May 4, 2005, Meeting of COMDA

Agenda
Agenda Item Information
Minutes

Agenda

Notice of PUBLIC MEETING - Notice is hereby given that a public meeting of the Committee on Dental Auxiliaries will be held as follows

Wednesday, May 4, 2005 – 10:30 a.m.

Westin Bonaventure Hotel, 404 S. Figueroa Street, Los Angeles 90071, (213) 624-1000

Agenda

1. Call to Order/Roll Call/Establishment of Quorum
2. Approval of January 26, 2005, Meeting Minutes
3. Report of the Chair
4. Report of the Executive Officer

5. Legislation of Interest to COMDA

1. SB248 (Figueroa) – Board and COMDA sunset dates
2. AB1334 (Salinas) – RDHAP Scope of Practice and Prescription Requirement
3. Other Legislation of interest to COMDA

RDA Program
6. Review of RDA Educational Programs and Courses/Recommendations to Board
7. Appointment of RDA Chief and Assistant Chief Examiners
8. Appointment of RDA Examiners

RDH Program
9. Appointment of RDH Chief and Assistant Chief Examiners
10. Appointment of RDH Examiners

All Programs
11. Implementation of SB1546 (dental assisting scopes of practice)

1. Clean-up legislation
2. Proposed New Regulation - Approval of Registered Orthodontic Assistant Courses
3. Proposed New Regulation - Approval of Registered Surgery Assistant Courses
4. Proposed New Regulation - Approval of Registered Restorative Assistant Courses
5. Proposed Changes to Title 16 CCR Section 1017 – Units Required for Renewal of License (as related to the new Specialty Assistant license categories)
6. Proposed Changes to Title 16 CCR Sections 1071 and 1071.1 – Approval of RDAEF Educational Programs
7. Other implementation issues

12. Agenda Items for Future Meetings
13. Public Comment
14. Adjournment

The Committee may take action on any item listed on the agenda unless listed as information only. All times are approximate and subject to change. Public comments will be taken on agenda items at the time the specific item is raised. Items may be taken out of order to accommodate speakers and to maintain a quorum. The meeting may be cancelled without notice. For meeting verification, call (916) 263-2595 or access the Committee’s website at www. comda. ca.gov. The meeting is accessible to the physically disabled. A person who needs disability-related accommodations or modifications in order to participate in the meeting shall make a request to the Committee by contacting Karen Wyant at (916) 263-2300 or sending a written request to the person at the Committee on Dental Auxiliaries, 1428 Howe Avenue, Suite 58, Sacramento, CA 95825, one week prior to the day of the meeting. Contact: Karen Wyant, (916) 263-2595 or email Karen_Wyant@dca.ca.gov.

Agenda Item Information

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 5. Legislation of Interest to COMDA

1. SB248

SB248 is the vehicle that will be used to extend the sunset dates for the Board and COMDA from the current sunset date of July 1, 2006, to an as yet unspecified date.

2. AB1334

   AB1334 would eliminate the RDHAP prescription requirement, and would specify that RDHAPs can perform all duties that RDHs are allowed to perform. Also attached is a letter from Dr. Gordon, President of the Dental Board, in response to Chair Wallace’s request that the Board provide their reasons in writing for rejecting COMDA’s recommendation at the January, 2005, meeting that legislation be sought to eliminate the RDHAP prescription requirement.

3. Other

Any other legislation of interest to COMDA that arises prior to the meeting will be presented at the meeting.

Note: Possible clean-up legislation to last year’s SB1546 (dental assisting scopes of practice) will be discussed under a separate agenda item.

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 6. Review of RDA Educational Programs and Courses

COMDA recommends approval of the RDA educational program of California College of Vocational Careers, Bakersfield

COMD recommends approval of the coronal polishing course and the radiation safety course of the following Summit Career College, Colton

B&P Code Section 1777, effective January 1, 2005, allows RDAs to apply pit and fissure sealants in certain public health settings, once they have provided evidence of having completed a Board-approved course in this function. The Board has already considered and adopted a regulation (1070.3) that defines the requirements that providers of pit and fissure sealant courses must meet to obtain Board approval, which is under review by the Department of Consumer Affairs.

In order to move expeditiously in approving such courses, COMDA developed an Application that directly reflects the provisions of the pending regulation, and distributed it to interested parties. Three (3) providers have already been approved by the Board with the stipulation that the approval will only be effective if and when proposed regulation 1070.3 becomes effective.

COMDA recommends that the following course also be given such provisional approval by the Board:

1. UC, San Francisco

Any other programs or courses that are ready for consideration by the meeting date will be presented at the meeting.

Committee on Dental Auxiliaries State of California
Dental Board of California Department of Consumer Affairs

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 7. Appointment of RDA Chief and Assistant Chief

Examiners

The RDA Practical Examination Subcommittee has chosen the following RDA Chief and Assistant Chiefs:

Chief Examiner – LaDonna Miles
First Assistant Chief – Cassandra Elston
Second Assistant Chief – Flordeliza Hererra

Pursuant to current COMDA policy, COMDA only needs to take action if it disagrees with the Subcommittee’s decision.

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 8. Appointment of RDA Examiners

The RDA Practical Examination Subcommittee recommends that COMDA recommend to the Board that it appoint the following RDA Examiners:

Susan Porrazzo, Redding
Diane Walters, Moreno Valley

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 9. Appointment of RDH Chief and Assistant Chief

Examiners

The RDH Examination Subcommittee has chosen the following RDH Chief and Assistant Chiefs:

Chief Examiner – Lori DeCaro
First Assistant Chief – Sharie Mikolajczyk
Second Assistant Chief Examiner – Cynthia Nelson

Pursuant to current COMDA policy, COMDA only needs to take action if it disagrees with the Subcommittee’s decision.

Committee on Dental Auxiliaries State of California
Dental Board of California Department of Consumer Affairs

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 10. Appointment of RDH Examiners

The RDH Examination Subcommittee recommends that COMDA recommend to the Board that it appoint the following RDH Examiners:

Heather McDonald, Fallbrook

TO: COMDA Members

Meeting Date: May 4, 2005

Re: Agenda Item 11. Implementation of SB1546

Attached are various proposals for implementing the provisions of SB1546, which substantially change the scope of practice and licensing structure for dental assistants.

COMMITTEE ON DENTAL AUXILIARIES

Draft Meeting Minutes - May 4, 2005

Members Present: Shanda Wallace, RDH, Chair; LaDonna Drury-Klein, Vice Chair; Linda Gipson; RDH, Secretary; Kevin Biggers, Public Member; Darla Dale, RDH; Marlyn Hiroto, RDA; Sonia Molina, DDS; Coragene Savio, DDS

Members Absent: Teresita Churchill, RDA

Staff Present: Karen R. Wyant, Executive Officer; Dyna Leonard, Associate Analyst; LaVonne Powell, DCA Legal Counsel; Lori Hubble, Staff Analyst, Donna Kantner, Staff

1. Call to Order/ Roll Call/ Establishment of Quorum

Chairperson Wallace called the meeting to order at 10:32 a.m. Secretary Linda Gipson called the roll and a quorum was established.

2. Approval of January 26, 2005 Meeting Minutes

Chair Wallace asked to change the wording on Page 3 to "Chair Wallace commended the work done thus far" for clarity. It was M/S/P(Biggers/Gipson) to approve minutes as corrected.

3. Report of the Chair

Wallace reported that she had attended the Dental Board meeting in San Jose on March 11^th, and the RDH Examination which was held in March for the first time on March 6 at UCSF.

4. Report of the Executive Officer

Executive Officer Wyant reported that our efforts have been toward this meeting and the implementation of SB 1546 which the Governor signed into law last year, clarifying that most of its provisions will be effective January 1, 2007. She reported that the new Hygiene exam including the new Law and Ethics components of the examination went very well, adding that the next Hygiene exams will be in June.

She reported that the budget looks good, COMDA will revert $100,000 to 150,000 this year, due to changes made three years ago to have written exam fees collected by the vendor. She noted that several years ago it was noted by the Legislature that COMDA had too large a reserve; however, that reserve will be exhausted by 2007-08 FY. Wyant reported that 3^rd and 4^th year Dental students are now allowed to apply for the RDH exam, though none have done so. She indicated that the update of all current active RDA Licensees by requiring proof of Coronal Polishing and X Ray certifications is still continuing, reporting that approximately 8,000 RDA licensees are still not in compliance and will be re-notified. She directed COMDA’s attention to Examination statistics in the package.

