BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 2331 Hearing Date: June 27,
2016
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|Author: |Dababneh |
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|Version: |June 16, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Huchel |
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Subject: Dentistry: applicants to practice
SUMMARY: Establishes an alternative clinical and written examination
for dental licensure applicants, requires a review of this exam
by the Office of Professional Examination Services (OPES).
Existing law:
1)Establishes the Dental Board of California (DBC) within the
Department of Consumer Affairs (DCA) to license and regulate
the practice of dentistry. (Business and Professions Code
(Business and Professions Code (BPC) §§ 1601.1, 1611)
2)Requires the examination of applicants for a license to
practice dentistry to be sufficiently thorough to test the
fitness of the applicant to practice dentistry, and that both
questions and answers are written in the English language.
(BPC § 1630)
3)Requires the DBC to require each dental licensure applicant
to: (BPC § 1632)
a) Successfully complete the Part I and Part II written
examinations of the National Board Dental Examination of
the Joint Commission on National Dental Examinations.
b) Successfully complete an examination in California law
and ethics developed and administered by the DBC.
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c) Have taken and received a passing score on one of the
following:
i) A portfolio examination of the applicant's
competence to enter the practice of dentistry, conducted
while the applicant is enrolled in a dental school
program at a DBC-approved school in California.
ii) A clinical and written examination administered by
the Western Regional Examining Board (WREB).
4)Requires all DCA boards and bureaus to ensure that every
licensing examination administered by or pursuant to contract
with the board is subject to periodic evaluation. The
evaluation shall include (1) a description of the occupational
analysis serving as the basis for the examination; (2)
sufficient item analysis data to permit a psychometric
evaluation of the items; (3) an assessment of the
appropriateness of prerequisites for admittance to the
examination; and (4) an estimate of the costs and personnel
required to perform these functions. The evaluation shall be
revised and a new evaluation submitted to the Director
whenever, in the judgment of the board, program, or bureau,
there is a substantial change in the examination or the
prerequisites for admittance to the examination. (BPC § 139)
5)States that it is unlawful for a licensing board to require
any examination or establish any other qualification for
licensing that has an adverse impact on any class by virtue of
its race, creed, color, national origin or ancestry, sex,
gender, gender identity, gender expression, age, medical
condition, genetic information, physical disability, mental
disability, or sexual orientation, unless the practice can be
demonstrated to be job related. If an examination or other
qualification for licensing is determined to be unlawful, that
determination shall not void, limit, repeal, or otherwise
affect any right, privilege, status, or responsibility
previously conferred upon any person by the examination or by
a license issued in reliance on the examination or
qualification. (Government Code § 12944)
This bill:
AB 2331 (Dababneh) Page 3
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1) Establishes an alternative clinical and written examination
for dental licensure applicants developed by the American
Board of Dental Examiners, Inc.
2) Strikes the ability for the WREB to determine the passing
score for its exam.
3) Authorizes the DBC to determine the testing format, as
relates to patients, for the exam developed by the American
Board of Dental Examiners, Inc.
4) Requires a review of the exam developed by the American Board
of Dental Examiners, Inc. by OPES prior to its implementation
to ensure compliance with current law and deliver this review
to the DBC.
5) Prohibits implementation of the exam if the DCA determines
that the examination process fails to meet specified
standards, does not deliver the review to the DBC, or if the
American Board of Dental Examiners, Inc. fails to pay costs
and expenses, as specified.
6) Requires the American Board of Dental Examiners, Inc.'s
examination process to be regularly reviewed by the DCA and
comply with statutory requirements.
7) Requires the American Board of Dental Examiners, Inc. to pay
all reasonable costs and expenses the DBC incurs for the
purposes of reviewing the exam.
8) States that the American Board of Dental Examiners, Inc.
examination may only be accepted for licensure by a candidate
after it is determined that the examination has met the
requirements of current law, and any examinations taken prior
to that date may not be used for licensure.
9) Authorizes the Department of Finance to accept funds for the
purposes of reviewing and analyzing the examination developed
by the American Board of Dental Examiners, Inc.
