AUGUST 2011 VOLUME 12, ISSUE 8 AVAILABLE ONLINE AT TDA.ORG

Inside

TDA Smiles FoundationTexas Mission of Mercy Texarkana Medicaid Electronic Health Record TDA Perks Preston’s Press TSBDE Rule Update

September Journal News

TDA Membership Directory

Allied Groups Listing

Component Societies Listing

Around the State

September 15 – 17AustinTexas Academy of General DentistryLone Star Dental Conference September 22 & 23El PasoEl Paso Dental Conference September 23El PasoTDA Executive Committee Meeting September 24Bridge CitySmiles on Wheels

Click & Connect

Join us on Facebookgroups.to/texasdental Follow us on Twittertwitter.com/theTDA Get LinkedInlinkedin.com, search “Texas Dental Association”

JUNE, 2008 VOLUME 9, ISSUE 6 AVAILABLE ONLINE AT TDA.ORG

InsideMedicaid in My Office?Yes, I Think So!Richard M. Smith, DDS

TDA Smiles FoundationTMOM gains ardent advocate

Ask the PresidentIncoming President’s messageHilton Israelson, DDS

Let’s TalkOutgoing President’s messageA. David May, Jr., DDS

2008-2009 TDA Board of Directors

Meet Your TDA StaffTDA’s new Finance Director Dee Dee Delagarza

Congratulations to TDA Component Societies

Streamline Your Insurance ClaimsSpeeding up confirmation of benefits and eligibility

TSBDE Rule UpdateRequirements for dental office radiograph machines

In the NewsTDA members in the news

July Journal NewsTooth Whitening: A Clinical Review

TDA Historical PerspectivesDentists, dental hygienists, and the dental team

The 2007 C.T. Rowland AwardOrthodontic case report

The El Paso Dental Conference

Around the StateAugust 14:TDA Board MeetingAustin, Texas

October 15-19:ADA Annual SessionSan Antonio, Texas

Click & ConnectUpdate Profile tda.org – Membership Info Ask a Colleague tda.org – Features TEXAS Meeting Photostexasmeeting.com/estore

Volunteer for ‘08 ADAtda.org/volunteerada08

Every Member MattersRise’ Lyman, DDS, TDA Future Focus Committee

Membership growth is vital to any thriving organization. The Texas Dental Association (TDA) Board is strongly committed to the Membership goal within the “TDA 2009” strategic plan, which addresses continued growth. I am proud to report that, as evidence of that commitment and for the second year in a row, the TDA received the following ADA awards in 2008:• Greatest Percentage Membership Net Gain: Texas had a net gain of 198 members in the year 2007.• Top Constituent Dental Society with Greatest Percentage of Non-Members to Membership: Represents a conversion of 4.7 percent of non-members into membership at end of year 2007.• Top Constituent Dental Society to Improve Retention Rate Percentage in 2007: Represents a 97 percent Association retention rate, which is an increase of 7 percent from the previous year.• Greatest Percentage of New Dentist Members: Represents a gain of 111 new dentist members (those dentists who are 1-9 years out of school).

Another example of the commitment to the growth of our Association is the TDA Externship Program, which builds student awareness of organized dentistry. This innovative program, created in 2007, offers students the opportunity to gain insight into the different components of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and to gain a better understanding of their role as future leaders of the dental team. The program is open to dental students from each of the three dental schools in Texas. This year the externship program will take place June 20 – June 27 in Austin at the TDA central office. As an ongoing effort to enhance the value and benefits of the Association, the TDA Council on Membership developed a survey that was sent to all members in 2006. The results clearly showed that members have a high satisfaction rating with benefits such as the TEXAS Meeting, TDA publications, and the ability to participate philanthropically in the TDA Smiles Foundation. A great number of the discounted programs offered to members through the TDA Perks Program also received a high satisfaction rating. In accordance with the strategic plan, the Council on Membership, will survey members again in 2009. Participation from all members and a collaborative effort between the ADA, TDA, and local component societies are the keys to successful membership recruitment and retention. We encourage every member to get involved whether it is by attending local meetings, taking part in Give Kids a Smile! Day activities, volunteering at a Texas Mission of Mercy, or participating in TDA Legislative Day activities in Austin. Each member matters and is essential to the continued growth of our Association and of organized dentistry. This is the seventh and final in a series of articles focused on the TDA’s accomplishments guided by the strategic plan. To view the entire plan, log in at www.tda.org and click on “TDA 2009” under “Current Issues” on the member homepage. For more information, please contact Lyda Creus Molanphy, staff liaison to the Future Focus Committee, at the TDA central office, (512) 443-3675.

MembershipDentists will value membership and participation in the TDA.

Objectives1. Improve perceived value and benefits of membership in TDA. a. Increase members’ knowledge about the impact and benefits of TDA membership. b. Ensure that components are an integral aspect of the membership process. c. Create greater awareness of the availability of the Peer Review, Ethics & Judicial, and Risk Management benefits. d. Actively promote adherence to the Code of Ethics. e. Enhance communication with members and non-members. f. Build student awareness of and interest in organized dentistry and membership in TDA. g. Ensure ongoing contact with students throughout dental school. h. Work closely with dental school faculty. i. Evaluate number of nonmember dentists who attend and participate in TDA activities (TEXAS Meeting, TDA Smiles Foundation programs, etc.).Metrics1. Seventy percent of active licensed dentists in TX will be members of TDA by 2009 (baseline of 68.5% in January 2007); increase

membership retention rate to 97 percent by April 2007 (baseline 96% in 2006). a-d. Increase the number of dentists serving on component peer review and ethics and judicial affairs committees to attain a

participation rate of 2-5 percent relative to the total number of component society members by August 2009.2. Ninety percent of TX dental school graduates actively licensed in TX will be members of TDA five years after graduation (89%

dental student conversion from the graduating class of 2005 in Texas).3. Increase the number of member dentists actively participating in TDA by 1 percent a year (as measured by a variety of means

– participation at TX Meeting, TMOM, TXDDS, FSI programs, DENPAC participations, TDA legislative day) with annual report to TDA Board by the Council on Membership.

