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Community Voices: Steven Alton's Experience with Uberly and Drug Affordability

My story is very concerning. I've been prescribed Ubrely for my severe migraine headaches this medication is $259.11 dollars for 10 pills and that is the donut hole price. I've been having migraines for about three years. It took them those three years to find a medication that would work and they tried many which made me feel like a guinea pig. Finally my doctor sent me to New Mexico Neurology. The Veterans Administration did an MRI and couldn't find anything. My neurologist said they don't understand why it happens it just does. They tried two medications one worked and one didn't. My health insurance company didn't want to pay for it because it was name brand and because of the price. My neurologist had to submit three priority authorizations which they denied. And they suggested two generic drugs that would have killed me, they finally okayed it and the Co-pay was $215.30 for 10 pills after that the price dropped to $ 66.60 for 10 pills. I have AARP Medicare Advantage because I can't afford a premium. I can't get Medicade or foodstamps because I make too much money. So the Veterans Administration helps out because I had eight years in the Military. I live on $1428.00 dollars a month I can't afford some of my drugs, rent, food, and so on because of my fixed income. And no one seems to care — not the governor, mayor, legislators, congress, not the president. They take money away from senior citizens and veterans and when we ask why they send us a form letter and say they want to help… ha !! Ha !! And drug companies want to help people get their medications but if you have Medicare or Medicaid you don't qualify for these programs. I know because my doctor and I have tried. And they still won't stop Big Pharma because 402 legislators just accepted 1.8 billion dollars for them to continue doing what they do….enough is enough! Because you're going to help me or you're not, because I can't afford these prices unless you want me dead…

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Nueva Ley, Permite acceso a Servicios Médicos Para Indocumentados en Nuevo México

Se trata de la ley HB-112, misma que lleva por nombre “Beneficios de Salud para Determinados no Ciudadanos.” La ordenanza recién fue firmada por la gobernadora Michelle Lujan Grisham y prohíbe la discriminación hacia inmigrantes en cualquier programa de cuidado médico financiado por el estado.

La ley federal excluye a muchas personas inmigrantes de programas federales tales como Medicaid, incluyendo a quienes poseen una visa, víctimas de violencia, niños y beneficiarios de DACA.

La legislatura de Nuevo México creó un sistema para que los condados y hospitales utilicen los impuestos locales para cubrir algunos costos de salud para las personas sin seguro.

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Dental therapy will be heard in Senate Public Affairs Committee on Friday, March 10!

Thanks to the dedication and persistence of all dental therapy supporters, HB 264 (Access to Dental Care Act) passed the House of Representatives by overwhelming margins!

House Health and Human Services Committee Vote: 5-0
House State Government, Indian and Veteran Affairs Vote: 9-0
NM House of Representatives Floor Vote: 60-5


Momentum is on our side and we must now get the bill through the Senate.


HB 264 is scheduled to be heard in the Senate Public Affairs Committee (SPAC) on Friday, March 10, 2017.
There is a chance that the bill will be heard on Saturday - we will keep you posted if this is the case. Please contact members of SPAC and urge them to support the bill.

Gerald Ortiz y Pino (D) 
986-4482 

Bill B. O'Neill (D)
986-4260

Craig W. Brandt (R)
986-4260

Candace Gould (R)
986-4266

Elizabeth "Liz" Stefanics (D)
986-4377

Jeff Steinborn (D)
986-4862

Mimi Stewart (D)
986-4267

Stuart Ingle (R)
986-4702

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Vermont Signs in to Law Dental Therapist Bill

A Victory in Vermont is a Victory for All
Vermont establishes the practice of dental therapists, increases access to dental care for all Vermonters.

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It took nine hundred community members and forty state organizations. It took the stories of the people and the facts that backed up their experience. It took the hard work of activists like Voices for Vermont Children. But it happened! 

We are so pleased to announce that this week, Vermont Governor Peter Shumlin signed a law that establishes the practice of dental therapists in Vermont. Vermont’s decision to authorize dental therapists is monumental step forward in this mission to make dental care more accessible. 

As we rally New Mexico residents and we urge our lawmakers to consider dental therapy as a cost-effective, scalable approach to making the dental care system work better for patients, we are thrilled to be able to point to this recent victory in Vermont. 

This innovative, team-based approach enables dental practices to increase the number of people they can serve, is cost-efficient and patient-focused. 

In the past year alone, close to a dozen states and tribes, including New Mexico, have pursued establishing these health care professionals as a way to solve deep oral health disparities and severe unmet dental needs. Dental therapists currently practice in Minnesota and on tribal land in Alaska and Washington. They are authorized to practice in Maine and will soon be practicing in Oregon under a statewide pilot program.  

And this is just the beginning! The momentum is building, and the need in New Mexico is real. Over half of all New Mexicans have advanced dental disease. One-in-three 3rd graders sit in class with untreated dental disease. And 1.3 million people live in counties that are recognized as having insufficient access to dental care. It’s time to work together to find a way to end this epidemic. It’s time to make dental therapists part of the dental care team.

