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1Board of Trustees FINAL 2April 8, 2017 3Page 1 of 7 4 Board of Trustees Pennsylvania Dental Association April 8, 2017 Omni Bedford Springs Resort Bedford, Pennsylvania

Present Consultants/Staff/Guests Present Dr. Anand V. Rao (1) Camille Kostelac-Cherry, Esq., CEO Dr. Charles J. Incalcaterra (2) Thomas J. Weber, Legal Counsel (late) Dr. Matthew A. Zale (3) Barbara Mladenoff, Executive Assistant Dr. Maria J. Tacelosky (4) Dr. Stanley Markiewicz, Trustee-elect (1) Dr. James M. Boyle III (5) Dr. John Coole, Trustee-elect (6) Dr. Nicole M. Quezada (6), Secretary Dr. David A. Schimmel, Trustee-elect (7) Dr. Cynthia A. Iseman (7) Dr. Andrew J. Kwasny, ADA Trustee Dr. Theodore J. Rockwell (8) Dr. Sam Mansour (9) Dr. James A.H. Tauberg (10) Dr. Herbert L. Ray, Jr., President Dr. Bruce R. Terry, President-elect Dr. Samuel E. Selcher, Treasurer

1Call to Order 2The meeting was called to order at 8:30 a.m. by Dr. Herbert L. Ray, Jr., president. 3 4Mid-Level Providers in Adjacent States 5Information was provided on mid-level providers in other states regarding licensure 6requirements, training, supervision and scope. A presentation on the social network 7highlighted states where dental therapists currently practice (Minnesota, Washington, 8Oregon, and Alaska). Currently, 26 states have or are considering dental therapists 9legislation. 10 11The board discussed Pennsylvania’s loan forgiveness program. Grant money is 12distributed among various healthcare practitioners with nothing specifically earmarked 13for dentists. Ms. Kostelac-Cherry updated the board on legislation being introduced by 14Rep. Boback to carve dentistry out of the existing loan forgiveness program in order to 15earmark money specifically for dentists. 16 17The board discussed the difficulty with establishing rural clinics within Pennsylvania. 18PDA needs to become proactive and approach the legislators with a proposed program 19to address access to care similar to Ohio. The board considered several options 20including: 21  Research on a public-private funding option with Pew or Kellogg foundations. 5Board of Trustees FINAL 6April 8, 2017 7Page 2 of 7 8 22  Create a small working group of several dentists, PDA staff and PDA lobbyist to 23 work with Rep. Boback to create a substantial bill that benefits Pennsylvania 24 dentists. 25 26Dr. Incalcaterra will post state-specific information on the board’s social network. 27(04/17BTDA04) 28 29Public Health Dental Hygienists (PHDH) Expansion 30In January, the BOT attended the January State Board of Dentistry (SBOD) meeting. 31Prior to the general meeting, the SBOD held a committee meeting on PHDH and efforts 32to expand the scope of practice. The public health dental hygienists are seeking to 33expand practice to schools, nursing homes, hospice care, childcare and primary care 34facilities. 35 36The board noted that public health dental hygienists are pushing to be attached to 37primary care physician practices, which would pose no safety concerns. However, it 38would create situations where the patients receive dental cleanings but may never 39receive a dental exam by a dentist. 40 41The board and legal counsel will review the Massachusetts legislation, which 42established an advanced dental hygiene practitioner level of practice. (04/17BTDA05) 43 44Reinstatement of Government Relations Committee (GRC) 45Ms. Kostelac-Cherry suggested the Government Relations Committee (GRC) be 46reinstated. The committee would work with Peg Callahan and PDA staff to refer, revise 47and finalize legislative action for board consideration. Reinstating this committee would 48eliminate the board from doing committee work and develop/groom future leaders of the 49PDA. 50 51The board discussed reinstating the GRC and determined the following: 52  Committee would need to be fully funded. Determine what fiscal implications 53 would be involved. 54  The committee would have at least 8 members with a maximum of 12 members. 55  Interested members would be required to submit a brief statement of interest for 56 board review. 57  The various dental specialties could be represented on the committee. 58  Poll the current members of the Government Relations Advisory Group (GRAG) 59 to determine who would be interested in joining the Government Relations 60 Committee. 61 62Since this would require a Bylaws change, Mr. Weber is directed to develop the 63language to reinstate the GRC. The amendment will be posted on the board’s social 64network for review and approval. (04/17BTDA06) 65 9Board of Trustees FINAL 10April 8, 2017 11Page 3 of 7 12 66At the appropriate time, Dr. Incalcaterra, ADA Consultant on the GRAG, will contact 67current members of the Government Relations Advisory Group to see who would be 68interested in serving on the Government Relations Committee. (04/17BTDA07) 69 70Dr. Ray volunteered to be an advisor to the committee. 