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AB-2510 Dental care for people with developmental disabilities.(2023-2024)

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Date Published: 04/15/2024 02:00 PM
AB2510:v98#DOCUMENT

Revised  April 24, 2024
Amended  IN  Assembly  April 15, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 2510

Introduced by Assembly Member Arambula
(Coauthor: Assembly Member Wood)
(Coauthor: Senator Ochoa Bogh)

February 13, 2024

An act to add Article 9 (commencing with Section 4698.50) to Chapter 6 of Division 4.5 of the Welfare and Institutions Code, relating to developmental services.


LEGISLATIVE COUNSEL'S DIGEST


AB 2510, as amended, Arambula. Dental care for people with developmental disabilities.
Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities disabilities, including intellectual disabilities and other conditions, and their families. Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. The services and supports to be provided to a regional center consumer are contained in an individual program plan (IPP), which is developed by the planning team according to specified procedures. Existing
Existing law defines “services and supports for persons with developmental disabilities” to mean specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. Under existing law, specialized medical and dental care are included within that definition. Under existing law, the determination of which services and supports are necessary for each consumer are made through the IPP process.

This bill would require the State Department of Developmental Services to contract with California Northstate University (CNU), no later than _____, to establish a statewide program centered in the state’s regional centers, to improve the provision of dental care services to people with developmental and intellectual disabilities, and specifically to prevent or reduce the need for developmental services consumers to receive dental treatment using sedation and general anesthesia. The bill would require the program to establish an Oral Health for People with Disabilities Technical Assistance Center, headquartered at CNU. The

This bill would require the department, by July 1, 2026, to enter into a contract with a dental school or college in the state that meets certain criteria relating to public status, accreditation, and a demonstrated record of working with regional centers, for the purpose of establishing a statewide program centered in the state’s regional centers. The bill would require that the contract expire on June 30, 2031. Under the bill, the program would be established to improve the provision of dental care services to people with developmental and intellectual disabilities, and specifically to prevent or reduce the need for developmental services consumers to receive dental treatment using sedation and general anesthesia.
The bill would require the dental school or college to establish an Oral Health for People with Disabilities Technical Assistance Center. The bill would require the center, among other responsibilities, to provide practical experience, systems development, and expertise in relevant subject areas, to train, monitor, and provide support for regional center and oral health personnel, and to collect and analyze program data with the support of participating regional centers and oral health providers. The bill would require the department to submit an annual report of the collected data to the Legislature. The bill also would specify regional center duties, including identifying consumers who can benefit from the program, and establishing vendor agreements with interested oral health professionals. Duties
Under the bill, duties of the department would include providing guidance and establishing protocols to support the program, and establish establishing procedures for regional center directors for participation in the program and allowing aggregation and publication by the center of deidentified results data, as specified.

This bill would make legislative findings and declarations as to the necessity of a special statute to facilitate timely, safe, and adequate dental care for individuals with developmental disabilities.

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 The Legislature finds and declares all of the following:
(a) People with intellectual and developmental disabilities are more likely to lack access to dental care and are disproportionately at risk of developing chronic dental illnesses. Lower-income Californians are less likely to go to an annual dental appointment and are less likely to receive preventative oral health treatment.
(b) The lack of oral health care leads to physical and mental health concerns, which creates cost burdens to an individual and health care institutions. Chronic conditions that are associated with neglected dental care and tooth decay include depression, cardiovascular disease, respiratory infection, and adverse pregnancy outcomes. Those at the most risk include the aging population, low-income adults, and people with intellectual and developmental disabilities.
(c) California is currently experiencing a labor shortage of dental providers, where 79 percent of the state’s dental providers currently do not provide oral health care for low-income Medi-Cal patients. In addition, there is a lack of representation among dental providers. Only 8 percent of Latino and Black dentists are dental providers in California in comparison to the low-income communities they serve. In the San Joaquin Valley, where 47 percent of the population identifies as low income, only 7 percent of the dentists practice in this region.
(d) People with intellectual and developmental disabilities are often referred for dental treatment with sedatives and general anesthesia, which leads to longer wait times to be treated and increases the cost of the procedure. This leads to the loss of access to essential and timely dental care. Medically underserved Californians who have an intellectual and developmental disability must be treated with respect and dignity to achieve improved dental and overall health outcomes.
(e) Developments in dental materials, dental procedures, and delivery systems have created alternatives to the use of sedation and general anesthesia for dental care for people with intellectual and developmental disabilities that can reduce risk, wait times, cost, and consequences of using sedation and general anesthesia. These alternatives have not been widely used because of policy barriers, payment and support systems, and lack of training and support in deploying these alternatives.

