SPONSOR: Bentley (Lakin)

COMMITTEE ACTION: Voted "do pass" by the Committee on Public Health by a vote of 11 to 0 with 3 present.

This substitute authorizes, upon voter approval, funding for various hospital and public health purposes and funding for certain public health programs and establishes various programs pertaining to dental awareness, dental hygienists, and dental services.


The substitute allows voters in Kansas City to approve an ordinance authorizing an annual tax levy for debt service and an annual tax for capital improvements and operating expenses for hospital, public health, recreation, and museum purposes. The tax levies are independent of the tax levies contained in Section 92.030, RSMo. The ordinance authorizing the tax levies will not be affected by the levy tax limits contained in Section 92.030.

The tax levy rate for capital improvements and operating expenses for hospital, public health, recreation, and museum purposes may be increased from the current rate, which will not exceed $1 per $100 assessed valuation on real and tangible personal property.


The substitute removes language prohibiting the use of general revenue funds for certain health care programs and initiatives. Any other funds may be used for these health care programs and initiatives.

The substitute also requires the Director of the Department of Health to include dentists in the development and implementation of a plan to provide a system of coordinated health care services accessible to all persons in designated health resource shortage areas. Currently, dentists are not included in the plan to attract health care practitioners to these areas.


The substitute allows the Bureau of Child Hygiene in the Department of Health to provide literature on the importance of routine dental care for children.

The substitute establishes a 5-member Advisory Commission for Dental Hygienists. The duties of the commission include recommending educational requirements for dental hygienist registration; annually reviewing the practice act of dental hygienists; providing recommendations to the Missouri Dental Board concerning the practice, licensure, examination and discipline of dental hygienists; and assisting the board in implementing the dental hygienist provisions of Chapter 332.

Members of the commission will be appointed by the Governor and approved with the advice and consent of the Senate. The requirements, composition, lengths of service, selection of commission members, and times of commission meetings are stated in the substitute. Members of the initial commission are required to be appointed by April 1, 2001.

Members of the commission will serve without compensation but will be reimbursed for actual and necessary expenses. The Missouri Dental Board is required to provide all necessary staff and support services for the commission.

Registered and currently licensed dental hygienists who have been practicing for at least 3 years and who practice in a public health setting can without the supervision of a licensed dentist provide fluoride treatments, teeth cleaning, and sealants, if appropriate, to children who are eligible for medical assistance as contained in Chapter 208.

The Medicaid program is prohibited from reimbursing dental hygienists and dentists who provide fluoride treatments, teeth cleaning, and sealants and pediatricians who provide fluoride treatments to eligible children at a rate less than 75% of the usual and customary charge as established by the Division of Medical Services.

The public health settings where a dental hygienist can practice without the supervision of a licensed dentist will be established jointly by the Department of Health and the Missouri Dental Board by rule. This provision will expire on August 28, 2005.

The substitute allows the Department of Health to contract with the Missouri Dental Board to establish a Donated Dental Services Program in conjunction with the provisions of Section 332.323.

Licensed volunteer dentists will provide comprehensive dental care for the needy, disabled, elderly, and medically compromised persons. Dental care can be provided to such persons in a licensed volunteer dentist's office. Eligible persons are required to pay for dental laboratory costs.

The department is required to contract with the Missouri Dental Board, its designee, or other qualified organizations to administer the program. The substitute also contains provisions specifying the contractual responsibilities of the organization administering the program.

FISCAL NOTE: Estimated Net Cost to General Revenue Fund of $67,142 to $2,856,942 in FY 2001, $79,311 to $2,869,111 in FY 2002, and $81,690 to $2,871,490 in FY 2003. Estimated Net Cost to Dental Board Fund of $8,352 in FY 2001, $13,439 in FY 2002, and $13,736 in FY 2003.

PROPONENTS: Supporters state that this program is needed to provide dental services to individuals unable to pay for services. Supporters also state that a similar program is in existence in Pennsylvania.

Testifying for the bill were Senator Bentley; Department of Health; and Missouri Dental Association. A letter of support was submitted by the Delta Dental Plan of Missouri.

OPPONENTS: There was no opposition voiced to the committee.

Joseph Deering, Legislative Analyst