Access to Care for the Developmentally Disabled Patient Current and Unfolding Policy, Reimbursement and Licensing Issues March 12, 2012 1/18/2019

Workgroup Members Dr. Gary Goldstein Bob Jones Dr. Jay Kumar NYS Task Force on Special Care Dentistry Bob Jones CFO, Wesley on East Dr. Jay Kumar Assistant Director, NYS Bureau of Dental Health Dr. Wayne Lipschitz Associate Professor, Eastman Institute for Oral Health Dr. Carl Tegtmeier Private Practice Dr. Richard Speisman Chief, Department of Dentistry, RGH; Workgroup Leader

Current Policies APG reimbursement Billing complexity Hospitals and Article 16 facilities not billing correctly resulting in decrease in revenue Poor/contradictory billing guidance for these facilities from the DOH Decreased reimbursement for providers delivering dental care in the OR 35% cut in provider fees on 4/10. DOH commitment to re adjust fees upward not fulfilled.

Unfolding Policies OPWDD People First Waiver (1115) “While the waiver will not have an immediate impact on the number of willing and qualified providers; the intent to incentivize collaborative alignment across providers and systems will help to, in time, to broaden the provider base.” Jill Pettingill, Psy. D. Assistant Commissioner, OPWDD Bureau of Behavioral and Clinical Solutions No input from providers No input from organized Dentistry No input from Caregivers

Post Graduate Dental Education and Licensing Training requirement for exposure to the DD patient for the dental student are stated in the American Dental Association CODA (Council on Dental Accreditation) standards. Training and exposure to the DD patient, however, is often minimal due to the increase in basic knowledge that must be presented to the dental student to meet board and licensing requirements. Educators rely on post graduate training programs for those students interested in care of the medically complex/ DD patient.

Advanced Training Programs in Dentistry Advanced training programs are charged with providing resident dentists experience in caring for patients with complex medical conditions and both intellectual and physical disabilities. The education standard is vague and leaves much of the actual training experience and curriculum development to the program directors.