Thursday, March 12, 2009

Federal Appropriations signed, State advances oral practitioner bill

President Obama signs FY2009 Appropriations Bill
The U.S. Senate passed the Omnibus Appropriations bill Tuesday night that will fund federal programs for fiscal year 2009, and President Obama signed the bill into law yesterday. The bill is a compilation of nine spending bills that the previous Congress was unable to finish before adjourning, including the Labor-HHS-Education bill. Overall, the bill spends $410 billion and provides a $4.4 billion increase in funding for educational programs over the fiscal year 2008 level. Included in the bill is $17.3 billion for Pell grants. In addition to the funds provided in the stimulus package, $17.3 billion would provide a maximum award of $5350 and is an increase of $3.1 billion over FY 2008.

Oral health practitioner bill advances
Two bills offering different approaches to establishing the requirements and practice limitations for an oral health practitioner were the focus of yesterday's Senate Health, Housing and Family Security Committee. Members heard extensive testimony on both bills before advancing one measure to the Committee on Finance.

SF 1106, sponsored by Sen. Ann Lynch, DFL-Rochester, establishes licensure and practice limitations for an oral health practitioner. SF 641 sponsored by Sen. Yvonne Prettner Solon, DFL-Duluth, establishes licensure and practice limitations for dental therapists.

Mike Scandrett, Minnesota Safety Net Coalition, said last year's legislation establishing a new mid-level dental professional called an oral health practitioner also established a work group to develop recommendations on the training and practice details. He said the result of the work group's recommendations are contained in SF 1106.

Scandrett said lack of access to dental care is one of the most important health problems for Minnesota children and adults, especially for those who are low-income, have a disability or special needs or live in rural areas. He said, according to the Dept. of Health, less than half of the low-income people who are on state health care programs received any dental care at all in 2006. He said the main barriers are the cost of dental care and a shortage of dentists who are willing to treat patients at reduced costs or practice in rural or communities or treatment settings.

Lynch said SF 1106 sets forth the licensure requirements for an oral health practitioner. Under the bill, the individual must have graduated with a bachelor's or master's degree from an accredited or approved oral health practitioner education program, passed a comprehensive, competency-based clinical exam and an exam on the state's laws and rules relating to dentistry. The bill also allows the oral health practitioner to use the services of dental assistants, dental technicians and licensed dental hygienists. Lynch said the bill requires the practitioner to practice under the supervision of a Minnesota licensed dentist, limits the practice to settings that serve low-income, uninsured, or underserved patients or settings located in a dental health professional area.

Prettner Solon said that SF 641 requires a dental therapist to work under the supervision of a Minnesota licensed dentist and requires the collaborating dentist to accept responsibility for all services authorized and performed by the dental therapist. The bill also provides that a dental therapist may perform preventive, evaluative and educational oral health services.

Marilyn Loen, dean, College of Nursing and Health Sciences, Metropolitan State University described the curriculum Metro State has developed for oral health practitioners. She said the scope of practice is widened under the Metro State approach to allow the individual to provide services to the underserved while the collaborative dentist is off-site.

Patrick Lloyd, dean, University of Minnesota described the curriculum developed by the School of Dentistry at the University of Minnesota. He said under the University's model the dental therapist could provide services only when the collaborative dentist is on-site.

The committee agreed to create two versions of dental therapists, with different training requirements: one would require more oversight, the other could operate more independently. Members adopted an amendment attaching the language of SF 641 to the language of SF 1106 and advanced SF 1106 as amended to the Committee on Finance.

At the Capitol:
Legislative schedules are available for the House and Senate.

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