Bill Text: CA SB653 | 2019-2020 | Regular Session | Amended

California Senate Bill 653 (Prior Session Legislation)

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Dental hygienists: registered dental hygienist in alternative practice: scope of practice.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Passed) 2020-09-24 - Chaptered by Secretary of State. Chapter 130, Statutes of 2020. [SB653 Detail]

Download: California-2019-SB653-Amended.html

Amended IN Senate March 27, 2019

CALIFORNIA LEGISLATURE— 2019–2020 REGULAR SESSION

Senate Bill

No. 653

Introduced by Senator Chang

February 22, 2019

~~An act to amend Section 2028.5 of the Business and Professions Code, relating to healing arts.~~ An act to amend Sections 1907, 1911, 1926, and 1926.05 of, and to add Sections 1911.5 and 1926.5 to, the Business and Professions Code, relating to healing arts.

LEGISLATIVE COUNSEL'S DIGEST

SB 653, as amended, Chang. ~~Telehealth.~~ Dental hygienists: registered dental hygienist in alternative practice: scope of practice.

Existing law, the Dental Practice Act, provides for the licensure and regulation of the practice of registered dental hygienists, registered dental hygienists in extended functions, and registered dental hygienists in alternative practice by the Dental Hygiene Board of California within the Department of Consumer Affairs. Existing law makes certain violations of specific provisions relating to healing arts by a licensee a crime.
Existing law specifies the scope of practice of a registered dental hygienist and authorizes a registered dental hygienist to perform, among other things, all functions performed by a registered dental assistant. Existing law requires any procedure performed by a registered dental hygienist that does not specifically require direct supervision of a dentist to be performed under the general supervision of a dentist. Existing law authorizes a registered dental hygienist to provide, without supervision, dental hygiene preventive services in addition to oral screenings in a specified federal, state, or local public health program.
This bill would authorize a registered dental hygienist to perform the functions of a registered dental assistant in a dental or medical setting and would authorize a registered dental hygienist to provide, without supervision, fluoride varnish to a patient. The bill would authorize a registered dental hygienist to provide dental hygiene preventive services and oral screenings in a public health program or in a community-based organization outreach program.
Existing law authorizes a registered dental hygienist in alternative practice to perform any of the duties or functions authorized to be performed by a registered dental hygienist and to additionally perform specified duties in residences of the homebound, schools, residential facilities and other institutions, and dental health professional shortage areas, as specified. Existing law requires the duties and functions of a registered dental hygienist in alternative practice in these settings to be performed under the general supervision of a dentist when specified.
This bill would additionally authorize a registered dental hygienist in alternative practice to perform specified functions and duties of a registered dental hygienist in dental or medical settings and would remove the authorization to practice in certified dental health professional shortage areas. The bill would authorize a registered dental hygienist in alternative practice to perform soft-tissue curettage, administration of local anesthesia, and administration of nitrous oxide and oxygen under the direct supervision of a dentist in the above-specified settings and would remove the general supervision requirement for specified duties in those settings. The bill would also authorize a registered dental hygienist in alternative practice to establish a practice in counties with 10 or fewer Denti-Cal providers accepting new Denti-Cal patients, as provided, and to perform specified duties in their practice without supervision of a dentist.
Because a violation of certain provisions of the bill would be a crime, the bill would create a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
The Medical Practice Act establishes the Medical Board of California to regulate, among other things, the practice of telehealth, as defined. Existing law authorizes the board to establish a pilot program to expand the practice of telehealth and to convene a working group to implement the pilot program.
~~This bill would make a nonsubstantive change to the pilot program provision.~~

Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NOYES

The people of the State of California do enact as follows:

SECTION 1.

Section 1907 of the Business and Professions Code is amended to read:

1907.

The following functions may be performed in a dental or medical setting by a registered dental hygienist, in addition to those authorized pursuant to Sections 1908 to 1914, inclusive:

(a) All functions that may be performed by a registered dental assistant.

