‘What More Can We Do?’: Lisa Murkowski Raises Concern About Poor Dental Healthcare In Rural Areas

5 months ago

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Transcript

00:00Thank you, Mr. Chairman, and thank you to the panelists.

00:04I'm sorry that I wasn't able to hear your opening statements but had an opportunity

00:07to look at the background.

00:08I want to focus on access to oral health, dental care in rural areas because it's really

00:18hard.

00:19I grew up in a part of the state where if you needed to go to the dentist, you got in

00:25an airplane or you got on a ferry, and more often than not, you went to Seattle.

00:33That was not a cheap trip, but that was how we got our health care.

00:36We have improved dramatically since then, but we still have far too many communities

00:40where access is an issue.

00:43So far as I know, you can't fill a cavity through telehealth.

00:49So how we have been able to address this requires a little bit of thinking outside

00:56the box.

00:57The dental health aid therapist program, the DHAT program is something that we put in place

01:03in Alaska.

01:04We got a lot of pushback from the American Dental Association who thought that this was

01:09going to be encroaching on their territory, and I said, you send me all the dentists that

01:14you want to come out to rural Alaska.

01:17And for more than just a couple weeks didn't, because these kids don't need dental care

01:25just one week or two weeks out of the year.

01:27We need somebody.

01:28And so we'll take a mid-level.

01:29We'll take somebody who will work with kids to encourage them on simple dental hygienics.

01:38And so we have made some good progress, but there is still so, so, so much more that we

01:44need to do to address access to dental care in our rural communities.

01:53I think, Dr. Swan, you may have mentioned the DHAT program, but share with me, if you

02:00will, what more we can do, what more we must do in our more rural and remote areas, because

02:07we're seeing health outcomes, overall health outcomes, that have been impacted negatively

02:15because it began with poor oral health care.

02:18Right.

02:19I agree with you.

02:20And I think in the state of Alaska, you've been a prime example with a state that large

02:25and being able to get a program that is seeing people.

02:29And I read just last year, in the 10 or 12 years you've had this program, there hasn't

02:34been one malpractice lawsuit.

02:37So it's working.

02:38And I think that we have to address that.

02:40Rural areas, we need more role models.

02:42In the schools of education, where we're teaching young people to become doctors, they need

02:47to see people who are able to function and work in rural areas.

02:51We don't see that, necessarily, in our faculty.

02:54There needs to be incentives, I think, that would help people.

02:57And just really innovative business models, GPR programs, general practice residency programs,

03:04those type of programs, I think, work, like in the state of New York, where it's a requirement

03:09to get a license that you spend one year doing public work.

03:13I think that works.

03:14And I just think that the rural communities would benefit from that.

03:18Other comments?

03:20Just to underscore, and thank you, Senator Murkowski, for raising this, just to underscore

03:25some of what you said.

03:26Our research shows that over one third of rural residents do not have dental insurance

03:30coverage.

03:31Four in ten adults in rural areas have not seen a dentist in over a year, which is about

03:3710% higher than suburban and urban areas.

03:40We also know that 67% of rural areas are health professional shortage areas.

03:44And so when I think about solutions, it is generally what Dr. Swan has said in terms

03:48of incentivizing providers, but also, to your point, creating greater opportunities for

03:53ancillary providers to provide services in rural areas and expanding the scope of practice

03:58in order to be able to do that.

04:01One of the things that we see is a great disparity.

04:05I'm talking about rural, but so many of our rural communities are predominantly Alaska

04:10Native, and so our Native population just suffers disproportionately when it comes to

04:15negative health outcomes related to dental health.

04:18So it's not an issue of insurance.

04:20I can tell you, I go around to the small regional or sub-regional clinics, and we will have

04:27a dental chair, but it's practically brand spanking new, great equipment, because we

04:33can't get the providers that are out there.

04:36So everything that we can be doing to focus on training those who will take on the, it's

04:47a challenge.

04:48It's a challenge.

04:49It's hard.

04:50It's not easy when you're moving around, when you really don't have the place to stay in

04:54these small communities.

04:56But it's an experience that ought to count for some level of support for the training.

05:06And I just, I would urge us all to think about how we fully connect all these dots.

05:12It's one thing to make it available with the chairs and the equipment.

05:17It's another thing to get the providers that are out there, whether they are the dentists

05:21or the mid-levels like we have with the DHATs.

05:24Thank you, Mr. Chairman.

05:26Thank you, Senator.

05:27Senator Hassan.

05:28Thank you.

‘What More Can We Do?’: Lisa Murkowski Raises Concern About Poor Dental Healthcare In Rural Areas

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