4. Establish baseline of nonmember participation at TDA activities (CAS, TDA Smiles Foundation, Membership) 5. Established baseline of members’ understanding of and satisfaction with the benefits of their TDA membership through Member

Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009.6. Sixty-five percent of all full-time faculty will be TDA members by 2009 (2006 baseline = 63%).

Mission: To be The Voice of DenTisTry in Texas

Manpower Advocacy OrganizationalExcellence

Public Image

Development Membership

The TDA will update it’s strategic plan with another statewide retreat in August of 2008.

In 2003, Texas Dental Association members from across the state develop TDA’s first strategic plan, TDA 2009.

Future Changes to Texas Medicaid Dental Program OnlyJuly27,2011,theHealthandHumanServicesCommission(HHSC)announcedtentativedentalcontractawardsforTexasMedicaidandtheChildren’sHealthInsuranceProgram(CHIP)—The“TexasDentalProgram”—tothefollowingmanagedcareorganizations(MCOs):• DeltaDentalInsuranceCompany• DentaQuestUSAInsuranceCompany,Inc.• MCNAInsuranceCompany

ThefinalawardsarecontingentuponthesuccessfulnegotiationandexecutionofcontractsbetweentheMCOsandtheState.ThefinalcontractsbetweentheMCOsandtheStateshouldbesignedbythefirstofSeptember.TDAstaffwillcontinueworkingwithHHSCandtheMCOstohelpassistinthetransitionforparticipatingdentistsandprogramenrollees.IfyouareinterestedinparticipatinginthenewTexasDentalProgram,thefirststepistocontacttheMCOs.Although,asofthiswriting,theMCOshavenotfinalizedcontractswiththeState,orestablishedfeeschedules,youmaywishtosignaLetterofIntent(LOI)tojoineachMCOsnetwork.SigningaLOIdoesnotobligateyoutocontract

withanMCO.ItismerelythefirststepintheMCOscredentialingprocess.ParticipatingdentistsmustbeenrolledasMedicaidproviderswiththeStateandcredentialedwiththeMCOsinwhichtheywishtoparticipate.

TheMCOscontactinformationisbelow:• DeltaDentalInsuranceCompany (800)775-0523Ext.3066 E-mail:PR-Texas@delta.org• DentaQuestUSAInsuranceCompany,Inc. (800)685-9971 E-mail:dqrecruiters@dentaquest.com• MCNAInsuranceCompany— DavidL.Brownell,DirectorofProviderRelations Website:http://www.mcna.net/provider/texas-program/

TheTDAwillcontinuepublicizingmonthlyupdatesintheTDA TodayaboutthecommercialadministrationoftheTexasDentalProgram.Youmayviewpreviousupdates,startinginNovember2010,byaccessingtheTDA Today archivesontda.org. Additionally,theTDAwillbesendingemailannouncementsasnewinformationbecomesavailable.TheTDAiscommittedtohelpingdentistsnavigatethenewTexasDentalProgramandwillbecreatingtoolstoassistparticipatingdentistsineducatingthemselvesandtheirpatientsabouttheupcomingchanges. Forquestionsorcomments,contactTDA’spolicymanagerMs.DianeRhodesat(512)443-3675ordiane@tda.org.

HHSC Rolls Out the New “Your Texas Benefits” Medicaid Card TheTexasHealthandHumanServicesCommission(HHSC)isintroducinganewsystemthatusesdigitaltechnologytostreamlinetheMedicaideligibilityverificationprocessandprovidesaccesstoMedicaidhealthhistory.

Thetwomainelementsofthesystemare:• TheYourTexasBenefitsMedicaidcard,whichreplacesthepaper

MedicaidIDletter(Form3087)thatclientsreceiveinthemailmonthly.

• AwebsiteforMedicaidprovidersthatsuppliesup-to-dateinformationonapatient’seligibilityandhistoryofservicesandtreatmentspaidbyMedicaid.

DuringthefirstweekofAugust2011,HHSCbeganmailingtheYourTexasBenefitMedicaidcardsto3.4millionTexanscoveredbyMedicaid.Medicaidclientscanbeginusingthecardsimmediately.Thenewplasticcardwillbetheclient’severydayMedicaidcardandwillonlybereplacediftheclientchangeshealthplansorifthecardisdamagedorlost.ThecurrentpaperMedicaidIDletter(Form3087)willbemailedouttoclientsforthemonthsofAugustandSeptember.ThispaperMedicaidIDletterwilldiscontinueafterSeptember2011. ParticipatingMedicaidproviderscanbeginusingyourtexasbenefitscard.comtoverifyapatient’sMedicaideligibility.Providerscanopttopurchaseequipment,suchasacardreader,toutilizethecard’smagneticstripethatcontainstheclient’sMedicaidIDnumber.However,noequipmentisrequired.Providersalsocancontinueverifyingeligibilitythroughexistingchannels,whichdonotrequirethepurchaseofanyadditionalequipment. AdditionalfunctionalityfortheYourTexasBenefitsMedicaidcardprojectwillrolloutinlate2011.

