Amended in Senate August 22, 2014

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

California Legislature—2013–14 Regular Session

Assembly Bill No. 1174

Introduced by Assembly Members Bocanegra and Logue

February 22, 2013

An act to amend Sections begin delete 1684.5 end delete begin insert 1684.5, 1925, end insert and 1944 of, to add Section 1926.05 to, and to add, repeal, and add Sections 1753.55 and 1910.5 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 exposing radiographs, as specified, make a dentist responsible to provide a patient or the patient’s representative written notice begin insert , end insert 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 begin delete promulgate end delete begin insert adopt end insert 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 begin delete that are not accredited end delete to $750.

(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.

(4) Existing law authorizes the Office of Statewide Health Planning and Development to approve Health Workforce Pilot Projects (HWPP) begin insert No. 172 end insert , as defined. The office has approved operation HWPP begin insert No. end insert 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 begin insert , and would make conforming changes end insert .

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) Expose emergency radiographs upon direction of the dentist.

(2) 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. begin insert A dentist is not required
to review patient records or make a diagnosis using telehealth. end insert

(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 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, 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 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.
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 and authorized in Section 1926.

(d) A dentist shall not concurrently supervise more than a total
of five 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)  begin delete In addition to the duties specified in Sections
1753.5 and 1753.6, a end delete begin insert A end insert registered dental assistant in extended
functions begin delete licensed on or after January 1, 2010, or having completed
the educational requirements to perform the duties authorized by
Section 1753.5, end delete is authorized to perform begin delete both of the following end delete
additional duties begin insert as set forth in subdivision (b) end insert pursuant to the
order, control, and full professional responsibility of a supervising
begin delete dentist: end delete begin insert dentist if the licensee meets one the following requirements: end insert

begin insert

(1) Is licensed on or after January 1, 2010.

end insert begin insert

(2) Is licensed prior to January 1, 2010, has successfully
completed a board-approved course in the additional procedures
specified in paragraphs (1), (2), (5), and (7) to (11), inclusive, of
subdivision (b) of Section 1753.5, and passed the examination as
specified in Section 1753.4.

end insert begin delete

(1)

end delete

begin insert (b) end insert begin insert   end insert begin insert (1) end insert  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.

(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 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 community clinics, under the
general supervision of a dentist.

(B) After begin delete a diagnosis and treatment plan end delete begin insert the diagnosis, treatment
plan, and instruction to perform the procedure provided end insert by a
dentist.

begin delete

(b)

end delete

begin insert ( end insert begin insert c) end insert  The functions described in subdivision begin delete (a) end delete begin insert (b) end insert 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 begin delete promulgate end delete
begin insert adopt end insert 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 begin insert end insert begin insert to the committee proposed end insert regulatory language begin delete pursuant
to approval of courses of instruction end delete for the Interim Therapeutic
Restoration to the committee for the purpose of promulgating
regulations for begin delete Registered Dental Hygienists and Registered Dental
Hygienists in Alternative Practice end delete begin insert registered dental hygienists and
registered dental hygienists in alternative practice end insert as described in
Section 1910.5. The language submitted by the board begin insert to the
committee end insert shall mirror the begin delete instructional end delete begin insert curriculum end insert 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 begin delete course end delete
curriculum shall be submitted to the committee.

(2)  begin delete Prior to January 1, 2018, end delete begin insert Until the regulations adopted by
the board pursuant to paragraph (1) become effective, end insert the board
shall use the competency-based training protocols established by
begin delete Health Workforce Pilot Project (HWPP) end delete begin insert HWPP end insert 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 begin delete the Health Workforce Pilot
Project end delete begin insert HWPP end insert 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.

begin delete

(c)

end delete

begin insert (d) end insert  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 begin delete (b) end delete begin insert (c) end insert .

begin delete

(d)

end delete

begin insert ( end insert begin insert e) end insert  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)  begin delete In addition to the duties specified in Section
1753.5, a end delete begin insert A end insert registered dental assistant in extended functions
begin delete 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, end delete is authorized to perform begin delete both of end delete the
begin delete following end delete additional duties begin insert as set forth in subdivision (b) end insert pursuant
to the order, control, and full professional responsibility of a
supervising begin delete dentist: end delete begin insert dentist, if the licensee meets one of the
following requirements: end insert

begin insert

(1) Is licensed on or after January 1, 2010.

end insert begin insert

(2)  Is licensed prior to January 1, 2010, has successfully
completed a board-approved course in the additional procedures
specified in paragraphs (1), (2), (5), and (7) to (11), inclusive, of
subdivision (b) of Section 1753.5, and passed the examination as
specified in Section 1753.4.

end insert begin delete

(1)

end delete

begin insert (b) end insert   begin insert (1) end insert begin insert   end insert 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.

(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 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 community clinics, under the
general supervision of a dentist.

(B) After begin delete a diagnosis and end delete begin insert the diagnosis, end insert treatment begin delete plan end delete begin insert plan,
and instruction to perform the procedure provided end insert by a dentist.

begin delete

(b)

end delete

begin insert (c) end insert  The functions described in subdivision begin delete (a) end delete begin insert (b) end insert 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.

begin delete

(c)

end delete

begin insert (d) end insert  No later than January 1, 2018, the board shall begin delete promulgate end delete
begin insert adopt end insert 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 begin insert to the committee proposed end insert regulatory language begin delete pursuant
to approval of courses of instruction end delete for begin insert the curriculum for end insert 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 begin delete requirements end delete begin insert curriculum end insert 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 begin delete course end delete curriculum shall be submitted to
the committee.

begin delete

(d)

end delete

begin insert (e) end insert  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 begin delete (b). end delete begin insert (c). end insert

begin delete

(e)

end delete

begin insert (f) end insert  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.

(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 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.

(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 community clinics.

(B) After begin delete a diagnosis and end delete begin insert the diagnosis, end insert treatment begin delete plan end delete begin insert plan,
and instruction to perform the procedure provided end insert 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) (1) No later than January 1, 2018, the committee shall
begin delete promulgate end delete begin insert adopt end insert 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 begin delete adopt end delete begin insert use end insert
the begin insert curriculum submitted by the dental board, pursuant to Section
1753.55, to adopt end insert regulatory language for approval of courses of
instruction for the Interim Therapeutic begin delete Restoration submitted by
the dental board, pursuant to Section 1753.55 in the regulations. end delete
begin insert Restoration. end insert Any subsequent amendments to the regulations for
the Interim Therapeutic Restoration begin delete course end delete curriculum that are
promulgated by the committee shall be agreed upon by the board
and the committee.

(2) Prior to January 1, 2018, the committee shall use the
competency-based training protocols established by begin delete Health
Workforce Pilot Project (HWPP) end delete begin insert HWPP end insert 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 begin delete the Health Workforce Pilot Project end delete begin insert HWPP end insert
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
begin delete subdivision (d) or (e), end delete begin insert this subdivision, end insert 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.

(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.

(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 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.

(ii) In a public health setting begin insert , end insert 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 community clinics.

(B) After begin delete a diagnosis and end delete begin insert the diagnosis, end insert treatment begin delete plan end delete begin insert plan,
and instruction to perform the procedure provided end insert 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) No later than January 1, 2018, the committee shall
begin delete promulgate end delete begin insert adopt end insert 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 begin delete adopt end delete begin insert use end insert
the begin insert curriculum submitted by the board pursuant to Section 1753.55
to adopt end insert regulatory language for approval of courses of instruction
for the Interim Therapeutic begin delete Restoration submitted by the dental
board, pursuant to Section 1753.55 in the regulations. end delete begin insert Restoration. end insert
Any subsequent amendments to the regulations for the Interim
Therapeutic Restoration begin delete course end delete 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.

begin insert

begin insert SEC. end insert begin insert 6. end insert   

end insert

begin insert Section 1925 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

1925.  

A registered dental hygienist in alternative practice may
practice, pursuant to subdivision (a) of Section 1907, subdivision
(a) of Section 1908, begin delete and end delete subdivisions (a) and (b) of Section 1910,
begin insert Section 1910.5, and Section 1926.05 end insert as an employee of a dentist
or of another registered dental hygienist in alternative practice, as
an independent contractor, as a sole proprietor of an alternative
dental hygiene practice, as an employee of a primary care clinic
or specialty clinic that is licensed pursuant to Section 1204 of the
Health and Safety Code, as an employee of a primary care clinic
exempt from licensure pursuant to subdivision (c) of Section 1206
of the Health and Safety Code, as an employee of a clinic owned
or operated by a public hospital or health system, or as an employee
of 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.

begin delete SEC. 6. end delete
begin insert SEC. 7. end insert   

Section 1926.05 is added to the Business and
Professions Code, to read:

1926.05.  

begin insert (a) end insert begin insert   end insert In addition to the duties specified in Section
1926, a registered dental hygienist in alternative practice is
authorized to perform the begin delete additional end delete duties begin delete specified in end delete begin insert pursuant
to end insert Section begin delete 1910.5 upon completion of the courses required in that
section, end delete begin insert 1910.5, end insert in the following settings:

begin delete

(a)

end delete

begin insert ( end insert begin insert 1) end insert  Residences of the homebound.

begin delete

(b)

end delete

begin insert (2) end insert  Schools.

begin delete

(c)

end delete

begin insert ( end insert begin insert 3) end insert  Residential facilities and other institutions.

begin insert

(b) A registered dental hygienist in alternative practice is
authorized to perform the duties pursuant to paragraph (2) of
subdivision (a) of Section 1910.5 in the settings specified in this
section under the general supervision of a dentist.

end insert

begin delete SEC. 7. end delete
begin insert SEC. 8. end insert   

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 or approval of course requirements
for licensure or procedures that require additional training begin delete that are
not accredited by a committee-approved agency end delete 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.

begin delete SEC. 8. end delete
begin insert SEC. 9. end insert   

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.

begin delete SEC. 9. end delete
begin insert SEC. 10. end insert   

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.