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June 21, 2012
TOPEKA Building the first dental school in Kansas would be among the top things that could be done to help deal with the state's dental workforce shortage, members of an oral health task force told the Kansas Board of Regents today.
But since that isn't expected any time soon, the task force recommended that more seats at dental schools in surrounding states be secured for Kansas students who agree to practice in rural and other underserved areas of the state after they graduate.
The projected cost of a new dental school would be $58 million to build and $19.5 million to operate annually, according to the task force. That would pay for a central location where 60 students per year would be trained for their first two years. The report did not recommend a location for the school.
The second two years would be spent training at satellite locations across the state — such as at federally qualified health centers and other safety net clinics in underserved areas, the report recommended.
"So the students would actually do rotations around the state," said State Sen. Jeff Longbine, an Emporia Republican and a task force member. "Hopefully, the students will find opportunity to set up practice in those areas and thereby address some of the critical needs that we have for dental access throughout the state."
At least 57,000 Kansans live in "dental deserts," where the closest dental office is at least a half-hour drive from the resident's home, according to a report published last fall. Of the state's 105 counties, 93 face deeper dental workforce shortages as dentists retire.
The way Kansas currently recruits dentists is not addressing the state's need, particularly in rural areas, Longbine said. Two-thirds of the state's dentists come from the 20 seats currently secured for Kansas dental students at the University of Missouri-Kansas City. But most those graduates go to work in urban areas, he said.
"It is unlikely that you are going to be able to recruit a student from an urban area, train them in an urban setting and then ask them to go to a rural setting to practice," Longbine said.
Dr. Dan Thomas, the task force chair and an Overland Park dentist, said it would be up to the board and the Regents institutions to determine where a dental school might be built. However, he said, the ability to recruit faculty to the location would narrow options.
"There's a good possibility it's going to be somewhere in Wichita, and then we'll have satellite clinics out in other places," Thomas said.
The project would take seven to 10 years before the first class would graduate and be ready to practice, task force officials predicted.
The task force also recommended that the state immediately seek at least 10 to 20 seats at dental schools at the University of Nebraska, Creighton University, the University of Oklahoma and a new school being built in Kirksville, Mo. No additional seats are available at the UMKC dental school, officials said.
Once those seats are secured, the state would pay the difference between in- and out-of-state tuition for Kansas students, contingent on an agreement that they return to Kansas and provide care in underserved areas as well as to underserved populations, including Medicaid enrollees, underinsured and low-income patients, the aged, disabled and children.
One estimate prepared for the task force put the cost at $800,000 per year for 25 seats at neighboring states' schools or about $3.2 million to bring 25 dental graduates back to Kansas.
The task force recommended instituting a recruitment and admissions process for the seats that gives preference to students from rural communities and those with a demonstrated commitment to community service.
Kevin Robertson, a task force member and director of the Kansas Dental Association, said that recommendation was based on a recruitment model used for the new University of Kansas Medical Center campus in Salina.
"The idea is you want to recruit the type of people as dentists that then will go back to those areas, not just wealthy people from urban areas who really have no desire to go to a place like say Ness City, or Sharon Springs or Coldwater," Robertson said.
Following the task force's recommendations, the Kansas Dental Project released a statement saying that a more expedient way to address the dental workforce shortages would be the licensing of mid-level dental providers. A mid-level dental provider's training places them between a regular dentist and a dental hygienist — able to fill cavities and perform simple extractions of teeth.
“Kansas has a dental access crisis now. We can’t afford to wait,” said Hays dentist Melinda Miner in the group's prepared statement. “Fort Hays State University has already agreed to educate and train Registered Dental Practitioners right here in Kansas. Within just a few years, we could have mid-levels seeing patients and helping dentists like me grow our practices.”
The mid-level training program would be a more "sustainable, home-grown solution" than purchasing seats at out-of-state dental schools, the group said.
Task force officials said that mid-level practitioners were discussed peripherally during their six months of work, but that such a recommendation would have been outside the Regents' charge for the group.
Regents officials said that the recommendations would be referred to the board's governance committee and that the full board would take up the matter again in September.
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