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New Mexico Regulation and Licensing Department BOARDS AND COMMISSIONS DIVISION New Mexico Board of Dental Health Care and New Mexico Dental Hygienist Committee Toney Anaya Building ▪ P.O. Box 25101 ▪ Santa Fe, New Mexico 87505 (505) 476-4680▪ Fax (505) 476-4545 ▪ www.rld.state.nm.us

New Mexico Dental Health Care REGULAR BOARD MEETING Friday, April 24, 2015 Albuquerque, NM

MEETING MINUTES - DRAFT 1. CALL TO ORDER

At 9:40 a.m. the Board Chair, Dr. Charles Schumacher, DDS, called the New Mexico Board of Dental Health Care April 24, 2015 meeting to order.

2. ROLL CALL

MEMBERS PRESENT: Charles Schumacher, DDS Burrell Tucker, DDS Kimberly Martin, DMD Leo Paul Balderamos, DDS Jolynn Galvin, DDS Ermelinda Baca, RDH Denise Teague-Myrick, RDH Richard Hatch, Public Member

MEMBERS ABSENT: Robert Blewer, Public Member

OTHERS PRESENT: Jennifer Salazar, Assistant Attorney General

STAFF PRESENT: Roberta Perea, Board Administrator Brian McBain, Compliance Liaison Roll Call was taken by Roberta Perea and a quorum was determined present.

3. APPROVAL OF AGENDA

Ms. Ermelinda Baca, RDH made a MOTION to approve the agenda as written. Dr. Paul Balderamos, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

4. APPROVAL OF MEETING MINUTES

January 30, 2015 Regular Meeting Dr. Burrell Tucker, DDS made a MOTION to approve the minutes of the January 30, 2015 Regular Meeting as written. Ms. Denise Teaque-Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

5. REPORTS A. Chair’s Report – Dr. Charles Schumacher, DDS Written Report (Attachment A) B. Secretary’s Report – Dr. Burrell Tucker, DDS Dr. Burrell Tucker, DDS reported to the board that from January 17, 2015 through April 9, 2015 the following licenses were issued: 10 Dental licenses issued by Examination 3 Dental licenses issued by Credentials 55 Dental Assistant Certificates 1 Expanded Function Dental Auxiliary Certificates 0 Community Dental Health Coordinator Certificates 1 Non-Dentist Owner Ms. Ermelinda Baca, RDH made a MOTION to enter and ratify the Boards Secretaries report into record. Dr. Jolynn Galvin, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

C. Dental Hygienist Committee Report – Ms. Ermelinda Baca, RDH Dr. Burrell Tucker, DDS made a MOTION to ratify the recommendations of the Dental Hygienist Committee. Ms. Denise Teague- Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL. Licenses Issued for Period 01/17/15 thru 04/09/2015 6 Dental Hygienists by Examination 2 Dental Hygienists by Credentials

D. Anesthesia Committee Report – Dr. John Mitchell, DDS (Attachment B) Dr. John Mitchell, DDS reported to the board that from January 17, 2015 thru April 9, 2015 the following permits were issued: 7 Nitrous Oxide Permits, 1 Conscious Sedation I permit, 1 Conscious Sedation II permits 0 Deep Sedation/General Anesthesia permits Dr. Jolynn Galvin, DDS made a MOTION to ratify the anesthesia committee report. Dr. Balderamos, DDS, SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

E. Administrator’s Report – Ms. Roberta Perea Written Report (Attachment C) F. Compliance Liaison Report – Mr. Brian McBain Verbal Report G. CODA Report. Charles Schumacher, DDS No Report H. NMDHA Report – Ms. Mary Kay Vigil, RDH Verbal Report I. NMDA Report Verbal Report J. NM Department of Health Report – Ms. Carol Hanson, RDH

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 2 of 34 No Report K. NM Health Services Medicaid Report – Dr. Devi Gajapathi No Report (Attachment D) L. PIMA Report – Ms. Melissa McDougal-Plese No Report M. AADB – Dr. Burrell Tucker, DDS Verbal Report N. WREB Report – Ms. Ermelinda Baca, RDH Written Report (Attachment E) O. CRDTS Report –Ms. Ermelinda Baca, RDH No Report P. CDCA Report – Ms. Denise Teague- Myrick, RDH No Report Q. SRTA Report No Report R. ADEX Report Verbal Report S. CITA Report – Dr. Kimberly Martin, DMD No Report T. Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council Report Verbal Report U. Health Action New Mexico – Ms. Pamela K. Blackwell, JD Written Report (Attachment F) V. Rules Committee – Dr. Charles Schumacher, DDS Verbal Report W. Statutes Committee – Dr. Charles Schumacher, DDS No Report X. Ad Hoc Committees 1. Anesthesia Committee – Dr. Balderamos Verbal Report Y. UNM Residency Report – Peter Jensen Verbal Report

6.OLD BUSINESS A. Confirm Future Meeting Dates and Locations July Board Meeting – July 17, 2015 – Ruidoso New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 3 of 34 October Board Meeting – October 16, 2015 – Santa Fe January Board Meeting – January 29, 2015 – Santa Fe April Board Meeting – April , 2015, Albuquerque

B. Licensing Exam Correspondence/Exam Comparability – Ms. Ermelinda Baca, RDH No Action Taken

7. NEW BUSINESS A. Elections: 1. Election of Board Officers a. Chair Dr. Burrell Tucker, DDS made a MOTION to nominate Dr. Charles Schumacher, DDS as Chair of the NM Board of Dental Health Care. Dr. Paul Balderamos, DDS SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.

b. Vice Chair Mr. Richard Hatch made a MOTION to nominate Dr. Paul Balderamos, DDS as Vice Chair of the NM Board of Dental Health Care. Ms. Ermelinda Baca, RDH SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.

c. Secretary Dr. Paul Balderamos, DDS made a MOTION to nominate Dr. Burrell Tucker, DDS Secretary of the NM Board of Dental Health Care. Ms. Ermelinda Baca, RDH SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.

2. Election of Two (2) Board Representatives for Dental Hygienists Committee Dr. Kimberly Martin, DMD made a MOTION to nominate Dr. Burrell Tucker, DDS and Dr. Jolynn Galvin, DDS as Representative from the NM Board of Dental Health Care to the NM Dental Hygienist Committee. Ms. Ermelinda Baca, RDH SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.

B. Correction on Filed Rules – Jennifer Salazar & Roberta Perea No Action Taken

C. Update on 2015 Legislation – Jennifer Salazar No Action Taken

D. Board Retreat/Training – Jennifer Salazar No Action Taken E. Appointment of Dr. Jason Flores from UNM to represent the NMBDHC on the Governor’s Prescription Drug Council – Dr. Balderamos Dr. Paul Balderamos, DDS made a MOTION to appoint Dr. Jason Flores to represent the NMBDHC on the Governor’s Prescription Drug Council. Ms. Ermelinda Baca, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 4 of 34 F. Discussion and Possible Action Regarding Examiners – Dr. Balderamos No Action Taken

G. Santa Fe Mission of Mercy 2016- Dr. Balderamos Dr. Jolynn Galvin, DDS made a MOTION to approve Santa Fe Mission of Mercy on April 7-10, 2016 as a charitable event. Ms. Denise Teague-Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

H. After Hours Emergency Call- Dr. Schumacher Dr. Charles Schumacher will work on language to add to the board’s website.

