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

2. 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

3. 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.

4. 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

5. 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.

6. 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.