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• Major Legislative Issues - 2006

Major Legislative Issues - 2006

Updated – 10/10/06

Following are brief summaries of bills and issues supported and opposed by CDA in 2006.

Instructions for using this page: 

Click on a bill number to find out more; this will take you to the California Legislative Counsel’s Legislative Information Page. Once you’re there:

• Select either "Assembly" or "Senate" in the "HOUSE" box;
• Type the number of the bill in the "BILL NUMBER" box; and
• Hit the "SEARCH" button.

Once you’re there, you can read the most recent version in either browser (HTML) or Adobe Acrobat Reader (*.pdf) format. You may also check the measure’s status and history. To learn more about the author, click on the surname after the bill number. You’ll be taken to the member’s official legislative web site, where the choices are self-explanatory.

Dental Assisting Licensure Reform:  In 2004, SB 1546 (Figueroa) was enacted, after several years of negotiations designed to develop new licensure pathways for the dental assisting profession.  SB 1546 created new categories of registered surgery assistant, registered restorative assistant, and registered orthodontic assistant.  The bill required the Dental Board to develop regulations governing the curriculum and training requirements for the new categories, and made the changes effective January 1, 2007.  In 2005, numerous discussions between the interested parties representing CDA, the affected dental specialties, dental assisting, and the Dental Board led to agreements on a number of technical and procedural amendments, which were incorporated into SB 1111 (Figueroa).  These amendments included clarifying the role of regional occupation programs, defining the patient monitoring responsibilities of each assistant category, and clarifying the linkage between existing registered dental assisting programs and the new, phased in requirements.  Most significantly, SB 1111 extended for one additional year (until January 1, 2008) the operative date for the new assisting categories and licensure requirements.  This extension was necessary in order to allow sufficient time for the various public and proprietary dental assisting programs to develop and obtain any necessary approvals for their new curricula.  SB 1111 was passed by both houses and was signed by the Governor on October 7th.  Discussions have since been continuing on the criteria governing the educational programs for the newly developed specialty assistant programs between the CDA and the Dental Assisting Alliance, which is comprised of representatives from the California Dental Assistant’s Association and the California Association of Dental Assisting Teachers.   

As the regulatory process unfolded, differences arose regarding the extent to which an on-the-job training (OJT) option should be available to dental assistants wishing to become licensed in the new specialty categories.  CDA sponsored SB 1541 (Ducheny) this year to clarify that issue, by specifically authorizing a work experience pathway option for the specialty dental assistants, something that has long been available for individuals wishing to become registered dental assistants (RDAs).  SB 1541 was passed by the Senate Business, Professions and Economic Development Committee and the Senate Appropriations Committee by unanimous votes, and was passed by the full Senate on May 18th.  Prior to the policy committee hearing, the author and CDA accepted a number of amendments to partially address concerns expressed by the opposition and committee staff.  They include clarifying the requirements for dentists wishing to train an assistant to first take a 6-hour teaching methodology course, requiring a practical exam for all assisting categories, and requiring that dentists notify patients verbally when their assistant is being trained.  Although the Dental Assisting Alliance and the California Dental Hygienists’ Association continued to oppose SB 1541 unless it was further amended to require that ultrasonic scaling, coronal polishing, and pit and fissure sealants be taught only by formal educational programs, in August the bill received final votes of 71-0 in the Assembly and 35-1 in the Senate.  It was signed by the Governor on September 30, 2006, though with a signature letter in which the Governor expressed some procedural concerns regarding the implementation of the practical exam requirement.  CDA will be working with the administration and other interested parties next year on clean-up legislation to address those concerns, which had been brought to CDA’s attention earlier but could not be dealt with prior to the close of the legislative session.   

