2011 fluoridation law off to a sluggish start

Some systems stalling, hoping for repeal

— While dozens of water systems have signed on to a plan to fluoridate water for thousands of Arkansans by 2016, some water systems have dragged their feet in hopes the Legislature will repeal the state’s 2-year-old fluoridation law.

In 2011, the Legislature passed Act 197, which required cities and towns that provide or sell water to more than 5,000 people to install fluoridation systems in their water plants, but only if private funding is available. There is an exemption for systems like Texarkana’s that receive water from outside the state.

Legislators approved the law with the understanding that the Delta Dental Foundation of Arkansas would foot the bill. The 35 systems that meet the qualifications sell water to 85 other systems.

Last week, opponents took their first swing at Act 197 of 2011 with a bill that would have let each of the 35 affected water systems decide whether to put fluoride in their water. The House Public Health, Welfare and Labor Committee failed to pass House Bill 1312 by Rep. Bruce Westerman, R-Hot Springs. The bill can be raised for consideration again.

At least two other bills to modify the law also have been filed.

Five of the 35 systems have received grants from Delta Dental and have finished installing the necessary equipment to fluoridate, foundation spokesman Melissa Masingill said. Dozens are waiting for final approval or to start construction.

All water naturally contains fluoride. Fluoridation is when a water system adds extra fluoride to get the concentration in drinking water up to the Environmental Protection Agency’s recommended level, which is currently 0.7 milligrams of fluoride per liter, or 0.7 parts per million of water.

Dozens of people testified or wrote letters opposing the original law, arguing that the state shouldn’t mandate a chemical additive that doesn’t serve a lifesaving function, such as chlorine, which is used to disinfect drinking water.

They point to warning labels on fluoride toothpaste packaging as proof that fluoride is poison.

In 1997, the U.S. Food and Drug Administration began requiring a warning label that recommends calling a poison control center if more toothpaste is swallowed than is needed for brushing teeth.

In the past, critics attempted to link the substance to crime in Little Rock and to bone disease.

Arkansas Surgeon General Joe Thompson said some people are misinformed.

“This goes back 50 years to where people thought that fluoride in the water was a communist plot to allow people to be able to be poisoned. Unfortunately we still have not successfully communicated the value of fluoride, particularly for kids, and the positive health impact and the lack of a negative health impact,” he said.

Thompson said Arkansas is home to two of the largest cities in the country that don’t fluoridate: Fort Smith and Hot Springs.

Proponents of the law say fluoride strengthens teeth and prevents tooth decay. Fixing dental problems can improve overall health.

THE CARROT

Delta Dental has offered up to $6 million in grants to encourage systems to fluoridate, Masingill said.

It is relatively inexpensive to purchase the fluoride to add to water, but the equipment to inject fluoride into water systems can be expensive.

According to the foundation, the five water systems have split $375,286.52 in grants. Those systems are De Queen Water Work, Dumas Waterworks, Southside Public Water Authority, Warren Water Association and Yorktown Water Association.

According to the foundation, the systems serve 37,756 people.

The foundation initially pledged $500,000 for systems, then raised the offer to $1.5 million in 2012, before increasing it again to $6 million after engineers determined that it would take more than expected to complete the project.

“There were just a lot of factors that we just didn’t know we’d have to incorporate until the project was well under way,” Masingill said.

That includes the age of the water systems or waterlines, she said.

Thompson said some systems initially filed extravagant grant requests so that if Delta Dental denied funding, the systems could argue that money wasn’t available.

“We had several communities come in wanting to build a whole new building. Delta Dental refused to put a mezzanine on a building or a second floor on a new building because it wasn’t necessary to do the fluoridation aspect,” Thompson said. “You have had some exploitation of Delta Dental’s offer.”

An additional 11 systems have been approved to split another $1.8 million in grants. The foundation agreed to put a grant for the Carroll-Boone Water District on hold until after the legislative session, Masingill said. The foundation has asked for more information from 12 water systems, which have requested a total of $2.93 million.

