The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on the clinical and written examination developed by the American Board of Dental Examiners, Inc., subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided, delivery of this review to the Dental Board of California, and payment of specified expenses incurred by the board.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Department of Finance to accept funds for the purposes of reviewing and analyzing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

This bill would incorporate additional changes to Section 1632 of the Business and Professions Code proposed by SB 1478 that would become operative if this bill and SB 1478 are enacted and this bill is enacted last.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on the clinical and written examination developed by the American Board of Dental Examiners, Inc., subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided, delivery of this review to the Dental Board of California, and payment of specified expenses incurred by the board.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Department of Finance to accept funds for the purposes of reviewing and analyzing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

This bill would incorporate additional changes to Section 1632 of the Business and Professions Code proposed by SB 1478 that would become operative if this bill and SB 1478 are enacted and this bill is enacted last.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on the clinical and written examination developed by the American Board of Dental Examiners, Inc., subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided, delivery of this review to the Dental Board of California, and payment of specified expenses incurred by the board.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Director of Finance to accept funds for the purposes of reviewing and analyzing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on the Patient Centered Curriculum Integrated Dental Examination Format clinical and written examination developed by the American Board of Dental Examiners, Inc., subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided, delivery of this review to the Dental Board of California, and payment of specified expenses incurred by the board.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Director of Finance to accept funds for the purposes of reviewing and implementing analyzing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on the Patient Centered Curriculum Integrated Dental Examination Format developed by the American Board of Dental Examiners, Inc., subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided, and delivery of this review to the Dental Board of California. California, and payment of specified expenses incurred by the board.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Director of Finance to accept funds for the purposes of reviewing and implementing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on an examination developed by the American Board of Dental Examiners, Inc. the Patient Centered Curriculum Integrated Dental Examination Format, Format developed by the American Board of Dental Examiners, Inc., subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided. provided, and delivery of this review to the Dental Board of California.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Director of Finance to accept funds for the purposes of implementing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on an examination developed by the American Board of Dental Examiners, Inc. Inc. Patient Centered Curriculum Integrated Dental Examination Format, subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Director of Finance to accept funds for the purposes of implementing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

The Dental Practice Act provides for the licensure and regulation of dentists and associated professions by the Dental Board of California within the Department of Consumer Affairs. The act requires each applicant for a license to practice dentistry to successfully complete specified examinations, including receiving a passing score on either a portfolio examination, as specified, or a clinical and written examination administered by the Western Regional Examining Board, which determines the passing score for that examination.

This bill would additionally allow an applicant to satisfy that examination requirement by receiving a passing score on an examination developed by the American Board of Dental Examiners, Inc.

Existing law authorizes the Director of Finance to accept on behalf of the state any gift of real or personal property whenever he or she deems the gift and the terms and conditions thereof to be in the best interest of the state. Existing law establishes the Special Deposit Fund, a continuously appropriated fund, which consists of money that is paid into it in trust pursuant to law when no other fund has been created to receive that money.

This bill would authorize the Director of Finance to accept funds for the purposes of implementing the dental examination developed by the American Board of Dental Examiners, Inc., described above. Because these funds would be deposited in the Special Deposit Fund, a continuously appropriated fund, this bill would make an appropriation.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2331

Author:(Dababneh)

As Amended Ver:August 19, 2016

Majority vote

Original Committee Reference: B. & P.

SUMMARY: Allows an applicant to satisfy the licensure examination requirement for a dental license by receiving a passing score on a clinical and written examination developed by the American Board of Dental Examiners, Inc. (ADEX) subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided. This bill would also authorize the Director of Finance to accept funds for the purposes of implementing the dental examination developed by the ADEX. Specifically, this bill:

1. Provides that a passing score on an examination developed by the ADEX, fulfills part of the examination requirements for the Dental Board of California (DBC).
2. Specifies that the DBC shall determine the passing score for the examination.
3. Indicates that the Department of Consumer Affair's Office of Professional Examination Services shall review the ADEX examination to ensure compliance with the requirements of Section 139 and to certify that the examination process meets those standards, prior to implementation of the examination.
4. Specifies that if the department determines that the examination process fails to meet those standards, or if the ADEX fails to pay the costs and expenses the DBC incurs, it shall not be implemented. The review of the ADEX examination shall be conducted during or after DBC's occupational analysis.
5. Requires the ADEX to pay all reasonable costs and expenses the DBC incurs, as specified.
6. Permits the Department of Finance to accept funds for the purposes of reviewing and implementing the examination developed by the ADEX.

