06/12/2015

CDA's concerns shape hygiene association bill


CDA's opposition to a problematic provision in a California Dental Hygienists' Association-sponsored bill led to its removal, facilitating CDA's support position on the bill as it makes its way into the final stages of the legislative process.

The provision removed from AB 502, authored by Assemblyman Ed Chau (D-Monterey Park), would have allowed registered dental hygienists in alternative practice (RDHAPs) to continue practicing in communities designated as underserved even if the area lost this designation (current law allows RDHAPs to establish their own brick-and-mortar hygiene practices in these areas).

CDA felt strongly that RDHAPs must maintain their intended purpose of treating underserved populations, and had begun discussions with the author on amendments that would clearly define "underserved populations" and require RDHAPs to serve a minimum percentage of these patients.

Several legislators expressed the need to incorporate such a requirement during the bill's committee hearings. Ultimately, the sponsor and author were unable to agree on amendments to address CDA's concerns and opted to remove the provision so the bill could move forward during this legislative session.

AB 502 will now move forward with two other provisions that would allow RDHAPs to incorporate and directly bill an insurance plan. The bill passed in the Assembly in June and is now under consideration in the Senate.

"We are pleased that the author and sponsor recognized that the changes proposed in AB 502 need more careful evaluation and we appreciate the Legislature upholding the current safeguards relating to care provided in alternative settings," said CDA President Walt Weber, DDS. "RDHAPs do critical work in underserved areas and we need to ensure they continue treating patients who are struggling to find care and that these patients can get the full range of treatment they need."

Another CDA-opposed provision was removed from AB 502 in March. That provision would have eliminated the current requirement for RDHAPs to obtain a dentist's prescription in order to continue providing services to patients after 18 months. The prescription must be renewed every two years.

CDA advocated strongly against this, as the prescription requirement encourages patients to seek critical services from a dentist that cannot be provided by a hygienist, and supports patients securing a full examination and development of a treatment plan by a dentist. This requirement acts as a safeguard to protect both patients and hygienists from situations where, despite hygiene-specific care, the patient's health deteriorates over time from untreated dental disease.

CDHA proposed similar changes last year as well during the legislative sunset review process for the Dental Hygiene Committee of California. CDA opposed the proposals and they did not move forward.

The RDHAP license was created through legislation in 1998 and allows RDHAPs to deliver hygiene services in alternative settings, such as schools and skilled nursing facilities, for patients who face difficulties in accessing care in a traditional dental office. There are now more than 500 RDHAPs who provide preventive and periodontal care in settings and locations throughout California, often serving as a patient's initial point of contact and essential support for his or her entry into the dental care delivery system.



Related Items

Legislation sponsored by the California Dental Hygienists’ Association (CDHA) that would eliminate an important safeguard for patients served by registered dental hygienists in alternative practice (RDHAPs) was substantially amended by a legislative committee in April to address problematic provisions opposed by CDA.

New legislation sponsored by the California Dental Hygienists’ Association (CDHA) would make a number of changes pertaining to registered dental hygienists in alternative practice (RDHAPs). Among the proposed changes in AB 502, authored by Assemblyman Ed Chau (D-Monterey Park), is eliminating the current requirement for RDHAPs to obtain a dentist’s prescription in order to continue providing services to patients after 18 months.

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