BILL NUMBER: SB 694 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 20, 2012
AMENDED IN SENATE JANUARY 25, 2012
AMENDED IN SENATE JANUARY 12, 2012
AMENDED IN SENATE JANUARY 4, 2012
AMENDED IN SENATE MARCH 29, 2011
INTRODUCED BY Senator Padilla
(Coauthors: Senators Emmerson and Price)
FEBRUARY 18, 2011
An act to add Section 104766 to, to add Article 2.5 (commencing
with Section 104767) to Chapter 3 of Part 3 of Division 103 of, and
to repeal Section 104767.1 of, the Health and Safety Code, relating
to dental care.
LEGISLATIVE COUNSEL'S DIGEST
SB 694, as amended, Padilla. Dental care.
Existing law requires the State Department of Public Health to
maintain a dental program that includes, but is not limited to,
development of comprehensive dental health plans within the framework
of a specified state plan.
This bill would make these provisions inoperative for a specified
period of time upon the creation of a Statewide Office of Oral Health
within the State Department of Public Health with a licensed dentist
who serves as the dental director. This bill would provide that no
General Fund moneys shall be used to implement the provisions
creating the office, but would authorize the state to accept other
public and private funds for the purpose of implementing these
provisions, and would provide that these provisions become
inoperative, as specified, if other public or private funds are not
deposited with the state in an amount sufficient to fully support the
activities of the office. This bill would authorize , until
January 1, 2017, the office to conduct a specified study under
described circumstances.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature finds and declares all of the
following:
(a) Nationally and statewide, tooth decay ranks as the most common
chronic disease and unmet health care need of children.
(b) Poor dental health can disrupt normal childhood development,
seriously damage overall health, and impair a child's ability to
learn, concentrate, and perform well in school. In rare cases,
untreated tooth decay can lead to death.
(c) Unmet dental needs have significant human and financial costs.
In 2007, it was estimated that California schools lost nearly thirty
million dollars ($30,000,000) in attendance-based school district
funding due to 874,000 missed school days related to dental problems;
and California's hospitals experienced over 83,000 emergency room
visits for preventable dental problems at a cost of fifty-five
million dollars ($55,000,000).
(d) With full implementation of the federal Patient Protection and
Affordable Care Act (Public Law 111-148), approximately 1.2 million
additional children in California are expected to gain dental
coverage.
(e) The burden of oral disease can be markedly decreased through
early intervention, including education, prevention, and treatment.
Effective prevention reduces the need for costly treatment of
advanced dental disease.
(f) To address this unmet need, a comprehensive coordinated
strategy is necessary, at the foundation of which is a strong state
oral health infrastructure to coordinate essential public dental
health functions, including assessing need and capacity to address
that need.
SEC. 2. Section 104766 is added to the Health and Safety Code, to
read:
104766. This article shall become inoperative on the date the
Department of Finance memorializes in writing, pursuant to paragraph
(2) of subdivision (e) of Section 104767, that sufficient funds have
been deposited with the state to establish the Statewide Office of
Oral Health, and shall become operative again on the date the
Department of Finance memorializes in writing, pursuant to paragraph
(2) of subdivision (f) of Section 104767, that the office has not
secured sustainable funding sources to maintain the activities of the
office, or on January 1, 2016, whichever occurs first.
SEC. 3. Article 2.5 (commencing with Section 104767) is added to
Chapter 3 of Part 3 of Division 103 of the Health and Safety Code, to
read:
Article 2.5. Statewide Office of Oral Health
104767. (a) There shall be a Statewide Office of Oral Health
within the State Department of Public Health.
(b) Within the office there shall be a licensed dentist who serves
as the dental director.
(c) The dental director and his or her staff shall have all of,
but not be limited to, the following responsibilities:
(1) Advancing and protecting the oral health of all Californians.
(2) Developing a comprehensive and sustainable state oral health
action plan to address the state's unmet oral health needs.
(3) Encouraging private and public collaboration to meet the oral
health needs of Californians.
(4) Securing funds to support infrastructure and statewide and
local programs.
(5) Promoting evidence-based approaches to increase oral health
literacy.
(6) Establishing a system for surveillance and oral health
reporting.
(d) The state may accept public funds and private funds for the
purpose of implementing this article.
(e) (1) No General Fund moneys shall be used for purposes of this
section. Moneys to fund the office shall be secured from other public
or private sources. The Department of Finance shall, on January 1,
2014, and annually thereafter, make a determination regarding the
funding status of the office. Moneys needed to sufficiently fund and
commence the study pursuant to Section 104767.1 shall not be
considered for purposes of determining the funding status of the
office pursuant to this paragraph.
(2) The office shall be established pursuant to this section only
after a determination has been made by the Department of Finance that
public or private funds in an amount sufficient to fully support the
activities of the office, including staffing the office, have been
deposited with the state. If the Department of Finance makes a
determination that sufficient funding has been secured to establish
the office, the Department of Finance shall file a written statement
with the Secretary of the Senate, the Chief Clerk of the Assembly,
and the Legislative Counsel memorializing that this determination has
been made.