We know that the victory in Vermont is a step in the right direction for our nation, and this victory provides an opportunity to continue to push for increased access to high-quality dental care in New Mexico. Just last year, the NM Dental Hygienists Association Health Action NM and the reached an agreement with the NM Dental Association to advance common ground legislation to make dental therapists part of the New Mexico dental care team. The legislation will be filed during the 2017 legislative session. We hope state leaders will rise to the occasion and make New Mexico the next state to bring high quality dental care to more of our people.

Join Health Action New Mexico as we applaud Vermont’s progress and join us as we make access to dental care a priority in New Mexico.

Word of Mouth

Standards for Dental Therapists are ready to be implemented!

by Ellie Perkins - Dental Therapy Intern at Health Action New Mexico

Big news on the dental therapy front! The Commission on Dental Accreditation (CODA), the organization responsible for accreditation of dental education facilities nationwide, adopted accreditation standards for dental therapy education programs on February 6th 2015. Now, Health Action NM, in partnership with numerous other national and local organizations, is asking CODA to begin implementing the newly adopted standards for existing and new educational programs. 

So what is keeping CODA from implementing dental therapy education accreditation? According to the American Dental Association, further information on two criteria are needed before accreditation can take place: (1) has the allied dental education area been in operation for a sufficient period of time to establish benchmarks and adequately measure performance, and (2) is there evidence of need and support from the public and professional communities to sustain educational programs in the discipline. It is the position of Health Action NM that these criteria have clearly been met in the three dental therapy training programs already operating in Alaska and Minnesota and will be met as more states establish dental therapy education programs to address the lack of access to dental care for underserved communities in their state.  The time is now to start implementing accreditation standards.  Click here to read our letter to CODA.

 

  

 
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Notes from the field: An Enrollment Outreach Worker Supports Dental Therapists

Guest post by Maria Perez

I worked on consumer outreach and education during this first open enrollment period in New Mexico. And as I talked to the uninsured about the amazing possibility of gaining health coverage, the first reaction I usually got was one of suspicion.

“Do you work for the State? For the Insurance Companies?”

This happened a lot. Once I explain, sometimes two or three times, that I work for a non-profit organization devoted to issues of health access and advocacy, people begn to warm up to the idea that maybe this Obamacare thing is actually happening, and that somehow it may actually benefit them and their families.

Then they start getting excited and asking lots of pertinent questions.

One of the most common questions I got was “Will dental be included in these plans?” It is amazing how much people have to put off getting dental care in this state! It is not uncommon to hear stories of how working families haven’t been able to get dental care in over a decade.

I tell them that Medicaid does include dental care in its plan, and the relief that I sense from these folks is intense.

But the question remains, how will so many people who have been putting off their dental care gain actual access to the services when there is such a shortage of providers? I advise them to be patient in regards to this. Yes, they will gain access to dental care, but it will take some time to come up with a workforce solution.

For this very reason, New Mexico needs Dental Therapists!

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Sobering map of NM's dental crisis

 

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There are five counties in the state of New Mexico that don't have a single dentist. And 32 of 33 counties are all, or in part, federally designated health provider shortage areas. 

It is time for this to change. Our legislators have the power to pass House Bill 306, the Dental Therapist Licensure Act bill, this week. Don't make New Mexicans wait another year.

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Maine is gaining some ground for dental health

Maine takes another big step for Dental Therapists

A major victory today in Maine – their Dental Therapy bill got initial approval from the state Senate. Earlier this week it passed the state House on Tuesday.  By conrast, last year the bill died in the Senate, losing by 7 votes. 

While they still have to have another vote next week on enactment, they got 19 votes. This means that they can lose one vote and still be safe to win 18-17.  They will need to hold those votes in the face of great pressure from the dental associations’ lobbyists.  We cannot assume this is a done deal.  However, it is great news and a huge acheivement for Maine's people.

Let's follow Maine's lead to make Dental Therapists a reality for New Mexico. 

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Maine takes another big step to improve dental access for their state. Photo source here.

 

EXERPT FROM THE ARTICLE:

Maine Senate advances bill to create ‘dental therapists’: The proposal would allow dental hygienists to perform some procedures currently performed by dentists.

AUGUSTA -- The Maine Senate on Wednesday continued to a push a bill that would allow some dental hygienists to perform some duties currently performed by licensed dentists.

The proposal, L.D. 1230, sponsored by House Speaker Mark Eves, D-North Berwick, would create a new dental health position in the state, a “mid-level dental therapist.” Proponents say the bill is an attempt to increase access to dental care, especially in rural areas. However, groups representing dentists have fiercely opposed the measure, saying the state’s current shortage of dentists will be filled.

...

Sen. John Patrick, D-Rumford, said the bill would increase dental care for poor and rural Mainers. He noted that only 12 percent of the state’s dentists currently accept MaineCare patients. MaineCare is the state’s version of Medicaid, the publicly funded health insurance program for the poor, elderly and disabled.

...

Sen. Roger Katz, R-Augusta, said he was originally ambivalent about the proposal, but not any longer. Katz said that proposal doesn’t force dentists to hire a dental therapists, but it could increase profits while expanding coverage if they do. He said that if two-thirds of the children in the state don’t have a dentists, then the current marketplace is broken.

