BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:                    AB 648    
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          |AUTHOR:        |Low                                            |
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          |VERSION:       |June 11, 2015                                  |
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          |HEARING DATE:  |June 24, 2015  |               |               |
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          |CONSULTANT:    |Teri Boughton                                  |
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           SUBJECT  :  Community-based services: Virtual Dental Home program.

           SUMMARY  :  Establishes the Virtual Dental Home (VDH) grant program at the  
          California Department of Public Health and appropriates $4  
          million from the General Fund to expand the VDH model of  
          community-based delivery of dental care to California residents.
          
          Existing law:
            
          1)Establishes the Dental Practice Act (DPA), administered by the  
            Dental Board of California (DBC).

          2)Permits the DBC to license as a registered dental assistant in  
            extended functions (RDAEF) a person who submits satisfactory  
            written evidence of specified eligibility requirements, such  
            as a current licensure as a registered dental assistant (RDA)  
            or completion of the requirements for licensure as an RDA;  
            successful completion of a DBC-approved course in the  
            application of pit and fissure sealants; successful completion  
            of DBA-approved extended functions post-secondary programs, as  
            specified; and, passage of a written examination and a  
            clinical or practical examination administered by the DBC or  
            by a DBC-approved extended functions program.

          3)Establishes within the jurisdiction of DBC a Dental Hygiene  
            Committee of California (DHCC), and states legislative intent  
            to permit the full utilization of RDAs, registered dental  
            hygienists in alternative practice (RDHAP), and registered  
            dental hygienists in extended functions (RDHEF) in order to  
            meet the dental care needs of all of the state's citizens.  
            Requires the DHCC to perform specified functions, including  
            making recommendations to the DBC regarding dental hygiene  
            scope of practice issues.







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          4)Permits the Office of Statewide Health Planning and  
            Development (OSHPD) to designate experimental health workforce  
            projects as approved projects where the projects are sponsored  
            by community hospitals or clinics, nonprofit educational  
            institutions, or government agencies engaged in health or  
            education activities. Permits, notwithstanding any other  
            provision of law, a trainee in an approved project to perform  
            health care services under the supervision of a supervisor  
            where the general scope of the services has been approved by  
            OSHPD.

          5)Requires, no later than January 1, 2018, regulations to be  
            promulgated related to establishing criteria for approval of  
            courses of instruction for the procedures using the  
            competency-based training protocols established by Health  
            Workforce Pilot Project No. 172 (HWPP No. 172) through OSHPD.  
            Requires, in developing regulations and any subsequent  
            proposed amendments to promulgated regulations, the DBC to  
            provide to the DHCC proposed regulations related to the  
            curriculum required for protective restorations.

          6)Requires OSHPD to extend HWPP 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.  
            Sunsets this provision January 1, 2016.

          
          This bill:
          1)Establishes the VDH grant program, administered by the dentist  
            of the Oral Health Unit of the State Department of Public  
            Health (DPH), to expand the VDH model of community-based  
            delivery of dental care to California residents.

          2)Requires the grant program to facilitate, coordinate, and  
            encourage development and expansion of the delivery of dental  
            health services through the use of the VDH model by providing  
            grants to:

                  a)        Develop training modules and Web-based  
                    technical assistance;
                  b)        Establish community-based learning  
                    collaboratives;








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                  c)        Fund essential VDH technology and equipment;  
                    and,
                  d)        Develop and fund other services, as determined  
                    by the grant administrator, as required by this bill.

          3)Authorizes the program administrator to seek additional  
            private or public funds to expand access to the VDH program.

          4)Requires the VDH program to be focused on providing needed  
            services in geographic areas of highest need, as determined by  
            the program administrator.

          5)Authorizes the program administrator to grant funds directly  
            to the public and private educational institutions or  
            nonprofit entities as required to meet the requirements of  
            this bill.

          6)Appropriates $4 million from the General Fund (GF) to DPH for  
            purposes of the VDH program.

           FISCAL  
          EFFECT  :  According to the Assembly Appropriations Committee:
          1)$4 million GF to DPH to establish the program.  DPH would  
            scale the effort, including number of sites, individuals  
            trained, and individuals served, to the available funding.   
            Supporters, who are familiar with the VDH model, project the  
            funding could be used to support training and equipment in 20  
            communities over a three-year grant period. 


          2)To the extent this model is successful in promoting access to  
            preventive and diagnostic dental services and more children  
            are able to receive such services through its widespread  
            adoption, there could be commensurate cost pressure on  
            Medi-Cal dental services to reimburse for additional services  
            (GF/federal funds).  However, any increased costs would likely  
            be offset to some extent by reductions in emergency dental  
            procedures or complications from untreated dental disease.   
            The magnitude and likelihood of such costs or savings is  
            unknown.













