OPINION: Why the dental compact threatens New Mexico's public health standards

New Mexicans feel the health care workforce shortage daily. From lengthy waits for appointments to traveling hours for care, access problems affect families across our state. The dental profession faces similar challenges, with many communities lacking enough dentists and dental hygienists to serve their needs.

Interstate licensure compacts offer a promising solution in many health care fields. These agreements allow qualified professionals to practice across state lines while maintaining public safety standards. The nursing compact, for instance, has successfully expanded workforce mobility while preserving patient protections.

Unfortunately, the Dentist and Dental Hygienist Compact currently awaiting Senate vote fails to follow this successful model. Instead, it creates serious risks for New Mexican patients and taxpayers while delivering questionable benefits.

Dangerous compromise of public health protections

The compact eliminates the requirement for hands-on clinical skills testing, a critical safeguard for patient protection. This testing ensures dentists and hygienists demonstrate competency in technical procedures before treating New Mexico patients. Without this verification, practitioners with substandard clinical skills could practice in our state, putting vulnerable populations at risk.

The compact also weakens continuing education requirements tailored to New Mexico's specific health challenges and creates inconsistent standards across participating states. Our rural communities and tribal populations face particular health disparities that require specialized knowledge and cultural competency that the compact fails to verify adequately.

The hidden costs to New Mexican taxpayers

The compact language creates an open checkbook to the state of New Mexico by transferring decision-making authority away from our state dental board to an unelected interstate commission with unlimited taxing and fee-making power. Implementation costs have the potential to exceed $200,000 for essential data systems, creating a substantial financial burden ultimately passed to New Mexico residents. This approach is far more costly than alternative solutions that would better serve our state.

Undermining New Mexico's dental board authority

Due to the fact that a license is not required for remote practitioners, our state dental board would lose authority over key decisions affecting dental care in our communities, despite our unique population and health care needs. The compact gives an unelected, out-of-state commission power to make rules affecting dental practice in New Mexico without accountability to our state's elected officials or dental regulators.

This loss of local control represents a troubling pattern New Mexico has experienced throughout its history, where outside entities impose their will without understanding our distinct needs.

Allowing distant decision-makers with no connection to our communities to determine our standards repeats a historical pattern where New Mexicans lose sovereignty over their own affairs. The commission would operate without transparency to New Mexico voters, creating rules that affect our citizens with minimal input from those who understand our state's health care landscape.

Public safety risks from inadequate verification systems

The verification system proposed in the compact contains alarming weaknesses. Background checks are insufficient and the data system would allow problematic practitioners to slip through the cracks. States that have already implemented similar systems have reported serious verification problems that put patient safety at risk.

Implementation failures and lack of transparency

The compact's implementation record should raise red flags for lawmakers. Only two additional states have joined since its initial adoption, and the American Dental Association recently withdrew financial support. States that adopted early report growing frustration with implementation delays, inadequate communication and missed deadlines. The April 2024 activation promised operational capability by early 2026, but the commission now acknowledges it cannot meet these targets.

The alternative path forward

New Mexico has better options. We can address dental workforce needs through targeted state-level innovations that preserve local control while maintaining public safety. Many states have successfully implemented reciprocity agreements and licensure by credential pathways without surrendering authority to an interstate commission.

Lawmakers must reject this flawed compact. The costs are too high, the verification systems too weak and the implementation too uncertain to justify transferring New Mexico's authority over dental licensure to an unaccountable interstate body. Our citizens deserve solutions that protect public safety while expanding access to care — this compact fails on both counts.

Contact your state senators today and urge them to vote against the dental compact legislation. New Mexico's dental health standards should be determined by New Mexicans, not by an unelected commission that threatens both our independence and our safety.

Ermalinda Baca, RDH, is the former board member of the New Mexico Board of Dental Health Care and the chair for the New Mexico Dental Hygienists Committee.