An Introduction to Advocacy at the Michigan Dental Association

Speaker: Bill Sullivan, Vice President of Advocacy and Professional Relations

Bill Sullivan: Hi, my name is Bill Sullivan. I'm Vice President of Advocacy and Professional Relations at the Michigan Dental Association. I'm going to talk to you about advocacy at the MDA Advocacy is a year round activity that involves many things. Most people think of advocacy as it is related to government. However, advocacy can take place with non-government entities as well. For example, the M D A Advocates to the Michigan Oral Health Coalition and the Michigan Chamber of Commerce. The purpose of this video is to review how the MDA Advocates for its members, the dental profession and for access to oral health care throughout the state.

Bill Sullivan: Let's start by focusing on advocacy as it relates to government. To do this appropriately, I must first get you into the right frame of mind. As normal people. you think that to go from point A to point D. You go A to B to C to D. However, in government you have to view going from point A to point D differently. Many times, the orderly process doesn't happen. Sometimes it's confusing and sometimes it defies logic and it's just downright stupid. Advocacy can be impacted by many things and some of these things are outside of our control. For example - politics. The situation the MDA was facing during the dental therapist fight was the Senate Majority Leader was using his authority to muscle through the dental therapy BILL. This caused some legislators who we had worked with to change their positions and they didn't tell us at the time if they were going to do it until the final vote. Another thing that can influence advocacy is bad timing. This happened to the MDA When it came to the Delta Dental Board fight It occurred at the same time as the dental therapist bill was going through and that caused a lot of problems. Money is another thing that can influence advocacy. The goodwill that some insurance companies built by making donations around the state from their foundations, impacts things and really turns things in their favor. Unexpected things like COVID can impact how advocacy works. This is an example of how it impacted a simple little BILL like creating some new dental specialties. This is a BILL that didn't have any opposition, but COVID outbreaks caused the legislature to close down and then this stopped us from getting the BILL done and we had to take it up the following year. All of this goes to show that in an advocacy many times you are not dealing with things that are black and white. A lot of the time, it's a world of gray. Things seldom go as planned and you have to be able to adjust as you go. In general, the legislative process works as follows. If you have an idea, the bill gets introduced, it is sent to committee and then it is taken up in one of the houses and it goes to the governor. Now, I said it goes to one of the houses that's because there's two houses in the Legislature and the above process gets repeated in both houses of the Legislature. So this would happen twice. In general. The rulemaking process works as follows - again, you have an idea which is drafted into a proposed rule. This rule then goes to the board of dentistry where if it's approved it moves on to the Office of Regulatory Reform and then to the Joint Committee on Administrative Rules. Now, it's important to note that a rule cannot be promulgated unless the law authorizes it. For example, the bill that authorizes the dental therapist had in there that the rules need to be promulgated, regarded as implementation. If the Legislature wants to stop a rule, they must introduce a BILL. They have no veto power. Now that you are all experts on the government process, Let's go on to the MDA's processes.

Bill Sullivan: Issues for the MDA can come about in many ways. There could be a problem that comes up from MDA A Members that needs to be addressed legislatively. An example of this is the tax on dental prosthetics. There could be a BILL introduced by someone else that the MDA has an interest in. An example of this s what occurred with surprise medical billing. Or there could be a non-legislative issue that comes about from rules and regulations. A good example of this occurred a few years ago when the rules for dentistry were going to be changed and one of the changes they did was that dentists would need to be present in the office for all delegated procedures regardless of whether it was under assignment, general, or direct supervision. The MDA Obviously was able to get this stopped. Otherwise things would be very different for dentists right now. Regardless of how the issues arise the process The MDA uses to determine policy happens in one of two ways. There's the normal process and the emergency process. Both processes are fairly straight-forward. An example of the normal process is how the MDA's policy on tele-dentistry came about. An example of the emergency process being used is what happened when the MDA policy on Dental providers getting vaccinated at the end of 2020. This had to happen quicker than normal because we became aware that the vaccine for COVID could be ready as early as the second week of December of 2020 and we wanted to get our comments into the governor as soon as possible for consideration so that dentists could be at the top of the list. In either case, final sign-off is from the board. Once we have policy, the MDA Advocacy Team starts its work. In addition to myself, this team includes Neema Katibai, who is Manager of Government and Insurance Affairs, April Stopczinski, who is Manager of Access and Donated Dental Services, Kesha Dixon, who is an assistant to the Government Insurance and Access areas, Lynn Aronoff, who is our Grassroots Program Coordinator, and Peter Riddell, who is our contract lobbyist.

Bill Sullivan: MDA MDA advocacy begins even before we have a particular issue. When new legislators or legislative committee members get elected or appointed, The MDA begins to build relationships with these people. When issues arise, we then have some familiarity with the legislator. The efforts used to lobby are varied and wide ranging and our grassroots program and Dental PAC are very important in these efforts. MDA advocacy includes many activities. There are legislative meetings in Lansing, legislative meetings in legislator's districts, Component legislative events, the Phone2Action system, fundraisers in Lansing and in the districts, and building alliances with other stakeholders. The legislative meetings in Lansing are between MDA staff and the legislators and their staff. The meetings in the districts are arranged by Lynn Aranoff and occur between legislators and dentists in the legislator's districts. Component meetings usually involve legislative breakfasts or evening get-togethers, Lynn assists the Components with these events. They're very easy to do and very helpful. Phone2Action is the legislative alert system used through text or email and if you haven't already done so be sure to text MDA to 52886. The more people we get participating with this, the stronger we will be. An important part of the process is supporting legislators who support us and this is where Dental PAC comes in. This also allows us another contact point with the legislators when we attend their fundraisers. Building alliances is important in legislative efforts because it adds more voices to the fight. An example of this is the work that we did with other groups such as the Michigan Oral Health Coalition and My Community dental clinics when it came to the kindergarten screening BILL. The ADA has also been very helpful with financial and technical support. The financial support comes through the SPA Grant and technical support is in the form of research and advice. The two areas that this really helped us out on were in the dental therapy fight and dealing with COVID. Advocacy in the government arena doesn't only involve the state legislature or governor. It can also involve other entities. Working with state departments can involve getting them on-board to support legislation or providing input on various issues. An example of this is when we worked with the Department of Licensing and Regulatory Affairs on reopening guidance after COVID. Regulatory agencies like the Board of Dentistry determine the rules for dentistry. And then there is working with local units of government - and this usually involves advocacy related to fluoride or sometimes amalgam separators.

Bill Sullivan: The advocacy work of the MDA Is ongoing and involves many issues. The current list of issues that we're working on include the MDS tele-dentistry proposal, rules for the new dental specialties, network leasing - which we are hearing more and more about from members, funding for dental programs such as Healthy Kids, Dental and Donated Dental Services, and hospital access for dentistry. The MDA's advocacy efforts are great collaborations involving MDA dentist leaders, MDA member dentists, and MDA staff working together for the dental profession. To learn more about the MDA's advocacy efforts, sign up for text alerts as I talked about earlier, or get more involved with these efforts and visit us online at michigandal.org You can also reach out to me directly with your concerns or questions. Thank you very much. I hope you found this helpful.