I. Dental Mobile Units – Dr. Schumacher No Action Taken

J. Approval of Hearing Officers – Brian McBain Ms. Ermelinda Baca, RDH made a MOTION to approve Ms. Laura Moss, RDH as a hearing officer. Ms. Denise Teague-Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

K. Public Comment None

8. EXECUTIVE SESSION

Chair: I will hear a motion for closure of the meeting to enter into Executive Session.

Board Member Ms. Ermelinda Baca, RDH: I move that the New Mexico Dental Health Care Board close this meeting in order to enter into Executive Session to discuss the items listed in the agenda. Pursuant to Sections 10-15-1.H 1of the Open Meetings Act authorizing closed sessions for matters related to issuance, suspension, renewal, revocation of a license. Dr. Burrell Tucker, DDS SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.

Chair: Would the Board Administrator take a roll call vote to enter into Executive Session?

Roll Call Vote: Charles Schumacher, DDS Burrell Tucker, DDS Kimberly Martin, DMD Leo Paul Balderamos, DDS Jolynn Galvin, DDS Ermelinda Baca, RDH Denise Teague-Myrick, RDH Richard Hatch, Public Member – Left at 12:40 p.m. New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 5 of 34 Chair: The motion is approved by a unanimous approval. Let the record show that at 11:35 p.m. the Board entered into closed session and the recorder has been turned off.

Back in Open Session

Let the record show that the recorder is back on. The New Mexico Board of Dental Health Care is back in open session. The time is 1:58 p.m. Pursuant to 10-15-1 H 1, 3 & 7 of the Open Meetings Act the matters discussed in the closed meeting were limited only to the items listed in the motion.

9. BOARD ACTION ON MATTERS DISCUSSED IN EXECUTIVE SESSION

APPLICATIONS:

14-69-APP Dr. Burrell Tucker, DDS made a MOTION to issue the temporary license, waive the application fee, coordinate approval of license with the Anesthesia Committee’s exam team to do the office evaluation within one week of issuance of the temporary license. Denise Teague-Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL with Board Member Dr. Paul Balderamos, DDS recusing.

15-24-APP Dr. Burrell Tucker, DDS made a MOTION to Approve the Application. Dr. Jolynn Galvin, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

15-30-APP Dr. Burrell Tucker, DDS made a MOTION to Approve the Application. Denise Teague-Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

15-31-APP Dr. Burrell Tucker, DDS made a MOTION to Approve the Application. Denise Teague-Myrick, RDH SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.

15-02-APP This item was TABLED until the next meeting.

13-37-COM This item was TABLED pending further contact with respondent.

COMPLAINTS:

Dr. Burrell Tucker, DDS made a MOTION to dismiss the following case(s): 13-108-COM, 14-23- COM, 14-60-COM, 14-94-COM, 15-03-COM, 15-04-COM, 15-05-COM, 15-08-COM, 15-09-

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 6 of 34 COM, 15-07-COM, 15-14-COM, 15-15-COM: Denise Teague-Myrick, RDH SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

Dr. Burrell Tucker, DDS made a MOTION to dismiss with Advisory Letter referring to the AADA Code of Ethics, the following case: 14-57-COM: Denise Teague-Myrick, RDH SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

14-42-MAL, 14-77-MAL, 14-93-INC, 15-18-INC, 15-16-MAL: No Action was taken by the Board on these items; these items were placed on the agenda for informational purposes only.

15-20-PRA

Dr. Burrell Tucker, DDS made a MOTION to refer to the RLD Legal Counsel for an issuance of a Notice of Contemplated Action for violations of the Parental Responsibilities Act 40-5A-6 NMSA 1978, for failure to comply. Denise Teague-Myrick, RDH SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

14-54-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (30), with a proposed early resolution (pre-NCA Settlement Agreement) with the following terms: (1) Respondent shall pay a $1,000 fine to the Board within 30 days of agreement; and (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of agreement. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

14-85-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (A), with a proposed early resolution (pre-NCA Settlement Agreement) with the following terms: (1) Respondent shall apply to a remediation program with the AADB within 30 days of agreement, pending acceptance and notify the Board within 60 days of status of application. (2) Supply the Board with documentation of all correspondence, respondent shall enroll and successfully complete the program. Denise Teague- Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining and Dr. Kimberly Martin, DMD, recusing.

14-15-COM This item was TABLED pending further investigation.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 7 of 34 14-36-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (B)(30), with a proposed early resolution (pre- NCA Settlement Agreement) with the following terms: (1) Respondent shall pay a $1,000 fine to the Board within 30 days of agreement; (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of agreement; (3) Respondent shall respond to the original complaint within 30 days of agreement. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

14-87-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violations of 61-5A-21 (A)(5); 61-5A-21 (A)(6) and Rule 16.5.40.10 (G); also refer this case to the New Mexico Pharmacy Board. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

15-06-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (29), with a proposed early resolution (pre-NCA Settlement Agreement) with the following terms: Respondent shall enroll in the New Mexico MTP program and report this action to the Board within 30 days of settlement. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

15-10-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rules 16.5.16.10, (B)(6)(A), 16.5.16.10 (B)(6)(B), and 16.5.16.10 (B)(6)(C), with a proposed early resolution (pre-NCA Settlement Agreement) with the following terms: (1) Respondent shall pay a $3,000 fine to the Board within 30 days of agreement; (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of agreement. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

15-13-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for a the issuance of a Notice of Contemplated Action for violation of 61-5A-21 (A)(5) and Rules 16.5.16.10 (B)(6)(A), 16.5.16.10 (B)(6)(B), and 16.5.16.10 (B)(6)(C), with the following terms proposed for early resolution (pre- NCA Settlement Agreement): (1) Respondent shall pay a $3,000 fine to the Board within 30 days

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 8 of 34 of agreement, (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of agreement. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

15-17-COM This item was TABLED until the next meeting.

15-11-COM AB

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (B)(3), with a proposed early resolution (pre- NCA Settlement Agreement) with the following terms: Respondent shall pay a $1,000 fine to the Board within 30 days of agreement, Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of agreement. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

15-21-COM

Dr. Burrell Tucker, DDS made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (B)(18), with a proposed early resolution (pre- NCA Settlement Agreement) with the following terms: (1) Respondent shall pay a $1,000 fine to the Board within 30 days of agreement; (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of agreement; (3) Respondent shall take 4 hours of Continuing Education Courses in the subject of Pharmacology within 90 days of settlement; (4) Respondent shall enroll in the New Mexico MTP program within 30 days of settlement and report this to the Board. Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

DISCUSSION AND BOARD ACTION

12-93-COM No Action was taken by the Board on this item, this was for informational purposes only.

13-117-COM Dr. Burrell Tucker, DDS made a MOTION to dismiss the following case based on SOL Violations: Denise Teague-Myrick, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

13-69-COM Dr. Burrell Tucker, DDS made a MOTION to Approve the Pre-NCA Agreement offered by the Attorney General’s Office. Denise Teague-Myrick, RDH SECONDED the Motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Kimberly Martin, DMD, Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 9 of 34 12-68-COM No Action was taken by the Board on this item, item was not discussed.

