KDA Today

KDA Today

For Immediate Release

Date: Oct 24th, 2016
Contact: Dr. Bill Collins
Phone: 800-292-1855
Email: info@kyda.org

Happy Trails from the Mountains of Eastern Kentucky

Albert Einstein once said, “We can't solve problems by using the same kind of thinking we used when we created them.” At first, I believed that Einstein was saying to “think outside the box”, but when I thought more about the statement, I also understood that we were the creators of our problems. Our profession is faced with many issues on the horizon - Medicaid, membership, commercial insurance, denturity, coalitions and many others, all with the potential to change the dental profession in some form or fashion. We, as individuals who deliver care, must also remember we are the problem solvers; we must look for solutions outside the way the problems were created.

Summer of 2016 is all but over, back to school has begun and the smell of fall is in the air. Eastern Kentucky is one of the most beautiful places in the world during the fall, the majestic mountains filled with an array of colors ranging from purples to bright orange. I truly love the spring and fall in the mountains because God’s beauty is all around us and the mountains seem to be alive. But, as the fall comes, it too will soon be over and “old man winter” will approach with his breath of frigid temperatures. I hope everyone has experienced a wonderful summer and I now have less than a year remaining as president!

Medicaid seems to have been the topic since I have taken office. Governor Bevin gave indication we would be included in talks about the dental component of Medicaid. Waiver 1115 then emerged, much to our surprise, without any input from ANY dentist and we learn dentistry is being excluded as a standard service for the expansion population. We sent people to speak during the comment period, we had KDA leadership meet with people from the governor’s office, and we all submitted written comments in hopes they would reconsider before sending the waiver to the federal level. Our pleas fell on deaf ears.

When we did RAM clinics, our target group was the uninsured and underinsured, in other words, “the working poor”, the ones that government programs did not include, the ones that went without medical or dental treatment. When the Medicaid expansion occurred, it pulled in all these people and there was no longer any need for RAM clinics in Kentucky. Kentucky leads the nation with the largest drop in our rate of uninsured, plummeting from 20.4 percent in 2013 to 7.5 percent in 2015. This translates into nearly 440,000 Kentuckians gaining affordable coverage, many for the first time in their adult lives. Coverage, alone, is not the end goal. It’s the foundation for better care, better health and better value. In 2014, preventive screenings for diabetes, cholesterol and cancer doubled. Trips to the emergency room in Kentucky decreased by 3 to 5%. The share of low-income Kentuckians with chronic conditions receiving regular care has increased by 15%. Tens of thousands more Kentuckians are benefiting from early detection, treatment and disease management. That’s good for all of Kentucky. Their ability to get care when they get sick means the rest of the state can stay healthier and less money is spent. It’s alarming to hear that Governor Bevin has vowed to end Medicaid expansion if this waiver isn’t approved. We need to remember that the purpose of this waiver is to demonstrate that Kentucky can provide better access and better care than we are already doing. This waiver will place more burden on low-income, working Kentuckians and our most vulnerable citizens.

Expanded coverage means more payments to providers and less uncompensated care. Since 2014, Medicaid providers have received well over $3 billion in additional revenue. This is further bolstered by a similar decrease in uncompensated care. In 2014, rural hospitals – on average – received 300% more revenue from Medicaid expansion than from the Disproportionate Share Payments, while urban hospitals received 257% more from Medicaid expansion.

I received an article from a friend titled, “A Good Dentist is Hard to Find in Rural America” by Alison Kodak. http://www.npr.org/sections/health-shots/2016/09/12/488416888/a-good-dentist-is-hard-to-find-in-rural-america?utm_campaign=storyshare&utm_source=facebook.com&utm_medium=social

When I read this article, I realized it was a continuation of the woes of Medicaid we are facing, but from a patient and a non-professional point of view. The very beginning talks about Pew Charitable Trusts. It is evident this group is heavily involved in trying to change how oral healthcare is delivered in America. This article shows how FQHCs and Primary Care facilities are addressing the problems of those in need. This is well worth reading and do so with an open mind; we as professionals need to be part of the solution. We need to listen to those in need.

