Louisiana Voice

We’ve already seen that Louisiana has dismal RANKINGS in overall dental care (47^th), oral health (44^th), dental habits (dead last), in the percentage of adults who visited a dentist in the past year (dead last), and the fewest dentists per capita (dead last).

So, what happened when the legislature in 2009 passed House Bill 687 by votes of 96-0 in the House and 34-0 in the Senate that allowed the Louisiana State Board of Dentistry to promulgate rules and regulations for the operation of MOBILE DENTAL CLINICS?

Short answer: the number of mobile clinics in Louisiana went from three to zero.

Dr. John Reese, III, DMD, writing for DENTAL ECONOMICS in 2009, said, “Access to care is a major problem facing dentistry today. Many recall when the U.S. Surgeon General gave a failing grade to the level of dental disease in this country, and reported that the number-one reason children visit the school nurse is for dental pain.

Dr. Reese went on to say that with mobile clinics, patients can be treated on-site with minimal interruption of daily routines.

Two major obstacles stand in the way of adequate dental care: cost and access. By bringing dental services to schools and treating indigent children on Medicaid, the mobile dental clinics met both challenges.

Between 2010 and 2014, the number of school-linked

MOBILE_and_PORTABLE_DENTISTRY_PROGRAMS increased from 1,930 to 2,315, an increase of 20 percent. That includes health clinics as well as dental and every state except South Dakota and Louisiana participated.

So, what happened to the bill pushed so hard by Slidell dentist Dr. Edward Donaldson, the bill that became Act 429 with the signature of Bobby Jindal?

Quite simply, MCNA DENTAL (Managed Care of North America, Inc.), which certifies Medicaid dental programs, refused to credential mobile dental practices in Louisiana.

But a better question is how did HB 687 by Rep. Kevin Pearson (R-Slidell) change from its original form to the language in the final passage?

Well, in its original form the LEGISLATIVE DIGEST said the proposed law “prohibits the practice of dentistry in the buildings, improvements, grounds, or any other construction of elementary or second schools.”

Perhaps it was mere coincidence that Dr. Donaldson and Rep. Pearson both reside in Slidell, but it’s no secret that Donaldson was pushing hard for the bill because he seemed to think that mobile clinics were cutting into his patient base. Never mind that virtually all mobile clinic patients were not otherwise seeing a dentist.

The bill was amended 13 times before being voted on in its final form and the regulations as written were sound rules, or so it seemed, until MCNA entered the picture.

Diana Chenevert, a former employee of the State Dentistry Board, in her testimony before a Senate committee, referred to the coalition of the State Board of Dentistry, the Louisiana Dental Association, MCNA, and Molina (the firm contracted to approve Medicaid payments by the State Department of Hospitals) as the “Medicaid Mafia,” led by Donaldson.

She provided a graph that showed that (a) MCNA receives money for every child covered by Louisiana Medicaid, (b) MCNA pays mobile clinic dentists a fee for service for every child treated (thereby cutting into MCNA’s profit base), and (c) by denying mobile dental services, and in the process eliminating the fees paid to treating dentists, MCNA’s profits are increased.

She cited testimony by Donaldson and dental board member Dr. Claudia Cavalina “about mobile dentistry’s purported unclean, unsafe, unsanitary practice with no follow-up care. What you don’t hear were the initial pleas to the LDA board to fight against mobile dentists, including my favorite LDA member quotes:

• “It’s gonna be more and more difficult for the private dentist to make a living trying to see these kids.”
• “I sure, personally, would not like to see us giving all these groups a leg up to compete against our members.”
• “They are eliminating the private sector. That’s not what I want.”
• “(Mobile dentists) would be (happy) because they’re getting the first shot” (at potential patients and income).
• “It’s unfair.”
• “You can’t get the patients that you do need in certain areas. They will focus on certain areas obviously wherever the children are.”

“Mafia dentists profit directly by closing mobile dental practices as the only model left standing is their brick and mortar offices, the inside of which will never be seen by hundreds of thousands of Medicaid children in Louisiana,” she said in her testimony. “And the children of Louisiana lose.”

So, it was simple math that the mobile clinics operated by Dr. Greg Foules of Lafayette and Drs. Luciana Sweis and Nikita Sarr, both of New Orleans, would be de-certified. In fact, when Dr. Sweis placed her equipment in storage after her forced closure, it would be destroyed by a mysterious fire. Hailed as a major gain for Louisiana when she moved to New Orleans from Chicago, she departed after her clinic was de-certified and her equipment destroyed.

It’s not that Donaldson neglected the necessary time-honored practice of taking care of Louisiana elected officials.

Included in the $143,000 in political contributions by Donaldson, his wife, and their clinic from 2003, were six contributions to Pearson totaling $5,250.

Other contributions by Donaldson included:

• $13,000 to Senate President John Alario;
• $5,000 to House Speaker Taylor Barras;
• $9,500 to various campaigns of Jay Dardenne;
• $9,000 to Sen. Jack Donahue of Mandeville;
• $8,000 to Sen. Jim Fannin of Jonesboro;
• $5,000 to Rep. Cameron Henry of Metairie;
• $9,000 to former House Speaker Charles Kleckley of Lake Charles;

But Donaldson’s contributions are dwarfed by the investments in good government totaling more than $1.5 million made by private dental practices, dental PACs and other dental-related organizations since 2003.

Just imagine, if you will, how many indigent children could receive desperately needed dental care with that kind of money.

Among the more fortunate beneficiaries of that investment were:

• $35,000 to Alario;
• $3,500 to Sen. Conrad Appel of Metairie;
• $8,550 to Barras;
• $7,500 to Rep. Johnny Berthelot of Gonzales;
• $6,000 to Rep. Robert Billiot of Westwego;
• $11,000 to former Rep. Simone Champagne;
• $8,000 to former Sen. Norbert Chabert;
• $8,000 to Rep. Charles Chaney of Rayville;
• $12,000 to Rep. Patrick Connick of Marrero;
• $25,500 to Donahue;
• $8,000 to Sen. Dale Erdy of Livingston;
• $13,000 to former Rep. and former Sen. Noble Ellington of Winnsboro;
• $23,000 to Fannin;
• $7,000 to Rep. Franklin Foil of Baton Rouge;
• $13,000 to former Rep. Brett Geymann;
• $12,000 to former Rep. Elbert Guillory of Opelousas;
• $8,500 to Henry;
• $18,000 to former Rep. Lydia Jackson;
• $31,000 to Jindal;
• $17,000 to Kleckley;
• $12,250 to former Rep. John LaBruzzo;
• $16,500 to Rep. Walt Leger of New Orleans;
• $15,500 to Rep. James H. Morris of Oil City;
• $9,500 to Pearson;
• $7,000 to Sen. Neil Riser of Columbia;
• $10,000 to former Rep. Mert Smiley of Gonzales;
• $14,500 to Rep. Patricia Haynes of Baton Rouge;
• $10,000 to Sen. Gary Smith of Norco;
• $11,000 to Sen. Greg Tarver of Shreveport;
• $7,000 to Sen. Michael Walsworth of West Monroe;
• $7,000 to former House Speaker Jim Tucker;
• $11,000 to former Sen. Sharon Weston Broome;
• $17,500 to Sen. Bodi White of Central.

And after all the bad publicity and legislative hearings about dental board actions, the board is now upping its game from extortion, intimidation, and exorbitant fines to witness tampering and cyber stalking.

And why not? Look at those campaign contributions which equate to a get out of jail free card.

If you can’t afford to buy good government (good for your interests, that is), it’s always for rent.