Children’s Oral Health Assessments:  Significant research over many years has demonstrated that poor dental health is one of the leading causes of missed school days for children (which results in lost average daily attendance revenues for schools), and is also one of the most preventable diseases.   CDA in 2005 sponsored AB 1077 by Assembly Member Wilma Chan (D-Oakland), which as originally written was modeled after legislation passed in Illinois that would generally require children to provide documentation of an oral health assessment by no later than May of their kindergarten, second, and sixth grade years, unless the child’s parent or guardian indicates that they choose not to obtain the assessment, cannot afford the assessment, or cannot find a dentist in their area.  AB 1077 was passed by the Assembly Health Committee April 5 on a 10-2 vote, and was passed by the Assembly Education Committee on April 20th on a 10-0 vote.  Some school organizations objected to the bill as an “unfunded mandate.”  The bill allows parents to “opt out” by completing a simple form and there is no punitive action for not completing the assessment.  This bill is intended to obtain information about the severity of the problem and to build capacity to help children find the dental care they need.  Because legislative staff had estimated an annual cost of $8 million, the bill was placed on the Assembly Appropriations Committee “suspense file,” where high-cost bills are prioritized in conjunction with the budget process.  The bill remained with the Appropriations Committee until January.   Although CDA had proposed amendments to reduce the bill’s cost by limiting the assessments to kindergarten only, and was in discussions with the Dental Health Foundation about other alternative approaches, AB 1077 nevertheless was held in the committee in January 2006, along with many other bills with fiscal impact, and was dead for this session. 

Following the loss of AB 1077, CDA continued to engage key legislators and administration staff in dialogue on the merits of this proposal.  These efforts culminated in the inclusion in the Governor’s May budget revision of a proposed appropriation of $4.4 million from Proposition 98 earmarked educational dollars and $2 million from the Medi-Cal and Healthy Families programs to implement the requirement for kindergarten children.  Assembly Member Bill Emmerson (R-Redlands), who has been instrumental in promoting this issue, and Assembly Member John Laird (R-Santa Cruz), chair of the Assembly Budget Committee, jointly authored AB 1433 to make the statutory changes necessary to establish the program for kindergarten children only.  In August, AB 1433 received final votes of 23-12 in the Senate and 71-3 in the Assembly, and it was signed by the Governor on September 22, 2006.  The new law takes effect January 1, 2007, and CDA will be working closely with its component dental societies, school districts, and the state to achieve as smooth an implementation of the new requirements as possible. 

 SB 438 (Migden) – Oral and Maxillofacial Surgery – Elective Cosmetic Procedures:   In 2004, CDA co-sponsored SB 1336 (Burton) with the California Association of Oral and Maxillofacial Surgeons (CalAOMS) in an effort to create a permitting process that would allow oral and maxillofacial surgeons who met certain criteria to perform specified elective procedures in accredited outpatient facilities.   Presently there is an anomaly in state law, whereby certain oral and maxillofacial surgeons are permitted to perform complete facial reconstructions in a hospital trauma care setting, but cannot perform the same or similar procedures on an elective basis in their offices.  Rather than trying to broadly redefine “dentistry” in statute for this purpose, the bill as introduced proposed to create a process by which oral and maxillofacial surgeons could obtain a permit from the Dental Board of California after having demonstrated and documented specific credentials.

SB 1336 ultimately was passed by the Senate with a final vote of 30-0, after passing out of the Assembly on a 67-2 vote, despite the continuous strong opposition from the California Medical Association, the California Society of Plastic Surgeons, and the California College of Emergency Physicians, who argued that the bill would be an inappropriate and potentially unsafe expansion of oral and maxillofacial surgery scope of practice.    However, the Governor vetoed the bill on August 27, 2004, stating that he was not yet comfortable that these practitioners were sufficiently qualified.  In his veto message, the Governor requested his Director of Consumer Affairs (DCA) to conduct an occupational analysis of the oral and maxillofacial surgeon profession to determine if the procedures in question could be performed safely and competently on an elective basis.    In the meantime, with Senator Burton having left the Legislature due to term limits, Senator Carole Migden (D-San Francisco), who was elected to take Senator Burton’s seat in November 2004, introduced SB 438, which is nearly identical to SB 1336 (Burton), and which could be used as a legislative vehicle to move this issue forward again depending upon the results of the state’s analysis.   With that understanding, SB 438 was passed by the full Senate May 16, 2005 on a 30-2 vote and was held in the Assembly for the remainder of the year.  

