Kan. mediation over MLPs ends without agreement

Deliberations aimed at resolving a dispute over whether to allow midlevel dental practitioners (MLPs) in Kansas have ended without agreement.

Negotiations between the Kansas Dental Association (KDA), which opposes MLPs because it says they jeopardize patient care, and the Kansas Dental Project (KDP) ended without compromise, according to a Kansas Health Institute story.

The KDP has pushed for legislation to allow advanced hygienists to perform routine procedures such as temporary fillings, extractions, and filing sharp edges off teeth. Approval of a new type of dental practitioner would help address Kansas' growing shortage of dentists by letting hygienists with additional training perform common procedures, according to the group.

In 2011, a bill written to establish a new model similar to nurse practitioners was proposed but stalled because of opposition from the KDA, which said only those with a dentist's training can do the work safely.

In October, the KDA and the KDP entered formal mediation in their debate over the licensing of MLPs, with the goal of finding compromise legislation that would allow advanced hygienists to perform some procedures in the state. But they ended without agreement, said Christie Appelhanz, who works with the group Kansas Action for Children -- one of 50 members of the KDP, according to the Kansas Health Institute.

The group will move forward in 2014 with the legislative package that it supported this year, Appelhanz said.

MLPs like the ones practicing in Minnesota could also help Kansas alleviate its shortage of dental care providers, according to the manager of a Minnesota dental clinic.

Jeff Bartleson, of Children's Dental Services in Minneapolis, was in Topeka this week to speak with members of the KDP coalition, according to a cjonline.com story.

Fort Hays State University has announced its willingness to train MLPs if the Kansas Legislature approved the concept. Minnesota passed legislation authorizing such practices in 2009, and its first registered dental practitioners were licensed in 2011.

Minnesota's reimbursement rates are very low compared with other states, Bartleson said -- only about 30¢ for every $1 spent providing care -- so community and nonprofit clinics are forced to try to stretch the small amount of funding to provide as much care as possible.

When qualified MLPs are available, they are much more affordable, and the quality of care is good, according to Bartleson. A dental therapist who was hired by his clinic sees 1,500 kids a year of the clinic's approximately 30,000 patients, he said.

Several Kansas dentists are supportive of the measure, according to Appelhanz. The coalition sees this as the most promising solution for the lack of access throughout the state, she said.

According to the U.S. Health Resources and Services Administration, 99 Kansas counties have a shortage of dental providers, and 13 counties have no dentists.

Private practices in Minnesota, as well as community and nonprofit clinics, now are embracing the practitioners, Bartleson said.

Alaska and Minnesota are the only states that have authorized MLPs, but many others are studying the concept.

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