BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2485


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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          2485 (Santiago)


          As Amended  August 15, 2016


          2/3 vote.  Urgency.


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          |ASSEMBLY:  |79-0  |(June 1, 2016) |SENATE: |38-0  |(August 18,      |
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          Original Committee Reference:  B. & P.




          SUMMARY:  Streamlines the California Dental Corps Loan Repayment  
          Program (DCLRP), under the jurisdiction of the Dental Board of  
          California (DBC), within the Department of Consumer Affairs  
          (DCA), expands eligibility of applicants to the program, and  
          reschedules the timeline that loan repayments may be disbursed.   
          Specifically, this bill:


          1)Reestablishes the DCLRP, under the jurisdiction of the DBC,  
            within the DCA, and authorizes the DBC to implement the DCLRP.


          2)Defines and reorders several terms for the purpose of  
            administering the DCLRP.










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          3)Provides that a program applicant must possess a current valid  
            license to practice dentistry in this state issued by the DBC  
            within the last five years, or be eligible for graduation from  
            an approved pre or post-doctoral dental education program, as  
            specified, and meet all criteria for licensure, subject to  
            successful completion of applicable requirements.


          4)Requires a program applicant to submit a completed  
            application, which includes documentation detailing current  
            loan obligations, the current balance owing, and monthly  
            installment plan, as applicable.


          5)Requires an application to disclose any and all obligations  
            for which the applicant has defaulted or has been subjected to  
            a lien within the last 10 years.


          6)Requires the applicant to sign an agreement with the DBC to  
            maintain qualified employment, as specified, and provide an  
            annual progress report, as specified.


          7)Specifies that the DBC give priority consideration to  
            applicants that are best suited to meet the cultural and  
            linguistic needs and demands of dentally underserved  
            populations and who also speak a Medi-Cal language; come from  
            an economically disadvantaged background; have received  
            significant training in cultural and linguistically  
            appropriate service delivery; have worked in a health field in  
            an underserved area or with an underserved population; and,  
            have recently received a license to practice dentistry, or has  
            received an offer of unemployment in an underserved area.


          8)Specifies that practice setting must be located in a dentally  
            underserved area or ensures that the program participant  
            serves a patient population that consists of at least 50%  
            dentally underserved populations.










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          9)Requires a program applicant to be working in, or have a  
            signed agreement with, an eligible practice setting and be  
            employed on a full-time basis, as specified, unless the DBC  
            determines on a case-by-case basis that a participant should  
            be exempted from the minimum requirements.


          10)Provides that a program participant is required to commit to  
            a minimum of three years of service in a qualified practice  
            setting, but may be eligible for leave of absence as  
            determined by the DBC; provides that loan repayment will be  
            deferred until the dentist is employed on a full-time basis.


          11)Requires the DBC to develop a process for a program  
            participant's repayment of loans or grants disbursed in the  
            event that the participant is terminated prior to completion  
            of, or is otherwise unable to complete, his or her three years  
            of service obligation.


          12) Specifies that "cause for termination" includes, but is not  
            limited to a) a recipient's termination of full-time,  
            qualified employment; b) a recipient's failure to maintain his  
            or her professional license in good standing; and c) a  
            recipient's failure to comply with any other term or condition  
            of this article.


          13)Permits the DBC to adopt any other standards of eligibility,  
            placement, and termination appropriate to achieve the aim of  
            providing competent dental services in these approved practice  
            settings.


          14)Provides that the DBC may coordinate with local and statewide  
            trade and professional dental organizations, as well as  
            educational institutions, for outreach to potentially eligible  
            applicants.


          15)Provides that funds paid out for loan repayment may have a  








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            funding match from foundations or other private sources.


          16)Provides that after a participant has completed six months of  
            service, the DBC may award up to $35,000 for repayment; upon  
            completion of a 18 months of service, a participant is  
            eligible for up to an additional $35,000; and upon completion  
            of 30 months of service, would earn an additional $35,000 in  
            loan repayment; and, specifies that loan repayments may not  
            exceed $105,000 or the total amount of the loan, whichever is  
            lesser.


