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Feb. 6, 2013

Advocates for mid­level dental providers

meet with legislators

Photo
by
Phil
Cauthon Sen.
Ralph
Ostmeyer
(R­Grinnell)
meets
with
dental
hygienist
Tammi
Engel
(left)
and
Heidi
Lowry,
director
of
the
Rawlins
County Dental
Clinic
in
Atwood.
The
two
were
among
about
30
hygienists
from
around
the
state
to
meet
with
their
legislators
today. By
Phil
Cauthon KHI
News
Service Feb.
6,
2013 TOPEKA
—
About
30
dental
hygienists
from
around
the
state
were
in
Topeka
today
to
ask their
legislators
to
approve
the
licensing
of
mid­level
dental
providers. A
bill
to
license
so­called
registered
dental
practitioners
was
introduced
last
week.
If
it becomes
law,
it
would
allow
hygienists
with
18­months
additional
training
to,
among
other things: •
permanently
fill
teeth,

(2)

•
extract
teeth, •
repair
dentures,
and •
temporarily
crown
teeth. The
Kansas
Health
Consumer
Coalition,
Kansas
Action
for
Children,
the
Kansas
Health Foundation
—
a
major
funder
of
the
Kansas
Health
Institute
—
and
other
groups
have supported
the
licensing
of
mid­level
dental
practitioners
in
Kansas,
and
organized
today's visits
by
the
hygienists. Heidi
Lowry
and
Tammi
Engel
were
among
those
who
traveled
the
farthest.
They
are
from Atwood
—
a
town
in
the
northwest
corner
of
the
state,
which
is
designated
a
"dental
desert." According
to
a
2011
report,
at
least
57,000
Kansans
live
in
"dental
deserts,"
areas
where
the closest
dental
office
is
at
least
a
half­hour
drive
from
the
resident's
home. Lowry
and
Engel
met
with
Sen.
Ralph
Ostmeyer,
a
Grinnell
Republican,
to
tell
him
how licensing
the
dental
practitioners
would
improve
oral
health
in
Rawlins
County
and
others
like it. "It's
not
just
access"
to
care,
said
Lowry,
a
trained
hygienist
who
now
spends
most
of
her
time as
director
of
the
Rawlins
County
Dental
Clinic. "With
the
current
economic
climate
on
the
state
and
federal
level,
we're
going
to
have
to
look at
ways
to
be
self­sustaining.
Being
able
to
use
(practitioners)
is
going
to
go
a
long
ways toward
being
able
to
provide
those
services
and
do
it
in
an
economic
manner.
That's
just
more fiscally
responsible
with
our
Medicaid
dollars,
and
all
the
way
around,"
Lowry
said.
"When you're
just
talking
economics,
a
(practitioner)
is
not
going
to
make
the
same
wage
as
a
dentist. And
when
we're
a
safety
net
clinic
and
write
off
a
significant
portion
of
services
every
year, it's
going
to
make
the
safety
net
clinics
more
sustainable
without
state,
federal
or
grant
dollars. That's
huge.
We
can
continue
to
see
those
who
don't
have
insurance
and
not
tax
emergency rooms." Ostmeyer
asked
the
women
if
dentists
were
any
less
opposed
to
the
idea
than
they
were

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"Are
you
able
to
sit
down
with
the
Kansas
Dental
Association?"
Ostmeyer
asked. The
dental
association
opposes
the
measure,
saying
there
are
better
ways
to
increase
access
to oral
health
care
—
including
its
Kansas
Initiative
for
New
Dentists,
which
would
offer
loan repayment
and
scholarships
to
dentists
and
students
who
agree
to
serve
for
at
least
two
years in
a
dental
desert.
The
dental
association
has
scheduled
an
event
at
the
Statehouse
tomorrow to
announce
the
first
four
recipients
of
awards
under
the
program. "I've
talked
with
several
dentists
in
our
area
and
we
don't
have
near
as
much
fight
back.
I
don't think
they'd
publicly
say
'I
support
this'
in
front
of
the
dental
association,
but
they
see
the need,"
Lowry
said.

