BILL NUMBER: SB 134 CHAPTERED 10/05/01 CHAPTER 532 FILED WITH SECRETARY OF STATE OCTOBER 5, 2001 APPROVED BY GOVERNOR OCTOBER 4, 2001 PASSED THE SENATE SEPTEMBER 13, 2001 PASSED THE ASSEMBLY SEPTEMBER 12, 2001 AMENDED IN ASSEMBLY SEPTEMBER 6, 2001 AMENDED IN ASSEMBLY AUGUST 23, 2001 AMENDED IN ASSEMBLY JULY 2, 2001 AMENDED IN SENATE APRIL 30, 2001 INTRODUCED BY Senator Figueroa (Coauthors: Senators Johannessen and Polanco) (Coauthors: Assembly Members Aanestad, Correa, and Thomson) JANUARY 29, 2001 An act to amend Sections 1601, 1603, 1628, 1636, 1636.5, 1742, 1749, and 1753 of, to amend, add, and repeal Section 1616.5 of, to add Sections 1638.7, 1645.1, 1648.15, and 1753.5 to, and to add and repeal Section 1601.1 of, the Business and Professions Code, relating to dentistry. LEGISLATIVE COUNSEL'S DIGEST SB 134, Figueroa. Dentistry. (1) Existing law provides that the Dental Board of California is in the Department of Consumer Affairs. Existing law provides for the licensing and regulation of dental professionals and dental auxiliaries by the Dental Board of California and the Committee on Dental Auxiliaries. The provisions creating the board, authorizing the board to appoint an executive officer, and creating the committee will become inoperative on July 1, 2002, and will be repealed on January 1, 2003. This bill would revise the procedures for appointment of the board and would provide that the current board would be repealed on January 1, 2002. The bill would provide that a new board, vested with the same powers as the previous board, would be created on January 1, 2002, and would become inoperative on July 1, 2004. The bill would also extend the provisions creating the Committee on Dental Auxiliaries to July 1, 2004, and repeal them on January 1, 2005. (2) Existing law provides that a person who has been issued a degree of doctor of dental medicine or doctor of dental surgery by a foreign dental school is eligible for the licensure examination if he or she has completed certain requirements. Existing law, as of January 1, 2003, revises the requirements that a person who has been issued a degree of doctor of dental medicine or doctor of dental surgery by a foreign dental school is required to complete to be eligible for the licensure examination. This bill would change the date for revision of the requirements for the graduates of a foreign dental school to January 1, 2004. (3) Existing law provides until January 1, 2003, that an applicant who fails to pass the licensure examination after 4 attempts is not eligible for further reexamination until he or she has successfully completed at least 2 academic years of education at an approved dental school. This bill would extend this provision to January 1, 2004. (4) Existing law requires the board to conduct occupational analyses to be used in the evaluation of dentistry licensing examinations. This bill would require the next occupational analysis to include a survey of the training and practices of oral and maxillofacial surgeons, and would require a report to be made to the Joint Legislative Sunset Review Committee. (5) Existing law provides a licensing scheme for dentists and requires dentists to meet certain requirements in their practice. Existing law sets forth provisions for permits for oral and maxillofacial surgery. This bill would require that the board inform all oral maxillofacial licensees of any existing statutory limitations on the services permitted under the authority of a dental license. The bill would also require that, prior to the performance of dental restoration work, a patient be provided with specified materials discussing possible health risks if the patient has not previously been provided with the materials by the dentist, and that these materials be made available to a patient upon request. (6) Existing law provides for a licensing scheme for registered dental assistants and requires applicants to meet certain educational, experience, and examination requirements in order to be eligible for a license. This bill would revise the licensure examination requirements. The bill would also require a registered dental assistant to provide evidence of having successfully completed a board-approved course in radiation safety and coronal polishing by January 1, 2005. (7) Existing law requires the Committee on Dental Auxiliaries to meet at least 4 times annually, at least once in Sacramento and at least once in Los Angeles. This bill would delete the requirements that the committee meet in Sacramento and Los Angeles. (8) This bill would make additional changes to the composition of the board if AB 447 is enacted and becomes effective on or before January 1, 2002. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1601 of the Business and Professions Code is amended to read: 1601. (a) There is in the Department of Consumer Affairs the Dental Board of California in which the administration of this chapter is vested. The board consists of eight practicing dentists, one registered dental hygienist, one registered dental assistant, and four public members. The board shall be organized into standing committees dealing with examinations, enforcement, and other subjects as the board deems appropriate. This section shall remain in effect only until January 1, 2002, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2002, deletes or extends that date. The repeal of this section renders the board subject to the review required by Division 1.2 (commencing with Section 473). (b) For purposes of this chapter, any reference in this chapter to the Board of Dental Examiners shall be deemed to refer to the Dental Board of California. SEC. 2. Section 1601.1 is added to the Business and Professions Code, to read: 1601.1. (a) There shall be in the Department of Consumer Affairs the Dental Board of California in which the administration of this chapter is vested. The board shall consist of eight