New Mexico Monitored Treatment Quarterly Report – FYI Only

Ms. Jennifer Salazar discussed the facts and court analysis of North Carolina Board of Dental Examiners V. Federal Trade Commission. In response to the board’s questions regarding teeth whiting rules, Ms. Jennifer Salazar advised that teeth whiting is not expletively defined as the practice of dentistry in the statute, hence the board should not promulgate rules on this matter.

XI. ADJOURNMENT

There being no other business to come before the Dental Board, Dr. Kimberly Martin, DMD, made a MOTION to adjourn the meeting at 3:20pm. Ermelinda Baca, RDH, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.

Submitted by: ______Roberta Perea, Board Administrator Date Approved by: ______Charles Schumacher, DDS, Chair Date

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 10 of 34 (ATTACHEMNT A)

Chair Report April 2015

The legislature passed without any resistance a continuation of the Dental Practice Act. Senate Bill 318 extended several practice acts, including the NM Board of Dental Health Care, which will now sunset July 1, 2023, and be repealed July 1, 2024. Essentially, this means our Practice Act continues on without any changes until then, unless otherwise modified by future legislation.

SB 6, the Dental Therapy legislation, failed several times to get out of committee, and thus died. The House version of the bill passed, but met with much opposition. A Memorial (SM 136) was introduced late in the Senate, and passed, that allows for a committee to meet in the interim and make recommendations to next year’s legislature on matters of the concept of dental therapy in our state.

I have asked a representative from the Department of Health to attend our meeting on the 24th of April. The reason is for discussion on Mobile Dental Units, and how much oversight the Board or DOH should have in their practices. We certainly do not want to discourage them in any way; we just need to have proper supervision so that the public is protected.

I have asked the Anesthesia Committee to propose language for updating the guidelines for anxiolysis and sedation. If this can be finished soon, then we can plan on a Rules Hearing in October of this year.

Respectfully submitted,

Charles Schumacher, DDS

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 11 of 34 (ATTACHMENT B) 13 April 2015

The New Mexico State Board of Dental Health Care Anesthesia Committee Report for 07 April 2015:

1. The meeting of the Anesthesia Committee of the New Mexico Board of Dental Health Care was held at the office of John C. Mitchell DDS on 07 April 2015 from 1730 until 1930.

2. The minutes of the last meeting were read and discussed.

a. Members present:

i. John Mitchell Chairman

ii. Ray Lyons

iii. Gary Cutrell

iv. Wai Pong Ng

b. Members present by Phone in:

i. Aaron Rasmussen

ii. L. Paul Balderamos

iii. Jason Flores

iv. Joy Trigo

c. Members Absent:

i. Mark Yarbrough

3. A discussion regarding examinations performed and/or permits approved since the last meeting.

a. See following documentation.

4. Assignments were made for members of the Anesthesia Committee to complete of Office Anesthesia Evaluations which are pending.

5. The recommendation made by Dr. Flores about the possibility of amending the requirements for facilities and types of agents to be used for anesthesia providers. (see addendum#1 from Dr. Flores)

a. Extensive discussion of these recommended changes led to unanimous agreement that these changes to the regulations governing sedation providers be enacted by the Board of dental Health Care.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 12 of 34 b. Special emphasis was given to the recommendation that the restriction of recognized general anesthetic agents should be restricted to the use by holders of DS/GA permits.

c. There was majority agreement that the Board should no longer accept ACLS courses taken on line as meeting the criteria for certification or re-certification at the CSII or DS/GA level.

d. All agreed that CSII and DS/GA permit holder who sedate pediatric patients (under the age of 12 years) be PALS certified as well as ACLS certified.

6. Discuss how to get Office Anesthesia Evaluations for doctors and facilities in far Southeast and far Southwest New Mexico. See addendum #2:

a. No agreement could be reached as to how to make these examinations happen given the geography and difficulties brought about by distances and travel times, etc. However:

b. A recommendation was made that the Board very strongly consider having applicants sign an affidavit (see addendum #3) upon application and upon permit renewal. This is a direction taken by other states (e. g. Colorado and Texas) with geographic difficulties similar to New Mexico. The follow-on recommendation is for this to take the place of Office Anesthesia Evaluations prior to issuing permits and that random, announced and unannounced Office Anesthesia Evaluations would be conducted (possibly by the contracted examiners mentioned in addendum #2)

c. Any failure of said evaluations would constitute perjury on the part of the permit holder and should result in permanent revocation of sedation privileges.

d. Obviously, the applications for CSI, CSII and DS/GA permits would continue to receive close scrutiny.

e. The Oral and Maxillofacial Surgeons would still undergo Office Anesthesia Evaluations as mandated by the American Association of Oral and Maxillofacial Surgeons for all members of that organization.

7. The Meeting was adjourned:

Permits recommended for approval since last committee meeting:

A. Nitrous Oxide/ Oxygen

a. Mital Amin El Paso, TX

b. Monica Dahiya Peoria, IL

c. Elizabeth Stockton Albuquerque

d. Henry Truong Santa Fe

e. Hojoong Ryu Albuquerque

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 13 of 34 f. Jared VandeMeyden Houston, TX

g. Jonathan Gifford Albuquerque

h. Seth Stockton Albuquerque

i. Tony Le Santa Fe

j. Kee Ju Hong Albuquerque

B. CSI:

a. Chun-Xiao Sun Albuquerque Permanent (Initial)

b. Alicia Abeyta Albuquerque Permanent (Renewal)

c. Cameron Hatch

i. 111 Coors Blvd NW Albuquerque Permanent (Initial)

ii. 201 San Pedro SW Albuquerque Permanent (Initial)

iii. 3510 Coors Blvd SW Albuquerque Permanent (initial)

d. Howard Rhoads Artesia Permanent (Renewal)

e. Michael Lysonski Albuquerque Permanet (Initial)

f. Phillip Abshere

g. Richard Rowan:

h. Kaitlyn Purcell

i. 201 San Pedro SW Albuquerque Permanent (Initial)

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 14 of 34 ii. 3510 Coors Blvd SW Albuquerque Permanent (initial)

C. CSII

a. Adam Bunker Clovis Temporary (Initial facility permit- will use CRNA’s)

b. Logan Behrman Alamagordo Temporary (Initial)

c. Christian Anderson Bloomfield Temporary (Renewal)

d. Cody Coleman Kirtland Temporary (Renewal)

D. DS/GA

a. David Eric Tuggle Albuquerque Temporary (Renewal)

Office Anesthesia Evaluations Completed

A. CSII

a. Keigm Crook Albuquerque Permanent (Renewal)

b. Michael Tornow Rio Rancho Permanent (Renewal)

B. DS/GA

a. Sean Healy Santa Fe Permanent (Initial)

Office Anesthesia Evaluations Pending:

