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Feb. 7, 2013
TOPEKA Organizations representing dentists today announced the first three scholarships awarded under the Kansas Initiative for New Dentists (KIND), which is aimed at steering more dentists to rural parts of the state.
Representatives from the Kansas Dental Association and the Delta Dental of Kansas Foundation said $25,000 per year scholarships would be given to three students who have agreed to serve in counties with fewer than 50,000 people for at least two years per year of scholarship accepted.
"We feel the KIND program has the ability to get dentists into these areas that are perceived to be underserved faster than any other vehicle," said Craig Herre, president of the dental association.
"These are second and third year students, so basically in two years we're going to have two dentists with four years of commitment, and in three years we'll have another with six years of commitment," he said.
Herre said the most prominent alternative approach being pushed by some advocates — licensing mid-level dental providers — would take much more time to place oral health workers in communities.
"It's estimated that it will be four to five years at the very earliest before they could get a trained mid-level practitioner out into the underserved areas," Herre told KHI News Service after today's event. "And the mid-level provider has as yet not even been adopted in any of the states (where its being pushed by advocates). I think it speaks volumes for the amount of time it will take for something like that."
But Suzanne Wikle — project director for the Kansas Dental Project, which is urging the Legislature to approve the licensing of mid-level practitioners — said the scholarship initiative wouldn't do enough to address the state's dental workforce shortage.
“Three new dentists in rural Kansas doesn’t even put a dent into our dental workforce shortage. Adding a mid-level provider like a Registered Dental Practitioner is a long-term, sustainable solution,” Wikle said in a prepared statement.
The scholarships were given to:
• Nathan Schmidt, a third year student at the University of Missouri-Kansas City who plans to practice in Wallace County, which is south of Goodland.
• Brittany Owens, a second year UMKC student who plans to practice in Marion County, which is north of Wichita.
• Taylor Allen-Merklein, a second year UMKC student who plans to practice in Doniphan County, which is just north of Atchison.
Allen-Merklein told KHI News Service that she'd always intended to go back near her hometown of Atchison to practice. However, her husband is an engineer and did not expect to have luck finding a job near Atchison.
"So, we've talked about going to Manhattan or Kansas City. I still wanted to go to Atchison but I had to get him on board. With the $25,000 he's now on board," she said, laughing.
She said her plan is to go to work for Dr. Allen Reavis in Atchison and open a satellite clinic 20 miles north in Troy, pop. 1,011.
"My husband's from Stuttgart (Kansas) and that's just a little bit too rural for me," Allen-Merklein said. "I almost didn't apply until they changed it to any county less than 50,000, because they just recently changed that. Before it was just five or six dental deserts, and it was specific locations like southeast Kansas or southwest Kansas. I didn't want to go somewhere I'm not from."
Schmidt said he also intended to set up practice near his hometown Tribune.
"This makes it much more appealing. I was already wanting to go back home — it didn't matter if I got this scholarship, but them helping me out makes it even more appealing," Schmidt said. "Mom and dad live there, and I have a sister there with (my) three-month-old nephew and three-year-old niece. And I'm not in a relationship or anything to tie me down to Kansas City, so I really wanted to go back there and see them grow up and everything."
He said when he was a kid with braces, his family frequently had to drive an hour and a half to Garden City. When his older brother had braces, the closest orthodontist was three and a half hours away in Colorado Springs.
"Out there, driving, you just get kind of used to it. It's not that big of a deal," Schmidt said. "Growing up out there, it's just understood — you take the entire afternoon off, or in the case of braces the whole day off. You drive to Garden City, get groceries, go out to eat, you make a day of it. It was a blast for us, but you realize mom and dad had to take time off work and I'm missing school," Schmidt said. "Looking back, they had to take a lot of time out, money, gas, missing work and everything just to get me out there all the time."
Owens said her dentist in Newton was 45 minutes away from her hometown, Lincolnville.
"That's actually what sparked my interest in dentistry," Owens said. She said because of the long drive, she always went to dentist appointments the same time as her three sisters.
"Luckily, I had a dentist who was so willing to talk to me about dentistry and let me watch and ask questions. This was back in middle school and that's when I became interested in dentistry."
Owens also said she was planning to set up practice somewhere near her hometown with or without incentives to do so. She said she thought the KIND program could help influence people who were torn between their smaller hometowns and an urban area.
"It takes a very specific individual and someone who grew up in a (small town) to want to move back there," Owens said. "I don't think you're going to get somebody who grew up in the middle of Wichita — their family's there, their whole life has been in Wichita — you're not going to get someone like that to move to western Kansas or where I'm from in central Kansas."
Rep. Brian Weber, a Dodge City Republican, attended the press conference and asked how many new dentists would accept Medicaid patients under KanCare.
Under KanCare, the state's new Medicaid program, adults for the first time can receive two cleanings, two examinations, and one set of oral x-rays annually. They also can have teeth extracted that are abscessed or otherwise very painful.
"We've had a continued problem trying to recruit dentists to take Medicaid," Weber said. "I don't blame them, I blame the system, because very few of us would want to work at a loss."
Kevin Robertson, director of the dental association, said more than 350 dentists have contracted with Amerigroup, one of the three KanCare managed care companies, and fewer with the other two. There are 2,164 dentists licensed in the state.
"It's something we continue to work on," Robertson said. "Dentists got a little later start (joining the MCO networks) because the provider manuals were not made available until late November, so we got a little later start. We know they continue to sign up throughout the month of January, so we think those numbers are going to be higher if you look at data today."
Robertson also said that the Kansas Dental Board recently approved a UMKC program to train hygienists seeking a Type III Extended Care Permit.
The new kind of permit, which was approved by the Legislature last year, expands the procedures trained hygienists can perform to include temporary fillings, denture adjustments, extractions of loose baby teeth and application of local anesthetics in certain situations.
"We expect that sometime by summer we'll have those people out to start working," Robertson said.
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.