In early June 2006, the final report from the consulting firm chosen by DCA was released to the public.  The report concluded that oral and maxillofacial surgeons were fully qualified to perform the elective cosmetic procedures permitted by SB 438.  Despite the report’s conclusions, the opposing organizations intensified their efforts against the bill, and in its initial hearing in the Assembly Business and Professions Committee on June 27th, the bill received a 5-0 vote, one short of passage in the 10-member committee.  However, a reconsideration hearing was granted two days later for all bills that had failed passage that day, and this time SB 438 was passed on a 7-0 vote.  Ultimately, in August the bill received final votes of 69-0 in the Assembly and 32-0 in the Senate, and was signed by the Governor on September 30th after an intense lobbying effort by both sides.  Although the new law takes effect January 1, 2007, it is unknown how long it will take before the Dental Board has approved regulations creating the required credentialing committee, which will consist of three California licensed oral and maxillofacial surgeons (at least one of whom must have a California medical license as well) and two California licensed physicians. 

SB 683 (Aanestad):  Licensure – Postgraduate Residency Program Recognition:  Senator Sam Aanestad (R-Grass Valley)  introduced SB 683 last year on CDA’s behalf.  SB 683 is a follow-up to SB 1865 (Aanestad), enacted in 2004, which gave California dental licensure applicants the option of taking the Western Regional Examining Board (WREB) exam instead of the state clinical exam.  California is one of many states that are beginning to develop alternatives to the traditional, one-time only clinical exam that relies on the use of human subject patients.  SB 683 would provide an additional alternative for licensure applicants, by allowing them to instead complete a clinically based, postdoctoral general dentistry program of at least one year’s duration, at a school or facility accredited by the Committee on Dental Accreditation (CODA) of the American Dental Association.  The residency program would be required to include a formal outcome assessment evaluation of each resident’s competence to practice dentistry.  This option would allow licensure applicants to have their clinical competency evaluated over an extended period of time, and would be more in line with the licensure process that has long been in place for physicians. 

Last year, SB 683 passed the Senate with unanimous votes, and was passed unanimously by the Assembly Business and Professions Committee and the Assembly Appropriations Committee.  However, the Department of Consumer Affairs (DCA) had taken an “oppose unless amended” position on the bill, expressing concerns about the ability to assure the core-level competencies of residents applying for licensure.  In order to allow additional time to try to address the Department’s concerns, SB 683 was held on the Assembly floor.  Subsequent discussions with DCA led CDA to the conclusion that the bill should be amended to apply only to general practice residency programs, since specialty programs are not currently equipped to evaluate the general dentistry skills of their residents in a manner that would satisfy the state’s concerns.  Those discussions also resulted in the adoption of amendments proposed by DCA that will require the development of a standardized competency certification form, consistent with requirements for the state clinical exam, to be completed by the residency program for each applicant.  The bill subsequently was passed by both the Assembly and Senate with unanimous votes and signed by the Governor on September 30, 2006. Although the new law will take effect January 1, 2007, the Dental Board will need additional time to adopt the regulations necessary to implement the process; thus students who are currently in residency programs may not benefit from this law unless their programs end sometime in late 2007 or early 2008.

Dental Board Structural Reform:  State law requires that all boards and commissions be reviewed periodically by the legislature to determine whether they serve a worthwhile public purpose and are adequately carrying out their statutory responsibilities.  Senator Liz Figueroa (D-Fremont), as chair of the Joint Committee on Boards, Commissions, and Consumer Protection, is the author of all bills extending boards and commissions that are under review this year, including last year’s SB 248, which as ultimately enacted extended the sunset date for the Dental Board and Committee on Dental Auxiliaries (COMDA) until January 1, 2009. While that bill was moving through the Assembly, Department of Consumer Affairs sent a letter to the committee stating that the administration was taking an “oppose unless amended” position on all board and commission sunset bills, and requesting that all boards be reconstituted to become public member majorities.  In the specific case of the Dental Board, the department requested that the board be reduced from 14 to 7 members, to be made up of 4 public members and 3 dentists.  In addition, the department requested that the Committee on Dental Auxiliaries (COMDA) be eliminated and its functions moved to a bureau within the department.  CDA strongly opposed the proposed public member majority Dental Board; no other state in the nation has one, and too many issues before the board require substantial clinical and professional expertise.   Legislative opposition eventually led the Administration to drop its overall proposal, and the sunset dates for the board and COMDA were extended without further changes, but with a general understanding that the issue of a separate regulatory entity for dental hygiene, which had been recommended by the Joint Legislative Sunset Review Committee five years ago, was likely to be looked at in 2006.

