BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 880 Hearing Date: June 29,
2015
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|Author: |Ridley-Thomas |
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|Version: |June 22, 2015 Amended |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Huchel |
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Subject: Dentistry: licensure: exemption.
SUMMARY: Authorizes final year dental students to practice dentistry at
free sponsored events under supervision and under specified
conditions.
Existing law:
1)Establishes the Dental Practice Act (Act), administered by the
Dental Board of California (DBC), which is under the
Department of Consumer Affairs (DCA), to license and regulate
the practice of dentistry. (Business and Professions Code
(BPC) §§ 1600 et seq.)
2)Prohibits the practice of dentistry unless a person has a
valid and unexpired license or special permit from the Board.
(BPC § 1626)
3)Exempts from that prohibition, operations in dental schools of
bona fide students of dentistry or dental hygiene in the
school's clinical departments or laboratories or in a dental
extension program if approved by the Board. (BPC § 1626(b))
4)Provides for the licensure and regulation of clinics by the
State Department of Public Health, including primary care
clinics, which include community clinics and free clinics.
(Health and Safety Code (HSC) §§ 1200 et seq.)
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5)Defines a "free clinic" as a clinic operated by a tax-exempt,
nonprofit corporation supported in whole or in part by
voluntary donations, gifts, grants, government funds or
contributions, and where there are no charges directly to the
patient for services rendered, as specified. (HSC § 1204(a))
6)Exempts specified health care practitioners from California
licensure who are licensed or certified in other states and
who provide health care services on a voluntary basis to
uninsured or underinsured persons in California until January
1, 2018, as specified. (BPC § 901)
This bill:
1)Exempts final year dental students from provisions of law
prohibiting the practice of dentistry without a license for
students who volunteer at a sponsored event under the
supervision of dental school faculty.
2)Specifies that the exemptions only include those operations
approved by the DBC that are rendered or performed under the
same conditions as operations in a student's dental program.
3)Defines the following terms:
a) "Final year student" means a student of dentistry in his
or her final year of completion at a dental school approved
by the DBC. "Final year student" also includes a dental
student enrolled in an advanced program.
b) "Licensed dentist" means a dentist licensed by the DBC.
c) "Sponsored event" means an event, not to exceed 10
calendar days, administered by a sponsoring entity or a
local governmental entity, or both, through which health
care is provided to the public without compensation, or
expectation of compensation.
d) "Sponsoring entity" means a nonprofit organization
pursuant to Section 501(c)(3) of the Internal Revenue Code,
or a community-based organization.
4)Requires the volunteer practice of dentistry by students to
comply with all of the following requirements:
AB 880 (Ridley-Thomas) Page 3
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a) Each patient shall be sufficiently informed that a
dental student may be providing some of the treatment that
he or she will be receiving.
b) Any information provided to the patient to give informed
consent shall offer the patient the option to decline to be
treated by the student.
c) The volunteer practice of a student shall be supervised
by faculty from the dental school in which the student is
enrolled.
d) Each volunteer student shall wear an identification
badge that clearly identifies the student as a dental
student. The identification badge shall display the
student's name, the name of the student's dental school,
and the name and the telephone number of the DBC. That
information shall be displayed in 14-point font, at
minimum.
e) Requires that supervision ratios and student oversight
be at least as stringent as required to meet the standards
of the Commission on Dental Accreditation at each school's
clinical department, laboratory, or dental extension
program.
f) Requires that supervision ratios be appropriate for the
procedure being performed by the student.
g) Requires the student to perform only those procedures in
which he or she is credentialed or those procedures he or
she is permitted to perform in the school's clinical
department, laboratory, or dental extension program.
5)Requires the administering entity of the sponsored event to
provide the DBC with a list of the names of the volunteer
students, the name of the school of enrollment of those
students, and the name and license number of the supervising
licensed dentist.
FISCAL
EFFECT: This bill is keyed "fiscal" by Legislative Counsel.
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According to the Assembly Appropriations Committee analysis
dated May 6, 2015, any costs to the DBC caused by this bill are
minor and absorbable.
