Better solutions (without lowering standards)

1) Fix retention first

Multiple public reports frame Virginia’s problem as not simply “number of licensed hygienists,” but retention and working conditions.

Solutions can include:

• improving workplace culture and staffing models;
• benefits and scheduling flexibility;
• clear pathways for advancement and leadership.

2) Transparency and patient education

If workforce roles evolve, require:

• clear patient-facing explanation of the provider role;
• explicit consent;
• accurate documentation of the scope of what was done.

3) Targeted pilots with independent evaluation

If Virginia wants to test new models:

• use a time-limited pilot;
• require independent outcome tracking (safety events, re-appointment rates, periodontal outcomes, patient understanding);
• publish results before statewide expansion.

4) Expand access where it is actually limited

If rural access is the goal, pair workforce policies with:

• incentives for rural practice;
• support for public health clinics;
• transportation/appointment support;
• workforce pipeline programs tied to underserved placement.

5) If SB 178 / HB 970 advance, add guardrails

At minimum:

• clear eligibility criteria;
• independent competency verification;
• robust supervision definitions;
• reporting, audits, and a sunset clause.

Next: Take action