BILL ANALYSIS �
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 562|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
THIRD READING
Bill No: SB 562
Author: Galgiani (D)
Amended: 4/30/13
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEVELOP. COMM. : 10-0, 4/22/13
AYES: Price, Emmerson, Block, Corbett, Galgiani, Hernandez,
Hill, Padilla, Wyland, Yee
SENATE APPROPRIATIONS COMMITTEE : 7-0, 4/29/13
AYES: De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg
SUBJECT : Dentists: mobile or portable dental units
SOURCE : California Dental Association
DIGEST : This bill specifies that portable dental units must
register with, and be subject to regulation by the Dental Board
of California, in the same manner that mobile dental clinics or
units are currently regulated. Also defines the terms "mobile
dental unit" and "portable dental unit."
ANALYSIS :
Existing law:
1. Authorizes a dentist to operate a mobile dental clinic or
unit that is registered with regulations adopted by the
Dental Board of California (DBC).
CONTINUED
SB 562
Page
2
2. Specifies registration requirements for mobile dental clinics
or units.
3. Under the Mobile Health Care Service Act, requires mobile
service units to be licensed by the Department of Health Care
Services (DHCS).
4. Outlines the following specifications:
A. The mobile unit shall be of sufficient size and
shall be arranged in a manner that is appropriate for
the provision of those health care services that it is
licensed to provide.
B. The mobile unit shall be equipped with appropriate
utilities for the comfort and safety of patients. The
Office of Statewide Health Planning and Development
shall review and approve hospital-provided utility
connections for mobile units that require utility
hookups with general acute care hospitals.
C. The mobile unit shall be maintained in good repair
and in a clean and sanitary manner.
D. All proposed modifications to previously approved
services and procedures shall be reviewed and approved
by DHCS before they are implemented. Modifications to
the mobile service unit shall be approved by the
Department of Housing and Community Development.
E. The licensee shall report to DHCS the location of
the site at least 24 hours prior to the operation of a
mobile unit at any site for the first time.
F. Notification shall be waived when the mobile unit
operates at any site for the first time at the request
of federal, state, or local authorities for the
purposes of responding to state or locally declared
emergencies, federally declared emergencies and
declared public health emergencies.
5. Requires a licensee using mobile services to maintain written
transfer agreements that shall include, but shall not be
limited to, provisions for communication with, and
CONTINUED
SB 562
Page
3
transportation to, one or more nearby hospitals and other
health facilities as needed to meet medical emergencies.
This bill:
1. Authorizes a dentist licensed by DBC to operate one mobile or
portable dental unit.
2. Specifies that a mobile or portable unit shall pay the fees
established by DBC.
3. Specifies that regulations regarding mobile or portable
dental units include the following requirements: (a)
follow-up and emergency care, (b) maintenance, and (c)
availability of provider and patient records and treatment
information for patients and other appropriate parties.
4. Defines the following terms:
A. "Mobile dental unit" means a facility in which
dentistry is practiced and that is routinely towed,
moved, or transported from one location to another.
B. "Portable dental unit" means a nonfacility in which
dental equipment used in the practice of dentistry is
transported to, and used on a temporary basis at, an
out-of-office location.
Background
Mobile units . Primary care clinics are defined as facilities
that directly or indirectly deliver health care services,
including dental services, to patients in an outpatient setting.
In accordance with the scope of services permitted by existing
law, primary care clinics currently operate dental clinics
throughout the state, including mobile health vans. Mobile
service units are licensed by DHCS pursuant to provisions of the
Health and Safety Code and provide medical, diagnostic and
treatment services to help ensure the availability of health
care services for patients who receive care in remote or
underserved areas. Patients, who are served by mobile units,
face significant transportation, language and economic barriers
when accessing health care. For example, according to the U.S.
Surgeon General, California children are 12 times more likely to
CONTINUED
SB 562
Page
4
miss school because of dental problems than children from
higher-income families (Health States Initiative, 2008).
Regulation of mobile units . Currently, mobile units are
licensed with DHCS and regulated by DBC. According to the
California Dental Association (CDA), the regulation of mobile
dental units is not robust enough. Traditionally, mobile units
have been operated by non-profit organizations with the
expressed intent of providing services to underserved areas.
Over the past five years, many for-profit companies have begun
sending mobile units to these areas. The CDA reports that some
of the for-profit units have provided services exclusively to
patients who have insurance and avoided providing
non-reimbursable services to those who do not have insurance.
In response, in 2010, the CDA and the Dental Health Foundation
created an "information kit" for schools to consider when
selecting mobile dental units to provide services to children at
their school. These guidelines were distributed to school
districts throughout California. Another problem noted by the
CDA is that some mobile units provide services but do not
provide coordination of care with a patient's existing dental
provider which may lead to duplication of services.
Portable Units . Portable units, are defined as activities
engaged in by licensed dental professionals outside of a mobile
unit, e.g., setting up portable dental equipment in a school
auditorium. These types of services are not covered under the
existing statute that regulates mobile units.
Dental Board of California Memo . In August of 2012, the CDA
approached the DBC to determine if DBC would adopt regulations
that include portable units and require units to provide
coordination of care services. In a memo from DBC's legislative
and regulatory analyst, DBC notes that seeking these changes via
regulations may conflict with existing statute and thus a
statutory change should be pursued instead.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to Senate Appropriations Committee, one-time costs of
about $75,000 to $150,000 for DBC to update regulations (State
Dentistry Fund).
CONTINUED
SB 562
Page
5
SUPPORT : (Verified 4/30/13)
California Dental Association (source)
ARGUMENTS IN SUPPORT : According to the author's office,
existing law provides DBC the authority to regulate mobile
dental units, but did not envision the use of portable
equipment, as the statutory language does not appear flexible
enough to provide the same authority over portable dental units.
As Californians rely on DBC to ensure proper consumer
protections through regulations, regardless of location or
manner in which those services are provided, it is imperative to
update the statute to extend DBC's authority over all practice.
The bill's sponsor, the California Dental Association, states,
"CDA has heard from dentists that they have had children come
into their offices who have clearly had some basic dental work
recently completed, but the parent does not know who did the
work or what exactly was completed. The community-based dentist
must begin again with new radiographs (which re-exposes children
unnecessarily) and a new treatment plan. Services that are easy
to accomplish have already been provided and billed, leaving the
community-based dentist to provide the care that is more
complex, time-consuming and costly to provide, without
consultation with the original treating dentist. Further, it is
entirely unclear upon completion of this treatment, how the
child will be followed and who is responsible for ongoing care,
as there is no communication between treating providers. This
model places the burden of treatment on the community dentist,
fragments care, and is not conducive to the child receiving
coordinated and appropriate ongoing care."
MW:d 5/1/13 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED