Rawson reveals novel plan to fund new dental school

Monday, May 17, 1999 | 1:28 a.m.

CARSON CITY -- Starting a dental school at UNLV, a project that wasn't given much chance of passage by the Nevada Legislature three months ago, is now close to becoming a reality.

Tucked away in the budget approved Friday by a subcommittee for the University and Community College System of Nevada was the authorization to begin a program for 40 students in September 2000.

A lot of things still have to fall into place, but Sen. Ray Rawson, D-Las Vegas, has put together a novel plan that will not require any additional state money.

Rawson's plan would use money already set aside for Medicaid dental care and Nevada Check-Up, a state program for uninsured children, to help fund the school. The school also would take out contracts with managed care organizations to provide care and raise more money for the school.

Rawson wants to start hiring this July and have the contracts with managed care organizations signed by October so the faculty and dentists at the school can start treating patients and build up enough reserve to be ready for the students in September next year.

Nevada ranks last in the nation in the ratio of dentists to patients, said Rawson, a dentist who heads the dental program at the Community College of Southern Nevada. The national ratio of dentists to patients is 1 to 1,700, compared with Nevada's ratio of 1 to 2,500. In Clark County it is even higher at 1 to 3,100 patients. And Nevada students have the hardest time getting into a dental school, he said.

Plans call for a $30 million building of 80,000 to 100,000 square feet with classrooms, labs, suites for special work and offices, probably to be located on Tropicana Avenue between Maryland Parkway and Paradise Road. There would be clinics on Martin Luther King Boulevard, on West Charleston Boulevard and in Henderson, Rawson said.

The school would be paid a certain fee each month for each participant, whether or not there was any care, Rawson said. That should amount to $1 million a month from Medicaid, he said.

The money now being paid to private dentists would be diverted to the dental school.

The idea is not to cut into the business of private dentists, Rawson said, but most private dentists don't like to treat Medicaid recipients because there's low pay, lots of paperwork and patients miss many appointments, he said. Only 15,000 of the eligible 50,000 children in this program got dental care last year.

Both Medicaid and Nevada Check-Up already have the money budgeted to spend on dental care, so no extra state money would be needed.

"There is no direct general fund dollars," Rawson said.

The school could also treat private patients, Rawson said. The Culinary Union is interested in signing a contract to care for its members, he said, adding "There are enough patients in the Culinary Union alone to support the dental school."

The plan calls for each faculty member to spend one day a week treating patients. Other dentists would be hired to help with the patient load.

The budget for the first year would be $7.4 million and it would jump to $13.7 million with the opening of the school and then $17.4 million in 2001-2002.

Budget analysts estimated the school could receive $7.8 million the first year; $13.7 million the second, then $17.4 million in the third year.

"This gives us a full year to earn money before we bond anything or accept students," Rawson said.

The remaining hurdle is Assembly Bill 527, which would allow bonds to be issued to pay for the building at UNLV. Both the Senate Finance Committee and the Assembly Ways and Means Committee must sign off on the program. Leaders of both those committees have endorsed the plan so far.

But some legislators still have concerns. "I'm not that all supportive of the dental school," Senate Minority Leader Dina Titus, D-Las Vegas, said. "It's not something that I have advocated."

Other legislators fear that starting a dental school might drain money from other needs of the universities and the community colleges. But Rawson says there won't be any more state money allocated, adding this is the first time this has been tried in the nation.

The $30 million building would be financed through revenue or pay-back bonds and no state tax money would be needed, he said. The fees collected from treating patients would pay off the debt.

First-year dental students would not have much clinical work, but by the second they should be ready to clean teeth and do simple cavity fillings. The students would be exposed to the full scope of dentistry in the third year and would build speed and confidence in the fourth year of school, Rawson said.

Students would be rotated so they spend time in rural Nevada, at hospitals and working with managed care organizations.

While the school would be based in Las Vegas, the program would be statewide. Dentists would be hired by the school in the north to treat Medicaid and Nevada Check-Up patients. In rural Nevada, modern equipment would be installed in dental offices that join the system. Those dentists will be paid so much per patient per month. "Rural dentists are eager to do this," Rawson said.

The Truckee Meadows Community College in Reno is beginning a dental hygiene programs and will have six chairs in which to treat patients, enrolled in either Medicaid or Nevada Check-Up, he said.