California Dental Hygienists Association Government Affairs Update Sept 1, 2014

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1 Califrnia Dental Hygienists Assciatin Gvernment Affairs Update Sept 1, 2014 Gvernment Relatins Cuncil (GRC) Members: C-Chairs Lisa Okamt and Maureen Titus, Kathy Frbes, Susan Lpez, Lin Sarfaraz, Vickie Kimbrugh Walls, Megan Carr, Brian Pepperill, Legislative Cnsultant JAnn Gallian. Ex-ffici members: CDHA Executive fficers Karine Strickland, Lygia Jlley and Nadine Lavell alng with CalHyPAC Chair Carle Ryan. Legislative Advcates: Aarn Read & Assciates Issues highlighted in this update: AB 1174, Scpe Expansin and Teledentistry CDHA psitin Supprt SB 850, Cmmunity Cllege Baccalaureate Prgrams CDHA psitin Supprt SB 1000, Sweetened Beverage Warning Label Status: Failed SB 1245, DHCC Sunset Extensin CDHA psitin Supprt Dental Hygiene Cmmittee f Califrnia (DHCC) Title 16 Prpsed Regulatins Bills ften underg numerus amendments during the legislative prcess and CDHA adjusted its psitin accrdingly during the year. The CA legislative calendar fr 2014 ended Aug 31 and all bills passed by the Legislature as f that date were sent n t the Gvernr. Legislative bills can be tracked at GRC thanks the members f CDHA fr their passinate and dedicated effrts this year twards ur legislative gals. Fr questins r mre infrmatin, cntact GRC C-Chairs: Lisa Okamt liskamt@al.cm r Maureen Titus naseema6@sbcglbal.net ² AB 1174 (Bcanegra/Lgue) Scpe Expansin and Teledentistry CDHA Psitin Supprt Status rdered t Enrllment (final cpy f bill passed by bth huses in identical frm) and Engrssing (fficial cpy f bill passed by bth huses including any flr amendments). Next Step Gvernr s desk Histry Intrduced in Assembly Feb 22, 2013 Amended March 21, 2013 Amended April 9, Passed Assembly Business & Prfessins Cmmittee (B&P) April 16 befre becming a tw year bill (CDHA Supprt if Amended) Amended Jan (CDHA Oppse Unless Amended) - Passed Assembly Health Jan 14, Apprpriatins Jan 23, and full Assembly Jan 27 Mved t Senate Amended May 21 (CDHA Oppse) Passed Senate B&P June 16 Passed as Amended Senate Health June 25 (CDHA supprted amendments) Amended July 2, 2014 (CDHA Supprt) - Passed Apprpriatins Aug 14 Amended in Senate August 22; Passed Senate Aug 27 Assembly cncurrence with Senate amendments Aug 28 Wuld incrprate int law new duties that were tested in the current Virtual Dental Hme, Health Wrkfrce Pilt Prject (HWPP #172). The bill seeks t imprve access t care fr underserved ppulatins, by expanding scpe f practice in designated areas fr all dental hygienists (RDH, RDHAP and RDHEF), as well as RDAEF (licensed after January 2010), withut a dentist n site, under general Gvernment Affairs Update September 1, f 5