“We don’t have a firm cutoff date for implementation,” Masingill said. “We don’t have a plan to shut off those funds at the end of five years.”

Four grants expired when the systems didn’t implement the fluoride system within 18 months, she said.

Ozark Mountain Regional withdrew its application after being awarded a $228,381 grant.

“They wanted to hold up on implementation to see if the fluoridation law was repealed,” she said.

She said the foundation contacted Hot Springs Waterworks and Watson Chapel Water Association about applying. No one responded, she said.

“We’re not going to force our grant on water systems. We believe that these water systems are just not interested in fluoridating,” Masingill said. “In some of the communities that were more reluctant to begin fluoridation, I suspect that they were optimistic that the law would be repealed.”

THE STICK

The Department of Health is enforcing the law and working to persuade water systems to apply for the grants, said Jeff Stone, director of the department’s engineering section.

He said the department sent the eligible systems two notices. One letter asked systems to apply for a grant by July 1. A second asked them to apply by Dec. 1.

“[Fluoridation is] not forgotten about, nor is it being necessarily rushed,” Stone said.

Randy Noles, public works director for Hot Springs Village, said residents have asked him to wait until after the session to make fluoridation plans.

“It’s kind of been on hold until we see what happens with the Legislature,” Noles said.

He said the village doesn’t see the benefit of providing fluoride for a largely elderly population; 93.2 percent of its residents are adults and 57 percent are 65 or older, according to U.S. Census data. The median age is 67.3.

“We feel like it’s an unnecessary expense that we’re going to have to deal with,” Noles said.

The village began an expansion of its water system at the beginning of February. Several residents testified before the House committee last week that the Health Department refused to grant water permits until the community agreed to fluoridate.

“They were in dire need of expanding their water system but were basically held hostage by the Department of Health telling them they couldn’t get their water permit until they agreed to the Department of Health’s terms,” said Westerman, the lawmaker who sponsored the bill to end the fluoride mandate.

Noles disagreed. He said the department made it clear that the system would have to fluoridate at some point, but “we were not forced to fluoridate in order to expand. All cities are forced to fluoridate. That’s the law. It just happened that we were expanding when it became law.”

Stone said the department asked whether there would be space for fluoridation equipment and if the system had applied for a grant. He said expansion didn’t depend on those factors.

“That’s not true, at least from my perspective that’s not true,” Stone said.

He said the department moved promptly to approve the plans, receiving the initial request at the end of 2011 and approving them in the fall of 2012.

“I don’t see how we can be accused of holding up a water-treatment plant expansion,” Stone said.

The Board of Health is considering penalizing one system for not applying for a grant.

On Jan. 15, the department held an enforcement hearing for the Watson Chapel Water Association. Officials with the system chose not to attend, department attorney Reginald Rogers said.

Watson Chapel Water Association manager Phil Miesner said there was a storm the day of the hearing.

“I wasn’t about to drive from Pine Bluff to Little Rock,” he said. “The Health Department has been very, very unhelpful.”

The board’s hearing subcommittee held the hearing without the system’s members present and recommended giving Watson Chapel 45 days to come up with their own plans to fluoridate. Failure to comply would lead to a $500-per-week fine.

The recommendation has not been presented to, or approved by, the Board of Health, which next meets April 25, Rogers said.

Miesner said the system’s members are uncomfortable with the contract Delta Dental wants them to sign.

“We’re not going to apply for a grant through Delta Dental,” Miesner said. He said the system will look for funding elsewhere but doesn’t have a source selected.

The contract from Delta Dental states that a system has to repay the grant if it stops fluoridating within 10 years, even if Act 197 is overturned, Masingill said.

He said the system is leery about the chemical makeup of fluoride being sold. Miesner said he asked several companies to explain the chemical compounds in the fluoride they sell, but hasn’t heard back.

“That kind of threw a red flag up for me,” he said. “We’re going to hold off until we can find a chemical company that can comply with our request.”

Front Section, Pages 1 on 03/03/2013

Upcoming Events