BILL ANALYSIS Ó AB 880 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 880 (Ridley-Thomas) As Amended August 18, 2015 Majority vote -------------------------------------------------------------------- |ASSEMBLY: | 78-0 | (May 14, |SENATE: |39-0 | (August 27, | | | |2015) | | |2015) | | | | | | | | | | | | | | | -------------------------------------------------------------------- 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. AB 880 Page 2 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, AB 880 Page 3 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; AB 880 Page 4 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 AB 880 Page 5