BILL NUMBER: AB 668 CHAPTERED 09/05/01 CHAPTER 249 FILED WITH SECRETARY OF STATE SEPTEMBER 5, 2001 APPROVED BY GOVERNOR SEPTEMBER 5, 2001 PASSED THE ASSEMBLY AUGUST 20, 2001 PASSED THE SENATE JULY 19, 2001 AMENDED IN SENATE JUNE 21, 2001 AMENDED IN ASSEMBLY JUNE 4, 2001 AMENDED IN ASSEMBLY MARCH 27, 2001 INTRODUCED BY Assembly Member Chan FEBRUARY 22, 2001 An act to add Section 128040 to the Health and Safety Code, relating to health. LEGISLATIVE COUNSEL'S DIGEST AB 668, Chan. California Dentist Loan Forgiveness Program. Existing law requires the Office of Statewide Health Planning and Development to perform various functions and duties with respect to health policy and planning and health professions development, including administering the federal National Health Service Corps State Loan Repayment Program. Under the existing program, federal funds are provided to states for the purpose of repaying qualifying educational loans of specified health care professionals who commit to provide full-time primary medical care or dental services for at least 2 and up to 4 years, at practice sites in designated Health Professional Shortage Areas. Under the existing program, the practice site is also responsible for repaying a portion of the health care professional's outstanding loan amount. This bill would require the office to report to the Legislature on or before June 30, 2002, on the feasibility of establishing a California dental loan forgiveness program. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. The Legislature finds and declares all of the following: (a) In California: (1) More than one-half of all children in California, which is twice the proportion of children in other states, have untreated tooth decay and more than half of all schoolage children have untreated tooth decay. (2) One-half of all preschool and 12 percent of high school students have never been to the dentist. (3) Almost one-third of the preschoolers and more than two-thirds of the elementary and high school students have experienced tooth decay. (4) Twenty-one percent of 10th graders are in urgent need of dental care for extensive decay, pain, or infection and 61 percent of 10th graders have periodontal (gum) disease requiring professional treatment. (5) The percentage of children ages six to eight years with untreated decay was more than twice as high as the United States average for this age group in 1986-87, and 175 percent higher than the year 2000 objective for the nation. (b) While various programs have been aimed at increasing access to dental care, very few of them are aimed at placing dentists in underserved areas. (c) While there is a federal program to provide health professional student debt forgiveness, the program itself acknowledges that it is only able to address about 12 percent of the need nationwide. (d) Only 92 dentists nationwide are in the National Health Service Corps program in which only one in every three applicants are selected. Some of these programs require matching funds from the clinic, which is very difficult to provide because the clinics are required not only to pay the dentist a wage, but also to contribute from twelve thousand five hundred dollars ($12,500) to seventeen thousand five hundred dollars ($17,500) each year in order for the dentist to receive the program's matching federal funds. At medicaid or Medi-Cal reimbursement rates, this is a hurdle many clinics cannot overcome. SEC. 2. Section 128040 is added to the Health and Safety Code, to read: 128040. (a) The Office of Statewide Health Planning and Development shall report to the Legislature on or before June 30, 2002, on the feasibility of establishing a California dental loan forgiveness program utilizing the same general guidelines applicable to the federal National Health Service Corps State Loan Repayment Program (42 U.S.C.A. Sec. 254q-1; 42 C.F.R., Part 62, Subpart C (commencing with Section 62.51)), except as follows: (1) A dentist shall be eligible to participate in the loan forgiveness program if he or she provides full-time or half-time dental services in either of the following: (A) A dental health professional shortage area (DHPSA), established pursuant to Section 254e(a) of Title 42 of the United States Code. (B) An area of the state where unmet priority needs for dentists exist as determined by the Health Manpower Policy Commission pursuant to Section 128225. (2) Matching funds to repay a portion of the dentist's outstanding loan amount shall be required from the practice site areas or from other private nonprofit sources. (3) A qualifying practice site shall include a private dental practice. (b) (1) The report required under subdivision (a) shall include all of the following: (A) A projection of the dentist-to-population ratio for California in the next decade. (B) A determination of the future need for dentists and dental care in underserved communities. The office shall work collaboratively with organizations that represent providers of dental services to underserved communities in making this determination. (C) A report on the utilization by dentists of tuition loan repayment programs at the federal and state level and identify the barriers to full utilization of these loan repayment programs. (D) A report on the projected cost increase of dental school education at public and private postsecondary educational institutions. (E) A report on the implications of administering an additional program, including a cost analysis. (2) The report also shall include recommendations on whether a program described in subdivision (a) should be established and, if so, suggested funding sources. In making its recommendations, the office shall consider the impact of the program on access to dental services in areas of the state that currently have a shortage of dentists.