TOPEKA — A controversial bill to allow specially trained dental hygienists to provide more tooth care to patients was heard today in the House Health and Human Services Committee.

But that may be the end of it for this year. House Bill 2280 will not be voted upon by the committee, the chairperson said following the hearing, which was split into two sessions, the second ending about 7:30 p.m.

"It's the first year for it. There's lots of questions, lots of concerns," about the proposal, said Rep. Brenda Landwehr, a Wichita Republican.

Her decision to hold the bill is a setback for its proponents because of looming legislative deadlines that limit ways they now can push the measure forward.

The bill, sought by a coalition that includes children's advocates and the state's 39 safety-net clinics, met stiff opposition from Kansas dentists.

New provider class

It would create a new class of dental care provider called a Registered Dental Practitioner. Already licensed hygienists with an additional 18 months of focused training could qualify for the new license, should the bill become law.

Supporters said the new "mid-level practitioners," would mean improved access to dental care for Kansans living in nursing homes, jails, rural counties and urban cores where dentists are hard to come by or unwilling to accept Medicaid patients.

"Registered dental practitioners are necessary to fill the gap in Kansas because it seems as though we have exhausted other options for bringing people care in rural areas," said Heidi Foster, chief executive of Rawlins County Dental Clinic in Atwood and one of the bill's proponents. "Even though we did recruit a second full-time dentist, she only plans on staying until her (student) loans are repaid. Upon completion of her obligation she plans to return to Omaha and open her own practice. Our second dentist that works three days a week is in his upper seventies. It's time to try something different."

But dentists testified that the "lives and safety" of Kansans would be jeopardized if lesser-trained dental technicians were allowed to do things such as pull baby teeth and install temporary crowns without direct supervision by a dentist.

Procedures that sound simple can quickly turn dangerous, the dentists said, or pain might be inflicted upon a child thereby sowing the seed for a lifelong, "dental phobic," adult.

"If there is one consistency in the practice of dentistry," said Dr. Glenn Hemberger, president of the Kansas Dental Board, "it is that procedures frequently do not go as planned."

The bill includes a list of 34 procedures that the technicians would be allowed to perform under a dentist's supervision, though the dentist would not need to be physically present during the work. Supporters said the technicians could stay in touch with a supervising dentist via email or telephone in case they ran into problems.

Heavily lobbied

The proposed legislation seems unlikely to capture much public attention, but some of the Capitol's most prominent lobbying firms have been paid to notice. One wag invoked an old Statehouse gag line, calling the bill the, "Lobbyist Full-Employment Act."

The Kansas Dental Association sent a fund raising letter to its members claiming that the "Kellogg Foundation" was spending $16 million in five states, including Kansas, to get dental practitioner laws such as HB 2280 on the books.

"Clearly, much of this money is being spent on slick media, videos, press releases, and other advocacy efforts designed to promote their plan," the letter stated. It was signed by the association's president, Dr. Dave Hamel.

The Feb. 10 plea asked for contributions of $250, $500 or $1,000 to help the association oppose the legislation.

Spokesmen for the W.R. Kellogg Foundation weren't immediately available for comment and the letter's claim about the organization's efforts could not be confirmed or refuted.

Lobbying shops hired to help fight the bill include Capitol Strategies LLC and Hein Law Firm.

Firms working in support of the measure include Kearney & Associates and Gaches, Braden & Associates.

The Kansas Dental Association is supporting another bill, SB 132, that would somewhat expand the scope of practice for hygienists but not to the extent sought by the coalition pushing HB 2280.

That bill was heard Wednesday by the Senate Public Health and Welfare Committee.

A Senate version of HB 2280 - SB 192 - also has been introduced in the Senate Ways and Means Committee but has not yet been scheduled for a hearing.

If that bill also is squelched this session, its proponents are vowing to come back each year until they succeed.

"Bottom line is we're in this for the long haul," said Shannon Cotsoradis, chief executive of Kansas Action for Children, one of the main organization backing the measure. "And if we're not successful this year, we'll be back next year and if not next year, the year after that."