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(Parenthesis ( ) Indicate Expenditure Decreases)

(Parenthesis ( ) Indicate Revenue Decreases)

Duplicates SB419

SOURCES OF INFORMATION

LFC Files

Health Policy Commission

Dental Health Care Board

New Mexico Association of Community Colleges

SUMMARY

Synopsis of HBIC Amendment

The House Business and Industry Committee amended House Bill 265 to add two new subsections to the Scope of Practice section of the Dental Health Care Act. Both subsections are complementary and provide for a new certification category for dental hygienists. The new category will allow hygienists to be certified to practice dental hygiene without the supervision of but in cooperation with a dentist. The collaborative application fee is not to exceed $150.00.

Synopsis of Bill

This bill changes the licensing of dentists and dental hygienists by credential and expands the scope of practice for dental hygienists. More specifically, Section 61-5A-4 NMSA 1978, which is the scope of practice in the Dental Health Care Act, is amended to: (1) strike the language that requires dental hygienists to practice under the general supervision of a dentist and (2) strike the language that requires dental hygienists to be supervised by a dentist when administering local anesthesia. Section 61-5A-12 NMSA 1978, which detail the requirements for dental licensure, is also amended to allow applicants for licensure as a dentist and as a dental hygienist to be licensed in New Mexico without taking a practical or clinical examination if such applicants are licensed and in good standing in another state.

Significant Issues

Dental access for Medicaid beneficiaries has been raised as an area of concern over the past year. According to the Health Policy Commission (HPC), only 5 counties have an adequate supply of dentists. New Mexico ranks 48^th in the nation in number of dentists to serve its population with 37 dentists per 100,000 patients. The national average is 60 dentists to 100,000 patients. More often than not, this means Medicaid beneficiaries have limited access to dental health services. Only 34% of New Mexico dentists provided any services to Medicaid recipients, according to an 1998 HPC survey.

This bill changes the scope of practice in the Dental Health Care Act and the licensure requirements for dentists and dental hygienists in order to increase access to services for Medicaid beneficiaries. The Dental Health Care Board is concerned that amending the language requiring hygienists to be supervised by a dentist will allow hygienists to open their own dental care practices to offer cosmetic and/or aesthetic dental services. Additionally, the board has pointed to a potential health risk for patients because the legislation would allow unsupervised care including application of local anesthesia.

FISCAL IMPLICATIONS

House Bill 265 as amended does not contain an appropriation. The Board of Dental Health Care anticipates an annual fiscal impact of approximately $7.0 offset by additional revenue of $17.5 resulting from new applicants.

In response to this bill, five two-year institutions will collaborate to offer rigorous dental hygiene and assisting courses: San Juan Community College, Luna Vocational Technical Institute, Clovis Community College, New Mexico Junior College and New Mexico State University - Doña Ana Branch. While the dental hygiene course will require two years to complete, the dental assisting course can be completed in one year. Each year, it is estimated that 20 students will enroll in dental hygiene and 30 students in dental assisting. The associated costs are:

$10.0 - $15.0 facility start-up costs for assisting;

$15.0 facility start-up costs for hygiene;

$5.0 - $10.0 annual operating costs per site; and

$35.0 - $40.0 for statewide program Director.

The New Mexico Association of Community Colleges notes that cost savings can be arrived at if the dental programs are able to use for instruction public health clinic sites and private dentist offices in the areas where the programs will be offered. The instruction and general funding formula will absorb some of the operating costs as student enrollment persists.

RLB/prr