Newfeatureswill:• Allowproviderstoviewpatients’claims,prescription,and

diagnosishistory;immunizationdetailsandlabdata;andallowe-prescribing.

• GiveMedicaidclientstheabilitytovieweligibilityinformation,detailsaboutservicesreceived,andExplanationofBenefits(EOBs).Clientswillalsobeabletorequestacardreplacementonlineandprintatemporarycard

FormoreinformationonthenewYourTexasBenefitsMedicaidcardvisityourtexasbenefitscard.com.Orcall,(855)827-3747.

Dentists Who Care Holds ConferenceDentistsWhoCareheldits15thAnnualCharityDentalConferenceonAugust5and

6,2011,atIslaGrandBeachResortinSouthPadreIsland,Texas.Arecordnumberof450peopleattendedtheevent. TDApresidentDr.J.PrestonColemanaddressedtheVIPluncheonattendeeswithawelcomeaddress.Speakersattheconferencetouchedonallareasofdentistry. DentistsWhoCareisagrassrootsmovementofdentistsworkingtostopchildhooddecay.Itsmissionistospreadthemessageofpreventivecaretochildren. Formoreinformation,pleasevisitdentistswhocare.us. Dentists Who Care 2011 Board of Directors: back row (L-R): president Dr. Larry Balli of Edinburg, secretary Dr. Grayson

Sellers of Los Fresnos, immediate past president Dr. Joe Peralez III of Edinburg, treasurer Dr. Noel Garza of Mission, and member Dr. Adam Lalonde of Los Fresnos; front row (L-R): member Dr. Sergio Guzman of McAllen; member Dr. Carlos Garcia of Weslaco; and vice president Dr. Ricardo Garcia and member Dr. Joey Cazares, both of McAllen.

August 2011 / TDA Today / 2

Happy, Healthy Smiles …

That’s Our Mission!

Texas Mission of Mercy TexarkanaTDASmilesFoundation(TDASF)heldits24thTexasMissionofMercy(TMOM)inTexarkanaAugust5-6,2011.Thiseventwasahugesuccess,providing532patientswith$438,691worthofcharitabledentalcare,including30partials!

ThiseventransmoothlythankstotheincrediblepartnershipwithCHRISTUSSt.Michael.CHRISTUSfinanciallysupportedtheevent,anddozensofitsemployeesvolunteered,allowingTDASFvolunteerstoprovidecaretoTexarkanaresidents.AlongwithCHRISTUSSt.Michael,TDASFofferssinceregratitudetoDr.andMrs.MilburnS.HaynesofTexarkanafortheirdentalandeventsupport,CrownDentalLabforthe30partialsprovidedfreeofchargetothepatients,HenryScheinforX-raysupport,PattersonDentalfordentalandequipmentsupport,plusmanyrestaurantsintheareathatprovidedfoodforTDASFvolunteers.

TwomoreTDASFcharitableeventsremainthisyear:aSmilesonWheelsinBridgeCityonSeptember24andaTMOMinAmarilloonOctober28and29.Toregistertovolunteerateitheroftheseevents,pleasevisittdasf.org.

Perks Partner News Saginaw Dentist Wins Perks’ Latest Giveaway Dr.FredLoeofSaginaw(FortWorthDistrictDentalSociety)istheluckywinnerofTDAPerksProgram’s$200Visa®Gift

CardGiveaway.TDAmemberswhoregisteredtheirpracticesforPerks’OfficeDepotdiscountprogrambyJuly31wereautomaticallyenteredinadrawingforthecard.Missedthecontest?YoucanalwaysregisterforthePerksOfficeDepotprogramtosave10percentonmorethan18,000officesupplyitems.Youoryourstaffcanregisteronlineattdaperks.com,orbycallingJohnListiat:(512)284-3392. Questions? Call TDA Perks Program at: (512) 443-3675.

Dallas Seminar Focuses on Attaining Practice Success Perkspartner,InsuranceAnswersPlus,ishosting“TheKeyEssentialsofaSuccessfulPractice”seminaronFridaySeptemer9atParkCitiesHiltoninDallas.The8:30a.m.-3:30p.m.seminarfeaturesspeakerDr.RhondaSavage,CEOofMilesGlobal,andwillcoverthesystemsofasuccessfulpractice,howtoattainclinicalexcellencethroughcomprehensivetreatmentplanning,howtoattractandretaintheidealteam,thefourbestschedulingtips,andmore.CEcreditsareavailable.Downloadcompleteinformationat:http://tinyurl.com/PerksSeminar. Questions? Call Insurance Answers Plus at: (800) 683-2501.

Dr. Frederic G. Sperry of Omaha is pictured with a patient at the TMOM Texarkana earlier this month.

Dr. Kent B. Macaulay of Round Rock consults a patient at the TMOM Texarkana earlier this month.

