BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 502| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: AB 502 Author: Chau (D) Amended: 7/16/15 in Senate Vote: 21 SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 7/6/15 AYES: Hill, Bates, Berryhill, Block, Galgiani, Hernandez, Jackson, Mendoza, Wieckowski SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8 ASSEMBLY FLOOR: 80-0, 6/4/15 - See last page for vote SUBJECT: Dental hygiene SOURCE: California Dental Hygienists Association DIGEST: This bill authorizes the creation of and establishes rules of governance for a registered dental hygienist in alternative practice (RDHAP) corporation. ANALYSIS: Existing law: 1) Establishes the Dental Hygiene Committee of California (DHCC) within the jurisdiction of the Dental Board of California (DBC) to administer laws pertaining to dental hygienists. (Business and Professions Code (BPC) § 1901(a)) 2) Authorizes the DHCC to license a person as a RDHAP who demonstrates satisfactory performance on an examination in California law and meets either of the following requirements: AB 502 Page 2 a) Holds a current California license as a registered dental hygienist and meets the following requirements: i) Has been engaged in the practice of dental hygiene as a registered dental hygienist in any setting, including, but not limited to, educational settings and public health settings, for a minimum of 2,000 hours during the immediately preceding 36 months. ii) Has successfully completed a bachelor's degree or its equivalent, as specified, and a minimum of 150 hours of additional educational requirements. b) Has received a letter of acceptance into the employment utilization phase of the Health Manpower Pilot Project No. 155 established by the Office of Statewide Health Planning and Development. (BPC § 1922) 3) Authorizes a RDHAP to perform all functions that may be performed by a registered dental assistant; dental hygiene assessment and development, planning, and implementation of a dental hygiene care plan; oral health education; counseling; health screenings; preventive and therapeutic interventions, including oral prophylaxis, scaling, and root planing; and application of topical, therapeutic, and subgingival agents used for the control of caries and periodontal disease in the following settings: a) Residences of the homebound. b) Schools. c) Residential facilities and other institutions. d) Dental health professional shortage areas, as certified by the Office of Statewide Health Planning and Development in accordance with existing office guidelines. (BPC § 1926) 4) Authorizes a RDHAP to operate a mobile dental hygiene clinic. (BPC §§ 1926.1, 1926.2) AB 502 Page 3 5) Authorizes a RDHAP to bill insurance and hire other RDHAPs and dental assistants. (BPC §§ 1928, 1929) 6) Authorizes an association, partnership, corporation, or group of three or more RDHAPs to practice if it obtains a permit issued by the DHCC. (BPC § 1962) 7) Authorizes a RDHAP to provide services to a patient without obtaining written verification that the patient has been examined by a dentist or physician and surgeon licensed to practice in this state. (BPC § 1931 (a)(1)) 8) Establishes the Moscone-Knox Professional Corporation Act (Moscone-Knox Act) which regulates the formation and operation of professional corporations, and defines a professional corporation as a corporation organized under the general corporation law, as specified, or a corporation that is engaged in rendering professional services in a single profession. (Corporations Code (CORP) §§ 13400 et seq.) 9) Specifies in the Moscone-Knox Act that certain licensed persons may be shareholders, officers, directors or professional employees of professional corporations controlled by licensed persons of a different profession so long as the sum of all shares owned by those certain licensed persons does not exceed 49% of the total number of shares of the professional corporation, and so long as the number of those certain licensed persons owning shares in the professional corporation does not exceed the number of persons licensed by the governmental agency regulating the designated professional corporation. (CORP § 13401.5) 10)Specifies that the Moscone-Knox Act does not limit employment by a professional corporation of only those licensed professionals listed. Any healing arts licensee may be employed to render professional services by a professional corporation designated, as specified. (CORP § 13401.5) This bill: 1) Authorizes a RDHAP to practice as an employee of a AB 502 Page 4 professional corporation under the Moscone-Knox Act. 2) States that a RDHAP corporation is a professional corporation that is authorized to render professional services, as specified, so long as that professional corporation and its shareholders, officers, directors, and professional employees rendering professional services are in compliance with the Moscone-Knox Act and other applicable laws and regulations. 3) Declares the violation of, attempt to violate, directly or indirectly, assist in or abet the violation of, or conspire to violate any provision or term laws and regulations relating to the practice of a RDHAP to be unprofessional conduct. 4) Prohibits a RDHAP from doing or failing to do anything that would constitute unprofessional conduct, as specified. 5) Prohibits a shareholder who is disqualified from providing professional services from deriving benefit from a RDHAP corporation attributable to professional services rendered while a shareholder is a disqualified person. 