71 72Council of Presidents (COP) Agenda 73Dr. Boyle discussed the agenda for the Council of Presidents (COP) at the 2017 PDM. 74There will be a COP luncheon on Saturday, April 22, 2017, where the COP will discuss 75the Bylaws amendments proposed by the board. Mr. Weber will provide language for 76the proposed Bylaws amendments, which will be posted on the social network for board 77approval possibly prior to the 2017 Pennsylvania Dental Meeting. 78 79The PDA Bylaws amendments for COP approval are: 80  Government Relations Committee (GRC) 81  Election Advisory Group (EAG) 82  ADA Delegation Roster Amendment 83 84Dr. Ray suggested and the board agreed that board approval of PDA Bylaws Article 8512.0 Member and Leadership Disciplinary Procedure be postponed until the July 21-22, 862017, board meeting. 87 88Other topics for COP discussion include the PDA website, member value and 89communications issues. 90 91President’s Report 922017 PDM Update 93Dr. Ray reviewed the 2017 PDM report and commended Schuler and the 3Rivers 94Committee for their work organizing this meeting. Room obligations for Friday night 95have been met, but there are 38 room nights not sold totaling $10,081 in attrition fees, 96and 22 of 28 booths have been sold. 97 98Dr. Gary Wegman is interested in having a suite at the PDM to announce his intentions 99to run for legislative office. The suite must be reserved through PDA and all food and 100beverage will appear on PDA’s master bill. PDA will invoice Dr. Wegman after the PDM 101for reimbursement. 102 103PDM Town Hall Issues Agenda Items 104Ms. Kostelac-Cherry discussed the proposed PDM Town Hall Issues Agenda. The 105complete Town Hall Agenda has been posted to the board and COP libraries, as well as 106on the PDM webpage. 107 108Questions submitted by the Council of Presidents have been arranged in an “Ask It 109Basket” category. 110 13Board of Trustees FINAL 14April 8, 2017 15Page 4 of 7 16 111The board discussed the physical setup of the meeting room based on comments from 112the COP. In 2016, the room layout was more casual with the board scattered throughout 113the room or in the back as a result of suggestions by 2015 attendees. The setup option 114for 2017 was discussed and the trustees will be seated upfront and off to the side with 115nametags and district numbers. The moderators will have handheld microphones and 116be on the floor with attendees. 117 118In preparation for the Town Hall Meeting, the board discussed and unanimously 119approved all committee minutes from the Membership Committee and New Dentist 120Committee as presented. 121 122Resolved: That the minutes for the Membership Committee and New Dentist 12304/17BT58 Committee be approved as presented. 124 125PDA CE Programs 126A collaboration between Pennsylvania Academy of General Dentistry (PAGD) and PDA 127was proposed to provide a series of workshops on required continuing education. The 128workload would be divided between the two organizations. PDA would be responsible 129for handling financials and registrations, as well as reporting to the SBOD and providing 130income and expenses statements so that all costs and income can be shared equally. 131PAGD would handle speaker recruitment, venue selection, and all logistical planning. 132PDA and PAGD would share all expenses and revenue, and marketing of the courses. 133 134After discussion, the board was not in favor of the PAGD and PDA partnership. The 135board directed Ms. Kostelac-Cherry to research association partnerships in other states 136and the costs involved. (04/17BTDA08) 137 138Ms. Kostelac-Cherry inquired if the board was interested in having Dr. Angel Stout 139develop an online child abuse program or continue with the live instruction. 140Development of an online child abuse CE will come at a cost. 141 142After discussion, the board consensus was to develop an online child abuse program 143and continue with the live instruction. The board directed Ms. Kostelac-Cherry to 144approach Dr. Angel Stout on developing an online PDA Child Abuse CE and a live 145instruction PDA Child Abuse CE. (04/17BTDA09) 146 147The board discussed the potential costs involved in holding child abuse courses as a 148member benefit. Member dentists would attend free with a small cost involved for staff. 149Non-member dentists would be charged a set price. Items for financial consideration 150include costs for travel, rooms, meals, and honorariums. The board directed Ms. 151Kostelac-Cherry to research costs on the PDA programs attended by members and 152member staff, non-members and non-member staff, and the income generated by each 153segment. (04/17BTDA10) 154 155The board inquired on an opioid program. The Pennsylvania Medical Society (PAMED) 156has developed already a series of instructional courses. Currently, PDA is aware of two 17Board of Trustees FINAL 18April 8, 2017 19Page 5 of 7 20 157dentists interested in developing opioid instruction for PDA. Until the guidelines are 158released, no development can be initiated. 159 160CEO Report 161Ms. Kostelac-Cherry reported on a member dentist’s offer to work with PA legislators on 162assignment of benefits legislation. Ms. Peg Callahan has advised the member dentist 163that the correct protocol to contact state legislators is through PDA staff and lobbyist. 