Hawaii 2025 Regular Session

Hawaii Senate Bill SB481 Compare Versions

Only one version of the bill is available at this time.

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1	1	THE SENATE S.B. NO. 481 THIRTY-THIRD LEGISLATURE, 2025 STATE OF HAWAII A BILL FOR AN ACT relating to community service licenses. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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3	3	THE SENATE S.B. NO. 481
4	4	THIRTY-THIRD LEGISLATURE, 2025
5	5	STATE OF HAWAII
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7	7	THE SENATE
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9	9	S.B. NO.
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11	11	481
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13	13	THIRTY-THIRD LEGISLATURE, 2025
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17	17	STATE OF HAWAII
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31	31	A BILL FOR AN ACT
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37	37	relating to community service licenses.
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43	43	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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47	47	SECTION 1. The legislature finds that access to comprehensive dental care in the State is critically limited for adults and children who are uninsured, under insured, or of Native Hawaiian or Pacific Islander ancestry, including Compact of Free Association migrants. The legislature further finds that on April 3, 2024, Dr. Diane Paloma, the chief executive officer of the Hawaii Dental Service, a Hawaii nonprofit corporation providing dental insurance in the State, testified before the house of representatives standing committee on finance that only fifty per cent of the State's med-QUEST eligible children received dental care in 2023, even though the majority of pediatric dental practices in the State accept med-QUEST patients. Dr. Paloma further testified that only eleven per cent of the State's med-QUEST eligible adults received dental care in 2023. The majority of med-QUEST eligible adult dental patients are treated at the fourteen federally qualified health centers located throughout the State. From 2009 to 2022, the State offered limited emergency adult dental med-QUEST benefits, resulting in the accumulated, untreated dental infections and diseases during this time period exceeding all currently available dental service capacity for the next several years. The legislature also finds that the State has made progress in addressing this need. In 2022, the State introduced measures to re-instate most adult dental med-QUEST benefits and to appropriate funds for dental care. In 2023, Act 100, Session Laws of Hawaii 2023, added community health centers, rural health clinics, and mobile dental outreach programs to the list of eligible organizations at which persons with community service licenses may practice. However, due to the high cost of living in the State, the med-QUEST dental benefit reimbursement is lower than the cost for private practice dental providers to provide care to med-QUEST patients. The legislature additionally finds that one way to improve access to dental care for eligible med-QUEST dental patients is to increase the number of dental providers with a community service license (CSL). According to the State's board of dentistry, there has been one hundred and six CSLs issued since 2004, with only fifteen verified as "Current, Valid & In Good Standing." The legislature finds that section 448-9.6, Hawaii Revised Statutes, contributes to this shortage of CSL availability as it limits the board of dentistry's authority to issue CSL to graduates of dental schools accredited by the American Dental Association Commission on Dental Accreditation (ADA CODA). This provision restricts the board of dentistry's fiduciary responsibility to provide access to comprehensive dental care for all med-QUEST beneficiaries. This restriction also prevents Hawaii Dental Service and other dental insurance companies from fulfilling their statutory obligations under section 431:26-103, Hawaii Revised Statutes, relating to network adequacy. The legislature believes that by repealing certain restrictions and requirements for the issuance of CSLs in the State, the board of dentistry can license Canadian dental school graduates, as was allowed in 2005 pursuant to Act 121, Session Laws of Hawaii 2005. According to the ADA CODA, Canadian dental schools are equivalent to those in the United States and no further education is required for eligibility for licensure in the United States. In addition, the United States Department of Education grants authority to ADA CODA to approve or accredit United States dental school programs. However, because Canada does not fall under the jurisdiction of the United States Department of Education, neither ADA CODA nor the United States Department of Education can accredit Canadian dental programs. The legislature finds that allowing Canadian dental school graduates to apply for a CSL in the State without examination increases the potential pool of applicants. As an incentive to attract candidates, the CSL should automatically convert to an unrestricted general dental license after the provider has served five thousand hours in patient care to the med-QUEST population. As proof of concept, the five current CSL providers with five thousand hours of community service to the State's dental patients should have their CSLs converted to a general dental license. The legislature additionally finds that existing law requires dental license applicants to pass the American Board of Dental Examiners (ADEX) as proof of minimum competency for licensure. Interestingly, the ADEX clinical restorative examination is a simulated examination, which does not test on a live patient but rather, a mannequin. Current dental providers in the State with a CSL have graduated from an ADA CODA-accredited dental school years ago. Those with five thousand hours of patient care, at an average of one patient per hour, have treated about five thousand patients. Treating live patients is a much better standard for proof of competency than testing on a mannequin and, therefore, those dental providers with a CSL and over five thousand hours of patient care have proven their competency beyond a doubt and, therefore, should be automatically