          17)Codifies existing regulations for the selection and placement  
            of applicants and the timeline for the disbursement of funds  
            to a recipient.


          18)Requires the DBC to submit a report to the Legislature during  
            its sunset review period detailing the experience of the  
            program, an evaluation of its effectiveness in improving  
            access to dental care for underserved populations, and  
            recommendations for maintaining or expanding its operation, as  
            specified.


          19)Makes other technical, non-substantive changes.


          The Senate amendments:


          1)Delete declaration of the Legislature's intent to streamline  
            the administration of the DCLRP such that the DBC does not  
            need to promulgate regulations to implement changes to the  
            DCLRP.


          2)Delete the requirement for applicants to sign the loan  
            repayment agreement under penalty of perjury.










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          3)Add an urgency clause to ensure that low-income communities  
            immediately receive the dental care they desperately lack as  
            soon as possible by removing barriers to available and unused  
            special funds for dentists who seek to serve designated  
            underserved populations.


          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, this bill will result in:


          1)Minor costs for revising existing regulations and  
            administering the Program by the Dental Board of California  
            (Dentally Underserved Account).


          2)Additional expenditure of loan repayment funds, up to $1.6  
            million (Dentally Underserved Account).  The Program has  
            existed for over 10 years with limited participation,  
            particularly in recent years.  The intention of the bill is to  
            broaden the participation in the program to make use of  
            existing funds.  To the extent that the bill is successful,  
            additional expenditures are likely.


          COMMENTS: 


          Purpose.  This bill is sponsored by the California Dental  
          Association (CDA).  The bill would streamline the California  
          DCLRP under the jurisdiction of the DCA, within the DCA, and  
          remove some of the statutory requirements, which have been  
          identified as deterrents to potential applicants. 


          According to the author, "The [DCLRP] was created to be a first  
          step in a long-term effort to improve access to dental care by  
          increasing the number of providers in underserved communities in  
          California, yet it never realized its full potential due to  
          administrative and statutory limits on its effectiveness.  The  
          funding is still available for this program, and many  
          Californians still face barriers accessing dental care.  The  








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          [L]egislature should act to remove the deterrents that keep away  
          potential applicants to the [DCLRP] and encourage participation  
          so that the state can better serve those individuals with the  
          most critical oral health needs."


          Background.  The Legislature passed the DCLRP in 2002 with an  
          initial investment of $3 million from the State Dentistry fund,  
          to be disbursed to eligible candidates over the course of three  
          years.  Fourteen years later, a little more than half of those  
          funds are still sitting in the grant program account, yet to be  
          awarded.  The lack of program participants stems from extensive  
          and burdensome qualification requirements, and a general lack of  
          awareness of the program's existence.  There is approximately  
          $1.6 million left in the account with very few or no applicants  
          to the DCLRP in almost 10 years.


          When the DBC was reviewed in 2015, as part of the joint Senate  
          Business, Professions and Economic Development Committee and the  
          Assembly Business and Professions Committee (Committees) Sunset  
          Review process, the DBC stated that it had promoted the program  
          on its website, included information about the program in its  
          presentation to senior students in California dental schools,  
          and distributed information through their stakeholder and  
          professional association publications.  At the time, DBC staff  
          and its Access to Care Committee was researching other loan  
          repayment programs offered by the California Dental Association,  
          the Medical Board of California, and the Office of Statewide  
          Health Planning and Development (OSHPD).  During the 2015 Sunset  
          Review hearings, the Committees recommended that the DBC  
          consider transferring the DCLRP to Health Professions Education  
          Foundation, housed within the OSHPD in order to increase  
          participation in the program and more effectively administer the  
          funds. 


          Instead, this bill will codify existing regulations for the  
          implementation of the program; expand the pool of applicants  
          eligible for the DCLRP; revise the timeline for loan  
          disbursements; remove deterrents that keep away potential  
          applicants; and, require the DBC to report on the effectiveness  








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          of the DCLRP at the time of its sunset review.


          Analysis Prepared by:                                             
                          Gabby Nepomuceno / B. & P. / (916) 319-3301  FN:  
          0004750