BILL NUMBER: AB 2390 CHAPTERED 08/30/04 CHAPTER 347 FILED WITH SECRETARY OF STATE AUGUST 30, 2004 APPROVED BY GOVERNOR AUGUST 27, 2004 PASSED THE ASSEMBLY AUGUST 12, 2004 PASSED THE SENATE JULY 29, 2004 AMENDED IN SENATE JUNE 24, 2004 AMENDED IN SENATE JUNE 22, 2004 AMENDED IN SENATE JUNE 7, 2004 AMENDED IN ASSEMBLY APRIL 26, 2004 AMENDED IN ASSEMBLY APRIL 12, 2004 INTRODUCED BY Assembly Members Reyes and Chan FEBRUARY 19, 2004 An act to amend Sections 1657, 1658, and 1658.2 of, and to add Section 1625.1 to, the Business and Professions Code, relating to the healing arts. LEGISLATIVE COUNSEL'S DIGEST AB 2390, Reyes. Dentistry. (1) Existing law, the Dental Practice Act, provides for the licensure and regulation by the Dental Board of California of those engaged in the practice of dentistry. Existing law provides that a person practices dentistry if the person, among other things, manages or conducts as manager, proprietor, conductor, lessor, or otherwise, in any place where dental operations are performed. This bill would exclude from the unlicensed practice of dentistry certain clinics and other entities that own or manage places where dental operations are performed if they comply with various requirements. (2) Existing law authorizes a dentist to operate one mobile dental clinic or unit that is registered and operated in accordance with regulations adopted by the board. Existing law also imposes specified registration requirements on a dentist who maintains additional places of practice. Other provisions of existing law, the Mobile Health Care Services Act, require, subject to specified exemptions, licensure by the State Department of Health Services to operate a mobile service unit. This bill would exempt certain mobile service units from the provisions of the Dental Practice Act that regulate mobile dental clinics or units and additional places of practice. (3) Existing law requires a dentist who desires to have more than one place of practice to pay a fee to, and receive permission in writing from, the board prior to opening an additional place of practice. This requirement does not apply to a dentist who also practices in certain primary and specialty care clinics. This bill would further exempt from this requirement a dentist who also practices in clinics operated by the federal government, a federally recognized Indian tribe, or a community clinic open for limited services no more than 20 hours per week. The bill would make corresponding changes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1625.1 is added to the Business and Professions Code, to read: 1625.1. (a) Any of the following entities may employ licensees and dental assistants and charge for the professional services they render, and shall not be deemed to be practicing dentistry within the meaning of Section 1625: (1) A primary care clinic that is licensed pursuant to subdivision (a) of Section 1204 of the Health and Safety Code. (2) A primary care clinic that is exempt from licensure pursuant to subdivision (b), (c), or (h) of Section 1206 of the Health and Safety Code. (3) A clinic owned or operated by a public hospital or health system. (4) A clinic owned and operated by a hospital that maintains the primary contract with a county government to fill the county's role under Section 17000 of the Welfare and Institutions Code. (b) The entities described in subdivision (a) shall not interfere with, control, or otherwise direct the professional judgment of a licensee or dental assistant acting within his or her scope of practice as defined in this chapter. A requirement that licensees shall constitute all or a percentage of the governing body of the entity shall not be applicable to these entities. SEC. 2. Section 1657 of the Business and Professions Code is amended to read: 1657. (a) A licensed dentist may operate one mobile dental clinic or unit registered as a dental office or facility. The mobile dental clinic or unit shall be registered and operated in accordance with regulations established by the board, provided these regulations are not designed to prevent or lessen competition in service areas. A mobile dental clinic or unit registered and operated in accordance with the board's regulations and that has paid the fees established by the board, including a mobile dental unit registered for the purpose specified in subdivision (d), shall otherwise be exempted from this article and Article 3.5 (commencing with Section 1658). (b) A mobile service unit, as defined in subdivision (b) of Section 1765.105 of the Health and Safety Code, and a mobile unit operated by an entity that is exempt from licensure pursuant to subdivision (b), (c), or (h) of Section 1206 of the Health and Safety Code, are exempt from this article and Article 3.5 (commencing with Section 1658). Notwithstanding this exemption, the owner or operator of the mobile unit shall notify the board within 60 days of the date on which dental services are first delivered in the mobile unit, or the date on which the mobile unit's application pursuant to Section 1765.130 of the Health and Safety Code is approved, whichever is earlier. (c) A licensee practicing in a mobile unit described in subdivision (b) is not subject to subdivision (a) as to that mobile unit. (d) Notwithstanding Section 1625, a licensed dentist shall be permitted to operate a mobile dental unit provided by his or her property and casualty insurer as a temporary substitute site for the practice registered by him or her pursuant to Section 1650 as long as both of the following apply: (1) The licensed dentist's registered place of practice has been rendered and remains unusable due to loss or calamity. (2) The licensee's insurer registers the unit with the board in compliance with subdivision (a). SEC. 3. Section 1658 of the Business and Professions Code is amended to read: 1658. (a) When a licensee desires to have more than one place of practice, he or she shall, prior to the opening of the additional office, apply to the board, pay the fee required by this chapter, and receive permission in writing from the board to have the additional place of practice. "Place of practice" means any dental office where any act of dentistry is practiced as defined by Section 1625, and includes a place of practice in which the applicant holds any proprietary interest of any nature whatsoever, or in which he holds any right to participate in the management or control thereof. A dentist who is the lessor of a dental office shall not be deemed to hold a proprietary interest in that place of practice, unless he is entitled to participate in the management or control of the dentistry practiced there. (b) This section shall not apply to a licensee who practices dentistry outside his or her registered place of practice in any of the following places: (1) Facilities licensed by the State Department of Health Services. (2) Licensed health facilities as defined in Section 1250 of the Health and Safety Code. (3) Clinics that are licensed under subdivision (a) of Section 1204 of, or that are exempt from licensure under subdivisions (b), (c), or (h) of Section 1206 of, the Health and Safety Code. (4) Licensed community care facilities as defined in Section 1502 of the Health and Safety Code. (5) Schools of any grade level, whether public or private. (6) Public institutions including, but not limited to, federal, state, and local penal and correctional facilities. (7) Mobile units which are operated by a public or governmental agency or a nonprofit or charitable organization and are approved by the board, provided that the mobile units meet all statutory or regulatory requirements. (8) The home of a nonambulatory patient when a physician or registered nurse has provided a written note that the patient is unable to visit a dental office. SEC. 4. Section 1658.2 of the Business and Professions Code is amended to read: 1658.2. (a) "Additional place of practice," as used in this article, means any place of practice that increases the number of places of practice of the applicant, and includes an additional office that the applicant proposes to originally establish, either individually or in association with another, as well as an established place of practice that the applicant acquires or proposes to acquire, in whole or in part, by purchase, repossession, reassignment, gift, devise, bequest, or operation of law, except as otherwise provided in this article. (b) A practice location described in subdivision (b) of Section 1658 does not constitute an additional place of practice.