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March 19, 2012
TOPEKA Over the objections of two senators who said it didn't go far enough, the Kansas Senate today gave initial approval to a measure aimed at expanding access to dental care. A final vote on the measure is expected tomorrow.
House Bill 2631 would create a new permit level for dental hygienists to allow them to provide more types of care to underserved patients. An Extended Care Permit, or ECP, Type III permit would allow trained hygienists to perform temporary fillings, adjust dentures, smooth sharp teeth, extract loose baby teeth and apply local anesthetics in certain situations.
Sen. Allen Schmidt, a Hays Democrat, said the expanded list of procedures wasn't sufficient to meet the need for more access to dental care.
"It doesn't serve our rural communities in the way that we need to be served," Schmidt said. "Being that we have 96 counties in Kansas that are underserved by dentists, we have been trying to get a program started to create (a new class of) mid-level dentist practitioner that could work, particularly in the rural communities."
Under a proposal that stalled last year in the Legislature, the practitioners would be able to to do more permanent, routine dental work than an ECP III.
Officials at Fort Hays State University have said they have a training program ready to go for the mid-level practitioners once Kansas policymakers agree to license them.
Supporters say licensing the practitioners in Kansas would improve access to dental care in nursing homes, jails, rural counties and urban cores where dentists often are hard to come by or unwilling to accept Medicaid patients. Opponents, including the state's dental association, say they think it would be unsafe to let the practitioners do things such as drill and fill teeth without a dentist at hand.
Sen. Vicki Schmidt, a Topeka Republican, said the bill creating the new ECP III license was a step in the right direction.
"This bill, while not perfect, does represent progress and does represent the areas that all parties agreed upon," Vicki Schmidt said. "I consider this bill tremendous progress."
Sen. Laura Kelly, a Topeka Democrat, said she supported creating the new position because it would expand services to some areas. But she said she was concerned that the temporary work done by the hygienists might be all the care a patient received.
"The fact that there is no required follow-up is what concerns me. There's nothing in there that requires the sponsoring dentist to provide those (permanent) services," Kelly said. "We know there's a tremendous shortage of dental services available, particularly in our rural areas and particularly to our Medicaid recipients. That's why I think it's imperative there be follow-up."
The bill also would:
• Require the Kansas Board of Regents to seek additional openings for Kansas students at the University of Missouri-Kansas City School of Dentistry. Graduates would be required to provide dental care in underserved areas of Kansas for at least four years.
• Establish a volunteer dental license for retired dentists who want to provide care to poor or underserved populations.
• Expand the locations where charitable dental services could be performed and dentists would be exempt from liability. Currently, dentists are limited to offering free dental care protected from lawsuits at large occasional events such as Mission of Mercy. The new locations would be sanctioned individually by the Kansas Department of Health and Environment and dentists would be required to organize the charitable care around the approved events in order to receive liability protection.
The House passed the bill last month.
In other business today, the Senate also gave preliminary approval to:
• HB 2660, which would make several adjustments to the law regulating maternity centers and child care facilities. Among other things, it would allow the Kansas Department of Health and Environment to suspend a license for part of a facility or otherwise modify the language of an existing license. The House passed the bill last month.
• HB 2416 would update statutes to change references to the Kansas Health Policy Authority following last session's Executive Reorganization Order 38. That ERO folded KHPA into KDHE and renamed it the Division of Health Care Finance. The bill, which passed the House last month, also would repeal the statutes that created KHPA.
• SB 327 among other things would lay out who could access data from the Prescription Monitoring Program and modify regulations to allow electronic prescriptions for controlled substances.
• Sub for HB 2659 would move the licensure and regulatory authority of speech-language pathologists and audiologists from KDHE to the new Kansas Department for Aging and Disability Services. KDHE officials had initially proposed moving that authority to the State Board of Healing Arts, but suggested amending the bill after resistance from professionals in the field. The House passed the bill last month.
• HB 2697 would let prospective Medicaid beneficiaries assign their life insurance policies to the state in order to meet the program's eligibility standards. Currently, life insurance policyholders must cash out and spend the money before qualifying for Medicaid. Legislative backers of the proposal said it would help the state Medicaid program recoup some expenses and help people who needed the program but otherwise would have to "spend down" to qualify for it. The House passed the bill last week.
• HB 2471 would standardize how appointments are made to the Board of Adult Care Home Administrators. The bill would put into law how appointments have long been made informally. Currently, the board is composed of three adult care home administrators, two health care providers and two consumer representatives. The House passed the bill last month.
The Senate passed over Senate Substitute for HB 2390, which would phase out the Kan-ed network. Senate leaders said they planned to work the bill on Wednesday.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.