BILL ANALYSIS �
SB 540
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Date of Hearing: July 5, 2011
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
SB 540 (Price) - As Amended: June 27, 2011
SENATE VOTE : 34-0
SUBJECT : Dentistry.
SUMMARY : Increases the size and reconfigures the membership of
the Dental Board of California (DBC) by eliminating the
registered dental hygienist (RDH) and registered dental
assistant (RDA) members and adding three additional public
members. Also extends DBC's sunset to January 1, 2016.
Specifically, this bill :
1)Deletes existing law requirements related to advertising by a
dentist of specialization or accreditation in a specialty area
of practice unless certain requirements are met.
2) Extends the sunset date of the DBC until January 1, 2016,
and provides that upon its sunset, the DBC becomes subject to
review by the appropriate policy committees of the
Legislature.
3) Increases the size of the DBC by adding a public member,
appointed by the governor.
4) Eliminates the RDH and RDA from the DBC membership, and
replaces them with two public members to the DBC, appointed
by the governor, by January 1, 2014.
5) Specifies that two of the public members appointed by the
Governor shall serve for a term of two years, and two of the
public members appointed by the Governor shall serve for a
term of three years.
6)Requires DBC, by January 1, 2013, to comply with existing
statute that requires boards within the Department of Consumer
Affairs (DCA), including DBC, to adopt regulations requiring
licensees to provide notice to clients or customers that they
are licensed by the state, and includes certain specified
notice requirements.
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7)Extends the sunset date of the appointment of DBC's executive
officer to January 1, 2016.
8)Requires DBC to adopt written guidelines on how to make
probation assignments for licensees, and to ensure that
probationary and evaluation reports are conducted consistently
and regularly.
9)Requires DBC to ensure that the law and ethics examination
required for licensure reflect current law and regulations,
and to ensure that the examinations are randomized.
10)Deletes existing law provisions requiring a licentiate to
sign an agreement of understanding that the withdrawal or
termination from DBC's diversion program at a time when a
diversion evaluation committee determines the licentiate
presents a threat to the public's health and safety shall
authorize DBC to use diversion treatment records in
disciplinary or criminal proceedings.
11)Requires that if a licentiate withdraws or is terminated from
DBC's diversion program for failure to comply or is determined
to be a threat to the public or his or her own health and
safety, all diversion records for that licentiate shall be
provided to DBC's enforcement program and may be used in any
disciplinary proceeding.
12)Requires the DBC diversion program manager to immediately
notify DBC's enforcement program when a licentiate in a
diversion program tests positive for any banned substance, and
provide the documentation evidencing the positive test result.
Authorizes this documentation's use in a disciplinary
proceeding.
13)Clarifies that fees related to licensing and permitting of
RDAs be established by regulation instead of by resolution.
14)Deletes legislative intent language for DBC to create and
implement an effective forum for dental assisting matters, as
specified.
15)Creates a Dental Assisting Council (Council) of DBC, to
consider all matters relating to RDAs, and make
recommendations to DBC including:
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a) Requirements for RDA examination, licensure, and
renewal;
b) Standards for approval of dental assisting educational
programs and courses;
c) Allowable RDA duties, settings, and supervision levels;
and,
d) Appropriate standards of conduct and enforcement for
RDAs.
16)Requires DBC to appoint members to the Council by July 1,
2012, and include two members of DBC, effective only until
January 1, 2014, and appointees from each of the following
categories in the Council:
a) One RDA and one registered dental assistant in extended
functions (RDAEF) recommended by each incorporated,
nonprofit professional society, association, or other
entity in California whose membership is comprised of RDAs
for selection by the DBC, as specified;
b) One dental assisting educator selected by DBC from a
board-approved or commission-accredited registered dental
assisting program with a current license issued by DBC for
no less than five years and whose teaching experience is no
less than five years; and,
c) Two at-large RDAs selected by DBC.
17)Provides that no Council appointee shall have served
previously on the dental assisting forum or have any financial
interest in any RDA school.
18)Requires certain Council information regarding candidates be
made available in published DBC materials and that final
candidate selection be conducted during DBC's public meetings.
19)Provides that a vacancy occurring during a Council term be
filled by appointment by the DBC for the unexpired term,
according to certain criteria within 90 days.
20)Requires each Council member to meet certain existing
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requirements and comply with conflict of interest
requirements, as specified.
21)Requires the Council to meet in conjunction with other DBC
committees, as specified.
22)Provides that each Council member term is four years, unless
otherwise exempted.
23) Requires DBC to approve, modify, or reject recommendations
by the Council within 90 days of submission to DBC.
Authorizes the Council to request DBC to provide its reasons
in writing for doing so within 30 days of the request.
24)Requires DBC to consider recommendations by the Council when
assigning specific procedures related to examinations for
licensure as a RDA or RDAEF.
25)Requires DBC to consider recommendations by the Dental
Hygiene Committee regarding scope of practice issues, within
90 days of submission to DBC, as specified.
26)Extends the sunset date of the California Dental Corps Loan
Repayment Program of 2002 from July 1, 2012, to until all the
moneys in the account are expended.
