EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1143*
HOUSE BILL 1143
J2, J1 5lr2078
CF SB 988
By: Delegates Bagnall, Cullison, and Kipke
Introduced and read first time: February 5, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Dental Services – Dental Hygienists in Schools and School–Based Health 2
Centers and the Maryland Collaborative to Improve Children’s Oral Health 3
Through School–Based Programs 4
FOR the purpose of providing that a general license to practice dental hygiene authorizes 5
the licensee to practice dental hygiene under the general supervision of a dentist in 6
a school or school–based health center; establishing the Maryland Collaborative to 7
Improve Children’s Oral Health Through School–Based Programs to study and make 8
recommendations on ways to improve school–based dental programs; and generally 9
relating to dental services. 10
BY repealing and reenacting, with amendments, 11
Article – Health Occupations 12
Section 4–308(f)(1) 13
Annotated Code of Maryland 14
(2021 Replacement Volume and 2024 Supplement) 15
BY adding to 16
Article – Health Occupations 17
Section 4–308(n) 18
Annotated Code of Maryland 19
(2021 Replacement Volume and 2024 Supplement) 20
Preamble 21
WHEREAS, The death of Deamonte Driver, a 12–year–old insured under the 22
Maryland Medical Assistance Program, from a tooth abscess on February 25, 2007, 23
triggered a call to action in public health; and 24
WHEREAS, In response to Deamonte Driver’s death, the Maryland Department of 25
Health, oral health advocates, the dental provider community, and the health care 26 2 HOUSE BILL 1143
community collaborated to advance significant systemic improvements for access to dental 1
services for all children, including children in underserved communities in the State; and 2
WHEREAS, Access to dental services for children covered by the Maryland Medical 3
Assistance Program improved steadily between 2008 and 2015 with the percentage of 4
children receiving preventive services rising from 50.1% to 64%; and 5
WHEREAS, Access to dental services for children covered by the Maryland Medical 6
Assistance Program remained steady between 2016 and 2019, with 63% to 64% of children 7
receiving preventive services; and 8
WHEREAS, Access to dental services for children covered by the Maryland Medical 9
Assistance Program plummeted with the onset of the COVID–19 pandemic and has yet to 10
recover, with only 56.5% of children receiving preventive dental services in 2023; and 11
WHEREAS, The 2022–2023 Children’s Oral Health Survey conducted by the 12
Maryland Department of Health demonstrated that 21% of children had untreated dental 13
decay, with Hispanic children having the highest prevalence of untreated decay at 30% and 14
the Western region of the State with the highest prevalence at 27%; and 15
WHEREAS, The 2022–2023 Children’s Oral Health Survey conducted by the 16
Maryland Department of Health demonstrated that 51% of Maryland’s school children 17
needed sealants, with Black children at the highest prevalence of need at 60% and the 18
Western region of the State with the highest sealant need at 72%; and 19
WHEREAS, Children in the State need public health action to improve access to 20
dental services to avoid serious long–term health consequences; and 21
WHEREAS, School–based dental programs offer the potential to provide preventive 22
and screening services and linkages to permanent dental homes for children in every 23
Maryland community; now, therefore, 24
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 25
That the Laws of Maryland read as follows: 26
Article – Health Occupations 27
4–308. 28
(f) (1) Except as provided in subsection (k) of this section, while it is effective, 29
a general license to practice dental hygiene issued under this title authorizes the licensee 30
to practice dental hygiene: 31
(i) Under the supervision of a licensed dentist who is: 32
1. On the premises and available for personal consultation 33
while the services are being performed; or 34 HOUSE BILL 1143 3
2. Not on the premises while authorized dental hygiene 1
services are provided when the requirements of subsection (l) OR (N) of this section have 2
been fully satisfied; and 3
(ii) Only in a: 4
1. Dental office; 5
2. Dental clinic; 6
3. Hospital; 7
4. School; 8
5. Charitable institution; or 9
6. Health maintenance organization certified by the State 10
