Senate Bill S9216

                                 
BILL NUMBER: S9216

SPONSOR: STAVISKY
 
TITLE OF BILL:

An act to amend the education law, in relation to requirements for
licensure as a dentist

 
PURPOSE:

The purpose of this bill is to provide a near-term boost to the pool of
dentists practicing in underserved areas while also providing a viable
pathway to licensure for qualified dentists from other jurisdictions who
seek to work in New York in the field of public health dentistry.

 
SUMMARY OF PROVISIONS:

Section 1: amends subdivision three of section 6604 of the education law
to expand the "experience" standard to authorize experienced dentists
licensed in other jurisdictions to be licensed in New York by completing
a minimum of one year of either (i) full-time faculty membership at an
approved New York state school of dentistry or (ii) full-time experi-
              

ence, or the equivalent thereof, as a general practice dental preceptee
in a preceptorship program under the supervision of a licensed dentist
in an area designated a federal dental health professional shortage
area; and amends subdivision six of section 6604 to create parity with
physicians by permitting the Board of Regents to issue a limited waiver
of citizenship requirements for continued licensure of a dentist who
holds an H-1b visa, an 0-1 visa, or an equivalent or successor visa.

Section 2: establishes the effective date.

 
JUSTIFICATION:

Despite graduating 750 dentists annually - among the highest numbers of
any state - New York continues to struggle with unmet need, particularly
with respect to Medicaid recipients and other vulnerable populations.
Several barriers contribute to the challenges of providing access to
dental care to low-income, rural or developmentally disabled individ-
uals, including a net annual out-migration of New York dentists,{1} a
decline in CODA*-accredited dental residency programs,{2} too few
dentists practicing in rural and high need areas,{3} the exorbitant
costs of attending dental school{4} and establishing a dental practice,
perennially insufficient Medicaid reimbursement rates, and a wave of
dentist retirements in the wake of the pandemic.

New York State currently has 156 dental Health Practitioner Shortage
Areas (HPSAs), including 92 designated HPSA facilities and 64 designated
HPSA population groups (mostly Medicaid eligible populations).{5} This
means that each of these designations has a population-to-provider ratio
of at least 4000 people per 1 dentist. Because NYS currently meets only
16.68% of the documented need, the federal Health Resources and Services
Administration (HRSA) estimates that New York needs an additional 1,100
dentists to remove all of its dental HPSA designations.{6} The NYS
Department of Health also recognizes the need for additional dentists in
strategic locations and, beginning in 2010, identified strategies for
increasing access to dental services.{7}


Current Department of Education regulations require all dentists who
have graduated dental school to complete a one-year graduate residency
program as a prerequisite to becoming licensed in New York.  This
requirement applies to all dentists - new and experienced - meaning that
even dentists with years of practice experience in another jurisdiction
must currently complete a graduate residency program before qualifying
to practice in New York. (New York's residency requirement is an outlier
among other states.) Because dental residencies are quite expensive and
the number of programs has declined significantly,{8} this requirement
creates a substantial barrier to attracting experienced dentists to
practice in New York. This bill offers qualified dentists the option in
lieu of a residency program - to join the full-time faculty of a dental
school or complete a preceptorship in a private practice, hospital or
clinic setting in a dental HPSA. By doing so, New York will become
better able to attract qualified dentists while still maintaining
current quality of care standards.

 
LEGISLATIVE HISTORY:

This is a new bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.
* CODA is the Commission on Dental Accreditation of the American Dental
Association.
{1} Health Policy Institute, American Dental Association. U.S. Dentist
Migration Dashboard. https://www.ada.org/resources/research/health-
policy-institute/dentist-migration-dashboard. Accessed online on
11/8/2023.
{2} Health Policy Institute, American Dental Association. Trends in
Advanced Education in General Practice Residency Programs in the U.S.,
December 2021. See www.ADA.org/HPI.
{3} Health Resources and Services Administration, U.S. Department of
Health & Human Services. HPSA Designations. HPSA Find. See
https://data.hrsa.gov/tools/shortage-area/hpsa-find.
{4} Whereas the average medical school graduate in 2023 owes $251,000,
the average dental student in 2023 owes $293,900. See
https://educationdata.org/average-medical-school-debt and
www.lendingtree.com/student/dentalschool-worth-it.
{5} Health Resources and Services Administration, U.S. Department of
Health & Human Services. Health Workforce Shortage Areas.
https://data.hrsa.gov/topics/health-workforce/shortage-areas. Accessed
online on 11/27/2023.
{6} Bureau of Health Workforce, Health Resources and Services Adminis-
tration, U.S. Department of Health & Human Services. Designated Health
Professional Shortage Areas Statistics, Fourth Quarter of Fiscal Year
2023 Designated HPSA Quarterly Summary. As of September 30, 2023.
{7} NYS Department of Health, increasing the Supply of Dentists,
Midwives, Physician Assistants, and Nurse Practitioners in Underserved
Areas Through Doctors Across New York Physician Loan Repayment Program
Incentives, February 2010.
{8} Health Policy Institute, American Dental Association. Trends in
Advanced Education in General Practice Residency Programs in the U.S.,
December 2021. See www.ADA.org/HPI.