BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



           ------------------------------------------------------------ 
          |SENATE RULES COMMITTEE            |                   SB 540|
          |Office of Senate Floor Analyses   |                         |
          |1020 N Street, Suite 524          |                         |
          |(916) 651-1520         Fax: (916) |                         |
          |327-4478                          |                         |
           ------------------------------------------------------------ 
           
                                         
                                 THIRD READING


          Bill No:  SB 540
          Author:   Price (D)
          Amended:  5/12/11
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE  :  9-0, 5/2/11
          AYES:  Price, Emmerson, Corbett, Correa, Hernandez, Negrete 
            McLeod, Vargas, Walters, Wyland

           SENATE APPROPRIATIONS COMMITTEE  :  9-0, 5/23/11
          AYES:  Kehoe, Walters, Alquist, Emmerson, Lieu, Pavley, 
            Price, Runner, Steinberg


           SUBJECT  :    Dentistry

           SOURCE  :     Author


           DIGEST  :    This bill extends the sunset date of the Dental 
          Board of California to January 1, 2016, and makes other 
          programmatic changes.

           ANALYSIS :    

          Existing law:

          1. Establishes the Dental Board of California (DBC) to 
             license and regulate the practice of dentistry.  

          2. Specifies that the DBC shall consist of eight practicing 
             dentists, one registered dental hygienist, one 
                                                           CONTINUED





                                                                SB 540
                                                                Page 
          2

             registered dental assistant, and four public members.  
             States that this provision shall remain in effect only 
             until January 1, 2012, and after that date, is repealed 
             unless a later enacted statute, that is enacted before 
             January 1, 2012, deletes or extends that date. 

          3. Provides that every board within the Department of 
             Consumer Affairs, as specified, shall initiate the 
             process of adopting regulations on or before January 1, 
             1999, to require its "licentiates", as defined, to 
             provide notice to their clients or customers that the 
             practitioner is licensed by this state.

          4. States that for purposes of advertising, a dentist may 
             not hold himself or herself out as a specialist, as 
             specified, unless the dentist satisfies specific 
             specialization requirements.  

          5. Allows DBC to issue a probationary license to an 
             applicant for licensure as a dentist or dental 
             auxiliary.  Allows DBC to require a licensee, as a term 
             or condition of issuing a probationary license, to 
             comply with certain requirements, as specified. 

          6. Requires licensees of DBC to fulfill continuing 
             education requirements.

          7. Specifies the intent of the Legislature to seek ways and 
             means to identify and rehabilitate licentiates whose 
             competency may be impaired due to abuse of dangerous 
             drugs or alcohol, so that licentiate so afflicted may be 
             treated and returned to the practice of dentistry in a 
             manner which will not endanger the public health and 
             safety.  

          8. Requires DBC to establish criteria for the acceptance 
             denial or termination of licentiates in a diversion 
             program.  States that licentiates shall sign an 
             agreement of understanding that withdrawal or 
             termination from the diversion program at a time when a 
             diversion evaluation committee determines the licentiate 
             presents a threat to the public's health and safety 
             shall result in the utilization of the DBC of diversion 
             treatment records in disciplinary or criminal 

                                                           CONTINUED





                                                                SB 540
                                                                Page 
          3

             proceedings.  

          9. States that the amount of fees that relate to the 
             licensing and permitting of dental assistants shall be 
             established by DBC resolution.  

          10.Finds and declares that dental assistants provide a 
             dental care services that is vital to good health.  It 
             is the intent of the Legislature that DBC create and 
             implement an effective forum where dental assistant 
             services and regulatory oversight of dental assistants 
             can be heard and discussed in full and where all matters 
             relating to dental assistants in this state can be 
             discussed, as specified.

          11.Establishes the Dental Corps Loan Repayment Program of 
             2002 to provide loan repayment assistance to dentists 
             who commit to a minimum of three years of services in a 
             "dentally underserved area", as defined.  

          This bill:

          1. Deletes existing law requirements relating to 
             advertising by a dentist of specialization or 
             accreditation in a specialty area of practice unless 
             certain requirements are met.

          2. Extends the sunset date of the DBC until January 1, 
             2016, and provides that upon the sunset, the DBC becomes 
             subject to review by the appropriate policy committees 
             of the Legislature.

          3. Deletes positions on the DBC reserved for a registered 
             dental hygienist and a registered dental hygienist, and 
             instead increases the number of public members of the 
             DBC by three members who will be appointed by the 
             Governor.

          4. Requires DBC, by January 1, 2013, to comply with 
             existing statute that requires boards within DCA, 
             including DBC, to adopt regulations to require licensees 
             to provide notice to clients or customers that the 
             licensee is licensed by the state.  Requires the notice 
             to include a provision indicating that DBC is the entity 

                                                           CONTINUED





                                                                SB 540
                                                                Page 
          4

             that regulates dentists and provide the telephone number 
             and Internet address of DBC.  States that DBC should 
             require the notice to be posted in a conspicuous 
             location accessible to public view.

          5. Extends the sunset date of the appointment of the 
             executive officer to January 1, 2018.

          6. Requires DBC to adopt written guidelines on how to make 
             probation assignments, and to ensure that probationary 
             and evaluation reports are conducted consistently and 
             regularly.

          7. Requires DBC to ensure that the law and ethics 
             examination reflect current law and regulations, and to 
             ensure that the examinations are randomized.

