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  ****