title: The origins of Minnesota's mid-level dental practitioner: alignment of problem, political and policy streams.
abstract: OBJECTIVE
  Using John Kingdon's agenda-setting model, this paper explores how Minnesota came to legislate a mid-level dental practitioner to its oral health workforce. Using a pluralist framework embracing the existence of various interests and convictions, this analysis highlights the roles of issue formation, agenda setting and politics in policymaking.
  
  
  METHODS
  Using Kingdon's agenda-setting model as a theoretical lens, and applying case study methodology, this paper analyzes how Minnesota came to legislate a mid-level dental practitione to its oral health workforce. Data have come from scholarly research, governmental and foundation agency reports, interviews with leaders involved in the mid-level dental practitioner initiative, news articles, and Minnesota statute.
  
  
  RESULTS
  After 2 years of contentious and challenging legislative initiatives, the problem, policy and political streams converged and aligned with the compromise passage of a bill legalizing mid-level dental practitioner practice. The Minnesota Dental Therapist Law was the first-in-the-nation licensing law to develop a new dental professional workforce model to address access to oral health care.
  
  
  CONCLUSIONS
  The Minnesota mid-level dental practitioner initiative demonstrates the important convergence and alignment of the access to oral health care problem and the subsequent collaboration between political interest groups and policymakers. Through partnerships and pluralist compromise, mid-level dental practitioner champions were able to open the policy window to move this legislation to law, enhancing the oral health workforce in Minnesota.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Gwozdek
authors.forename: Renee
authors.initials: R
authors.lastname: Tetrick
authors.forename: H Luke
authors.initials: HL
authors.lastname: Shaefer
mesh_terms: D002983:Clinical Competence; D019058:Community Networks; D003299:Cooperative Behavior; D032022:Delegation, Professional / Q000331:legislation & jurisprudence; D003727:Dental Auxiliaries / Q000331:legislation & jurisprudence*; D003729:Dental Care; D003756:Dental Hygienists / Q000193:education / Q000331:legislation & jurisprudence; D006297:Health Services Accessibility; D006801:Humans; D008004:Licensure / Q000331:legislation & jurisprudence; D008910:Minnesota; D008962:Models, Theoretical; D009909:Oral Health; D011050:Policy Making; D011057:Politics; D011203:Poverty; D011340:Problem Solving; D011364:Professional Practice / Q000331:legislation & jurisprudence; D011639:Public Opinion; D011640:Public Policy; D064876:Safety-net Providers; D014495:Universities; D035862:Vulnerable Populations
keywords: Kingdon's agenda-setting model; access to care; advanced dental therapist; dental health aide therapist; dental therapist; mid-level dental practitioner; policy