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News & Press: Advocacy

Legislative Update 08/21/17

Sunday, October 8, 2017   (0 Comments)
Posted by: Steven Niethamer
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Date:     August 21, 2017

To:        CSPD Elected Leadership

Re:        Legislative Update 08/21/17

As the legislature prepares to reconvene today after a month-long summer recess, I thought this would be an opportune time to bring everyone up-to-date on legislative activity occurring prior to the July 21 adjournment and what might be expected in the next four weeks before the session ends. I will begin with the three bills concerning sedation in the dental setting and then discuss other legislative issues CSPD has been following and/or involved in. A current Legislative Summary is enclosed by file attachment.

AB 224 (Thurmond) Pediatric Dental Sedation which would have established new definitions and revised permitting structure for the administration of deep sedation/general anesthesia, moderate sedation, and minimal sedation for patients under 13 years of age was removed from consideration by the author during hearing before the Senate Business, Professions and Economic Development Committee July 10. As you will recall, the bill as introduced would have required an independent anesthesia provider for deep sedation/general anesthesia when surgical treatment is rendered to a child under seven years of age in the dental setting. That provision was removed during committee hearing in the Assembly in late May before the bill moved to the Senate. CSPD in early June, following adoption of revised general anesthesia personnel guidelines by the AAPD General Assembly May 28, removed its earlier opposition to the bill and adopted a WATCH position until provisions relating to moderate and minimal sedation could be clarified. The bill will remain inactive for the remainder of this legislative session.

SB 501 (Glazer) Anesthesia and Sedation also revises sedation definitions and the requirements for the administration of all levels of sedation in the dental setting. It requires at least three people present when deep sedation/general anesthesia is provided to a patient under 7 years of age, with one person solely dedicated to monitoring the patient. CSPD is seeking amendments which would establish a single standard for all patients under 13 years of age (instead of a less stringent requirement for 7 – 13 years of age) under moderate sedation, establish personnel requirements for moderate sedation consistent with AAPD guidelines, and remove the prohibition that minimal sedation be limited to the administration of a single drug in addition to local anesthesia and a mix of oxygen and nitrous oxide. CSPD has secured the agreement of the author and the sponsor of the bill (Cal-AAOMS) to these three changes (and to other subsequent modifications favorable to our administration of moderate and light sedation) which will bring the bill closer to AAPD guidelines and allow a SUPPORT position. The amended bill should be released tomorrow and I will forward a copy to all included in this message. The bill is now in the Assembly Appropriations Committee awaiting hearing, which must occur before September 1.

SB 392 (Bates) Pediatric Dental Patients: Access to Care: Continuing Education died in the Assembly Business and Profession Committee without hearing on July 21. The bill would have directed the Dental Board to develop curriculum requirements for a proposed course in Pediatric Life Support for anesthesia permit holders and required an analysis of the peripheral ramifications of requiring the addition of a second general anesthesia permit holder during the administration of deep sedation/general anesthesia on a patient seven years of age or younger if the operator-provider is also a general anesthesia permit holder. Both provisions were regarded as either duplicative of other legislation (SB 501 and AB 224) or unnecessary. CSPD had a WATCH position on the bill.

AB 15 (Maienschien) Denti-Cal: Reimbursement Rates which would have doubled provider payments for the 15 most common Denti-Cal services (paid for out of Proposition 56 Tobacco Tax Revenues) died in the Assembly Appropriations Committee in July. Passage was never considered likely (Medi-Cal funding is normally part of the overall budget process). CSPD had SUPPORTED the measure. Another bill, AB 753 (Caballero), which would have dedicated 15% of Proposition 56 tax revenue to increased Denti-Cal funding, failed for the same reason. Both bills were largely symbolic attempts to call attention to the chronically underfunded program.

AB 1277 (Daly) Dental Waterlines is pending a Senate floor vote. The bill directs the Dental Board to adopt regulation to require that water or other irrigates used for procedures on the exposed dental pulp be sterile or contain recognized disinfecting or antibacterial properties. CSPD SUPPORTS the measure, which will undergo several non-substantive amendments to provide increased clarity before the vote. The bill arises out of the cases of mycobacterium abscesses infections contracted at an Anaheim dental clinic last year.

AB 1707 (Assembly Business and Professions Committee) Dental Assistants: Practical Examination was passed last week by the legislature and sent to the Governor, where it was signed into law and will take effect immediately. Under existing law, the suspension of the RDA practical examination mandated by the Office of Professional Examination Services expired July 1, 2017. This bill will extend that suspension until January 1, 2020, or until the board determines an alternative way to measure competency. More information on the RDA licensure process is included in my report of the August meeting of the Dental Board of California sent separately to CSPD leadership.

SB 220 (Pan) Medi-Cal Children’s Health Advisory Panel is pending a floor vote in the Senate. The bill would make minor changes to the composition of the three Med-Cal parent members, create member term limits, and provide the ability to remove a panel member for cause. Nothing in the bill will improve the structure or the authority of the panel, which has not been significantly effective in Medi-Cal oversight or reform, but are necessary “housekeeping” arrangements.  CSPD is in SUPPORT of the measure as a matter of good public policy.   

SB 379 (Atkins) Oral Health Assessments is held in the Assembly Appropriations Committee Suspense File. It would require the Department of Education to consult with the State Dental Director in strengthening the reporting requirements of the school-entrance Oral Health Assessment on caries experience and centralizing the reporting of data. It is intended to increase school district compliance with the Oral Health Assessment requirement as well as serve as an ongoing measure of the effectiveness of one component (reduction in childhood caries) of the State Dental Plan. CSPD is in active SUPPORT of the measure, which must be released by the Appropriations Committee by September 1 if it is to be consider on the Assembly floor.

As always, I solicit comment or questions from CSPD leadership on these or other public policy issues.

Respectfully submitted,

Paul Reggiardo, DDS
Public Policy Advocate, California Society of Pediatric Dentistry

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