The New Mexico statute defines collaborative dental hygiene practitioner as a hygienist who is certified by the New Mexico Board of Dental Health Care and Dental Hygienists’ Committee to provide dental hygiene services without general supervision in a cooperative working relationship with a dentist. A collaborative dental hygienist provides the same scope of services as any licensed New Mexico hygienist practicing under general supervision.
“Collaborative Dental Hygiene Practice” was established in 1999 by the state legislature. The rules and protocols were defined a year later. The legislation was recommended by the New Mexico Health Policy Commission, as a result of a study by a task force comprised of various health care professionals. It was recognized by the task force that dental hygienists were an underutilized provider, limited by restrictions in the state statute. By removing supervision requirements, collaborative hygienists are able to work in various health care settings, providing dental hygiene services to many who would not otherwise have access to care.
Collaborative practice experienced slow growth because of some problems encountered at the outset, including difficulty in finding consulting dentists, especially Medicaid providers, and reluctance of third party payers to recognize dental hygienists as primary care providers. In 2004, SB818 was signed into law to prohibit discrimination against collaborative dental hygienists by third party payers. Another bill introduced in 2005 (SB371) proposed to penalize third party payers who discriminate against certified providers. It passed both houses but was not signed by the governor. Reimbursement problems persist because many large corporate employers are self-insured in which cases, state laws pertaining to third party payers do not apply.
From the standpoint of success, collaborative practice is an entry point for many New Mexico citizens into the dental care system. There are many variations of collaborative practice in New Mexico. Some have established a private practice, hiring a dentist(s) and other collaborative hygienists. Others are working in public health type settings. There are collaborative hygienists that contract with the schools for sealants and dental hygiene services. The nursing home setting has been the most difficult to establish due to reimbursement difficulties and a shortage of dentists willing to serve as consulting dentists. A criticism of collaborative practice is that many are located in densely populated areas where there are sufficient numbers of dentists. However, there is a great need in urban areas where large underserved populations reside.
Collaborative hygienists can obtain their own Medicaid provider number if they are partnered with a consulting dentist who is also a Medicaid provider.
Because collaborative hygienists partner with a consulting dentist who provides further diagnostic and restorative care for the patients, collaborative practice can be a beneficial situation for everyone. Collaborative practice will continue to evolve and reach even more people needing basic preventive oral health care services.
Legislative Chair nmdhadropbox@gmail.com