ground: The ADA House of Delegates (HOD) holds exclusive authority to establish official policy for the American Dental Association. This authority is explicitly defined in the ADA Bylaws and reinforced within the ADA Governance and Organizational Manual, which clearly prohibits ADA leadership and staff from implementing or publicly advocating for any policy, program, partnership, or initiative without formal approval by the House of Delegates
Despite this binding mandate, ADA leadership and administrative staff have repeatedly promoted specific legislative initiatives, political partnerships, and policy proposals before they were formally approved by the HOD. This conduct undermines the tripartite structure and erodes trust among members and constituent societies, particularly when these actions conflict with the will of constituent organizations
A prominent example involves the ADA’s continued promotion of national licensure compacts. While the HOD has authorized the exploration of licensure portability in general, it has not approved any specific compact as ADA policy. Compact-related resolutions have been referred back to councils for further study and were not adopted by the House of Delegates. Despite this, ADA staff and leadership have publicly supported one version of a compact in multiple states, including testifying in Maryland in direct opposition to the position of the Maryland State Dental Association. These public statements occurred without HOD authorization and in contradiction to constituent society guidance.
Maryland State Dental Association Testimony (opposed):
https://www.youtube.com/live/NhYr-w_Vw3A?t=16350
ADA Staff Testimony (in support):
https://www.youtube.com/live/NhYr-w_Vw3A?t=18821 [5, 6]
Additionally, the ADA entered into a policy development agreement with the National Association of Dental Plans (NADP) and the National Council of Insurance Legislators (NCOIL) to co-develop national model Dental Loss Ratio (DLR) legislation, known as the “NCOIL DLR.” This agreement—also made without HOD approval—undermined legislative efforts in Rhode Island, where the dental association had pursued a different DLR approach modeled after Massachusetts Question 2. This interference was documented in a public interview with the President of the Rhode Island Dental Association, who confirmed that the ADA’s support for the NCOIL DLR hampered state-level negotiations.
https://youtu.be/e-1MRTI6Pk4 [3]
As noted above, these actions not only violate ADA policy, but also contradict the ADA Principles of Ethics and Code of Professional Conduct requires national leadership to operate with honesty, transparency, and respect for constituent authority.
In addition, Resolution 203H-2024, requires communication with state societies before launching new initiatives. Furthermore, ADA policy on Legislative Assistance by the Association (Trans.1977:948; 1986:530; 2019:310) prohibits advocacy in any state without the expressed consent of that state’s dental society.
The below resolution does not oppose compact development or innovation in national policy. This resolution calls for the ADA to establish a formal process to ensure that any proposed compact, legislative partnership, or advocacy agreement involving external political entities is reviewed through appropriate internal channels and brought to the House of Delegates before being promoted as official ADA policy.
Recognizing that the legislative process can move quickly, this resolution does not seek to limit ADA engagement—it seeks to ensure that such engagement is informed by representative governance. To support timely and effective advocacy, the ADA should develop and present a range of compact or policy options with clear legal and professional implications, allowing the House to direct advocacy efforts in alignment with the profession’s priorities.
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