granted an unrestricted general dental license in the State. Accordingly, the purpose of this Act is to increase the number of dental service providers in the State by: (1) Allowing a dental graduate from a dental college accredited by the Commission on Dental Accreditation of Canada to be an eligible candidate for CSL; (2) Repealing the requirement that the licensing examinations be completed within five years of a request for a CSL; (3) Repealing the requirement that a CSL applicant provide a copy of an active, unrestricted dental practice license from another state; (4) Repealing the prohibition against a person who failed the license examination from obtaining a CSL; and (5) Requiring a CSL to be eligible for conversion to a general unrestricted dental license when a dental provider holding a CSL completes at least five thousand hours of community service to patients in the State. SECTION 2. Section 448-9.6, Hawaii Revised Statutes, is amended to read as follows: "§448-9.6 Community service license. (a) The board may issue, without examination, a community service license to practice dentistry in the employment of the department of health, a federally qualified health center, Native Hawaiian health center, community health center, rural health clinic, mobile dental outreach program, or post-secondary dental auxiliary training program accredited by the American Dental Association Commission on Dental Accreditation. Community service licensees under this section shall abide by the requirements and conditions placed upon those fully licensed under this chapter. Eligible candidates shall: (1) Provide copies of documentation and credentials that include but are not limited to: (A) A diploma or certificate of graduation from a dental college accredited by [or that has a reciprocal agreement with] the American Dental Association Commission on Dental Accreditation, or the Commission on Dental Accreditation of Canada, recognized and approved by the board; and (B) Either of the following: (i) A certificate or other evidence satisfactory to the board of having passed part II of the National Board Dental Examination or the Integrated National Board Dental Examination [within five years of the date of request]; or (ii) Evidence of active practice of clinical dentistry of not less than one thousand hours per year for the three years immediately prior to the date of request; [(2) Provide a copy of an active, unrestricted dental practice license from another state; (3)] (2) Disclose to the board all previous and pending legal or regulatory action relating to claims of malpractice, or personal or professional misconduct; and [(4)] (3) Pay applicable registration fees, which shall be one half of the prevailing biennial registration fee for dentists. [No person who, after July 2, 2004, has failed to pass the license examination administered under this chapter shall have the benefit of a community service license.] (b) Community service licensees shall actively participate in a formal and ongoing program of clinical quality assurance. (c) A license may be renewed biennially, pending review and reauthorization of the board of dentistry. (d) A community service license authorizes the licensee to practice dentistry only within the employment of an eligible organization and shall be in force until the earliest of the following occurs: (1) The date the person leaves the employment authorized under the community service license; (2) The date on which the results of the license examination taken by the person under this chapter are posted by the board; (3) The date the community service license expires; or (4) The date on which the board revokes the community service license; provided that the board may revoke the community service license at any time for cause. (e) Commissioned officers of the United States Army, the United States Navy, the United States Air Force, the United States Public Health Service, or the United States Department of Veterans Affairs practicing in the department of health, a federally qualified health center, or Native Hawaiian health systems center shall qualify for a community service license to practice dentistry, which may be issued for the term of the officer's federal duty assignment. Officers shall provide to the board of dentistry: (1) A copy of an active, unrestricted dental practice license from another state; and (2) A copy of documentation reflecting official duty assignment to a qualifying community service dental license site. (f) Notwithstanding any other law to the contrary, a dental provider holding a community service license who completes or has completed at least five thousand hours of community service to patients in the State, shall be eligible for automatic conversion of the provider's community service license to an unrestricted dental practice license." SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored. SECTION 4. This Act shall take effect upon its approval. INTRODUCED BY: _____________________________
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49	49	SECTION 1. The legislature finds that access to comprehensive dental care in the State is critically limited for adults and children who are uninsured, under insured, or of Native Hawaiian or Pacific Islander ancestry, including Compact of Free Association migrants.
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51	51	The legislature further finds that on April 3, 2024, Dr. Diane Paloma, the chief executive officer of the Hawaii Dental Service, a Hawaii nonprofit corporation providing dental insurance in the State, testified before the house of representatives standing committee on finance that only fifty per cent of the State's med-QUEST eligible children received dental care in 2023, even though the majority of pediatric dental practices in the State accept med-QUEST patients. Dr. Paloma further testified that only eleven per cent of the State's med-QUEST eligible adults received dental care in 2023. The majority of med-QUEST eligible adult dental patients are treated at the fourteen federally qualified health centers located throughout the State. From 2009 to 2022, the State offered limited emergency adult dental med-QUEST benefits, resulting in the accumulated, untreated dental infections and diseases during this time period exceeding all currently available dental service capacity for the next several years.
