Health Center State Policy

Making Sense of State Policies & Dental Health

maxey_hannah_hiresOur guest blog post today is by Hannah L. Maxey, PhD, MPH, RDH, Assistant Professor and Director of the Bowen Center for Health Workforce Research & Policy, Indiana University School of Medicine :

Community Health Centers and the professionals working within these organizations are the backbone of the dental safety-net. As a dental hygienist who spent years practicing in health centers, I know firsthand how important dental services are for health center patients. I also saw the influence state policy had on my professional practice and ability to provide care for patients in need. As with licensed health professions, the practice of dental hygiene is regulated at the state level through statute and licensing boards. Unfortunately, there are wide variations in these policies, depending where you practice.  I worked in a state where the policies where more restrictive.  I was not able to provide preventive services, such as fluoride varnish and dental sealants, without oversight by a licensed dentist.  Yet, I heard of dental hygienists in other states who were able to practice at health centers with fewer or even without any restrictions. Other states even allowed health centers to bill directly for services provided by the hygienist.   The differences in states across the map deserved a closer look.

Armed with my own experience, and after  spending years in graduate school, I was finally able to do just that.  Findings in my current Journal of Public Health Dentistry article, “State policy environment and the dental safety net: a case study of professional practice environments’ effect on dental service availability in Federally Qualified Health Centers” have been published and are available online at this link.    The takeaway is that health centers located in states which support greater independence among dental hygienists were more likely to provide dental services directly to their patients.  Additional research is needed, but these findings suggest a link between state workforce policies and the ability for health centers to provide needed services, most especially oral health.  It is critical for the health center community to be aware of this and similar issues so that they can advocate for policies that enhance access to care for the underserved.