Dentistry; Licensing; Payment
Permits licensing by credentials for dentists who work solely for safety net dental providers, an agency, or in a private practice located in a federally designated dental health professional shortage area. Allows the issuance of a temporary 3-yr. license for dentists practicing under obligation of the National Health Service Corps or under a state-supported professional education program. Authorizes payment to these temporarily licensed dentists.
TWENTY-SECOND LEGISLATURE, 2003
STATE OF HAWAII
A BILL FOR AN ACT
relating to dentistry.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that Hawaii's children have some of the highest rates of dental caries and baby bottle tooth decay in the nation. This is especially true among native Hawaiian, Southeast Asian, Filipino, and Pacific Islander children, whose unmet dental treatment needs range between forty and sixty per cent.
Although the adult population in Hawaii fares better when it comes to dental health needs, a considerable number of residents live without the most basic oral health care. Over three hundred thousand Hawaii residents have no dental insurance or little money to pay for adequate dental care.
Despite having the largest number of practicing dentists in the nation, per capita, Hawaii has one of the lowest rates of dentists who participate in the medicaid program. There are a variety of reasons for this disparity, including the fact that:
(1) Hawaii's medicaid and QUEST programs do not include coverage for basic dental care for low income adults;
(2) Employer-sponsored dental insurance is not a required benefit under Hawaii's Prepaid Health Care Act; and
(3) Medicare benefits for the elderly lack dental benefits.
This lack of participation results in a serious problem of access to dental care for thousands of medicare, medicaid, and QUEST program enrollees, as well as people with no dental insurance, in Hawaii.
Neighbor island communities are also greatly affected by this lack of adequate dental care and have been found to have the greatest oral health disparities, highest ratios of residents who are uninsured or covered by medicaid or QUEST, and lower dentist to per capita population ratio.
Safety net dental providers are critically important in addressing Hawaii's unmet oral health care needs through the provision of dental services to those who fall through the cracks in the system. However, these safety net providers, especially those on the neighbor islands, have difficulty providing adequate incentives to recruit dentists as employees or volunteers.
The purpose of this Act is to amend Hawaii's dentistry regulation law for dentists working or volunteering for safety net dental providers, or in a federally designated dental health professional shortage area, to provide incentives for incoming dentists to serve underserved populations, while maintaining the quality of dental care available in Hawaii.
SECTION 2. Section 346-59, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:
"(b) Rates of payment to providers of medical care who are individual practitioners, including doctors of medicine, dentists, podiatrists, psychologists, osteopaths, optometrists, and other individuals providing services, shall be based upon the Hawaii medicaid fee schedule[
.]provided that dentists temporarily licensed pursuant to section 448-12(b)(6) also shall be compensated based upon the Hawaii medicaid fee schedule. The amounts paid shall not exceed the maximum permitted to be paid individual practitioners or other individuals under federal law and regulation, the medicare fee schedule for the current year, the state limits as provided in the appropriation act, or the provider's billed amount.
The appropriation act shall indicate the percentage of the medicare fee schedule for the year 2000 to be used as the basis for establishing the Hawaii medicaid fee schedule. For any subsequent adjustments to the fee schedule, the legislature shall specify the extent of the adjustment in the appropriation act."
SECTION 3. Section 448-12, Hawaii Revised Statutes, is amended to read as follows:
"§448-12 Temporary license[
(1) The date the person leaves the employment authorized under the temporary license;
(2) Three years following the date of issuance of the temporary license for dentists practicing under obligation of the National Health Service Corps or under obligation of any state-supported professional education program;
(2)] (3) The three hundred ninety-sixth calendar day following the date of issuance of the temporary license[ ;] for other applicants without service obligations pursuant to paragraph (2);
(3)] (4) The date on which the results of the licensure examination taken by the person under this chapter are posted by the board; or
(4)] (5) The date on which the board revokes the temporary license;
provided that the board may revoke the temporary license at any time for cause.
No person who has failed an examination shall have the benefit of any temporary license.
(b) The board of dental examiners may issue without examination to any resident or nonresident [
licensed in another state and otherwise qualified to be examined a temporary license to practice dentistry while in the employment of the department of health to provide dental services to Hansen's disease sufferers. The temporary license shall be valid for a period of three years or until the first board examination after the conclusion of the three-year period and only while the person to whom the temporary license is issued is in the employment of the department of health and works under the general direction and supervision of a duly licensed dentist. The temporary license shall not be renewed and shall be reviewed annually by the board of dental examiners for continuance and shall be subject to revocation and suspension as provided in section 448-17. The temporary licensee shall not be eligible for examination by the board of dental examiners while the temporary license is in effect.] a temporary license to practice dentistry; provided that the person:
(1) Has a license to practice dentistry issued pursuant to the laws of another state or territory of the United States or the District of Columbia;
(2) Has practiced dentistry pursuant to the laws of another state or territory of the United States or the District of Columbia for a minimum of three years;
(3) Has not had the person's license to practice dentistry revoked or suspended in this state, any other state or territory of the United States, or the District of Columbia;
(4) Has not been refused a license to practice dentistry in this state, any other state or territory of the United States, or the District of Columbia;
(5) Is not involved in or does not have pending disciplinary action concerning the person's license to practice dentistry in this state, any other state or territory of the United States, or the District of Columbia; and
(6) Works exclusively as an employee of a safety net dental provider organization, or for an agency or in a private practice located in a federally designated dental health professional shortage area; provided that the dentist serves uninsured patients without regard to the ability to pay, uses a sliding fee scale based on the federal poverty level, and does not restrict the number of patients covered by medicaid in the practice.
(c) Dentists practicing under a temporary license obtained pursuant to subsection (b)(6) shall be compensated for services provided at rates comparable to licensed dentists through any state or state administered federal health funding program.
(d) For purposes of this section, "safety net dental provider organization" means an entity that:
(1) Is a private, nonprofit corporation, determined to be a charitable organization under 26 United States Code section 501 (c)(3);
(2) Provides care to all patients regardless of their ability to pay for the services rendered;
(3) Employs a sliding fee scale based on federal poverty guidelines for Hawaii; and
(4) Accommodates individuals with disabilities and those who require language assistance."
SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 5. This Act shall take effect on July 1, 2003.