SENATE BILL REPORT

                   SB 5321

              As Reported By Senate Committee On:

            Health & Long-Term Care, March 4, 1997

Title:  An act relating to improving access for oral health care services for rural and underserved populations.

Brief Description:  Improving access for oral health care services for rural and underserved populations.

Sponsors:  Senators Deccio, Thibaudeau, Wood, Fairley, Strannigan, Kohl, Oke and Winsley.

Brief History:

Committee Activity:  Health & Long‑Term Care:  2/11/97, 2/20/97, 3/4/97 [DPS-WM].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  That Substitute Senate Bill No. 5321 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

  Signed by Senators Deccio, Chair; Wood, Vice Chair; Benton, Fairley, Franklin, Strannigan and Wojahn.

Staff:  Rhoda Jones (786-7198)

Background:  In 1994 the Department of Health conducted a survey of 6,000 children in 11 counties around the state and found that dental problems are among the most pressing health issues facing children in the publically funded Head Start program and those in the state's Early Child Evaluation and Assessment Programs (ECEAP).  The University of Washington studied 3,000 third graders statewide and found that 20 percent of those studied had 84 percent of the tooth decay.

In 1995 the Legislature authorized the creation of a Joint Select Committee on Access to Oral Health Care to make recommendations on improving access to underserved populations. Among its recommendations, the committee identified an increased role for the state's public health system in providing access to children in underserved communities.

Currently, 12 of the 33 public health jurisdictions have dental sealant programs which target low-income school children who have had little or no dental care. The sealants, which are plastic-like applications to biting surfaces, are provided to elementary school children with new permanent teeth. This is considered an optimal time to control tooth decay with this procedure. Community health clinics around the state provide dental services at 28 sites, primarily to low-income individuals who have no insurance. 

Currently 19 percent of children in the state have sealants, most of whom are from high income groups. The Public Health Improvement Plan has stated a goal that 50 percent of children should have sealants by the year 2000.                 

The committee also identified the need for more dentists to provide care in underserved areas of the state where there is a high percentage of dental disease.  Increasing the number of dental students who train in rural areas was identified as one way to increase dentists exposure to rural and underserved populations.

Summary of Substitute Bill:  A sum of $300,000 is appropriated to fund community-based oral health grants to pay for sealant programs, education, prevention and other oral health interventions.  Priority will be given to communities with oral health coalitions.

A sum of $300,000 is appropriated from the general fund to continue the University of Washington School of Dentistry Aextern@ program at the Yakima Valley Farmer Workers Clinic, the Yakima Neighborhood Health Services, and other state or federally funded clinics throughout the state.

The Department of Health is directed to target funds in the health professional recruitment and retention programs to dentists and dental hygienists.

The Higher Education Coordinating Board is directed to target dentists and dental hygienists when allocating eligible students for loan repayment monies. 

Substitute Bill Compared to Original Bill:  The sum of $300,000 is appropriated to expand the School of Dentistry=s Dental Extern Program.  The sum of $300,000 is appropriated to pay for community oral health grants.

Appropriation:  $600,000.

Fiscal Note:  Available.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  These measures open up opportunities for oral health care to reach underserved populations of the state.  Community-based grants allow flexibility in approaches.  The UW Dental Extern Program gets dental students and dental hygiene students to experience real problems in rural and underserved areas of the state.  This is one way to attract both types of oral health care professionals to underserved areas.

Testimony Against:  All references to promoting water fluoridation should be eliminated.

Testified:  PRO:  Jane Beyer, DSHS/MAA; Mimi Fields, M.D., DOH; Betty Sherman, WSDHA; Lana Poole, WSHDA; Ruth Needham, WSHDA; CON: Elizabeth Gentala, David Clumpner, Al Shaefer, J.S. Hattersley, Paul Drnjevic; Maurice Lauty; Anne Anderson, Janet Nagel; Marjorie C. Williams (concerns).