This has been a very busy time, with the June Board of Trustees meeting tucked between two campaign stops, followed by the New Dentists Meeting. My report this time summarizes the actions of the June Board of Trustees meeting at ADA headquarters in Chicago

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Proposed 2005 Budget

After actions taken by the Board at its June meeting, the current proposed 2005 operating budget for the Association includes $95,667,800 in revenue with expenses of $96,244,200 after consideration of all base budgets and proposed new programs. New initiatives included in the proposed budget total $2,663,100. The proposed budget indicates a net deficit of $576,400 for 2005.

Consistent with the recently adopted financial strategy of dues stabilization, which seeks to maintain dues increases at or below the level of inflation whenever possible, the 2005 budget includes dividend and interest revenues of $675,000 on the assets of the ADA Reserve Fund. A key component of the overall dues stabilization strategy is to maintain a strong reserve position and use the cash yield portion of investment revenues realized on reserve assets to reduce the reliance on dues revenues in the operating budget.

After carefully evaluating all strategic considerations, the Board voted to propose a dues level of $440 to achieve a balanced budget for 2005. This would equate to a $5 increase over the 2004 dues rate, representing a 1.1% rise, compared to expert projections of 3% general inflation. However, given the strong position of Association reserves, which are at a level above the minimum target level of 30% of annual operating expenses, the Board would consider the use of reserves to fund the budget deficit and forego any dues increase for 2005. The Board believes that such action would be consistent with the 2002 House resolution urging the Board to use reserve funds in excess of the 30% target level in developing the following year’s budget. The Board also believes the action would be consistent with the long-term financial strategy of dues stabilization. In effect, funding the budget deficit through reserves, combined with the budgeting of interest and dividends from reserve investments, equates to reserve funding of more than $1.2 million of the 2005 operating budget. That $1.2 million would equate to $11.00 per active member if funded through dues.

If the House approves funding the deficit using reserves, this will be the second year in a row that the level of membership dues has remained flat.

The $5 dues increase amount does not reflect any actions that may be adopted by the 2004 House with financial implications. Certainly if the House adds significant spending to the budget, it might not be possible to fund such additional spending and the budgeted deficit from reserves.

The Board also voted to submit to the 2004 House a proposed change in ADA Bylaws specifying that beginning in 2006 and each year thereafter the dues of active members shall be as the House establishes annually. Currently the Bylaws state the specific current dues amount, so that a Bylaws change is required any time a dues increase is proposed.

Study of the Commission on Dental Accreditation

The Board reviewed, discussed, and preliminarily approved a report from

a special Board committee, created in response to a directive from the 2003 ADA HOD, to study the Association’s arm’s length relationship with the Commission on Dental Accreditation (and the Commissions’ relationship with the U.S. Department of Education). The report preliminarily approved by the Board included resolutions that were amended by the Board and call for measures including the following:

• encouraging the Commission to continue conducting open hearings at ADA Annual Meetings to provide opportunities for practitioners to comment on issues of interest, and the ADA leadership will seek additional opportunities for direct communication and dialogue with the Commission;

• urging the Commission to define more clearly standards that address the relationship between educational programs and non-traditional methods for educational funding, as well as to consider the use of intent statements to further define and give examples of practices that comply with standards addressing program integrity, independence, and external influence;

• encouraging the Commission to ensure that students fully understand the terms and conditions of any financial assistance, and to strongly urge that students have legal advice before accepting admission to a program that is contingent upon scholarship or other financial support involving future payback and/or employment commitments, and that such financial assistance be offered only after acceptance to the program with acceptance to the program not being contingent upon the student’s acceptance of financial assistance;

• urging the Commission to closely monitor outcomes for educational programs involving non-traditional models of funding;

• urging the Commission to consider a process for approving educational programs in new educational tracks in advanced educational/training areas in general dentistry that involve development of standards through consensus of applicable specialty disciplines and general dentistry groups.

A final version of the report is to be submitted to the Board at its August meeting and will then be sent to appropriate U.S. Department of Education officials. The report will also be transmitted to the 2004 House of Delegates.

In addition, the Board approved a Protocol for Orientations of ADA Appointees to the Commission.

The Board is submitting to the 2004 ADA House of Delegates a proposed change in the Association’s Bylaws specifying that four members of the Commission are to be selected from nominations open to all trustee districts from the active, life, or retired members of the ADA. Nominations are currently by trustee district on a rotational basis.

