BILL NUMBER: AB 1174 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 2, 2014
AMENDED IN SENATE MAY 21, 2014
AMENDED IN ASSEMBLY JANUARY 6, 2014
AMENDED IN ASSEMBLY APRIL 9, 2013
AMENDED IN ASSEMBLY MARCH 21, 2013
INTRODUCED BY Assembly Members Bocanegra and Logue
FEBRUARY 22, 2013
An act to amend Sections 1684.5 and 1926
1944 of, to add Section 1926.05 to, and to add,
repeal, and add Sections 1753.55 , and
1910.5 , and 1926.05 of, the Business and
Professions Code, and to add and repeal Section 128196 of the Health
and Safety Code, and to amend Section 14132.725 of the Welfare and
Institutions Code, relating to oral health.
LEGISLATIVE COUNSEL'S DIGEST
AB 1174, as amended, Bocanegra. Dental professionals.
(1) Under existing law, the Dental Practice Act, the Dental Board
of California licenses and regulates dentists. Existing law creates,
within the jurisdiction of the board, a Dental Assisting Council that
is responsible for the regulation of dental assistants, registered
dental assistants, and registered dental assistants in extended
functions and a Dental Hygiene Committee of California, that is
responsible for the regulation of registered dental hygienists,
registered dental hygienists in alternative practice, and registered
dental hygienists in extended functions. Existing law governs the
scope of practice for those professionals, and authorizes a dentist
to require or permit one of those professionals, referred to as a
dental auxiliary, to perform specified duties, including exposing
emergency radiographs upon the direction of the dentist, prior to the
dentist examining the patient.
This bill would add to those specified duties determining
and performing exposing radiographs, as
specified, make a dentist responsible to provide a patient or the
patient's representative written notice including specified contact
information and disclosing that the care was provided at the
direction of that authorizing dentist, and would prohibit a dentist
from concurrently supervising more than a total of 5
dental auxiliaries, as specified. The bill would authorize specified
registered dental assistants in extended functions, registered dental
hygienists, and registered dental hygienists in alternative practice
to determine which radiographs to perform and to place protective
restorations, as specified. The bill would require the board to
promulgate related regulations, and would also require the committee
to review proposed regulations and submit any recommended changes to
the board for review to establish a consensus.
(2) Existing law requires the committee to establish by resolution
the amount of the fees that relate to the licensing of a registered
dental hygienist, registered dental hygienist in alternative
practice, and registered dental hygienist in extended functions.
Existing law limits the fee for each review of courses required for
licensure that are not accredited to $300. Under existing law, those
fees are further limited to the reasonable regulatory cost incurred
by the committee.
This bill would instead limit the fee for each review or approval
of course requirements for licensure or procedures that require
additional training that are not accredited to $750.
(2)
( 3) Existing law provides for the Medi-Cal
program, which is administered by the State Department of Health Care
Services, under which qualified low-income individuals receive
health care services, including certain dental services, as
specified. Existing law provides that, to the extent that federal
financial participation is available, face-to-face contact between a
health care provider and a patient is not required under the Medi-Cal
program for "teleophthalmology and teledermatology by store and
forward," as defined to mean the asynchronous transmission of medical
information to be reviewed at a later time by a licensed physician
or optometrist, as specified, at a distant site.
This bill would additionally provide that face-to-face contact
between a health care provider and a patient is not required under
the Medi-Cal program for teledentistry by store and forward, as
defined.
(3)
( 4) Existing law authorizes the Office of
Statewide Health Planning and Development to approve Health Workforce
Pilot Projects (HWPP), as defined. The office has approved operation
HWPP 172, relating to dental workforce, through December 15, 2014.
This bill would extend the operation of HWPP through January 1,
2016. The bill would also delete redundant provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1684.5 of the Business and Professions Code is
amended to read:
1684.5. (a) In addition to other acts constituting unprofessional
conduct under this chapter, it is unprofessional conduct for any
dentist to perform or allow to be performed any treatment on a
patient who is not a patient of record of that dentist. A dentist
may, however, after conducting a preliminary oral examination,
require or permit any dental auxiliary to perform procedures
necessary for diagnostic purposes, provided that the procedures are
permitted under the auxiliary's authorized scope of practice.
