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Legislative and Government
You Can Affect your Government
The Montana Dental Association represents your interests in the dental health policy debate at all levels of government. The MDA follows the activities of local, state, and federal officials to make sure that your interests and the dental health care needs of all Montana citizens are represented.
The Montana Dental Association helps to keep you involved in important health public policy debates and informed of the issues that affect your practice.
Mid-Session Report for 2005 Montana Legislature
The Fifty-Ninth Legislative Assembly recessed on February 23rd for its mid-session transmittal break. Legislators returned to Helena on March 1 to resume their work.
The Montana Dental Association has been closely following the activities of the Legislature. Following is a brief report on some of the bills of interest to MDA.
Amalgam Wastewater Bill
The Montana Dental Association achieved a significant legislative victory in avoiding dental amalgam wastewater regulation due in large part to its efforts in promoting best management practices (BMPs) among MDA members. HB 665, introduced by Rep. Teresa Henry (D-Missoula) provided for regulation and disposal of mercury-added products and required notification by manufacturers and sellers before mercury-added products could be sold in the state.
The bill also would have required all dental office to install mercury amalgam wastewater separators that comply with the ISO standard of 95% removal efficiency by January 1, 2007. Separators installed after that date would required a removal efficiency of 98%; dentists would have had to comply with considerable record-keeping requirements and work with the state department of public health and human services to implement a pollution prevention plan that involves mercury source reduction by July 15, 2006.
When the bill was introduced MDA executive director Mary McCue and MDA member Dr. Bill Jones, a new legislator from Bigfork, met with Rep. Henry to describe the extensive voluntary efforts the association has taken in the past nearly two years to promote best management practices (BMPs) among its members. MDA persuaded Rep. Henry to amend the bill to remove the portions related to installation of amalgam wastewater separators. The entire bill was subsequently tabled by a legislative committee and is dead for this session.
In discussing the bill with Rep. Henry, MDA was able to relate the association's volunteer efforts to encourage its members to adopt BMPs. In August 2003 MDA sent Montana dentist and board member Dr. Jill Frazier Thompson of Missoula to the ADA training program, "The Train-the-Trainer Workshop" regarding BMPs. Dr. Thompson then toured the state, teaching other MDA members about the best way to dispose of mercury amalgam wastewater. By getting out ahead of the issue MDA was able to effectively argue against mandatory installation of separators in dental offices.
HB 522: Appropriation of $10,000 for study of a regional dental education program
Rep. Bill Jones of Bigfork, dentist and newly-elected member of the House of Representatives, and Sen.Sam Kitzenberg of Glasgow, introduced HB 522, a bill to help fund a study of the University of Washington's proposal for a regional dental education program. The bill was introduced at the request of the MDA Board of Directors. The study will explore development of a de-centralized model for dental education that addresses workforce shortages and mal-distribution of dentists. The ultimate goals are to improve oral health and access to care and to ensure dental care for all Montanans, including those in rural areas
Rep. Margarett Campbell of Poplar, introduced HB 362, a bill to reduce the credentialing requirements for dentists applying for licensure in Montana. After discussion with MDA representatives and members of the Board of Dentistry, Rep. Campbell agreed to have this issue addressed by the Board in its rule-making process. Her bill was then tabled at her request and the Board of Dentistry is considering rule changes relating to credentialing.
Rep. Campbell introduced this bill to help the community of Wolf Point which has been without the services of a local dentist for some time.
She sought to reduce the period a dentist from another state would have to practice before being allowed to apply for licensure in Montana from 5 years to a shorter period.
Health care advocates, including MDA, testified in favor of HB 643, a bill to ban cigarette smoking in all public places, including schools. The bill failed to pass out of the House Human Services Committee and therefore has not yet had a hearing on the House floor.
HB 578 proposed to regulate vending machines in public school by limiting the kinds of food and beverages that could be sold in them. The bill would have prohibited schools from selling soda pop in machines. MDA and other health advocates testified in favor of this bill. However, it was tabled in committee and is now dead.