On April 6, 2006, SB 1472 (Figueroa) was amended to propose the creation of a California Dental Hygiene Bureau within the Department of Consumer Affairs, which would take over licensing and enforcement duties involving all categories of dental hygienist, including the determination of level of dentist supervision required for hygienists’ duties.  CDA was opposed to SB 1472 as amended, on the grounds that there has been no demonstrated public safety need for a separate dental hygiene bureau; that the bill would create unnecessary bureaucratic duplication and potential state general fund costs; and that it would leave unclear the relative enforcement responsibilities of the Dental Board and the Dental Hygiene Bureau.  In August, SB 1472 received final votes of 44-31 in the Assembly and 21-16 in the Senate, and was sent to the Governor, with CDA requesting a veto.  The Governor vetoed the bill on September 30th; in his veto message, he stated his belief that “the concerns of dentists and dental hygienists can be addressed within the existing regulatory structure,” and urged the Board to work with dental hygienists “to provide the existing Committee on Dental Auxiliaries with a stronger voice on Dental Board.”  

 AB 1334 (Salinas) – Registered Dental Hygienists in Alternative Practice:   After being opposed to AB 1334 by Assembly Member Simon Salinas (D-Salinas) for most of the 2005-06 session, CDA removed its opposition in August 2006 after significant legislative amendments were agreed to.  The licensure category of registered dental hygienist in alternative practice (RDHAP) was created in 1997, and provides an opportunity for hygienists with specified education and clinical experience to practice independently (without a dentist’s supervision) in certain settings.  The law does, however, require RDHAPs to obtain a prescription from a dentist or physician before providing treatment to new patients.  AB 1334, in its original form, would have removed that prescription requirement, thereby allowing RDHAPs to commence treatment without the involvement of a dentist or physician.  CDA believed that a complete elimination of the prescription requirement was premature at best.  Until very recently, when the two existing RDHAP programs began graduating significant numbers of students, there were too few RDHAPs practicing in the state to allow for a reasonable evaluation of the prescription requirement’s impact.  Until data indicates otherwise, CDA believes that requiring a level of involvement by a dentist is not unreasonable for RDHAPs, who can provide a limited scope of services to patients.  CDA has been engaged in an ongoing educational and outreach campaign to dentists in the state to assist RDHAPs in developing relationships with dentists who can provide the necessary prescriptions.   

AB 1334 was passed by the Assembly Business and Professions Committee April 26, 2005 on a 5-2 vote, and moved to the Assembly floor.  The author moved the bill to the Inactive File on the Assembly floor in order to allow discussions on this issue to continue.  AB 1334 was passed by the Assembly on January 30, 2006 by a 44-23 vote.  While the bill did receive enough votes for passage, a number of Assembly members received a commitment from the author that he would explore amendments to deal with some of the problem areas before the bill came back from the Senate for final concurrence in the Assembly. 

Beginning in late June, following a meeting in his office with representatives of CDA and the bill’s sponsors, the California Dental Hygienists Association, Assembly Speaker Fabian Nunez, who supported CDA’s position that a dentist must remain part of the equation, directed his staff to work with both sides to settle the prescription issue, so that it would not keep returning to the legislature year after year.  The amendments ultimately agreed to by the author and sponsor will allow RDHAPs to see new patients without a prescription for a maximum of 18 months.  After 18 months, further treatment could not take place until the patient provided a prescription along with documentation of an exam by a dentist or physician.  Future prescriptions could be in effect for a maximum of 2 years, at the dentist’s discretion.  With these amendments, CDA  removed its opposition to AB 1334, believing that it represented a reasonable compromise that gives RDHAPs the opportunity to increase access to care, while still providing for the long-term involvement of dentist who can assure that patients receive comprehensive care.  Following the adoption of these amendments, AB 1334 received final votes of 28-11 in the Senate and 78-1 in the Assembly, and was signed by the Governor on September 30, 2006.   