Additionally, a dentist may require or permit a dental auxiliary to
perform all of the following duties prior to any examination of the
patient by the dentist, provided that the duties are authorized for
the particular classification of dental auxiliary pursuant to Article
7 (commencing with Section 1740):
(1) Determine and perform Expose
emergency radiographs upon direction of the dentist.
(2) Determine If the dental auxiliary is a
registered dental assistant in extended functions, a registered
dental hygienist, or a registered dental hygienist in alternative
practice, determine and perform radiographs for the specific
purpose of aiding a dentist in completing a comprehensive diagnosis
and treatment plan for a patient using telehealth, as defined by
Section 2290.5, for the purpose of communication with the
supervising dentist pursuant to Sections 1753.55, 1910.5, and
1926.05.
(3) Perform extra-oral duties or functions specified by the
dentist.
(4) Perform mouth-mirror inspections of the oral cavity, to
include charting of obvious lesions, malocclusions, existing
restorations, and missing teeth.
(b) For purposes of this section, "patient of record" refers to a
patient who has been examined, has had a medical and dental history
completed and evaluated, and has had oral conditions diagnosed and a
written plan developed by the licensed dentist.
(c) For purposes of this section, if dental treatment is provided
to a patient by a dental auxiliary registered
dental assistant in extended functions, a registered dental
hygienist, or a registered dental hygienist in alternative practice
pursuant to the diagnosis and treatment plan authorized by a
supervising dentist, the supervising dentist shall ensure
at a location other than the dentist's practice
location, it is the responsibility of the authorizing dentist
that the patient or the patient's representative is notified
in writing of the supervising receive written
notification that the care was provided at the direction of the
authorizing dentist and that the notification include the authorizing
dentist's name, practice location address, and
telephone number, and email address, and that the care was
provided at the direction of the dentist. number. This
provision shall not require patient notification for dental hygiene
preventive services provided in public health programs as specified
and authorized in Section 1911, or for dental hygiene care when
provided as specified a nd authorized in Section 1926.
(d) A dentist shall not concurrently supervise more than a
total of five dental auxiliaries
registered dental assistants in extended functions,
registered dental hygienists, or registered dental
hygienists in alternative practice providing services pursuant
to Sections 1753.55, 1910.5, and 1926.05.
(e) This section shall not apply to dentists providing
examinations on a temporary basis outside of a dental office in
settings including, but not limited to, health fairs and school
screenings.
(f) This section shall not apply to fluoride mouth rinse or
supplement programs administered in a school or preschool setting.
SEC. 2. Section 1753.55 is added to the Business and Professions
Code, to read:
1753.55. (a) In addition to the duties specified in Sections
1753.5 and 1753.6, a registered dental assistant in extended
functions licensed on or after January 1, 2010, or having completed
the educational requirements to perform the duties authorized by
Section 1753.5, is authorized to perform both of the following
additional duties pursuant to the order, control, and full
professional responsibility of a supervising dentist:
(1) Determine which radiographs to perform on a patient who has
not received an initial examination by the supervising dentist for
the specific purpose of the dentist making a diagnosis and treatment
plan for the patient. In these circumstances, the dental assistant in
extended functions shall follow protocols established by the
supervising dentist. This paragraph only applies in the following
settings:
(A) In a dental office setting, under the direct or
general supervision of a dentist as determined by the dentist.
setting.
(B) In public health settings, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions community clinics ,
under the general supervision of a dentist.
(2) Place protective restorations, which for this purpose are
identified as interim therapeutic restorations, and defined as a
direct provisional restoration placed to stabilize the tooth until a
licensed dentist diagnoses the need for further definitive treatment.
An interim therapeutic restoration consists of the removal of soft
material from the tooth using only hand instrumentation, without the
use of rotary instrumentation, and subsequent placement of an
adhesive restorative material. Local anesthesia shall not be
necessary for interim therapeutic restoration placement. Interim
therapeutic restorations shall be placed only in accordance with both
of the following:
(A) In either of the following settings:
(i) In a dental office setting, under the direct or general
supervision of a dentist as determined by the dentist.
(ii) In public health settings, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions, community clinics,
under the general supervision of a dentist.
(B) After a diagnosis and treatment plan by a dentist.
(b) The functions described in subdivision (a) may be performed by
a registered dental assistant in extended functions only after
completion of a program that includes training in performing those
functions, or after providing evidence, satisfactory to the board, of
having completed a board-approved course in those functions.
(1) No later than January 1, 2018, the board shall promulgate
regulations establishing requirements for courses of instruction for
the procedures authorized to be performed by a registered dental
assistant in extended functions pursuant to this section.
(1) No later than January 1, 2018, the board shall promulgate
regulations to establish requirements for courses of instruction for
the procedures authorized to be performed by a registered dental
assistant in extended functions pursuant to this section, using the
competency-based training protocols established by the Health
Workforce Pilot Project (HWPP) No. 172 through the Office of Health
Planning and Development. The board shall submit regulatory language
pursuant to approval of courses of instruction for the Interim
Therapeutic Restoration to the committee for the purpose of
promulgating regulations for Registered Dental Hygienists and
Registered Dental Hygienists in Alternative Practice as described in
Section 1910.5. The language submitted by the board shall mirror the
instructional requirements for the registered dental assistant in
extended functions. Any subsequent amendments to the regulations that
are promulgated by the board for the Interim Therapeutic Restoration
course curriculum shall be submitted to the committee.
(2) Prior to January 1, 2018, the board shall use the
competency-based training protocols established by Health Workforce
Pilot Project (HWPP) No. 172 through the Office of Statewide Health
Planning and Development to approve courses of instruction for
the procedures authorized in this section .
(3) A registered dental assistant in extended functions who has
completed the prescribed training in the Health Workforce Pilot
Project No. 172 established by the Office of Statewide Health
Planning and Development pursuant to Article 1 (commencing with
Section 128125) of Chapter 3 of Part 3 of Division 107 of the Health
and Safety Code shall be deemed to have satisfied the requirement for
completion of a course of instruction approved by the board.
(4) In addition to the instructional components described in this
subdivision, a program shall contain both of the instructional
components described in this paragraph:
(A) The course shall be established at the postsecondary
educational level.
(B) All faculty responsible for clinical evaluation shall have
completed a one-hour methodology course in clinical evaluation or
have a faculty appointment at an accredited dental education program
prior to conducting evaluations of students.
(c) The board may issue a permit to a registered dental assistant
in extended functions who files a completed application, including
the fee, to provide the duties specified in this section after the
board has determined the registered dental assistant in extended
functions has completed the coursework required in subdivision (b).
(c)
( d) This section shall remain in effect
only until January 1, 2018, and as of that date is repealed, unless a
later enacted statute, that is enacted before January 1, 2018,
deletes or extends that date.
SEC. 3. Section 1753.55 is added to the Business and Professions
Code, to read:
1753.55. (a) In addition to the duties specified in Section
1753.5, a registered dental assistant in extended functions licensed
on or after January 1, 2010, or having completed the educational
requirements to perform the duties authorized by Section 1753.5
and 1753.6 , is authorized to perform both of the following
additional duties pursuant to the order, control, and full
professional responsibility of a supervising dentist:
(1) Determine which radiographs to perform on a patient who has
not received an initial examination by the supervising dentist for
the specific purpose of the dentist making a diagnosis and treatment
plan for the patient. In these circumstances, the dental assistant in
extended functions shall follow protocols established by the
supervising dentist. This paragraph only applies in the following
settings:
(A) In a dental office setting, under the direct or
general supervision of a dentist as determined by the dentist.
setting.
(B) In public health settings, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions, community clinics,
under the general supervision of a dentist.
(2) Place protective restorations, which for this purpose are
identified as interim therapeutic restorations, and defined as a
direct provisional restoration placed to stabilize the tooth until a
licensed dentist diagnoses the need for further definitive treatment.
An interim therapeutic restoration consists of the removal of soft
material from the tooth using only hand instrumentation, without the
use of rotary instrumentation, and subsequent placement of an
adhesive restorative material. Local anesthesia shall not be
necessary for interim therapeutic restoration placement. Interim
therapeutic restorations shall be placed only in accordance with both
of the following:
(A) In either of the following settings:
(i) In a dental office setting, under the direct or general
supervision of a dentist as determined by the dentist.
