EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1143*
HOUSE BILL 1143
J2, J1 5lr2078
CF SB 988
By: Delegates Bagnall, Cullison, and Kipke Pena–Melnyk, Alston, Bhandari,
Guzzone, Hill, S. Johnson, Kaiser, Kerr, Lopez, Martinez, Rosenberg,
Taveras, Woods, Woorman, and Ross
Introduced and read first time: February 5, 2025
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 3, 2025
CHAPTER ______
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 – Establishment 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 school–based 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
2 HOUSE BILL 1143
Preamble 1
WHEREAS, The death of Deamonte Driver, a 12–year–old insured under the 2
Maryland Medical Assistance Program, from a tooth abscess on February 25, 2007, 3
triggered a call to action in public health; and 4
WHEREAS, In response to Deamonte Driver’s death, the Maryland Department of 5
Health, oral health advocates, the dental provider community, and the health care 6
community collaborated to advance significant systemic improvements for access to dental 7
services for all children, including children in underserved communities in the State; and 8
WHEREAS, Access to dental services for children covered by the Maryland Medical 9
Assistance Program improved steadily between 2008 and 2015 with the percentage of 10
children receiving preventive services rising from 50.1% to 64%; and 11
WHEREAS, Access to dental services for children covered by the Maryland Medical 12
Assistance Program remained steady between 2016 and 2019, with 63% to 64% of children 13
receiving preventive services; and 14
WHEREAS, Access to dental services for children covered by the Maryland Medical 15
Assistance Program plummeted with the onset of the COVID–19 pandemic and has yet to 16
recover, with only 56.5% of children receiving preventive dental services in 2023; and 17
WHEREAS, The 2022 –2023 Children’s Oral Health Survey conducted by the 18
Maryland Department of Health demonstrated that 21% of children had untreated dental 19
decay, with Hispanic children having the highest prevalence of untreated decay at 30% and 20
the Western region of the State with the highest prevalence at 27%; and 21
WHEREAS, The 202 2–2023 Children’s Oral Health Survey conducted by the 22
Maryland Department of Health demonstrated that 51% of Maryland’s school children 23
needed sealants, with Black children at the highest prevalence of need at 60% and the 24
Western region of the State with the highest sealant need at 72%; and 25
WHEREAS, Children in the State need public health action to improve access to 26
dental services to avoid serious long–term health consequences; and 27
WHEREAS, School–based dental programs offer the potential to provide preventive 28
and screening services and linkages to permanent dental homes for children in every 29
Maryland community; now, therefore, 30
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 31
That the Laws of Maryland read as follows: 32
Article – Health Occupations 33
4–308. 34
HOUSE BILL 1143 3
(f) (1) Except as provided in subsection (k) of this section, while it is effective, 1
a general license to practice dental hygiene issued under this title authorizes the licensee 2
to practice dental hygiene: 3
(i) Under the supervision of a licensed dentist who is: 4
1. On the premises and available for personal consultation 5
while the services are being performed; or 6
2. Not on the premises while authorized dental hygiene 7
services are provided when the requirements of subsection (l) OR (N) of this section have 8
been fully satisfied; and 9
(ii) Only in a: 10
1. Dental office; 11
2. Dental clinic; 12
3. Hospital; 13
4. School; 14
5. Charitable institution; or 15
6. Health maintenance organization certified by the State 16
Insurance Commissioner. 17
(N) WHILE IT IS EFFECTIVE , A GENERAL LICENSE TO PRACTICE DENTAL 18
HYGIENE ISSUED UNDER THIS TITLE AUTHORIZE S THE LICENSEE TO PR ACTICE 19
DENTAL HYGIENE UNDER THE GENERAL SUPERVIS ION OF A LICENSED DE NTIST IN A 20
SCHOOL OR SCHOOL –BASED HEALTH CENTER IF THE LI CENSEE SUBMITS ON A FORM 21
PROVIDED BY THE BOARD A STATEMENT THA T THE LICENSEE INTEN DS TO 22
PRACTICE IN A SCHOOL OR SCHOOL–BASED HEALTH CENTER . 23
SECTION 2. AND BE IT FURTHER ENACTED, That: 24
