BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 648 (Low) - Health care access demonstration project grants:
Virtual Dental Home Grant Program
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|Version: August 1, 2016 |Policy Vote: HEALTH 8 - 0 |
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|Urgency: No |Mandate: No |
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|Hearing Date: August 8, 2016 |Consultant: Brendan McCarthy |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: AB 648 would establish a grant program to provide
funding to support virtual dental homes. The bill would
appropriate $4 million from the General Fund for the grant
program.
Fiscal
Impact:
One-time appropriation of $4 million to support virtual dental
home projects (General Fund).
Unknown increase in Medi-Cal spending for dental procedures
(General Fund and federal funds). The Medi-Cal program
provides dental coverage for children and limited coverage for
adults. According to a report by the State Auditor,
utilization of dental services by Medi-Cal beneficiaries is
low compared to other states. In part, this is due to limited
availability of dental providers willing to see new patients
at the rates paid by the Medi-Cal program. The virtual dental
home model has the potential to increase access, by bringing
AB 648 (Low) Page 1 of
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care to individuals who are not otherwise being served. To the
extent this happens, it could increase Medi-Cal expenditures
for dental service. On the other hand, early interventions
through a virtual dental home model may reduce future costs by
catching problems early. The extent to which the savings from
early interventions will offset the costs of overall increases
in utilization is unknown.
Background: Under the virtual dental home model, individuals needing
dental care are seen in person by a dental assistant or dental
hygienist who is connected via teledentistry with an offsite
dentist. This model of care allows allied health professionals
to provide dental care within their scope of practice with the
ability to interact with a dentist on issues beyond their scope
of practice. Supporters of this model of care point out that it
allows dental care to be provided in alternative locations such
as schools or residential care facilities which expands access
to care, while still allowing for access to the skills and
training of a dentist via teledentistry.
Under the oversight of the Office of Statewide Health Planning
and Development, a Health Workforce Pilot Project (#172) has
been undertaken to evaluate the changes in scope of practice and
the use of telehealth that would needed to establish a virtual
dental home model. According to a review of the Pilot Project by
researchers at the University of the Pacific, allied dental
professionals are able to perform the duties tested in the Pilot
Project safely and effectively with a high level of patient
satisfaction. AB 1174 (Bocanegra, Statutes of 2014) expanded the
scope of practice for registered dental assistants in extended
functions, registered dental hygienists, and registered dental
hygienists in alternative practice, to facilitate virtual dental
homes.
Proposed Law:
AB 648 would establish a grant program to provide funding
related to virtual dental homes. The bill would appropriate $4
million from the General Fund for the grant program.
Specific provisions of the bill would:
Establish the Virtual Dental Home grant program under
the State Dental Director (within the Department of Public
Health);
AB 648 (Low) Page 2 of
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Require the program to develop training modules, fund
virtual dental home technology and equipment, and develop
and fund other services to meet the requirements of the
bill;
Require the program to be focused on areas of highest
need;
Require an evaluation of grants awarded;
Appropriate $4 million from the General Fund for the
program.
Staff comments: Previously, this bill was amended in this
committee to shift the fund source for the program from the
General Fund to the California Health Facilities Financing
Authority Fund and require the program to be implemented by the
Authority.
Recent amendments revert the source of funding for the bill to
the General Fund.
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