164Ms. Kostelac-Cherry has scheduled a meeting with the member dentist and Ms. 165Callahan. 166 167The board discussed the situation and determined several requirements the member 168dentist must meet to work with PDA on assignment of benefits legislation. The 169requirements are joining PADPAC and the Government Relations Advisory Group. The 170member dentist must take direction from PDA staff and lobbyists, and must be 171mentored by an active PDA legislative spokesperson, and follow all PDA 172recommendations. 173 174Ms. Kostelac-Cherry updated the board on legislative bills on assignment of benefits. 175Currently there are two pieces of legislation. The senate bill has a long list of sponsors. 176Sen. Don White reportedly will push hard for assignment of benefits. The house bill has 177fewer co-sponsors. Ms. Callahan needs direction on which bill to push; her 178recommendation is to move Sen. Eichelberger’s senate bill. PDA dentists must show up 179and meet with legislators on the committees. 180 181The board directed Ms. Peg Callahan to work on the Eichelberger senate bill for 182assignment of benefits. (04/17BTDA11) 183 184Dr. Ray offered to contact Sen. White to push for the assignment of benefit legislation. 185Dr. Selcher offered to contact Sen. Laughlin to support assignment of benefits 186legislation. Another good contact for Sen. Laughlin would be Dr. Radack. 187 188Board Liaison to PDAIS Board of Directors 189The board discussed the Board of Trustees liaison appointment to the PDAIS Board of 190Directors. 191 192Dr. Gary Davis was suggested due to close proximity to PDA Central Office. Dr. Boyle 193will contact Dr. Davis to determine his interest. 194 195Legal Counsel Report 196To address a gap in the PDA Bylaws regarding an incomplete ADA delegation roster, 197Mr. Tom Weber provided the following amendments. 198 1995.1.4 In the event of a vacancy of a PDA Trustee serving as ADA delegates, the 200 trustee district may shall select a replacement delegate as permitted by ADA. In 201 the event of any other vacancy in the PDA ADA Delegation, the Executive 202 Committee shall select a replacement delegate(s) as permitted by ADA. 21Board of Trustees FINAL 22April 8, 2017 23Page 6 of 7 24 203 or 2045.1.4 In the event of any vacancy in the PDA ADA Delegation, the Executive 205 Committee shall select a replacement delegate(s) as permitted by ADA. 206 207A discussion and vote will take place on the board’s social network. 208 209During the PDM, Mr. Weber will hold several sessions of “Ask a Lawyer” and will 210provide a “cheat sheet” on the topics covered. 211 212Mr. Weber updated the board on the Delta Dental settlement with the California Dental 213Association. The settlement highlights include a monetary settlement of $37.5 million to 214be paid to California dentists for incorrect reimbursement level adjustments. The 215settlement highlights: 216  Dentists will now receive a 120-day notice on change to reimbursement levels. 217  Delta Dental will provide dentists with a 12-month breakdown on how new 218 reimbursement levels will affect them. 219  Delta Dental will reimburse California Dental Association for legal fees from 220 $1.5 million to $2 million. 221The board directed Mr. Weber to investigate whether the Delta Dental settlement in 222California would apply to Pennsylvania for incorrect reimbursement levels. Mr. Weber is 223directed to report his findings to the board via the social network or at the July 2017 224board meeting. (04/17BTDA12) 225 226ADA Find-a-Dentist Initiative 227Dr. Tauberg discussed the ADA Find-a-Dentist initiative. A link to the program has been 228uploaded to the board’s social network. Registration instructions are included to aid 229dentists through the signup process. A chat link is included to usher members through 230the process and to provide online help. 231 232Treasurer Report 233Dr. Selcher provided instructions on how to find the PDA budget on the website. 234 235Dr. Selcher provided the board with an update on the PDA budget. As of April 2017, 236PDA revenue has increased by $30,000. The unrealized investment gains (account line 237442) increased by $65,458 and without the unrealized investment gains, PDA would 238have decreased income by $35,000. Total expenses are down by $21,000 for the year. 239The largest expense is due to salaries and wages. 240 241The board directed the 2017 PDA budget be posted to the COP social network for 242review. (04/17BTDA13) 243 244The board also directed that all PDA committee minutes be deemed approved if staff 245receives no objection to the draft minutes within 10 days. (04/17BTDA14) 246 25Board of Trustees FINAL 26April 8, 2017 27Page 7 of 7 28 247Executive Session 248The board went into executive session from 1:38 p.m. to 1:44 p.m. No resolutions or 249directed actions were reported. 250 251Adjournment 252The meeting adjourned at 1:45 p.m. 253 254The next meeting of the PDA Board of Trustees is scheduled for Friday, July 21, 2017, 255and on Saturday, July 22, 2017, with both sessions beginning at 8:30 a.m., at PDA’s 256Central Office. 257