The Senate amendments add language to avoid chaptering out issues with SB 1478 (Hill) of the current Legislative Session.

FISCAL EFFECT: According to the Senate Appropriations Committee, this bill will result in:

1. Initial costs of about $20,000 for an occupational and psychometric evaluation of the new examination to ensure that it complies with the occupational requirements for dentists and state law regarding non-discrimination (State Dentistry Fund). The DBC will incur a similar cost every seven years to validate the continuing appropriateness of the examination. The costs to validate the examination will be reimbursed by the ADEX.
2. One-time costs of $90,000 and ongoing costs of $82,000 per year to develop regulations and to process additional licensure applications by the DBC (State Dentistry Fund). By providing an additional examination for licensure, the DBC anticipates some growth in the number applicants for licensure who trained at out-of-state dental schools.

COMMENTS:

Purpose. This bill is sponsored by the American Board of Dental Examiners, Inc. According to the author, "AB 2331 will facilitate the recognition of the ADEX Patient Centered Curriculum Integrated Dental Examination Format (PC-CIF) as an option for initial licensure in California. This additional exam option will allow out-of-state dental students seeking to practice in California, including California residents choosing to return to their home state, the opportunity to take the ADEX PC-CIF test in other states where it is administered. This exam format meets the American Dental Association and California Dental Associations guidelines for the ethical use of patients during a licensure exam."

Background. Examination Requirements. The DBC requires that applicants for licensure as a dentist meet a number of examination requirements including: 1) passing Parts I and II of the written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations, and 2) obtaining a passing score on either the Western Region Examining Board examination written or clinical examination, or a portfolio examination. Applicants must also complete a California law and ethics examination.

History of the DBC Portfolio Examination. In 2008, the DBC commissioned Comira Psychometric Services to conduct a study of competencies in dental education programs. The Board had concerns about existing clinical examinations, especially in terms of validity of the content tested and the reliability of judgments made on examinee performance. Comira identified four alternatives to initial licensure based on interviews, observations, and documentation; those alternatives were: 1) Curriculum Integrated Format (CIF), 2) Objective Standardized Clinical Examination (OSCE), 3) traditional portfolio, and 4) a hybrid portfolio examination. The hybrid portfolio examination was an alternative based upon the synthesis of the traditional portfolio and test cases (or competency cases) used in the dental schools for competency evaluations.

In February 2009, Comira prepared a report for the DBC entitled, Alternative Pathways for Initial Licensure for General Dentists, Final Report, February 9, 2009, which provided findings and evidence to support the feasibility of an additional examination for the DBC to add as a pathway to initial licensure. The report supported the conclusion that the hybrid portfolio examination model satisfied the criteria identified by the DBC and the psychometric consultants. Subsequently, Comira prepared an additional report for the DBC entitled Portfolio Examination to Qualify for California Dental Licensure, December 1, 2009 which defined the competencies to be tested in the portfolio examination and provided background research for the examination's implementation process.

Using the findings of these two reports, the DBC sponsored legislation, AB 1524 (Hayashi), Chapter 446, Statutes of 2010. AB 1524 eliminated the clinical and written examination administered by the DBC and replaced it with a portfolio examination of an applicant's competence to enter the practice of dentistry, to be conducted while the applicant is enrolled in a DBC-approved dental school located in California.

