SENATE BILL No Introduced by Senator Padilla (Coauthors: Senators Emmerson and Price) February 18, 2011

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AMENDED IN SENATE JANUARY, 0 AMENDED IN SENATE JANUARY, 0 AMENDED IN SENATE JANUARY, 0 AMENDED IN SENATE MARCH, 0 SENATE BILL No. Introduced by Senator Padilla (Coauthors: Senators Emmerson and Price) February, 0 An act to repeal, add, and repeal Article (commencing with Section 00) of add Section 0 to, to add Article. (commencing with Section 0) to Chapter of Part of Division 0 of, and to repeal Section 0. of, the Health and Safety Code, relating to dental care. legislative counsel s digest SB, as amended, Padilla. Dental care. Existing law requires the State Department of Public Health to maintain a dental program that includes, but is not limited to, development of comprehensive dental health plans within the framework of a specified state plan. This bill would repeal make these provisions and would provide for inoperative for a specified period of time upon the creation of a Statewide Office of Oral Health within the State Department of Public Health with a licensed dentist who serves as the dental director. This bill would provide that no General Fund moneys shall be used to implement these the provisions creating the office, but would authorize the state to accept other public and private funds for the purpose of implementing these provisions, and would provide that these provisions become inoperative, as specified, if federal other public or private funds

SB are not deposited with the state in an amount sufficient to fully support the activities of the office. This bill would authorize the office to conduct a specified study under described circumstances. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no. The people of the State of California do enact as follows: 0 0 0 SECTION. The Legislature finds and declares all of the following: (a) Nationally and statewide, tooth decay ranks as the most common chronic disease and unmet health care need of children. (b) Poor dental health can disrupt normal childhood development, seriously damage overall health, and impair a child s ability to learn, concentrate, and perform well in school. In rare cases, untreated tooth decay can lead to death. (c) Unmet dental needs have significant human and financial costs. In 00, it was estimated that California schools lost nearly thirty million dollars ($0,000,000) in attendance-based school district funding due to,000 missed school days related to dental problems; and California s hospitals experienced over,000 emergency room visits for preventable dental problems at a cost of fifty-five million dollars ($,000,000). (d) With full implementation of the federal Patient Protection and Affordable Care Act (Public Law -), approximately. million additional children in California are expected to gain dental coverage. (e) The burden of oral disease can be markedly decreased through early intervention, including education, prevention, and treatment. Effective prevention reduces the need for costly treatment of advanced dental disease. (f) To address this unmet need, a comprehensive coordinated strategy is necessary, at the foundation of which is a strong state oral health infrastructure to coordinate essential public dental health functions, including assessing need and capacity to address that need. SEC.. Article (commencing with Section 00) of Chapter of Part of Division 0 of the Health and Safety Code is repealed.

SB 0 0 0 0 SEC.. Section 0 is added to the Health and Safety Code, to read: 0. This article shall become inoperative on the date the Department of Finance memorializes in writing, pursuant to paragraph () of subdivision (e) of Section 0, that sufficient funds have been deposited with the state to establish the Statewide Office of Oral Health, and shall become operative again on the date the Department of Finance memorializes in writing, pursuant to paragraph () of subdivision (f) of Section 0, that the office has not secured sustainable funding sources to maintain the activities of the office, or on January, 0, whichever occurs first. SEC.. Article. (commencing with Section 00)0) is added to Chapter of Part of Division 0 of the Health and Safety Code, to read: Article... Statewide Office of Oral Health 00. 0. (a) There shall be a Statewide Office of Oral Health within the State Department of Public Health. (b) Within the office there shall be a licensed dentist who serves as the dental director. (c) The dental director and his or her staff shall have all of, but not be limited to, the following responsibilities: () Advancing and protecting the oral health of all Californians. () Developing a comprehensive and sustainable state oral health action plan to address the state s unmet oral health needs. () Encouraging private and public collaboration to meet the oral health needs of Californians. () Securing funds to support infrastructure and statewide and local programs. () Promoting evidence-based approaches to increase oral health literacy. () Establishing a system for surveillance and oral health reporting. (d) The state may accept public funds and private funds for the purpose of implementing this article. (e) () No General Fund moneys shall be used for purposes of this section. Moneys to fund the office shall be secured from other

