BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 880|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
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THIRD READING
Bill No: AB 880
Author: Ridley-Thomas (D), et al.
Amended: 7/1/15 in Senate
Vote: 21
SENATE BUS, PROF. & ECON. DEV. COMMITTEE: 8-0, 6/29/15
AYES: Hill, Bates, Block, Galgiani, Hernandez, Jackson,
Mendoza, Wieckowski
NO VOTE RECORDED: Berryhill
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 78-0, 5/14/15 (Consent) - See last page for
vote
SUBJECT: Dentistry: licensure: exemption
SOURCE: Oral and Facial Surgeons of California
DIGEST: This bill authorizes final year dental students to
practice dentistry at free sponsored events under supervision
and under specified conditions.
ANALYSIS:
Existing law:
1)Establishes the Dental Practice Act, administered by the
Dental Board of California (DBC), which is under the
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Department of Consumer Affairs, 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 DBC.
(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 DBC.
(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.)
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:
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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:
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
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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 sponsoring 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.
Background
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
seven 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.
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.
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)
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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 increases the potential pool of volunteers by allowing
final year dental students to provide services at free sponsored
healthcare events under supervision.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
SUPPORT: (Verified7/14/15)
Oral and Facial Surgeons of California (source)
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: (Verified7/14/15)
None received
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."
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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 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."
ASSEMBLY FLOOR: 78-0, 5/14/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,
Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,
Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Linder, Medina
Prepared by:Sarah Huchel / B., P. & E.D. / (916) 651-4104
7/15/15 15:14:07
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