A bill approved today by a House committee would make several changes to state law to allow dental hygienists to provide more types of care to underserved patients.
House Bill 2631 represents a small step toward expanded access to dental care in the state, said Rep. Brenda Landwehr, a Wichita Republican who chairs the House Health and Human Services Committee.
"What we're doing here today with (HB) 2631 doesn't solve everything. It is definitely a small step. This issue is by no means over," Landwehr said.
Among other things, the bill would add a new class of dental hygienist who would be able to perform more procedures than currently allowed, including certain types of temporary fillings, smoothing chipped teeth, adjusting dentures and applying local anesthetics.
Currently, hygienists are allowed to provide preventive care such as cleanings and fluoride treatments in a dentist’s office.<a name="continued"></a>
If they want to see patients in nursing homes, senior centers, safety-net clinics, jails, schools or other locations where access to dental care is limited, they're required to have an extended-care permit.
There are two types of permits:
• Type I: Allows hygienists to work with children outside a dentist’s office. The permit requires 1,200 hours of experience. There are now 52 hygienists with a Type I permit.
• Type II: Allows hygienists to work with patients over age 65. The permit requires 1,800 hours of experience. There are now 96 hygienists with a Type II permit.
The bill approved today would create a third type of permit that would allow hygienists to work outside a dentist's office with both children and patients over age 65 and would expand the list of procedures they could perform.
The new Type III permit would require 2,000 hours experience and completion of new coursework to be approved by the Kansas Dental Board.
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 to include dentists' offices and locations that host charity programs. The new locations would be sanctioned individually by the Kansas Department of Health and Environment.
Rep. Bob Bethell, R-Alden, said the bill was a step in the right direction, "but I don't think it's the extent that we really need in the state of Kansas."
He said that, while the bill would allow hygienists to do temporary procedures — such as certain types of fillings — that doesn't offer patients a long-term solution.
"They would then have to come back and find a dentist in an area that could be very much underserved," Bethell said. "There are still concerns, but it is good to the extent of what it does do."
Dental practitioner bill
Bethell and Landwehr both alluded to ongoing discussions about allowing a new type of oral health care provider in Kansas as a potential way to better improve access to dental care.
House Bill 2280 calls for licensing registered dental practitioners. It was introduced in the 2011 Legislature but stalled after the Kansas Dental Association weighed in heavily against it. The organization speaks for most of the state’s dentists.
Backers of the bill include the state’s safety net clinics, major health foundations, several dentists who disagree with the association’s stand and officials at Fort Hays State University, which wants to launch a program to train the registered dental practitioners if lawmakers will authorize them to practice in the state. Supporters of the bill include the Kansas Health Foundation, which is a major funder of the Kansas Health Institute.
Landwehr held a roundtable meeting Jan. 27 with hopes of brokering a compromise.
"The one thing that came out of it that day was for all parties to agree that out of the legislation we have out there, that this was one we could move forward to help serve more folks," Landwehr said. "At some point we're still going to have to address the other issue that's still sitting out there that was actually the reason for the roundtable."
Neither backers of the bill nor Kevin Robertson, executive director of the dental association, would say whether they expected discussions to move forward on HB 2280.
"I wish I had a grand answer for you," Robertson told KHI News Service after today's meeting. "That's really up to the committee chair."