Proposed DSO Legislation in Washington State: Senate Bill 5158

Washington state senators Ann Rivers (R), Annette Cleveland (D), and Karen Keiser (D) sponsored a dental support organization bill on January 19th, 2017 in Olympia.  The proposed Senate Bill 5158 is concerning ‘dental practice and solicitation by corporations,’ and has been modeled after the Oregon law passed in 2003. DSOs have been in Washington state for 30 years, and contract with 150 dentists, serving 300,000 patients.

Senator Rivers, once opposed to the idea of DSOs, is now the prime sponsor of the bill and is also the Chair of the Senate Health Care Committee: “The more that I learned about the type of structure of DSOs, the more supportive I became. I care deeply about dental access.”  Two driving forces behind the bill were Senator Rivers’ concern with placement of graduating dental students with significant debt, as well as accessible, quality dental care for patients.  Rivers said, “Dentistry is too powerful to play politics with.”

Currently, corporations are prohibited from practicing dentistry or soliciting dental patronage for dentists employed by a corporation. This restriction does not apply to corporations or associations that furnish information or clerical services to a licensed dentist, so long as the information or services can be furnished by unlicensed persons and the dentist assumes full responsibility for the information and services.

In brief, the proposed bill states that persons not licensed to practice dentistry may:

  • own or lease assets used by a dental practice;
  • employ or contract for the services of personnel other than dental professionals;
  • provide business support and management services to a dental practice; and
  • receive fees for any of these services as agreed to by the dental practice owner or owners.

Pacific Dental Services, Willamette Dental Group, the Association of Dental Support Organizations, as well as Brian Polillo, DDS, testified on the pro-side of the bill.  Dr. Polillo testified that his crushing debt, upwards of $400,000, and mentorship by another DSO dentist led him to work for a DSO, saying, “The idea that the ‘money people’ within a DSO are telling you what to do is simply false.”  He went on to explain that he was eventually able to purchase his practice, contracting with his DSO. Both Willamette Dental Group and Pacific Dental Services currently operate in the state of Washington.  Willamette Dental’s Washington locations are listed HERE.  New to Washington, Pacific Dental Services’ locations are listed HERE.

Testifying on the con-side of the bill were several solo practitioners, a patient, as well as a representative from the Washington State Dental Association, Trent House. House said, “We have language [in the bill] that we do believe creates a relationship between a corporate entity and a licensed dentist that we could support and would allow us to come to a resolution this session.”  House also stated, “There needs to be certainty about the relationship between the practicing dentist and the clinic, which we believe the legislation before you today does not include and needs if it is going to gain industry support.”

If the bill becomes law, the effective date will be ninety days after adjournment of session in which bill is passed. The senate bill report can be read HERE.

Persons Testifying: PRO: Senator Ann Rivers, Prime Sponsor; Roman Daniels-Brown, Pacific Dental Services; Brian Polillo, DDS, Practicing Dentist; Melissa Johnson, Willamette Dental Group; Jennifer Bryant, Association of Dental Support Organizations; Lisa Thatcher, Association of Dental Support Organizations. CON: Trent House, WSDA; Dr. Enneking; Tanna Wells; Negar Sherkat; Timothy Hess; Kalob Lesh.

Persons Signed In To Testify But Not Testifying: CON: Cynthia Pauley; Emily Studebaker; Carrie Tellefson; Bryan Edgar, Washington Academy of General Dentistry.

To watch the public hearing on the DSO bill, click the video link below.