HB519

SECTION 1. The legislature finds that Hawaii's oral health system has been ailing for decades and has struggled to meet the growing needs of its population statewide, especially those with health and social disparities, such as Native Hawaiians, Pacific Islanders, persons with low incomes, persons living in rural communities, and persons with disabilities.

The legislature further finds that there are currently more than 288,000 recipients of adult dental benefits across Hawaii. The legislature also finds that statewide emergency department data analyzed from calendar years 2016-2020 shows that significant numbers of Hawaii's adult population who receive medicaid use emergency facilities as their "dental care home", which is an ineffective method of dental care and a misuse of resources.

Furthermore, the legislature finds that estimates indicate that the fourteen federally qualified health centers in Hawaii, the State's safety-net care system, served almost forty thousand patients of all ages (not all of whom receive medicaid assistance) statewide in calendar year 2021 for dental care needs. Dental care in federally qualified health centers for medicaid recipients may be underreported, since the encounters are "uninsured", due to prior emergency-only medicaid coverage.

Moreover, the legislature finds that there are a total of three hundred thirty-nine active (defined as filing at least one claim in the last six months) medicaid dentists providing dental care for medicaid recipients. This total includes twenty active dentists at federally qualified health centers. Only eleven per cent of Hawaii's dental providers serve one hundred or more persons who receive medicaid assistance, likely due in part to the fact that recipients have had access to emergency-only dental benefits since 2009.

The purpose of this Act is to expand access to dental care by:

(1) Amending the State's qualifications for community service dentist and dental hygienist licenses by requiring the acceptance of candidates who are graduates of programs recognized by the American Dental Association Commission on Dental Accreditation, which would increase the pool of eligible dental professional candidates available to work at the department of health, federally qualified health centers, and Native Hawaiian health care systems, which also includes post-doctorate dental residency programs for which a temporary license is applicable;

(2) Adding "community health center" to the list of eligible organizations at which those with a community service license may practice, thus allowing these providers to better serve Hawaii's medicaid and uninsured populations; and

(3) Amending the State's qualifications for dentist temporary licenses by requiring the acceptance of candidates who are graduates of a dental college recognized by the American Dental Association Commission on Dental Accreditation.

SECTION 2. Section 447-1.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) The board of dentistry may issue, without examination, a community service license to practice dental hygiene in the employment of a federally qualified health center, Native Hawaiian health care system, community health center, or post-secondary dental auxiliary training program accredited by the American Dental Association Commission on Dental Accreditation. Community service licensees under this section shall abide by the requirements and conditions placed upon those fully licensed under this chapter.

Eligible candidates shall:

(1) Provide copies of documentation and credentials that include but are not limited to:

(A) A diploma or certificate of graduation from a dental hygiene college accredited or recognized by the American Dental Association Commission on Dental Accreditation, recognized and approved by the board; and

(B) Either of the following:

(i) A certificate or other evidence satisfactory to the board of having passed the examination of the National Board Dental Hygiene Examination, within five years of the date of request; or

(ii) Evidence of active clinical dental hygiene practice of not less than one thousand hours per year for the three years immediately prior to the date of request;

(2) Provide a copy of an active, unrestricted dental hygiene practice license from another state;

(3) Disclose to the board of dentistry all previous and pending legal or regulatory action relating to claims of malpractice, personal, or professional misconduct; and

(4) Pay applicable registration fees, which shall be one half of the prevailing biennial registration fee for dental hygienists.

No person who after July 2, 2004, has failed to pass the license examination administered under this chapter may be issued a community service dental hygiene license."

SECTION 3. Section 448-9.6, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

"(a) The board of dentistry may issue, without examination, a community service license to practice dentistry in the employment of the department of health, a federally qualified health center, Native Hawaiian health systems center, community health center, or post-secondary dental auxiliary training program accredited by the American Dental Association Commission on Dental Accreditation. Community service licensees under this section shall abide by the requirements and conditions placed upon those fully licensed under this chapter.

Eligible candidates shall:

(1) Provide copies of documentation and credentials that include but are not limited to:

(A) A diploma or certificate of graduation from a dental college accredited or recognized by the American Dental Association Commission on Dental Accreditation, recognized and approved by the board; and

(B) Either of the following:

(i) A certificate or other evidence satisfactory to the board of having passed part II of the National Board Dental Examination or the Integrated National Board Dental Examination within five years of the date of request; or

(ii) Evidence of active practice of clinical dentistry of not less than one thousand hours per year for the three years immediately prior to the date of request;

(2) Provide a copy of an active, unrestricted dental practice license from another state;

(3) Disclose to the board of dentistry all previous and pending legal or regulatory action relating to claims of malpractice, or personal or professional misconduct; and

(4) Pay applicable registration fees, which shall be one half of the prevailing biennial registration fee for dentistry.

No person who after July 2, 2004, has failed to pass the license examination administered under this chapter shall have the benefit of a community service dental license."

SECTION 4. Section 448-12, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"[[](b)[]] The board of dentistry may issue a temporary license without examination to any person otherwise qualified to be examined, who is enrolled in a post-doctoral residency program that is accredited and recognized by the American Dental Association Commission on Dental Accreditation. Eligible candidates shall include graduates from a dental college accredited or recognized by the American Dental Association Commission on Dental Accreditation, recognized and approved by the board. The temporary license shall authorize the person to whom the license is issued to practice dentistry exclusively under the auspices of the dental residency program and shall be in force until the earliest of the following occurs:

(1) The date the person completes or leaves the residency program; or

(2) The date on which the board revokes the temporary license;

provided that the board may revoke the temporary license at any time for cause."

SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________

HOUSE OF REPRESENTATIVES	H.B. NO.	519
THIRTY-SECOND LEGISLATURE, 2023
STATE OF HAWAII