Legislative Analysis
Phone: (517) 373-8080
REQUIRE DENTAL SCREENING OF CHILDREN http://www.house.mi.gov/hfa
Senate Bill 280 (S-1) as reported from House committee Analysis available at
Sponsor: Sen. Sam Singh http://www.legislature.mi.gov
House Committee: Health Policy
Senate Committee: Health Policy
Complete to 9-20-23
SUMMARY:
Senate Bill 280 would amend the Public Health Code to require dental oral assessments for
children who are registering for the first time in kindergarten or the first grade in a school
in Michigan. However, the requirement would not apply to a child whose parent, guardian,
or person in loco parentis provides a written statement that the requirement violates their
personal religious beliefs. (Currently, such assessments are allowed and not required.) The
bill also would eliminate a January 1, 2024 expiration date that now applies to these
provisions.
The bill would amend section 9316, which was added to the code in 2020 and which,
among other things, requires the Department of Health and Human Services (DHHS) to
contract with a government entity or person to establish and maintain a dental oral
assessment program. This program provides dental oral assessments for children
registering for the first time in kindergarten or the first grade whose parents, guardians, or
persons in loco parentis want such an assessment and did not have a dentist or dental
hygienist conduct the assessment within the six months before the child’s school
registration. 1 Section 9316 took effect beginning in the 2021-2022 school year and will no
longer apply beginning January 1, 2024. 2
Under the bill, beginning in the 2023-2024 school year, a parent, guardian, or person in
loco parentis applying to have a child registered for the first time in kindergarten or the
first grade in a school in Michigan would have to do the following:
• Have a dentist or dental hygienist conduct a dental oral assessment on the child not
earlier than six months before the date of the child’s school registration and obtain
from the dentist or dental hygienist a written statement, on a form prescribed by
DHHS, certifying that the child received the assessment within that time frame.
• If the parent or guardian does not meet the above requirements, have a dental oral
assessment conducted on the child by the government entity or person contracted
with by DHHS for the dental oral assessment program established under the code.
1
See https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Adult-and-Childrens-Services/Children-
and-Families/Healthy-Children-and-Healthy-Families/Oral-Health/FAQs_Schools.pdf
2
HFA summary of the 2020 public act that added section 9316: https://www.legislature.mi.gov/documents/2019-
2020/billanalysis/House/pdf/2019-HLA-4223-A9FEFDA9.pdf
House Fiscal Agency Page 1 of 3
 Beginning in the 2023-2024 school year, a parent, guardian, or person in loco parentis
applying to register a child for the first time in kindergarten or the first grade in a school in
Michigan would have to present one of the following to school officials at the time of
registration or by the first day of school:
• The written statement provided by a dentist or dental hygienist, as described above,
certifying that the child received the dental oral assessment within the six months
before the date of the child’s school registration.
• A written statement indicating that the parent, guardian, or person in loco parentis
will provide for the child’s dental oral assessment by the government entity or
person selected by DHHS for the dental oral assessment program.
• A written statement that the dental oral assessment requirement violates the
personal religious beliefs of the parent, guardian, or person in loco parentis. (This
statement would exempt the child from the requirement.)
However, a child could not be excluded from school attendance if the parent, guardian, or
person in loco parentis does not present a statement described above to school officials on
or before the first day of school as required by the bill.
In addition, section 9316 currently allows a school district to continue to use a
governmental entity or person it has contracted with to administer dental oral assessments
to its students as long as all of the following are met:
• The district ensures that assessments are conducted by May 31 of each year.
• Notification requirements are met concerning indicated follow-up care.
• Reporting requirements are met concerning dental reports received by schools.
• The district provides DHHS with the name of the government entity or person that
conducts the dental oral assessments; each date the entity or person is scheduled to
provide the assessments; and the total number of assessments scheduled.
The bill would eliminate the last bulleted item above.
The bill also would make largely technical amendments to other provisions of section 9316
to reflect its proposed general requirement of dental oral assessments.
Finally, the bill would eliminate the sunset (expiration) clause that now provides that
section 9316 does not apply beginning January 1, 2024.
MCL 333.9316
FISCAL IMPACT:
Senate Bill 280 would increase costs for the Department of Health and Human Services
and local units of government by an additional $2.7 million of state funding. According to
DHHS, the estimated cost to the state to fully administer the Oral Health Assessment
program across 45 local health departments would be $4.5 million, serving approximately
112,000 kindergartners. For FY 2023-24, $1.8 million has been appropriated on an ongoing
basis from the School Aid Fund and GF/GP with an additional $1.5 million of one-time
House Fiscal Agency SB 280 (S-1) as reported Page 2 of 3
 private funding from Delta Dental to carry out the program in the DHHS budget. The
additional $2.7 million of state funding would be needed for Phase 1 expansion completion
along with the onboarding of the 25 local health departments that have not yet implemented
the program. Senate Bill 280 may also increase costs to local units of government due to
the administrative costs of implementing or maintaining the program expansion for local
health departments.
It should be noted that initial program cost estimates were based on pre-pandemic wages,
which have increased in previous years. Total cost will also be dependent on the number
of families that take advantage of the program, as well as the cost of full coverage of large
geographic areas, which is not accounted for in the current estimate.
POSITIONS:
Representatives of Smiles on Wheels testified in support of the bill. (9-6-23)
The following entities indicated support for the bill (9-6-23):
• Department of Health and Human Services
• Blue Cross Blue Shield of Michigan
• Delta Dental
• District Health Department #2 and #4
• Michigan Association for Local Public Health
• Michigan Association of Health Plans
• Michigan Council for Maternal and Child Health
• Michigan Dental Hygienists Association
• Michigan Oral Health Coalition
• My Community Dental Centers
• MyCare Health Center
• United Way of Northwest Michigan
• Van Buren/Cass District Health Department
Legislative Analyst: Rick Yuille
Fiscal Analyst: Sydney Brown
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
House Fiscal Agency SB 280 (S-1) as reported Page 3 of 3


Statutes affected:
Substitute (S-1): 333.9316
Substitute (H-1): 333.9316
Senate Introduced Bill: 333.9316
As Passed by the Senate: 333.9316
As Passed by the House: 333.9316
Senate Concurred Bill: 333.9316
Public Act: 333.9316
Senate Enrolled Bill: 333.9316