Insurance Commissioner. 11
(N) WHILE IT IS EFFECTIVE , A GENERAL LICENSE TO PRACTICE DENTAL 12
HYGIENE ISSUED UNDER THIS TITLE AUTHORIZE S THE LICENSEE TO PR ACTICE 13
DENTAL HYGIENE UNDER THE GENERAL SUPERVIS ION OF A LICENSED DE NTIST IN A 14
SCHOOL OR SCHOOL –BASED HEALTH CENTER IF THE LICENSEE SUBMITS ON A FORM 15
PROVIDED BY THE BOARD A STATEMENT THA T THE LICENSEE INTEN DS TO 16
PRACTICE IN A SCHOOL OR SCHOOL–BASED HEALTH CENTER . 17
SECTION 2. AND BE IT FURTHER ENACTED, That: 18
(a) There is a Maryland Collaborative to Improve Children’s Oral Health Through 19
School–Based Programs. 20
(b) The Collaborative consists of the following members: 21
(1) two members of the Senate of Maryland, appointed by the President of 22
the Senate; 23
(2) two members of the House of Delegates, appointed by the Speaker of 24
the House; 25
(3) the Secretary of Health, or the Secretary’s designee; 26
(4) the Secretary of Education, or the Secretary’s designee; 27
(5) the Deputy Secretary of Public Health Services, or the Deputy 28
Secretary’s designee; 29 4 HOUSE BILL 1143
(6) the Chair of the Maryland Community Health Resources Commission, 1
or the Chair’s designee; and 2
(7) the following members, appointed by the Secretary of Health: 3
(i) one representative of the Maryland Medical Assistance Program; 4
(ii) one representative of the Maryland Association of School Health 5
Nurses; 6
(iii) one representative of the Maryland Assembly of School–Based 7
Health Care; 8
(iv) one representative of the Maryland Dental Action Coalition; 9
(v) one representative of the Maryland Dental Hygienists’ 10
Association; 11
(vi) one representative of the Maryland State Dental Association; 12
(vii) one representative of a federally qualified health center that 13
manages a school–based dental program; 14
(viii) one representative of the Maryland Association of Boards of 15
Education; 16
(ix) one representative of the Public School Superintendents’ 17
Association of Maryland; and 18
(x) one representative of the National Maternal and Child Health 19
Resource Center. 20
(c) The Secretary of Health shall designate the chair of the Collaborative. 21
(d) The Maryland Department of Health shall provide staff for the Collaborative. 22
(e) A member of the Collaborative: 23
(1) may not receive compensation as a member of the Collaborative; but 24
(2) is entitled to reimbursement for expenses under the Standard State 25
Travel Regulations, as provided in the State budget. 26
(f) The Collaborative shall study and make recommendations to improve the oral 27
health of children in the State through school–based dental programs by analyzing the 28
impact of: 29 HOUSE BILL 1143 5
(1) supporting schools and community dental partners in linking families 1
and children to permanent dental facilities; 2
(2) increasing the number of dental hygienists providing school–based 3
services through policy initiatives, including grant support for services for uninsured 4
children and Medicaid reimbursement of dental hygienists who render dental services; 5
(3) authorizing school nurses to provide fluoride varnishes among other 6
clinically appropriate services by modifying school health guidelines and providing 7
reimbursement through the Maryland Medical Assistance Program; 8
(4) expanding the capacity of school–based health centers to provide dental 9
services; and 10
(5) other innovative models for providing dental services to children in 11
schools. 12
(g) The Collaborative may consult with any other individual or organization with 13
expertise in school–based dental programs. 14
(h) (1) On or before December 1, 2025, the Collaborative shall submit an 15
interim report of its findings and recommendations to the Governor and, in accordance with 16
§ 2–1257 of the State Government Article, the General Assembly. 17
(2) On or before October 1, 2026, the Collaborative shall submit a final 18
report of its findings and recommendations to the Governor and, in accordance with § 19
2–1257 of the State Government Article, the General Assembly. 20
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect July 21
1, 2025. Section 2 of this Act shall remain effective for a period of 2 years and, at the end of 22
June 30, 2027, Section 2 of this Act, with no further action required by the General 23
Assembly, shall be abrogated and of no further force and effect. 24