What some past participants are saying:

“Dr. Sperry really was a blessing to me. I am so very thankful to him! I am also so thankful to God for everyone who has helped me and the others today!” — Ms. Angela Reed, Texarkana (Dr. Fred Sperry, Omaha)

“Dr. Pratt did an amazing job!” — Ms. Roshonda Black, Texarkana (Dr. Steven Pratt, Atlanta)

“Dr. Bunel did amazing work on me!” — Ms. Agnes Guy, Texarkana (Dr. Kirby Bunel, Texarkana)

“Dr. Dickerson is wonderful!” — Mr. Ray Burns (Dr. Rein Dickerson, Mineral Wells)

“Dr. James was a very friendly doctor. He was very quick. Thank you.” — Anonymous (Dr. Joe James, Texarkana)

“Dr. Lathrop was very, very good! All of the workers were great.” — Mr. Bobby Walker, New Boston (Dr. Colin Lathrop, The Woodlands) ”

“

Texas Medicaid Electronic Health Record (EHR) Incentive Program This is the ninth in a series of articles to keep you informed of the Texas Medicaid Electronic Health Record (EHR) Incentive Program and continuing efforts to implement health information exchange initiatives across Texas. The incentive program provides incentive payments to Medicaid providers for the adoption and meaningful use of certified EHR technology. Future articles will focus on helpful reference websites, health information exchange, meaningful use for dentists, certified EHR technology for dental practices, and other relevant topics of interest to dentists. Thisarticleisacontinuationoflastmonth’sdiscussionaboutMeaningfulUse(MU)ObjectivesandClinicalQualityMeasures(CQM)fortheMedicaidEHRprogram.Dentistsmustmeetthesameeligibilityrequirementsasothereligibleprofessionals(EP)inordertoqualifyforpaymentsundertheMedicaidEHRIncentiveProgram.Thisalsomeansthattheymustdemonstrateall15ofthecoreMUobjectivesandfivefromthemenuoftheirchoosing.ThecoresetincludesreportingofsixCQMs(threecoreandthreefromthemenuoftheirchoosing).Severalmeaningfuluseobjectiveshaveexclusioncriteriathatareuniquetoeachobjective.ParticipatingdentistswillhavetoevaluatewhethertheyindividuallymeettheexclusioncriteriaforeachapplicableobjectiveasthereisnoblanketexclusionbytypeofEP. TheTexasDentalAssociation’sCommitteeonAccess,Medicaid&CHIPrecentlyreviewedandgaverecommendationstotheTexasHealthandHumanServicesCommission(HHSC)regardingthefederalMUobjectivesandCQMsastheyrelatetodentistry.ItishopedthatHHSCwillsharethisinformationwiththeCentersforMedicareandMedicaidServices(CMS)andreferenceitastheydeveloptheactualdataexchangewithMedicaidprovidersaspartoftheState2implementationoftheMedicaidEligibilityandHealthInformationServices(MEHIS)project.MEHISisastatewidesystemthatreplacesthecurrentpaperMedicaididentificationformwithapermanentplasticcard,automatesMedicaideligibilityverification,providesanEHRforallMedicaidclients,offerselectronicprescribingfunctionality,andestablishesafoundationforafutureHealthInformationExchangeforimprovedefficiency,continuityofcare,andhealthoutcomes.MEHISStage2implementationwilloccurincoordinationwithTexas’MedicaidEHRIncentiveProgramandthecollectionofMUandCQMs. CMShasdetailedinformationfortheMedicaidEHRprogramatwww.cms.gov/EHRIncentivePrograms.ForhelpintheTexasenrollmentprocess,emailHealthIT@tmhp.comorcall(800)925-9126,option4.

TDA Conducts Freshmen Day at UTSD, Baylor TDAsponsored

FreshmenDayattheUniversityofTexasHealthScienceCenterSchoolofDentistryatHouston(UTSD)andBaylorCollegeofDentistry–TexasA&MHealthScienceCenteronAugust12.

Seventy-threeUTSDfreshmenand106Baylorfreshmenattendedtheevenys.Thestudentsweretreatedtolunch,hadthechancetowindoorprizes,andlearnedaboutthebenefitsoforganizeddentistryandtheservicesofferedthroughthetripartitemembershipsystem.

UTSDAssociateDeanforStudentandAlumniAffairsDr.HughP.Pierpont,TDACommitteeontheNewDentistmemberDr.JeremyChance,GreaterHoustonDentalSociety(GHDS)

presidentDr.KarenA.Walters,andGHDSmemberDr.RichardCollinshostedtheeventatUTSD.TDACouncilonMembershipmemberDr.LynneGerlach,CommitteeontheNewDentistchairDr.AndreaJ.Keith,andDr.SarahTevisPoteethostedtheeventatBaylor.TDAandlocalsocietystaffalsoattendedtheevents. HighlightsfromtheUniversityofTexasHealthScienceCenteratSanAntonioDentalSchoolwillbefeaturedinafutureTDA Todayissue. Formoreinformation,pleasecontacttheTDADepartmentofMemberServices&Administration,(512)443-3675.

TDA Committee on the New Dentist member Dr. Jeremy Chance speaks to freshmen dental students at TDA Freshmen Day at UTSD.

Incoming freshmen attend the TDA Freshmen Day at UTSD earlier this month.

TDA Perks Opens Electric Service to TDA Staff, Adds Residential Service ThroughitspartnershipwithJLTEnergyConsultants,TDAPerksEnergyProgramisswitchingtoanewretailenergyprovider(REP)thatwillallowTDAmembersandtheirstafftoenjoyexclusiveenergysavingsattheirhomes,inadditiontoattheoffice.Moreenergychoices;faster,easieronlineenrollment;andprogramavailabilitytoTDA-members’staffaresomeofthenewfeaturesoftheupdatedprogram.Visittdaperks.com,clickon“EndorsedPartners”and“TDAPerksEnergy”formoreinformation.*Youmustliveinaderegulatedareatobeeligibletoparticipate.

