The chairwomen of the state House and Senate health committees joined forces Tuesday to push legislation aimed at providing basic dental care to hundreds of thousands of children and elderly Georgians who have limited access to a dentist.
They said it is the type of legislation the politically powerful Georgia Dental Association has fought in the past.
Under the legislation, dental hygienists would be allowed to do basic cleaning and preventive care at so-called “safety-net settings,” qualified health centers, school-based health clinics and dental offices without a dentist present.
The work would have to be authorized by a dentist. Currently, Georgia law requires that a dentist actually be present in the facility for a hygienist to do such work.
Georgia Dental Association officials said earlier this year that they were concerned about the safety of patients. Supporters of the legislation say dentists may fear it will open the way for legislation allowing dental hygienists to open their own practices and do dental care outside the supervision of a dentist.
Nicoleta Serban, a Georgia Tech researcher, told a legislative committee in August that more than 600,000 Georgia children with families on Medicaid do not live within what the state considers an acceptable distance to a dentist who accepts Medicaid patients.
House Health and Human Services Chairwoman Sharon Cooper, R-Marietta, and Senate Health and Human Services Chairwoman Renee Unterman, R-Buford, said their aim is to provide needed care to the state's most vulnerable residents, many of whom live in areas with few dentists.
“All we’re saying is why not provide more access to (dental) care? ” Unterman said. “We’ve heard lots of excuses about why this shouldn’t be done.”
Cooper said the dentists’ lobby at the Capitol — traditionally a big donor to lawmakers — backed away from its initial support of similar legislation during the 2016 session.
“This is going to be seen as being against the dentists because apparently anything you say that is not in agreement with them they see as an attack,” Cooper said. “This is about (hygienists) working with their dentist to allow them to go out into the community and help our most vulnerable citizens.”
In a statement, the GDA said Tuesday: “The Georgia Dental Association has not had an opportunity to review the proposed legislation at this time. However, the association understands the concerns and shares the General Assembly’s goal to increase dental care for underserved and needy populations in Georgia.”
As is the case of many associations that lobby for health providers, the GDA pulls some political weight at the Capitol. An Atlanta Journal-Constitution review of campaign records found the group’s lobbying association and dental practices contributed more than $825,000 to state candidates and political action committees over the past five years. And the association typically spends $7,000 to $8,000 each summer hosting key lawmakers at its annual beachside convention.
Cooper and Unterman said there simply aren’t enough dentists to go around in many areas, and particularly not enough who will handle low-income patients because they say Medicaid reimburses them at such a low rate.
Out of 4,044 dentists actively practicing in Georgia in 2012, about 22 percent accepted patients on Medicaid, the state-federal health care program for the poor and disabled. Georgia ranked 49th in the country in dentists per capita, Serban said.
She said the state could save millions of dollars annually by delivering basic preventive dental care to children of Medicaid-eligible families who don’t get services now. Unterman, a former emergency room nurse, said toothaches are one of the leading reasons the poor come to hospital emergency rooms.
Unterman called poor children and the elderly “forgotten people” in society.
“Children are because they don’t vote and they don’t contribute (campaign) money, and the elderly or the disabled because they don’t have the ability to lobby on their own behalf,” she said.
State Sen. Valencia Seay, D-Riverdale, joined the two chairwomen at a press conference Tuesday announcing the legislation, as did dentists, hygienists and other health advocates.
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