I want to thank Garth Bobrowski, David Narramore, Susie Riley, Libby Milligan, John McCarthy and Rick Whitehouse for all their efforts on Medicaid Waiver 1115. These individuals made several trips to Frankfort to fight on behalf of dentistry. They displayed themselves very well and gave constructive alternatives to the waiver. They met with Secretary Brinkman, Adam Meier and Medicaid Commissioner Stephen Miller. Everyone was well prepared and presented data and facts as to why dental should remain a standard service in Medicaid, but their pleas were not heard. Enough on the Medicaid front. I am sure everyone is tiring of the amount of time being spent, but I feel obligated to keep everyone informed.

As always, I must mention the KDPAC and its importance. I was speaking with a friend and asked them to donate to the PAC. I listened quietly as they told me why they would not. When I was told they won’t donate because our PAC gives to politicians they don’t support or have political views that were different from theirs, I realized it was time that we explained how and why we choose to donate to particular individuals. As the KDPAC, we don’t take wide political stances, we donate because the politician has expressed interest in organized dentistry and they share the same interests as our association. Our PAC is not inclined to donate to only one party, but swings openly to all sides. It is important that we as members donate to the KDPAC; it allows us to become more articulate in Frankfort and ensures our voices will be heard. It should not be against anything you are, professionally. Its sole purpose should be the support of dentistry. I hope this clarifies - our PAC is a dental PAC - not one for personal opinions. If you donate to the PAC or if you know of a legislator who supports our views in dentistry, contact Mike Johnson and request the PAC donate to this legislator. Mike does a wonderful job with the KDPAC. He works hard and takes a lot of flak, but he always manages to get the job done. Thanks, Mike, we do appreciate everything you do.

For those of you in bourbon country who chase the elusive spirits, fall is upon us and the new releases are soon to be out! I know that Kentucky Owl has hit the streets and is already in short supply. I don’t think it will be long before Pappy Van Winkle, Elijah Craig and other premiums will be meandering the streets of our cities. Good hunting to all of you who strive to find the “hard to gets”. I know this is not dentistry, but it’s a hobby that is growing in participation and it’s also good for Kentucky’s economy.

Soon, we will be in Denver for the annual meeting. I am looking forward to the time with my family and those I have not seen in a while. I am looking forward to attending the House of Delegates and other events. It has been many years since I have been to Denver. I think it was in 1975 or 1976 – anyway, a long time ago and I am sure things have changed a bit. Time seems to go by so quickly at these meetings and then we enter the holiday season. I wish everyone safe travels and hope to see you in Denver.

As morning approaches in the mountains, the smell of fresh brewed coffee looms in the room. I had to wait for quiet time to put together my thoughts as I look outside to the darkness fading into the light of day. My time seems to be limited as I spend my extra time at Red Bird Mission in Clay County, which is one of the poorest and unhealthiest counties in the state. I must say, the people of Red Bird have welcomed me with open arms and they have embraced dentistry by providing services to the underserved of their counties.

As I sit and think of Dr. Bobrowski’s comment, “Where did the year go?” I am beginning to feel the same way. It seems as only yesterday that I took office and this is my fourth KDA TODAY article. I am looking forward to French Lick and hope everyone decides to attend for the next two years. I am also really excited that in 2019 we are going back to the Galt House! What a homecoming this will be. For those of you who remember the Galt House days, remember the special times we had there. If only Kunz’s Restaurant would be re-born it would be as the days of yesteryear. I have to say thank you to B.J. Moorhead and the Council on Annual Sessions for getting us back to the Galt House. The only difference, it will be the fall of the year. The carriage rides should be much more comfortable and will bring back fond memories.

Until we meet again, happy trails from the mountains of Eastern Kentucky. I hope everyone had a great 2016 summer.

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