Wyant reported that new regulations are taking a very long time to work their way through the process. The regulation for approval of Pit and Fissure Sealant courses was due to be approved last Thursday, however it is not on OAL’s website as yet. Regarding the regulations for Radiation Safety courses, she noted that those are still in process at the Department, and those for Coronal Polishing and Ultrasonic Scaling have been submitted to the Dental Board for review, and must subsequently go to OAL for review.

5. Legisation of Interest to COMDA
1. SB 248 (Figueroa) – Board and COMDA Sunset Dates

Executive Officer Wyant reported that this bill has been amended recently with new dates inserted, noting that COMDA has been on a two year cycle. Vice Chair Drury Klein asked if this would be the implementation vehicle for clean up legislation, and Wyant indicated that it could be.

2. AB 1334 (Salinas) – RDHAP Scope of Practice and Prescription Requirement

Executive Officer Wyant reported that this bill eliminates the prescription requirement for RDHAPs, and is currently on the Assembly floor. Chair Wallace noted that the Board’s response from Dr. Gordon is in the packet.

3. Other Legislation of Interest

None at this time.

1. Review of RDA Educational Programs and Courses/Recommendations to the Board

   Chair Wallace noted that courses for approval are in the packet for the RDA Educational Program at California College of Vocational Careers in Bakersfield, and the Coronal Polishing course and Radiation Safety course at Summit Career College in Colton. It was M/S/P (Savio/Biggers), to recommend approval of the courses to the Dental Board.

   Chair Wallace reported that Pit and Fissure sealant courses have been adopted by the Board and COMDA has developed an application, pending regulatory approval of Section 1070.3. COMDA staff recommends that UCSF’s course also be given conditional approval under the same restriction. It was M/S/P (Biggers/Savio) to recommend approval of UCSF’s Pit and Fissure sealant course pending the approval of regulation Section 1070.3.

2. Appointment of RDA Chief and Assistant Chief Examiners

   Chair Wallace noted that the RDA Examination Subcommittee has chosen LaDonna Miles as Chief Examiner, Cassandra Elston as First Assistant Chief, and Flordeliza Herrera as Second Assistant Chief, indicating no action is necessary unless COMDA disagrees with any of the choices. No action was taken.

3. Appointment of RDA Examiners

   Chair Wallace noted that the RDA Examination Subcommittee recommends appointment of Susan Porrazzo of Redding and Diane Walters of Moreno Valley as RDA Examiners. It was M/S/P (Savio/Biggers) to accept the recommendations of the Subcommittee and recommend appointment by the Board.

   9. Appointment of RDH Chief and Assistant Chief Examiners

Chair Wallace noted that the RDH Examination Subcommittee has chosen Lori DeCaro as Chief Examiner, Sharie Mikolajczyk as First Assistant Chief, and Cynthia Nelson as Second Assistant Chief Examiner, indicating no action is necessary unless COMDA disagrees with any of the choices. No action was taken.

10. Appointment of RDH Examiners

Chair Wallace noted that the RDH Examination Subcommittee recommends that COMDA recommend to the Dental Board that it appoint Heather McDonald as an RDH Examiner. It was M/S/P (Savio/Biggers) to recommend to the Board that Heather McDonald be appointed as an RDH Examiner.

11. Implementation of SB 1546 (dental assisting scopes of practice)

Executive Officer Wyant reported that there will be a few changes for dental assistants, such as requirements that courses in infection control and California law be taken, and many changes to the RDA category. She indicated that there will be three specialty categories, Registered Orthodontic Assistant, Registered Surgery Assistant, and Registered Restorative Assistant, and that this will be one of the pathways to RDA licensure in the future. She continued that there will be two categories of EF licensees, those who are allowed to perform the new duties, and those who already hold EF licenses that will not be allowed to perform the new duties until approved coursework is completed.

She indicated that the sponsors of this bill were The Alliance and the California Dental Association, and once the bill became law, implementation caused many questions. She noted that this has been documented, and the material in the packet is what has been addressed, what will work under the new law, and what will need to be changed, adding that clean up legislation will be needed to correct those areas.

a. Clean Up Legislation

Regarding Specialty Assistants, Issue #1, Executive Officer Wyant noted that legislation will be sought to allow for approval of the specialty courses beginning January 1, 2006 so that students can be in process rather than waiting until January 1, 2007 to begin taking courses.

She reported that Issue #2 is that some duties that unlicensed dental assistants have always been allowed to perform were inadvertently eliminated, and this needs to be addressed. Legal Counsel LaVonne Powell noted that COMDA might consider adding the ability to adopt emergency regulations in statute since there is no opposition and this really needs to move quickly. Chair Wallace asked for clarification. Legal Counsel Powell noted that emergency regulations could take effect within 10 days of submission to OAL as long as there is no opposition. She agreed that the regulatory process has become even slower, and there is nothing to lose by the request.

Edmund Carolan, CDA, noted that there could be some concerns if the regulatory process were shortened, simply because there would not be a time for public comment. Legal Counsel Powell clarified that all that is being discussed here are course approvals. Member Hiroto noted that it is early course approvals that is being discussed. Powell noted that there may be some controversy over what the bill would look like, but once that is determined and the Legislative session is over, there should be no controversy. Wyant felt that there will be controversy, as may be shown later in the meeting. She agreed that there could come a point that emergency regulations would be explored.

Wyant noted that Issue #3 is that there is consensus that other duties should be allowed for certain categories, including placement of surgical dressings for Restorative Assistants, and Orthodontic Assistants cementing bands and taking facebow transfers and bite registrations.

Wyant reported that issues #4 and #5 are clarifications needed for the requirement of the dentist’s presence chairside during certain duties, such as adding medication to IV lines and also specification of drugs, medications and fluids. She noted that Issue #6 is that SB 1546 did not establish a licensing fee for the Specialty licenses.

Regarding Registered Dental Assistants, Wyant indicated that Issue #1 is that there are many new duties that under current law would allow existing RDAs to perform. Because of the potential for public harm, it is proposed that the Registered Restorative Assistant Duties of selecting, pre-positioning, curing in and removing orthodontic brackets as well as the Registered Surgery Assistant duties of monitoring of patients during the preoperative, intraoperative and postoperative phases using noninvasive instrumentation such as pulse oximeters, electrocardiograms, and capnography and adding medications to intravenous lines, in the presence of a licensed dentist should require completion of a Board approved course by existing RDAs. Wyant further noted that due to the cost involved in the instruction of adding medications to IV lines, it is proposed that the regulations governing full RDA educational programs not require that they instruct in this function, and that it be a separate certification course much like the current duty of ultrasonic scaling which RDA educational programs are not required to instruct.

Wyant reported that Issue #2 is that there will be a significant number of applicants for RDA licensure who will be pending on January 1, 2007, who have qualified by completion of a full RDA educational program, but who have not taken or have not passed the written examination or the practical examination, or both. She noted that neither a written nor a practical examination will be required for licensure on and after that date, therefore those candidates will automatically be issued a license. However, those candidates qualifying through work experience would not automatically be issued a license, but would be required to complete either a full RDA educational program or complete the three specialty courses.

She noted that amendments will be sought to specify that applicants must apply by September 1, 2006, and that they may take the written and practical examinations no more than two more times each, before July 1, 2007. She felt this would assist staff in accommodating the pool of existing applicants. She explained that if applicants continue to be accepted after September, it would add new applicants to the applicant pool rather than trying to accommodate existing applicants.

Continuing to Issue #3, Wyant pointed out that the law does not state that a person applying on and after January 1, 2007 by completion of an RDA educational program must have been instructed in a program that included all the new duties. It is proposed that after 1/1/07, any applicant must take a course in the new duties. Issue #4 is that all RDAs will be allowed to apply sealants, in all settings as of January 1, 2007. Current law allows this duty only in public health settings.