FISCAL
EFFECT: This bill is keyed "fiscal" by the Legislative Counsel.
According to the Assembly Appropriations analysis dated April
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20, 2016, this bill has one-time costs to the DBC and to the
OPES of $200,000 to perform reviews and issue regulations (State
Dentistry Fund). These costs could be reimbursed by private
donations as the bill authorizes; however, the requirement to
perform the review is not contingent on such donation. Ongoing
costs will depend upon volume of additional applications.
COMMENTS:
1. Purpose. This bill is sponsored by The American Board of
Dental Examiners (ADEX) . According to the Author's office,
"Once a dental student has completed dental school they are
required to pass an exam approved by the DBC prior to
licensure. This exam is either administered by the WREB or
completed through a recently approved DBC sponsored,
Portfolio Exam process. The Portfolio Exam is only offered
in California, however. At this time, graduates from
out-of-state dental programs, including California residents,
can only take the WREB exam in particular locations where the
exam is offered.
"Over the last few years, the DBC has been examining how
patients are involved in dental exams. For each dental exam,
candidates must demonstrate their clinical knowledge by
practicing on live patients. The American Dental Association
(ADA), as well as the California Dental Association, have
adopted ethical guidelines for the inclusion of patients in
licensure exams. These guidelines require structured patient
involvement, informed consent, and patient follow-up.
Patients who are involved in these exams are "patients of
record" and receive ongoing, appropriate care. The DBC has
developed the Portfolio exam to address these issues. The
Portfolio exam is currently being offered to students at some
California dental schools.
"ADEX has also developed such an exam that includes all the
guidelines outlined by the dental associations. The ADEX
Patient Centered Curriculum Integrated Dental Examination
Format (PC-CIF) is designed to specifically addresses each of
the concerns listed above. It is currently provided in 6
states, with a growing number of additional dental schools
adding this option for their graduating students. The exam
tests the same high criteria as the ADEX exam recognized in
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43 states, but it is offered in the patient-centered format.
This format also meets the ADA standard for patient centered
exams. The recent amendments will allow the DBC to require
this testing format as the required test for ADEX.
"AB 2331 will allow the California Board of Dentistry to
recognize the ADEX PC-CIF exam so that students outside of
California can choose this exam for admission to the state.
This provides these students with an exam option that
complies with the patient-centered guidelines established by
the industry leaders."
2. Background. California requires dental applicants to take
either a portfolio examination of the applicant's competence
to practice dentistry, which is offered only by California
schools, or a clinical and written examination administered
by WREB. This bill will allow ADEX to provide funding to the
state to have its test validated and, if determined
sufficient, offered as an alternative clinical and written
examination.
ADEX is a nonprofit corporation of the State Boards of
Dentistry focused on the development of a "state of the art,
high quality uniform National dental and dental hygiene
clinical licensure examination for the sole use by States
Board of Dentistry." In a letter to the DBC last year, ADEX
wrote, "Dentistry is the only health profession that does not
have a uniform national licensure examination. ADEX believes
that the acceptance of the ADEX by California will set the
cornerstone that will bring to fruition the goal of a Uniform
National Dental Licensure examination."
3. Previous Legislation. AB 1524 (Hayashi, Chapter 446,
Statutes of 2010) repealed the clinical and written
examination administered by the DBC and replaced it with a
portfolio examination of an applicant's competence to
practice dentistry to be administered while the applicant is
enrolled in a dental school program.
SB 1865 (Aanestad, Chapter 670, Statutes of 2004) provided
that an applicant for a license to practice
dentistry may either successfully complete the current
clinical and written examination developed and administered
by the DBC, or a clinical and written examination
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administered by the WREB.
4. Arguments in Support. The American Board of Dental Examiners
write, "AB 2331 will allow the DBC to recognize the ADEX
PC-CIF exam so that students outside of California can choose
this exam for admission to the state. This provides these
students with an exam option that complies with the
patient-centered guidelines established by industry leaders."
SUPPORT AND OPPOSITION:
Support:
American Board of Dental Examiners (Sponsor)
California Dental Association
Opposition:
None on file as of June 21, 2016.
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