practicing dentists, one registered dental hygienist, one registered dental assistant, and four public members. The appointing powers, described in Section 1603, may appoint to the board a person who was a member of the prior board. The board shall be organized into standing committees dealing with examinations, enforcement, and other subjects as the board deems appropriate. (b) For purposes of this chapter, any reference in this chapter to the Board of Dental Examiners shall be deemed to refer to the Dental Board of California. (c) The board shall have all authority previously vested in the existing board under this chapter. The board may enforce all disciplinary actions undertaken by the previous board. (d) This section shall become operative on January 1, 2002. (e) This section shall become inoperative on July 1, 2004, and, as of January 1, 2005, is repealed, unless a later enacted statute that is enacted before January 1, 2005, deletes or extends the dates on which it becomes inoperative and is repealed. The repeal of this section renders the board subject to the review required by Division 1.2 (commencing with Section 473). SEC. 2.5. Section 1601.1 is added to the Business and Professions Code, to read: 1601.1. (a) There shall be in the Department of Consumer Affairs the Dental Board of California in which the administration of this chapter is vested. The board shall consist of eight practicing dentists, one registered dental hygienist, one registered dental assistant, and four public members. Of the eight practicing dentists, one shall be a member of a faculty of any California dental college and one shall be a dentist practicing in a nonprofit community clinic. The appointing powers, described in Section 1603, may appoint to the board a person who was a member of the prior board. The board shall be organized into standing committees dealing with examinations, enforcement, and other subjects as the board deems appropriate. (b) For purposes of this chapter, any reference in this chapter to the Board of Dental Examiners shall be deemed to refer to the Dental Board of California. (c) The board shall have all authority previously vested in the existing board under this chapter. The board may enforce all disciplinary actions undertaken by the previous board. (d) This section shall become operative on January 1, 2002. (e) This section shall become inoperative on July 1, 2004, and, as of January 1, 2005, is repealed, unless a later enacted statute that is enacted before January 1, 2005, deletes or extends the dates on which it becomes inoperative and is repealed. The repeal of this section renders the board subject to the review required by Division 1.2 (commencing with Section 473). SEC. 3. Section 1603 of the Business and Professions Code is amended to read: 1603. Except for the initial appointments, members of the board shall be appointed for a term of four years, and each member shall hold office until the appointment and qualification of his or her successor or until one year shall have elapsed since the expiration of the term for which he or she was appointed, whichever first occurs. A vacancy occurring during a term shall be filled by appointment for the unexpired term, within 30 days after it occurs. No person shall serve as a member of the board for more than two terms. The Governor shall appoint two of the public members, the dental hygienist member, the dental assistant member, and the eight licensed dentist members of the board. The Senate Rules Committee and the Speaker of the Assembly shall each appoint a public member. Of the initial appointments, one of the dentist members and one of the public members appointed by the Governor shall serve for a term of one year. Two of the dentist members appointed by the Governor shall each serve for a term of two years. One of the public members and two of the dentist members appointed by the Governor shall each serve a term of three years. The dental hygienist member, the dental assistant member, and the remaining three dentists members appointed by the Governor shall each serve for a term of four years. The public members appointed by the Senate Committee on Rules and the Speaker of the Assembly shall each serve for a term of four years. SEC. 4. Section 1616.5 of the Business and Professions Code is amended to read: 1616.5. The board may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the board and vested in him or her by this chapter. This section shall remain in effect only until January 1, 2002, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2002, deletes or extends that date. SEC. 5. Section 1616.5 is added to the Business and Professions Code, to read: 1616.5. (a) The board, by and with the approval of the director, may appoint a person exempt from civil service who shall be designated as an executive officer and who shall exercise the powers and perform the duties delegated by the board and vested in him or her by this chapter. (b) This section shall become operative on January 1, 2002. (c) This section shall become inoperative on July 1, 2004, and, as of January 1, 2005, is repealed, unless a later enacted statute that is enacted before January 1, 2005, deletes or extends the dates on which it becomes inoperative and is repealed. SEC. 7. Section 1628 of the Business and Professions Code, as amended by Section 1 of Chapter 792 of the Statutes of 1997, is amended to read: 1628. Any person over 18 years of age is eligible to take an examination before the board upon making application therefor and meeting all of the following requirements: (a) Paying the fee for applicants for examination provided by this chapter. (b) Furnishing satisfactory evidence of having graduated from a reputable dental college, which shall have been approved by the board; provided, also, that applicants furnishing evidence of having graduated after 1921 shall also present satisfactory evidence of having