(ii) In public health settings, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions community clinics ,
under the general supervision of a dentist.
(B) After a diagnosis and treatment plan by a dentist.
(b) The functions described in subdivision (a) may be performed by
a registered dental assistant in extended functions only after
completion of a program that includes training in performing those
functions, or after providing evidence, satisfactory to the board, of
having completed a board-approved course in those functions.
(c) The board shall promulgate regulations establishing criteria
for approval of courses of instruction for the procedures authorized
to be performed by a registered dental assistant in extended
functions pursuant to this section. The committee shall review
proposed regulations, and any subsequent proposed amendments to the
promulgated regulations, and shall submit any recommended changes to
the board for review to establish a consensus.
(c) No later than January 1, 2018, the board shall promulgate
regulations to establish requirements for courses of instruction for
the procedures authorized to be performed by a registered dental
assistant in extended functions pursuant to this section using the
competency-based training protocols established by the Health
Workforce Pilot Project (HWPP) No. 172 through the Office of Health
Planning and Development. The board shall submit regulatory language
pursuant to approval of courses of instruction for the Interim
Therapeutic Restoration to the committee for the purpose of
promulgating regulations for registered dental hygienists and
registered dental hygienists in alternative practice as described in
Section 1910.5. The language submitted by the board shall mirror the
instructional requirements for the registered dental assistant in
extended functions. Any subsequent amendments to the regulations that
are promulgated by the board for the Interim Therapeutic Restoration
course curriculum shall be submitted to the committee.
(d) The board may issue a permit to a registered dental assistant
in extended functions who files a completed application, including
the fee, to provide the duties specified in this section after the
board has determined the registered dental assistant in extended
functions has completed the coursework required in subdivision (b).
(d)
( e) This section shall become operative on
January 1, 2018.
SEC. 4. Section 1910.5 is added to the Business and Professions
Code, to read:
1910.5. (a) In addition to the duties specified in Section 1910,
a registered dental hygienist is authorized to perform the following
additional duties, as specified:
(1) Determine which radiographs to perform on a patient who has
not received an initial examination by the supervising dentist for
the specific purpose of the dentist making a diagnosis and treatment
plan for the patient. In these circumstances, the dental hygienist
shall follow protocols established by the supervising dentist. This
paragraph shall only apply in the following settings:
(A) In a dental office setting, under the general
supervision of a dentist. setting.
(B) In a public health setting, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist community clinics .
(2) Place protective restorations, which for this purpose are
identified as interim therapeutic restorations, and defined as a
direct provisional restoration placed to stabilize the tooth until a
licensed dentist diagnoses the need for further definitive treatment.
An interim therapeutic restoration consists of the removal of soft
material from the tooth using only hand instrumentation, without the
use of rotary instrumentation, and subsequent placement of an
adhesive restorative material. Local anesthesia shall not be
necessary for interim therapeutic restoration placement. Interim
therapeutic restorations shall be placed only in accordance with both
of the following:
(A) In either of the following settings:
(i) In a dental office setting, under the general
supervision of a dentist. setting.
(ii) In a public health setting, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist community clinics .
(B) After a diagnosis and treatment plan by a dentist.
(b) The functions described in subdivision (a) may be performed by
a registered dental hygienist only after completion of a program
that includes training in performing those functions, or after
providing evidence, satisfactory to the committee, of having
completed a committee-approved course in those functions.
(1) No later than January 1, 2018, the dental board shall
promulgate regulations establishing criteria for approval of courses
of instruction for the procedures authorized to be performed by a
registered dental hygienist pursuant to this section. Proposed
regulations, and any subsequent proposed amendments to the
promulgated regulations, shall be reviewed by the committee. The
committee shall submit any recommended changes to the board for
review to establish a consensus.
(c) (1) No later than January 1, 2018, the committee shall
promulgate regulations to establish requirements for courses of
instruction for the procedures authorized to be performed by a
registered dental hygienist and registered dental hygienist in
alternative practice pursuant to Sections 1910.5 and 1926.05 using
the competency-based training protocols established by the Health
Workforce Pilot Project (HWPP) No. 172 through the Office of Health
Planning and Development. The committee shall adopt the regulatory
language for approval of courses of instruction for the Interim
Therapeutic Restoration submitted by the dental board, pursuant to
Section 1753.55 in the regulations. Any subsequent amendments to the
regulations for the Interim Therapeutic Restoration course curriculum
that are promulgated by the committee shall be agreed upon by the
board and the committee.