TDA Perks’ Advocate Program Launches AnyTDAmemberinterestedinbecomingachartermemberofTDAPerksProgram’snewAdvocateProgramisencouragedtocontactthePerksstaffimmediately.AnadvocateisavolunteerTDAmemberwhoservesasTDAPerksProgramliaisonathis/herrespectivelocalsociety’smeetings.AdvocateswillhavetheopportunitytotryPerksprogramstohelpevaluatetheirquality,jointheTDAFinancialServicesBoardatitsmeetingsinAustin,andreceivespecialrecognition.Chartermembersinclude:Dr.RolandDavies,CapitalAreaDentalSociety;Dr.LisaHeinrich-Null,GuadalupeDistrictDentalSociety;andDr.WilliamNantz,DentalSocietyofSoutheastTexas.Formoreinformation,contactthePerksstaffat(512)443-3675ore-mailJoshEpsteinatjosh@tda.org. Questions? Call TDA Perks Program at: (512) 443-3675.

August 2011 / TDA Today / 3

Green Lights!

OrganizationalexcellenceisoneofthegoalsforTDA2014,coveringawiderangeofobjectivesfromincreasingthenon-duesrevenuestoenhancementoftheTDAfacilities.Iwillbrieflyfocusonobjectivefour:maximizetheeffectivenessofallTDAmanagementandgovernance. Lastyear,therewereconcernsthatourfinancialreportsneededreevaluating/redesigntosimplifytheinformation.Thisspring,anindependentauditingfirmpraisedourfinancialreportingsystem.ThefirmsuggestedthatadditionaltrainingmighthelptheBoardseethebigfinancialpicture.Asaresult,theAugustboardmeetingincludeda2-hourpresentationbyMr.MattKouri,presidentandexecutivedirectorofGreenlightsforNonprofitSuccess. Thepresentationcoveredrolesandresponsibilitiessharedbyallnon-profitboards,fundamentalboardrolesandresponsibilities,advancedboardpractices,andfinancialoversight.KourialsopresentedontheNon-ProfitandTexasBusinessOrganizationsCode.Healsoexplainedthatthemostimportantdutiesofadirectorareloyalty,care,andobedience.Loyaltyrequiresadirectortoperformhisorherdutiesingoodfaith,alwaysactinginthebestinterestoftheorganization.Carerequiresdirectorstousesoundjudgmentindecision-makingonbehalfoftheorganization,devotingareasonableamountoftimeandattention—“ordinarycare”—tounderstandthemattersbeforethem.Obediencerequiresadirectortoactinthebestinterestofthenon-profit,settingpolicyandmakingdecisionsthatareconsistentwiththemissionoftheorganization. KourialsopointedoutthatintheTDABylawsandBoardManual,BoardresponsibilitiesincludemonitoringthemanagementoftheAssociation’spropertyandpayingtaxes.Thedocumentsstate,“…duringthetermofofficeontheBoardofDirectors,eachmemberhasthedutyofconsideringnotonlytheinterestsofthemembersoftheirparticulardivisionorgeographicalarea,butalsothewelfareofthisAssociation,thedentalprofessionasawholeandthepublicweserve.”ThisisborneoutbythefactthatBoardmembersarenominatedbyoneofthefourdivisionsandarealsoelectedbyavoteoftheHouseofDelegates. TheTDABoardofDirectorsmustbestrategicallyengagedintheoperationoftheAssociation,walkingafinelinebetweenmicro-managementandhands-offneglect.Therearethreemodesofgovernance:fiduciary,strategic,andgenerative.WhentheBoardworkswellacrossallthreemodesofgovernance,leadershipistheresult. Financialoversightiseveryone’sjob,butthetreasurerismostoftentheleader.Effectiveoversightrequiresgoodreports,questions,andactions.TheTDABoardreceivesa16-pagefinancialreportateachmeeting.Onepageshowsthebigpictureofcashflow,budgetprogress(andcomparisonwiththepreviousyear)aswellasrevenueoverexpensesfortheyeartodate.Therearefivepagesofdetailsupportingthesummaryreportandfourreportstoexplainotherareasthatarenotapartofthesummary,butrequireoversight.ThreepageshaverecentlybeenaddedtoprovidetheBoardmemberswithgreaterdetailsoftransactionsintheTDAreservefunds. Ourbudgetingprocessisthoughtfulandrealistic,takingintoconsiderationthatadequateresourcesareneededtosupporttheprogrammaticandadministrativeplan.ThisprocessiscarriedoutbytheBudgetCommitteeundertheguidanceofthetreasurer. TheAuditCommitteeandthedirectoroffinanceworkdiligentlyeachyeartoprovideaccurateandcompleteinformationfortheannualauditofthefinancialstatements.Theresultsintheauditors’reportsandcommentshavealwaysreflectedpositivelyonourstaffandorganization. ReviewingthepointsofKouri’spresentation,IfeelthatwearefinanciallysoundbothinregardstoourfiscalconditionandtheBoard’sfunctionforfinancialoversight.Nevertheless,thereareimprovementstobemadetobettertierthefinancialrolesoftheTDA,allowingtheBoardtoconcentratemoreonthebigpictureandofwhatliesaheadinthefuture.

Preston’s Press

J. Preston Coleman, D.D.S., TDA President 2011-12

ThisTSBDEUpdatewilladdressTexasStateBoardofDentalExaminers(TSBDE)Chapter110—22TAC§110.4—MinimalSedation(Level1)permit.TheTSBDEdefinesLevel1MinimalSedationas,“Nitrousplusoneenteraldrug .”(1) AdentistholdinganactiveEnteralSedationpermitbeforeJune1,2011,willautomaticallyhavehis/herpermitreclassifiedasaLevel1MinimalSedationpermitinaccordancewith§110.4(a)(3).ALevel1PermitautomaticallyqualifiesanapplicantforNitrousOxideandLevel1privileges(1). Asareminder,althoughChapter110becameeffectiveJune1st,theTSBDEwillnotstartenforcingrequirementsuntilJanuary 1, 2012.Thisdelayisintendedtoallowampletimefordentiststobecomecompliantwithallfacetsofthenewregulationssuchasstandardsofcareandmonitoring. TheTSBDEdefinesMinimalSedationas,“Aminimallydepressedlevelofconsciousness,producedbyapharmacologicalmethod,inwhichthepatientretainstheabilitytoindependentlyandcontinuouslymaintainanairwayandrespondsnormallytotactilestimulationandverbalcommand(2).” ThesummarybelowistakendirectlyfromChapter110—22TAC§110.4—MinimalSedation. AdentistapplyingforaMinimalSedationpermitmustmeetoneofthefollowingeducational/professionalcriteria: §110.4(a)(1):satisfactorycompletionoftrainingtothelevelofcompetencyinminimalsedationconsistentwiththatprescribedintheAmericanDentalAssociation(ADA)GuidelinesforTeachingPainControlandSedationtoDentistsandDentalStudents,oracomprehensivetrainingprograminMinimalSedationthatsatisfiestherequirementsdescribedintheADAGuidelinesforTeachingPainControlandSedationtoDentistsandDentalStudents.This

includesaminimumofsixteen(16)hoursofdidactictrainingandinstructioninwhichthecompetencyinenteraland/orcombinedinhalation-enteralminimalsedationtechniqueisdemonstrated;or §110.4(a)(2):satisfactorycompletionofanadvancededucationprogramaccreditedbytheADACommissiononDentalAccreditation(CODA)thataffordscomprehensivetrainingnecessarytoadministerandmanageminimalsedation,commensuratewiththeADA’sGuidelinesforTeachingPainControlandSedationtoDentistsandDentalStudents. Additionally,adentistperformingminimalsedationmustadheretostandardofcarerequirements(§110.4(b)(1-4))andclinicalrequirements(§110.4(c)(1-8)(d))includingmaintainingundercontinuousdirectsupervisionauxiliarypersonnelcapableofreasonablyassistinginprocedures,problems,andemergenciesincidenttotheuseofminimalsedationaswellasmaintainingcurrentcertificationinBasicLifeSupport(BLS)forHealthcareProvidersfortheassistantstaffbyhavingthempassacoursethatincludesawrittenexaminationandhands-ondemonstrationofskills. Thedentistisresponsibleforthesedativemanagement,adequacyofthefacilityandstaff,diagnosisandtreatmentofemergenciesrelatedtoadministrationofminimalsedation,andprovidingtheequipmentandprotocolsforpatientrescue. Inadditiontothedentist,atleastoneadditionalpersontrainedinBLSforHealthcareProvidersmustbepresent. Thepatient’sbaselinevitalsmustbeobtainedinaccordancewith§§108.7(MinimumStandardofCare,General)and108.8(RecordsoftheDentist).Afocusedphysicalevaluationmustbeperformedasdeemedappropriate,andpre-proceduredietaryrestrictionsmustbeconsideredbasedontheprescribedsedativetechnique.Pre-procedureverbalandwritteninstructionsmustbegiventothepatient,parent,escort,guardian,orcare-giver.

Continued on page 4

BelowisasummaryofactionsoftheTDABoardofDirectorsduringtheMay8,2011,meetingwithTDApresidentDr.J.PrestonColemanpresiding.

Non-Policy Resolutions

APPOINTMENTS1-2012-B: Re-appointedDr.ArthurH.JeskeasTDAhistorian.2-2012-B: AppointedtotheTDAHoldingCompanyBoard:PresidentDr.RonaldL.Rhea;Vice-PresidentDr.MichaelL.Stuart;Secretary-TreasurerDr.RonCollins;Dr.W.KennethHorwitz,presidentofTDAFinancialServices,Inc.3-2012-B: AppointedTDAseniordirectorDr.T.BethVanceaschairoftheSunsetReviewCommittee.

OUT-OF-STATE TRAVEL4-2012-B:ApprovedTDAexecutivedirectorMs.MaryKayLinn,TDAdirectorofmemberservicesandadministrationMs.LeeAnnJohnson,andTDAexecutiveaffairsmanagerMs.DonnaCorteztoattendtheADAManagementConferenceinChicago,Illinois,onJuly18-21,2011.

BelowisasummaryofactionsoftheTDABoardofDirectorsduringtheJune24,2011,meetingwithTDApresidentDr.J.PrestonColemanpresiding.

Policy Resolutions

APPOINTMENTS26-2012-B (P): NominatedRonaldG.Presswood,D.D.S.fortheNortonM.RossAwardforExcellenceinClinicalResearch.

MISCELLANEOUS18-2012-B (P): Supportscommunitywaterfluoridationwithintherecommendedtherapeuticlevelsasdeterminedbytheappropriatefederalagencies.RescindedResolution88-1972-H.