completed at dental school or schools the full number of academic years of undergraduate courses required for graduation. (c) Furnishing the satisfactory evidence of financial responsibility or liability insurance for injuries sustained or claimed to be sustained by a dental patient in the course of the examination as a result of the applicant's actions. (d) This section shall remain in effect only until January 1, 2004, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2004, deletes or extends that date. SEC. 8. Section 1628 of the Business and Professions Code, as amended by Section 2 of Chapter 792 of the Statutes of 1997, is amended to read: 1628. Any person over 18 years of age is eligible to take an examination before the board upon making application therefor and meeting all of the following requirements: (a) Paying the fee for applicants for examination provided by this chapter. (b) Furnishing satisfactory evidence of having graduated from a reputable dental college, which shall have been approved by the board; provided, also, that applicants furnishing evidence of having graduated after 1921 shall also present satisfactory evidence of having completed at dental school or schools the full number of academic years of undergraduate courses required for graduation. (c) Furnishing the satisfactory evidence of financial responsibility or liability insurance for injuries sustained or claimed to be sustained by a dental patient in the course of the examination as a result of the applicant's actions. (d) If the applicant has been issued a degree of doctor of dental medicine or doctor of dental surgery by a foreign dental school, he or she shall furnish all of the following documentary evidence to the board: (1) That he or she has completed in a dental school or schools approved by the board pursuant to Section 1636.4, a resident course of professional instruction in dentistry for the full number of academic years of undergraduate courses required for graduation. (2) Subsequent thereto, he or she has been issued by the approved dental school, a dental diploma or a dental degree, as evidence of the completion of the course of dental instruction required for graduation. (e) Any applicant, who has been issued a dental diploma from a foreign dental school, which has not been approved by the board pursuant to Section 1636.4 at the time of his or her graduation from the school, shall not be eligible for examination until the applicant has successfully completed a minimum of two academic years of education at a dental college approved by the board pursuant to Article 1 (commencing with Section 1024) of Chapter 2 of Division 10 of Title 16 of the California Code of Regulations. This subdivision shall not apply to applicants who have successfully completed the requirements of Section 1636 on or before December 31, 2002. (f) This section shall become operative on January 1, 2004. SEC. 9. Section 1636 of the Business and Professions Code is amended to read: 1636. (a) Notwithstanding subdivision (b) of Section 1628, a person who has been issued a degree of doctor of dental medicine or doctor of dental surgery by a foreign dental school shall be eligible for examination as provided in this section upon complying with subdivisions (a) and (c) of Section 1628 and furnishing all of the following documentary evidence satisfactory to the board, that: (1) He or she has completed in a dental school or schools a resident course of professional instruction in dentistry for the full number of academic years of undergraduate courses required for graduation. (2) Subsequent thereto, he or she has been issued by the dental school, a dental diploma or a dental degree, as evidence of the completion of the course of dental instruction required for graduation. (b) An applicant who is a graduate of a foreign dental school accredited by a body which has a reciprocal accreditation agreement with any commission or accreditation agency whose findings are accepted by the board shall be exempt from the qualifying examination provided for in paragraph (2) of subdivision (c). (c) Examination by the board of a foreign-trained dental applicant shall be a progressive examination given in the following sequence: (1) Examination in writing which shall be comprehensive and sufficiently thorough to test the knowledge, skill, and competence of the applicant to practice dentistry, and both questions and answers shall be written in the English language. The written examination may be the National Board of Dental Examiners' examination or other examination, but in no event shall the examination given to foreign-trained applicants be a different examination than that given to applicants who have met the requirements of subdivision (b) of Section 1628. A foreign-trained applicant who passes the written examination shall be permanently exempt from retaking the examination. Those applicants who have passed the California written examination are permanently exempt from retaking any written examination, except any examination required for continuing education purposes. (2) Demonstration of the applicant's skill in restorative technique. An applicant who obtains an overall average grade of 75 percent in the restorative technique examination and a grade of 75 percent or more in two of the three subsections shall be deemed to have passed the examination. However, an applicant who obtains a grade of 85 percent in any subsection of the examination is exempt from retaking the subsection for two years following the date of the examination in which a grade of 85 percent was obtained. Every applicant who passes the entire restorative technique examination is permanently exempt from retaking the examination. (d) An applicant who has successfully completed the written examination and the restorative technique examination shall be eligible to take and shall pass the examinations in diagnosis-treatment