(a) There is a Maryland Collaborative to Improve Children’s Oral Health Through 25
School–Based Programs. 26
(b) The Collaborative consists of the following members: 27
(1) two members of the Senate of Maryland, appointed by the President of 28
the Senate; 29
4 HOUSE BILL 1143
(2) two members of the House of Delegates, appointed by the Speaker of 1
the House; 2
(3) the Secretary of Health, or the Secretary’s designee; 3
(4) the Secretary of Education, or the Secretary’s designee; 4
(5) the Deputy Secretary of Public Health Services, or the Deputy 5
Secretary’s designee; 6
(6) the Chair of the Maryland Community Health Resources Commission, 7
or the Chair’s designee; and 8
(7) the following members, appointed by the Secretary of Health: 9
(i) one representative of the Maryland Medical Assistance Program; 10
(ii) one representative of the Maryland Association of School Health 11
Nurses; 12
(iii) one representative of the Maryland Assembly of School–Based 13
Health Care; 14
(iv) one representative of the Maryland Dental Action Coalition; 15
(v) one representative of the Maryland Dental Hygienists’ 16
Association; 17
(vi) one representative of the Maryland State Dental Association; 18
(vii) one representative of the Maryland Dental Society; 19
(viii) one representative of the State Board of Dental Examiners; 20
(vii) (ix) one representative of a federally qualified health center 21
that manages a school–based dental program; 22
(viii) (x) one representative of the Maryland Association of Boards 23
of Education; 24
(ix) (xi) one representative of the Public School Superintendents’ 25
Association of Maryland; and 26
(x) (xii) one representative of the National Maternal and Child 27
Health Resource Center. 28
(c) The Secretary of Health shall designate the chair of the Collaborative. 29 HOUSE BILL 1143 5
(d) The Maryland Department of Health shall provide staff for the Collaborative. 1
(e) A member of the Collaborative: 2
(1) may not receive compensation as a member of the Collaborative; but 3
(2) is entitled to reimbursement for expenses under the Standard State 4
Travel Regulations, as provided in the State budget. 5
(f) The Collaborative shall study and make recommendations to improve the oral 6
health of children in the State through school–based dental programs by analyzing the 7
impact of: 8
(1) supporting schools and community dental partners in linking families 9
and children to permanent dental facilities; 10
(2) increasing the number of dental hygienists providing school–based 11
services through policy initiatives, including grant support for services for uninsured 12
children and Medicaid reimbursement of dental hygienists who render dental services; 13
(3) authorizing school nurses to provide fluoride varnishes among other 14
clinically appropriate services by modifying school health guidelines and providing 15
reimbursement through the Maryland Medical Assistance Program; 16
(4) expanding the capacity of school–based health centers to provide dental 17
services; and 18
(5) clarifying the law governing the practice of dental hygienists in school 19
settings to reduce confusion among practitioners and school–based programs; and 20
(5) (6) other innovative models for providing dental services to children in 21
schools. 22
(g) The Collaborative may consult with any other individual or organization with 23
expertise in school–based dental programs. 24
(h) (1) On or before December 1, 2025, the Collaborative shall submit an 25
interim report of its findings and recommendations to the Governor and, in accordance with 26
§ 2–1257 of the State Government Article, the General Assembly. 27
(2) On or before October 1, 2026, the Collaborative shall submit a final 28
report of its findings and recommendations to the Governor and, in accordance with § 29
2–1257 of the State Government Article, the General Assembly. 30
SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 31
July 1, 2025. Section 2 of this Act It shall remain effective for a period of 2 years and, at 32 6 HOUSE BILL 1143
the end of June 30, 2027, Section 2 of this Act, with no further action required by the 1
General Assembly, shall be abrogated and of no further force and effect. 2
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.