Public Health - Office of the Chief Medical Examiner - Perinatal Autopsies (Lung Float Test Ban)
HB1143 makes two related changes to Maryland law aimed at improving children’s oral health in schools. First, it amends the Health Occupations Article to clarify that a general dental hygiene license authorizes a dental hygienist to provide services under the general supervision of a licensed dentist in a school or school-based health center, so long as the hygienist submits the required notice to the State Board. This is intended to reduce uncertainty about when and how hygienists may work in school settings.
Second, the bill creates the Maryland Collaborative to Improve Children’s Oral Health Through School-Based Programs. The Collaborative includes legislators, state health and education officials, school health and dental stakeholders, Medicaid representatives, and other public health and education partners. It is charged with studying school-based dental care and making recommendations on ways to expand access, improve coordination with permanent dental homes, increase the use of dental hygienists, consider fluoride varnish services by school nurses, expand school-based health center capacity, and identify other innovative delivery models. The Collaborative must issue an interim report by December 1, 2025, and a final report by October 1, 2026, and the temporary body sunsets on June 30, 2027.
The bill amends § 4-308 of the Health Occupations Article to expressly permit dental hygienists to practice in schools and school-based health centers under general supervision, which may broaden the settings in which preventive dental services can be delivered. It also establishes a temporary, multi-agency advisory collaborative within the Maryland Department of Health to study and recommend policy changes affecting school-based oral health programs. The practical effect is to support expanded preventive dental access for children, especially through school-linked services, while generating recommendations that could lead to future changes in Medicaid reimbursement, school health protocols, and school-based dental program operations.
The overall sentiment reflected in the bill’s passage is strongly supportive. The bill passed both chambers overwhelmingly, with 136-2 in the House and 47-0 in the Senate, indicating broad bipartisan agreement on the need to improve children’s access to dental care. The preamble frames the measure as a public health response to persistent gaps in preventive dental services and untreated decay among Maryland children, reinforcing the bill’s public-health-oriented purpose.
The main policy issues addressed by the bill involve how far to expand the role of dental hygienists and other school health personnel in delivering oral health services. The Collaborative is specifically tasked with examining whether additional reimbursement, grant support, and school health guideline changes are needed, which suggests that implementation questions remain around funding, Medicaid payment, and professional scope-of-practice boundaries. Any contention appears to have been limited, given the near-unanimous votes, but the bill’s focus on clarifying hygienist practice in schools and considering fluoride varnish authority for school nurses indicates that professional roles and regulatory authority were the central areas of policy debate.