Kelsey Mo, The Republic | azcentral.com
Published 11:55 a.m. MT May 17, 2018
Gov. Doug Ducey signed a bill into law Wednesday that creates a new class of dental care provider in a move intended to increase access in underserved areas of the state, including tribal lands.
Ducey signed House Bill 2235, which licenses dental therapists to work in certain circumstances under a collaborative agreement or the direct supervision of a dentist.
The bill, which the state Senate passed unanimously in April, received House approval on the final day of the session. And it passed despite criticism from many in the dental profession.
But tribal leaders, in particular, supported the measure, which they argued would help address disparities in care that have Native American adults with more than double the average rate of untreated tooth decay. The rural location of many tribes in Arizona makes it difficult to attract and retain dentists, officials said.
But state Rep. Regina Cobb, a dentist, was among its opponents. She noted dental therapists are "less-trained" providers, adding that all Arizonans should have access to the same level of care.
"I don't feel that those areas of the communities need to be treated as second-class citizens," she said.
Dental therapists are required to receive at least three academic years of instruction, compared to dentists who generally have a Bachelor’s degree and attend a four-year dental program.
A dental therapist will be able to perform 80 of the roughly 435 procedures performed by a general dentist. A collaborative practice agreement would outline the procedures each therapist can perform.
Not sure how laws are created in Arizona? Here's a brief overview. Wochit
Dental therapists can practice in urban Indian clinics or tribal health centers, community health centers, non-profit dental practices, federally qualified health centers and other locations under the new law. A federal law enacted in 2010 as part of the Affordable Care Act allowed tribes to hire dental therapists and have them operate on tribal lands; however, tribes would need to regulate the practice.
That presented a problem.
"For the most part, the tribes across the nation don't have regulatory structures to regulate a lot of health professions. They defer to the state to do that," Kim Russell, executive director of the Arizona Advisory Council on Indian Healthcare, said.
That prompted the Inter Tribal Association of Arizona to support HB 2235.
The Tohono O'odham Nation has four clinics serving between 15,000 and 16,000 patients a year at Sells Indian Hospital, San Simon, San Xavier and Santa Rosa. Dentists and assistants also travel to schools and do preventative care.
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