2 supervisin utilizing telehealth technlgy. Revisins t the Dental Practice Act wuld: Allw RDAEF and all hygienists t determine and take radigraphs n a patient, wh has nt had an initial exam by a dentist, fr the purpse f securing a dental diagnsis, treatment plan and instructins t perfrm an Interim Therapeutic Restratin (ITR). Allw RDAEF and hygienists t remve sft material with hand instruments (n rtary devices) and place an ITR (defined as a direct prvisinal restratin placed t stabilize the tth until a dentist diagnses the need fr further definitive treatment) after the diagnsis and authrizatin by a dentist Allwable settings fr the new duties fr RDAEF and RDH include the dental ffice; and public health settings such as schls, head start, pre-schl prgrams, and cmmunity clinics, utilizing telehealth. Additinal allwable settings fr RDHAP include the residences f the hmebund, schls, and residential facilities and institutins. The setting f Dental Prfessinal Shrtage Areas (DPSA) fr RDHAP was excluded. Defines telehealth as a means f cmmunicatin with an authrizing dentist and allws fr Medi-Cal billing f teledentistry Stipulates that is the dentists respnsibility t prvide written patient f recrd ntificatin fr care prvided at the directin f a dentist. Als clarified that this patient ntificatin is nt required fr dental hygiene preventive services and care prvided by public health hygienists and RDHAP. Curriculum regulatins fr RDH and RDHAP new scpe will be develped and adpted by the DHCC, with the regulatins fr ITR matching thse develped and adpted by the DBC fr the RDAEF. Until such regulatins are adpted, the prtcls established by Health Wrkfrce Pilt Prject (HWPP) 172 (Virtual Dental Hmes) will be used. CDHA will cntinue t advcate fr the inclusin f DPSA as an allwable setting fr the new RDHAP duties in the future. ² Senate Bill (SB) 850 (Blck/Hill) Cmmunity Cllege Baccalaureate Pilt Prgrams CDHA Psitin Supprt Status Enrllment/Engrssing; Next step Gvernr s desk Histry Intrduced in Senate Jan 9, 2014 Amended April 10 Passed as Amended Senate Cmmittee n Educatin April 24 Amended May 1 - Passed Apprpriatins May 23 and full Senate May 27 Mved t Assembly Amended June 16 Passed as Amended Assembly Cmmittee n Higher Educatin June 24 Amended June 26 and again August 4 Passed as Amended Assembly Apprpriatins August 14 Amended Aug 18 - Passed full Assembly August 20 Senate Cncurrence with Assembly amendments Aug 21 Wuld authrize the establishment f ne baccalaureate degree pilt prgram per cmmunity cllege campus per district, at a limited number f campuses t be determined by the Chancellr Gvernment Affairs Update September 1, f 5

3 ² Senate Bill (SB) 1000 (Mnning/Steinberg) Sweetened Beverage Warning Label CDHA Psitin Supprt Status Failed in Assembly Health Cmmittee Histry Intrduced in Senate February 13, 2014, amended March 27, Passed Senate Health April 29 Passed as Amended Senate Apprpriatins May 23 Amended May 27 and passed full Senate n May 29 Failed passage by Assembly Health June 17. Recnsideratin granted but did nt ccur. This bill wuld have established the Sugar-Sweetened Beverage Safety Warning Act mandating warning labels, n beverage cntainers, packs and dispensing machines, f the relatinship between the cnsumptin f sugar-sweetened beverages and besity and assciated health risks as well as dental disease. ² Senate Bill (SB) 1245 (Lieu/Bnilla) - DHCC Sunset Extensin CDHA Psitin Supprt Status Ordered t Engrssing/Enrllment. Next step Gvernr s Desk Histry Intrduced in Senate Feb 20, 2014 Passed Senate B&P April 28, Senate Apprpriatins May 23, and full Senate n May 27 Passed Assembly B&P June 24, Assembly Apprpriatins Aug 14, full Assembly Aug 26 Cntinues the peratins f the DHCC beynd the current January 2015 sunset date and sets the next sunset date t January 1, 2019, when the DHCC peratins existence and benefit t Califrnia cnsumers must nce again be reviewed and validated. As part f this year s sunset review prcess, suggestins by bth the DHCC and CDHA t imprve service t the public as well as increase access t care were submitted t the Assembly and Senate Business and Prfessins Jint Sunset Review Sub-Cmmittee (JLSRC). The JLSRC staff reprt cmmented favrably n sme f thse recmmendatins and CDHA will fllw up n the JLSRC suggestin f separate legislatin in 2015 t implement changes t the Dental Practice Act. Dental Hygiene Cmmittee f Califrnia (DHCC) ² Title 16 Prpsed Regulatins fr Dental Prgram Curriculum Status The rulemaking relative t RDH Educatinal Prgrams has been sent t the Department f Cnsumer Affairs (DCA) and is currently underging Departmental review. After DCA Legal, Budgets and Executive Office apprval, the package will g t Business, Cnsumer Services and Husing Agency, and then Department f Finance. Regulatins usually take 12 t 18 mnths t cmplete. This rulemaking began in March 2014 after the first public cmment perid. The final review will ccur at the Office f Administrative Law (OAL), hpefully by February Histry Gvernment Affairs Update September 1, f 5

