Louisiana school dentistry bill stalls

May 19, 2009

A bill to ban dentistry in Louisiana schools narrowly missed passage last week after an hour of heated debate on the floor of the state House of Representatives. The Legislature agreed to revisit the issue this week.

“There are thousands of children who, if they don't see a dentist in school, will not get dental services at all.”
— Rep. Karen Carter Peterson
(D-New Orleans)

The House amended the bill twice and defeated a third amendment before casting 51 votes in favor and 38 against -- just a few votes shy of the two-thirds majority needed for its passage.

The author of the bill, Rep. J. Kevin Pearson (R-Slidell), then moved to reconsider the bill, a maneuver that will give proponents a chance to wrangle more votes at the future hearing.

As originally written, the bill would bar all dentistry in Louisiana schools except for dentistry done by federally qualified health centers; fluoride treatments, cleanings, and exams when offered for free; or sealants applied by either of two state-run universities.

The first amendment, which duplicated one already approved in the House Health and Welfare Committee, gave the state dentistry board authority to designate "underserved" areas within the state where full-service for-profit dentists would be allowed to work in schools.

A second amendment required the Board of Dentistry to report to the Legislature on its progress in providing "dental homes" -- that is, fixed offices -- where Medicaid patients can be seen. Both of these amendments passed without objection.

A third amendment, giving the state's Department of Health and Hospitals (DHH) the responsibility for determining what constitutes an underserved area, occasioned more debate. The author of the amendment, Rep. Sam Jones (D-Franklin), argued that the DHH, which already makes that determination for medical services, would be more objective than the Board of Dentistry. "The dental board has a very confined responsibility to their membership," Rep. Jones said.

But some members questioned whether the amendment would lead dentists to lobby school superintendents for or against the designation, while others wondered if the DHH would need money for the new task. The amendment was defeated 47-43.

In the ensuing discussion, Rep. Pearson argued repeatedly that the legislation would encourage parents to accompany their children on dental appointments.

He pointed out that many of the dentists referred to specialists by general dentists in schools never saw the specialists. "We have worked in committee to make sure all our children have a dental home and are not gathered together in a gym, a lunch room, or a locker room to have their teeth partially taken care of."

Opponents of the bill questioned whether anyone was available to see the patients who were referred. They argued that there simply aren't enough dentists in the state to meet the needs of Medicaid patients.

"My understanding is that there are thousands of children who, if they don't see a dentist in school, will not get dental services at all," said Rep. Karen Carter Peterson (D-New Orleans).