October 19, 2021
This year, the Illinois legislature was considering measures to expand oral health treatment in a state where millions of people live in dental care deserts.
But when the Illinois State Dental Society met with key lawmakers virtually for its annual lobbying day in the spring, the proposals to allow dental hygienists to clean the teeth of certain underprivileged patients without a dentist seemed doomed.
State Sen. Dave Syverson, a Republican legislative leader, warned against the bills even if they sounded minor. “It’s just getting the camel’s nose under the tent,” he said in an audio recording of the meeting obtained by KHN. “We’ll have, before long, hygienists doing the work that, if they wanted to do, they should have gone to dental school for.”
The senator added that he missed “the reception and the dinners that you guys host” and the “nice softball questions that I usually get” from the dental society’s past president, who happens to be his first cousin.
The bills never made it out of committee.
The situation in Illinois is indicative of the types of legislative dynamics that play out when lower-level health care providers such as dental hygienists, nurse practitioners and optometrists try to gain greater autonomy and access to patients. And the fate of those Illinois bills illustrates the power that lobbying groups such as the Illinois dental society have in shaping policies on where health professionals can practice and who keeps the profits.
“There’s always a struggle,” said Margaret Langelier, a researcher for the Center for Health Workforce Studies at the University of Albany in New York. “We have orthopedists fighting podiatrists over who can take care of the ankle. We have psychiatrists fighting with clinical psychologists about who can prescribe and what they can prescribe. We have nurses fighting pharmacists over injections and vaccinations. It’s the turf battles.”
In 2015, the Illinois Dental Practice Act was revised to let hygienists treat low-income patients on Medicaid or without insurance in “public health settings” — such as schools, safety-net clinics and programs for mothers and children — without a dentist examining them or being on-site. Besides doing cleanings, the hygienists can take X-rays, place sealants and apply fluoride.
This year, lawmakers proposed bills that would have expanded those settings to include nursing homes, prisons and mobile dental vans.
The state dental society, in a memo to members, wrote that the fact it took years for hygienists to develop their public health training program shows “they have no real interest in providing access to care to needy patients.”
As it is, Illinois trails many other states in allowing dental hygienists unsupervised contact with patients. In Colorado, on the extreme end, hygienists can own practices.
“It’s just the nature of the beast politically in Illinois. The dental lobby isn’t as strong in those other states,” noted Margaret Vaughn, executive director of the Illinois Rural Health Association. “The Illinois State Dental Society is much more powerful, and they’re much more organized than the hygienists are politically.”
From 2015 to 2019, the dental society spent more than $55,000 on lobbying, for its annual gathering and meals for lawmakers, typically hosted at a swanky Italian spot near the state Capitol in Springfield, according to public disclosures. In the same period, the Illinois Dental Hygienists Association reported spending nothing in its lobbying reports. (Neither group has listed any expenditures since the beginning of 2020.)
The dental society has two exclusive lobbyists and four lobbying firms on contract, state records show. The hygienist group, meanwhile, employs no lobbyists and contracts with just one firm.
The dental society donates generously to both Republicans and Democrats. Its political action committee had nearly $742,000 in cash on hand as of June 30, according to Reform for Illinois’ Sunshine Database. While the PAC has given $4,050 since 2014 to support the campaigns of state Sen. Melinda Bush, a Democrat who sponsored the nursing home bill, the database shows it has contributed far more to help elect Syverson, the senator who spoke at the conference. It has given more than $123,000 to his campaigns since 1999, with bigger annual gifts than to Bush.
“I receive contributions from many groups on both sides of issues,” Syverson emailed KHN. “They are not contributing to influence my vote on a particular bill. In fact, if a PAC sent a check while we were negotiating or voting on an issue they are involved with, I would not accept it.”
The hygienists’ PAC gave $1,100 to the campaign committee of Bush, according to the database, but nothing to Syverson. Bush did not respond to requests for comment.
“The bottom line is, if you don’t have a healthy mouth, you don’t have a healthy body,” said Ann Lynch, director of advocacy and education for the American Dental Hygienists Association. “It only makes sense that we would remove any barriers that do not allow a licensed health care provider to practice at the top of their scope.”
But Dave Marsh, a lobbyist for the Illinois dental society, said it would be dangerous for hygienists to treat nursing home residents, who are often elderly and sick.
“I just don’t feel anybody with a two-year associate’s degree is medically qualified to correct your health,” Marsh added. “They’re trained to clean teeth. They take a sharp little instrument and scrape your teeth. That’s what they do. That’s all they do.”
He said the problem is not a shortage of dental professionals but, rather, a lack of dentists who can afford to accept Medicaid patients — and “nobody wants to raise taxes to actually be able to reimburse” dentists at higher rates.