Wyant noted that the final issues dealt with RDAEF licensure. Issue #1 is that under current law the Board can only draft regulations, and students may only take courses in all of the new EF procedures after January 1, 2007, which would cause a substantial delay in licensure. Statutory amendments will be sought to clarify that the Board can approve EF courses beginning on January 1, 2006. Wyant reported that Issue #2 considers the pending EF applicants on January 1, 2007, noting that the current EF applicant pool is extremely small, approximately 12 individuals who will be notified that they must take exams soon or take new courses.

Wyant reported that Issue #3 concerns the use of the term "composite restorations" to define the type of restorations that EFs will be allowed to place. She noted that it is proposed that the term be changed to "non-metallic restorations" so that materials are not limited currently or over time. She noted that Issue #4 is that the statute as it exists now will allow current EFs to be able to do the new RDA duties, and that amendments will be sought to clarify that RDAEFs licensed before January 1, 2007 must complete Board-approved courses and be certified in those functions before they are allowed to perform them. Issue #5, proposes that the Dental Board be allowed to specify whether the written examination be given by COMDA or by the program.

Wyant noted that there may be other issues, such as how the RDHEF fits into this picture. She is currently identifying the issues involved for discussion between CDA and CDHA. JoAnn Galliano, CDHA, agreed that this discussion needs to take place for the RDHEF to continue to be a category and how it will fit in.

Member Savio felt that the State should handle any type of exams that are mandatory to achieve the EF category. Wyant noted this is only a written exam, which she explained that COMDA has never administered since it was a part of the EF program, only the clinical. She clarified that the program will continue to give the written exam and COMDA will give the clinical exam.

It was M/S/P (Drury-Klein/Biggers) to recommend to the Board that COMDA approves the positions taken in concept in the document titled "Proposed Statutory Amendments 4/15/05".

Member Molina had concerns with the assistant adding medications to the IV lines, as well as on Page 3, regarding Pit and Fissure sealants, she felt that either an RDH or a dentist must check before application. Vice Chair Drury-Klein asked what exactly is the concern regarding IV lines. Member Molina felt that if the dental assistant is responsible for putting in medications, some of the mistakes are not reversible, and she felt that there is not much control or supervision even if it is chairside.

Edmund Carolan, CDA, noted that this is one of the duties that was negotiated by the Oral Surgeons Association, who felt that the stricture of having chairside supervision would give control over the situation and address any concerns regarding public safety. Member Molina wished to go on record as being opposed. Bruce Whitcher, Oral & Maxillofacial Surgeons Association, stated that the dentist assumes all responsibility for this action, and it takes place under very limited circumstances. Member Molina felt that incorrect medication or the wrong amount could compromise the patient or potentially even be fatal.

Vice Chair Drury-Klein noted that the intent of SB 1546 was to allow assistants to perform these duties only after full education and training regarding the procedures has been received by the assistant. She felt that all of these procedures could be accomplished through appropriate education and training. Edmund Carolan, CDA, noted that some RDAs will be allowed to do some of the new duties without education. Drury Klein noted that this is the case for some duties, but this particular procedure and others will require educational instruction.

Morehead asked if only EFs will be allowed to take facebows. Wyant noted that has not been proposed as a change, it is allowed for diagnostic and case studies only. Morehead asked it to be changed so that people won’t be breaking the law. Vice Chair Drury-Klein asked if Dr. Morehead was suggesting a modification to the proposed changes on Page 9, Item 12 regarding Registered Orthodontic Dental Assistant duties to read "taking facebow transfers and bitewing impressions" only. Morehead agreed that this was her intent, as well as the Registered Restorative Assistant stating that if they are capable of taking the impression for the study model, they are capable of taking them after the tooth has been drilled on.

Barbara Blade, The Alliance, noted that CDA and The Alliance had workgroups and long conversations regarding this issue. She indicated that the feeling of the group was that there needs to be delineation between impressions taken for study models and those which have to do with fixed prostheses, that the degree of education is so extensive that it must stay within the Registered categories. Morehead found it to be the opposite in her practice.

