BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 502 Hearing Date: July 6,
2015
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|Author: |Chau |
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|Version: |June 29, 2015 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Huchel |
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Subject: Dental hygiene.
SUMMARY: Authorizes the creation of and establishes rules of governance
for a registered dental hygienist in alternative practice
(RDHAP) corporation.
Existing law:
1)Establishes the Dental Hygiene Committee of California (DHCC)
within the jurisdiction of the Dental Board of California
(DBC) to administer laws pertaining to dental hygienists.
(Business and Professions Code (BPC) § 1901(a))
2)Authorizes the DHCC to license a person as a RDHAP who
demonstrates satisfactory performance on an examination in
California law and meets either of the following requirements:
a) Holds a current California license as a registered
dental hygienist and meets the following requirements:
i) Has been engaged in the practice of dental hygiene
as a registered dental hygienist in any setting,
including, but not limited to, educational settings and
public health settings, for a minimum of 2,000 hours
during the immediately preceding 36 months.
ii) Has successfully completed a bachelor's degree or
its equivalent, as specified, and a minimum of 150 hours
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of additional educational requirements.
b) Has received a letter of acceptance into the employment
utilization phase of the Health Manpower Pilot Project No.
155 established by the Office of Statewide Health Planning
and Development. (BPC § 1922)
3)Authorizes a RDHAP to perform all functions that may be
performed by a registered dental assistant; dental hygiene
assessment and development, planning, and implementation of a
dental hygiene care plan; oral health education; counseling;
health screenings; preventive and therapeutic interventions,
including oral prophylaxis, scaling, and root planing; and
application of topical, therapeutic, and subgingival agents
used for the control of caries and periodontal disease 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. (BPC §
1926)
4)Authorizes a RDHAP to operate a mobile dental hygiene clinic.
(BPC §§ 1926.1, 1926.2)
5)Authorizes a RDHAP to bill insurance and hire other RDHAPs and
dental assistants. (BPC §§ 1928, 1929)
6)Authorizes an association, partnership, corporation, or group
of three or more RDHAPs to practice if it obtains a permit
issued by the DHCC. (BPC § 1962)
7)Authorizes a RDHAP to provide services to a patient without
obtaining written verification that the patient has been
examined by a dentist or physician and surgeon licensed to
practice in this state. (BPC § 1931 (a)(1))
8)Establishes the Moscone-Knox Professional Corporation Act
AB 502 (Chau) Page 3
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(Moscone-Knox Act) which regulates the formation and operation
of professional corporations, and defines a professional
corporation as a corporation organized under the general
corporation law, as specified, or a corporation that is
engaged in rendering professional services in a single
profession. (Corporations Code (CORP) §§ 13400 et seq.)
9)Specifies in the Moscone-Knox Act that certain licensed
persons may be shareholders, officers, directors or
professional employees of professional corporations controlled
by licensed persons of a different profession so long as the
sum of all shares owned by those certain licensed persons does
not exceed 49% of the total number of shares of the
professional corporation, and so long as the number of those
certain licensed persons owning shares in the professional
corporation does not exceed the number of persons licensed by
the governmental agency regulating the designated professional
corporation. (CORP § 13401.5)
10)Specifies that the Moscone-Knox Act does not limit employment
by a professional corporation of only those licensed
professionals listed. Any healing arts licensee may be
employed to render professional services by a professional
corporation designated, as specified. (CORP § 13401.5)
This bill:
1) Authorizes a RDHAP to practice as an employee of a
professional corporation under the Moscone-Knox Professional
Corporation Act.
2) States that a RDHAP corporation is a professional corporation
that is authorized to render professional services, as
specified, so long as that professional corporation and its
shareholders, officers, directors, and professional employees
rendering professional services are in compliance with the
Moscone-Knox Professional Corporation Act and other
applicable laws and regulations.
3) Declares the violation of, attempt to violate, directly or
indirectly, assist in or abet the violation of, or conspire
to violate any provision or term laws and regulations
relating to the practice of a RDHAP to be unprofessional
conduct.
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4) Prohibits a RDHAP from doing or failing to do anything that
would constitute unprofessional conduct, as specified.
5) Prohibits a shareholder who is disqualified from providing
professional services from deriving benefit from a RDHAP
corporation attributable to professional services rendered
while a shareholder is a disqualified person.
6) Requires the bylaws of a RDHAP corporation to include a
provision whereby the capital stock owned by a disqualified
person or a deceased person be sold to the professional
corporation or to the remaining shareholders of the
professional corporation not later than 90 days after
disqualification, if the shareholder becomes a disqualified
person, or not later than six months after death, if the
shareholder becomes deceased.
7) Requires a RDHAP to provide adequate security by insurance or
otherwise for claims against it by its patients arising out
of the rendering of professional services.
8) Exempts a professional corporation rendering professional
services by persons licensed by the DHCC from any requirement
to obtain a certificate of registration in order to render
those professional services.