6) Requires the bylaws of a RDHAP corporation to include a provision whereby the capital stock owned by a disqualified person or a deceased person be sold to the professional corporation or to the remaining shareholders of the professional corporation not later than 90 days after disqualification, if the shareholder becomes a disqualified person, or not later than six months after death, if the shareholder becomes deceased. 7) Requires a RDHAP to provide adequate security by insurance or otherwise for claims against it by its patients arising out of the rendering of professional services. 8) Exempts a professional corporation rendering professional services by persons licensed by the DHCC from any requirement to obtain a certificate of registration in order to render those professional services. AB 502 Page 5 9) Authorizes the creation of a RDHAP professional corporation and states that a dental assistant, licensed dentist, registered dental hygienist, or registered dental hygienist in extended functions may be a shareholder, officer, director, or professional employee of the professional corporations so long as the sum of all shares owned by those licensed persons does not exceed 49 percent of the total number of shares of the professional corporation, and so long as the number of those licensed persons owning shares in the professional corporation does not exceed the number of persons licensed by the governmental agency regulating the designated professional corporation. 10)Makes clarifying and technical amendments. Background RDHAP. Dental hygienists clean teeth, examine patients for signs of oral diseases such as gingivitis, and provide other preventative dental care. They also educate patients on ways to improve and maintain good oral health. An RDHAP is dental hygienist who has a baccalaureate degree, completed a DBC-approved continuing education course and passed a state licensure examination to practice independently in underserved settings. These settings are defined as Dental Health Professional Shortage Areas, residences of the homebound, nursing homes, hospitals, residential care facilities, and other public health settings. RDHAPs may independently provide all services that, as a registered dental hygienist, they are licensed to provide under general supervision. RDHAPs must have a "dentist of record" on file with the Dental Hygiene Committee of California to gain licensure. This documented relationship is for referral, consultation, and emergency services. RDHAPs can provide dental hygiene services to patients for 18 months without involvement of a dentist or physician. If an RDHAP continues to provide services to that patient, he or she is required to obtain written verification that the patient has been examined by a dentist or physician licensed to practice in the state and a prescription for further services. There are currently 508 licensed RDHAPs in California. AB 502 Page 6 Professional corporations. Although existing law appears to authorize RDHAPs to incorporate, DHCC's Web site explicitly states that they may not because they are not included in the Moscone-Knox Professional Corporations Act of 1968. A professional corporation is an organization made up of individuals of the same trade or profession. The Moscone-Knox Act authorized the formation of professional corporations to obtain certain benefits of the corporate form of doing business, such as limited legal liability. At that time, only medical, law and dental professional corporations were envisioned. There are now 16 authorized healing arts professional corporations. Existing law specifies which healing arts licensees may be shareholders, officers, directors or professional employees of professional corporations controlled by a differing profession so long as the sum of all shares owned by those licensed persons does not exceed 49% of the total number of shares of the professional corporation. This bill authorizes the creation of a RDHAP corporation and permits a dental assistant, licensed dentist, registered dental hygienist, or registered dental hygienist in extended functions to be a shareholder, officer, director or professional employee of the professional corporation, as specified. FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No According to the Assembly Appropriations Committee, any costs to the California Department of Insurance and the Department of Managed Health Care to assess compliance with this bill's requirements are expected to be minor and absorbable. SUPPORT: (Verified8/17/15) AB 502 Page 7 California Dental Hygienists' Association (source) California Dental Association Dental Hygiene Committee of California OPPOSITION: (Verified8/17/15) None received ARGUMENTS IN SUPPORT: The source of this bill, the California Dental Hygienists' Association support passage of this bill because, "The [RDHAPs] have successfully provided dental hygiene care in California for over 15 years. It's time to update the statute to address roadblocks to care that have become apparent." The California Dental Association states, "The Corporations Code does not currently recognize the ability authorized in the Business and Professions Code for RDHAPs to legally incorporate, and AB 502 will align these two code sections, providing clarity and protection for RDHAPs." ASSEMBLY FLOOR: 80-0, 6/04/15 AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins Prepared by: Sarah Huchel / B., P. & E.D. / (916) 651-4104 AB 502 Page 8 8/21/15 9:33:46 **** END ****