Maryland Collaborative to Improve Children's Oral Health Through School-Based Programs - Establishment
SB988 expands where licensed dental hygienists may provide services by expressly allowing them to practice under the general supervision of a licensed dentist in a school or school-based health center, so long as they file a statement with the State Board indicating their intent to practice in those settings. The bill amends the Health Occupations Article to clarify that school and school-based health center settings are included within the scope of general dental hygiene licensure, reducing ambiguity about when and how hygienists may work in those environments.
The bill also creates the Maryland Collaborative to Improve Children’s Oral Health Through School-Based Programs, a temporary multi-agency and stakeholder body charged with studying school-based dental care and making recommendations to improve children’s oral health. The Collaborative is directed to examine strategies such as linking families to dental homes, increasing the number of dental hygienists in schools, supporting Medicaid reimbursement and grant funding, authorizing school nurses to provide fluoride varnish and other services, expanding school-based health center capacity, and clarifying the law governing school-based dental practice. It must issue an interim report by December 1, 2025, and a final report by October 1, 2026, and the Collaborative sunsets on June 30, 2027.
SB988 changes Maryland’s Health Occupations law by adding a new subsection to § 4-308 and modifying existing supervision rules for dental hygienists. It broadens the settings in which hygienists may practice under general supervision to include schools and school-based health centers, which may increase access to preventive dental services for children, especially in underserved areas. The bill also establishes a temporary advisory collaborative within the Department of Health to study school-based oral health delivery and recommend policy, reimbursement, and program changes that could affect Medicaid, school health services, and school-based dental providers.
The bill appears to have been broadly supported. It passed the Senate on third reading by a unanimous 46-0 vote, and the committee report was favorable with amendments. The bill’s findings and structure reflect a strong public-health orientation, emphasizing children’s access to preventive dental care, the effects of the COVID-19 pandemic on utilization, and the need for school-based solutions. Overall, the available record suggests consensus around improving children’s oral health through expanded school-based services.
The main policy issues embedded in the bill concern how far to expand dental hygienists’ authority in school settings, whether Medicaid should reimburse hygienists directly, and whether school nurses should be authorized to provide fluoride varnish and related services. Those questions implicate professional scope-of-practice boundaries, reimbursement policy, and coordination among schools, health centers, and dental providers. The bill’s creation of a collaborative including dentists, hygienists, school health groups, education officials, and state agencies suggests these issues were important enough to warrant further study and stakeholder input, even though no recorded floor opposition appears in the available voting history.