New Mexico's Dental Health Summit 2000: Region VI-b QIC

By Marilyn Smith

In January 2000, New Mexico's Primary Care Association (NMPCA) coordinated a statewide forum sponsored by HRSA, HCFA, and the New Mexico Department of Health's Primary Care Bureau which brought together key decision makers, state agencies, advocacy groups and other stakeholders. The purpose of the summit was to identify barriers, discuss solutions, and build broad-based support for the implementation of strategies to improve dental health care access in New Mexico.

Over 110 participants attended the summit, including representatives from various dental associations, the New Mexico public schools, HCFA, and HRSA. Two legislators, several advocacy groups who represent children with disabilities, Native American tribes and pueblos, and grassroots dental providers attended as well.

The issue of dental health access for all New Mexicans regardless of income is complex and challenging. Many dental health access issues had been addressed prior to the summit through Senate Joint Memorial 21, which amended the Dental Health Care Act by–

• allowing dental hygienists to work in "collaborative practices" with dentists
  
• explicitly requiring licensure by credential for dentists and dental hygienists without practical or clinical examination for those applicants who are duly licensed by clinical examination as a dentist or hygienist under the laws of another state, who are in good standing, and who otherwise meet the requirements of the Dental Health Care Act

The Dental Health Summit was viewed as an opportunity to continue the momentum in New Mexico and provide another source of input to the legislative process in assuring access to dental health services for all New Mexicans.
The first afternoon's large group discussion proposed an intensive review of five major areas–

1) Health promotion/disease prevention
2) Supply/demand
3) Access/infrastructure
4) Education/training
5) Finance/Medicaid/insurance issues

Topic groups were charged with evaluating these issues and proposing recommended strategies. The strategies were presented the following afternoon and approved by the general assembly.

Recommendations under the health promotion/health prevention category included–

• Promoting an early childhood caries program that addresses prenatal women and children age birth–3
  
• Encouraging innovative technology for prevention and treatment
  
• Promoting educational media campaigns
  
• Mandating the fluoridation of community water

Under the supply and demand category, recommendations included–

• Encouraging the legislature to pass legislation that encourages a dental scholarship program
  
• Supporting a tax credit or exemption as an incentive to dentists in rural areas
  
• Reinstating New Mexico's National Health Service Act to promote a greater distribution of providers
  
• Encouraging states to publicize and promote "loan for service" programs
  
• Initiating a "Dental Career Ladder" supported through community colleges
  
• Establishing dental auxiliary programs through the dental board and the community
  
• Expanding the roles of dental assistants and hygienists
  
• Expanding Medicaid's scope of practice to include participation in recruitment of dental personnel

The access/infrastructure category recommended–

• Encouraging partnerships between the private and public sector
  
• Educating the legislature to address oral health access and funding issues
  
• Promoting the use of alternative services such as mobile dental services
  
• Employing capital funds for school-based clinics, Medicaid outreach workers pay, and cost reimbursement for licensed social workers
  
• Assessing current models and improving or duplicating where feasible
  
• Promoting media participation to educate people about the disparities in access

The education and training category developed the following recommendations–

• Integrating a dental educator into Welfare to Work efforts
  
• Expanding dental training programs including those for dental hygienist
  
• Educating the general population about the need for preventive and primary dental care
  
• Encouraging collaboration among private and public sectors to support linkages between education, supply, access, finance, and health promotion and disease prevention strategies

Recommendations from the financial category included–

• Looking into ways in which Medicaid could have independent dental contracts as opposed to contracting solely with HMOs
  
• Encouraging the reduction of barriers within the payment system
  
• Advocating for pre-authorization to reduce the potential problem of dental denial
  
• Creating a current state administered database for dental providers, services, participants, and expenses
  
• Mandating the fluoridation in community water

These recommendations are viewed as necessary steps in the elimination of inadequate dental health care for many New Mexicans. A dental health coalition was created to further promote Senate Joint Memorial 21 and to work to address the recommendations of the workgroups. The goals and recommendations identified by summit participants, if acted upon by the coalition, would go a great distance toward assuring preventive and curative dental health care for those in New Mexico who presently suffer the consequences of inadequate dental health care.

Marilyn Smith is a Health Specialist, West Texas Cluster Manager, Head Start QIC, Texas Tech University – Institute for Child and Family Services, T: 800-527-2802; E: msmithrn@worldnet.att.net.