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           PRIOR  
          VOTES  :  
          
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          |Assembly Floor:                     |79 - 0                      |
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          |Assembly Appropriations Committee:  |17 - 0                      |
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          |Assembly Health Committee:          |19 - 0                      |
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          COMMENTS  :
          1)Author's statement.  According to the author, in 2014, the VDH  
            pilot project was made permanent as a sustainable and scalable  
            model for delivering dental care in California. The project  
            demonstrated that early dental disease prevention can be  
            provided safely and effectively in community-based sites by  
            allied dental team members who are connected to a dentist at  
            an off-site location via "teledentisty." Patients served by  
            VDH systems have access to comprehensive dental care,  
            including diagnosis, treatment planning and restorative care,  
            as well as other complex care as needed. Through the project,  
            nearly 3,000 patients have been seen at more than 50 sites  
            around California with overwhelmingly positive results and  
            approximately two-thirds of the patients seen were able to  
            receive the care they needed at the community site. Good  
            dental health is critical to a child's ability to grow up  
            healthy. Yet, tooth decay is the most common chronic disease  
            and unmet health care need of children in California.  
            California has identified 341 Dental Health Professional  
            Shortage Areas (DHPSA), areas so designated because the  
            dentist-to-population ratio is below the threshold set by the  
            federal government.  By their very nature, DHPSA's identify  
            areas throughout the state where patients frequently  
            experience barriers to comprehensive dental care.  This bill  
            is an innovative and cost-effective model for providing dental  
            services to the residents of this state who are in need of  
            receiving dental care.
            

          2)HWPP No. 172 and VDH. The HWPP No. 172 was approved by OSHPD  
            in December 2010, and patient care with the new HWPP No. 172  
            duties began in January of 2011. The purpose of the pilot was  
            to test two new duties to be performed by allied dental  








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            personnel to demonstrate that these duties could be performed  
            safely and effectively and contribute to the development of a  
            community-based oral health delivery system using  
            telehealth-connected teams in a system called the VDH.  The  
            system was designed to reach and improve the oral health of  
            underserved and vulnerable populations not fully participating  
            in the current dental care delivery system. HWPP No. 172 was  
            funded by public and private grants and was sponsored by the  
            Pacific Center for Special Care at the University of the  
            Pacific (UOP) School of Dentistry. 

          The HWPP No. 172 provided dental services to approximately 3,000  
            patients in 13 California communities, operating at more than  
            50 sites, including in elementary school-based facilities,  
            Head Start Preschools, a nursing home, residential care  
            facilities and a community center.  Ninety percent of patients  
            seen were eligible for Denti-Cal. There were a total of 12  
            trainees licensed and experienced as RDAs, RDHs, or RDHAPs.   
            In addition to the allied dental personnel, there were 23  
            dentists that participated, serving as "collaborating  
            dentists" in the various community sites.  

          Under the VDH and HWPP 172, RDA, RDH or RDHAPs use portable  
            imaging equipment and an internet-based dental record system  
            to collect electronic dental records such as X-rays,  
            photographs, charts of dental findings, and dental and medical  
            histories, and upload the information to a secure website,  
            where they are reviewed by a collaborating dentist. The  
            dentist reviews the patient's information and creates a  
            tentative dental treatment plan. The RDHAP, RDH or RDA then  
            carries out the aspects of the treatment plan that can be  
            conducted in the community setting. After the dentist reviews  
            the electronic dental records, the RDHAP, RDH or RDA refers  
            patients to dental offices for procedures that require the  
            skills of a dentist. When these visits occur, the patient  
            arrives with health history and consent arrangements  
            completed, a diagnosis and treatment plan already determined,  
            preventive practices in place and preventive procedures having  
            been performed.  As of 4/30/15 there were 2,858 patients seen,  
            2,083 radiographs taken, and 994 interim therapeutic  
            restorations placed.  All procedures were rated as acceptable  
            and there were no reports of adverse outcomes.  With regard to  
            patient satisfaction 86% who responded to the survey were very  
            satisfied with the overall dental care received.









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          3)Dental Access. According to OSHPD's Health Care Atlas,  
            approximately five percent of Californians live in a DHPSA;  
            DHPSAs are Medical Service Study Areas that meet federally  
            mandated criteria to qualify facilities for benefit programs,  
            such as loan repayment programs. The designation is based on  
            the availability of dentists and dental auxiliaries.  A July  
            2010 article published in Health Affairs, indicates, children  
            in Medicaid, especially Latinos and African Americans,  
            experience high rates of tooth decay, yet they visit dentists  
            less often than privately insured children. Even Latino and  
            African American children with private insurance are less  
            likely than white children to visit dentists and have longer  
            intervals between dental visits. Furthermore, Latino and  
            African American children in Medicaid are more likely than  
            white children in Medicaid to have longer intervals between  
            visits. According to a 2008 publication from the California  
            HealthCare Foundation, the burden of oral disease continues to  
            fall more heavily on children from poor, minority households.  
            And despite growing awareness of the lifelong effects of poor  
            oral care, nearly one quarter of California children have  
            never been to a dentist, including half of all children under  
            the age of five. 