He also pointed to the scarcity of research on the benefits of dental hygienists having more professional freedom.
Langelier acknowledged that little academic literature exists on this topic, in part because of inadequate data collection on oral health. But in 2016, a study she co-authored in Health Affairs found that, as dental hygienists gained more autonomy, fewer people had teeth removed because of decay or disease. And she said Medicaid data shows more children had dental visits as hygienists expanded their practice.
“I don’t want this to be acrimonious,” said Laura Scully, chair of the access-to-care committee of the state hygienists association. “I would like it to be more of a collaboration, because truly that’s what this is about: getting together so we can help more people.”
Karen Webster works as a dental hygienist for the Tri City Health Partnership, a free clinic in St. Charles, Illinois, about 40 miles west of Chicago. In the past, she could only briefly screen patients before scheduling them with one of the center’s volunteer dentists, often months out.
“Imagine if you had a toothache and the doctor couldn’t see you that day,” she said, noting that her patients have low incomes. “They can’t afford the services. They wait till something hurts.”
But since becoming a public health dental hygienist, Webster now does immediate cleanings, takes X-rays she sends to teledentists for exams, and applies a solution called silver diamine fluoride that can halt tooth decay.
“The whole thing, start to finish, it’s just a lot more efficient,” she said.
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SPRINGFIELD – The statewide mask mandate indoors is back, and educators and health care professionals will be required to receive the COVID-19 vaccine, Gov. JB Pritzker announced Thursday amid an ongoing surge in the pandemic that first arrived in Illinois in March 2020.
Beginning Monday, people will be required to wear masks indoors, Pritzker announced.
The vaccine requirement, which goes into effect Sept. 5, will apply to “all P-12 teachers and staff, all higher education personnel, all higher education students, and health care workers in a variety of settings, such as hospitals, nursing homes, urgent care facilities and physician's offices,” Pritzker said at a news conference in Chicago.
“Effective Sept. 5, individuals working in these settings who are unable or unwilling to receive their first dose of vaccine will be required to get tested for COVID-19 at least once a week, and IDPH and (the Illinois State Board of Education) may require more frequent testing in certain situations, like in an outbreak,” he said.
Illinois Department of Public Health Director Dr. Ngozi Ezike said the state is seeing 220 hospital admissions per day, a number on par with a surge in May. Pritzker said 98 percent of cases, 96 percent of hospitalizations and 95 percent of deaths since January have been among unvaccinated people.
While vaccines are the best defense, Ezike said, “wearing a mask continues to be one of the simplest, cheapest ways to reduce the spread of COVID-19.”
Intensive care bed availability in southern Illinois is at 3 percent, he said.
“That's because the regions with the lowest vaccination rates are the regions where there are fewer hospitals, and lower hospital capacity,” Pritzker said. “And those hospitals are sometimes the least well equipped to handle cases as they become more acute.”
He added, “We are continuing to rely on experts at the (U.S. Centers for Disease Control and Prevention) and (Illinois Department of Public Health), but you don't need to be an epidemiologist to understand what's going on here. This is a pandemic of the unvaccinated.”
The current vaccination rates – nearly 53 percent of the state’s population is vaccinated – “are not enough to blunt the ferocity of the delta variant,” which has led to hospitals “again fighting the battle that we had hoped would be behind us by now.”
Republicans, meanwhile, continue to call on the governor to further involve the General Assembly in his COVID-19 response.
House Republican Leader Jim Durkin, of Western Springs, shared a letter he sent to Pritzker on Monday, noting he got a call from the governor Wednesday night seeking input on a potential response amid the new COVID-19 wave.
But, according to the letter which his office shared with members of the media, Durkin said he received a breaking news brief shortly after the phone call which outlined Pritzker’s planned announcement for the Thursday news conference.
“I will reiterate my plea on our call yesterday to please make your experts available to the General Assembly so that we can examine their data and plans, review the results of your many previous mandates and together plot a course of action that will work,” Durkin said in the letter. “You have the authority to call for a special session of both chambers to address this very critical issue, and I am imploring you to do so immediately.”
Pritzker said he’s “always been available” to GOP leadership and rank-and-file members, and “when the legislature talks to me, I listen.”
Capitol News Illinois is a nonprofit, nonpartisan news service covering state government and distributed to more than 400 newspapers statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation.
Jerry Nowicki
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Today the Pfizer Covid-19 vaccine received FDA approval.
"Today, the U.S. Food and Drug Administration approved the first COVID-19 vaccine. The vaccine has been known as the Pfizer-BioNTech COVID-19 Vaccine, and will now be marketed as Comirnaty (koe-mir’-na-tee), for the prevention of COVID-19 disease in individuals 16 years of age and older. The vaccine also continues to be available under emergency use authorization (EUA), including for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals."