9) Authorizes the creation of a RDHAP professional corporation
and states that a dental assistant or licensed dentist may be
a shareholder, officer, director, or professional employee of
the professional corporations so long as the sum of all
shares owned by those licensed persons does not exceed 49
percent of the total number of shares of the professional
corporation, and so long as the number of those licensed
persons owning shares in the professional corporation does
not exceed the number of persons licensed by the governmental
agency regulating the designated professional corporation.
10)Makes clarifying and technical amendments.
FISCAL
EFFECT: This bill has been keyed "fiscal" by the Legislative
Counsel. According to an analysis by the Assembly
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Appropriations Committee dated May 13, 2014, any costs to the
California Department of Insurance and the Department of Managed
Health Care to assess compliance with this bill's requirements
are expected to be minor and absorbable.
COMMENTS:
1. Purpose. This bill is sponsored by the California Dental
Hygienists' Association . According to the Author's office,
"Even though BPC 1962 authorizes RDHAPs to incorporate, the
DHCC does not have enough regulatory and oversight authority
to ensure that consumers are protected from RDHAP
corporations. Currently other boards, such as the Physical
Therapy Board of California and the Dental Board of
California have statutory authority to regulate and impose
oversight of Physical Therapy Corporations or Dental
Corporations. AB 502 would provide the DHCC with the same
type of regulatory and oversight authority as other
California Boards."
2. RDHAP. Dental hygienists clean teeth, examine patients for
signs of oral diseases such as gingivitis, and provide other
preventative dental care. They also educate patients on ways
to improve and maintain good oral health.
An RDHAP is dental hygienist who has a baccalaureate degree,
completed a DBC-approved continuing education course and
passed a state licensure examination to practice
independently in underserved settings. These settings are
defined as Dental Health Professional Shortage Areas,
residences of the homebound, nursing homes, hospitals,
residential care facilities, and other public health
settings. RDHAPs may independently provide all services that,
as an RDH, they are licensed to provide under general
supervision. RDHAPs must have a "dentist of record" on file
with the Dental Hygiene Committee of California to gain
licensure. This documented relationship is for referral,
consultation, and emergency services.
RDHAPs can provide dental hygiene services to patients for 18
months without involvement of a dentist or physician. If an
RDHAP continues to provide services to that patient, he or
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she is required to obtain written verification that the
patient has been examined by a dentist or physician licensed
to practice in the state and a prescription for further
services. There are currently 508 licensed RDHAPs in
California.
3.Professional Corporations. Although existing law appears to
authorize RDHAPs to incorporate, DHCC's website explicitly
states that they may not because they are not included in the
Moscone-Knox Professional Corporations Act of 1968.
A professional corporation is an organization made up of
individuals of the same trade or profession. The Moscone-Knox
Professional Corporations Act authorized the formation of
professional corporations to obtain certain benefits of the
corporate form of doing business, such as limited legal
liability. At that time, only medical, law and dental
professional corporations were envisioned. There are now 16
authorized healing arts professional corporations. Current
law specifies which healing arts licensees may be
shareholders, officers, directors or professional employees of
professional corporations controlled by a differing profession
so long as the sum of all shares owned by those licensed
persons does not exceed 49% of the total number of shares of
the professional corporation.
This bill would authorize the creation of a RDHAP corporation
and would permit dental assistants and licensed dentists to be
shareholders, officers, directors or professional employees of
the professional corporation, as specified.
4. Prior Related Legislation. AB 1174 (Bocanegra, Chapter 662,
Statutes of 2014) authorized RDHAPs to determine which
radiographs to perform and to place protective restorations.
AB 123 , (Cohn, Chapter 549, Statutes of 2003) provided that
physicians and surgeons, dental assistants, registered dental
assistants, registered dental assistants in extended
functions, registered dental hygienists, registered dental
hygienists in extended functions, or RDHAPs may be
shareholders, officers, directors, or professional employees
of dental corporations.
SB 853 (Perata, Chapter 31, Statutes of 2008) created the
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DHCC as the separate body within the DBC to oversee the
practice of dental hygiene.
5. Arguments in Support. The sponsors of this bill, the
California Dental Hygienists' Association support passage of
this bill because, "The [RDHAPs] have successfully provided
dental hygiene care in California for over 15 years. It's
time to update the statute to address roadblocks to care that
have become apparent."
The California Dental Association states, "The Corporations
Code does not currently recognize the ability authorized in
the Business and Professions Code for RDHAPs to legally
incorporate, and AB 502 will align these two code sections,
providing clarity and protection for RDHAPs."
6. Policy Consideration. The bill currently states that a RDHAP
corporation must provide "adequate security" for claims. It
is recommended that DHCC use its existing authority to
promulgate regulations further defining this term in order to
protect the public against financial harm.
SUPPORT AND OPPOSITION:
Support:
California Dental Hygienists' Association (Sponsor)
California Dental Association
Dental Hygiene Committee of California
Opposition:
None on file as of June 30, 2015.
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