Western Regional Examination Board (WREB) Exam Recognition):  In 2004, SB 1865 (Aanestad) was passed by the legislature and signed by the Governor.  Co-sponsored by CDA and the deans of the five California dental schools, the new law allows dental licensure applicants to take the Western Regional Examination Board (WREB) exam instead of the California clinical exam, after meeting all other California qualifications for licensure.  Although the bill officially took affect on January 1, 2005, and will eventually apply to all individuals who passed the WREB exam after that date, it first required the Office of Examination Resources within the state Department of Consumer Affairs to evaluate the WREB exam to determine if it is clinically equivalent to the California exam.  At the end of September 2005 the evaluation was completed and was favorable.  However, the emergency regulations to implement the bill were not sent from the Department of Consumer Affairs to the state Office of Administrative Law (OAL) until March 1, 2006.  CDA provided OAL with nearly 300 signatures from dental students supporting the regulations, and the regulations were approved in mid-March.  At that point the Dental Board immediately made the application forms available on its web site. 

Those students taking the WREB will also be required to take the state’s law and ethics examination, and the Dental Board earlier this year began allowing them to take that exam on the same days that the California clinical exam is offered.  Although earlier this year Board staff was only allowing these applicants to take the law and ethics exam after they had passed the WREB, the Board has subsequently stated that that will no longer be made a condition.  The Board also is now offering the law and ethics exam on separate dates in several locations throughout the state.  In the future, it is anticipated that the law and ethics exam will be offered online as well.  To ensure that there will be minimal prerequisites for taking the law and ethics exam, Senator Aanestad amended his SB 683 to include language to that effect.  SB 683 was signed by the Governor on September 30th, and the Board is now developing regulations to create a separate and distinct application for the law and ethics exam. 

Denti-Cal/State Budget:  Last year, after much negotiation during a difficult state budget year, the state enacted an annual $1,800, calendar-year cap on adult Denti-Cal benefits, with exclusions for dentures, maxillofacial and complex oral surgery, and implants, and with a 2009 sunset date.  Later in the year, a court decision ended an injunction that had prevented the implementation of a 5 percent, across-the-board Medi-Cal provider reimbursement rate reduction that had been enacted as part of the 2003 state budget.  Subsequent legislation allowed the 5 percent rate cut to take effect January 1, 2006, but required that it  remain in effect only until January 1, 2007.  CDA and a coalition of health care provider organizations believed that even a rate reduction limited to one year would have a direct negative impact on provider’s willingness to participate in the Medi-Cal program.  The coalition therefore sponsored SB 912 (Ducheny/Runner), which proposed to delete the rate reduction requirement on an urgency basis.  SB 912 was passed with unanimous votes in both houses and was signed by the Governor on February 17, 2006. Although the Governor in his signature message indicated that he remains concerned about the need for long-term cost containment in the Medi-Cal program, his proposed 2006-07 budget does not include any significant changes to the program.

This year, CDA supported SB 1403 (Scott), which will eliminate the requirement that pretreatment X-rays be submitted with post-treatment claims involving Denti-Cal patients who are four years of age and under or developmentally disabled, when the treatment involves  four or more teeth in a 12-month period.  It often is impractical to obtain quality X-rays from very young children and the developmentally disabled, and this bill will allow the dentists treating these patients to submit photographs instead, which are easier to obtain while still providing appropriate documentation for reimbursement purposes.  SB 1403 was passed by both houses with unanimous votes, and was signed by the Governor on July 7th.  The bill will take effect January 1, 2007.     