(b) All persons holding a license as a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions as of December 31, 2005, are authorized to perform the duties of a registered dental assistant specified in this chapter. All persons issued a license as a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions on or after January 1, 2006, shall qualify for and receive a registered dental assistant license prior to performance of the duties of a registered dental assistant specified in this chapter.

SEC. 2.

Section 1911 of the Business and Professions Code is amended to read:

1911.

(a) A registered dental hygienist may provide, without supervision, educational services, oral health training programs, and oral health screenings.

(b) A registered dental hygienist shall refer any screened patients ~~with possible oral abnormalities~~ to a dentist for a comprehensive examination, diagnosis, and treatment plan.

(c) In any public health program ~~created by federal, state, or local law or administered by a federal, state, county, or local governmental entity,~~ or a community-based organization outreach program, a registered dental hygienist may provide, without supervision, dental hygiene preventive services in addition to oral screenings, including, but not limited to, the application of fluorides and pit and fissure sealants. A registered dental hygienist ~~employed~~ practicing as described in this subdivision may submit, or allow to be submitted, any insurance or third-party claims for patient services performed as authorized in this article.

(d) For purposes of this section, “community-based organization” shall be defined as in subdivision (a) of Section 1149 of Title 16 of the California Code of Regulations.

SEC. 3.

Section 1911.5 is added to the Business and Professions Code, to read:

1911.5.
Notwithstanding Section 1912, a registered dental hygienist may provide, without supervision, fluoride varnish to a patient.

SEC. 4.

Section 1926 of the Business and Professions Code is amended to read:

1926.

A registered dental hygienist in alternative practice may perform the duties authorized pursuant to subdivision (a) of Section 1907, subdivision (a) of Section 1908, subdivisions (a), (b), and (c) of Section 1909, and subdivisions (a) and (b) of Section 1910 in the following settings:

(a) Residences of the homebound.

(b) Schools.

~~(d)Dental health professional shortage areas, as certified by the Office of Statewide Health Planning and Development in accordance with existing office guidelines.~~
(d) Dental or medical settings.

SEC. 5.

Section 1926.05 of the Business and Professions Code is amended to read:

1926.05.

(a) In addition to the duties specified in Section 1926, a registered dental hygienist in alternative practice is authorized to perform the duties pursuant to Section 1910.5, in the following settings:

(1) Residences of the homebound.

(2) Schools.

(3) Residential facilities and other institutions.

(4) Dental or medical settings.
(5) Counties described in Section 1926.5.

(b) A registered dental hygienist in alternative practice is authorized to perform the duties pursuant to paragraph (2) of subdivision (a) of Section 1910.5 in the settings specified in this ~~section under the general supervision of a dentist.~~ section.

SEC. 6.

Section 1926.5 is added to the Business and Professions Code, to read:

1926.5.
(a) A registered dental hygienist in alternative practice may practice in a county with 10 or fewer Denti-Cal providers accepting new Denti-Cal patients.
(b) A registered dental hygienist in alternative practice may practice in a county with more than 10 Denti-Cal providers accepting new Denti-Cal patients only if the registered dental hygienist in alternative practice established the practice in accordance with subdivision (a) and 15 percent of the practice’s patients are persons without dental insurance or are persons eligible for Denti-Cal.

SEC. 7.
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.

SECTION 1.Section 2028.5 of the Business and Professions Code is amended to read:
2028.5.
~~(a)The board may establish a pilot program to expand the practice of telehealth in the state.~~
(b)To implement this pilot program, the board may convene a working group of interested parties from the public and private sectors, including, but not limited to, state health-related agencies, health care providers, health plan administrators, information technology groups, and groups representing health care consumers.
(c)The purpose of the pilot program shall be to develop methods, using a telehealth model, to deliver throughout the state health care to persons with chronic diseases as well as information on the best practices for chronic disease management services and techniques and other health care information as deemed appropriate.