Testimony before the Kansas Senate Committee on Public Health and Welfare
Charlie Katebi, State Government Relations Manager,
The Heartland Institute
Thursday, February 1, 2018
Chairman Schmidt and Members of the Committee:
Thank you for offering me the opportunity to testify today. My name is Charlie Katebi, and I am a state government relations manager for The Heartland Institute, a 34-year old independent national nonprofit organization. Heartland’s mission is to develop and promote public policy solutions that expand opportunity and empower people. The Heartland Institute is headquartered in Illinois and focuses on providing national, state, and local elected officials with reliable and timely analyses on important policy issues.
Kansas faces a looming dental care crisis that threatens all residents, but especially the poor and disadvantaged. As the state’s population ages, residents will be demanding more healthcare than ever before. At the same time, medical professionals will be retiring in increasingly greater numbers. Unless new dental professionals take their place, oral care will almost certainly become more expensive and less accessible in the future.
Dental therapists and hygienists can help satisfy Kansas’ growing dental care needs. These midlevel professionals already provide a variety of routine treatments under the supervision of dentists in private practices, as well as community settings such as schools and nursing homes. And unlike dentists who must train for four years and pay more than $270,000 for schooling, therapists and hygienists can get certified within two years and pay as little as $36,000. This allows midlevel providers to more easily enter the marketplace and provide less expensive treatments to patients.
Unfortunately, Kansas’ licensing rules prohibit these qualified professionals from providing patients the care they need. Despite the fact that dental therapists are trained and qualified to drill and fill cavities, Kansas restricts them from treating patients unless a dentist is physically present. This means an estimated 1.4 million Kansans, including 342,000 children, who reside in counties designated as “Dental Care Health Professional Shortage Areas” lack access to critical dental care.
The proposal now under consideration, if approved, would ensure Kansas takes several promising first steps toward empowering dental therapists to treat patients without the direct supervision of a dentist. The plan would authorize them to independently provide 35 non-surgical procedures, including tissue conditioning, tooth reimplantation, and placing crowns.
Although this legislation would make some important policy improvements, it would also keep certain Kansas laws on the books that prevent mid-level providers from offering extremely important procedures to Kansas’ sickest patients. For instance, therapists would still be barred from drilling and filling cavities (preparation and placement of direct restorations fabricated or made directly inside the mouth in primary and permanent teeth) without a dentist present. As a result, patients in underserved areas who are unable to travel for care, children whose parents can’t travel long distances or don’t have the resources to travel, and elderly patients in rural nursing homes will continue to live without reliable access to dentists.
Stakeholders are right to be concerned about the health of Kansas’ patients. However, more than 1,100 studies across 26 countries have found dental therapists provide patients safe and effective care. Even the American Dental Association’s Council on Scientific Affairs concluded that “the results of a variety of studies indicate that appropriately trained mid-level providers are capable of providing high-quality services, including irreversible procedures such as restorative care and dental extractions.” With such positive results recorded around the world, it’s clear mid-level providers in Kansas should be permitted to treat significantly more dental health problems than they do now.
To ensure Kansans enjoy greater access to high-quality dental care services, this committee should consider authorizing therapists and hygienists to independently drill and fill cavities and other essential services the proposal now under consideration would continue to limit.
Thank you for the opportunity to testify on this important issue.
For more information about The Heartland Institute’s work, please visit our websites at www.heartland.org and http:/news.heartland.org, or call Charlie Katebi at 978-855-2992 or reach him by email at [email protected].