BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 1524|
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THIRD READING
Bill No: AB 1524
Author: Hayashi (D)
Amended: 6/29/10 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEVELOP. COMM. : 6-1,
6/21/10
AYES: Negrete McLeod, Aanestad, Calderon, Correa, Florez,
Walters
NOES: Yee
NO VOTE RECORDED: Wyland, Oropeza
SENATE APPROPRIATIONS COMMITTEE : 6-0, 8/2/10
AYES: Kehoe, Ashburn, Leno, Price, Wolk, Wyland
NO VOTE RECORDED: Alquist, Corbett, Emmerson, Walters, Yee
ASSEMBLY FLOOR : 68-0, 1/27/10 (Consent) - See last page
for vote
SUBJECT : Dentistry: examination requirements
SOURCE : Dental Board of California
DIGEST : This bill repeals the clinical and written
examination administered by the Dental Board of California
and replaces that examination 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.
CONTINUED
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ANALYSIS : Existing law:
1. Establishes the Dental Board of California (Board) to
license and regulate the practice of dentistry in
California.
2. Provides that dentistry is the diagnosis or treatment,
by surgery or other method, of diseases and lesions and
the correction of malpositions of the human teeth,
alveolar process, gums, jaws, or associated structures;
and such diagnosis or treatment may include all
necessary related procedures as well as the use of
drugs, anesthetic agents, and physical evaluation.
3. Requires examinations by the Board to be sufficiently
thorough to test the fitness of the applicant to
practice dentistry, and requires questions and answers
to be written in English.
4. Specifies that the subjects in which the applicant shall
be examined shall be those subjects as the Board may
from time to time prescribe in accordance with curricula
provided by dental schools within California, and that
dental schools shall be informed two years in advance of
any proposed changes in the list of subjects to be
provided on the examinations.
5. Requires each applicant for dentistry licensure to
successfully complete the written examinations of the
National Board Dental Examination of the Joint
Commission on National Dental Examinations (NBDE); an
examination in California law and ethics administered by
Board, and one of the following: A clinical and written
examination developed and administered by the Board; or
a clinical and written examination administered by the
Western Regional Examining Board (WREB).
6. Authorizes the Board to issue a license to practice
dentistry, without requiring the taking of the state
exam, to applicants who are currently licensed to
practice dentistry in another state, and who meet
specified clinical practice and other requirements.
7. Provides that when an applicant for a license has
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received a grading of 85 percent or above in any given
subject on the state exam, he or she shall be exempt
from re-examination on that subject in subsequent
examinations.
8. Provides that, notwithstanding a general statutory
prohibition against imposing additional prerequisites on
unsuccessful examinees, applicants who fail to pass the
state exam after three attempts must take 50 hours of
remedial education for any of the three subjects which
the applicant failed in his or her last unsuccessful
examination.
9. States that occupational analyses and validation studies
are fundamental components of licensure programs.
10.Requires the Department of Consumer Affairs (DCA) to
develop, in consultation with boards, programs, bureaus,
and divisions under its jurisdiction, a policy regarding
examination development and validation, and occupational
analysis.
11.Requires every regulatory board and bureau, and every
program and bureau administered by the DCA to submit to
the director on or before December 1, 1999, and on or
before December 1 of each subsequent year, its method
for ensuring that every licensing examination
administered by or pursuant to a contract with the board
is subject to periodic evaluation. Requires the
periodic evaluation to include: (a) a description of the
occupational analysis serving as the basis for the
examination; (b) sufficient item analysis data to permit
a psychometric evaluation of the items; (c) an
assessment of the appropriateness of prerequisites for
admittance to the examination; and (d) an estimate of
the costs and personnel required to perform these
functions. States that 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.
12.Indicates that the evaluation may be conducted by the
board, program, or bureau, the Office of Professional
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Examination Services of the DCA, or pursuant to a
contract with a qualified private testing firm. States
that a board, program, or bureau that provides for
development or administration of a licensing examination
pursuant to contract with a public or private entity may
rely on an occupational analysis or item analysis
conducted by that entity. Requires the DCA to compile
this information, along with a schedule specifying when
examination validations and occupational analyses shall
be performed, and submit it to the appropriate fiscal,
policy, and sunset review committees of the Legislature
by September 30 of each year.
