Colorado’s Workforce Shortage

Molly PereiraFeatured News

By Carrie Mauterer, D.D.S., CDA Immediate Past President and NEW CDA Editor
An Excerpt From the Summer 2021 Journal of the Colorado Dental Association

Witnessing the strategy, the nimbleness and the effectiveness of the Colorado Dental Association during a time of crisis absolutely humbled me. I wish you could have seen it through my eyes this past year. Our collective successes cannot be attributed to just one member. The reason why we have political influence and power is because of years and years of laying the groundwork for such a moment of crisis. We have strong relationships with our state legislators because we consistently find the most dental friendly state senators and representatives and strengthen our relationships with them. This involves hours and hours of interviews and town halls with our legislative members and candidates. When they have questions about how a house or senate bill might affect the day-to-day practice of dentistry, they all know who to call.

Throughout all these past moments of crisis, the CDA worked tirelessly on behalf of our members. Today, the current crisis is one that many industries are facing—a workforce shortage.

The CDA is very aware of this issue and is exploring the growing concern of workforce shortages and viable options to pursue.  A few (but not an exhaustive list) of the ideas that our Colorado dentists brainstormed are:

  • Increase capacity of hygiene programs
  • Increase number of hygiene programs
  • Broaden the scope of practice to allow dental assistants to scale teeth
  • Incentivize hygienists from other states to relocate to Colorado
  • Incentivize re-entry of hygienists into the workforce
  • Use federal and Colorado stimulus funding to help dentists

With this slate of ideas in mind, the CDA started research and conversations with stakeholders, including the Colorado Dental Hygienists’ Association. We began by looking into increasing the capacity of hygiene programs. This would be one of the quickest methods to increase the number of hygienists in the state (timeframe: two-to-three years to educate and graduate an increased number of hygienists). The current barriers we face are finding the funding and faculty to increase the student capacity. Colorado state funding for higher education is one of the lowest in the nation. Serendipitously, House Bill 21-1330 passed this year, which will form a task force to look at state spending on higher education. This will be our opportunity to advocate this summer for an increase in state funding for hygiene programs.

Next, we investigated increasing the number of hygiene programs in the state (timeframe: at least four years to perform a community needs assessment, receive CODA accreditation, and graduate a class of hygienists). The constraints that we face here is a long timeline, lack of funding for new programs, difficulty in establishing an ROI for a program (it is very expensive to educate a hygienist) and faculty shortage. When speaking with the Colorado Dental Hygienists’ Association, we learned that there are about five community colleges in Colorado that have seriously looked into starting a new hygiene program, but none have been successful in launching one. It is a daunting and expensive task to begin a new program and after investigating this option, the CDA felt this would likely be an uphill battle to advocate for this solution.

Third, we investigated changing the scope of practice for dental assistants to include scaling teeth (timeframe: at least four years). The constraints for this approach include required statutory (state legislative) change. Our legislative environment makes Colorado a minimalist state when it comes to regulation in dentistry. There would be opposition (both inside and outside the profession) if we were to introduce a new area of regulation. This process would likely require a “sunrise review” of the Dental Practice Act, which at the earliest would take place between December 2021 and October 2022. Following a sunrise review, the concept would need to go before the Colorado legislature (January 2023-May 2023), and then if it successfully passed, it would go through the DORA rulemaking process (Fall 2023). Following rulemaking, standardized training programs would need to be established to teach this skill to dental assistants, and dental assistants would need to graduate from these programs and likely apply for a licensure, registration or certification. This option is complex and would take substantial time to achieve.

Fourth, we took a close look at using American Rescue Plan Act (ARPA) stimulus dollars to help our dentists recover from this rocky year. We wrote a letter to the governor and requested that stimulus funding be provided for incentives to help licensed hygienists re-enter the workforce; to include hygienists and dentists in premium pay for essential workers; to create a grant pool, bonus pay or tax credit to help providers cover increased cost for PPE; to create incentives for dentists who provided care to underserved populations; to give tax credit to those who donated PPE; and finally to ask for funding to increase capacity at dental hygiene programs.

This summer, Colorado senators and representatives will decide how ARPA stimulus money is distributed. We will continue to advocate for relief for our dental profession.