          4)State Audit.  The California State Auditor published audit  
            results in December 2014 of an audit conducted on the  
            Department of Health Care Services (DHCS) administration of  
            dental services for children on Medi-Cal which raises issues  
            with access to services.  According to the audit, although the  
            proportion of children who had at least one dental procedure  
            performed during the year increased by as much as 1.2  
            percentage points each year from 2011 to 2013, annual  
            utilization rates are still lower than those of many other  
            states. Data from the federal Centers for Medicare and  
            Medicaid Services (CMS) indicate that nearly 56% of the 5.1  
            million children enrolled in Medi-Cal in federal fiscal year  
            2013 (October 1, 2012, through September 30, 2013) did not  
            receive dental care through the program. The CMS data indicate  
            that the national average utilization rate was 47.6% and  
            ranged from a low of 23.7% in Ohio to a high of 63.4% in Texas  
            for that same federal fiscal year. CMS's data also indicate  
            that California's utilization rate of 43.9% was the 12th worst  
            among the states that submitted data. The auditor's review of  
            DHCS' data for 2011 through 2013 found similar results.  
            Studies reviewed suggested several reasons for low utilization  
            rates, including an uneven distribution of dentists nationwide  








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            and a relatively small number of dentists who participate in  
            Medicaid.

          5)State Budget.  SB 75 (Committee on Budget and Fiscal Review)  
            eliminates the 10% Medi-Cal payment reductions pursuant to AB  
            97 (Committee on Budget, Chapter 3, Statutes of 2011) for  
            dental providers effective July 1, 2015.  SB 75 is awaiting  
            action by the Governor.

          6)VDH Grant Program.  According to a representative of UOP, the  
            grant funds anticipated in this bill might include funding to  
            cover the following start-up costs:  The equipment and  
            instrument cost is about $35,000 - $40,000 as a one-time  
            expense; there are supported salaries, decreasing over time,  
            during the ramp up to a fully billable and sustainable model  
            at a total of around $70,000 - $80,000, spread over 3 years;  
            and, the costs for site selection and enrollment, program  
            planning, system training, procedure training, monitoring,  
            technical assistance and evaluation could be expected to be  
            around a total of $80,000 - $90,000 spread over 3 years.

          7)Related legislation.  AB 502 (Chau) would require insurance  
            companies to reimburse registered RDHAPs for dental hygiene  
            care legally provided and covered by insurance, and clarifies  
            that RDHAPs are authorized to establish corporations.  

          8)Prior legislation.  AB 1174 (Bocanegra, Chapter 662, Statutes  
            of 2014), expands the scope of practice for a RDAEF, RDH, and  
            RDHAP to better enable the practice of teledentistry in  
            accordance with the findings of a HWPP 172, and authorizes  
            Medi-Cal payments for teledentistry services provided to  
            individuals participating in the Medi-Cal program.    
          
          9)Support.  Proponents support this bill because it would  
            provide upfront investment necessary for the VDH to become a  
            sustainable and scalable model for dental care delivery.   
            Without an upfront investment in training, equipment,  
            technical assistance, and other support that providers need to  
            get started, the system will not be able to develop a critical  
            mass needed to spread statewide and truly be integrated into  
            California's dental delivery system.  The Children's  
            Partnership cosponsors this bill to ensure the VDH - an  
            innovative and cost-effective system for providing dental care  
            to California's most vulnerable children and adults in  
            community settings- can spread across the state.  The  








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            California Dental Association also cosponsors this bill,  
            because the VDH model of dental care uses technology to  
            connect allied dental team members located at community sites  
            with dentists in offices or clinics, facilitating the  
            provision of comprehensive dental care to underserved children  
            and adults.
          
          10)Suggested Amendment.  The committee may wish to require an  
            evaluation of the grant program in order to measure the extent  
            to which it meets the stated objectives.  Evaluation  
            provisions could include the following:
          
            (g) The program administrator shall develop a method for  
            evaluating each grantee's progress toward meeting the  
            objective to expand the virtual dental home model of  
            community-based delivery of dental care to residents in  
            geographic areas of highest need.  Upon completion of the  
            grantee evaluations, the program administrator shall post a  
            grant program evaluation summary associated with expenditure  
            of the General Fund appropriation contained in this bill.
            
          
           SUPPORT AND OPPOSITION  :
          Support:  California Dental Association (co-sponsor)
                    Children's Partnership (co-sponsor)
                    Alameda County Board of Supervisors
                    Alameda County Developmental Disabilities Council
                    California Chronic Care Coalition
                    California Dental Hygienists' Association
                    California Society of Pediatric Dentistry
                    Children Now
                    Community Clinic Association of Los Angeles County
                    Community Health Systems, Inc.
                    Delta Dental
                    Dental Hygiene Committee of California
                    East Bay Developmental Disabilities Legislative  
                              Coalition
                    First 5 Sonoma County
                    Liberty Dental Plan of California, Inc.
                    Maternal and Child Health Access
                    Mendocino Community Health Clinic, Inc.
                    Neighborhood Mobile Dental Van Prevention Program
                    Shasta Community Health Center 
                    State Council on Developmental Disabilities
                    United Ways of California








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                    Venice Family Clinic
                    2 individuals

          
          Oppose:   None received

                                      -- END --