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Minutes for SB312 - Committee on Health and Human Services
Short Title
Licensure of dental therapists.
Minutes Content for Wed, Mar 14, 2018
For the first order of business, Chairperson Hawkins opened the hearing on SB312.
Norm Furse, Revisor Emeritus, Office of Revisor of Statutes briefed the committee on the contents of the bill, which as amended, would expand the Dental Practices Act by creating the practice of dental therapy and requiring the Kansas Dental Board to authorize a person to practice as a dental therapist if they meet the qualifications, education, clinical training, and if licensed, the dental therapist must purchase professional liability insurance as set out in the bill. He explained that the bill would define direct and general supervision and would also specify the terms and conditions for which a dentist or dental therapist's license may be suspended or revoked (Attachment 1).
Proponents:
Kevin Robertson, Executive Director, Kansas Dental Association, supports this bill over the one introduced last year, because he said 1) a dentist can supervise no more than three dental therapists; 2) extractions of primary and permanent teeth have been modified or eliminated, and; 3) irreversible surgical dental procedures are performed under the direct supervision of a dentist (Attachment 2.
Jon T. Fales, Jr., DDS, MS, Pediatric Dentist, Olathe, KS, reported that he supports SB312 because work on this bill created a compromise solution that will work to increase access to care for Kansans while also protecting their safety (Attachment 3).
Christi Nance, Policy Director, Oral Health Kansas, said her organization recognized the need to expand and strengthen the dental workforce in Kansas and supports the efforts being undertaken to address this issue through SB312 (Attachment 4).
Denise Cyzman, Executive Director, Kansas Association for the Medically Underserved, supports this bill because it will increase access to dental care in rural and underserved areas, besides increasing access to dental care by establishing a new type of dental provider in Kansas, a dental therapist (Attachment 5.
Travis Lowe, Executive Director, Kansas Dental Hygienist's Association, explained to the committee that Kansas has tried to address the health issue of the number of Kansans without access to adequate oral health care. He further stated that this is a public health issue that Kansans has been trying to address for several years without much success. He said because of that, he supports SB312 because this bill could have a dramatic impact on access to oral heath care in underserved areas in Kansas (Attachment 6).
Opponent:
Mariah Frazier, DDS, FAAPD, a pediatric dentist, says there is no language in the bill that identifies a term of practice for a dental therapist in a designated health professional shortage area, and there is no language in the bill that specifies that population data will be used to ensure Kansans have access to quality safe health care. She stressed that Kansas has enough dentists to provide care; however, they can't afford to, because Medicaid reimburses 40 cents per dollar, and this does not pay the overhead of their practices (Attachment 7).
Mark Troilo, DDS, Wichita, Kansas, opposes the bill because, he said, Kansas does not have an access to care issue because there is no shortage of dentists. He further stated that dentists do not turn patients away and are providing free dentistry now, even for those patients who lack the ability to pay for the services rendered to them (Attachment 8).
David Casteel, a 4th year dental Student at the University of Kansas City, opposes SB312, saying the proponents of dental therapists largely market themselves as an incredible solution that addresses the care issue we face in so many areas nationwide; however, these barriers to care are a major focus of most dental students. He further stated that dental therapy has been tried worldwide but has never survived without significant government subsidization (Attachment 8).
Antoine E. Wakinm, DDS, PA, adamantly opposes SB312 because it takes 4 years of education and training to have adequate hand and judgement skills to surgically prepare teeth for restorations, fillings, and for performing crown procedures. He said furthermore, this bill endangers the public, is unnecessary and will lead to abuse because it was swiftly crafted without general membership knowledge and will be bad for the under privileged (Attachment 10).
Dr. Marc Huslig, DDS reported to the committee that he has asked a significant number of his patients about using mid-level therapists, and they felt they would be penalized and unwilling to accept mediocrity when it comes to their oral care with most of them conveying the fact they don't need it and don't want it (Attachment 11).
Alexandra Blasi, Executive Secretary, Kansas Board of Pharmacy, appeared before the committee as an opponent because the bill provides large sweeping authority for dental therapists to dispense and administer certain medications, and the Board of Pharmacy strongly supports amending the language in Section 2, subsection (d)(17) to ensure proper supervision, regulation, and oversight that is necessary to protect the public (Attachment 12).
Neutral:
Nancy Lusk, State Representative, Kansas Legislature, testified as neutral to this bill and she hopes the committee will step back and take a deeper look because she sees dental care an important factor to overall health. She feels Kansas needs to increase the workforce for dental care and believes it as a multifaceted problem and thinks it will take a multifaceted solution (Attachment 13).
Proponent written:
The following proponents provided written testimony in support of SB312:
Dr. Nick Rogers, President, Kansas Dental Association (Attachment 14);
John Bellome, DDS, AARP Kansas (Attachment 15);
Jeff Glendening, Director, Kansas Americans for Prosperity (Attachment 16);
Rachel Monger, Vice President Government Affairs, LeadingAge Kansas (Attachment 17);
Steve Coen, President & CEO, Kansas Health Foundation (Attachment 18);
Cathleen Taylor-Osborne, DDS, MA, State Dental Director, Kansas Department of Health and Environment (Attachment 19).
Opponents written:
The following dentists submitted written testimony opposing the bill:
Dr Lindy Cope, DDS (Attachment 20);
Brian Hendrick, DDS (Attachment 21).
Neutral written:
Written testimony was submitted as neutral parties concerning SB312:
Linda MowBray, Vice President, Kansas Health Care Association (Attachment 22);
Kansas Dental Board (Attachment 23).
