The 2011 Oregon Legislative Session finished its work on June 30, 2011.

            ODHA’s bill (HB 2384), to establish in statute the membership and authority of the Dental Hygiene Committee in the Board of Dentistry, did not pass.  Instead the Board committed to the Legislature to hold meetings of the Dental Hygiene Committee at least quarterly, and to respectfully consider its recommendations. ODHA needs to plan for issues and items that should be considered by the DH Committee as an ongoing task so that this committee can address professional and practice issues in a meaningful way.  Possible topics include expanded functions, development of new practice agreements for Expanded Practice Dental Hygienists, populations served and permitted locations for LAP/EPDH practices, and others.

            The Oral Health Coalition bill (SB 738) passed the legislature in the last few days of the session, on a party line vote in the Senate (16 – 14) and overwhelmingly (50 – 5) in the House.  The bill allows the Oregon Health Authority to establish pilot projects for Dental Therapists and Community Dental Health Educators (the ADA model).  The bill also modifies the LAP statutes as follows.  The LAP is renamed, and now these permit holders will be called Expanded Practice Dental Hygienists.  New EPDH’s applicants will need to take 40 classroom/clinic hours of classes before applying (reverting to the requirement in place before 2009), but it has been made clear that these do not have to be in subject areas specified by the Board. (The Board’s rules will have to be changed again.) If an EPDH, either a current LAP whose permit will be converted to EPDH, or a new applicant, wants to perform local anesthesia, temporary restorations, or prescribe non-steroidal analgesics or prophylactic antibiotics, the EPDH will have to enter into a Practice Agreement in a format approved by the Board.  That Practice Agreement will address assessment and referral guidelines for those services.

            Funding for oral health services (and almost all other types of services) under the Oregon Health Plan will be cut significantly in the biennial budget that starts next week.  Fee for service dental provider fee schedules will be cut 5% starting August 1.  Dental Care Organizations that are reimbursed on a per-capita basis will be cut an average of 11.2% beginning July 1. DCOs have proposed that their cuts be implemented through reductions in restorative services to adult patients, but that is still being negotiated.

            Looking forward, the Legislature returns on February 1, 2012 for a short (35 day) session.  Many difficult policy and budget decisions have been deferred to the February session.  The details on the new service delivery system for Oregon Health Plan enrollees (the new “Coordinated Care Organizations” created by the “Health Transformation” bill – HB 3650) will need to be reviewed and approved by the legislature.  Funding gaps for the second year of the biennia in many large agencies will have to be addressed.  For example, the gap in the Oregon Health Authority budget for the Oregon Health Plan in the 12 months beginning July 1, 2012 is $239.2 million General Fund.  If “Health Transformation” doesn’t realize big savings immediately through better coordination of care, more cuts in provider rates, in addition to this year’s cut of 11.2%, will be necessary.

Paul S. Cosgrove, Of Counsel
Lindsay, Hart, Neil & Weigler, LLP
220 NW Skyline Boulevard
Portland, Oregon  97210-1069
503.291.6700
503.291.6709 (fax)
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