MacIver News Service | Feb.5, 2019
By M.D. Kittle
MADISON — There’s hope yet for legislation that would create a dental therapist licensure program in Wisconsin.
But will protectionist interests, as they did last session, shoot down the bill before it moves?
State Rep. Mary Felzkowski who co-authored Assembly Bill 945 last year, said support is growing for a dental therapist measure in the Badger State.
“I think it’s something we can get done this session,” Felzkowski (R-Irma) recently told MacIver News Service.
Dental therapists are mid-level practitioners, similar to physician assistants. Under the general supervision of a dentist, DTs can perform routine dental procedures either at a dental practice or in satellite clinics in underserved areas.
Felzkowski hopes to introduce a new bill later this session.
But the bill has faced stiff opposition from industry special interests like the Wisconsin Dental Association, which has claimed a licensure program for dental therapists would dilute the quality of care in the Badger State.
“Dental therapists work independently. They diagnose and treat without oversight by a dentist. Once they are licensed, they do as they wish,” wrote Dave Clemens, president of the 3,000-member WDA in December 2017.
Supporters counter that there would be ample oversight through a licensure law.
States like Minnesota have had great success in expanding dental health care, particularly to the Gopher State’s poorest and most underserved populations, since the Minnesota State Legislature passed a dental therapist bill 10 years ago.
As MacIver News Service reported last year, Christy Jo Fogarty became Minnesota’s first certified advanced dental therapist in 2011, about two years after the state Legislature passed a bill creating the licensure program.
Minnesota was the first state to recognize the mid-level therapist position, despite a campaign by the American Dental Association to kill it.
As is often the case, opponents issued dire warnings about this free-market solution to the state’s oral health care gap.
Fogarty will tell you the gloomy predictions didn’t pan out. In fact, Minnesota has become a national leader in the field, and a lot of doubters at the time have become true believers.
“What we are doing here in Minnesota is really amazing and helping open up access to care. I really hope our neighbors to the east join us in this legislation,” said Fogarty, a member of the Minnesota Board of Dentistry and former president of the Minnesota Dental Therapy Association.
Wisconsin has long lagged behind in dental care coverage.
The federal Health Resources and Services Administration found that dental provider shortages exist in 65 of Wisconsin’s 72 counties, affecting 1.5 million Wisconsinites. Only one-third of poor children covered by Medicaid saw a dentist in 2016, according to the U.S. Department of Health and Human Services.
Minnesota faced similar access problems in 2011 when Fogarty became the state’s first dental therapist. Particularly in rural areas.
“There are literally counties in Minnesota that didn’t even have a dentist. No one (in those areas) had access to dental care,” Fogarty said. “Now we have dentists who are hiring dental therapists in those rural areas.”
Wisconsin has improved slightly in the rankings, but still has a long way to go, Felzkowksi said.
“Two years ago our state was 50th in children in poverty getting dental care. We have moved up to 45th, but we’re still doing a terrible job,” the lawmaker said.
Dentists are pushing for increased assistance in Medicaid, a disparity fix that some lawmakers are willing to support. But a coalition of health professionals, legislators and advocacy groups says it’s time to expand oral care opportunities in Wisconsin.
Felzkowski said supporters are now working on the “education piece” before introducing legislation. But things are moving behind the scenes, the lawmaker said.
“I am excited to get going on it,” Felzkowski said.