BILL NUMBER: S3243A

SPONSOR: COONEY
 
TITLE OF BILL:

An act to amend the social services law, in relation to a dental health
demonstration project; and providing for the repeal of such provisions
upon expiration thereof

 
SUMMARY OF PROVISIONS:

Section one amends the social services law by adding a new section 368-G
to stipulate the goals of the demonstration project, the target area,
the target population, and the goal of reimbursement for eligible dental
diagnostic services for eligible populations.

Section two establishes the effective date.

 
JUSTIFICATION:

The American Dental Association estimates that about one third of people
in the U.S. won't see a dentist this year due to a variety of barriers
              

to care.

When it comes to children, tooth decay is the single most preventable
chronic childhood disease. Tooth decay impacts academic performance, a
leading cause of absenteeism. Children nationwide miss almost 52 million
school hours each year because of dental problem. Limited access to
dental care disproportionately affects marginalized and low-income
communities, significantly impacting residents' overall health. This
inequity places a substantial burden on the medical system as untreated
oral diseases result in pain, infection, and emergency room visits.

As one of the very few dental providers left who accepts Medicaid as a
form of insurance, the University of Rochester's Eastman Institute for
Oral Health has taken on the enormous challenge to try to ensure all can
receive the critical dental care they need. However, currently, at the
Eastman Institute for Oral Health, the wait time for care is staggering:
9,000 adults on the waitlist for general dentistry care; over 900 chil-
dren for Pediatric Dentistry Operating Room (OR); and over 1,000 people
on the waitlist for Special Needs OR and IV sedation. The waiting times
exceed 2-3 years.

Scientists at the University of Rochester's Computer Science Department
and Eastman Institute for Oral Health, thanks to support from the
National Science

Foundation, has developed a smartphone app that can detect tooth decay.
The primary goal of the app is to create supportive environments outside
the traditional dental care setting, empower community self-care by
reorienting health services from curative to preventive, and to use Al
technology to achieve population-wide dental screening and early
detection, ultimately reducing the severity of tooth decay and dental
disease-related emergencies.

Currently, the SMARTeeth app is being used at the University of
Rochester's Lattimore Health & Wellness, where Community Health Workers
employed by the University of Rochester take pictures of a patient's
teeth, detect what is happening, and, working with a dentist, provide an
assessment, education, and risk assessment to the patient. They have
been working with 200 pregnant women in the Lattimore office. They are
receiving reimbursement for the role of the Community Health Worker, but
they are not receiving reimbursement for the diagnostic work done.

This legislation seeks to create a five-year demonstration program in
Monroe County where diagnostic services associated with the use of the
SMARTeeth app would be reimbursed. Such diagnostic services will include
clinical services to treat existing dental problems, testing, self-di-
rect imagery or patient encounters. The target population for the demon-
stration project would be pregnant persons and those persons who are
postpartum twelve months afterbirth.

 
LEGISLATIVE HISTORY:

2023-24: S.8882

 
FISCAL IMPLICATIONS:

NYS shall set rates of payment for such diagnostic services on a fee-
for-service basis. Managed care plans serving such populations may elect
to cover such services, provided that, upon such election, the depart-
ment shall adjust the administrative portion of managed care plan rates
for such purpose.

 
EFFECTIVE DATE:
This act shall take effect immediately and shall expire and be deemed
repealed 5 years after such date.