This bill:
1. Repeals the requirement that a dentistry applicant
complete and pass a clinical and written examination
developed and administered by the Board and replaces it
with a portfolio examination.
2. Requires the portfolio examination specified in item #
1) above to be conducted while the applicant is enrolled
in a dental school program at a board-approved school in
the state. Requires the examination to utilize uniform
standards of clinical experiences and competencies, as
established by the Board.
3. Requires an applicant to additionally pass a final
assessment of the submitted portfolio at the end of his
or her dental school program.
4. Provides that before any portfolio assessment may be
submitted to the Board, the applicant must remit a $350
fee, to be deposited into the State Dentistry Fund, and
a letter of good standing signed by the dean of his or
her dental school or delegate stating that the applicant
has graduated or will graduate with no pending ethical
issues.
5. Prohibits the portfolio examination from being conducted
until the Board adopts regulations, requires the Board
post notice on its Internet Web site when these
regulations are adopted and provide written notice to
the Legislature and the Legislative Counsel when these
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regulations have been adopted.
6. Requires the Board to independently monitor and audit
the standardization and calibration of dental school
competency instructors at least biennially to ensure
standardization and an acceptable level of calibration
in the grading of the examination. Requires the board
to audit each dental school's competency examinations.
7. Requires the Board to oversee all aspects of the
portfolio examination process, but shall not interfere
with the dental school authority to establish and
deliver an accredited curriculum. Requires the Board to
determine an end-of-year deadline, in consultation with
the current board-approved dental schools, to determine
when the portfolio examinations shall be completed and
submitted to the Board for review by its examiners.
8. Requires the Board, in consultation with the current
board-approved dental schools, to determine portfolio
examination competencies and the minimum number of
clinical experiences required for successful completion
of the portfolio examination.
9. Provides that the Board shall require and verify
successful completion of competency examinations that
were performed on a patient of record at a
board-approved dental school, including but not limited
to:
A. Comprehensive oral diagnosis and
treatment planning.
B. Periodontics.
C. Direct restorations.
D. Indirect restorations.
E. Removable prosthodontics.
F. Endodontics.
10.Clarifies that an applicant must successfully complete
Part I and Part II of the NBDE written examinations.
11.Requires the Board to review the portfolio examination
to ensure compliance with the requirements of current
law and certify that the portfolio examination process
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meets those requirements. If the board determines that
the portfolio examination fails to meet those
requirements, the portfolio examination will no longer
be an option for applicants. The Board's review and
certification or determination shall be completed and
submitted to the Legislature and the Department of
Consumer Affairs by December 1, 2016.
Background
Licensure Requirements for Dentistry Applicants . The Board
regulates over 38,000 dentists in California, and five
approved dental schools in the state, namely, the
University of the Pacific School of Dentistry, UCSF School
of Dentistry, Loma Linda School of Dentistry, UCLA School
of Dentistry, and the USC School of Dentistry. The
examination requirements for dentistry licensure are as
follows: 1) passage of Part I and Part II of the NBDE; 2)
passage of the California law and ethics examination and 3)
passage of either the clinical or written examination
administered by the Board or the WREB. Additionally, an
applicant who has completed a minimum of 12 months of a
general practice residency or advanced education in general
dentistry program approved by the ADA's Commission on
Dental Accreditation is also eligible for licensure.
