BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 1416 (Block)
          As Amended  
           April 10, 2014     
          Majority vote 

           SENATE VOTE  :33-0  
           
           BUSINESS & PROFESSIONS      8-1                                 
           
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          |Ayes:|Bonilla, Dickinson,       |     |                          |
          |     |Eggman, Gordon, Holden,   |     |                          |
          |     |Mullin, Skinner, Ting     |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Wilk                      |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Increases the fee for an initial license and the  
          biennial renewal of a license to practice dentistry to $525.  

           FISCAL EFFECT  :  None.  This bill is keyed non-fiscal by the  
          Legislative Counsel. 

           COMMENTS  :   

          1)Purpose of this bill.  This bill would eliminate the fee cap  
            and set the fee for an initial license and the renewal of a  
            license to practice dentistry at $525, an increase over the  
            $450 fee currently set in regulation, to ensure the Dental  
            Board of California (DBC) is solvent and has the funding it  
            needs to support its programs in future years.  This bill is  
            sponsored by the DBC.

          2)Author's statement.  According to the author, "The DBC is  
            projecting a fund balance deficit of $2.239 million in [Fiscal  
            Year (FY)] 2015-16 as well as an ongoing fund balance deficit  
            thereafter.  The DBC has worked in consultation with the DCA  
            [Department of Consumer Affairs] Budget Office and has  
            determined it is necessary for the DBC to increase the initial  
            licensure and biennial renewal fees assessed to its dentist  
            licensees.  Averting or delaying an immediate fee increase  
            will cause the DBC to become insolvent in FY 2015-16.  The DBC  








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            is proposing to correct a structural imbalance between its  
            revenue and expenditures."

          3)The Dental Board of California.  The DBC licenses and  
            regulates over 100,000 licensees, including over 45,000  
            dentists.  The DBC's highest priority is the protection of the  
            public when exercising its licensing, regulatory, and  
            disciplinary functions.  The primary functions of the DBC are  
            issuing licenses to eligible applicants; investigating  
            complaints against licensees and disciplining licensees for  
            violations of the Dental Practices Act (Act); monitoring  
            licensees whose licenses have been placed on probation  
            (roughly 35 per year); and managing the Diversion Program for  
            licensees whose practice may be impaired due to abuse of  
            dangerous drugs or alcohol.  Last quarter, DBC received 778  
            complaints, closed 746 complaints, and closed, filed with the  
            Attorney General (AG), or filed with a district or city  
            attorney 218 cases.  Averaging these statistics over the year,  
            DBC could expect to receive over 3,000 complaints, close over  
            2,900 complaints, and close, file with the AG or file with the  
            district or city attorney over 800 cases.     

          4)License fee increases.  In 1997, SB 1243 (Hughes), Chapter  
            791, increased the statutory ceiling for license fees from  
            $250 to $450.  Shortly after the passage of SB 1243, the  
            initial license and the biennial license renewal fees were  
            increased through regulation from $240 to $365.  For the last  
            16 years, fees have remained at $365.  In 2013, DBC  
            promulgated regulations to increase the fee amount to $450.   
            These regulations will go into effect on July 1, 2014.

          An analysis conducted by DCA's Budget Office, based on the last  
            five fiscal years, indicated that the initial license and  
            renewal fees should be raised to $525 in order for DBC to  
            remain solvent into the foreseeable future.  With the fee  
            increase, the fund may be solvent until FY 2017-18, assuming  
            DBC will incur cost savings of $1 million dollars from reduced  
            enforcement expenditures and additional revenue of over  
            $200,000 from cost recovery efforts annually.  

          If license fees were raised to $525 pursuant to this bill, the  
            following ancillary fees would also be impacted because those  
            fees are based on initial and renewal license fee amounts:   
            inactive licenses, licenses on retired or disability status,  








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            oral and maxillofacial surgery permit renewal fees, fictitious  
            name permit application fees, and delinquent  
            retirement/disability renewals.  DBC expects that the  
            additional fee increase contained in this bill would raise  
            close to an additional $1.4 million dollars annually. 

          5)The State Dentistry Fund.  The State Dentistry Fund is  
            maintained by the DBC and includes the revenues and  
            expenditures related to licensing for dentists.  If this fee  
            increase is not adopted, for FY 2014-15, the fund is expected  
            to have $9,732,000 in total revenues, based on the recently  
            adopted increase in license fees to $450, and $12,454,000 in  
            total disbursements ($12,444,000 for program expenditures),  
            leading to an imbalance of $2,722,000.  (There is no projected  
            deficit for FY 2014-15 because the fund began with a balance  
            of $3,457,000.)  By FY 2015-16, that imbalance is projected to  
            increase to a deficit of $2,239,000.  

          Between FY 2012-13 and FY 2013-14, DBC's program expenditures  
            increased by almost $2.5 million.  The reason for this jump in  
            expenditures includes, among other things, funding 12.5 new  
            enforcement positions to improve processing investigations;  
            funding the operation of the diversion program; increased  
            expenses associated with the development and implementation of  
            DCA's BreEZe system; and unanticipated expenses as a result of  
            litigation.  For example, in FY 2013-14 and FY 2015-16, DBC is  
            expected to spend almost $600,000 on the diversion program  
            alone.  The structural imbalance between the fund's revenues  
            and expenditures can be attributed to these reasons, in  
            addition to the general increase in the cost of doing business  
            and the fact that fees have not increased since 1998.  

          According to DBC, it may be unable to maintain existing programs  
            and services without this proposed fee increase, and  
            operations may suffer if it reduces expenditures, including  
            reduction of staffing and operating resources and equipment.   
            Reducing staff may result in increased delays in responding to  
            licensing inquiries and application approvals, which would  
            create a barrier to licensure for those applicants graduating  
            dental school and seeking licensure and employment in a timely  
            manner.  It may also lead to delays in processing consumer  
            complaints, conducting investigations, and referring cases to  
            the Attorney's General's Office for prosecution.









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          6)License fees in other states and for other professions.   
            Establishing a biennial renewal fee of $525 would result in an  
            average cost per year for licensure at $262.50, which is  
            comparable to licensing renewal fees for dentists in other  
            states and below the biennial licensing renewal fees for other  
            healing arts professions in California.  

          For example, the average cost per year of licensure for dentists  
            is $183 in New Mexico, $216 in Arizona, $300 in Nevada, and  
            $350 in Texas.  The average cost per year for licensure for  
            other healing arts professions in California is $210 for  
            psychologists $404 for physicians and surgeons, and $560 for  
            podiatrists.
           
           7)Arguments in support.  According to the DBC, this bill "will  
            enable the [DBC] to sustain operations to effectively protect  
            consumers through its licensing and enforcement functions. 

          "To provide better public protection, the [DBC] has made  
            enhancements to its enforcement program over the last [15]  
            years; these enhancements have included increased analytical  
            and investigative staffing to process and investigate consumer  
            complaints in an effective and efficient manner.  The proposed  
            fee increases will support the [DBC's] enforcement program so  
            that it may continue to process and investigate consumer  
            complaints effectively and efficiently."

          8)Arguments in Opposition.  There is no opposition on file.


           Analysis Prepared by  :    Eunie Linden / B., P. & C.P. / (916)  
          319-3301 


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