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53	53	The legislature also finds that the State has made progress in addressing this need. In 2022, the State introduced measures to re-instate most adult dental med-QUEST benefits and to appropriate funds for dental care. In 2023, Act 100, Session Laws of Hawaii 2023, added community health centers, rural health clinics, and mobile dental outreach programs to the list of eligible organizations at which persons with community service licenses may practice. However, due to the high cost of living in the State, the med-QUEST dental benefit reimbursement is lower than the cost for private practice dental providers to provide care to med-QUEST patients.
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55	55	The legislature additionally finds that one way to improve access to dental care for eligible med-QUEST dental patients is to increase the number of dental providers with a community service license (CSL). According to the State's board of dentistry, there has been one hundred and six CSLs issued since 2004, with only fifteen verified as "Current, Valid & In Good Standing."
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57	57	The legislature finds that section 448-9.6, Hawaii Revised Statutes, contributes to this shortage of CSL availability as it limits the board of dentistry's authority to issue CSL to graduates of dental schools accredited by the American Dental Association Commission on Dental Accreditation (ADA CODA). This provision restricts the board of dentistry's fiduciary responsibility to provide access to comprehensive dental care for all med-QUEST beneficiaries. This restriction also prevents Hawaii Dental Service and other dental insurance companies from fulfilling their statutory obligations under section 431:26-103, Hawaii Revised Statutes, relating to network adequacy.
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59	59	The legislature believes that by repealing certain restrictions and requirements for the issuance of CSLs in the State, the board of dentistry can license Canadian dental school graduates, as was allowed in 2005 pursuant to Act 121, Session Laws of Hawaii 2005. According to the ADA CODA, Canadian dental schools are equivalent to those in the United States and no further education is required for eligibility for licensure in the United States. In addition, the United States Department of Education grants authority to ADA CODA to approve or accredit United States dental school programs. However, because Canada does not fall under the jurisdiction of the United States Department of Education, neither ADA CODA nor the United States Department of Education can accredit Canadian dental programs.
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61	61	The legislature finds that allowing Canadian dental school graduates to apply for a CSL in the State without examination increases the potential pool of applicants. As an incentive to attract candidates, the CSL should automatically convert to an unrestricted general dental license after the provider has served five thousand hours in patient care to the med-QUEST population. As proof of concept, the five current CSL providers with five thousand hours of community service to the State's dental patients should have their CSLs converted to a general dental license.
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63	63	The legislature additionally finds that existing law requires dental license applicants to pass the American Board of Dental Examiners (ADEX) as proof of minimum competency for licensure. Interestingly, the ADEX clinical restorative examination is a simulated examination, which does not test on a live patient but rather, a mannequin. Current dental providers in the State with a CSL have graduated from an ADA CODA-accredited dental school years ago. Those with five thousand hours of patient care, at an average of one patient per hour, have treated about five thousand patients. Treating live patients is a much better standard for proof of competency than testing on a mannequin and, therefore, those dental providers with a CSL and over five thousand hours of patient care have proven their competency beyond a doubt and, therefore, should be automatically granted an unrestricted general dental license in the State.
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65	65	Accordingly, the purpose of this Act is to increase the number of dental service providers in the State by:
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67	67	(1) Allowing a dental graduate from a dental college accredited by the Commission on Dental Accreditation of Canada to be an eligible candidate for CSL;
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69	69	(2) Repealing the requirement that the licensing examinations be completed within five years of a request for a CSL;
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71	71	(3) Repealing the requirement that a CSL applicant provide a copy of an active, unrestricted dental practice license from another state;
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73	73	(4) Repealing the prohibition against a person who failed the license examination from obtaining a CSL; and
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75	75	(5) Requiring a CSL to be eligible for conversion to a general unrestricted dental license when a dental provider holding a CSL completes at least five thousand hours of community service to patients in the State.
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77	77	SECTION 2. Section 448-9.6, Hawaii Revised Statutes, is amended to read as follows:
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79	79	"§448-9.6 Community service license. (a) The board may issue, without examination, a community service license to practice dentistry in the employment of the department of health, a federally qualified health center, Native Hawaiian health center, community health center, rural health clinic, mobile dental outreach program, or post-secondary dental auxiliary training program accredited by the American Dental Association Commission on Dental Accreditation. Community service licensees under this section shall abide by the requirements and conditions placed upon those fully licensed under this chapter.