(2) Prior to January 1, 2018, the dental board
committee shall use the competency-based training
protocols established by Health Workforce Pilot Project (HWPP) No.
172 through the Office of Statewide Health Planning and Development
to approve courses of instruction for the procedures authorized
in this section .
(3) A registered dental hygienist who has completed the prescribed
training in the Health Workforce Pilot Project No. 172 established
by the Office of Statewide Health Planning and Development pursuant
to Article 1 (commencing with Section 128125) of Chapter 3 of Part 3
of Division 107 of the Health and Safety Code shall be deemed to have
satisfied the requirement for completion of a course of instruction
approved by the committee.
(4) In addition to the instructional components described in
subdivision (d) or (e), a program shall contain both of the
instructional components described in this paragraph:
(A) The course shall be established at the postsecondary
educational level.
(B) All faculty responsible for clinical evaluation shall have
completed a one-hour methodology course in clinical evaluation or
have a faculty appointment at an accredited dental education program
prior to conducting evaluations of students.
(c)
( d) This section shall remain in effect
only until January 1, 2018, and as of that date is repealed, unless a
later enacted statute, that is enacted before January 1, 2018,
deletes or extends that date.
SEC. 5. Section 1910.5 is added to the Business and Professions
Code, to read:
1910.5. (a) In addition to the duties specified in Section 1910,
a registered dental hygienist is authorized to perform the following
additional duties, as specified:
(1) Determine which radiographs to perform on a patient who has
not received an initial examination by the supervising dentist for
the specific purpose of the dentist making a diagnosis and treatment
plan for the patient. In these circumstances, the dental hygienist
shall follow protocols established by the supervising dentist. This
paragraph only applies in the following settings:
(A) In a dental office setting, under the general
supervision of a dentist. setting.
(B) In a public health setting, using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist, including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist community clinics .
(2) Place protective restorations, which for this purpose are
identified as interim therapeutic restorations, and defined as a
direct provisional restoration placed to stabilize the tooth until a
licensed dentist diagnoses the need for further definitive treatment.
An interim therapeutic restoration consists of the removal of soft
material from the tooth using only hand instrumentation, without the
use of rotary instrumentation, and subsequent placement of an
adhesive restorative material. Local anesthesia shall not be
necessary for interim therapeutic restoration placement. Interim
therapeutic restorations shall be placed only in accordance with both
of the following:
(A) In either of the following settings:
(i) In a dental office setting, under the general
supervision of a dentist. setting.
(ii) In a public health setting using telehealth, as defined
by Section 2290.5, for the purpose of communication with the
supervising dentist , including, but not limited to, schools,
head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist community clinics .
(B) After a diagnosis and treatment plan by a dentist.
(b) The functions described in subdivision (a) may be performed by
a registered dental hygienist only after completion of a program
that includes training in performing those functions, or after
providing evidence, satisfactory to the committee, of having
completed a committee-approved course in those functions.
(c) The dental board shall promulgate regulations establishing
criteria for approval of courses of instruction for the procedures
authorized to be performed by a registered dental hygienist pursuant
to this section. The committee shall review proposed regulations, and
any subsequent proposed amendments to the promulgated regulations,
and shall submit any recommended changes to the board for review to
establish a consensus.
(c) No later than January 1, 2018, the committee shall promulgate
regulations to establish requirements for courses of instruction for
the procedures authorized to be performed by a registered dental
hygienist and registered dental hygienist in alternative practice
pursuant to Sections 1910.5 and 1926.05, using the competency-based
training protocols established by the Health Workforce Pilot Project
(HWPP) No. 172 through the Office of Health Planning and Development.
The committee shall adopt the regulatory language for approval of
courses of instruction for the Interim Therapeutic Restoration
submitted by the dental board, pursuant to Section 1753.55 in the
regulations. Any subsequent amendments to the regulations for the
Interim Therapeutic Restoration course curriculum that are
promulgated by the committee shall be agreed upon by the board and
the committee.