Earl Johnson, California Association of Orthodontists, would like the proposal regarding bonding brackets to be specific that it be only after approval by the dentist. Wyant noted that was stated on page 8, number (7) of the proposal. Johnson felt it should be more specific. He questioned the proposed change to that item with regard to bracket removal, asking if the assistant can remove the bonding material, and if not, the change should specify what they can remove and the device/s that can be used. Vice Chair Drury-Klein noted that this will change the education required. Johnson suggested the wording be changed to "prepositioning, curing in a position specifically pre-approved by the supervising dentist". Wyant suggested that an ongoing discussion be directed toward language that would be acceptable to all. Edmund Carolan, CDA, believed that this can be dealt with in the regulatory format, and does not need to be built into the Legislation.

b. Proposed New Regulation – Approval of Registered Orthodontic Assistant Courses

Regarding the proposed new regulations for course approvals of the Specialty Registered Assistant categories Wyant noted that these have been drafted primarily by The Alliance with CDA’s input in their development, and all are quite specific as to the criteria for approval. She noted that in the past, guidelines have been used to interpret what equipment is necessary and what is to be taught. These regulations are very detailed because regulations must be specific.

Chair Wallace noted that the proposed regulations would be recommended to the Dental Board and move forward for public hearing. Legal Counsel Powell asked that the motion include those small technical changes that would be necessary to conform to OAL standards, such as numbering, things which have no substance in the discussion. Wyant agreed, noting that the fast timeline is needed, since the courses are necessary by next year and the regulatory process currently takes more than a year. She explained that COMDA’s revenue base could be seriously impacted if there are delays and there is a period when no one applies for licensure. It was M/S/P (Drury-Klein/Biggers) to recommend the Board seek a regulatory change for Section 1017 as proposed and move forward to hearing.

Edmund Carolan, CDA, wished to address Issues #1, #2 and #3 at once, seeing implementation of SB 1546 as a complete package but acknowledging there is not agreement on all issues. He urged that these proposals be held until agreements had been reached. He noted that the educational pathways have been addressed, however there should be alternatives. Wyant then read a handout letter from the California Society of Periodontists regarding the Registered Surgical Assistant regulation citing concerns about the length of the course, the faculty to student ratio, the financial burden of the course, and the number of hours required in the RSA educational programs.

Earl Johnson, California Association of Orthodontic Assistants, asked how these numbers were reached. He felt the training to be ponderous and irrelevant, more suited to the junior college setting and that there are other ways to develop this profession. He felt it negatively impacts the profession, believing that assistants can be trained online followed with an externship. He felt that closing the on the job training path is a big mistake. The proof is in testing, and that system worked well, but is going by the wayside.

Executive Officer Wyant noted that the law states that the courses must be approved by the Board, and that the Board shall adopt regulations for and define the minimum education and training requirements, and that is what these proposals do. Cathy Mudge, CDA, stated that there have been several Orthodontists who have been a part of this process. She clarified that each category was not interested in development of the other specialties, so they were separated into the three groups to address each of their specialties. She explained that CDA first approached this issue because orthodontists and oral surgeons felt the dental assisting programs were educating people, but not educating them in the areas they needed their assistants to be educated in. The intent was to try to reach an agreement that there would be education and training programs that would focus on those categories.

She stated that the further intent was to not require the full RDA program for the other categories not utilizing those specialized functions and to encourage people to enter the dental profession with these certifications in the different areas and to maintain the recognition that some training should be recognized toward that end. She noted that dental assistants can grow within a practice and not be forced into going to a Community College program to enable that, indicating that courses will be approved by the Dental Board, and the local Dental Society can be a provider of some of those courses.

Member Molina noted that in looking at the schematic, dental assistants trained on the job will have to take the law and Infection control courses, but that category will not be eliminated. Mudge stated that existing course providers may apply to be a provider of the new specialty courses. Member Molina said that on the job trained assistants have been able to apply to take the test without having to go through any educational program, now that path is being closed. Johnson agreed, believing that the intent of this bill was to eliminate a state sanctioned exam, and by eliminating this exam it has put in its place mandatory education and training for licensure.