SEC. 2.

 Article 9 (commencing with Section 4698.50) is added to Chapter 6 of Division 4.5 of the Welfare and Institutions Code, to read:
Article  9. Dental Health Services
4698.50.

No later than ____, the department shall contract with California Northstate University to establish a statewide program centered in the state’s regional centers, to improve the provision of dental care services to people with developmental and intellectual disabilities, and specifically to prevent or reduce the need for developmental services consumers to receive dental treatment using sedation and general anesthesia. The program shall establish an Oral Health for People with Disabilities Technical Assistance Center headquartered at California Northstate University to do all of the following:

(a)Provide practical experience, systems development, and expertise in relevant subject areas.

(b)Work with regional centers to engage their participation.

(c)Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center.

(d)Design and support customized systems in each community in conjunction with the local oral health community and regional center personnel.

(e)Provide an initial and ongoing training, monitoring, and a support system for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel.

(f)Provide an initial and ongoing training, monitoring, and a support system for regional center personnel.

(g)Monitor and support development and sustainability of the systems for each regional center.

(h)Organize and direct a statewide advisory committee and learning community.

(i)Collect and analyze program data with the support of participating regional centers and oral health providers. The department shall submit an annual report of these data to the Legislature, consistent with Section 9795 of the Government Code.

4698.50.
 (a) By July 1, 2026, the State Department of Developmental Services shall enter into a contract with a dental school or college for the purpose of establishing a statewide program centered in the state’s regional centers, as described in subdivision (c). The contract shall expire on June 30, 2031.
(b) The dental school or college described in subdivision (a) shall meet all of the following criteria:
(1) It a public entity located in the state.
(2) It is approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
(3) It has faculty with a demonstrated record of working with multiple regional centers in the state in programs that have developed and implemented community-based dental care programs that use teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings and improve oral health in those settings.
(c) The purpose of the statewide program established pursuant to subdivision (a) shall be to improve the provision of dental care services to people with developmental and intellectual disabilities, and specifically to prevent or reduce the need for developmental services consumers to receive dental treatment using sedation and general anesthesia. The dental school or college shall establish an Oral Health for People with Disabilities Technical Assistance Center to do all of the following:
(1) Provide practical experience, systems development, and expertise in relevant subject areas.
(2) Work with regional centers to engage their participation.
(3) Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center.
(4) Design and support customized systems in each community in conjunction with the local oral health community and regional center personnel.
(5) Provide initial and ongoing training, monitoring, and a support system for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel.
(6) Provide initial and ongoing training, monitoring, and a support system for regional center personnel.
(7) Monitor and support development and sustainability of the systems for each regional center.
(8) Organize and direct a statewide advisory committee and learning community.
(9) Collect and analyze program data with the support of participating regional centers and oral health providers.
(d) For the duration of the contract period, the department shall submit to the Legislature an annual report of the data described in paragraph (9) of subdivision (c), in accordance with Section 9795 of the Government Code.
(e) To implement this section, the department may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and the review or approval of the Department of General Services.

4698.51.
 Participating regional centers shall have the following program responsibilities:
(a) Designate a lead person at each regional center with responsibility for duties related to this article.
(b) Establish vendor agreements with interested oral health professionals.
(c) Identify consumers who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future.
(d) Provide social, medical, and consent history and information needed for a referral to a participating oral health professional.
(e) Provide referrals to participating oral health professionals.
(f) Monitor program and individual consumer activity and progress.

4698.52.
 (a) The department shall work with the technical assistance center to do all of the following:
(1) Provide guidance for regional centers regarding their participation in various aspects of the program, including the use of specialized therapeutic services payments.
(2) Provide guidance and establishing protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments.
(3) Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
(b) The department shall establish procedures for regional center directors, or their designees, for participation in the program and allow aggregation and publication by the center of deidentified results data.
(c) The department may consult and share information with other state entities as necessary to implement this article.
(d) The department shall adopt regulations as necessary to implement this article.

SEC. 3.

The Legislature finds and declares that a special statute is necessary and that a general statute cannot be made applicable within the meaning of Section 16 of Article IV of the California Constitution due to the unique challenges of finding dentists and associated dental personnel with appropriate knowledge, training, and support to provide timely, safe, and adequate dental care services to individuals with developmental disabilities who are regional center consumers, including avoiding the unnecessary use of sedation or general anesthesia in the course of providing those services.

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REVISIONS:
Heading—Line 2.
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