BILL ANALYSIS Ó
AB 836
Page 1
Date of Hearing: April 2, 2013
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Richard S. Gordon, Chair
AB 836 (Skinner) - As Introduced: February 21, 2013
SUBJECT : Dentists: continuing education.
SUMMARY : Restricts the continuing education (CE) requirement
hours for retired active dentists at a maximum of 60 percent of
that required for non-retired active dentists. Specifically,
this bill :
1)Prohibits the Dental Board of California (DBC) from requiring
more than 60 percent of the hours of CE that is required of
other licensed dentists for dentists who:
a) Have practiced dentistry for 20 years or more in
California;
b) Have reached the age of retirement under the federal
Social Security Act; and,
c) Customarily provide his or her services free of
charge to any person, organization, or agency.
EXISTING LAW :
1)Establishes DBC to license and regulate the practice of
dentistry. (Business and Professions Code (BPC) Section
1601.1)
2)Establishes an active and inactive retired dentist license.
(BPC 1716.1)
3)Authorizes DBC to reduce the renewal fee for registered active
dentists by up to one half. (BPC 1716.1(a))
4)Requires dentists to complete 50 units of CE for each biannual
license renewal cycle. (16 California Code of Regulations
(CCR) 1017)
5)Requires CE providers to be registered with DBC. (BPC 1645)
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6)Permits, until January 1, 2014, out-of-state medical
practitioners with valid, current, and active licenses to
participate in sponsored free health care events in
California. (BPC 901)
FISCAL EFFECT : None. This bill is keyed non-fiscal by
Legislative Counsel.
COMMENTS :
1)Purpose of this bill . This bill incentivizes retired dentists
to provide free care for dentally underserved populations by
effectively reducing the number of CE hours required for
license renewal from 50 to 30. The sponsor of this bill, the
California Dental Association (CDA), argues that access to
dental care has been hampered by state budget cuts, requiring
more people to rely on charity services. CDA hosts several of
these free clinics, which rely on volunteer dentists. This
bill would encourage active retired dentists to maintain their
licensure in order to offer their services for free. However,
it is unclear whether reducing CEs will result in greater
volunteerism because the DBC reports they have had no
complaints from retired active dentists regarding their
ability to comply with current law.
2)Types of dental licenses . DBC issues the following licenses to
dentists:
a) Active dental license . An active dentist must meet
all the requirements for licensure, including 50 hours of
CE.
b) Retired inactive dental license . An inactive retired
dentist license may be issued if a licensee demonstrates
to the satisfaction of DBC that he or she is unable to
practice dentistry due to a disability. DBC may waive 50%
of the license renewal fee and the licensee is not
required to complete CEs. An inactive retired dental
licensee may not practice dentistry.
c) Retired active dental license . DBC provides a
retired active dentist's license at 50% of the active
license fee for those dentists who have practiced
dentistry for 20 years or more in California, reached the
age of retirement under the federal Social Security Act,
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and customarily provide their services free of charge to
any person, organization, or agency. The active retired
dental license does not restrict the licensee to
volunteer services, but limits any income from the
practice of dentistry to less than the amount that would
make the licensee ineligible for full social security
benefits.
There are currently 1,754 active retired dentist
licensees in California.
3)Author's statement . According to the author, "California has
one of the highest CE requirements of any state and adjusting
the CE units for retired dentists - from 50 CE units to 30 CE
units for a two-year licensure renewal cycle would bring
California's requirement for retired volunteer dentists in
line with the requirement for actively practicing dentists in
half of the other states.
"As dentists retire, it will be critical for California to
leverage their wealth of experience and keen technical
abilities to provide care to currently un- or underserved
populations."
4)Access to dental care in California . Access to dental care is
limited for many Californians. Denti-Cal, Medi-Cal's
fee-for-service dental program, was the primary public
financer of dental care for more than eight million
low-income, elderly, and disabled Californians in 2007. In
2009, most of the Medi-Cal adult dental benefits were
eliminated due to the state's budget deficit. Children's
services, as required by federal law, continue to be
delivered. However, California also cut $3 million from school
programs that provided oral care preventive services such as
fluoride rinses and sealants for low-income children. CDA
estimates that upwards of 10 million Californians experience
barriers to dental care.
5)Free dental care opportunities . Community-wide free healthcare
events have increased in frequency in recent years in response
to greater need.
CDA sponsored two such events in May and August 2012 in
Modesto and Sacramento, respectively, for dental care that
served over 3,600 people with the assistance of over 1,300
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volunteers. Remote Area Medical, also volunteer-based,
provided 19,500 California patients with nearly 46,000 vision,
dental, and medical services from 2009 to 2011. According to
CDA, demand for health services usually exceeds the capacity
of these events.
6)Continuing education . Continuing education is intended to
ensure dentists remain current in the practice of dentistry
throughout their careers. Many CE classes focus on discrete
subjects or recent developments in dental specialties.
However, in most volunteer situations, dentists provide basic
care: fillings, extractions, dental sealants, stainless steel
crowns, etc. This diminishes their need for ongoing education
in the use of advanced techniques and new technologies.
Current law requires active retired dental licensees to
complete the same amount of CEs as active dentists: 50 hours.
Each renewal cycle also requires dentists to complete two
hours each of coursework in infection control and the
California Dental Practice Act, and a maximum of four hours in
Basic Life Support. These special requirements would remain
in place for retired active dentists.
States nationwide require between 25 and 50 hours per two-year
renewal cycle, with a median of 40. According to information
provided by the author's office, only four other states,
Virginia, Maryland, Missouri, and Kansas, have no or reduced
CE units for volunteer dentists.
CEs range in cost per hour from zero to hundreds of dollars,
so a reduction in hour requirements may also reduce the
financial cost of active retired license renewal.
7)Questions for the Committee . Current law does not place any
practice restrictions on an active retired licensee. However,
an active retired licensee may not receive more payment from
practice than would make him or her ineligible for full social
security benefits. To ensure that the reduced CE requirement
aligns with the bill's intent incentivize volunteer work, the
Committee may wish to consider whether or not the retired
active license should be explicitly restricted to volunteer
practice only.
At least 10 other DCA boards issue retired licenses, but all
except the Board of Optometry prohibit a retired licensee from
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practicing. The Board of Optometry issues a license with a
"retired volunteer" service designation which permits a
licensee who is otherwise eligible for an active license to
pay a reduced renewal fee ($50 versus $425 for active
licensees) as long as they certify that the sole purpose of
the retired volunteer license is to perform voluntary, unpaid
services. This license designation requires full CE
compliance (40 hours).
8)Suggested committee amendment . The Committee and author may
wish to consider including a five-year sunset date on the
reduction of CE requirements for active retired dentists in
order to see if the reduction succeeds in attracting more
dental volunteers.
On page 2, line 29, after (b), insert "This subsection shall
become inactive on January 1, 2019."
9)Previous Legislation . AB 1428 (Aanestad), Chapter 507,
Statutes of 2001. This bill permits the Board to grant a
license to practice dentistry to applicants licensed to
practice dentistry in another state for at least five years
without taking the licensure examination.
AB 2821 (Knight), Chapter 400, Statutes of 1994. This bill
authorizes the Board to require licensees to complete a
portion of the required continuing education by taking a
certain number of hours of coursework in specific areas
adopted in regulations by the Board.
REGISTERED SUPPORT / OPPOSITION :
Support
California Dental Association (sponsor)
California Society of Pediatric Dentistry
Opposition
None
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301
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