Policy for sustainable oral health improvements

Spring trees and flowers bloom in front of the Washington state capitol building

Policy Director Alison Mondi shares highlights from the 2023 Legislative Session.

Washington state’s 2023 Legislative Session has concluded, and legislators are back in their home districts for the interim. It was a busy 105 days! Arcora Foundation is pleased to share the many wins for oral health and health equity.

Thanks to the dedication and advocacy of oral health providers, patient advocates, and oral health champions in the Legislature, lawmakers passed bills and budgets that support improved access to oral health care, prevention of disease, and a more robust workforce. Arcora works alongside provider organizations, patient advocates, community-based organizations, and others as we pursue meaningful systems change to reduce disparities and further oral health equity.

Here is a summary of the oral health measures that passed this session. We look forward to continued work with advocacy partners, legislative champions, and other state leaders on implementation.

Community Water Fluoridation

ESHB 1251, which requires 90 days of public notice before a decision to stop or start community water fluoridation, passed the House and Senate with unanimous votes and was signed by Gov. Inslee on April 20.

Fluoridation is an effective and equitable way to prevent tooth decay. This legislation will help ensure residents, as well as their dental and medical providers, have timely and accurate information about a decision that impacts their health and wellbeing. Thank you to prime sponsor Rep. Monica Stonier, Senate companion prime sponsor Sen. June Robinson, and everyone who advocated for this important public health measure!

“Tooth decay is preventable and yet it is the number one chronic disease facing children. Parents and providers need to know if their water system is considering changing its fluoridation status in order to take the needed steps to protect oral health, which is why I strongly support ESHB 1251.”

Dr. Elisabeth Warder, Dental Director, CHAS Health

Apple Health (Medicaid) Dental and Access to Care

The final operating and capital budgets included funding to support increased access to oral health care for Apple Health enrollees and Washingtonians who face challenges accessing dental care.

Two improvements for the Apple Health dental program will go into effect on January 1, 2024:

  • A 40% reimbursement rate increase for pediatric dental cleanings (code D1120) in the Apple Health program to support access to preventive oral health care for kids.
  • An increase in the allowable number of periodontal treatments (code D4910) to up to four per 12-month period for adult Medicaid enrollees with diabetes to support better health outcomes.

The Legislature also continued the public/private partnership for DentistLink, which works to support providers and connect more patients to care. DentistLink—fully funded by Arcora and the Washington State Health Care Authority—is a no-cost referral service that connects people with Apple Health (Medicaid) or no insurance to care.

The capital budget includes funding to increase dental clinic capacity with seven projects at six Community Health Centers. The projects will serve people with low-incomes, communities of color, and those in rural areas. Funding these projects will increase access to oral health services by providing an additional 37,503 dental appointments.

Legislators also passed SHB 1683 (Rep. Stephanie Barnard), which requires stand-alone dental carriers to pay for covered denture services, with the goal of increasing access to care.

Oral Health Workforce

Access to timely and culturally relevant care is only possible with an adequate and representative oral health workforce. We’re pleased legislators took up this issue and passed several measures aimed at increasing the oral health workforce and supporting a more diverse workforce:

  • ESHB 1503 requires collection of health care professionals’ demographic information at the time of license application and license renewal. Thank you to Rep. Marcus Riccelli for championing this measure to support better information about the composition of our workforce!
  • Several bills will make it easier for hygienists trained in other states to work in Washington: ESHB 1576 (Rep. Michelle Caldier), HB 1287 (Rep. My-Linh Thai), and ESHB 1466 (Rep. Marcus Riccelli).
  • SB 5113 permits out-of-state dentists to practice as faculty at all accredited dental schools in Washington.

“Passage of ESHB 1503 is a significant step forward to helping to identify health care gaps across our state, especially in rural areas and for historically underrepresented populations.”

Lolinda Turner, Program Manager for Dental Workforce Diversity & Inclusion, Delta Dental of Washington

In a significant milestone, legislators passed ESHB 1678 (Rep. Marcus Riccelli), which authorizes dental therapy in federally qualified health centers (FQHCs). Dental therapists are mid-level dental providers who work under the supervision of a dentist and provide prevention as well as a limited set of restorative services for patients. Dental therapy is currently only authorized in Tribal settings in Washington.

Legislators also funded several budget items to support the oral health workforce:

  • Continued funding for a University of Washington Center for Health Workforce Studies program to track dental workforce trends.
  • Funding to support the startup of the dental therapy education program at Skagit Valley College in partnership with the Swinomish Indian Tribal Community.
  • Funding for the Pacific Northwest University of Health Sciences (PNWU) School of Dental Medicine Community Health Partnership. This partnership places students in rural and underserved community settings after the first year, where they will receive hands-on clinical training observed by a supervising dentist.

None of these wins would be possible without so many partners across the state and in the Legislature who tirelessly advocate for policy changes that support providers; increase access to timely and culturally relevant care; and prevent oral disease.

If you have questions about the 2023 Legislative Session, or would like to discuss potential areas of collaboration for future legislative sessions, please reach out to AMondi@ArcoraFoundation.org.

Alison Mondi
Policy Director, Arcora Foundation

We can’t do this work without you. Advancing oral health requires public and private partnerships, policy advocacy, and funding. Join us in our mission to bend the arc of oral health toward equity. Learn more and contact us at info@arcorafoundation.org.

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