Non-Policy and Board Policy Resolutions

APPOINTMENTS5-2012-B (NP): Appointed2011-12BoardliaisonstotheTDAcouncilsandcommittees.6-2012-B (NP): AppointedDr.VictoriaA.Vickers(SW)to

MK’s Board Notes

Mary Kay Linn, TDA Executive Director

TSBDE Rule UpdateThis recurring section is designed to help TDA members keep up with important Texas State Board of Dental Examiners (TSBDE) rules, other regulations, and state law affecting their practices.

filltheunexpiredtermofDr.DavidC.Woodburn(NW)(2014)ontheCouncilonEthicsandJudicialAffairs.7-2012-B (NP): AppointedDr.JeanE.Bainbridge,director,totheTDAAssetsManagementCommittee.8-2012-B (NP): AppointedTDAdirectorsDr.GregoryK.OelfkeandDr.DavidC.WoodburntotheTDABudgetCommittee.9-2012-B (NP):AppointedDr.GregoryK.Oelfke,director,totheTDAFutureFocusCommittee.10-2012-B (NP): EstablishedaReliefFundworkgrouptoreviewlettersofinterestreceivedconcerningdistributionofReliefFundgrantswithareportofrecommendationstobegiventotheBoardofDirectorsatitsMarch2012meeting.11-2012-B (NP): Re-appointedthemembersoftheExecutiveDirectorSearchCommittee:Dr.MichaelL.Stuart,chair(NE);Dr.MatthewB.Roberts,TDApastpresident(SE);Dr.LisaB.Masters,Board(SW);Dr.RitaM.Cammarata,Board(SE);Dr.MichaelJ.Goulding,Board(NW);Dr.LarryD.Herwig,Board(NE);Dr.DavidH.McCarley,TDACouncilonConstitutionandBylawschair;Dr.J.GregoryCondrey,TDAHouseofDelegates(SE);andthefollowingconsultants:Ms.DeeDeeDelagarza,staff—director;Ms.DianeRhodes,staff;andMs.TerryJordan,humanresourceconsultant.20-2012-B (BP): AuthorizedtheExecutiveDirectorSearchCommitteetoresearchandpreparerecommendationstoandresolutionsfortheBoardinhiringanexecutivedirector.21-2012-B (BP): ApprovedthejobdescriptionfortheTDAexecutivedirector.22-2012-B (BP): ApprovedthepositionqualificationsfortheTDAexecutivedirector.23-2012-B (BP): ApprovedthetimelinefortheTDAExecutiveDirectorSearchCommittee

BUDGET ISSUES14-2012-B (NP): Approveditems$400overbudgetforatotalfinancialimplicationof$42,630:salaries-temporary,consultants,andhumanresources.27-2012-B (BP): AdjustedreimbursementratesforBoardmembersrentingautomobileswhentravelingforTDAbusiness.28-2012-B (BP): AdjustedreimbursementratesforBoardmembersusingtaxiswhentravelingforTDAbusiness.29-2012-B (BP): AdjustedtheTDAtravelpolicytoincludereimbursementtomembersforairlineluggageexpensesfortwobagsnottoexceed50poundseach.RescindedResolution40-2010-B.31-2012-B (BP):ApprovedtheTDAout-of-stateandin-stateautomobiletransportationandsurfacetransportationreimbursementrateformileagebeadjustedconcurrentlywiththebusinessmileagerateadjustmentsbytheInternalRevenueService.RescindedResolution107-2006-H.

OUT-OF-STATE TRAVEL15-2012-B (NP): ApprovedTDAlegalcounselMr.WilliamH.BinghamtoattendtheAmericanDentalAssociationManagementConferenceinChicago,Illinois,onJuly18-19,2011.16-2012-B (NP): ApprovedMs.CassidyNeal,programmanager,toattendtheNationalDentalBenefitsConferenceinChicago,Illinois,onAugust5,2011.

• Seamless access to all your data from every computer.

• All the technology components of your offi ce implemented correctly—the fi rst time. (Software, hardware, intraoral cameras, patient entertainment/education screens)

• Complete and automatic daily backup of all your practice data.

• Everything smoothly integrated by foremost experts in dental computing.

MBS—Perks’ offsite back up and full service IT provider—can provide all this for your practice. TDA members have access to reduced rates on all services!

I no longer worry if my staff backed up and verifed all my practice data last night. For less than the price of a cup of coffee a day, I know all my data is safe with MBS.Arthur C. Morchat, DDS

(877) MBS-0787mbssecure.com | mbsdentalit.com

Learn about other great programs: tdaperks.com.Or call: (512) 443-3675.

MBS MakesIT Painless!AUGUST 2011 VOLUME 12, ISSUE 8 AVAILABLE ONLINE AT TDA.ORG

EDITORIAL STAFFStephen R. Matteson, D.D.S., Editor

Nicole Scott, Managing EditorLauren Oakley, Publications Coordinator

Barbara Donovan, Art DirectorPaul H. Schlesinger, Consultant

BOARD OF DIRECTORS

J. Preston Coleman, D.D.S., PresidentMichael L. Stuart, D.D.S., President-elect

Ronald L. Rhea, D.D.S., Immediate Past PresidentVice Presidents

Lisa B. Masters, D.D.S., SouthwestRobert E. Wiggins, D.D.S., NorthwestLarry D. Herwig, D.D.S., NortheastKaren E. Frazer, D.D.S., Southeast

