Support for mid-levels gains momentum in Washington

In Washington state, supporters of a proposal to bring in a new kind of mid-level dental care provider say that a solid focus on relationship-building has been key to advancing their cause.  The proposal took a major step forward in February, when it passed the Senate Health & Long-Term Care Committee.  Although the bill did not proceed further, momentum for mid-levels as a solution to Washington’s oral health care access problems is gaining.  A year ago, a similar proposal failed to make it out of committee.

Tera Bianchi, oral health access manager for the Children’s Alliance, attributes this progress largely to the time and energy spent nurturing the coalition that championed the mid-level proposal.  “Our work has been about keeping the relationships inside the coalition strong and meeting continuously to build trust among our key partners,” Bianchi says.

The Washington Dental Access Campaign (WDAC), convened by the Children’s Alliance, includes the American Indian Health Commission of Washington, Washington Community Action Network and the Washington State Dental Hygienists’ Association.  Additional support for improving oral health care access came from AARP Washington, Affiliated Tribes of Northwest Indians, SEIU Health Care 775NW and the Washington State Hospital Association.

This year, the coalition engaged two active dentist champions for the cause.  Alex Narvaez, DDS, dental director of Sea Mar Community Health Centers, and Raymond Dailey, DDS, dental chief for the Swinomish/Upper Skagit Dental Clinic, both testified on behalf of the mid-level bill.
 
Bianchi says that Dailey’s and Narvaez’s support made a huge difference.  “Many dentists are enthusiastically supportive of mid-level providers.  They are helping show the need for improved access to care and for policy makers to consider strong, innovative solutions.”

In addition, Bianchi cites the following as important lessons learned:

• Having regular and consistent conversations with key groups such as the state hospital association and making sure they had all the information they needed about the mid-level model so that they could take a position when they were ready.
• Keeping the campaign’s focus on access and creating a platform for consumers to share their experiences.  “The voices of real people crystalized the issue for lawmakers,” Bianchi says.
• Making a strong case for how the mid-level provider model can help improve oral health care access, instead of countering every single opposition argument or statement.
• Leveraging success.  Dr. Dailey wrote an op-ed that was published in a weekly newspaper called Real Change.  That article spurred KUOW-Radio, a local public radio station, to do a story on the mid-level proposal featuring Dr. Dailey.  Strong support for mid-levels from dental hygienist Anita Rodriguez was parlayed into another op-ed published in the Tacoma Tribune.  And Dr. Narvaez was featured in an-depth feature on the mid-level proposal by Dr. Bicuspid.

Looking ahead, Bianchi says the coalition is energized to continue building awareness and support for a mid-level approach and pushing forward.