COMMENTS:
1.Purpose. This bill is sponsored by the California Association
of Oral and Maxillofacial Surgeons . According to the Author's
office, "Regular dental care is extremely important to
everyone's overall health. However in the underserved
communities in California, access to regular dental care is
almost non-existent.
"Since the Medi-Cal and Denti-Cal programs are underutilized,
free healthcare and dental clinics are an essential source of
dental care for the many members of those same communities.
Since existing law already allows dental students to treat
patients in clinics on the dental school campuses under
supervision, it would follow that these same students should
be allowed to treat similar patients, under supervision, in
the free health fairs. It is very important to maintain a pool
of willing volunteer providers both in the licensed
professional community and in the dental schools to provide
dental care in underserved communities."
2.Access to Dental Dare and Denti-Cal. According to a 2012
report by the California Dental Association (CDA), an
estimated 11 million of California's 38 million people lack
any form of dental benefits. For those 7 million who qualify
for dental services through Medi-Cal, that coverage does not
necessarily translate into access; the California State
Auditor reported in December 2014 that over half the children
in Denti-Cal (Medi-Cal's dental program) do not get regular
services. The auditor determined that this was primarily due
to the lack of providers deterred by low reimbursement rates.
3.Free Dental Health Care Events. In addition to the lack of
participating providers in Denti-Cal, CDA also reports that
there is a misdistribution of the current supply; California
has over 200 dental professional shortage areas; areas where
the ratio of dentists to the population is so low that the
state considers the area underserved.
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Several not-for-profit entities have entered the market to
provide free or low-cost healthcare to underserved
individuals: CDA Cares, California CareForce, Remote Area
Medical, and Care Harbor are a few of the major providers in
this space that offer dental care (and/or other medical care,
depending on the event) to the underserved population. These
entities primarily rely on volunteers to provide services,
frequently in a temporary medical space set up in a convention
hall, fairground, or other public space. These volunteers are
subject to professional regulation and are held to the same
standard of care as in a traditional setting.
This bill would increase the potential pool of volunteers by
allowing final year dental students to provide services at
free sponsored healthcare events under supervision.
4.Previous Legislation. AB 2699 (Bass) Chapter 270, Statutes of
2010, exempts specified health care practitioners from
California licensure who are licensed or certified in other
states and who provide health care services on a voluntary
basis to uninsured or underinsured persons in California until
January 1, 2014, as specified.
AB 512 (Rendon) Chapter 111, Statutes of 2013, extended the
sunset date on
AB 2699 (above) until 2018.
5.Arguments in Support. The Oral and Facial Surgeons of
California write, "[We are] sponsoring this legislation in
order to enhance the pool of volunteer providers at the much
needed free healthcare clinics in California's many
underserved communities. In addition, by allowing final year
students to treat patients under the supervision of licensed
dentists, these students will be getting real life healthcare
treatment exposure in the EXACT same way that they are
currently allowed to practice in on-campus clinics in the
California dental schools."
The University of the Pacific, Arthur A. Dugoni School of
Dentistry writes, "Currently the six approved dental schools
in California offer clinics on campus that allow dental
students to treat patients who qualify for Medi-Cal or
Denti-Cal at reduced fees. Free clinics and health fairs
offer dental care to the most severely underserved
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communities. The ability to draw volunteers (both faculty and
students) from schools ensures that the pool of providers will
not evaporate and that they will be fresh and eager to serve
the community."
6.Recommended Technical Amendment. The following amendment is
recommended to align terms within this bill.
On page 3, line 24, delete "administering" and add
"sponsoring"
SUPPORT AND OPPOSITION:
Support:
Oral and Facial Surgeons of California (Sponsor)
California CareForce
Dental Hygiene Committee of California
Loma Linda University School of Dentistry
University of California, Los Angeles School of Dentistry
University of California, San Francisco School of Dentistry
University of the Pacific, Arthur A. Dugoni School of Dentistry
University of Southern California
Western University of Health Sciences College of Dental Medicine
Opposition: None on file as of June 23, 2015.
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