ul></ul><ul><ul><li>No single payer </li></ul></ul><ul><ul><li>No decoupling of health coverage from employer </li></ul></ul><ul><li>Changes in Policy </li></ul><ul><ul><li>Changes in reimbursement policy: </li></ul></ul><ul><ul><ul><li>Reductions / carrot-and-stick </li></ul></ul></ul><ul><ul><ul><li>Value-Based Purchasing </li></ul></ul></ul><ul><ul><li>Prevention and Wellness </li></ul></ul><ul><ul><li>Comparative Effectiveness </li></ul></ul><ul><ul><li>Prescription drugs </li></ul></ul><ul><ul><ul><li>Generics </li></ul></ul></ul><ul><ul><ul><li>Medicare negotiation </li></ul></ul></ul>
  18. 18. Health Care Reform: Opposition <ul><li>Opposition is expected to be fierce, though all stakeholders are engaged in the debate at this time. </li></ul><ul><li>House Republicans have little recourse - Senate Republicans are the key </li></ul><ul><li>If insurers, employers, providers, others coalesce in opposition, the health care reform debate will collapse under its own weight </li></ul>
  19. 19. Health Care Reform: Outlook <ul><li>Chances of success are limited … </li></ul><ul><ul><li>Window of opportunity is narrow </li></ul></ul><ul><ul><li>Opposition could be broad if mishandled </li></ul></ul><ul><li>But better than they ever have been </li></ul><ul><ul><li>Political stars may have aligned – 20 years from idea to implementation </li></ul></ul><ul><ul><li>Democrats in control of Federal Government </li></ul></ul><ul><ul><li>Public support (different environment from 1993 Hillary-Care debacle) </li></ul></ul><ul><ul><li>Stakeholders on board for change: Providers, Insurers, Employers </li></ul></ul><ul><ul><li>Budget is no obstacle </li></ul></ul><ul><li>“ Stronger than all the armies is an idea whose time has come.” (Victor Hugo / Everett Dirkson) </li></ul>
  20. 20. Health Care Reform: AGD <ul><li>Must be prepared for this to move forward </li></ul><ul><li>Unlike in 1993, all stakeholders are engaged – there is danger in being isolated if uninvolved </li></ul><ul><li>Unlike 1993, several opportunities to engage policymakers </li></ul><ul><li>Very important to inform and educate so that decisions are made with AGD input </li></ul><ul><li>“No, because …” vs. “Yes, if …” </li></ul>
  21. 21. Health Care Reform: AGD <ul><li>A G reat D entist Goes to Washington is the beginning of an ongoing dialogue </li></ul><ul><li>Let Members and staff know that you are ready to engage and available to participate </li></ul><ul><li>Share the White Paper – Explain that AGD staff is prepared to follow up to answer any questions / concerns </li></ul>
  22. 22. Meth Mouth Prevention and Community Recovery Act (S. 450) <ul><li>Sponsored by Sen. Baucus </li></ul><ul><li>Creates three (3) new grant programs: </li></ul><ul><ul><li>Funds grants to determine whether, how, and to what degree educating youth about meth mouth is an effective anti-drug strategy </li></ul></ul><ul><ul><li>Requires study to determine whether, how, and to what degree meth use affects demand for dental care </li></ul></ul><ul><ul><li>Supports training to ensure dentists and allied health professionals can recognize signs of substance abuse in their patients </li></ul></ul>
  23. 23. Dental Emergency Responder Act of 2009 (H.R. 903) <ul><li>Sponsored by Bart Stupak (D-MI) </li></ul><ul><li>Amends several federal disaster response programs to include dentists in the definition of “emergency response provider” </li></ul>
  24. 24. Essential Oral Health Care Act <ul><li>Not yet introduced </li></ul><ul><li>Authorizes grants to dental schools to purchase portable or mobile dental equipment and support operation of volunteer dental projects that provide free dental services </li></ul><ul><li>Increases FMAP by 25 percentage points (up to a maximum federal match of 90 percent) for states that meet various dental health goals: </li></ul><ul><ul><li>Medicaid populations have same access to dental services as the general population </li></ul></ul><ul><ul><li>Payment for dental services is made at market-based rates </li></ul></ul><ul><ul><li>At least 35 percent of practicing dentists in the state are participating in the State Medicaid program </li></ul></ul><ul><ul><li>Administrative barriers to providing dental services are reduced </li></ul></ul><ul><ul><li>State provides services for educating caregivers on the importance of oral health care and oral health care literacy issues are addressed </li></ul></ul>

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