New laws and regulations took effect Jan. 1: Are you in compliance?

Eight new or updated laws and regulations affecting dentistry and dental practice management took effect Jan. 1. To help ensure members are currently in compliance — and stay in compliance — CDA Practice Support offers summaries of the laws, including what they require and where to go for resources and support.

Mandatory informed-consent discussion when prescribing opioids to minors

What’s required: Before a prescriber issues the first prescription to a minor for a controlled substance containing an opioid, the prescriber must discuss the following information with the minor or the minor’s parent or guardian:

  • The risks of addiction and overdose associated with the use of opioids
  • The increased risk of opioid addiction to individuals who are suffering from both mental and substance-abuse disorders
  • The danger of taking an opioid with central nervous system depressants including alcohol and benzodiazepines

Law: Senate Bill 1109 was signed into law in September 2018 and took effect Jan. 1, 2019.

Resources: The Dentists Insurance Company developed the form “Consent to Prescribe an Opioid to a Minor” to help dentists conduct the required discussions. The downloadable form is available in English and Spanish at tdicinsurance.com/risk-management/informed-consent or cda.org/practicesupport.

Also read “TDIC’s informed consent form helps dentists follow law when prescribing opioids to minors” for more background on the law and recommendations from TDIC Senior Risk Management Analyst Taiba Solaiman. Find the article on cda.org and in the January Update.

Unique serial number required on controlled-substance prescription forms

What’s required: Tamper-resistant prescription forms for controlled substances must now contain a unique 15-digit alphanumeric serial number that is linked to corresponding records in CURES, California’s prescription-drug monitoring database. Pharmacies may reject prescriptions that are not written on the new forms. Prescribers should only order forms from a printer listed on the Department of Justice’s website; however, prescribers may use forms without the unique serial numbers to prescribe noncontrolled drugs. Forms that will not be used must be destroyed.

Law: AB 1753 was signed into law in September 2018 and took effect Jan. 1, 2019.

Resources: Order forms only from printers listed on the DOJ’s “Approved List of Security Prescription Printers.”

A new CDA-supported bill to address implementation problems with AB 1753 is rapidly moving through the Legislature. AB 149 will further change controlled-substance prescription form requirements but also allow 2018-compliant forms to be utilized longer. CDA will publish more details in the April Update.

Infection-control standard for procedures that expose dental pulp

What’s required: When performing procedures on exposed dental pulp, water or other methods used for irrigation must be “sterile or contain recognized disinfecting or antibacterial properties.” CDA members have asked Practice Support if treated dental-unit water is considered to contain recognized disinfecting or antibacterial properties. It is not; dental-unit water is treated to control bacterial cfus/ml; it is not treated to confer antibacterial action on tissues upon which it is used.

Law: AB 1277 was signed into law in 2017 and took effect Jan. 1, 2019.

Resources: For more details, read previous articles, including “Clarification on new infection-control requirement for dental pulp procedures” on cda.org.

New state minimum wage, new ‘living wage’ in some California counties

What’s required: The state minimum wage for employers in California with 26 or more employees increased from $11 per hour to $12 per hour. For employers with 25 or fewer employees, the minimum wage increased from $10.50 per hour to $11 per hour. Some cities and counties have their own local ordinances calling for living wages that pay more than the state minimum wage.

Law: Signed into law in 2017, SB 3 amending the California Labor Code requires the state minimum wage to rise annually until it reaches $15 in 2022 for all employers.

Resources: Reference CDA Practice Support’s resource “Minimum Wage and Paid Sick Leave Ordinances by City” available at cda.org/practicesupport (login required). Check with your city or county to ensure you are in compliance with local wage ordinances.

Access the mandated California Minimum Wage workplace posting on the Department of Industrial Relations’ website.

Prescribing naloxone to patients

What’s required: A prescriber must offer to a patient a prescription for naloxone hydrochloride or other FDA-approved drug for the complete or partial reversal of opioid depression when one or more of the following conditions are present:

  1. The prescription dosage for the patient is 90 or more morphine milligram-equivalents of an opioid medication per day. 
  2. An opioid medication is prescribed concurrently with a prescription for benzodiazepine.
  3. The patient presents with an increased risk for overdose, including a patient with a history of overdose or substance-use disorder.

In the circumstances described above, the new law also requires that a prescriber provide education to the patient (or the patient’s guardian if the patient is a minor) on overdose prevention and the use of naloxone hydrochloride or a similar FDA-approved drug.

Law: AB 2760 was signed into law September 2018 and took effect Jan. 1, 2019.
Resource: To assist with the first condition listed above, see the Centers for Disease Control and Prevention’s document “Calculating Total Daily Dose of Opioids for Safer Dosage.”

New standard mileage reimbursement rate for 2019

What’s required: California employers are required to reimburse common business expenses such as work-related travel, dining expenses and mileage when an employee uses a personal car for work-related business. The mileage reimbursement rate for 2019 is 58 cents per mile — up 35 cents from last year. Employees who can prove they spent more than 58 cents per mile to operate their personal vehicles for business use may be entitled to reimbursement of the actual expense.  

Resources: Read the press release from the IRS: www.irs.gov/newsroom/irs-issues-standard-mileage-rates-for-2019.

Updated requirement for lactation accommodation in labor code

What’s required: Employers must make reasonable efforts to provide the employee the use of a room other than a bathroom and in close proximity to the employee’s work area to express milk in private. Employers should update their employee policy to reflect the new lactation-accommodation requirement. 

Law: AB 1976 was signed into law in September 2018 and took effect Jan. 1, 2019.

Resources: Use CDA Practice Support’sSample Employee Manual” to access template policies revised for 2019. Read more about the requirement in the article “More changes for employment practices beginning in 2019” in the December 2018 Update and on cda.org.

Updated requirement to salary history ban

What’s required: The new law amends the California Labor Code to specify that an employer may now ask for an applicant’s salary expectations for the position being applied for only by external applicants (not current employees). The employee is entitled to request a pay scale for the position being applied for but only after completing an initial interview. The pay scale provided only needs to include salary and hourly wage ranges. This new law clarifies ambiguities in the salary history ban that passed in 2017 as part of AB 168.

Law: AB 2282 was signed into law in July 2018 and took effect Jan. 1, 2019.

Resources: Download CDA Practice Support’s sample “Application for Employment” (login required). Find more information in the article “More changes for employment practices beginning in 2019” in the December 2018 Update and on cda.org.

As new laws and regulations affecting dental practices become known, they are added to the “Are You in Compliance?” page at cda.org/practicesupport. The section provides a summary of each requirement and the deadline date for compliance and includes links to Practice Support resources or additional information where relevant.

To keep track of compliance deadlines, visit the “Are You in Compliance” page at cda.org/practicesupport.

Related Items

A bill to address problems implementing new requirements for controlled-substance prescription forms sailed through the California Legislature and is expected to receive Gov. Gavin Newsom’s signature this week. Assembly Bill 149 delays the requirement that prescribers use a new form approved by the Department of Justice as part of an earlier bill that passed last year.

Dentists have contacted CDA Practice Support with questions about the new infection-control requirement that all licensed dentists in California should be following as of Jan. 1, 2019. As explained in a December Update article and according to the new law, when performing procedures on exposed dental pulp, water or other methods used for irrigation must be “sterile or contain recognized disinfecting or antibacterial properties.”