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Oct. 17, 2012
TOPEKA Members of the governance committee for the Kansas Board of Regents agreed today that the full board should hear the pros and cons of a proposal to train mid-level dental practitioners.
Regents' officials said that discussion among board members likely would happen before the Legislature convenes in January, perhaps when the board that oversees state universities, junior colleges and technical schools next meets in November.
Bills authorizing the licensing of "registered dental practitioners" as a way of improving access to dental care for Kansans in rural and other underserved areas were considered by lawmakers in each of the past two sessions of the Legislature but were not advanced because of stiff opposition from the Kansas Dental Association, which represents about 75 percent of the state's dentists, of which there are fewer than 1,500.
Had the proposals become law, the mid-level practitioners would have been allowed to perform about 30 routine services and procedures — such as extracting loose baby teeth, taking X-rays and administering local anesthetic — that currently are limited to dentists. The practitioners, similar to a nurse practitioner, would be required to work under a dentist's "general" supervision, though the dentist would not be required at the technician's side.
Spokespersons for the dental association have argued that routine procedures quickly can turn dangerous and that allowing lesser-trained practitioners to do what dentists now do could put patients at risk.
But supporters of the measure, including a coalition that includes the state's safety-net clinics, argue that some people in Kansas, including children, have died due to lack of dental care and that putting more oral health workers into the field is essential for meeting the state's needs. They also cite studies from countries and states where the practitioners are licensed showing they provide good quality, cost-effective care.
According to the Kansas Department of Health and Environment the state's dental workforce is below the national average and shrinking. More than a dozen of the state's 105 counties have no dentist and many more than that have too few.
A proposal to create the new class of dental technician is expected to be before the Legislature again in the 2013 session, which begins in January.
About a year ago, Fort Hays State University President Ed Hammond, told an interim legislative committee that FHSU was prepared to launch a new dental degree program to train the mid-level practitioners, if legislators would approve their licensing. He said he was confident he could raise private funds to launch the new program.
New degree programs also require approval from the Regents.
A task force appointed by the higher education board earlier this year released a report recommending that the state begin long-term planning to have its own dental school and immediately secure 10 or 20 additional seats for Kansas students in dental schools in surrounding states, which is where many Kansas dentists currently are trained. Kansas currently doesn't have a dental school.
But the board last month didn't include funding for those task force recommendations in its spending plans. Instead it recommended adding $1.2 million for an advanced training program for dentists at Wichita State University.
The proposal to train registered dental practitioners was not considered by the task force.
Tim Emert, a former state senator, is chair of the Regents board and of its governance committee, which today considered whether the mid-level dental practioner proposal should be advanced for discussion by the full board at a later date.
He argued against doing that, citing the ongoing legislative impasse over the issue.
"I don't think we have any power or control," in the matter, he said. "I think it's got to come from the Governor's Office. I don't think it's our responsibility to set the policy for the state," regarding mid-level dental practitioners.
But board member Fred Logan, a Johnson County attorney and former chairman of the Kansas Republican Party, said he thought board members were obliged to consider the matter given that Fort Hays State was proposing the new degree program.
Governance committee members agreed to invite supporters and opponents of licensing the practitioners to speak at a future board meeting on a date yet to be determined.
(Editor's Note: The Kansas Health Foundation, a major funder of the Kansas Health Institute, is among the supporters of licensing registered dental practitioners.)
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