A. CSII

a. Logan Behrman Alamagordo Initial (Aug ‘15)

b. Venkata Nalla Hobbs Initial (Jun ’15)

c. Kendra Velasquez Rio Rancho Initial (Jun ’15)

d. Christian Anderson Bloomfield Renewal (Aug ’15)

e. Cody Coleman Kirtland Renewal (Aug ’15)

f. Adam Bunker Clovis Initial (Aug ’15)

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 15 of 34 B. DS/GA

a. Sean Healy

i. Taos Initial-Facility only

ii. Los Alamos Initial-Facility only

b. Nathan Gunning Portales Initial-Facility only

c. Jon Wagner Albuquerque Initial (April ’15)

d. Jeremy Hixson Farmington Initial (Jun ’15)

e. David Eric Tuggle Albuquerque Renewal (Sep ’15)

Addendum #1

16.5.15.11 ADMINISTRATION OF CONSCIOUS AND DEEP SEDATION: The following three categories of anesthesia shall not be administered in a dental facility unless the licensed dentist has obtained a permit from the board. The conscious sedation II and deep sedation/general anesthesia permits are issued to the dentist for a specific practice location, unless the anesthesia provider holds an anesthesia permit at large. Administration without a permit is grounds for disciplinary action against the licensee.

A. Conscious sedation I permit allows a licensed dentist to use only oral or rectal medications or combined inhalation-enteral conscious sedation to obtain conscious sedation on an outpatient basis for dental patients. B. Conscious sedation II permit allows a licensed dentist to use parenteral injection to obtain conscious sedation on an outpatient basis for dental patients. C. Deep sedation/general anesthesia permit allows a licensed dentist to use deep sedation or general anesthesia on an outpatient basis for dental patients. (1) A dentist without a deep sedation/general anesthesia permit shall not administer or employ any agent(s) which has a narrow margin for maintaining consciousness, or is federally classified as an anesthetic including, but not limited to, (a) Ultra short acting barbiturates including, but not limited to, sodium methohexital, thiopental, thiamylal; (b) Alkylphenols — propofol (Diprivan) including precursors or derivatives; (c) Neuroleptic agents; (d) Dissociative agents — i.e. ketamine; (e) Etomidate; and similarly acting drugs (f) Rapidly acting steroid or anti-histamine IV preparations; or and (g) Volatile inhalational agents. (h) Or quantity of agent(s), or technique(s), or any combination, thereof, that would possibly render a patient deeply sedated or generally anesthetized These drugs/techniques are conclusively presumed to produce general anesthesia and may only be used by a licensee holding a valid deep sedation/general anesthesia permit issued by the board.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 16 of 34 (2) A licensee that does not hold a deep sedation/general anesthesia permit may not, for the purpose of anxiolysis or sedation, administer benzodiazepines or narcotics in children under 12 years of age via parenteral routes. D. Permit levels: The level of permits in order of increasing complexity are conscious sedation I, conscious sedation II, and deep sedation/general anesthesia. When a permit is issued for one a higher level, all levels of lesser complexity are considered within the scope of that permit.

… 16.5.15.12 PERMIT REQUIREMENTS: … C. Deep sedation/general anesthesia: (1) To administer deep sedation/general anesthesia, the dentist must satisfy one of the following criteria: (a) completion of an advanced training program in anesthesia and related subjects beyond the undergraduate dental curriculum that satisfies the requirements described in part II of the current ADA guidelines for teaching and comprehensive control of anxiety and pain in dentistry; (b) completion of an ADA accredited post-doctoral training program (e.g. oral and maxillofacial surgery, dental anesthesiology), which affords comprehensive and appropriate training necessary to administer and manage deep sedation/general anesthesia, commensurate with these rules; (c) current permit holders would be grandfathered by New Mexico laws in effect at the time of original issue of their permit. (moved to (f))

(c) verify appropriate training for the level of anesthesia being provided (formal documentation from the anesthesia training program verifying at least 50 DS/GA cases in the patient age population served) (d) verify appropriate case documentation for pediatric (age 12 and under) cases if anesthesia is to be provided to children (formal documentation from the anesthesia training program verifying at least 50 DS/GA pediatric cases and 1 month rotation dedicated to pediatric anesthesia) (e) Anesthesia for children (age 12 and under) must be provided in a facility that is large enough to accommodate the patient in an operating chair/table, permit easy movement of the anesthesia and surgical team, and allow for easy access of emergency wheeled equipment (In compliance with current AAOMS Office Anesthesia Evaluation Manual recommended operatory standards) (f) current permit holders would be grandfathered by New Mexico laws in effect at the time of original issue of their permit.

(2) For any anesthesia provider, dentist, physician, nurse anesthetist, anesthesia assistant providing deep sedation/general anesthesia in a dental office, the operatory in which anesthesia will be administered must: a. have a site certification issued by the NM Anesthesia Board b. be large enough to accommodate the patient in an operating chair/table, permit easy movement of the anesthesia and surgical team, and allow for easy access of emergency wheeled equipment (In compliance with current AAOMS Office Anesthesia Evaluation Manual recommended operatory standards) A dentist who does not hold a deep sedation/general anesthesia permit may not allow any persons to administer anesthesia to his/her patients unless the treatment is rendered in a facility that meets the above size requirement. (3) The office is staffed with supervised clinical auxiliary personnel capable of handling procedures, problems and emergencies incident thereto.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 17 of 34 (4) The dentist and auxiliary clinical personnel have current basic life support certification. (5) The patient's record shall reflect that the pre-operative patient evaluation, pre-operative preparation, monitoring recovery, discharge and documentation was performed in accordance with the current ADA guidelines for the use of conscious sedation, deep sedation and general anesthesia for dentists. (6) The dentist passes the examination and receives approval after facility inspection by the anesthesia committee or designated examiner. (7) The following rules shall apply to the administration of deep sedation/general anesthesia in the dental office.

Addendum #2:

Please see the Statute Below 61.5A.10 Powers and Duties of the Board - these are used for the answers questions 2 and 3

1. The committee feels the board should be charging more than the current $300.00 fee and would like to charge $3,000.00 Pursuant to 61.5A.20 the board cannot exceed the $300,00 administrative fee, I talked to the boards attorney, Jennifer Salazar, we discussed changing the fee to $300.00 for an application fee & $300.00 office evaluation fee. If someone fails, the rules say that they will need to reapply, we would charge the fees again for the new application and office evaluation fee. This will increase the board’s revenue, but this will not help with the needs of the anesthesia committee. The revenue that is brought in every year is not used for the board’s expenditures, the legislature gives the board an operating budget each year based on the board needs. This money brought in cannot be used for office evaluation reimbursements.

2. Increase the amount that is paid to the committee members since they are loosing revenue when having to do office evaluations

Pursuant to 61.5A.10 (K) & (J) committee members will receive per diem according the mileage and per diem act, this only allows members to be reimbursed at the rate of $85.00 per diem (for overnight stays) or $95.00 stipend (day trips and meetings) and mileage. If we are going to reimburse for actual costs for lodging, meals and mileage we will need to get prior approval from the RLD Superintendent. I understand this is minimal but unfortunately we are only allowed to reimburse members according to the mileage and per diem act.