Vice Chair Drury-Klein stated that the spirit and intent of SB 1546 was to eliminate a state sanctioned examination, and replace it with mandatory education. However that education under these regulations may be provided by any Board approved provider. She indicated this could include the California Orthodontists Association, California Dental Association, Contra Costa College, or by Sonia Molina, DDS. Member Molina felt that when this first was proposed it was not understood that the test would be removed. Vice Chair Drury-Klein disagreed, stating that it is very clear in the bill that the mandatory education is in lieu of testing for licensure. She clarified that we are not discussing pathways, but talking about educational regulations. With regard to hours, she noted that if you add up theory, pre-clinical, and clinical hours, 160 hours compared to a full RDA program of 720 hours, that is opening up the category. She wished to stay focused on the issue, which is how the education will be provided as the statute stands today.

Johnson felt that the statute as it exists is a huge mistake, and instead of changes in clean up legislation COMDA should reverse and look at the statute and create some other pathways. He felt that a lot of people in this profession didn’t know that this would happen. Cathy Mudge, CDA, noted that if you want to utilize the services of an unlicensed dental assistant that is still allowed, that scope of practice has been expanded, as are RDAs and new duties will be occurring that will hopefully be helpful to the dentist. She stated that we must work together to insure that the candidates take appropriate courses to fit the needs of the dentist without onerous requirements.

Barbara Blade, The Alliance, felt it is not a time to discuss alternative pathways that are governed by statute, but the educational requirements for the Board-approved courses for the specialty categories. The Alliance is made up of educators of 70 Board approved dental assisting programs and dental programs, and they sat down with the CDA and their workgroups to attempt to draft regulatory language. She noted that didactic training can be provided in many ways, through online, home study, or in class. Lab instruction involves practice on typodonts for approximately ten procedures which are new to the DA. The exam is now gone, and there is no way to allow recognition of illegal practice. If they choose to do direct patient care services, they must be competent. She noted that similar regulations insure educational requirements that are utilized to certify X-ray, coronal polishing, ultrasonic scaling, and now pit and fissure sealants.

Bruce Whitcher, California Association of Oral and Maxillofacial Surgeons, prepared a written document stating their position. He noted appreciation for all the work everyone has done on this proposal, adding there are many good points. He indicated there are significant problems with implementation, one of which is cost in the surgery section in particular. He noted that a teaching manikin is a $40,000 piece of equipment, and believed it is not realistic to expect course providers to obtain that. He also felt that a fully functioning operatory would need a separate facility, and cannot be incorporated into an extramural facility. He did not see how it can be implemented realistically in order to train a sufficient number of people. He further stated his concern with the economic feasibility of offering the surgical program, since this has never before been required in an RDA program. He did not feel that we are at the point to move forward with a hearing.

Joan Greenfield, Sacramento City College, noted that you have to have curriculum changes a year in advance in a community college or an ROP program so it is important that these regulations move forward now. She disagreed with estimates regarding the cost of the program, noting that manikins exist for learning these new procedures for about $1200, and arms are about $400 for learning the IV administration. She added that there are programs in existence for nursing which might expand to give the surgical assistant course, and reported that refurbished equipment also exists.

Carol Johnson, Sacramento County ROP Program, stated that their program provides a great number of well trained dental assistants, and agrees there are a tremendous number of opportunities through different avenues to prepare students for this program. She indicated that the ROP programs currently have the ability to provide the base knowledge to articulate students into Community College or other programs. She wished to ensure that the ROP programs are recognized as being able to provide the course content required to move forward.

It was M/S/P(Drury-Klein/Biggers) to recommend approval of the three proposed educational regulations as a package and that they be set for hearing, while allowing any technical changes to conform to OAL requirements. The motion passed unanimously to recommend the Dental Board set the regulations for hearing.

f. Proposed Changes to Title 16 CCR Section 1071 and 1071.1 – Approval of RDAEF Educational Programs

Wyant noted that this area deals with how EFs will be educated in the new duties that will be allowed, reporting that the proposal is very detailed compared to existing EF programs and reflects what programs must contain to obtain Board approval. It was M/S/P (Drury-Klein/Biggers) moved to recommend the proposed changes to Section 1071 and 1071.1 and move to hearing, while allowing for any technical changes to conform to OAL requirements.

12. Agenda Items for Future Meetings

Vice Chair Drury Klein felt those have been established by this meeting.

13. Public Comment

None.

14. Adjournment

Chair Wallace adjourned the meeting at 1:35pm.