(f) (1) If the office is established pursuant to this section, the
office shall assume responsibility for identifying and securing
funding sources in order to maintain the functions of the office.
(2) If the Department of Finance makes a determination that the
office has not secured sustainable funding sources to maintain the
activities of the office pursuant to paragraph (1), the Department of
Finance shall file a written statement with the Secretary of the
Senate, the Chief Clerk of the Assembly, and the Legislative Counsel
memorializing that this determination has been made.
(g) This section shall become inoperative on January 1, 2016.
104767.1. (a) The Legislature finds and declares that, as part of
a comprehensive integrated system of dental care, with the dentist
as the head of that system, additional dental care
providers who provide basic preventive and restorative oral health
care to underserved children, located at or near where children live
or go to school, may have the potential to reduce the oral health
disease burden in the population most in need.
(b) The office may design and implement a scientifically rigorous
study to assess the safety, quality, cost-effectiveness, and patient
satisfaction of expanded dental procedures performed by dental
care providers for the purpose of informing future decisions
about how to meet the state's unmet oral health need for the state's
children. The research parameters of the study shall include public
health settings, multiple models of dentist supervision, multiple
pathways of education and training, and multiple dental providers.
Procedures performed during the study shall be performed only by
dental care providers within the confines of a
university-based study.
(c) The dental director or, in the absence of a dental
director, the Secretary of California Health and Human Services or
his or her designee shall convene an advisory group on study
design and implementation. The advisory group shall be comprised of
representatives of all dental practices, including traditional and
nontraditional, as well as nondentists and consumer advocates
.
(d) The dental director or, in the absence of a dental
director, the Secretary of California Health and Human Services or
his or her designee shall provide input regarding study design
and implementation, receive all study data and reports, and develop a
report and recommendations to be submitted to the Legislature based
on the study findings. The dental director or, in the absence of
a dental director, the Secretary of California Health and Human
Services or his or her designee shall also consult with the
Legislative Analyst's Office in designing the study and selecting any
contractors.
(e) (1) The study shall be limited to a dentist licensed pursuant
to Article 2 (commencing with Section 1625) of Chapter 4 of Division
2 of the Business and Professions Code and at least two of each of
the following dental care providers:
(A) A registered dental hygienist, as defined in Article 9
(commencing with Section 1900) of Chapter 4 of Division 2 of the
Business and Professions Code, who is educated in a limited number of
additional dental procedures.
(B) A registered dental assistant in extended function licensed
pursuant to Section 1753 of the Business and Professions Code who is
educated in a limited number of additional dental procedures.
(2) The dental procedures that may be examined in the study shall
be limited to the following:
(A) Administration of local anesthesia.
(B) Tooth preparation for, and the placement and finishing of,
direct restorations.
(C) Placement of interim therapeutic restorations.
(D) Stainless steel crown placement.
(E) Therapeutic pulpotomy.
(F) Pulp cap placement, direct and indirect.
(G) Extraction of primary teeth.
(3) The study shall examine and compare the procedures described
in paragraph (2), as performed under the following types of
supervision:
(A) Direct supervision, as defined in subdivision (c) of Section
1902 of the Business and Professions Code.
(B) General supervision, as defined in subdivision (d) of Section
1902 of the Business and Professions Code.
(C) Remote supervision by a dentist where the supervising dentist
is not onsite while a dental care provider is practicing as
authorized by this section and shall be facilitated by "standing
orders" as an agreement between the dental care provider and
supervising dentist. The dental care provider shall not perform
duties beyond what is agreed upon in the standing orders. Remote
supervision may consist of all of the following:
(i) Incorporate the use of technology, such as telehealth, to
facilitate dentists providing remote supervision to the dental care
provider, where the dental care provider does not have to be in the
same location as the supervising dentist.
(ii) Include a mechanism for the dental care provider to seek and
receive additional professional advice in a timely manner as needed.
(iii) Include a mechanism for the dental care provider to make
referrals to a qualified dentist, as needed.
(4) The study shall examine dental care providers in public health
settings that represent the racial, ethnic, urban, and rural
diversity of California's child population. Settings may include, but
not be limited to, community health clinics, Head Start, and schools
with greater than 50 percent participation in the federal free and
reduced-price lunch program.
(5) The study shall be conducted through a dental school at an
institution of higher education within the state.
(e) There shall be no
( f) No General Fund
moneys shall be used to implement this section. Moneys to
fund the study, including analysis and findings, and all procedures
administered by dental care providers during the study,
shall be secured from other public or private sources. No one
provider group or interest group may provide more than half the
private funding for the study.
(f)
( g) Notwithstanding subdivision
(g) (h) , if the study described in this section
is not sufficiently funded and commenced by January 1, 2014, this
section shall become inoperative on January 1, 2014.
(g)
(h) This section shall remain in effect only until
January 1, 2016 2017 , and as of that
date is repealed, unless a later enacted statute, that is enacted
before January 1, 2016 2017 , deletes
or extends that date.