planning, prosthetic dentistry, diagnosis and treatment of periodontics, and operative dentistry in the identical manner in which the examinations are taken by and administered to other dental applicants. Exemptions in the examinations shall be applied to foreign-trained applicants in the same manner as they are applied to other dental applicants. (e) This section shall remain in effect only until January 1, 2004, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2004, deletes or extends that date. SEC. 10. Section 1636.5 of the Business and Professions Code is amended to read: 1636.5. (a) Notwithstanding Section 135, on and after January 1, 1993, an applicant who fails to pass the examination required by paragraph (2) of subdivision (c) of Section 1636 after four attempts shall not be eligible for further reexamination until the applicant has successfully completed a minimum of two academic years of education at a dental school approved by either the Commission on Dental Accreditation or a comparable organization approved by the board. When the applicant applies for reexamination, he or she shall furnish proof satisfactory to the board that he or she has successfully completed the requirements of this subdivision. (b) This section shall remain in effect only until January 1, 2004, and as of that date is repealed, unless a later enacted statute, which is enacted before January 1, 2004, deletes or extends that date. SEC. 11. Section 1638.7 is added to the Business and Professions Code, to read: 1638.7. The next occupational analysis of dental licensees and oral and maxillofacial facial surgeons pursuant to Section 139 shall include a survey of the training and practices of oral and maxillofacial surgeons and, upon completion of that analysis, a report shall be made to the Joint Legislative Sunset Review Committee regarding the findings. SEC. 12. Section 1645.1 is added to the Business and Professions Code to read: 1645.1. By January 1, 2005, each person who holds a registered dental assistant license shall provide evidence of having successfully completed board-approved courses in radiation safety and coronal polishing. The length and content of the courses shall be governed by applicable board regulations. Failure to comply with this section shall result in automatic suspension of the license which shall be reinstated upon the receipt of evidence that the licensee has successfully completed the required courses. Completion of the courses may be counted toward fulfillment of the continuing education requirements governed by Section 1645. SEC. 13. Section 1648.15 is added to the Business and Professions Code, to read: 1648.15. The fact sheet set forth by Section 1648.10 shall be provided by a dentist to every new patient and to patients of record prior to the performance of dental restoration work. The dentist needs to provide the fact sheet to each patient only once pursuant to the previous requirements of this section. An acknowledgment of the receipt of the fact sheet by the patient shall be signed by the patient and a copy of it shall be placed in the patient's dental record. If updates to the fact sheet are made by the board, the updated fact sheet shall be given to patients in the manner provided above. A dentist shall also provide the fact sheet to the patient upon request. SEC. 14. Section 1742 of the Business and Professions Code is amended to read: 1742. (a) There is within the jurisdiction of the board a Committee on Dental Auxiliaries. (b) The Committee on Dental Auxiliaries shall have the following areas of responsibility and duties: (1) The committee shall have the following duties and authority related to education programs and curriculum: (A) Shall evaluate all dental auxiliary programs applying for board approval in accordance with board rules governing the programs. (B) May appoint board members to any evaluation committee. Board members so appointed shall not make a final decision on the issue of program or course approval. (C) Shall report and make recommendations to the board as to whether a program or course qualifies for approval. The board retains the final authority to grant or deny approval to a program or course. (D) Shall review and document any alleged deficiencies that might warrant board action to withdraw or revoke approval of a program or course, at the request of the board. (E) May review and document any alleged deficiencies that might warrant board action to withdraw or revoke approval of a program or course, at its own initiation. (2) The committee shall have the following duties and authority related to applications: (A) Shall review and evaluate all applications for licensure in the various dental auxiliary categories to ascertain whether a candidate meets the appropriate licensing requirements specified by statute and board regulations. (B) Shall maintain application records, cashier application fees, and perform any other ministerial tasks as are incidental to the application process. (C) May delegate any or all of the functions in this paragraph to its staff. (D) Shall issue auxiliary licenses in all cases, except where there is a question as to a licensing requirement. The board retains final authority to interpret any licensing requirement. If a question arises in the area of interpreting any licensing requirement, it shall be presented by the committee to the board for resolution. (3) The committee shall have the following duties and authority regarding examinations: (A) Shall advise the board as to the type of license examination it deems appropriate for the various dental auxiliary license categories. (B) Shall, at the direction of the board, develop or cause to be developed, administer, or both, examinations in accordance with the board's instructions and periodically report to the board on the progress of those examinations. The following shall apply to the examination procedure: (i) The examination shall