3. Pursuant to 61.5A.10 (I) the board's attorney suggested that we contract dentists to do office evaluations, we would have to contract with someone or several people who are not on the committee, we were thinking maybe retired dentists who held CSII or Deep/GA permits. If this is feasible we need to request additional funds for FY17 and go through the procurement process, this may delay evaluations until the contracts and purchase orders are approved. This means the committee will need to continue to do the office evaluations for FY16 (July 2015 - June 2016) until contracts are approved. If the board has extra funds we may be able to work on the contracts for FY16. Please let me know since we will be working on FY17 appropriation requests soon.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 18 of 34 Roberta and I discussed all these issues with Dr. Baldaramos, but I don’t know if he discussed them with the committee.

If you feel you want me to attend the meeting, please let me know what time and the location. It would be a pleasure to finally meet you. The board and staff are grateful to the committee's dedication and hard work.

Kathy Ortiz

61-5A-10. Powers and duties of the board and committee. (Repealed effective July 1, 2016.) In addition to any other authority provided by law, the board and the committee, when designated, shall:

A. enforce and administer the provisions of the Dental Health Care Act; B. adopt, publish, file and revise, in accordance with the Uniform Licensing Act [61-1-1 NMSA 1978] and the State Rules Act [14-4-1 NMSA 1978], all rules as may be necessary to:

(1) regulate the examination and licensure of dentists and, through the committee, regulate the examination and licensure of dental hygienists;

(2) provide for the examination and certification of dental assistants by the board;

(3) provide for the regulation of dental technicians by the board;

(4) regulate the practice of dentistry, dental assisting and, through the committee, regulate the practice of dental hygiene; and committee, as appropriate;

(5) provide for the regulation and licensure of non-dentist owners by the board; C. adopt and use a seal; D. administer oaths to all applicants, witnesses and others appearing before the board or the committee, as appropriate; E. keep an accurate record of all meetings, receipts and disbursements; F. grant, deny, review, suspend and revoke licenses and certificates to practice dentistry, dental assisting and, through the committee, dental hygiene and censure, reprimand, fine and place on probation and stipulation dentists, dental assistants and, through the committee, dental hygienists, in accordance with the Uniform Licensing Act for any cause stated in the Dental Health Care Act; provide for the regulation and licensure of non-dentist owners by the board; adopt and use a seal; administer oaths to all applicants, witnesses and others appearing before the board or the G. grant, deny, review, suspend and revoke licenses to own dental practices and censure, reprimand, fine and place on probation and stipulation non-dentist owners, in accordance with the Uniform Licensing Act, for any cause stated in the Dental Health Care Act; H. maintain records of the name, address, license number and such other demographic data as may serve the needs of the board of licensees, together with a record of license renewals, suspensions, revocations, probations, stipulations, censures, reprimands and fines. The board shall make available composite reports of demographic data but shall limit public access to information regarding individuals to their names, addresses, license numbers and license actions or as required by statute; I. hire and contract for services from persons as necessary to carry out the board's duties; J. establish ad hoc committees whose members shall be appointed by the chair with the advice and consent of the board or committee and shall include at least one member of the board or committee as it deems necessary for carrying on its business; K. have the authority to pay per diem and mileage to individuals who are appointed by the board or the

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 19 of 34 committee to serve on ad hoc committees; L. have the authority to hire or contract with investigators to investigate possible violations of the Dental Health Care Act; M. have the authority to issue investigative subpoenas prior to the issuance of a notice of contemplated action for the purpose of investigating complaints against dentists, dental assistants and, through the committee, dental hygienists licensed under the Dental Health Care Act; N. have the authority to sue or be sued and to retain the services of an attorney at law for counsel and representation regarding the carrying out of the board's duties; O. have the authority to create and maintain a formulary, in consultation with the board of pharmacy, of medications that a dental hygienist may prescribe, administer or dispense in accordance with rules the board has promulgated; and P. establish continuing education or continued competency requirements for dentists, certified dental assistants in expanded functions, dental technicians and, through the committee, dental hygienists.

Addendum #3:

APPLICANT NAME ______

AFFIDAVIT OF APPLICANT APPLICATION

CONSCIOUS SEDATION 1, CONSCIOUS SEDATION 2,

DEEP SEDATION/GENERAL ANESTHESIA PERMITS

I, the below named applicant, hereby declare under penalty of perjury that I am the person described and identified in this application and that my answers and all statements made by me on this application and accompanying attachments are true and correct. Should I furnish any false information, or have substantial omission, I hereby agree that such an act shall constitute cause for denial, suspension, or revocation of my license or personal/ facility permit to provide Conscious Sedation 1, Conscious Sedation 2, or Deep Sedation/General Anesthesia permanently and without recourse for reapplication. I also declare that if I did not personally complete the foregoing application that I have fully read and confirmed that I have fully read and confirmed each question and accompanying answer, and take full responsibility for all answers contained in this application.

I understand that I have no legal authority to administer Conscious Sedation 1, Conscious Sedation 2, or Deep Sedation/General Anesthesia until a permit has been granted.

I certify that I am trained and capable of administering Basic Life Support and certify that I am trained and capable of administering Advanced Cardiac Life Support if I provide sedation exclusively for adult patients and certify that I am trained and capable of administering Pediatric New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 20 of 34 Advanced Life Support if I provide sedation for children under twelve (12) years of age or younger.

I certify that I employ qualified auxiliary personnel that are trained in and are capable of monitoring vital signs, assisting in emergency procedures, and administering basic life support.

I understand that if a patient enters a deeper level of sedation than what I am qualified to provide, I must stop the dental procedure until the patient returns to the intended level of sedation. I understand that I am responsible for the sedative management, adequacy of the facility and staff, diagnosis and treatment of emergencies and providing the equipment and protocols for patient rescue. I understand that I must be able to rescue patients who enter a deeper state of sedation than intended and must be prepared to treat emergencies that may arise.

I understand that if I perform a procedure for which Conscious Sedation 1, Conscious Sedation 2, is being employed I shall not administer the pharmacologic agents prohibited in TITLE 16. OCCUPATIONAL AND PROFESSIONAL LICENSING, CHAPTER 5. DENTISTRY. PART 15. DENTISTS, ANESTHESIA ADMINISTRATION and shall not administer pharmacologic agents or monitor the patient without the presence and assistance of at least one additional person trained in Basic Life Support for Healthcare Providers.

I understand that if I perform a procedure for which Deep Sedation/General Anesthesia is being employed that I shall not administer the pharmacologic agents and monitor the patient without the presence and assistance of two additional individuals who have current certification in Basic Life Support for Healthcare Providers.

I am aware that in signing this form, I declare that the appropriate (defined by current standards of care set by the AAOMS, Office Anesthesia Evaluation Manual, current edition) equipment, emergency supplies, and conditions are met for each facility in which anesthesia is performed, including but not limited to:

- Appropriate history and pre-sedation preparation of each patient

- Appropriate vital monitors for each patient with direct writing capability

- Appropriate agents used, including non-expired drugs and Controlled Substance logs in compliance with

TITLE 16. OCCUPATIONAL AND PROFESSIONAL LICENSING, CHAPTER 19.

