Dr. White Calls on OSHA to Revise or Remove COVID-19 Guidance for Dentistry

  • by AGD Staff
  • May 18, 2020
5-18-Advocacy_AThe following is a reprint from the May 13, 2020, edition of “Capitol Connections.”

The U.S. Occupational Safety and Health Administration (OSHA) recently published guidance for COVID-19 control and prevention for dentistry workers and employers. AGD sent a letter to Loren Sweatt, OSHA principal deputy assistant secretary, May 4 requesting that the agency substantially alter the guidance or remove it entirely.

Several of the statements and recommendations OSHA included in the guidance regarding both personal protective equipment (PPE) usage and patient treatment are questionable and lack a basis in scientific evidence. The guidance also fails to address the issue of point-of-care testing in dental practices as a reliable means to differentiate between COVID-19-positive patients and COVID-19-negative patients. These glaring deficiencies in the guidance may present mixed or impractical messages as dentists seek clarity on practice operations as they provide oral healthcare during this crisis.

Impact on General Dentistry: AGD is continuing to work with OSHA to be a meaningful partner as it formulates and revises guidance for work within dental settings. Working with OSHA on this guidance is a critical priority of AGD as the country begins the process of reopening, especially dental facilities given the known risks personnel will face until this infectious disease is eradicated.

AGD Joins America’s Recovery Fund Coalition

The Academy of General Dentistry joined America’s Recovery Fund Coalition alongside a wide-ranging group of over 100 additional members, who will press Congress to make additional capital available for businesses experiencing hardship due to COVID-19. The Coalition’s campaign officially launched May 4 and its members represent 30 business sectors that employ more than 58 million Americans, or approximately 45 percent of the nation’s workforce.

Together, we are advocating for a grant-based Recovery Fund to provide federal assistance that businesses can spend over an expanded period of time. Funding options like the Paycheck Protection Program (PPP) were well-intentioned, but we recognize there are flaws within the system that make this option unattainable for all of our members. Businesses who receive relief from the Recovery Fund could cover more expenses in addition to payroll, such as paying rent, adapting to new requirements, meeting certain debt obligations, and paying state and local taxes.

Impact on General Dentistry: AGD joined this Coalition to support the implementation of another federal funding mechanism that may help provide relief to dental practices. Funding programs such as the Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) are not suitable for all AGD members experiencing hardship during this time, which is why the AGD stands with the Coalition to establish the Recovery Fund and provide members with a different, more flexible option to obtaining financial assistance.

Lawmakers Introduce Business Interruption Insurance Reform Bills

Many businesses that currently hold business interruption insurance have recently learned that their policies specifically exclude coverage if the damages are the result of a global virus transmission or pandemic, such as the current COVID-19 crisis. This lack of coverage has had an extremely negative impact on the businesses under the assumption that the insurance policies they have been paying premiums on for years would provide support during this crisis. 

Members of Congress from both sides of the aisle are considering including provisions to address these gaps in business interruption policy coverage in the next COVID-19 relief package. Rep. Brian Fitzpatrick (R-PA) recently introduced H.R.6497, the Never Again Small Business Protection Act, and Rep. Mike Thompson (D-CA) has introduced H.R.6494, the Business Interruption Insurance Coverage Act

Both pieces of legislation would compel insurers to offer policies that at least provide the option for coverage of losses that stem from federal, state, or local government-ordered business shutdowns. An important note is that the bills’ provisions would not apply retroactively for COVID-19 but would set the standard for insurance policies going forward.

Impact on General Dentistry: AGD supports efforts in Congress, such as H.R.6497 and H.R.6494, to reform the status quo as it relates to business interruption insurance, and is coordinating an effort with allied dental organizations to support these provisions in future COVID-19 relief. AGD is also advocating for Congress to use its legislative authority to require insurers to retroactively provide business interruption insurance coverage for COVID-19 related business shutdowns. During this crisis, most dental practices have been compelled to forgo providing non-emergency services or close entirely, and states are just beginning the process of reopening and allowing routine (elective) care.

House Democrats Urge HHS to Provide Funds to Medicaid Providers

Democratic leaders of the House Energy & Commerce and Senate Finance Committees sent a letter to Secretary Alex Azar of the U.S. Department of Health and Human Services (HHS) May 5. The letter called on the administration to distribute funding from the dedicated Provider Relief Fund allocated under the CARES Act to Medicaid providers, including dentists. 

While Congress initially provided the Public Health and Social Services Emergency Fund (PHSSEF) with $100 billion in the CARES Act and an additional $75 billion through the Paycheck Protection Program and Health Care Enhancement Act, HHS has yet to meaningfully direct funding to Medicaid providers. The committee leaders state that HHS has been ignoring congressional intent in its funding methodologies thus far, as the formulas used for the general allocations have directed aid to Medicare facilities and providers.