(d) This section shall become operative on January 1, 2018.
SEC. 6. Section 1926 of the Business and
Professions Code is amended to read:
1926. A registered dental hygienist in alternative practice may
perform the duties authorized pursuant to subdivision (a) of Section
1907, subdivision (a) of Section 1908, subdivisions (a) and (b) of
Section 1910, and Section 1926.05 in the following settings:
(a) Residences of the homebound.
(b) Schools.
(c) Residential facilities and other institutions.
(d) Dental health professional shortage areas, as certified by the
Office of Statewide Health Planning and Development in accordance
with existing office guidelines.
SEC. 7. SEC. 6. Section 1926.05 is
added to the Business and Professions Code, to read:
1926.05. (a) In addition to
the duties specified in Section 1926, a registered dental hygienist
in alternative practice is authorized to perform the
following additional duties , as
specified in Section 1910.5 upon completion of the courses
required in that section, in the following settings :
(1) Determine which radiographs to perform on a patient who has
not received an initial examination by the supervising dentist for
the specific purpose of the dentist making a diagnosis and treatment
plan for the patient. In
these circumstances, the dental hygienist in alternative practice
shall follow protocols established by the supervising dentist. This
paragraph only applies in the following settings:
(A) In a dental office setting, under the general supervision of a
dentist.
(B) In a public health setting, including, but not limited to,
schools, head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist.
(2) Place protective restorations, which for this purpose are
identified as interim therapeutic restorations, and defined as a
direct provisional restoration placed to stabilize the tooth until a
licensed dentist diagnoses the need for further definitive treatment.
An interim therapeutic restoration consists of the removal of soft
material from the tooth using only hand instrumentation, without the
use of rotary instrumentation, and subsequent placement of an
adhesive restorative material. Local anesthesia shall not be
necessary for interim therapeutic restoration placement. Interim
therapeutic restorations shall be placed only in accordance with both
of the following:
(A) In either of the following settings:
(i) In a dental office setting, under the general supervision of a
dentist.
(ii) In a public health setting, including, but not limited to,
schools, head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist.
(B) After a diagnosis and treatment plan by a dentist.
(b) The functions described in subdivision (a) may be performed by
a registered dental hygienist in alternative practice only after
completion of a course or program that includes training in
performing those functions, or after providing evidence, satisfactory
to the committee, of having completed a committee-approved course in
those functions.
(1) No later than January 1, 2018, the dental board shall
promulgate regulations establishing criteria for the approval of
courses of instruction for the procedures authorized to be performed
by a registered dental hygienist in alternative practice pursuant to
this section. Proposed regulations, and any subsequent proposed
amendments to the promulgated regulations, shall be reviewed by the
committee. The committee shall submit any recommended changes to the
board for review to establish a consensus.
(2) Prior to January 1, 2018, the dental board shall use the
competency-based training protocols established by Health Workforce
Pilot Project (HWPP) No. 172 through the Office of Statewide Health
Planning and Development.
(3) A registered dental hygienist in alternative practice who has
completed the prescribed training in the Health Workforce Pilot
Project No. 172 established by the Office of Statewide Health
Planning and Development pursuant to Article 1 (commencing with
Section 128125) of Chapter 3 of Part 3 of Division 107 of the Health
and Safety Code shall be deemed to have satisfied the requirement for
completion of a course of instruction approved by the committee.
(4) In addition to the instructional components described in this
subdivision, a program shall contain both of the instructional
components described in this paragraph:
(A) The course shall be established at the postsecondary
educational level.
(B) All faculty responsible for clinical evaluation shall have
completed a one-hour methodology course in clinical evaluation or
have a faculty appointment at an accredited dental education program
prior to conducting evaluations of students.
(c) This section shall remain in effect only until January 1,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2018, deletes or extends
that date.
(a) Residences of the homebound.
(b) Schools.
(c) Residential facilities and other institutions.