- Appropriate infection control techniques

- Appropriate monitoring for patient recovery and transport

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 21 of 34 - Adequate knowledge of emergencies related to anesthesia administration and associated age/size

appropriate rescue equipment and reserve oxygen in working order and easily accessible

- Appropriate logs kept of regular equipment checks

- Appropriate safety and fire rescue equipment per Code of Federal Regulations, OSHA Standards, OSHA 3187-

09R, Title 29.

- Appropriate compressed gases safety per OSHA Safety Regulations, 29CFR, Part 1910, Subpart: H, Hazardous

Materials, 1910.101, Compressed gases

- Appropriate office emergency protocols, including Emergency Procedure Record form and emergency phone

numbers

I understand that all aspects of the facility and provider that pertain to the use of anesthesia, including previous sedation records, are subject to inspection, scheduled or unannounced.

I am aware that pursuant to TITLE 16. OCCUPATIONAL AND PROFESSIONAL LICENSING, CHAPTER 5. DENTISTRY. PART 15. DENTISTS, ANESTHESIA ADMINISTRATION 16.5.15.13 REPORTING ADVERSE INCIDENTS, I must report any adverse occurrences related to the use of sedation.

I hereby authorize the release of any and all information and records the Board shall deem pertinent to the evaluation of this application, and shall supply to the Board such records and information as requested for evaluation of my qualifications for a permit to administer Conscious Sedation 1, Conscious Sedation 2, Deep Sedation/General Anesthesia in the State of New Mexico.

I understand that based on evaluation of credentials, facilities, equipment, personnel, and procedures, the Board may place restrictions on the permit, or revoke the personal/facility permit entirely.

I further state that I have read the rules related to the use of anesthesia and sedation, as described in TITLE 16, CHAPTER 5, of the New Mexico Occupational and Professional Licensing Code. I hereby agree to abide by the laws and rules pertaining to the practice of dentistry and anesthesia and sedation in the State of New Mexico.

MUST BE SIGNED

IN THE PRESENCE New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 22 of 34 OF A NOTARY PUBLIC

SIGNATURE OF APPLICANT: ______

SUBSCRIBED AND SWORN BEFORE ME, THIS

______DAY OF ______,

YEAR ______.

(NOTARY SEAL)

NOTARY PUBLIC SIGNATURE:______

NOTARY PUBLIC NAME

(TYPED OR PRINTED):______

MY COMMISSION EXPIRES:______

John C. Mitchell DDS

Chairman of Anesthesia Committee

(ATTACHMENT C)

ADMINISTRATOR’S REPORT BOARD OF DENTAL HEALTH CARE 1/30/2015

BOARD MEMBERSHIP Member Name Professional Member, Board Chair Charles Schumacher, DDS Professional Member, Vice Chair Kimberly Martin, DMD Professional Member, Secretary Burrell Tucker, DDS Professional Member Leo Paul Balderamos, DDS Professional Member Jolynn Galvin, DDS Dental Hygiene Committee Representative Ermelinda Baca, RDH Chair of the Hygiene Committee Sits on Hygiene Committee & Board Dental Hygiene Committee Representative Denise Teague-Myrick, RDH Vice Chair of Hygiene Committee Sits on Hygiene Committee & Board Professional Member of Dental Hygiene Committee Melissa Barbara, RDH New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 23 of 34 Professional Member of Dental Hygiene Committee Sarah Kay Thiel, RDH Professional Member of Dental Hygiene Committee Paula Jenkins Public Member Robert Blewer Public Member Richard Hatch

THE NUMBERS

NUMBER OF CURRENT LICENSES

DD’S = 1,554

DA’S = 2,625

DH’S = 1,346

CDHC = 1

EFDA’s =3

NON-DENTIST OWNER = 20

ACCOMPLISHMENTS/UPDATES

 Renewal postcards were mailed out the beginning of March.

 As of January 1st the board has received a total of 29 complaints

(ATTACHMENT D)

04-03-2015

Since March 1, 2015, Qualis Health has been providing Third Party Assessor (TPA) and Utilization Review (UR) services to the State of New Mexico Human Services Department/Medical Assistance Division (HSD/MAD).

Qualis Health is currently experiencing delays in processing review requests. Beginning March 2, 2015, Qualis Health experienced a significant influx of revision requests and utilization review work carried over from the previous TPA. The volume and extent of the revisions and unfinished reviews was not predictable. The Human Services Department (HSD) is working closely with Qualis Health by providing daily technical assistance and support to address delays in reviews.

Fee for Service Eligibility, Benefits and Claims

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 24 of 34  Call the Xerox provider help desk at: 505‐246‐0710 or 800‐299‐7304 for eligibility, benefit

and claims inquiries. Do not call Qualis Health for this information.

 The Medicaid automated eligibility inquiry phone line (AVRS) is also available at 1‐800‐

820‐6901.

 Centennial Care MCO client service requests, transportation requests, eligibility issues and claims inquiries are not handled by Qualis Health.

Dental Requests

 Continue submitting dental claims for processing to Xerox.

 Submit requests for dental authorization to Qualis.

 Mark the applicable box in section 1 on the ADA Dental Claim Form to identify the transaction as a request for predetermination/preauthorization. Dental claim forms submitted with Dates of Service will be considered a dental claim and will not be processed by Qualis.

 Qualis does not credential dental providers. Contact Xerox provider relations for questions on provider enrollment.

Qualis can be reached at 1-866-962-2180 or FFS Prior Authorizations Fax Line: (888) 515-2067 Website: http://www.qualishealth.org/patients-families/new-mexico-medicaid

The HSD/Medical Assistance Division’s TPA contract manager, Gina Capener, is available to assist with emergency cases. Her contact information is email: [email protected] or phone number: 505‐476‐7251.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 25 of 34 HSD sincerely appreciates your patience at this critical time while work through this TPA transition.

Dr. Devi Gajapathi B.D.S Dental Program Manager New Mexico Medicaid (Attachment E)

Hygiene Exam Review Board Meeting

March 13, 2015

Phoenix, AZ

Executive Summary

HERB members in attendance:

Ermelinda Baca, RDH Marilyn McClain, RDH

Sally Berg, RDH Sharon Osborn Popp, PhD

Catherine Cornell, RDH Lois Palermo, RDH

Mary Davidson, RDH Deborah Polc, RDH

Kathy Heiar, RDH Janet Primiano, RDH

Janet Ingrao, RDH Kelly Reich, RDH

Diane Klemann, RDH Melinda Reich, RDH

Jackie Leakey, RDH Karen Sehorn, RDH

Cheryl Lewis, RDH Caryn Solie, RDH

Meg Long Woodhouse, RDH Gail Walden, RDH

Yadira Martinez, RDH Robin Yeager

WREB Update

WREB has held Educator Forums in Arizona, California, New Mexico, Oregon, Texas, and Washington since we last met. WREB will also be presenting in Missouri. In addition to the educator forums WREB has also hosted pre-candidate orientations to dental hygiene programs in New Mexico, California and Texas.

WREB reduced the base fee for the dental hygiene examination to $650 per candidate per attempt.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 26 of 34 Individual school use fees still apply and those vary from site to site.

