State Board of Dentistry Report – January 15, 2021

Chairperson Dr. Lugo welcomed attendees, including incoming board counsel Shana Walter. The minutes were approved with minor corrections.

Prosecutorial Report

The prosecutions were discussed in executive session. One consent agreement that involved a dentist who was found to have left their prescription pad in an unsecured location was rejected as too lenient.

Budget Report

Kim Adams, chief budget analyst for the department of state, presented the financial position of the board. The number of licensees has risen steadily, and growth continued in 2020/21. 91.6 percent of all revenue from the board derives from renewals and initial applications

Ms. Adams anticipated a $237,806.90 shortfall for the upcoming biannual renewal period. Board members asked Ms. Adams how delaying fee increases would impact these numbers. Ms. Adams indicated that this would make their deficit worse but left the decision to delay to the board’s discretion. Other board members asked about other medical boards who have waived renewal or application fees for 2021. Board counsel noted that many boards are operating at a surplus and can afford to waive fees.

Legal Report

Carolyn DeLaurentis of the department legal office presented statistical analysis of prosecutions, which have been conducted virtually during the pandemic. They are down in the number of cases, but the number of closed cases is close to the open cases, which means they are progressing in their investigations. There were 1,223 opened cases regarding violations of DOH or CDC orders related to COVID-19 in 2020.

Fee Regulations

Dr. Lugo noted the grim financial position of the board. Regulations for fee increases were approved in 2019 but were not published until November 2020. Comments from the Independent Regulatory Review Commission were not received until mid-January. IRRC comments reflected those sent in from PAGD and PDA, which showed concern about the implications of increased fees during the financial hardships dental offices are experiencing.

BPOA Chief Counsel Cynthia Montgomery described the financial structure of the board. Most licensing boards contribute to the Professional Licensing Augmentation Account (PLAA). Boards are permitted to borrow from the PLAA when they enter deficits, which the SBOD is currently in.

The recommendation of IRRC and the Bureau of Professional and Occupational Affairs is to delay the rulemaking for fee increases until 2023. BPOA explored the possibility or pushing licensure back until May/June of 2021, but that would stress staffing levels and potentially confuse licensees for CE requirements.

Board members asked if there would be implications for continuing to operate with a deficit. Ms. Montgomery noted that the consequence is that the board would continue to borrow from the PLAA. The estimation is with fee increases in 2023, the board would be solvent again in 2027/28.

Ms. Montgomery was asked if the PLAA was in danger of being insolvent due to other boards operating in a deficit. She noted that only six of the 25 boards that contribute to the fund are operating at a deficit. Ms. Hart Hughes voiced her anger about the irresponsibility of this board regarding fee increases. She noted that fee increases in 2016/17 were approved but never enacted, which have led to their current financial state. She was assured that this fee increase would be seen through to implementation.

The board moved to direct counsel to redraft the regulations to delay implementation of fee increases until 2023. It was approved unanimously.

Report of the Chair

Dr. Lugo presented notes from a conference of the American Association of Dental Boards. Other states reported efforts to license dental assistants and dental therapists, as well as create standards of practice for Botox and tooth whitening.

CDCA Report

Pat Connolly-Atkins from the Commission for Dental Competency Assessments presented. Much of her presentation discussed the difficulties of licensing examinations during pandemic, including mannequin examinations. The board showed concern about what was considered high passage rates for mannequin examinations compared to those of live patients. The board moved to accept mannequin examinations and provisional licenses for hygienists during the state of emergency. Board counsel noted that this exception would extend 90 days beyond the state of emergency so licensees could be prepared to apply for full licensure upon its expiration. The motion passed with two nays.