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BILLS OF INTEREST FALL 2017
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CSPD follows a number of bills under consideration by the state legislature which potentially impact pediatric oral health. Members having questions or wishing to comment on these or any other legislative matters are invited to contact CSPD’s Public Policy Advocate, Dr. Paul Reggiardo, at reggiardo@prodigy.net.

AB 15 (Maienschein) - Denti-Cal: Reimbursement Rates. The bill would have directed that Denti-Cal provider reimbursement rates for the 15 most common services be doubled beginning in the 2017-2018 fiscal year and that funds derived from the 2016 Proposition 56 Tobacco Tax Initiation be used to pay for the additional costs.

CSPD Position: Support

Outcome: Died in Senate Appropriations Committee

Comment: Proposition 56 allocates a specified percentage of tobacco tax revenues to the Department of Health Care Services to increase funding for existing health care services which increase access and improve quality under the Medi-Cal program. This bill would be consistent with these objectives. Passage was always unlikely.

AB 224 (Thurmond) - Pediatric Dental Sedation. This bill 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 and require an analysis of outcomes and complications related to dental sedation.

CSPD Position: Oppose Unless Amended

Outcome: Removed from consideration in this session of the legislature by the author. May be reconsidered in 2018.

Comment: A provision to require a separate anesthesia provider for children 7 years of age or younger from that of the operating dentist included in earlier renderings of the bill is absent from this version. The author proposed in hearing that the dedicated anesthesia monitor for patients under 7 years of age be a dentist holding a general anesthesia permit, a physician anesthesiologist, a clinical nurse specialist with pediatric critical care or recovery room experience, a registered nurse anesthetist, or a nurse practitioner with pediatric critical care or recovery room experience. That provision was not accepted by the by the Senate Business, Professions and Economic Development Committee.

AB 1277 (Daly): Dental Waterlines. The bill directs the Dental Board of California to adopt final regulations by 12/31/18 to require that water or other irrigates used for procedures that expose the dental pulp to be sterile or contain recognized disinfecting or antibacterial properties.

CSPD Position: Support

Status: Passed by the legislature and signed into law by the Governor 10/2/17.

Comment: The bill arises out of the cases of mycobacterium abscesses contracted at a dental clinic in Anaheim last year. In November, the Dental Board instructed staff to prepare regulation that would require sterile water or disinfectant when procedures are performed on the exposed dental pulp (a subtle difference from procedures that expose the dental pulp). 

AB 1707 (ASB B&P): Registered Dental Assistants: Practical Examination. Under existing law, the suspension of the RDA practical examination mandated by the Office of Professional Examination Services expires July 1, 2017. This bill extends that suspension until January 1, 2020, or until the board determines an alternative way to measure competency, whichever occurs first.

CSPD Position: Support

Outcome: Passed by the legislature and signed into law by the Governor 8/7/17.

 Comment: The bill allows the Dental Board to proceed with abolition of the practical examination as a condition of RDA licensure. More information is included in the Report of the Dental Board of California located elsewhere in The Bulletin.


SB 220 (Pan) - Medi-Cal Children’s Health Advisory Panel. This bill makes minor to the changes to the composition of the three Medi-Cal parent members, creates member term limits, and provides the ability to remove a panel member for cause.

CSPD Position: Support

Status: Passed by the legislature and signed into law by the Governor 9/25/17.

Comment: These are changes that do nothing to improve the structure or effectiveness of the panel..

SB 379 (Atkins) - Oral Health Assessments. The bill will 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.

CSPD Position: Support

Status: Passed by the legislature and signed into law by the Governor 10/13/17.

Comment: The reporting on caries experience is intended as an ongoing measure of the effectiveness of one area (reduction in childhood caries) of the State Dental Plan.

SB 392 (Bates) - Pediatric Dental Patients: Access to Care; Continuing Education. The bill would require the Dental Board to provide to the Legislature an analysis of the effects on access to care for pediatric dental patients as it relates to requiring the addition of a second general anesthesia permitholder during the administration of general anesthesia on a patient seven years of age or younger, if the operator-provider is holds a general anesthesia permit.

CSPD Position: Watch

Status: Held in the Assembly. May be heard and considered in 2018.

Comment: The bill earlier would have directed the Dental Board to develop curriculum requirements for a course in Pediatric Life Support to be required of anesthesia permit holders. The reporting requirement closely duplicates that in SB 501 (Glazer).

SB 501 (Glazer): Dentistry: Anesthesia and Sedation. The bill revises sedation definitions and the requirements for the administration of all levels of sedation in the dental setting. 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 Position: Watch

Status: Held in the Assembly Appropriations Committee. May be heard in 2018. 

Comment: The bill most closely mirrors AAPD Guidelines regarding all levels and all aspects of dental sedation. CSPD created and required amendments to establish a single requirement for all patients under 13 years of age (instead of a less stringent requirement for 7 – 13 years of age), establish a single personnel requirement for all children under 13 years of age 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.

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