SB 299 (Chesbro) – Licensure By Credential:  Since 2002, California has allowed dentists licensed in other states who graduated from Commission on Dental Accreditation approved dental programs, and who have met specified clinical experience requirements, to become licensed in California without having to take the state clinical examination.  That legislation included provisions allowing applicants with at least two years of experience willing to work for two years in a clinic or dental school to have those two years credited in advance toward the total five-year clinical experience requirement.  In order to provide further incentive for dentists coming to California to provide much-needed work in those settings, CDA sponsored SB 299 by Senator Wes Chesbro (D-Arcata), which will eliminate the two-year experience requirement for qualified applicants who commit to practice in a clinic or dental school.  SB 299 passed the Senate and Assembly with unanimous votes in 2005, but remained on the Senate consent calendar awaiting concurrence in Assembly amendments, due to the Senate’s failure to vote on the consent calendar on the last day of the 2005 session.  In January 2006, the bill was sent back to the Assembly, amended to add an “urgency” clause, passed again by both houses and sent to the Governor.  The Governor signed SB 299 on January 30th, and it took effect immediately.

AB 1386 (Laird) – Oral Conscious Sedation:   California’s Dental Practice Act requires dentists administering or ordering the administration of general anesthesia or conscious sedation (often referred to as IV-conscious sedation) to obtain permits from the Dental Board, and requires dentists using oral conscious sedation on children under age 13 to obtain a certificate from the board.  When the oral conscious sedation law was enacted in 1998, the technique was primarily being used to assist in treating young children with behavioral issues.  Recent years, however, have seen a steady increase in marketing of “sleep dentistry” to adults, by dentists using essentially the same types of oral conscious sedation techniques that require a Dental Board certificate when used on children.  Last year, a blue ribbon panel of the Dental Board considered this along with other anesthesia issues, and concluded that a certificate requirement was equally warranted for dentists using oral conscious sedation to treat individuals over the age of 13.  To that end, CDA and the Dental Board co-sponsored AB 1386  by Assembly Member John Laird (D-Santa Cruz), which would enact the additional certification requirement, along with a number of other largely technical changes to the state’s anesthesia laws.  The bill was amended along the way to clarify that the certification requirement would not apply to dentists who only prescribe single doses designed for home usage. AB 1386 was passed by both houses with solid bipartisan votes and was signed by the Governor on October 5th. The new law took effect January 1, 2006, and as of this date the Dental Board is accepting applications from all categories of dentists other than those who require completion of a training course; regulations establishing the curriculum standards for those courses are pending final approval.

AB 1143 (Emmerson) – Special Permits:  Current law allows the Dental Board to grant special permits to dentists who have not passed the California licensure examination, but who have been offered full-time faculty positions with a state dental school.  Dental schools are facing increasing difficulty recruiting faculty members, particularly in specialties and emerging areas of practice.  The special permit allows the faculty member to supplement his or her teaching salary with income earned by practicing one day per week in the school’s dental clinic.  The current special permit law applies only to graduates of CODA-accredited specialty programs, which has proven a significant hindrance to attracting talented faculty from the international community and for non-ADA recognized specialty areas.  In order to alleviate this problem, CDA sponsored AB 1143 by Assembly Member Bill Emmerson (R-Redlands), which will expand the special permit law to allow up to five permits per dental school to be granted to specialists who graduated from non-CODA accredited (i.e., international) dental programs, as well as up to five general dentists from non-CODA accredited programs with expertise in emerging non-specialty disciplines, along with existing special permit holders who wish to move to part-time faculty status.  AB 1143 was passed by both houses and was signed by the Governor on October 5th.