This bill is sponsored by Representative Mary Caferro of Helena and would eliminate the asset test for Medicaid children and make children eligible up to 133% FPL. The bill was amended to directly appropriate $2.1 million from the I-149 Medicaid initiatives account in FY 2007. It will have a hearing in the House Appropriations Committee.
The State Budget -- House Bill 2
HB2, the budget bill, will be heard over several days in the House Appropriations Committee. Work will commence Thursday, March 3 and continue through Tuesday, March 8. The Joint Appropriations Subcommittee on Human Services adopted the Governor's recommended budget; the Legislature will now refer to its own budget worksheets and narrative published by the Legislative Fiscal Division to continue its work on the budget.
MDA has advocated for an increase in the Medicaid reimbursement rate for dental procedures to bring the level to 90% of dentists' usual and customary charges. The Governor's budget recommends only a 10% increase in reimbursement, well short of the amount sought by MDA. As the Legislature continues its work on the state budget, MDA will continue to advocate for a significant increase in the Medicaid dental reimbursement rate.
Also included in HB 2 is funding for the Donated Dental Services Program. Since the inception of the Montana Donated Dental Services Program in 1997 the state has helped to fund the administrative costs of the program. The budget proposal of the Department of Public Health and Human Services includes $25,000 per year for funding for DDS. MDA is following the budget process to ensure the money remains in the budget.
HB 2 also includes continued funding for the dental hygiene education program in the state's university budget.
Rep. Don Roberts, Billings oral surgeon, and Sen. Sam Kitzenberg introduced a bill to use part of the tobacco tax increase passed in I-149 to fund an increase in the Medicaid dental program. The bill was heard in the House Appropriations Committee and has not yet been acted on. However, the Governor's budget does not include this level of spending for dental services from I-149 proceeds.
Implementation of I-149, Increase in Tobacco Tax
HB 667 sponsored by Representative Dave Wanzenried of Missoula, implements a portion of the initiative, I-149, by addressing the uninsured small business employee. The bill would create purchasing pools for one population, and tax credits for another. Funding comes from the health and Medicaid initiative account managed by DPHHS created by the passage of I-149 and funded by the increase of $1.00 in the tobacco tax. Portion of the increased tax generated by I-149 is also intended to fund the CHIP program, prescription drug program, and Medicaid services and provider rates.
This bill was heard February 17 in the House Taxation Committee. No action yet taken.
SB 324 sponsored by Senator Jon Tester of Big Sandy by request of the Governor, would provide for prescription drug access and information; a state pharmacy access program to complement the federal Medicare Part D Program administered by the DPHHS; and a prescription drug consumer information and technical assistance program and education outreach for consumers and professionals. The fiscal note shows the bill using $7 million of I-149 tobacco tax money in FY 2006 and $8.75 million in FY 2007.
The bill was amended to prohibit contracting with in-state or out-of-state mail service pharmacy for at least one year and to make it effective July 1, 2005. The bill passed second reading in the Senate, but was then re-referred to Senate Finance & Claims Committee for a hearing.
Bills Related to CHIP
HB 88, sponsored by Representative Mary Caferro of Helena, will allow DPHHS to create a simpler application form for CHIP. The bill passed the House and has been transmitted to the Senate.
SB 154, sponsored by Senator John Cobb of Augusta. limits the CHIP administrative and reserve costs. It passed the Senate and has been assigned to the House Human Services Committee.
SB 156, presented by Senator Mike Cooney of Helena, allows DPHHS to raise the CHIP eligibility up to 200% of the federal poverty level, as funding allows. The bill passed the Senate and has been assigned to the House Human Services Committee.
As a member of MDA you can help support the association's priority issues.
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The following sites contain more information about current topics and initiatives affecting health care in Montana and nationwide.
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