Help urge ALL Congressional Representatives to put teeth in Medicare. Thank you to all who have participated in ADHA’s latest advocacy campaign to add an oral health benefit to Medicare Part B and provide coverage to the millions of seniors without access to routine preventive and restorative oral health care. We have reached 320 congressional representatives so far and we need your help to get to all 435 offices. Taking action is easy! Just click to send a message here.
The Illinois State Dental Society (ISDS) sent out a fact sheet with misinformation to their member dentists and also to IL Senators discussing the dental hygienists of Illinois, and also IDHA's intentions of the recent access to care legislation regarding the PHDH certification. This misinformation was toted and boasted about even further during a recent publicized meeting called the 2021 Capitol Conference held by ISDS on April 28, 2021.
Please review the Fact Vs. Fiction sheet created by IDHA to help squash this misinformation and bring to light the facts regarding what a PHDH is and can do. IDHA also addressed further disparaging remarks directed towards dental hygienists in IL.
Let's put this misinformation to rest once and for all and move forward with professionalism like the true professionals us dental hygienists are.
Illinois Dental Hygienists' Association and the Public Health Dental Hygienists of Illinois need YOUR'S and your friends/family's help with getting this Senate Bill passed in Illinois that will allow an expansion of practice settings to allow the PHDH to see patients in nursing homes- where dental care is vastly over looked and the elderly at high risk for aspiration pneumonia (and death from) of the oral bacteria from poor oral health. Very simple to sign a witness slip stating that you are in support of this bill passing into law. We need you to sign the slips stating PROPONENT for SB 2561! Instructions available here.
See here for the FACT SHEET regarding what this bill is about.
See here for the ISDS FACT SHEET with misleading and incorrect information about this bill and what the PHDH does, also what IDHA is trying to accomplish. IDHA will post the correct information in direct response shortly. The ISDS version was sent to their members and sent to legislators as an incorrect statement to create fear that dental hygienists want independent practice. Illinois dental hygienists are not in any way looking to gain independent practice, in fact the PHDH must be directly employed (and paid) by the dentist they hold a collaborative agreement with. Expansion of practice settings is meant to assist with the Federal health initiative of Healthy People 2030.
"Did you know" that you can read this month's IDHA President's Message here?
Take action now and encourage your Illinois House Representative and Senator to support these bills to expand the practice settings of the Public Health Dental Hygienist! HB3068 is a bill adding Prisons as an additional PHDH practice setting. HB3087 is a bill that adds Mobile Dental Vans as a PHDH practice setting. Please call and/or email your Illinois State Representative today and ask them to SUPPORT or CO-SPONSOR these bills. Having additional Representatives as bill co-sponsors provides a stronger case for our legislation when it is being heard in a committee hearing. Attached below are separate fact sheets to provide your Representative to support the additional practice settings. Mobile Vans Fact Sheet Prisons Fact Sheet Use this link to find your IL State Representative. Please email to their Springfield address. Here is a sample email that you can use to send to your Representative. Please help to spread the word to fellow colleagues so that they may assist with these advocacy efforts on behalf of dental hygienists in Illinois! "It's amazing what we can accomplish, when we're in it together." - Author Unknown
Click here to read this month's message from IDHA President Sherri Foran.
Saehae bok mani badeuseyo or Happy New Year! It is a Korean tradition to eat tteokguk or rice cake soup to celebrate the new year. It symbolizes adding another year to your age, and since the rice cakes are in coin-like shape, it also symbolizes prosperity in the new year. Although it is a tradition to eat this soup on New Year’s Day, this hot, hearty soup will also hit the spot on cold, winter days.
https://www.koreanbapsang.com/tteokguk-korean-rice-cake-soup/
This is a great traditional recipe that is very similar to my mother’s recipe.
Another plus about this soup is that there are a lot options and varieties from the kind of broth you can use to adding dumplings or other vegetables to your soup. I grew up eating this with beef broth, but you can substitute with chicken or anchovy broth, or even vegetable broth for vegetarians and vegans. I like to add pork or kimchi dumplings to my soup. This should be added and almost cooked before adding the sliced rice cakes, or else your rice cakes will be too mushy.
Pictured is one I made with chicken broth and chicken and cilantro dumplings I brought from Costco.
I can’t wait to hear how your soup turned out. Let me know what you thought about this traditional soup, and how you made it your own.
Lydia Park
Lydiap.rdh@gmail.com
2021 IDHA President-Elect
400 E. Randolph St., Suite 3115
Chicago, IL 60601(800) 550-4342www.idha.netmail@idha.net© 2024 IDHA – Illinois Dental Hygienists' Association
