The Wisconsin Hospital Association, together with Children’s Hospital of Wisconsin, Ascension-Columbia St. Mary’s and the Children’s Health Alliance of Wisconsin, testified March 22 before the Assembly Health Committee in favor of Assembly Bill 146
. Assembly Bill 146 expands the settings in which dental hygienists are allowed to provide preventive oral health care and education without dentist supervision. The bill is co-authored by Rep. Kathy Bernier (R-Lake Hallie) and Sen. Sheila Harsdorf (R-River Falls) and has 60 additional legislative co-sponsors.
Dental hygienists are currently allowed to independently practice in schools, dental schools and local public health departments. If AB 146 is enacted, dental hygienists will be able to independently provide dental hygiene services in hospitals, outpatient medical clinics, nursing homes, community–based residential facilities, hospices, prisons and jails, and through home health agencies, nonprofit dental care programs serving low-income persons, and charitable institutions.
Laura Rose, WHA vice president of policy development, told the Committee data from the WHA Information Center (WHAIC) shows that in 2015, there were 33,113 hospital emergency department (ED) visits for preventable dental conditions. In addition, there were 8,274 ED visits that same year where preventable dental conditions were not the primary presenting condition, but appeared in the ED patient record. When these two figures are combined, there were 41,387 ED patients in 2015 with a primary or secondary diagnosis of a preventable dental condition. Further, Rose cited 2015 WHAIC data showing that 56 percent of dental-related ED visits were paid for by Medicaid. She added that Wisconsin’s Medicaid reimbursement rates, which are the second lowest in the country, have created a “hidden health care tax” for Wisconsin families and businesses by shifting Medicaid costs onto private payers of health care.
One of the potential outcomes of this legislation will be the integration of dental hygiene into primary health care visits, especially for young children from birth to age three. Matt Crespin of the Children’s Health Alliance of Wisconsin told the Committee that incorporating a dental hygienist into the medical team in a physician’s office will reduce disease by allowing the hygienist to begin interacting with children and families as early as six months of age. Bill Solberg, director of community services for Ascension-Columbia St. Mary’s, noted the importance of integrating oral health and primary care. Solberg stated medical research has demonstrated the connection of oral health to overall physical health. Heart disease and diabetes are conditions that are exacerbated by inflammation and infection from periodontal gum disease. Further, according to Solberg, pregnant women are more likely to have oral infections related to pregnancy, and oral infection increases the possibility of premature delivery. Pam Fraser of Children’s Hospital cited national data that up to 79 percent of dental ED visits could be diverted to community settings if appropriate oral health care is available.
WHA expects the Committee to vote on the bill March 29 and expects swift action on it in both houses of the Legislature yet this spring.