Maryland lawmakers consider implementing penalties for parents who don’t get their kids dental screenings under in-progress bill


James Sklar


On Jan. 25th, Dels. Heather Bagnall (D – Anne Arundel), Dana Jones (D – Anne Arundel), Sheila Ruth (D – Baltimore), Gary Simmons (D – Anne Arundel), Deni Taveras (D – Prince George’s), and Jennifer White (D – Baltimore) introduced House Bill 290, which concerns dental services in the state of Maryland. 


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HB 290 would require parents and guardians of children enrolled in the Maryland Public School System, a childcare home, or childcare center to provide the system or facility evidence that the child has received dental screening. The bill would also set requirements and eligibility standards regarding dental services and reimbursements under Maryland’s Medical Assistance Program.

HB 290 would require Maryland’s State Board of Dental Examiners to include a list of licensed providers who provide mobile dental services and to distribute more dental materials to raise awareness of these types of services in the state. The bill would also expand Maryland’s Higher Education Loan Assistance Grant to dental hygienists, which is currently only available to dentists.

On Jan. 23rd, Sen. Katherine Klausmeier introduced Senate Bill 237, HB 290’s Senate counterpart. HB 290 and SB 237 were immediately referred to the House committee on Health and Government Operations and Senate Finance Committee, respectfully. 

On Feb. 14th, Bagnall spoke to the Health and Government Operations Committee regarding HB 290. Bagnall explained that HB 290 was recommended by Maryland’s Oral Health Task Force, which was created two years ago to study, analyze, and make recommendations based on the current landscape of oral health services in the state.

Last December, Maryland’s Oral Health Task Force created a final report, which gave a detailed and broad list of barriers citizens face in dental care, which include the lack of access to care, a dental workforce shortage, the public’s misunderstanding of care and programs already available, and geographical and transportation challenges for select populations and areas in Maryland.

In the committee hearing, Bagnall went on to explain that the chair of the task force wanted to have a multi-year plan to address the priorities identified in the task force’s final report. Consequently, based on a broad spectrum of concerns in the final report, all the final recommendations were incorporated into the bill which focused on four categories: pediatric preventive care, workforce expansion, reducing non-medical barriers to care, and better identification and utilization of mobile services. 

“Expanding this program for dental hygienists will increase the number of hygienists providing care in Maryland, which will in turn increase access to the first line of care in dental treatment,” Bagnall said. “These provisions ensure that Maryland’s youngest and most vulnerable populations are able to receive proactive and complete care through our state’s dental care systems.”

Bagnall explained that she will be amending the bill’s timelines and requirements based on contributions of some of the bills stakeholders, which include Maryland Dental Action Coalition, Maryland Community Health System, and Public Justice Center.  

With a delayed timeline, Bagnall hopes to overcome one of the state’s biggest dental issues, which is the low number of Maryland’s dentists who still do not accept Medicaid recipients. Bagnall hopes that more participants will step up as this program gets underway.

Numerous sponsors spoke in favor of HB 290 during the meeting. Dr. Anupama Tate, director of research and advocacy at Children’s National, spoke about how she has seen firsthand untreated oral decay in adults and children, which causes them to miss work and school.

“This is an opportunity to have a dialogue with the family to build a relationship to talk about prevention and have a guided conversation about dietary changes they can make at home,” Tate said. “Young children with dental decay on their baby teeth are three times more likely to have decay on their permanent teeth. This prevention is key. We can do a lot better by preventing the problem than trying to treat it.”

At the same time HB 290 was being discussed, its counterpart SB 237 was being discussed in the Senate’s Finance Committee. Klausmeier was the first to speak to the committee regarding the substance of the bill, which mirrors HB 290 and its current amendments.

Following Klausemeier’s introduction of SB 237, Sen. Clarence Lam, MD, (D – Anne Arundel) asked if there would be ramifications if parents did not provide evidence to a children’s care system that their child had not received a dental screening by a certain date.

Dr. Charles Doring, who chaired Maryland’s Oral Health Task Force, responded, saying even though the bill would require parents to have their children get an oral screening, there was not going to be a punishment if they failed to do so, which perplexed many of the senators in the meeting.

Sen. Dawn Gile (D – Anne Arundel) raised a similar concern—that if she was a lawyer representing a daycare, she would want evidence that the child has received an oral screening or else the child would not be admitted. Doring responded that they are still working on the language of the bill, and that there would not be penalties because the bill is silent on penalties.

“I realize everyone has lots of questions.” Klausemeier said. “But the bottom line is, some way or another, we have to get these children’s oral healthcare going when they are young, instead of waiting until they are 6 and 7 when they need fillings.”

HB 290 heads to the House’s Public Health and Minority Health Disparities Subcommittee for further debate, while SB 237 awaits a final vote in the Senate Finance Committee.