The clinical and written examination administered by the
Board is offered two to five times a year. Currently, the
examination subjects include Endodontics, Removable
Prosthodontics Evaluation; Periodontics; Class II Amalgam
Restoration; Class III or IV Composite Resin Restoration;
and Simulated Fixed Prosthetics. The Endodontics
examination is a written, 50-multiple choice questions that
test the candidates ability to diagnose, treatment plan,
interpret radiographs and critically evaluate treatment,
strategies for pulpal and periapical pathoses as well as
systemic conditions. The Removable Prosthodontics
Evaluation, conducted in a laboratory setting, tests the
candidate's knowledge, understanding and judgment in the
diagnosis and treatment of complete dentures, partial
dentures and implants. Candidates evaluate cases in a
laboratory station-based examination providing answers to
50 multiple-choice questions. The Periodontics examination
consists of three parts: clinical examination and
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diagnosis; scaling of a patient; and a written examination
comprised of 54 multiple-choice questions based upon
projected slides. The candidate must provide a patient for
both the clinical periodontal examination and diagnosis and
scaling portions of the examinations. If a patient is
deemed unacceptable, it is the candidates' responsibility
to provide another patient who is acceptable. Specific
patient requirements are included for Class II amalgam
restoration, Class III or Class IV composite resin
restoration. The Simulated Fixed Prosthetics examination
involves a typodont or a model of the oral cavity,
including teeth, gingival, and the palate, that is mounted
in manikin. This examination tests for partial denture,
and crown preparation.
Since candidates provide their own patients, there are
general requirements that apply to these patients,
including completion of a medical history, and the taking
and recording of blood pressure. Additionally, candidates
are required to furnish their own instruments, handpieces,
typodonts, and materials necessary to carry their
assignments to completion.
State's Requirements for Examination Validation and
Occupational Analysis . Occupational analyses and exam
validations are critical components of appropriate and
legally defensible licensure programs. Both types of
reviews help the State ensure that the standards for entry
into professions are consistent with the skills required in
those professions. Section 139 of the Business and
Professions Code also expresses the policy of the State
that any licensing examination provided in California for
purposes of licensure must be evaluated and reviewed to
assure it has been appropriately validated and has had an
occupational analyses conducted that meets both the legal
requirements and testing standards of California.
Examinations recognized and used by State licensing boards
must also meet the requirements of subdivision (a) of
Section 12944 of the Government Code to assure that they do
not have an adverse impact on any class by virtue of its
race, creed, color, national origin or ancestry, sex, age,
medical condition, physical disability, mental disability,
or sexual orientation.
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FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12
2012-13 Fund
Develop of portfolio
examination $100-$150 Special*
Implement portfolio
examination assessments $175-$210**
annually Special*
fully offset by certification fee
*State Dentistry Fund
**Estimated 500 to 600 assessments
SUPPORT : (Verified 8/4/10)
Dental Board of California (source)
Loma Linda University
UC Los Angeles Dental School
UC San Francisco Dental School
ARGUMENTS IN SUPPORT : According to the Dental Board of
California, this bill streamlines the licensure process for
California dental school graduates by eliminating the
requirement of a clinical examination administered by the
board. It points out that the current clinical examination
is administered over three days, costs each applicant over
$2,000, and requires the participation of a volunteer
patient provided by the student. Supplying the patient has
been especially problematic for dental students, as finding
an appropriate test subject raises practical and ethical
issues. Additionally, concerns have been raised about the
reliability judgments made about candidate performance in
these one shot examinations. The Board points out the new
examination requirements proposed by this bill will provide
a higher probability that candidates who successfully
complete the process will meet minimum competency
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standards, while also providing greater protection and
safety to consumers.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Bradford, Brownley, Buchanan, Caballero, Charles
Calderon, Chesbro, Cook, Coto, De La Torre, Emmerson,
Eng, Evans, Feuer, Fletcher, Fong, Fuentes, Fuller,
Furutani, Gaines, Galgiani, Garrick, Gilmore, Hagman,
Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal,
Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,
Nielsen, John A. Perez, Portantino, Ruskin, Saldana,
Silva, Skinner, Smyth, Solorio, Audra Strickland,
Swanson, Torres, Torrico, Tran, Villines, Yamada
NO VOTE RECORDED: Carter, Conway, Davis, De Leon, DeVore,
Hall, V. Manuel Perez, Salas, Torlakson, Bass
JA:nl 8/4/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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