SEC. 8. Section 1926.05 is added to the
Business and Professions Code, to read:
1926.05. (a) In addition to the duties specified in Section 1926,
a registered dental hygienist in alternative practice is authorized
to perform the following additional duties, as specified:
(1) Determine which radiographs to perform on a patient who has
not received an initial examination by the supervising dentist for
the specific purpose of the dentist making a diagnosis and treatment
plan for the patient. In these circumstances, the dental hygienist in
alternative practice shall follow protocols established by the
supervising dentist. This paragraph only applies in the following
settings:
(A) In a dental office setting, under the general supervision of a
dentist.
(B) In a public health setting, including, but not limited to,
schools, head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist.
(2) Place protective restorations, which for this purpose are
identified as interim therapeutic restorations, and defined as a
direct provisional restoration placed to stabilize the tooth until a
licensed dentist diagnoses the need for further definitive treatment.
An interim therapeutic restoration consists of the removal of soft
material from the tooth using only hand instrumentation, without the
use of rotary instrumentation, and subsequent placement of an
adhesive restorative material. Local anesthesia shall not be
necessary for interim therapeutic restoration placement. Interim
therapeutic restorations shall be placed only in accordance with both
of the following:
(A) In either of the following settings:
(i) In a dental office setting, under the general supervision of a
dentist.
(ii) In a public health setting, including, but not limited to,
schools, head start and preschool programs, and residential
facilities and institutions, under the general supervision of a
dentist.
(B) After a diagnosis and treatment plan by a dentist.
(b) The functions described in this section may be performed by a
registered dental hygienist in alternative practice only after
completion of a course or program that includes training in
performing those functions, or after providing evidence, satisfactory
to the committee, of having completed a committee-approved course in
those functions.
(c) The dental board shall promulgate regulations establishing
criteria for approval of courses of instruction for the procedures
authorized to be performed by a registered dental hygienist in
alternative practice pursuant to this section. The committee shall
review proposed regulations, and any subsequent proposed amendments
to the promulgated regulations, and shall submit any recommended
changes to the board for review to establish a consensus.
(d) This section shall become operative on January 1, 2018.
SEC. 7. Section 1944 of the Business
and Professions Code is amended to read:
1944. (a) The committee shall establish by resolution the amount
of the fees that relate to the licensing of a registered dental
hygienist, a registered dental hygienist in alternative practice, and
a registered dental hygienist in extended functions. The fees
established by board resolution in effect on June 30, 2009, as they
relate to the licensure of registered dental hygienists, registered
dental hygienists in alternative practice, and registered dental
hygienists in extended functions, shall remain in effect until
modified by the committee. The fees are subject to the following
limitations:
(1) The application fee for an original license and the fee for
issuance of an original license shall not exceed two hundred fifty
dollars ($250).
(2) The fee for examination for licensure as a registered dental
hygienist shall not exceed the actual cost of the examination.
(3) For third- and fourth-year dental students, the fee for
examination for licensure as a registered dental hygienist shall not
exceed the actual cost of the examination.
(4) The fee for examination for licensure as a registered dental
hygienist in extended functions shall not exceed the actual cost of
the examination.
(5) The fee for examination for licensure as a registered dental
hygienist in alternative practice shall not exceed the actual cost of
administering the examination.
(6) The biennial renewal fee shall not exceed one hundred sixty
dollars ($160).
(7) The delinquency fee shall not exceed one-half of the renewal
fee. Any delinquent license may be restored only upon payment of all
fees, including the delinquency fee, and compliance with all other
applicable requirements of this article.
(8) The fee for issuance of a duplicate license to replace one
that is lost or destroyed, or in the event of a name change, shall
not exceed twenty-five dollars ($25) or one-half of the renewal fee,
whichever is greater.
(9) The fee for certification of licensure shall not exceed
one-half of the renewal fee.
(10) The fee for each curriculum review and site evaluation for
educational programs for dental hygienists who are not accredited by
a committee-approved agency shall not exceed two thousand one hundred
dollars ($2,100).
(11) The fee for each review of courses required for licensure
that are not accredited by a committee-approved agency, the Council
for Private Postsecondary and Vocational Education, or the Chancellor'
s Office of the California Community Colleges shall not exceed three
hundred dollars ($300).
(11) The fee for each review or approval of course requirements
for licensure or procedures that require additional training that are
not accredited by a committee-approved agency shall not exceed seven
hundred fifty dollars ($750).
(12) The initial application and biennial fee for a provider of
continuing education shall not exceed five hundred dollars ($500).