“The status quo isn’t working,” he said. “This is the right thing for our state.”

 


The full article can be found on our Dental News feed. You can subscribe to the news feed to get real-time updates! Just click the small orange button in the top right corner.

Story from the  

 

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Once Is Chance, Twice is Coincidence, Third Time Is a Trend

This post was originally posted on the Health Policy Hub Blog.

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Rowena Ventura, director of We Are the Uninsured in Cleveland, knows firsthand the horrific effects that the lack of affordable dental care can have. She tells of how a woman she knew died on the streets after losing her job because she was unable to see a dentist and of how her own son, a roofer, wound up pulling his own tooth and losing three more after he got an infection.

Every day, millions of Americans, like those in Rowena’s life, suffer and struggle because they can’t get dental care. In 2010, 181 million children and adults went without any dental care at all.

With glaring gaps in the delivery system preventing people from getting affordable care in their community, policymakers, researchers and the media are increasingly focusing on the use of dental therapists – an evidence-based solution that can address this crisis, one that expands the ability of the dental team to treat underserved populations. In the last few weeks, we have seen a trend of independent research and support from policymakers and dentists emerge.

First, Senators Max Baucus and Charles Grassley issued a Joint Staff Report in which they note that access to dental services is a concern and empowering mid-level providers is a common-sense solution.

Dr. Richard Katz, a California dentist and business owner, raised mid-level dental providers again, in an op-ed published Aug. 6 in the Huffington Post, where he asserted that mid-levels known as dental therapists “can improve the lack of access to many Americans, as one in seven live in an area where there is very little availability. These mid-level practitioners would be able to serve more people at a lower cost.”

And, on Aug. 9, the Washington Post’s Wonkblog carried a piece by Harold Pollack that shed light on the severe problems in our dental delivery and financing system. Some 85 million Americans lack dental insurance; Pollack notes that while raising Medicaid rates for dental services is important, money alone won’t solve this problem. One important way to bring dental care to Medicaid patients, he says, is to “expand services provided by mid-level providers known as dental therapists.” Which, as a recent report released by Community Catalyst demonstrates, is exactly what dental therapists in Minnesota and Alaska are doing: increasing the capacity of safety-net providers to treat underserved populations in their communities.

Taken together, these articles and studies bring to mind the old saying, “Once is chance, twice is coincidence, third time is a trend.” Dental therapists are catching on.

Someday, the practice of dental therapists in the United States will be the norm – in much the same way that the practice of medical mid-levels such as nurse and physician practitioners is the norm today. Demographic realities and market changes will continue drive this trend. The tipping point for dental therapists will happen sooner rather than later because from a cost and access perspective, we simply can’t afford to wait.

Stay tuned for part II of this post, which will detail how dental costs are driving this issue.

- David Jordan, Dental Access Project Director, Community Catalyst

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Lemons to Lemonade: NM declared dental provider shortage is a job creation opportunity

I see facts and statistics all the time that put New Mexico at the bottom of the national list in health, education and other socioeconomic indicators. There is plenty of work to be done in our state on high school dropout rates, teenage pregnancy, children in poverty, and other areas of socioeconomic wellbeing. Oral health is no different.

The number of dental providers in New Mexico is not enough to meet current demand for dental services let alone the additional demand brought about through newly insured New Mexicans under Medicaid Expansion and the Affordable Care Act (ACA), according to a May 2013 report to the state Legislative Finance Committee.

This is not news for many of us working to bring access to dental services to all New Mexicans.  And it’s certainly not news for over 1.31 million New Mexicans, 63% of our population, who according to the report, don’t have access to a dental provider because they live in dental provider shortage areas or underserved areas of our state. 

New Mexico has a choice:

  1. We can either be depressed by the shortage of dental providers and stand frozen in a state of worsening status quo, OR
  2. We can embrace an innovative, evidence-based solution that creates jobs in NM for NM.

The Solution:  Add mid-level dental providers called “Dental Therapists” to NM’s dental team. 

In fact, one of the key findings of the report was the NM Legislature should “revisit the concept of dental therapists as an additional way to provide care to underserved areas under the supervision of dentists…" 

Dental therapists come from underserved communities and return to serve their home communities.  Dental therapists mean: 

  • Careers and livable wage jobs for all NM communities. 
  • Serving the oral health needs of their home community.
  • Keeping money in the community rather community members taking their dollars to other towns and cities.
  • Increased worker and student productivity, fewer school and work days missed because the dental therapist is in town.
  • Job opportunities at NM educational institutions with dental therapy education programs.

This makes sense for our communities. People want dental care; and they want jobs for the next generation. Schools are on board, also: at least four NM education institutions are interested in having dental therapy education programs.  (Southwestern Indian Polytechnic Institute, Northern NM College, Eastern NM University – Roswell, and Dona Ana Community College).  They see dental therapists as a viable solution both to serve their community’s oral health needs and to create new work opportunities. We can turn what is currently a sour situation into better care and increased opportunities for New Mexico communities. 

- Pamela

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