12 Mar IDA Legislative Update-Wrap Up 2020
So this is it: the IDA’s final legislative update of the 2020 session. I can’t say it’s been easy: from skimming over 800 submitted bills, to last-minute bill amendments, to listening to hours of citizen testimony, I have a newfound appreciation for the work our Director of Government Affairs Ed Popcheff has been doing all these years. The way I see it, change, even in the healthcare industry, is going to happen with our without us: I’m glad that we have someone down “in the muck” advocating for our members, even if the benches are uncomfortable.
As many of you know, the IDA’s Contact Dentist program has been essential to our lobbying efforts for the last several years. This year, we had over 91 dentists engaged in our legislative process and sent over 200 letters during the 2020 session. Our Contact Dentists really stepped up this year, and we are so grateful to have such active and engaged members. As we begin to draft our “plan of attack” for 2021, I look forward to continued improvement, and welcome any feedback you may have.
Below is a comprehensive list of bills we alerted you on over the past ten weeks, along with a description of its status, our actions taken, and what it all means for dentistry.
–Alex Sumner, Director of Public Affairs
HB 1067: Dental Hygiene
This dental hygienist “cleanup” bill clarifies under what circumstances hygienists and assistants can administer nitrous oxide, restates restrictions on use of a laser by a dental hygienist, and provides that a dental hygienist may administer topical local dental anesthetics, other than nitrous oxide or similar analgesics, without supervision. HB 1067 passed unanimously out of the first and second house. During the House vote where Dr. John Roberts testified, Representative Dr. Brad Barrett commented on the IDA-IDHA joint effort, stating: “I think it’s refreshing that both entities have come together and worked this out prior to it coming to committee… its very refreshing that the stakeholders have agreed on this and brought it to us in such a nice fashion.”
That feeling of cooperation and unity was certainly not happenstance. While there was originally some opposition to the nitrous oxide provisions by the Indiana Society of Anesthesiologists, Dr. Chuck Poland and IDA’s Director of Public Affairs Ed Popcheff were able to assuage and address their concerns about this bill. We would like to thank Dr. Chuck Poland and Dr. John Roberts for testifying in support of the bill at committee and house hearings. Their direct engagement in the politics of their profession sets a great example for all IDA dentists, and we are very grateful to have such politically-engaged members.
HB 1004: Health Matters
HB 1004 has been widely referred to as the “surprise billing” initiative. Authored by Representative Ben Smaltz, the bill provides that an out of network practitioner who provides health care services to a covered individual in an in network facility may not charge more for the health care services provided to a covered individual unless the out-of-network patient agrees to pay the higher cost (in a signed writing) at least five days before the procedure. While there are still quite a few specifics that need to be ironed out in the bill, the Conference Committee was able to come to an agreement late Wednesday night. While both sides of the aisle seem to be upset with the final version and how it will be implemented by providers, this public health bill hopes to better the lives of everyday citizens and make sure no one is “surprised” by the financial repercussions of healthcare.
HB 1008: Occupational Licensure Endorsement
HB 1008 gave IDA staff quite a headache this session. The bill would have destroyed barriers to licensure for regulated professions (including dentistry) and would require a board to issue a license to an individual who: (1) is licensed in another state or jurisdiction in the regulated occupation; (2) has established residency; (3) has passed a substantially equivalent examination as determined by the appropriate board. In our opinion, HB 1008 sidestepped important safeguards put in place to protect patients and bill erred by focusing on licensure rather than education. The IDA worked diligently to defeat this bill throughout the entirety of session; Director of Governmental Affairs Ed Popcheff testified against the bill during the first Employment, Labor and Pension meeting of the session and Executive Director Doug Bush reiterated our concerns in the final meeting of the Senate Commerce and Technology Committee. With the help of our many Contact Dentists, we were able to get an amendment introduced which would have exempted dentistry and several other professions but the original bill author—Representative Martin Carbaugh—objected to the amendment and took the bill all the way to Conference Committee, where it died. While the IDA encourages license transparency and mobility, it could not endorse a bill that mandated the Indiana State Dental Board to grant licenses to potentially unqualified candidates.
