Dental compact draws split testimony: portability supporters face objections over hands‑on clinical assessment and multistate rulemaking

Testimony on the dentist and dental hygienist compact (S1494/H2563) showed a sharp divide: supporters described the compact as a tool to improve workforce mobility and access to care, while licensing experts and former regulators said the compact could undermine Massachusetts’ ability to ensure clinical hand‑skills competency and cede lawmaking authority to a multistate commission. Amanda Berthiaume, a dental hygienist and educator, and other proponents told the committee the compact modernizes licensure portability, helps military families and facilitates multi‑state practice—relying on a flexible Council of State Governments (CSG) model designed to avoid embedding a single exam in statute. By contrast, Dr. Mina Paul, a former chair of the Massachusetts Board of Registration in Dentistry, said Massachusetts’ licensure historically requires a hands‑on clinical skills exam and argued the CSG compact does not mandate such an assessment. She said dentistry involves irreversible procedures and that Massachusetts patients deserve a demonstrated hand‑skills assessment for practitioners. Pat Connolly Atkins, a dental hygienist and accreditation advisor, echoed that position and explained how hand‑skills exams such as ADEX use simulated procedures assessed by observers to ensure dexterity and clinical judgment. David Hanke, outside counsel for the Council on Dental Competency Assessments (CDCA), raised legal concerns about the compact’s governance. He told the committee that the compact creates a multistate commission authorized to issue binding rules across member states and that it could assess financial obligations against states without an adequate mechanism for pushback; he noted litigation on similar issues in other states. Supporters said the compact would improve access to care, reduce the cost of relicensure and help military spouses maintain careers, while opponents focused on clinical competency safeguards and state sovereignty over licensing standards. Several witnesses urged the committee to weigh both access benefits and regulatory protections before advancing the bill.