Senior DirectorsT. Beth Vance, D.D.S., Southwest

Michael J. Goulding, D.D.S., NorthwestArthur C. Morchat, D.D.S., NortheastRita M. Cammarata, D.D.S., Southeast

DirectorsYvonne E. Maldonado, D.D.S., SouthwestDavid C. Woodburn, D.D.S., Northwest

Jean E. Bainbridge, D.D.S., NortheastGregory K. Oelfke, D.D.S., Southeast

Ron Collins, D.D.S., Secretary-TreasurerGlen D. Hall, D.D.S., Speaker of the HouseDavid H. McCarley, D.D.S., Parliamentarian

Stephen R. Matteson, D.D.S., EditorMary Kay Linn, Executive DirectorWilliam H. Bingham, Legal Counsel

TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental As-sociation, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S. IH-35, Ste 400, Austin, TX 78704-3698.Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental As-sociation (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30.Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6.Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Associa-tion, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles. Advertisements: Publication of advertisements in this publication does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made of it by its manufacturer.

Member Publication

Post-procedureverbalandwritteninstructionsmustalsobegiventothepatient,parent,escort,guardian,orcare-giver.Post-procedure,patientsshouldbeaccompaniedbyanadultcaregiverforanappropriateperiodofrecovery. Patientsconsideredforminimalsedationmustbesuitablyevaluatedpriortothestartofanysedativeprocedure.Inhealthyormedicallystableindividuals(ASAI,II),thismayincludeareviewoftheircurrentmedicalhistoryandmedicationuse.However,patientswithsignificantmedicalconsiderations(ASAIII,IV)mayrequireconsultationwiththepatient’sprimarycarephysicianorconsultingmedicalspecialist. The patient, parent, guardian, or care-giver must be advised regarding the procedure associated with the delivery of any sedative agents and must provide written, informed consent for the proposed sedation. Monitoringduringtheadministrationofsedationmustincludeoxygenationwhereinthecolorofmucosa,skin,orbloodmustbecontinuallyevaluated.Tothatend,oxygensaturationmonitoringbypulse-oximetryshouldbeusedwhenasingledrugminimalsedativeisused.The additional use of nitrous oxide has a greater potential to increase the patient’s level of sedation to moderate sedation, and a pulse oximeter must be used. Thedentist(orappropriatelyqualifiedindividual)mustobservechestexcursionsand must verify respirations continually.Bloodpressureandheartrateshouldbeevaluatedpre-procedurally,post-procedurallyandintra-procedurallyasnecessary. Documentation must be made in accordance with §§108.7 (Minimum Standard of Care, General) and 108.8 (Records of the Dentist) and must include the names and dosages of all drugs administered and the names of individuals present during administration of the drugs. Atime-orientedsedationrecordmaybeconsideredfordocumentationofallmonitoringincluding:pulse oximetry, heart rate, respiratory rate, and blood pressure may be documented at appropriate intervals of no more than 10 minutes. PermitteddentistsunderthissectionshallnotsuperviseaCertifiedRegisteredNurseAnesthetistperformingaminimalsedationprocedureunlessthedentistholdsaMinimalSedationpermitissuedbytheTSBDE. Thedentistshalldeterminethatanadequateoxygensupplyisavailableandevaluateequipmentforproperoperationanddeliveryofadequateoxygenunderpositivepressure.

Apositive–pressureoxygendeliverysystemsuitableforthepatientbeingtreatedmustbeimmediatelyavailable.Wheninhalationequipmentisused,itmusthaveafail-safesystemthatisappropriatelycheckedandcalibrated.Theequipmentmusthaveeitherafunctioningdevicethatprohibitsthedeliveryoflessthan30percentoxygen,or,anappropriatelycalibratedandfunctioningin-lineoxygenanalyzerwithaudiblealarm.Anappropriatescavengingsystemmustbeavailableifgasesotherthanoxygenorairareused. The dentist administering the sedation and must remain in the operatory room with the patient until the patient meets the criteria for discharge to the recovery area.Atthattime,thedentistmaydelegatemonitoringtoaqualifieddentalauxiliary.Oxygen and suction equipment must be immediately available in the recovery area if a separate recovery area is utilized. The dentist must determine and document that the patient’s level of consciousness, oxygenation, ventilation, and circulation are satisfactory prior to discharge. The dentist shall not leave the facility until the patient meets the discharge criteria and is discharged from the facility. AdentistholdingaMinimalSedationpermitshallnotintentionallyadministerModerateSedation,DeepSedation,orGeneralAnesthesia. Becausesedationisacontinuum,itisnotalwayspossibletopredicthowanindividualwillrespond.If a patient enters a deeper level of sedation than the dentist is qualified to provide, the dentist must stop the dental procedure until the patient returns to the intended level of sedation. Adentistmustbeabletorescuepatientswhoenteradeeperstateofsedationthanintended.Thedentist,personnel,andfacilitymustbepreparedtotreatemergenciesthatmayarisefromtheadministrationofminimalsedation. For children twelve (12) years of age or under, the dentist should observe the American Academy of Pediatrics/American Academy of Pediatric Dentists Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures. Formoreinformation,pleasecontactTDApolicymanagerMs.DianeRhodesat(512)443-3675,diane@tda.org.

References1. TSBDEWebpage:NewAnesthesiaPermitRegulationstobe

EnforcedJanuary1,2012!:Http://www.tsbde.state.tx.us.2. TSBDEChart:AnesthesiaRules–SummaryofRequirements:

http://www.tsbde.state.tx.us.

TSBDE Update, continued from page 3