Bill Text: CA SB694 | 2011-2012 | Regular Session | Amended
Bill Title: Dental care.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Engrossed - Dead) 2012-08-16 - Set, second hearing. Held in committee and under submission. [SB694 Detail]
Download: California-2011-SB694-Amended.html
BILL NUMBER: SB 694 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY AUGUST 6, 2012
AMENDED IN ASSEMBLY JUNE 28, 2012
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. The bill would provide that
the office would be established only upon receipt of sufficient
funds, as specified, for the purposes of performing various duties
relating to the oversight of dental care in California. This
bill would provide that no prohibit
General Fund moneys shall be from being
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
dental director or, in the absence of a dental
director, the Secretary of California Health and Human Services or
his or her designee to conduct provide
administrative oversight with respect to a specified study
conducted 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 2017 ,
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 Subject to receipt of
sufficient funds, as specified in subdivision (e), there shall
be a Statewide Office of Oral Health established within
the State Department of Public Health.
(b) Within the office there shall be a licensed dentist who serves
as the dental director. The dental director shall be
appointed by the Governor, subject to confirmation by the Senate, and
shall serve at the pleasure of the Governor. The
dental director shall serve as a public official and shall be subject
to all relevant statutory requirements relating to conflicts of
interest. The dental director shall be a licensed dentist in
good standing who has demonstrated dental and management experience,
including at least five years of experience in public dental health.
(c) The office shall may have all
of, but not be limited to, the following responsibilities ,
which shall be prioritized depending upon the receipt of funding, as
described in subdivision (e) :
(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) If the office is established pursuant to this section, the
office shall administer the dental programs described in Section
104750.
(d)
(e) The state department
may accept public funds and private funds for the purpose of
implementing receive for the office any financial aid
granted by any private, federal, or other grant or source, and the
office shall use these funds to carry out the provisions and purposes
of this article.
(e)
(f) (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 within 90 days of
receiving any funds , 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 dental director shall
be established appointed pursuant to
this section only after a determination has been made by the
Department of Finance that sufficient 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 for purposes of establishing
the office pursuant to subdivision (a) . 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)
(g) (1) If the office dental
director is established appointed
pursuant to this section, the office dental
director 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 dental director 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)
(h) This section shall become inoperative on January 1,
2016 2017 .
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 dental director or, in the
absence of a dental director, the Secretary of California Health
a nd Human Services or his or her designee
may provide administrative oversight to the design
and implement implementation of 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
The study shall be designed and implemented as
described in subdivisions (c) to (h), inclusive, and procedures
performed during the study shall be performed only by dental care
providers within the confines of a university-based
the 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 administrative oversight necessary to
ensure that the study is conducted as described in this section,
provide input to the university described in paragraph (5)
of subdivision (e), 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 regarding oversight of
the study and selecting selection of
any contractors.
(e) (1) The study shall be limited to a dentist
dentists 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 , who have received training in
a limited number of additional dental procedures :
(A) A registered dental hygienist
Registered dental hygienists , 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
Registered dental assistants 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 , and who have completed the requirements
of Section 1753.4 of the Business and Professions Code .
(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 section.
Remote supervision 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 described
in paragraph (1) who are delivering care for children in public
health settings that represent the racial, ethnic, urban, and rural
diversity of California's child population. Settings
The public health settings may include, but
are not be limited to, community health
clinics, Head Start facilities , and schools with greater
than 50 percent 50-percent pupil
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.
A California university dental school, under the auspices of its
institutional review board and in accordance with accepted academic
standards, shall design and implement the study, with all instruction
conducted under the oversight of a dentist.
(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.
(g) Notwithstanding subdivision (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.
(h) This section shall remain in effect only until January 1,
2017, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2017, deletes or extends
that date.