HB 1110: Health Workforce Student Loan Repayment Program
Representative Ethan Manning’s bill would have created (1) the health workforce student loan repayment program, (2) the health workforce council, and (3) the health workforce student loan repayment program fund. The bill was assigned to the House Public Health Committee, but was never scheduled for a hearing and died early in session. The IDA hopes to revisit this issue next session.
HB 1149: Dental screenings and services in schools
This bill would have required each school corporation to enter into one or more agreements with one or more dentists or dental groups to: (1) provide a free, annual dental screening to each student enrolled in kindergarten through grade 12 in the school corporation; and (2) make comprehensive dental services available at each school in the school corporation for students in kindergarten through grade 12. The bill was referred to the Education Committee but was never scheduled for a hearing.
SB 1: Tobacco Regulation
This bill, high on the list of the governor’s priorities and a step in the right direction for public health, raises the legal age to purchase tobacco from 18 to 21, triples the monetary penalties for retailers selling people who are underage, and revokes a tobacco license from repeat retail offenders. In addition, the bill prohibits a tobacco business from locating within 1,000 feet of a school (after June 30, 2020), and requires a seller of tobacco products to verify the age of a purchaser who appears to be less than 30 years old. SB 1 was heard in Conference Committee on Wednesday, where additional language was added to specify the penalties for tobacco possession. Thankfully, both houses were able to agree on the change and ultimately pass the bill.
SB 41: Definition of Dentistry
This IDA-sponsored bill carried by Senator Merritt would have amended current language to more closely mirror that of the ADA. Specifically, the new language would have dictated that a person “practices dentistry if the person offers to diagnose, professes to diagnose, treats, or professes to treat any lesion or disease of the oral and maxillofacial region or associated and adjacent structures.” The bill was assigned to the Senate Health and Provider Services Committee but even with the help of our many Contact Dentists was unable to get a hearing. The IDA looks forward to continued efforts on this issue going forward.
SB 98: Certified Registered Nurse Anesthetists
Prior to the legislative session, a preliminary draft of SB 98 was released and included a provision to allow dentists to supervise Certified Registered Nurse Anesthetists (CRNA). While this measure has been introduced in the past, the IDA has always asked to be removed. The bill was heard in the Senate Health and Provider Services Committee and passed out of the first house on a 30-18 vote. However, the bill was unable to get a hearing in the second house. Although it was assigned to the House Public Health Committee, it was never scheduled for a hearing.
SB 427: Provisional Occupational License
This bill, authored by Senator Brian Buchanan and coauthored by Senator Mark Messmer, allows a person who is the spouse of an active duty member of the armed forces assigned to Indiana to be issued a provisional license for the regulated occupation at the same practice level allowed by the license held by the person in the other state. The bill originally was applicable to all out-of-state applicants, but was amended in Committee to limit the potential applicants to just military spouses. After the amendment, the bill passed through the second house without issue.
SB 455: Various Education Matters
This bill, originally introduced by Senators Brian Buchanan and Dennis Kruse, addressed a variety of education matters and was amended to include allow a school corporation to enter into an agreement to provide free, annual dental screenings to students and stipulated that the agreement: (1) must provide for a free, annual dental screening to be offered to each student enrolled in the school corporation in grade 1; and (2) may, at the election of the governing body, provide for a free, annual dental screening to be offered to each student enrolled in the school corporation in kindergarten through grade 12. The bill officially “died” when it was unable to get a third reading in the House. While the IDA favors health care improvements and increased access to care, especially in young children, this slapdash compilation posed significant liability on the dentists and failed to address the overall issue of payment and care.
2020 was certainly a year for healthcare and progress down at the statehouse. We look forward to 2021 and all the change we might accomplish. If you have any suggested legislation issues or topics, please feel free to reach out to Alex Sumner or Ed Popcheff.