be submitted to the board for its approval prior to its initial administration. (ii) Once an examination has been approved by the board, no further approval is required unless a major modification is made to the examination. (iii) The committee shall report to the board on the results of each examination and shall, where appropriate, recommend pass points. (iv) The board shall set pass points for all dental auxiliary licensing examinations. (C) May appoint board members to any examination committee established pursuant to subparagraph (B). (4) The committee shall periodically report and make recommendations to the board concerning the level of fees for dental auxiliaries and the need for any legislative fee increase. However, the board retains final authority to set all fees. (5) The committee shall be responsible for all aspects of the license renewal process, which shall be accomplished in accordance with this chapter and board regulations. The committee may delegate any or all of its functions under this paragraph to its staff. (6) The committee shall have no authority with respect to the approval of continuing education providers; the board retains all of this authority. (7) The committee shall advise the board as to appropriate standards of conduct for auxiliaries, the proper ordering of enforcement priorities, and any other enforcement-related matters that the board may, in the future, delegate to the committee. The board shall retain all authority with respect to the enforcement actions, including, but not limited to, complaint resolution, investigation, and disciplinary action against auxiliaries. (8) The committee shall have the following duties regarding regulations: (A) To review and evaluate all suggestions or requests for regulatory changes related to dental auxiliaries. (B) To report and make recommendations to the board, after consultation with departmental legal counsel and the board's executive officer. (C) To include in any report regarding a proposed regulatory change, at a minimum, the specific language of the proposed changes and the reasons for and facts supporting the need for the change. The board has the final rulemaking authority. (c) This section shall become inoperative on July 1, 2004, and, as of January 1, 2005, is repealed, unless a later enacted statute which becomes effective on or before January 1, 2005, deletes or extends the dates on which it becomes inoperative and is repealed. The repeal of this section renders the committee subject to the review required by Division 1.2 (commencing with Section 473). SEC. 15. Section 1749 of the Business and Professions Code is amended to read: 1749. (a) The committee shall meet at least four times annually. The committee shall conduct additional meetings as are necessary in appropriate locations to conclude its business. Special meetings may be held at the time and place the committee designates. (b) Notice of each meeting of the committee shall be given at least two weeks in advance to those persons and organizations who express an interest in receiving such notification. (c) The committee shall obtain permission of the director to meet more than six times annually. The director shall approve the meetings that are necessary for the committee to fulfill its legal responsibilities. SEC. 16. Section 1753 of the Business and Professions Code is amended to read: 1753. The board shall license as a registered dental assistant a person who submits written evidence, satisfactory to the board, of either one of the following requirements: (a) Graduation from an educational program in dental assisting approved by the board, and satisfactory performance on a written examination required by the board. On and after January 1, 1984, every applicant seeking licensure as a registered dental assistant pursuant to this subdivision shall provide evidence of his or her satisfactory performance on a written and practical examination required by the board. (b) Satisfactory work experience of more than 12 months as a dental assistant in California or another state and satisfactory performance on a written and practical examination required by the board. The board shall give credit toward the 12 months work experience referred to in this subdivision to persons who have graduated from a dental assisting program in a postsecondary institution approved by the Department of Education or in a secondary institution, regional occupational center, or regional occupational program, that are not, however, approved by the board pursuant to subdivision (a). The credit shall equal the total weeks spent in classroom training and internship on a week-for-week basis not to exceed 16 weeks. The board, in cooperation with the Superintendent of Public Instruction, shall establish the minimum criteria for the curriculum of nonboard-approved programs. Additionally, the board shall notify those programs only if the program's curriculum does not meet established minimum criteria, as established for board-approved registered dental assistant programs, except any requirement that the program be given in a postsecondary institution. Graduates of programs not meeting established minimum criteria shall not qualify for satisfactory work experience as defined by this section. SEC. 17. Section 1753.5 is added to the Business and Professions Code, to read: 1753.5. In addition to the requirements of Section 1753, each applicant for registered dental assistant licensure on or after July 1, 2002, shall provide evidence of having successfully completed board-approved courses in radiation safety and coronal polishing as a condition of licensure. The length and content of the courses shall be governed by applicable board regulations. SEC. 18. Section 2.5 of this bill shall become operative only if AB 447 is enacted and becomes effective on or before January 1, 2002, in which case Section 2 of this bill shall not become operative.