BILL ANALYSIS                                                                                                                                                                                                    Ó



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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          880 (Ridley-Thomas)


          As Amended  August 18, 2015


          Majority vote


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          |ASSEMBLY:  | 78-0 | (May 14,      |SENATE: |39-0  | (August 27,     |
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          Original Committee Reference:  B. & P.


          SUMMARY:  Authorizes students enrolled in their final year at a  
          California dental school, approved by the Dental Board of  
          California (Board), to practice dentistry under the supervision  
          of licensed dentists at free sponsored events, as specified.  


          The Senate amendments:


          1)Require that each patient be informed that a dental student  
            may be providing some of the treatment that he or she will be  
            receiving, and offer the patient the option to decline to be  
            treating by the student. 


          2)Require the student to be supervised by clinical faculty from  
            the dental school in which he or she is enrolled and practice  
            under specified supervision ratios and oversight.








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          3)Limit a student to performing only those procedures in which  
            he or she is credentialed or that he or she is already  
            permitted to perform, as specified. 


          4)Require the sponsoring entity of the sponsored event to  
            provide specified information to the Board.


          5)Require the student or the student's sponsoring dental school  
            to ensure liability insurance coverage is obtained that covers  
            all services provided by the student, including diagnosis,  
            treatment, and evaluation.


          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.


          COMMENTS:


          Purpose.  This bill is sponsored by the Oral and Facial Surgeons  
          of California.  According to the author, "Regular dental care is  
          extremely important to everyone's health.  However in the  
          underserved communities in California, access to regular dental  
          care is almost nonexistent.  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."


          Background.  Board-approved dental schools are required to,  








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          among other things, have a formal system of quality assurance  
          for their patient care program including standards of patient  
          centered care with a focus on comprehensive care, including  
          measurable assessment criteria and ensures the delivery of  
          comprehensive patient care to individual patients.  In addition,  
          schools are required to ensure that students have adequate  
          patient experiences to achieve the institution's stated goals  
          and competencies within a reasonable time.  Currently, there are  
          six Board-approved dental schools in California.  This bill  
          would only apply to dental students at one of these  
          institutions.  


          Current Exemptions for Student Practice.  Business and  
          Professions Code Section 1626 specifically exempts from  
          licensure requirements, "? operations, in dental schools  
          approved by the board, of bona fide students of dentistry? in  
          the school's clinical departments or laboratories or in a dental  
          extension program approved by the board."  Under the California  
          Code of Regulations, there are two types of facilities that may  
          be approved by the Board as an adjunct to, and an extension of,  
          the clinical and laboratory departments of an approved school:   
          1) an extramural dental facility, and 2) a mobile dental clinic.  
           An extramural dental facility as defined in 16 California Code  
          of Regulations 1025 is "? any clinical facility employed by an  
          approved dental school for instruction in dentistry which exists  
          outside or beyond the walls, boundaries or precincts of the  
          primary campus of the approved dental school, and in which  
          dental services are rendered."  A mobile dental clinic as  
          defined in 16 California Code of Regulations 1026 is "? any  
          clinical facility employed by an approved dental school for  
          instruction in dentistry which may be moved, towed or  
          transported from one location to another, and in which dental  
          services are rendered."


          Services that are provided by dental students to the public  
          through an extramural dental facility or a mobile dental clinic  
          are required to constitute a part of the dental education  
          program.  In addition, approved dental schools are required to  
          register these facilities with the Board, and provide with that  
          registration information relating to:  1) faculty supervision;  








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          2) scope of treatment to be rendered; 3) postoperative care; 4)  
          proposed itinerary showing locations by dates, for mobile dental  
          clinics, or the name and location of the facility and date  
          operation will commence, for extramural dental facilities; 5)  
          discipline of which such instruction is a part; and 6) a brief  
          description of the equipment and facilities available.  For  
          extramural dental facilities, the school must also provide a  
          copy of the agreement between the approval dental school, or  
          parent university and the affiliated institution establishing  
          the contractual relationship.  Any change in the information  
          initially provided to the Board is required to be communicated  
          to the Board.    


          According to the sponsor, the intent of this bill is to allow  
          final year dental students to volunteer their services at free  
          health and dental events.  Currently, students are not exempt  
          from practicing at those events because those free health care  
          events do not fall under the definition of a mobile dental  
          health clinic or an extramural dental facility.  As a result,  
          those health care events currently have no registration or other  
          requirements relating to the standard of care.  In addition,  
          unlike extramural dental facilities, which are brick and mortar  
          locations, and mobile dental clinics, which are also  
          self-contained places to provide services, free healthcare  
          events are fleeting and not grounded to any one location.  While  
          existing law permits dental students to treat patients, who are  
          usually eligible for dental services under Medi-Cal's dental  
          program and treated under supervision, in on-campus clinics,  
          mobile dental clinics and at dental extension programs approved  
          by the Board, current law does not allow these same  
          opportunities at health care events.  According to the author,  
          the ability to draw final year students to the clinics as dental  
          service providers who work alongside licensed dentists will  
          increase the number of volunteers available to work as these  
          clinics and provide much needed services to underserved  
          communities much needed services.          


          Analysis Prepared by:                                             
                          Eunie Linden / B. & P. / (916) 319-3301  FN:  
          0001468








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