Charlie Norwood

While 2006 has been an encouraging year for dentists, there are a couple of issues that will affect us.

Currently, TRICARE, the medical health insurance program for members of the Armed Services and their dependents, will currently pay for medically necessary dental work in a hospital setting if the condition has a medical component. For example, dental work in conjunction with a car crash would be covered; but a child with a serious dental condition, or who is mentally or physically challenged and the dentist feels that the treatment should be done with the patient under general anesthesia in a hospital or ambulatory surgical setting, the family gets stuck with the hospital anesthesia cost. This imposes a serious financial burden resulting in military families postponing necessary dental treatments for their children.

I introduced legislation to correct this inequality (H.R. 5050), which was exactly included in the House version of the 2007 Defense Authorization Bill. The Senate included similar but less comprehensive language in their bill. Either bill will most likely pass and become law.

The other matter is stopping the Dental Health Aide Therapists, who perform dentistry and irreversible dental procedures, from spreading the concept out of Alaska. I am working on this with Congressman Donald Young of Alaska, and the ADA. However, the Senators from Alaska, particularly Senator Stevens, have stopped our language from getting into the bill.

As you know, the Indian Health Service (IHS) has allowed Alaskan tribes to send people to New Zealand to acquire some certificate called a "dental therapist degree." These therapists are then permitted to perform procedures that require a high degree of skill without their having the proper training or experience. IHS has ignored suggestions from the ADA and other knowledgeable health professionals to solve this problem. They have not insisted that the State of Alaska include dentistry in their Medicaid Program for the tribes. Instead, they are trying to "dumb down" our profession and to regulate these Native American citizens to having third-world dentistry.

My first solution was to remedy the 25% vacancies in the IHS dental positions by enticing recruits to the program through a currently available loan repayment program free of federal taxation. The National Health Service Corps has been doing this with success for years.

The second suggestion was to provide a pilot program and education campaign on the benefits of bottled fluoridated water to tribal areas under the direction of the IHS. It also aimed to educate the population to the health risks of overuse of soft drinks.

My final thought was to streamline the certification process for dentists who want to serve in IHS without the time-consuming re-credentialing that now exists for dental personnel to practice. Currently, the IHS credentialing is site-specific. The Department of Defense (DoD) credentials dentists through a centralized process to place them in situations where they are needed the most, at any given time. Why re-invent the wheel when the DoD procedures are already in place, working, and are successful?

The fight for Title VII funding continues to provide money to programs that are designed to train dentists who will serve the needs of underserved populations, such as rural areas. The increased funding has received much better support than when we started the fight three years ago, but it is nowhere near the levels we have requested.

The little-known Ryan White CARE Act provides $2 billion in federal funds to local and State governments to provide health care services for people affected by HIV or AIDS who cannot afford them. These funds can be used for dental care as well. Another $15 million is specifically provided for dental treatment due to the disease or the medicaments used for treating the condition. While this is not funded to the level we believe necessary, we had to pull it off the table from being totally eliminated this year. This year, we have them convinced to establish core services guidelines, which the States will have to fund 75% of the cost, and oral health care is to be a core service.

Your support of my efforts has been wonderful in the past, and I appreciate all you have done to help me in this joint effort. Call me when you get to Washington, DC, to see if I am available to have a cup of coffee with you and discuss your local dental concerns.

Sincerely,
Charlie Norwood, DDS
U.S. Representative