Impact on General Dentistry: AGD appreciates these congressional leaders exercising oversight on HHS on this issue and for their recognition that supporting dental providers during this crisis is essential. Medicaid-provider dentists have been overlooked thus far in HHS distributions from the provider relief fund. AGD will continue to communicate the hardships dental practices are facing at this time as well as the importance of the department adhering to the congressional intent of the assistance provided in the CARES Act.

Legislation Introduced to Allow Nonprofits to Qualify for PPP Loans

Representatives Chris Papas (D-NH) and Brian Fitzpatrick (R-PA) introduced H.R. 6697, the “Local Chamber, Tourism, and 501(c)(6) Protection Act,” May 5. The legislation would expand the SBA’s Paycheck Protection Program (PPP) loan eligibility to include 501(c)(6) organizations with 300 or fewer employees. Many nonprofit organizations are experiencing financial hardships brought on by COVID-19 but are currently ineligible for financial support through PPP loans.

AGD and allied dental and medical organizations have been strongly urging Congress to make these revisions for 501(c)(6) organizations, as they support the healthcare community through educational resources and tools needed to administer the highest quality care during this unprecedented time. 

Impact on General Dentistry: AGD greatly appreciates the introduction of H.R. 6697 and is working to advance the bill in Congress. The bill would provide valuable relief not only to large national nonprofits but especially to smaller state and local organizations. The legislation’s provisions may be a candidate for future coronavirus relief legislation, such as in a potential “CARES 2.0” package.

AGD Comments on Water Resources Legislation

On May 1, AGD President Connie L. White, DDS, FAGD, submitted written comments to the Senate Environment and Public Works (EPW) Committee on its bipartisan water resources reauthorization legislation, S. 3590, Drinking Water Infrastructure Act of 2020, and S. 3591, America’s Water Infrastructure Act of 2020. White’s testimony stressed the importance of maintaining ample levels of funding for water systems and infrastructure. With many community water systems in need of assistance, they may have difficulty in maintaining and improving community water fluoridation infrastructure.

Both water resources bills were approved by the Senate EPW committee on May 6 and are pending before the full Senate for consideration. It is unclear what the timeline will be for the legislations’ passages, as the focus in Congress continues to be primarily on responding to the COVID-19 crisis.

Impact on General Dentistry: AGD is pleased that the Senate EPW Committee is working to advance these water resources bills, which are critical for many water systems around the country. Community water fluoridation is one of the most practical, cost-effective, equitable and safe measures communities can take to prevent tooth decay and improve oral health. AGD has long supported appropriate water fluoridation as a safe and effective way to prevent and control dental decay. 

In the States

AGD constituent leaders from Missouri, Delaware, Maryland and Oklahoma sent messages to members of Congress from their respective states, urging them to co-sponsor and introduce legislation for the Recovery Fund. The action of these constituents is very much appreciated, and may assist in securing sponsorship for the Recovery Fund Legislation.

On March 16, several New Jersey Assemblymembers introduced A3844 relating to business interruption insurance coverage during the COVID-19 emergency. Since then, several other states have followed suit in introducing similar legislation including Ohio, Massachusetts, New York, Pennsylvania, Louisiana and South Carolina, though none have been passed yet.

AGD constituents have implemented efforts in support of these bills in New Jersey, Ohio, Massachusetts and New York, including sending messages to their state legislators and working with bill sponsors to advocate for its necessity. Additionally, the Colorado AGD is urging their state legislators to implement similar legislation, and help small businesses across their state stay afloat. Please read below for background information on the issue:

Commercial insurance policies cover loss or damage to property, which includes the loss of use and occupancy and business interruption. However, these policies specifically exclude coverage if the damages are the result of a global virus transmission or pandemic. As the first state to do so, New Jersey introduced A3844 which would require any such policy to include coverage for business interruption due to global virus transmission or pandemics as of March 9, 2020 – the date a State of Emergency was declared by New Jersey’s Governor through the Executive Order. Through this, policyholders must be indemnified by their insurers for any loss of business or business interruption that was a result of COVID-19, subject to the limits under the policy. Since the introduction of A3844, six additional states have followed suit in introducing similar legislation.

If you would like more information on legislative matters in your state or are interested in carrying out advocacy efforts on AGD issues, please contact us at advocacy@agd.org or visit the AGD’s Advocacy webpage.

Don't forget to respond to the most recent Take Action alert and ask Congress to prioritize the needs of dentistry in next COVID-19 relief package.