Report Title:

Dentistry; service obligation

Description:

Requires that dentists who were recipients of state support for dental school through the Western Interstate Commission for Higher Education program or who participated in the state-subsidized dental residency program repay their obligation through service in federally qualified health centers or other underserved areas.

HOUSE OF REPRESENTATIVES

H.B. NO.

2682

TWENTY-FIRST LEGISLATURE, 2002

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO RECIPIENTS OF CERTAIN STATE SUPPORTED DENTAL TRAINING.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that Hawaii has a considerable number of residents with unmet oral health needs. Our children have some of the worst rates of dental caries and baby bottle tooth decay in the nation. The percentage of native Hawaiian, Southeast Asian, Filipino, and Pacific Islander children who suffer from unmet dental treatment needs ranges between forty and sixty-three per cent.

In addition, the legislature finds that over three hundred thousand Hawaii residents have no dental insurance and little money to pay for out-of-pocket dental expenses. Moreover, low-income adults enrolled in medicaid or QUEST do not have coverage for basic dental care. The elderly covered by medicare also do not receive dental benefits. Hawaii's Prepaid Health Care Act does not require employer-sponsored health plans to offer dental benefits. Due to these and other factors, Hawaii has one of the lowest rates of dentists who participate in the medicaid program, despite having the largest number of practicing dentists, per capita, in the nation. The overall result is a serious problem of access to dental care for hundreds of thousands of medicaid and QUEST enrollees and people with no dental insurance. The problem is even more pressing in neighbor island communities that have the greatest oral health disparities, highest ratios of residents who are uninsured or covered by medicaid or QUEST, and the lowest ratio of dentists to population.

The legislature also finds that "safety net" dental providers represent a critical component in addressing Hawaii's unmet oral health needs. However, these "safety net" providers, especially on the neighbor islands, have difficulty attracting and recruiting dentists to work in these areas.

The legislature further finds that state funds are currently being invested in supporting professional dental education for certain Hawaii residents through the Western Interstate Commission for Higher Education (WICHE) program. Additionally, the state supports the costs of training dental residents in a hospital-based setting.

The purpose of this Act is to obligate all recipients of state funds supporting their dental education through the WICHE program and all beneficiaries of state-supported dental residency programs to serve in federally qualified health centers (FQHCs) or in other underserved communities.

SECTION 2. Recipients of financial support received under the WICHE program for dental school and beneficiaries of state-supported dental residency programs shall be required to provide one year of obligated service in an underserved community for each year of state financial support received under the WICHE program for dental school or for each year of participation in a state supported dental residency program.

First priority for obligated service shall be employment at an FQHC. If no positions are available at an FQHC, service may be fulfilled by employment within an agency or in a private practice located in a federally-designated dental health professional shortage area (HPSA); provided that the obligated dentist:

(1) Serves uninsured patients without regard to ability to pay, using a sliding fee scale based on the federal poverty level; and

(2) Does not restrict the number of patients covered by medicaid in the practice.

Obligated dentists shall receive fair and reasonable compensation during their period of service from their employers. Volunteer work by obligated dentists, while not discouraged, shall not be a condition of employment, and shall be performed during non-working hours.

SECTION 3. The University of Hawaii shall advise students who accept state financial support under the WICHE program for dental school of the service obligation required in section 2 of this Act. Dental residency programs receiving state funds shall advise participants of the service obligation required in section 2 of this Act. The administrator of the WICHE program and the administrators of each state-supported dental residency program shall communicate information about beneficiary students and residents, respectively, to the Hawaii Primary Care Association (HPCA). The HPCA shall be responsible for placing obligated dentists in underserved communities in accordance with the following ranking of priorities in descending order:

(1) FQHC;

(2) Agency or private practice located in a federally-designated dental HPSA; and

(3) Any other underserved community as determined by HPCA.

SECTION 4. Dentists under this program who are unwilling or unable to fulfill their service obligations shall repay the WICHE program or, in the case of a dental residency program, the department of health, at double the value of state financial support received. Dental students who have received state financial support under the WICHE program for dental school, but fail to complete their dental training and are, therefore, unable to practice dentistry, shall repay one hundred per cent of the state financial support received.

SECTION 5. This Act shall take effect on approval and shall apply to those who receive financial support on July 1, 2002, or later.

 

INTRODUCED BY:

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