2004 ADA Distinguised Service Award

The Board approved the nomination of David A. Whiston, D.D.S., as the recipient of the 2004 Distinguished Service Award, the highest honor the Association confers on any individual.

For more than 20 years, Dr. Whiston has been a dedicated representative of the Association. He served as ADA president in 1997-98, and since that time has represented the Association on the Board of Commissioners of the Joint Commission on Accreditation of Healthcare Organizations and as the official ADA observer at the annual and interim meetings of the American Dental Association.

His service to the profession and the Association also includes tenure as a member and Chair of the Council on Community Health, Hospital and Medical Affairs (the predecessor of the current Council on Access, Prevention and Interprofessional Relations) and a term as the Association’s Sixteenth District Trustee.

In addition, Dr. Whiston serves on many professional boards, including the National Foundation for Dentistry for the Handicapped, the National Museum of Dentistry, and the Medical College of Virginia School of Dentistry.

An oral and maxillofacial surgeon, Dr. Whiston is a diplomate of the American Board of Oral and Maxillofacial Surgery and a fellow of the Virginia Dental Association, American College of Dentistry, American Association of Oral and Maxillofacial Surgeons, and the International College of Dentists.

In Other Actions, the Board:

• conducted a strategic discussion on the international accreditation of dental schools, with presentations by Drs. Donald Simmons of the American Veterinary Medical Association and Richard Valachovic, Executive Director of the American Dental Education Association. The discussion also included presentations by the members of the Task Force on International Accreditation: Drs. Kenneth Kalkwarf and Michael Biermann, co-chairs; James Cole, Cyril Meyerowitz, Kathleen Roth, and myself. The committee’s report will be coming to the August Board meeting with the anticipated recommendation to follow the veterinary model.

• reviewed and discussed a report on a Honolulu City Council ordinance, signed by the Honolulu mayor in February 2004, which prevents chemicals such as fluoride from being added to the Oahu, Hawaii water supply. The Board then adopted a resolution calling for proactive measures to promote rescinding of this ordinance and help bring water fluoridation to the people of Hawaii.

• approved 12 candidates to participate in the 2004 class of the ADA Institute for Diversity in Leadership and six candidates as alternates;

• heard a presentation on the economics of dental education by former JADA editor Dr. Lawrence Meskin of the University of Colorado Health Sciences Center and Dr. L. Jackson Brown, Associate Executive Director, ADA Health Policy Resources Center. From 1980 to 1995, exams and prophylaxis per patient have gone up (the average patient sees the dentist more frequently); restorations per patient have gone down; extractions per patient have decreased twofold; endodontics under age 34 have decreased and stabilized for patients over age 34; crowns under 34 have decreased and increased slightly for those over that age; dentures have decreased greatly and periodontal therapy over age 34 has increased. Overall, the expenditures per patient are going down  when adjusted

for inflation.

• heard a presentation on challenges facing the dental education community by representatives of the American Dental Education Association, including Drs. Frank Catalamotto, president; Richard Valachovic, Executive Director; and Karl Haden, Associate Executive Director and Director, Center for Educational Policy and Research. The cost of dental education today ranges from a low of $48,180 to a high of $190,232 for four years of tuition. The average cost to educate one dental student for one year is $77,027. The costs of dental education are covered 33% by tuition, 33% by government funding, 20% by patient care delivered by students, and the remainder by other sources. Some of the dental school faculty shortage and costs could be solved by dental school mergers. The cost of dental education per student is reduced with larger school size.

• conducted a strategic discussion on evidence-based dentistry, with presentations by Drs. Amid Ismail, member, Council on Scientific Affairs and professor, Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan; and Jeffrey Hutter, Chair, ADA Advisory Committee on Evidence-Based Dentistry, Associate Dean for Academic Affairs, Goldman School of Dental Medicine, Boston University. The American Association of Dental Editors (AADE) will be meeting in Orlando, Florida September 29, 2004 to discuss issues of quality publications in dental journals, as this is the foundation of evidence-based dentistry.

• approved the search process for editor of the Journal of the American Dental Association following the resignation of Dr. Marjorie Jeffcoat.

The campaign schedule is very heavy during the next few months. Unfortunately, I will miss the North Dakota and Minnesota House of Delegates meetings because of campaign stops in other districts. I deeply appreciate the support the members of the ADA Tenth District have given me during this campaign.