BILL ANALYSIS Ó SENATE COMMITTEE ON HEALTH Senator Ed Hernandez, O.D., Chair BILL NO: AB 648 --------------------------------------------------------------- |AUTHOR: |Low | |---------------+-----------------------------------------------| |VERSION: |June 11, 2015 | --------------------------------------------------------------- --------------------------------------------------------------- |HEARING DATE: |June 24, 2015 | | | --------------------------------------------------------------- --------------------------------------------------------------- |CONSULTANT: |Teri Boughton | --------------------------------------------------------------- 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. AB 648 (Low) Page 2 of ? 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; AB 648 (Low) Page 3 of ? 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. AB 648 (Low) Page 4 of ? PRIOR VOTES : ----------------------------------------------------------------- |Assembly Floor: |79 - 0 | |------------------------------------+----------------------------| |Assembly Appropriations Committee: |17 - 0 | |------------------------------------+----------------------------| |Assembly Health Committee: |19 - 0 | | | | ----------------------------------------------------------------- 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 AB 648 (Low) Page 5 of ? 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. AB 648 (Low) Page 6 of ? 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 AB 648 (Low) Page 7 of ? 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 AB 648 (Low) Page 8 of ? 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 AB 648 (Low) Page 9 of ? Venice Family Clinic 2 individuals Oppose: None received -- END --