          8. Deletes existing law provision requiring a licentiate to 
             sign an agreement of understanding that the withdrawal 
             or termination from the diversion program at a time when 
             a diversion evaluation committee determines the 
             licentiate presents a threat to the public's health and 
             safety shall result in the utilization by DBC of 
             diversion treatment records in disciplinary or criminal 
             proceedings.

          9. Requires that if a licentiate withdraws or is terminated 
             from the diversion program for failure to comply or is 
             determined to be a threat to the public or their own 
             health and safety, all diversion records for that 
             licentiate shall be provided to DBC's enforcement 
             program and may be used in any disciplinary proceeding.  
             States that if a licentiate in a diversion program tests 
             positive for any banned substance, the board's diversion 
             program manager shall immediately notify DBC's 
             enforcement program and provide the documentation 
             evidencing the positive test result to the enforcement 
             program.  Provides that this documentation may be used 
             in a disciplinary proceeding. 

          10.Deletes the requirement that dental assisting fees that 
             relate to licensing and permitting be established by DBC 
             resolution and instead requires these fees to be 
             established by regulation.

                                                           CONTINUED





                                                                SB 540
                                                                Page 
          5


          11.Deletes existing intent language for DBC to create and 
             implement an effective forum for dental assisting 
             matters, as specified.

          12.Creates a Dental Assisting Council (Council) of DBC, 
             which shall consider all matters relating to dental 
             assistants in this state, including matters that relate 
             to standards for approval of dental assisting 
             educational programs and courses, and make appropriate 
             recommendations to DBC, as specified.

          13.Requires that members of the Council to be appointed by 
             the DBC president, and shall consist of two members of 
             DBC, and five members who are either registered dental 
             assistants or registered dental assistants in extended 
             functions.  Requires the Council to meet in conjunction 
             with other DBC Committees, and at other times as deemed 
             necessary.  

          14.Provides that the Council members shall serve a term of 
             four years, except that, of the initial appointments of 
             the nonboard members, one of the members shall serve a 
             term of one year, two members shall serve a term of two 
             years, and two members shall serve a term of three 
             years.  

          15.Requires the Council to be the sole entity of DBC that 
             will provide recommendations on dental assisting 
             matters. 

          16.Extends the California Dental Corps Loan Repayment 
             Program of 2002 until all the moneys in the account are 
             expended.  

          17.Makes other technical, non-substantive, and conforming 
             changes.

           Background  

          DBC was created by the California Legislature in 1885, and 
          was originally established to regulate dentists.  Today, 
          DBC is responsible for regulating the practice of 
          approximately 71,000 licensed dental health professionals 

                                                           CONTINUED





                                                                SB 540
                                                                Page 
          6

          in California, including 35,500 dentists, 34,300 registered 
          dental assistants (RDAs), and 1,300 registered dental 
          assistants in extended functions (RDAEFs).   In addition, 
          DBC is responsible for setting the duties and functions of 
          approximately 50,000 unlicensed dental assistants.  The 
          Dental Practice Act provides that the "Ýp]rotection of the 
          public shall be the highest priority of the Dental Board of 
          California in exercising its licensing, regulatory and 
          disciplinary functions.  Whenever the protection of the 
          public is inconsistent with other interests sought to be 
          promoted, the protection of the public shall be paramount." 
           DBC implements regulatory programs and performs a variety 
          of functions to protect consumers.  These programs and 
          activities include setting licensure requirements for 
          dentists, and dental assistants, including examination 
          requirements, issue and renew licenses, issue special 
          permits, monitor probationer dentists and RDAs and manage a 
          Diversion Program for dentists and RDAs whose practice may 
          be impaired due to chemical dependency or mental illness.  
          DBC is composed of 14 members; eight practicing dentists, 
          two dental auxiliaries (registered dental hygienists and 
          RDA), and four public members.  The eight licensed 
          dentists, the registered dental hygienist, the RDA, and two 
          public members are appointed by the Governor.  The Speaker 
          of the Assembly and the Senate Rules Committee each get a 
          public member appointment.   According to DBC, public 
          membership is 29 percent of the Board's composition.

          Existing law allows the Legislature to conduct policy 
          review of regulatory boards within DCA.  This review 
          includes an evaluation of a board's regulatory programs, 
          including staffing, enforcement, budgetary, examination, 
          and practice issues to ensure that consumer protection 
          remains the priority of these boards.  This year, DBC was 
          reviewed by the Senate Business, Professions and Economic 
          Development Committee and an oversight hearing was held on 
          March 14, 2011.  As part of this hearing, Committee staff 
          prepared an extensive background paper detailing various 
          issues and recommendations for the DBC.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

          According to the Senate Appropriations Committee:

                                                           CONTINUED





                                                                SB 540
                                                                Page 
          7


                         Fiscal Impact (in thousands)

           Major Provisions       2011-12     2012-13    2013-14     Fund  

          Dental Assisting Council       up to $60          up to 
          $120                 up to $120         Special*

          * State Dentistry Fund

           SUPPORT  :   (Verified  5/24/11)

          Dental Assisting Alliance 


           ARGUMENTS IN SUPPORT  :    The Dental Assisting Alliance 
          states that it supports replacing the Dental Assisting 
          Forum with a Dental Assisting Council that meets in 
          conjunction with other Board committees, and establishes 
          the Council as the sole entity making dental assisting 
          recommendations to DBC.  As a result, the Alliance points 
          out, dental assisting matters will be much more efficiently 
          and effectively integrated into DBC's deliberations.  


          JJA:mw  5/24/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

                                ****  END  ****
          














                                                           CONTINUED