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81	81	Eligible candidates shall:
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83	83	(1) Provide copies of documentation and credentials that include but are not limited to:
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85	85	(A) A diploma or certificate of graduation from a dental college accredited by [or that has a reciprocal agreement with] the American Dental Association Commission on Dental Accreditation, or the Commission on Dental Accreditation of Canada, recognized and approved by the board; and
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87	87	(B) Either of the following:
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89	89	(i) A certificate or other evidence satisfactory to the board of having passed part II of the National Board Dental Examination or the Integrated National Board Dental Examination [within five years of the date of request]; or
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91	91	(ii) Evidence of active practice of clinical dentistry of not less than one thousand hours per year for the three years immediately prior to the date of request;
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93	93	[(2) Provide a copy of an active, unrestricted dental practice license from another state;
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95	95	(3)] (2) Disclose to the board all previous and pending legal or regulatory action relating to claims of malpractice, or personal or professional misconduct; and
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97	97	[(4)] (3) Pay applicable registration fees, which shall be one half of the prevailing biennial registration fee for dentists.
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99	99	[No person who, after July 2, 2004, has failed to pass the license examination administered under this chapter shall have the benefit of a community service license.]
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101	101	(b) Community service licensees shall actively participate in a formal and ongoing program of clinical quality assurance.
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103	103	(c) A license may be renewed biennially, pending review and reauthorization of the board of dentistry.
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105	105	(d) A community service license authorizes the licensee to practice dentistry only within the employment of an eligible organization and shall be in force until the earliest of the following occurs:
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107	107	(1) The date the person leaves the employment authorized under the community service license;
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109	109	(2) The date on which the results of the license examination taken by the person under this chapter are posted by the board;
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111	111	(3) The date the community service license expires; or
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113	113	(4) The date on which the board revokes the community service license; provided that the board may revoke the community service license at any time for cause.
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115	115	(e) Commissioned officers of the United States Army, the United States Navy, the United States Air Force, the United States Public Health Service, or the United States Department of Veterans Affairs practicing in the department of health, a federally qualified health center, or Native Hawaiian health systems center shall qualify for a community service license to practice dentistry, which may be issued for the term of the officer's federal duty assignment. Officers shall provide to the board of dentistry:
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117	117	(1) A copy of an active, unrestricted dental practice license from another state; and
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119	119	(2) A copy of documentation reflecting official duty assignment to a qualifying community service dental license site.
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121	121	(f) Notwithstanding any other law to the contrary, a dental provider holding a community service license who completes or has completed at least five thousand hours of community service to patients in the State, shall be eligible for automatic conversion of the provider's community service license to an unrestricted dental practice license."
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123	123	SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
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125	125	SECTION 4. This Act shall take effect upon its approval.
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129	129	INTRODUCED BY: _____________________________
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131	131	INTRODUCED BY:
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139	139	Report Title: Board of Dentistry; Community Service License; Accreditation; Unrestricted Dental Practice License; Commission on Dental Accreditation of Canada Description: Allows a dental graduate from a dental college accredited by the Commission on Dental Accreditation of Canada to be an eligible candidate for a community service license (CSL). Repeals the requirement that the licensing examinations be completed within five years of a request for a CSL. Repeals the requirement that a CSL applicant provide a copy of an active, unrestricted dental practice license form another state. Repeals the prohibition against a person who failed the license examination from obtaining a CSL. Requires a CSL to be eligible for conversion to an unrestricted dental practice license when a dental provider who holds a CSL completes at least five thousand hours of community service to patients in the State. The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
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147	147	Report Title:
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149	149	Board of Dentistry; Community Service License; Accreditation; Unrestricted Dental Practice License; Commission on Dental Accreditation of Canada
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153	153	Description:
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155	155	Allows a dental graduate from a dental college accredited by the Commission on Dental Accreditation of Canada to be an eligible candidate for a community service license (CSL). Repeals the requirement that the licensing examinations be completed within five years of a request for a CSL. Repeals the requirement that a CSL applicant provide a copy of an active, unrestricted dental practice license form another state. Repeals the prohibition against a person who failed the license examination from obtaining a CSL. Requires a CSL to be eligible for conversion to an unrestricted dental practice license when a dental provider who holds a CSL completes at least five thousand hours of community service to patients in the State.
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163	163	The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.