As the Legislative Chair for MDHA I attend the Maine Board of Dental Practice meetings every month. At the meeting I attended in August there was discussion about chapter 7 in our rules which pertains to our fees for licensure and how these need to increase to meet its regulatory obligations. You might remember that in 2012 our fee was reduced from $175 (which was the maximum it could be as regulated by statute) to $140. The board is claiming that adjustment was too aggressive and now fees have to increase significantly to make up for that shortfall.
Let me take you back 2 years for a minute though. In 2016 the board had a complete repeal and replace of our statutes before the legislature and one of the changes was to eliminate our license fee cap of $175 and the dentist cap of $550 and make all license categories a cap of $550. I testified before the LCRED committee strongly against this change for the very reason that we are seeing now. If they removed that cap, our fee could go up to $550. I was told by the executive director of the MBDP at the time that that was not the intention but I still insisted that it could happen. Well it was not changed by the LCRED committee and it went through the legislature lost in a very large bill of our entire statutes.
That brings us to the meeting last month of the MBDP and the proposed fee changes that I was able to catch from listening but the board will not provide us with a copy of the entire proposal. The following is a list of fee increases I was able to take note of for renewals:
Dentist: $440 to $500 which isn’t even the max of $550, increase of 14% / +$60
Hygienist: $140 to $300, increase of 115% /+$160
Local Anesthesia Permit: $40 every 5 years to $50 every 2 years, 300% increase
Nitrous Oxide Administration Permit: $16 every 2 years to $50 every 2 years, increase of 210%/+$34
Public Health Supervision Authority: $0 to $50, increase of 100%
Independent Practice Dental Hygienist Authority: $0 to $50, increase of 100%
Expanded Function Dental Assistant: $80 every 5 years to $250 every 2 yrs., increase of 300%
Radiographer: $100 every 5 years to $200 every 2 years
There are the same discrepancies with initial application fees and the increases just don’t seem to be fair between the different licensees especially when the majority of the board business has to do with dentists who have the smallest increase. In some cases there will be hygienists who will actually pay more than a dentist for their license if they have local, nitrous, EFDA, PHS, or IPDH. I truly don’t+ believe this is what the LCRED committee and the legislature intended to let happen when they allowed that cap to be removed.
This proposed rule is exactly that at this time. It is a PROPOSAL so nothing set in stone and the proposal is for 2020. The board discussed it and board members Nancy Foster, RDH, Tracey Jowett, RDH and Dr. Dunbar voiced strong opposition against it but only Nancy Foster RDH voted against it. I do feel that the others would have voted against it as well but were made to feel that they had to increase these fees or the board would wouldn’t be able to function and they had to submit a budget. I also don’t feel they had all the information necessary to make the proper decision of which was the fact that the board requested the statute change to remove the cap on the hygiene fees in 2016. Only 2 board members would have been on the board at that time. I still believe that this fee increase was the intent at the time of that statute change as they were already well aware of the reduced fees from 2012 and could have easily increased the dentists cap to make up for that shortfall and put the fees on the licensees who take the time of the board.
The proposal has been sent to the Commissioner’s office for review and approval and then goes to the Governor for approval. It then comes back to the board if it makes it that far and will be put out for public hearing. MDHA will be sure to send out notice and would expect hundreds of hygienists to show up and testify as to why this increase should not happen. This will be our opportunity to speak. If this goes forward it could still be months away or it could be in Oct. There is now way to know but we will have plenty of notice before public hearing.
I have written a letter to the MBDP and asked them to reconsider their vote and I received notice back that it’s on their agenda for Sep 14th. I did send another letter noting an error because the cap in the previous statute was $175 not $275 as noted in my first letter. There will be no opportunity to speak at the Sept meeting but it will be interesting to see what their comments are. I believe everyone should attend at least one board meeting in their career to see how the board works and this would be a good one! I will keep you posted on the progress of this fee change and when the time comes we will need to hear your voice!
Lorraine P. Klug, RDH, IPDH
Maine Dental Hygienists’ Association