4 T fulfill its duty f apprving dental hygiene prgrams in Califrnia, prpsed curriculum definitins and regulatins were develped in Public hearings were held n January 6 and April 28 f 2014 t slicit public cmment, as well as a presentatin made t the Califrnia Dental Hygiene Educatrs Assciatin (CDHEA) in February. Amendments were taken at the April hearing and the ensuing public cmment perid ended June 6. CDHA supprts the prpsed definitins and the need fr DHCC regulatins, fllwing natinally recgnized dental hygiene standards f care, leaving the details f the curriculum regulatins t CDHEA and the DHCC. GRC member Kimbrugh-Walls, a DH prgram directr, kept GRC apprised f CDHEA cncerns and submitted public cmment. CDHA respnded t Califrnia Dental Assciatin (CDA) attrney letters t the Department f Cnsumer Affairs, the Dental Bard f Califrnia, and the DHCC. The CDHA respnse letter can be fund in the Members Sectin. ² Title 16 Prpsed Regulatins fr New DH Prgram Feasibility Study Prpsed regulatins have been develped and were n the agenda at the DHCC May 2-3, 2014 Meeting. A 45 day public cmment perid ensued. ² Title 16 Prpsed Regulatins fr Apprval f RDH Educatinal Prgram Ntice f Public Hearing, Initial Statement f Reasns and Prpsed Language have been psted n the DHCC website The Public Hearing is set fr September 10 Fr mre Infrmatin n DHCC prpsed regulatins, g t and the link Regulatry Hearings Califrnia Dentists Licensure by Prtfli - in 2008, the Dental Bard f Califrnia (DBC) began cnsidering alternative pathways t initial licensure fr dentists in Califrnia. The Califrnia clinical and written exams fr dentists were eliminated by Assembly Bill 1524 in 2010, and replaced with a prtfli examinatin pathway, t be develped. Over the past 4 years, the DBC has been develping thse guidelines fr the Licensure by Prtfli pathway. It is currently in the Finance stage f rulemaking. Nte that Licensure by Prtfli des nt eliminate the live patient exam, but rather prvides a 3 rd pathway t licensure fr Califrnia dentists, alng with Licensure by Residency and the Western Reginal Exam Bard (WREB) clinical exam. This pathway is being mnitred by the DHCC as well as CDHA, as we t cnsider alternative pathways t initial licensure fr dental hygienists. Recent Histrical Infrmatin ² Effective January 1, 2014, the DHCC increased biannual dental hygiene license renewal fees as well as ther select fees, and reflect the perating csts f a self regulating bard. Fr the full list f fee increases, g t ² The DHCC has accepted Central Reginal Dental Testing Services (CRDTS) as an apprved testing site fr initial DH licensure in Califrnia. This prvides Califrnia dental hygiene students a third ptin fr initial licensure, alng with the Califrnia and Western Reginal (WREB) exams ² SB 1202, a bipartisan bill spnsred by CDHA and authred by Senatrs Len (D) and Wyland (R), became law n January 1, Key features f the bill included clean Gvernment Affairs Update September 1, f 5

5 up language t legislatin that created the Dental Hygiene Cmmittee f Califrnia (DHCC) and prvided Califrnia with sme cntrl ver dental hygiene educatinal prgrams in ur state. The bill achieved the fllwing gals: Special Permit language allws an RDH licensed in anther state t teach in a dental hygiene prgram withut a Califrnia license with a Special Permit Allws DHCC the discretin f requiring a needs assessment fr applicatins f new dental hygiene prgrams befre they apply t CODA. New prgrams must nw prvide prf that they have adequate facilities, adequate faculty and adequate emplyment pprtunities fr graduating students. It shuld be nted that in February, 2012, the ADA Cmmissin n Dental Accreditatin accepted the ADHA recmmendatin t require needs assessment t determine the feasibility f new dental hygiene prgrams. Changed statutry language s that, nce a new dental hygiene prgram is apprved by CODA, the DHCC may apprve the prgram. The previus mandate stated the DHCC must apprve. Requires cmpletin f an extended functins curse fr initial dental hygiene licensure Clarifies requirement that educatin hurs used twards licensure be in the immediately preceding five years Requires applicants failing the clinical exam three times r causing grss trauma t prvide prf f remediatin prir t retaking the clinical exam Allws RDHAPs t establish mbile clinics Requires RDHAPs t register additinal sites with the DHCC. This prvisin applies t brick and mrtar sites wned by RDHAPs, nt settings where RDHAPs practice. Prviders f CE curses apprved by the Dental Bard f Califrnia may als be apprved by the DHCC Gvernment Affairs Update September 1, f 5