AB 1268 (Oropeza) – Advertising:   In 2002, the Legislature passed and the Governor signed AB 1026 (Oropeza), sponsored by CDA, which was intended to prevent dentists who have not completed a Commission on Dental Accreditation approved specialty program from advertising in a manner that could mislead patients into believing that the dentists are in fact bona fide specialists.  Specifically, AB 1026 prohibited advertising as a specialist unless the dentist did in fact complete a CODA-accredited specialty program, and allowed a dentist to advertise an emphasis in a particular area of practice (whether a recognized specialty or not) only if the dentist clearly stated in the advertisement that he or she is a general dentist.  Following the bill’s enactment, the American Academy of Implant Dentistry filed a legal challenge to the bill’s constitutionality (Potts v. Hamilton).  Last year, a federal district court judge ruled in the Academy’s favor, finding that the new law’s outright prohibitions on advertising in certain instances violated the advertising dentists’ free speech rights.  In his initial ruling, the judge indicated that a requirement that dentists advertising a particularly practice emphasis include a disclaimer indicating that they are not in fact a specialist, might be a constitutional alternative to the existing prohibitions.  The Attorney General’s office, which represents the Dental Board and the Department of Consumer Affairs in the case, elected to attempt mediation prior to formally appealing the judge’s decision, and a number of meetings and discussions have taken place.  The Dental Board, represented by the Attorney General’s office, has decided to appeal the original decision and a decision on the appeal should be rendered by January 2007.  While that process continued, CDA was sponsoring AB 1268 by Assembly Member Jenny Oropeza (D-Long Beach), which contained language that CDA believed would withstand legal scrutiny.  AB 1268 was passed by the Assembly in January, but in June the Government Affairs Council decided not to pursue legislation any further this year.  CDA will reevaluate the need for legislation once the appeal process has been completed.    

AB 966 (Saldana) – Dental Amalgam:  As it was originally introduced last year, CDA was strongly opposed to AB 966 by Assembly Member Lori Saldana (D-San Diego), but  negotiations over the course of 2005 have resulted in amendments which have moved CDA to a “Support” position on the bill. AB 966 as introduced would have phased in a requirement that certain dental offices install amalgam separators by January 1, 2007.  This language would essentially have given dentists no choice but to install amalgam separators in their offices, regardless of whether their local water agencies have detected problems with mercury discharges.  CDA already strongly encourages dentists to use well-established best management practices in their handling of dental office wastewater, and local publicly owned treatment works (water treatment facilities) can and sometimes do require the installation of amalgam separators.  These local regulatory agencies already have the statutory authority to require dentists to implement any pollution prevention strategy, including amalgam separators, and CDA has cooperated with every agency that has developed additional requirements and worked with the local component dental societies to ensure compliance.  CDA has also worked effectively with local water agencies to resolve specific local issues involving mercury and amalgam.  AB 966 was passed by the Assembly Environmental Safety and Toxic Materials Committee April 26 on a 5-2 vote, and by the Assembly Appropriations Committee May 25 on an 11-6 vote.  Amendments taken on May 11 in response to concerns expressed by Environmental Safety Committee members, which exempt various specialists, nonprofit practices, and practices where a majority of the patients are Denti-Cal patients, did not change CDA’s fundamental objections to the bill.  After vigorous opposition lobbying by CDA, the author moved the bill to the Inactive File on the Assembly floor.  Discussions with the author during the interim resulted in an agreement to amend AB 966 to delete the separator mandate and instead require all dental offices to adhere to standard best management practices (BMPs) in their storage and disposal of amalgam waste, management practices the CDA has long promoted to its membership.  CDA moved to a “Support” position after AB 966 was amended on January 26th, and the bill was passed unanimously by the Assembly on January 30th.  Later in the year, however, Assembly Member Saldana elected to use AB 966 for an unrelated purpose. 

AB 775 (Yee) – Interpreters – Prohibition On Use Of Children:  CDA opposed AB 775 by Assembly Member Leland Yee (D-San Francisco).  AB 775 would prohibit any entity that receives state funds from using, or permitting the use of, any child under age 15 as an interpreter in a hospital, clinic, or “physician’s office” for purposes of diagnosis or treatment.  The bill would require the entity to have procedures in place for making “competent interpretation services” available to the patient.  Violations could cause the provider to lose its eligibility for state funding after failure to comply within 90 days.  While CDA appreciates the author’s interest in preventing children from being placed in stressful and emotional situations when translating difficult health care information for a parent, most dental health information is preventive in nature.  Requiring dentists to make professional interpretation services available in all cases will only serve as a further disincentive for them to participate in already low reimbursement programs such as Denti-Cal and Healthy Families, and would therefore only result in a reduction in access to dental care services.  AB 775 was passed by the Assembly in June 2005 on a 41-35 vote, but failed passage in the Senate Judiciary Committee June 28 on a 2-3 vote.  The bill was amended to deal with an unrelated issue in May 2006.