SB 0 0 0 0 public or private sources. The Department of Finance shall, on January, 0, and annually thereafter, make a determination regarding the funding status of the office. Moneys needed to sufficiently fund and commence the study pursuant to Section 0. shall not be considered for purposes of determining the funding status of the office pursuant to this paragraph. (e) () () The office shall be established pursuant to this section only after a determination has been made by the Department of Finance that federal public or private funds in an amount sufficient to fully support the activities of the office, including staffing the office, have been deposited with the state. If the Department of Finance makes a determination that sufficient funding has been secured to establish the office, the Department of Finance shall file a written statement with the Secretary of the Senate, the Chief Clerk of the Assembly, and the Legislative Counsel memorializing that this determination has been made. () No General Fund moneys shall be used to fund this section. Moneys to fund the office shall be secured from other public or private sources. If the Department of Finance makes a determination that the amount of federal or private funds deposited with the state is not sufficient to support the activities of the office, it is the intent of the Legislature that this section become inoperative. (f) () If the office is established pursuant to this section, the office shall assume responsibility for identifying and securing funding sources in order to maintain the functions of the office. () If the Department of Finance makes a determination that the office does not secure has not secured sustainable funding sources to maintain the activities of the office pursuant to paragraph (), this section shall become inoperative on January, 0 the Department of Finance shall file a written statement with the Secretary of the Senate, the Chief Clerk of the Assembly, and the Legislative Counsel memorializing that this determination has been made. (g) This section shall become inoperative on January, 0. 0. 0.. (a) The Legislature finds and declares that, as part of a comprehensive integrated system of dental care, with the dentist as the head of that system, additional dental providers who

SB 0 0 0 provide basic preventive and restorative oral health care to underserved children, located at or near where children live or go to school, may have the potential to reduce the oral health disease burden in the population most in need. (b) The office may design and implement a scientifically rigorous study to assess the safety, quality, cost-effectiveness, and patient satisfaction of irreversible expanded dental procedures performed by traditional and nontraditional providers for the purpose of informing future decisions about scope of practice changes in the dental workforce that include irreversible or surgical procedures how to meet the state s unmet oral health need for the state s children. The research parameters of the study shall include public health settings, multiple models of dentist supervision, multiple pathways of education and training, and multiple dental providers, including dentists and nondentists. Procedures performed during the study shall be performed only by providers within the confines of a university-based study. (c) The dental director shall convene an advisory group on study design and implementation. The advisory group shall be comprised of representatives of all dental practices, including traditional and nontraditional, as well as nondentists. (d) The dental director shall provide input regarding study design and implementation, receive all study data and reports, and develop a report and recommendations to be submitted to the Legislature based on the study findings. The dental director shall also consult with the Legislative Analyst s Office in designing the study and selecting any contractors. (e) () There shall be no General Fund moneys used to implement this section. Moneys to fund the study, including analysis and findings, and all procedures administered by providers during the study, shall be secured from other public or private sources. No one provider group or interest group may provide more than half the private funding for the study. () All procedures administered by providers during the study shall be paid for by private or federal funds. No General Fund moneys shall be used to fund procedures performed as part of the study. (f) In the event that Notwithstanding subdivision (g), if the study described in this section is not sufficiently funded and commenced

SB by January, 0, this section shall become inoperative on January, 0. (g) This section shall remain in effect only until January, 0, and as of that date is repealed, unless a later enacted statute, that is enacted before January, 0, deletes or extends that date. 0. This article shall become inoperative on January, 0, and as of that date is repealed, unless a later enacted statute, that is enacted before January, 0, deletes or extends that date. O