WREB is now providing candidates challenging the dental hygiene exam with preliminary performance results onsite. In addition, if a candidate is unsuccessful, and they choose to do so, they will have an opportunity to register and pay to retake the exam at that same site on the last day of the exam. This will save candidates from having to travel to an alternative site or wait for the next available exam, if they make that choice.

In addition to the above changes, WREB elected to discontinue the computer based Process of Care (POC) exam. Candidates will not be required to take any other examination than the WREB dental hygiene clinical examination in 2015. Board members were asked to bring feedback from their states as to what content should be on the WREB clinical dental hygiene exam in lieu of this change.

Year End Statistics

Sharon Osborn Popp, PhD, presented on pass rates and examiner performance.

Pass rates are on track and remain consistent. Most candidates pass on the first attempt, but the pass rate decreases with each subsequent attempt. Tracking data over a rolling seven years shows that about 3% never pass at all. 2% fail and do not retake the WREB examination, and the other 1% continue to fail upon retake.

Practice Analysis

WREB plans to do a practice analysis for dental hygiene in 2015.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 27 of 34 (Attachment F)

April 24, 2015

RE: Dental Therapist Report I. NM Dental Therapist Legislation Update  Dental Therapist Legislation (SB6/HB349)  Dental Therapist Taskforce Memorial  Request for Corrections and Updating of Regulation & Licensing Dept. (RLD) Fiscal Impact Reports (FIRs) for SB6/HB349 and future dental therapist legislation

II. Commission on Dental Accreditation (CODA) adopts standards for Dental Therapist Education Programs

III. Federal Trade Commission (FTC) Actions  FTC Supports CODA Adopted Dental Therapist Standards  FTC wins U.S. Supreme Court case finding that North Carolina state dental board’s anticompetitive actions against non-dentists were illegal.

IV. Dental Therapists in the News, Media Coverage in NM

Dear NM Dental Board and Hygienist Committee Members,

Thank you for the opportunity to provide an update on our New Mexico dental therapist legislation and dental therapist practice here in the U.S. for your April meeting.

I. NM Dental Therapist Legislation Update A. Dental Therapist Licensure Bill (SB 6/ HB 349) We are pleased to report that on March 16, the NM House of Representatives passed HB 349 by a bipartisan vote of 34 to 25. HB 349 was also passed with a bipartisan vote by the House Regulatory & Public Affairs Committee and also passed by the House Health Committee. Unfortunately, the 2015 session ended before HB 349 could be considered by the Senate.

HB 349 as voted on, on the House floor was amended to include the following:  Deleted the dental therapist or dental therapist representative from being a member of the Joint Committee. The Joint Committee would make recommendations to the Dental Board

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 28 of 34 on rules and regulations regarding the practice and licensure of dental therapists. (The Joint Committee would be comprised of currently sitting dentists and hygienists on the board and hygienists committee and public members.)  Requires that dental therapists graduate from dental therapist education programs that are accredited by the Commission on Dental Accreditation (CODA). o This means CODA would be responsible for accrediting NM’s dental therapy training programs. The NM Dental Board and related agencies would not have the financial burden or regulatory responsibility of accrediting the state’s programs.  Requires that the NM Department of Health produce an outcome report on dental therapist practice in NM five years after the graduation of the first graduating class of dental therapists in New Mexico. (This would be a similarly structured report as the Minnesota Dept. of Health Report that was issued Feb. 2014.)  Requires that dental therapists could only practice in the following locations:  Federally Qualified Health Center (FQHC),  FQHC “look-‐alike” facilities (same as FQHCs but funding source is different),  School-‐based health center or clinic,  Indian Health Service (IHS) facility,  638 tribally operated facility,  non-‐profit dental clinic,  mobile clinic,  a healthcare facility owned and operated by federal, state or local government,  a dental practice that is a sole proprietorship that serves a patient population of which at least 25% is composed of Medicaid recipients, OR  a county with a population of less than fifty thousand individuals as of the last decennial census

SB 6 unfortunately did not pass through its first Senate committee, the Senate Public Affairs Committee so was not further considered in the Senate.

B. Dental Therapist Taskforce Memorial (SM 136) – We are also pleased to announce that on March 20, the NM Senate passed SM 136 – Dental Therapist Taskforce Memorial by a vote of 40 to 0. SM 136 was sponsored by Majority Leader, Sen. Michael Sanchez. Health Action New Mexico initiated and led this effort to establish the taskforce and pass the memorial.

The taskforce calls on the NM Legislative Council Service to establish a dental therapy taskforce to prepare legislation for introduction in the 2016 legislative session that would establish the licensure and practice of dental therapists in NM. The taskforce members would include six people selected by the NM Dental Association, 6 people selected by the NM Dental Hygienists Association New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 29 of 34 and four state legislators, two from the House and two from the Senate representing each political party in each house. The legislative council service is instructed to hire a professional facilitator to facilitate the taskforce meetings. The draft legislation and report would be presented to the Legislative Health and Human Services Committee at its October 2015 meeting. Taskforce meetings are subject to the NM Open Meetings Act.Opposition to dental therapist legislation were unfortunately successful in amending the memorial to exclude Health Action New Mexico (HANM) from express membership on the taskforce. The exclusion of HANM means that consumers’ and patients’ voices, especially those living in underserved dental provider shortage areas are not expressly included in the taskforce. Patients and underserved communities in NM have a right to have a seat at the table determine how, where and by whom they receive dental services. HANM and its coalition of supporters will continue to work to see that HANM and underserved communities are represented on the taskforce.

C. Request for Corrections and Updating of Regulation & Licensing Dept. (RLD) Fiscal Impact Reports (FIRs) for SB6/HB349 and future dental therapist legislation

A significant portion of the Fiscal Impact Report (FIR) analysis of SB 6/HB 349 provided by the Regulatory & Licensing Department (RLD) is unfortunately not accurate, nor up-‐to-‐ date and the analysis seems to be of previous years’ bills rather than for the current SB 6/ HB 349 as presented to the dental board and committee Fall 2014 and introduced for the 2015 legislative session. Previous years’ FIR analysis by RLD for dental therapist legislation was unfortunately also inaccurate and out of date.

We hope that RLD and the Dental Board and Hygienist Committee can work with RLD, to in future years provide accurate and up-‐to-‐date reports that reflect current legislation. HANM welcomes the opportunity to meet with RLD staff and board and committee members and staff to answer any questions about dental therapist legislation and assist in correcting and updating FIR reports.

II. CODA adopts standards for Dental Therapist Education Programs On Feb. 6, 2015, the Commission on Dental Accreditation (CODA) adopted national dental therapist education program standards. The CODA adopted standards are consistent with NM dental therapist legislation SB6/HB 349.

NM education institutions will be able to use these standards to establish quality, accredited dental therapist programs. CODA adoption of standards is recognition that accredited dental therapy education programs are in the best interest of the dental profession and the public.

