BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 562| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- UNFINISHED BUSINESS Bill No: SB 562 Author: Galgiani (D) Amended: 9/6/13 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 León, Walters, Gaines, Hill, Lara, Padilla, Steinberg SENATE FLOOR : 32-0, 5/6/13 (Consent) AYES: Anderson, Beall, Block, Calderon, Cannella, Corbett, Correa, De León, DeSaulnier, Emmerson, Evans, Fuller, Gaines, Galgiani, Hancock, Hernandez, Hill, Hueso, Huff, Knight, Leno, Lieu, Liu, Monning, Nielsen, Padilla, Pavley, Price, Roth, Steinberg, Wright, Wyland NO VOTE RECORDED: Berryhill, Jackson, Lara, Walters, Wolk, Yee, Vacancy, Vacancy ASSEMBLY FLOOR : 76-0, 9/10/13 - See last page for vote SUBJECT : Dentists: mobile or portable dental units SOURCE : California Dental Association DIGEST : This bill requires the Dental Board of California (DBC) to develop registration and operating regulations for mobile dental units and dental practices that routinely use CONTINUED SB 562 Page 2 portable dental units, and deletes restrictions limiting dentists to operating only one mobile dental clinic. Assembly Amendments clarify the definition of a "mobile dental unit;" require registration for dental practices using portable dental units to provide treatment in nondental office locations; require DBC to promulgations requiring a mobile dental unit or a practice routinely using portable dental units identify a licensed dentists responsible for the unit or practice; and make other technical and clarifying changes. ANALYSIS : Existing law: 1. Authorizes a dentist to operate a mobile dental clinic or unit that is registered with regulations adopted by the DBC. 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 CONTINUED SB 562 Page 3 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 transportation to, one or more nearby hospitals and other health facilities as needed to meet medical emergencies. This bill: 1. Requires a dental practice that routinely uses portable dental units to be registered and operated in accordance with regulations to be established by DBC, and prohibits the regulations from preventing or lessening competition in service areas. 2. Deletes the restriction on a licensed dentist operating only one mobile dental clinic or unit registered as a dental office or facility. 3. Requires DBC to adopt regulations requiring a registrant to identify a licensed dentist responsible for the mobile dental unit or portable practice, and requires the regulations to include, but not be limited to, requirements for availability of follow-up and emergency care, maintenance and availability of provider and patient records, and provision of treatment information to patients and other appropriate parties. 4. Exempts portable dental units from requirements related to additional offices, clinics operated by federal entities, federally recognized Indian tribes or tribal organizations, CONTINUED SB 562 Page 4 intermittent clinics, and mobile service units, as specified. 5. Defines the following terms: A. "Mobile dental unit" means a self-contained facility, which may include a trailer or van, in which dentistry will be practiced that may be moved, towed, or transported from one location to another; and, B. "Portable dental unit" means a self-contained unit housing equipment used for providing dental treatment that is transported to, and used on a temporary basis at, non-dental office locations. 6. Makes other technical or clarifying changes. Background Nontraditional dental practice settings . California regulates the practice of dentistry in many settings beyond the traditional brick-and-mortar office: 1. Mobile service unit . A mobile service unit is basically a primary clinic on wheels, typically in a specialized commercial coach. These units are approved by the Department of Public Health and may provide dental services, in addition to other procedures, but are not regulated by DBC. 2. Mobile dental clinic . A mobile dental clinic, or mobile dental unit, is a commercial coach, trailer, van, or other self-contained unit that may appear similar to a mobile service unit, but only provides dental services. A mobile dental clinic is regulated by DBC, and may be operated by a dentist after receiving a permit from DBC and proving that the unit complies with existing health and safety regulations. 3. Portable dental unit . A portable dental unit consists of portable dental chair and suitcase-like container housing a collection of dental tools which may be set up to enable a dental professional to perform dental services at various field sites. FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes CONTINUED SB 562 Page 5 Local: No According to the Senate Appropriations Committee, one-time costs of about $75,000 to $150,000 for DBC to update regulations (State Dentistry Fund). SUPPORT : (Verified 9/10/13) California Dental Association (source) California Academy of Physician Assistants California Primary Care Association The Children's Partnership 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, "Lifting the numerical restriction will encourage access to care by allowing dentists to cover multiple sites with multiple mobile and/or portable units, either themselves or through general supervision of dental hygienists." ASSEMBLY FLOOR : 76-0, 9/10/13 AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom, Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Conway, Cooley, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier, Beth Gaines, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gorell, Gray, Grove, Hagman, Hall, Harkey, Roger Hernández, Holden, Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal, Maienschein, Medina, Melendez, Mitchell, Morrell, Mullin, Muratsuchi, Nazarian, Nestande, Olsen, Pan, Patterson, Perea, V. Manuel Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone, Ting, Wagner, Waldron, Weber, Wieckowski, Wilk, Williams, Yamada, John A. Pérez CONTINUED SB 562 Page 6 NO VOTE RECORDED: Donnelly, Mansoor, Vacancy, Vacancy MW:d 9/11/13 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED