Kelsch: The elephant in the room for California dental hygienists

May 9, 2016
Noel Kelsch, RDHAP, explains the reason why California dental hygienists are considering changes in their relationship with the American Dental Hygienists' Association.  

By Noel Brandon Kelsch, RDHAP

I first must disclose this article does not represent the California Dental Hygienists’ Association (CDHA) or the Dental Hygiene Committee of California. I am writing this as an individual because I care about the average hygienist—the person who goes to work each day and supports themselves by cradling people in their laps and making smiles a little brighter and health a little better.

There is an elephant in the room. There has been a lot of speculation during the past few months about the CDHA’s decision to refuse to sign a piece of paper. I know they did not come upon this decision easily. The CDHA is not alone; they are not the only state that found it difficult to put pen to paper because of some of the requirements and the plans that ADHA put into place. I am not opposed to the ADHA. They have a place. Sadly, that place does not meet the needs of the average hygienist.

I don’t want to discuss the charter agreements. For me, it is way more than a charter agreement since there is a much bigger elephant in the room. A simple example is the town hall meeting they set up to discuss the issues with California. They scheduled it for noon on a week day when hygienists work. Truly, they do not understand the needs and challenges of the average hygienist who cannot afford to miss an hour of work. Although they have changed the time to include a 6 p.m. repeat of the meeting, the fact that they scheduled the meeting in the middle of the day speaks volumes.

Yes, I said it, and I am willing to go “Norma Rae”—not willing to take it anymore. There are bad things happening to dental hygienists across the United States, because there is no one to represent them on labor issues. They call their state labor boards and get no answers. To quote their national association: “It is not their job.”

Hygienists in many situations are being treated unfairly in the work place. They get no breaks. They are told to clock out when the patient does not show. They are illegally paid with 1099s. The list goes on. I wrote this letter to ADHA last year after being approached over and over again as I travel around the country. I started small and just asked for a simple paper that hygienist could share with their employer, or to understand their personal rights.

Dear ADHA Trustees,

I would like to request that my professional organization develop resources for grassroots labor issues that all hygienists may face in their careers. According to the 2012 dental hygiene practitioner survey, 80% of hygienists work in the clinical setting. A vast majority of hygienists work for small businesses. Hygienists and employers may not be aware of the rights of hygienist or the laws governing employer responsibilities. This leaves the hygienists vulnerable, because they are not aware of their rights or understand their rights.

This is a situation that has been echoed by many hygienists across the country. The areas that have been identified as major concerns include:

  • No breaks
  • No overtime
  • Being paid improperly as an independent contractor with a 1099
  • Being paid improperly with a 1099, therefore not having disability insurance when an accident occurs on the job
  • Being asked to clock out when patients do not show and clock back in when the patient comes
  • Being sent home when patients do not show
  • Not being paid for required OSHA meetings (federal law)
  • Not provided personal protective equipment
  • Being paid per day rather than by the hour
  • Not paid for a “working interview”

The list could go on.

What I am requesting of ADHA is to facilitate the gathering of these facts and become a clearing-house with the information. Much like the system ADHA uses for scope of practice and venues that can be practiced in. This would add value to membership in ADHA.

I know this is labor intensive. So to empower this happening state hygiene organizations could be asked to go to their governing body for labor laws and request a letter in writing that covers the issues below. ADHA could then develop a spreadsheet that includes the laws and resources that govern employment of hygienists for each state. This is not asking anyone to do anything legislatively; it is asking to gather the existing inform in an empowering manner.

The things that this sheet should include are:

Can a hygienist in your state:

  • Be paid with a 1099?
  • Be an independent contractor
  • Be asked to clock out when patients do not show
  • Not be paid for mandatory staff meetings or OSHA meetings?
  • Not have 10 minute breaks
  • Work though lunch
  • Clock out when patient does not show
  • Be sent home after arriving at work with no compensation
  • Be paid per day rather than hourly
  • Be paid on commission rather than hourly
  • Be paid on collections rather than hourly
  • Be paid a different wage when they are performing clerical duties

This list also could go on.

This would bring value to ADHA and help to support our grass-root members. I am sure that membership would go up because of the value seen in ADHA.

Sincerely, Noel Kelsch, RDH, RDHAP

You are probably wondering about the wonderful plans and replies that I received from ADHA? I never received a reply at all from the board. Months later, I inquired with my trustee, and it was explained that it is not the “ADHA’s job. It is the state’s job.” I have asked this question of ADHA many times. The reply is always the same “It’s not our job.”

Oh, they did state that in the future they may put on a continuing education class. This is not something that can be solved in a continuing education course, and the average hygienist who is experiencing labor board issues cannot afford to go to the national meeting to attend a course. They are willing to put out scope of practice, CE requirements, social events, etc., but they are not willing to stand up for the labor rights of our profession and provide resources.

I am a member of ADHA, have paid my dues and volunteered. Currently, I am disappointed. I am looking for an organization that is willing to stand up for the average dental hygienist. If it is not ADHA’s job, then me and my elephant are going to have to become a part of another circus. This does not mean I won’t support ADHA; it just means that I need something more than the ADHA is willing to give. No offense, but if you do not match the need, then someone else will. I keep hearing that if CDHA leaves ADHA it will impact all the small states. Since ADHA is not willing to address the needs of the small states, the small states have not lost anything.

If there is not a match between the organizations perhaps we should be looking at why nurses split off into two organizations? One organization could serve the social needs and educational needs of dental hygienists. The other one could serve the labor needs and to represent the most requested needs of dental hygienists.

Right now, there is an elephant in the room and clearly ADHA does not hear it or see it. Since the number one issue of dental hygienists is not the “ADHA’s job,” something has to change.

NOEL BRANDON KELSCH, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienists' Association.

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