The CODA standards allow for:

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 30 of 34  An associate’s degree level, dental therapist program. o NM community colleges can establish complete dental therapist education programs at their schools with graduates earning an associate’s degree in dental therapy. o While a school could have a bachelor’s or master’s degree level dental therapist program, a bachelor’s or master’s degree is not required.  Licensed dental therapists to practice under the general/off-‐site supervision of a dentist.  Education programs to include an accelerated education pathway for hygienists and dental assistants to be trained and educated to be eligible to become licensed dental therapists.

Why is CODA adoption of dental therapist accreditation standards important for NM?

 NM’s dental therapist training programs can be accredited by a national accrediting body. o Accreditation helps to ensure that a training program provides the quality of education that the general public has the right to expect.  NM institutions of higher education would be able to follow a streamlined national framework for accrediting dental therapy programs making establishing the training programs easier.  Graduates of NM’s CODA accredited dental therapist programs would be: o Guaranteed access to financial aid, o The assurance of receiving a quality education, o Recognition by other educational institutions and employers of the course credits and degrees they have earned.  CODA would be responsible for accrediting NM’s dental therapy training programs. The NM Dental Board and related agencies would not have the financial burden or regulatory responsibility of accrediting the state’s programs.

III. Federal Trade Commission (FTC) Actions  FTC Supports CODA Adopted Dental Therapist Standards  FTC wins U.S. Supreme Court case finding that North Carolina state Dental Board’s anticompetitive actions against non-dentists were illegal.

A. FTC Supports CODA Adopted Dental Therapist Standards The Federal Trade Commission (FTC) supported the CODA adoption of dental therapist education program standards. The FTC asked CODA “to finalize and adopt proposed [dental therapy education program] standards without unnecessary therapy education program] standards without unnecessary delay, so that the development of this emerging service model can proceed, and consumers can reap the likely benefits of increased competition.” The FTC comments to

CODA also stated, "[A]ny further delay in the adoption of accreditation standards could New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 31 of 34 discourage and delay the development of education programs, reduce the availability of these new professionals, and hinder their ability to practice in different states.” http://www.ftc.gov/news - ‐ events/press - ‐ releases/2014/12/ftc - ‐ staff - ‐ urges - ‐ dental - ‐ accreditation - ‐ commission - ‐ adopt - ‐ dental (Dec. 1, 2014)

B. FTC wins U.S. Supreme Court case finding that North Carolina state Dental Board’s anticompetitive actions against non-dentists were illegal. The Supreme Court of the United States issued a ruling on Feb. 25, 2015, that could have major implications on the composition and authority of state medical, dental and other health professions boards. In its ruling in the case of North Carolina Board of Dental Examiners v. Federal Trade Commission (FTC), the Court found that the North Carolina Board of Dental Directors acted illegally by trying to prevent anyone other than a dentist from whitening teeth. The Court found that the state board’s actions constituted an attempt to limit competition and protect professional self-‐interest.

The Court’s ruling has great import given long-‐standing scope of practice conflicts in all states. It is especially timely given ongoing efforts in many states aimed at establishing dental therapists as a way to expand access to dental care for millions of Americans who need it but can’t get it either due to a lack of providers or cost. Dental boards in various states have opposed these efforts despite substantial evidence of their safety and ability to expand care to people where they need it.

Most importantly, the ruling affirms that state health and dental professions boards have a duty to act in the public interest which includes ensuring public safety, and considering ways to allow for competition to improve access to needed services.

The ruling also highlights the need for states to strengthen oversight with respect to boards and to diversify their membership to mirror the public they are trusted to serve.

Wall Street Journal article on FTC Supreme Court case ruling: Letting Dentists Feel the Bite of Competition: A Supreme Court ruling about teeth- ‐whitening should bring a smile to foes of licensing cartels. March 8, 2015. By REBECCA HAW ALLENSWORTH And AARON EDLIN http://www.wsj.com/articles/rebecca - ‐ haw - ‐ allensworth - ‐ and - ‐ aaron - ‐ edlin - ‐ letting - ‐ dentists - ‐ feel - ‐ the - ‐ bite - ‐ of - ‐ competition - ‐ 1425855260

IV. Dental Therapists in the News, Media Coverage in NM

Below are headlines and links to editorials, op-‐eds, letters to the editor and articles recently published in NM regarding dental therapists.

LOCAL NEWS What do the eyes have, but the teeth do not? Failure to pass the dental therapist bill means NM’s well established dire need for dental health care has been left unresolved once again. Carlsbad Current-‐Argus. Opinion, by Merilee Dannemann. (March 24, 2015)

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 32 of 34 Dental Therapist bill passes NM House of Representatives. ABQ Journal (March 17,

2015) Santa Fe New Mexican editorial endorses Dental Therapist bill. (Feb. 24, 2015)

Albuquerque Journal Editorial Board shows support for dental therapists in NM. (Dec. 24, 2014)

Hygienists can become dental therapists. Current-‐Argus, Carlsbad. Guest Columnist, by Christie Baca RDH. (March 11, 2015)

Dental therapist legislation is a viable, safe solution to end the suffering and address the oral health care crisis in New Mexico. Tribal and all NM communities deserve to have this solution. Tribal dental care falls short. Opposition should think about needless suffering. By Michael Bird MSW MPH, Kewa Pueblo. Santa Fe New Mexican, op-‐ed. (March 7, 2015) ABQ Journal (March 9, 2015)

NM doctor, fmr Cabinet Secretary calls dental therapists the future of NM dental care now . I’m tired of sending patients home without help. Alfredo Vigil MD, Fmr. NM Cabinet Secretary of Health & Human Services. ABQ Journal (Jan.19, 2015). Las Cruces Sun News (Feb. 2, 2015)

Dental Therapists make front page of Albuquerque Journal. Dentists claim no dental crisis in NM and if you pay us more we will serve the underserved. ABQ Journal (Dec. 14, 2014)

Rural NM Dentist says dental therapists can combat our dentist shortage and provide quality dental care. Howard Rhoads, DDS. Santa Fe New Mexican (Dec. 14, 2014).

NM Dentist Howard Rhoads says Dental Therapists are vital to NM health care (Dec. 8, 2014) ABQ Journal

Dental therapists are an ideal option. Calls out opposition dentists for protecting profession and status quo rather than promoting the health of all NM citizens. Mim Dixon, ABQ Journal (Nov. 11, 2014)

NM Urgently needs dental therapists. 16 years is too long to wait. Sets the facts straight. Jerry Harrison. ABQ Journal (Nov. 4, 2014)

Dental therapists should be part of solving NM dental crisis . Joanne Krell, Vice President of Communications WK Kellogg Foundation. ABQ Journal (Oct. 31, 2014)

Dental therapists could be solution to shortage of dentists in NM. (KOB TV News (Oct. 21,

2014) Dental therapists will help fill gaps in care . NM Native American Youth for dental therapists. New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 33 of 34 Littlebear Sanchez. Santa Fe New Mexican (Oct. 4, 2014) Littlebear Sanchez, Center for Native American Youth. NM needs dental therapists for its rural communities. Native American youth support dental therapists. ABQ Journal (Sept. 28, 2014)

Dental Therapists offer alternatives. Santa Fe New Mexican posts Washington Post’s editorial supporting dental therapists. Santa Fe New Mexican. (July 18, 2014)

Thank you for your time and consideration.

New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 34 of 34