27)Makes technical, conforming changes.
EXISTING LAW
1)Establishes the DBC to license and regulate the practice of
dentistry.
2)Specifies that DBC consists of eight practicing dentists, one
RDH, one RDA, and four public members, effective until January
1, 2012.
3)Requires every board within DCA, as specified, to initiate the
process of adopting regulations on or before January 1, 1999,
requiring its "licentiates", as defined, to provide notice to
their clients or customers that they are licensed by this
state.
4)Prohibits a dentist from holding himself or herself out as a
specialist, unless certain specialization requirements are
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met, for purposes of advertising.
5)Authorizes DBC to issue a probationary license to an applicant
for licensure as a dentist or dental auxiliary. Allows DBC to
require a licensee, as a term or condition of issuing a
probationary license, to comply with certain requirements, as
specified.
6)States legislative intent to seek ways and means to identify
and rehabilitate licentiates who abuse dangerous drugs or
alcohol, so that licentiate may be treated and returned to the
practice of dentistry in a manner which will not endanger the
public health and safety.
7)Requires DBC to establish criteria for the acceptance, denial,
or termination of licentiates in a DBC diversion program.
Requires licentiates to sign an agreement of understanding
that withdrawal or termination from the DBC diversion program
at a time when a diversion evaluation committee determines the
licentiate presents a threat to the public's health and safety
and authorizes DBC to use diversion treatment records in
disciplinary or criminal proceedings.
8)Provides that fees related to the licensing and permitting of
RDAs be established by DBC resolution.
9)Makes legislative findings and declarations that RDAs provide
dental care services that are vital to good health. States
legislative intent that DBC create and implement an effective
forum where services, regulatory oversight, and all matters
related to RDAs can be discussed, as specified.
10)Establishes the Dental Corps Loan Repayment Program of 2002
to provide loan repayment assistance to dentists who commit to
a minimum of three years of service in a "dentally underserved
area", as defined.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "This
bill is necessary to extend the sunset date of the DBC and make
programmatic and administrative changes to the DBC as reflected
in the Sunset Background Paper for DBC."
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Background . DBC was created by the California Legislature in
1885, and was originally established to regulate dentists.
Today, DBC is responsible for regulating the practice of
approximately 71,000 licensed dental health professionals in
California, including 35,500 dentists, 34,300 RDAs, and 1,300
RDAEFs. In addition, DBC is responsible for setting the duties
and functions of approximately 50,000 unlicensed dental
assistants. The Dental Practice Act provides that the
"�p]rotection of the public shall be the highest priority of DBC
in exercising its licensing, regulatory and disciplinary
functions. Whenever the protection of the public is
inconsistent with other interests sought to be promoted, the
protection of the public shall be paramount." DBC implements
regulatory programs and performs a variety of functions to
protect consumers. These programs and activities include
setting licensure requirements for dentists, and RDAs, including
examination requirements, issue and renew licenses, issue
special permits, monitor probationer dentists and RDAs and
manage a diversion program for dentists and RDAs whose practice
may be impaired due to chemical dependency or mental illness.
DBC is composed of 14 members: eight practicing dentists, one
RDH, one RDA, and four public members. The eight licensed
dentists, the RDH, the RDA, and two public members are appointed
by the Governor. The Speaker of the Assembly and the Senate
Rules Committee each appoint a public member.
The author's office asserts that a public member majority for
occupational regulatory boards, or greater representation of the
public where current board membership is weighted in favor of
the profession, is preferred for consumer protection. Further,
increasing the public's representation on DBC assures the public
that the professions' interests do not outweigh what is in the
best interest of the public. However, they have not supported
this opinion with any evidence of the failure by DBC, as
currently configured, to protect consumers or that DBC's
professional members only serve to protect their own
professions. Accordingly, the need to change the configuration
of DBC is unsupported particularly with respect to removing the
RDA and RDH representation on DBC.
Although the DBC supports this bill, they do oppose
reconfiguring its membership. The DBC states, "DBC believes
that RDA representation on DBC is critical and therefore opposes
removing the RDA positions from DBC. We respectfully request
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that you re-consider the composition of DBC to include eight
dentists, five public members, and two dental assistants."
The Dental Assisting Alliance proposes that instead of
eliminating dental assisting representation on DBC, the number
of dental assistants and the complexity of their regulation,
dictates their increased formalized input into the decision
making processes of DBC, just as the eight dentist positions on
DBC provide varying types of expertise.
Opponents of this bill argue that DBC oversees over 85,000
dental assistants, as compared to 35,500 dentists, making it
illogical to expand the public representation on the DBC at the
expense of dental assisting. Further, opponents disagree with
the notion that eliminating DBC level participation by
representatives of the regulated community will in any way
result in proper prioritization of, and resolution of, dental
assisting issues as they arise before DBC.
REGISTERED SUPPORT / OPPOSITION :
Support
Dental Board of California
Opposition
California Association of Dental Assisting Teachers
Numerous individuals
Analysis Prepared by : Rebecca May / B.,P. & C.P. / (916)
319-3301