On March 11, two hearings were held in the Minnesota Senate and House of Representatives addressing the mid-level provider language. As we have reported, two different bills have been introduced, one by MNSCU, the dental hygienists and the Safety Net Coalition, and the other by the University of Minnesota School of Dentistry that is supported by the Minnesota Dental Association.
Going into the hearing, we knew that the deck was stacked against us. The Chairman, Senator John Marty (DFL-Roseville), had determined that his committee would only hear and vote on the OHP bill because, in his words, it was the language from the Department of Health’s OHP work group - which it wasn’t. Prior to the hearing we were able to convince the Senator to hear the Dental Therapist bill, but he said that it was to be only informational and that we would not be given the opportunity to get a vote on it.
The strategy of our the Safety Net Coalition, MNSCU, and the dental hygienists was to bring in “experts” from Alaska and Canada to talk about the mid-level practitioner models that they have in place. They also contended that this would not cost MNSCU any money and that it was not necessary for a dentist to be supervising with anything more than a written agreement.
Following their lengthy testimony, we were finally able to talk about the dental therapist bill and our support of it. We were able to argue that access was important to all of us but that safety had to be a key element. That is why we contended that a dentist had to be in the building when surgical or irreversible procedures were being performed. Also, a school accredited to teach oral surgical procedures should be the only place to teach the clinical work.
However, with the committee’s time running out, we were forced to shorten our testimony and attempt a procedural move.
Senator David Hann (R-Eden Prairie) attempted to get a vote on the dental therapist bill, but was blocked by the Committee Chairman from doing so. Senator Hann then offered an amendment to add all of our language from the dental therapist bill onto the OHP bill. After Senator Lynch (DFL-Rochester), the author of the OHP bill, expressed some concerns, the amendment was passed unanimously.
While we were working at a disadvantage in this hearing, we were able to preserve the language that we support and move it forward. While it is attached to language we do not support, there will be new opportunities for us to advance our position in the Senate. This bill was referred to the Senate Higher Education Finance Committee where our next debate will occur.
Later in the day, during an evening hearing of the House Licensing Subcommittee we were faced with a very similar setup. The OHP bill was to be heard and voted on, and then the dental therapist was to be heard. Fortunately, the Chairman “allowed” the committee to vote on the DT bill this time.
During the identical testimony from our opponents that we had heard in the Senate, Representative Matt Dean (R-Dellwood) offered an amendment to strip the scope and supervision provisions out of the OHP bill and replace them with the language from the dental therapist bill. The amendment failed by a 3-4 vote. The OHP bill was then passed on a 4-3 margin.
One frustrating dynamic was that Representative Tom Emmer (R-Delano) who would have been the tying vote to pass our amendment and block the OHP bill, was not at the Capitol for the committee hearing.
Representative Kim Norton (DFL-Rochester) then did a great job of introducing the dental therapist bill and all of our testifiers were allowed to speak. The arguments that were made included an emphasis on safety and even went on to debate the merits of what is going on in other countries and Alaska. There was also testimony from a number of safety net members that were opposed to the OHP.
The dental therapist bill was then passed out of committee on a 5-2 margin (more votes than the OHP bill got) with only Representatives Jim Abeler (R-Anoka) and Cy Thao (DFL-St. Paul) voting against it.
The bottom line is that the superior proposal survived to fight another day. While we are pleased that the MDA and School of Dentistry proposal was met with little resistance and was enthusiastically supported, we are also frustrated that the legislature appears to be willing to pass BOTH bills and are not inclined to pick one over the other.
Special thanks go to Senator Yvonne Prettner Solon (DFL-Duluth), Representative Kim Norton (DFL-Duluth) for authoring our bills; Senator David Hann (R-Eden Prairie) and Representative Matt Dean (R-Dellwood) for offering our amendments; as well as Representative Julie Bunn (DFL-Lake Elmo) who after much deliberation cast her votes in our favor.
Also, special thanks to all of the Grassroots members that contacted their legislators regarding this subject. Please keep in mind that the battle is far from over and we will be calling on you many more times to reach out and remind your elected officials of our position.
Also we would like to thank the following MDA dentists who testified on behalf of the profession:
Bob Brandjord, DDS
Tony DiAngelis, DDS
Mike Flynn, DDS
Ryan Lindner, DDS
Scott Lingle, DDS
Patrick Lloyd, DDS
Jamie Sledd, DDS
Donna Stenberg, DDS
Bruce Templeton, DDS
Kou Vang, DDS