The
need

It's
not
easy
to
recruit
and
keep
a
dentist
in
rural
areas,
Lowry
said. Before
she
and
her
supervising
dentist
arrived
in
Rawlins
County
in
2008,
citizens
there
had been
trying
to
lure
a
dentist
for
10
years,
she
said. "When
you
live
in
that
rural
of
an
area,
there's
things
you
just
don't
think
about,"
Lowry
told KHI
News
Service
after
her
talk
with
Ostmeyer.
"If
you
have
to
see
a
medical
specialist, you're
driving
to
Denver.
There's
concern
with
(obstetrics)
care,
if
(a
potential
recruit
is) young
wanting
to
start
a
family,"
she
said. "We're
30
miles
from
the
closest
Walmart,
shopping
is
not
really
available,
there's
no
fast
food per
se...our
movie
theater
is
open
Saturdays
and
Sundays.
During
the
summer
they
show
on Fridays
but
as
soon
as
sports
start
up,
they
close,"
Lowry
said.
"You
have
to
really
want
a rural,
community­minded
area." One
of
the
two
dentists
the
community
recruited
using
a
school
loan
repayment
program
is leaving
soon,
she
said. "She's
coming
back
to
the
city,
to
Kansas
City.
So
we're
going
to
be
down
to
one,
which
is going
to
be
difficult,"
Lowry
said.

(4)

A
different
mindset

She
said
if
practitioners
were
licensed,
the
needs
of
Rawlins
County
could
be
met
with
two
of them
in
addition
to
the
current
three
hygienists
and
dentist. Among
the
needs
that
would
be
most
immediately
met:
fillings
in
the
baby
teeth
of
children the
clinic
serves
in
schools
using
portable
equipment.
Currently
the
closest
dentist
who accepts
Medicaid
referrals
is
60
miles
away
in
Norton
and
only
handles
"extreme"
cases. Ostmeyer
asked
why
it
was
difficult
to
get
dentists
to
see
Medicaid
patients. Lowry
said
Medicaid
doesn't
pay
as
well
and
"that's
compounded
by
the
fact
that
there's
just
a shortage
of
dentists
in
general,
so
their
schedules
are
full
seeing
(patients
who
have)
private insurance." She
said
practitioners
also
would
fill
a
need
for
caring
for
the
developmentally
disabled children
and
adults
her
staff
treats. "What
we've
found
is
that
if
we
can
see
them
on
site,
they
don't
have
to
have
as
much
valium or
other
things
to
make
them
chemically
relax,
they
don't
have
to
be
restrained.
So
if
we
could bring
services
to
them,
it
would
be
much
better,"
Lowry
said. "I've
just
found
that
the
mindset
of
a
hygienist,
generally
it's
just
a
little
bit
different personality
than
dentists
—
one's
a
little
bit
more
willing
to
go
do
the
on­site,
portable dentistry,"
she
said. Alaska
was
the
first
state
to
sanction
licensing
of
mid­level
dental
providers
in
2006,
and
only Minnesota
has
done
so
since.

Related
coverage:
Kansas'
Oral
Health
Care
Provider
Shortage

→ Dentist groups announce scholarships for dentists going to rural areas (2/7/13) → Advocates for mid­level dental providers meet with legislators (2/6/13) → Bill to license mid­level dental providers introduced (1/29/13) → Regents will hear proposal to train mid­level dental practitioners (10/17/12) → Dentist shortage proposal not funded in Regents' recommended budget (9/20/12) → Report questions economic viability of mid­level dental providers (7/26/12)

(5)

→ Worldwide review says mid­level dental providers give good care (4/10/12) → Bill to increase dental care access given initial approval in Senate (3/15/12) → New caucus told of oral health success in southeast Kansas (3/8/12) → More Kansans head to ER for dental care (2/29/12) → Dental association says new program will increase access in rural areas (2/2/12) → ‘Turf battle’ continues over dental practitioner bill (1/30/12) → Summit to focus on training plan for mid­level dental practitioners (11/29/11) → Between a hygienist and a dentist, a hard sell (10/26/11) → Political fight continues over mid­level dental practitioners (10/11/11) → Better prevention would help solve dentist shortage, advocate says (7/22/11) → Dentists: Practitioner bill flawed (3/9/11) → Videos detail shortage of Kansas dental providers (12/8/10) → Slow going in efforts to solve state’s dentist shortage (8/30/10) → Safety­net clinics filling gap in dental services to low­income Kansans (8/30/10) → Replacing town’s only dentist ‘hardest’ project ever (8/30/10) → Progress made on oral health, but problems remain (1/14/09) → Funding bill contains seed money for 'dental hubs' (5/4/07) → Increasing access aim of oral health coalition (12/21/06) The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in­depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783­2529.

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