(13) The amount of fees payable in connection with permits issued
under Section 1962 is as follows:
(A) The initial permit fee is an amount equal to the renewal fee
for the applicant's license to practice dental hygiene in effect on
the last regular renewal date before the date on which the permit is
issued.
(B) If the permit will expire less than one year after its
issuance, then the initial permit fee is an amount equal to 50
percent of the renewal fee in effect on the last regular renewal date
before the date on which the permit is issued.
(b) The renewal and delinquency fees shall be fixed by the
committee by resolution at not more than the current amount of the
renewal fee for a license to practice under this article nor less
than five dollars ($5).
(c) Fees fixed by the committee by resolution pursuant to this
section shall not be subject to the approval of the Office of
Administrative Law.
(d) Fees collected pursuant to this section shall be collected by
the committee and deposited into the State Dental Hygiene Fund, which
is hereby created. All money in this fund shall, upon appropriation
by the Legislature in the annual Budget Act, be used to implement the
provisions of this article.
(e) No fees or charges other than those listed in this section
shall be levied by the committee in connection with the licensure of
registered dental hygienists, registered dental hygienists in
alternative practice, or registered dental hygienists in extended
functions.
(f) The fee for registration of an extramural dental facility
shall not exceed two hundred fifty dollars ($250).
(g) The fee for registration of a mobile dental hygiene unit shall
not exceed one hundred fifty dollars ($150).
(h) The biennial renewal fee for a mobile dental hygiene unit
shall not exceed two hundred fifty dollars ($250).
(i) The fee for an additional office permit shall not exceed two
hundred fifty dollars ($250).
(j) The biennial renewal fee for an additional office as described
in Section 1926.4 shall not exceed two hundred fifty dollars ($250).
(k) The initial application and biennial special permit fee is an
amount equal to the biennial renewal fee specified in paragraph (6)
of subdivision (a).
(l) The fees in this section shall not exceed an amount sufficient
to cover the reasonable regulatory cost of carrying out the
provisions of this article.
SEC. 9. SEC. 8. Section 128196 is
added to the Health and Safety Code, to read:
128196. (a) Notwithstanding Section 128180, the office shall
extend the duration of the health workforce project known as Health
Workforce Pilot Project No. 172 until January 1, 2016, in order to
maintain the competence of the clinicians trained during the course
of the project, and to authorize training of additional clinicians in
the duties specified in HWPP No. 172.
(b) This section shall remain in effect only until January 1,
2016, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2016, deletes or extends
that date.
SEC. 10. SEC. 9. Section 14132.725 of
the Welfare and Institutions Code is amended to read:
14132.725. (a) To the extent that federal financial participation
is available, face-to-face contact between a health care provider
and a patient is not required under the Medi-Cal program for
teleophthalmology, teledermatology, and teledentistry by store and
forward. Services appropriately provided through the store and
forward process are subject to billing and reimbursement policies
developed by the department.
(b) For purposes of this section, "teleophthalmology,
teledermatology, and teledentistry by store and forward" means an
asynchronous transmission of medical or dental information to be
reviewed at a later time by a physician at a distant site who is
trained in ophthalmology or dermatology or, for teleophthalmology, by
an optometrist who is licensed pursuant to Chapter 7 (commencing
with Section 3000) of Division 2 of the Business and Professions
Code, or a dentist, where the physician, optometrist, or dentist at
the distant site reviews the medical or dental information without
the patient being present in real time. A patient receiving
teleophthalmology, teledermatology, or teledentistry by store and
forward shall be notified of the right to receive interactive
communication with the distant specialist physician, optometrist, or
dentist and shall receive an interactive communication with the
distant specialist physician, optometrist, or dentist, upon request.
If requested, communication with the distant specialist physician,
optometrist, or dentist may occur either at the time of the
consultation, or within 30 days of the patient's notification of the
results of the consultation. If the reviewing optometrist identifies
a disease or condition requiring consultation or referral pursuant to
Section 3041 of the Business and Professions Code, that consultation
or referral shall be with an ophthalmologist or other appropriate
physician and surgeon, as required.
(c) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, and make specific this section
by means of all-county letters, provider bulletins, and similar
instructions.