“There is a quote I love that reads, ‘If you’re not at the table, you’re on the menu,’” says Barbara Clyburn, a fourth-year student at the College of Dental Medicine at Western University of Health Sciences.
Clyburn was one of 20 California dental students who met with Assemblymember Jim Wood, DDS, and 12 legislative offices at the state Capitol during CDA’s Student Advocacy Day March 12. Together the student delegates representing six dental schools advocated for state budget funding for the Specialty Dental Clinic Grant Program and for CDA-sponsored legislation that would protect California dentists from the predatory practices of virtual credit card companies.
CDA coordinates the small-group discussions throughout the day to allow students, lawmakers and legislative staff to have in-depth, interactive conversations about major issues impacting the dental profession and patient care.
Connecting her experience in Sacramento with the quote she loves, Clyburn continued: “Many times, we take a passive approach to issues we see in our communities in hopes that someone else will eventually step up and address the problem for us, but it is important to know that anyone can be an advocate,” she said. “Organized Dentistry allows us to do so in a way that benefits the greater good of the dental profession as a whole.”
Difficult VCC opt-out process and ‘costly fees’ harm dentists
Dental offices that accept virtual credit card payments, which are issued by third-party companies in contract with dental benefit plans, pay not only the standard merchant transaction fee but also additional processing fees of 2% to 5% charged by the virtual credit card companies. Taken together, dentists commonly pay service fees up to 10% per transaction on every payment the dental plan owes them.
Along with his fellow delegates, Arman Zograbyan, a first-year student at Herman Ostrow School of Dentistry of USC, explained to legislative staff how virtual credit card fees harm dentists and patient care and how a CDA-sponsored bill, SB 1369 by Sen. Monique Limon (D-Santa Barbara), aims to fix the most predatory practices.
“Virtual credit cards are an increasingly popular method of payment used by dental insurance plans. Unfortunately, VCCs are associated with high processing fees, and once the VCC becomes the ‘standard’ form of payment, many dentists have difficulty opting out of this method,” Zograbyan said.
Because SB 1369 would require dental insurance companies to create an opt-in option for accepting VCCs, dentists would fully understand what they are opting into rather than being defaulted into a payment method that includes additional processing fees. Dentists would pay the fees set by their contracts with the dental plans and would receive full payment for the dental services they provide — ultimately spending more time and resources on patient care and less on accounting and administrative challenges.
“My peers and I conveyed to legislative staff that these costly processing fees strip dentists of finances that could otherwise be allocated to patient care and well-being,” Zograbyan said. “SB 1369 will help ensure our patients receive the care that they rightfully deserve.”
SB 1369 will further solve the VCC problem for dentists by, among other things, mandating that any provider payment that includes a processing fee cannot be the default payment method. Dental plans would also need to provide notice of any fees associated with a particular payment method.
Funding for specialty dental clinics would help treat ‘grossly underserved patients’
“Student Advocacy Day thoroughly surprised me by making me realize how much power we have as dentists and student dentists within organized dentistry,” said Sarah Jean Donahue, a first-year student at UCLA School of Dentistry.
Donahue spoke to legislative staff about the need to maintain budget funding for the Specialty Dental Clinic Grant Program to expand, adapt or construct clinics that serve individuals with special health care needs. CDA led the successful push to fund the program in 2022, and the program began accepting applications in fall 2023, but funding for the program is now delayed due to a 2023-24 state budget shortfall.
“This issue really hit a chord with me as I’ve been shocked and disappointed by inequality in patient care throughout my experience in the dental field,” Donahue said. “Patients across the spectrum of visible and invisible disabilities have a dramatic lack of access to dental care. I had a heart-to-heart with staffers on the importance of immediately ending the pause on this program so that grossly underserved patients could be treated as soon as possible, avoiding the tragedy of unnecessarily prolonged pain and disease.”
The program, if funded, would permit dentists and dental schools in California to apply for grants up to $5 million to create facilities to serve patients who have physical, developmental or cognitive disabilities that can require stabilization, deep sedation and other special accommodations that otherwise can only be provided in a hospital or surgery center.
Clyburn agrees with Donahue that maintaining budget funds for the program is crucial.
“This grant is crucial as its resources will help build more clinics that can better accommodate our special needs communities,” Clyburn said. “With already limited resources, and without this funding, treatment will continue to be delayed for this population which equates to poorer oral health and quality of life. We must be intentional in our efforts to address barriers like these in accessing care, as everyone deserves to be in optimal oral health regardless of class, color or mental status.”
‘Thrilled to speak on behalf of my school, dental professionals and Californians’
This year’s Student Advocacy Day was a first for Zograbyan and Donahue, but both suggested it won’t be their last.
“CDA Student Advocacy Day was an invaluable lifetime experience for me and something that I will carry on for the rest of my professional career,” Zograbyan said. “I was thrilled to speak on behalf of my school, dental professionals and Californians to bring attention to oral health care issues that must be addressed.”
Donahue remarked on the advocacy tactics she learned and her increased awareness of critical legislation affecting dentistry “that we as students had the invaluable opportunity to influence.”
“I came out of Student Advocacy Day much more confident that I will be heard in my field and able to advocate for the best conditions to provide care to patients,” she said.
Clyburn, who will graduate this year, is a two-time Advocacy Day participant, having attended in 2022 when the COVID-19 pandemic demanded the event still be held virtually. She was thrilled to be physically present for the overviews, the working lunch with CDA staff to discuss strategy, meetings with legislators and staff and the debriefings at the end of the day.
“We ended our time at the Capitol with a conversation with the only dentist in the California Legislature, Assemblymember Jim Wood,” said Clyburn, who called Wood’s journey to the Legislature exciting and inspiring.
“Advocacy Day is an amazing opportunity for dental students to develop lifelong connections with members of the legislature,” Zograbyan added. “I strongly encourage all students to utilize their voices by participating in CDA’s upcoming Advocacy Days!”
See CDA’s Advocacy Activity page for ways to get involved in grassroots advocacy to help shape the future of dentistry. Read more about CDA’s major issues and priorities for 2023-24.