The DBC implemented the Portfolio Examination process in 2014. The Portfolio Exam is currently offered at four of the six dental schools in California including: 1) University of California, Los Angeles, 2) University of California, San Francisco, 3) University of the Pacific, and 4) University of Southern California

Portfolio Examination Application Process. The portfolio examination is to be conducted while the applicant is still enrolled in a DBC-approved dental school located in California. The portfolio examination is required to utilize uniform standards of clinical experiences and competencies approved by the DBC. An applicant is required to pass a final assessment of the submitted portfolio at the end of his or her dental school program. Before the portfolio may be submitted to the DBC, the applicant must pay the Board a $350 application fee and provide a letter of good standing signed by the dean of the dental school, or his or her delegate, stating that the applicant has graduated or will graduate with no pending ethical issues.

The ADEX Examination. The ADEX examination has been recognized in 43 states. The new PC-CIF, which the author compares to the DBC's Portfolio Exam, is only recognized in New York. The PC-CIF includes structured patient involvement, informed consent, and patient follow-up.

The author purports that graduates from out-of-state dental programs, including California residents, have to pass the Western Regional Examining Board examination which requires out-of-state students to travel to California to take the examination. The author believes that by adding the ADEX's PC-CIF as an option, students will be able to take this examination in the state they are located in

Occupational Analysis. An occupational analysis generally employs survey methodology to gather job information. That information may be used to help establish recruitment and selection criteria for entry into the occupation, and identify training standards for evaluating training efficacy and efficiency. Prior to the DBC accepting the ADEX PC-CIF, an occupational analysis must be completed. In addition, this measure allows the DBC to accept funding from entities to cover the costs associated with conducting the occupational analysis of the ADEX examination to ensure it meets California's standards.

Analysis Prepared by: Le Ondra Clark Harvey Ph.D. / B. & P. / (916) 319-3301 FN: 0004892

 THIRD READING  

Bill No: AB 2331

Author:

:

Vote:

SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/27/16

AYES: Hill, Bates, Block, Gaines, Galgiani, Hernandez, Jackson, Mendoza, Wieckowski

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/1/16

AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen

ASSEMBLY FLOOR: 79-0, 6/1/16 - See last page for vote

SUBJECT:

SOURCE: American Board of Dental Examiners

DIGEST: This bill establishes an alternative clinical and written examination for dental licensure applicants, requires a review of this exam by the Office of Professional Examination Services (OPES).

Senate Floor Amendments of 8/19/16 add chaptering amendments to incorporate SB 1478 (Committee on Business, Professions and Economic Development).

ANALYSIS:

Existing law:

1. Establishes the Dental Board of California (DBC) within the Department of Consumer Affairs (DCA) to license and regulate the practice of dentistry. (Business and Professions Code (BPC) §§ 1601.1, 1611)
2. Requires the examination of applicants for a license to practice dentistry to be sufficiently thorough to test the fitness of the applicant to practice dentistry, and that both questions and answers are written in the English language.
   (BPC § 1630)
3. Requires the DBC to require each dental licensure applicant to: (BPC § 1632)
   1. Successfully complete the Part I and Part II written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations.
   2. Successfully complete an examination in California law and ethics developed and administered by the DBC.
   3. Have taken and received a passing score on one of the following:
      1. A portfolio examination of the applicant’s competence to enter the practice of dentistry, conducted while the applicant is enrolled in a dental school program at a DBC-approved school in California.
      2. A clinical and written examination administered by the Western Regional Examining Board (WREB).
4. Requires all DCA boards and bureaus to ensure that every licensing examination administered by or pursuant to contract with the board is subject to periodic evaluation. The evaluation shall include (a) a description of the occupational analysis serving as the basis for the examination; (b) sufficient item analysis data to permit a psychometric evaluation of the items; (c) an assessment of the appropriateness of prerequisites for admittance to the examination; and (d) an estimate of the costs and personnel required to perform these functions. The evaluation shall be revised and a new evaluation submitted to the Director whenever, in the judgment of the board, program, or bureau, there is a substantial change in the examination or the prerequisites for admittance to the examination. (BPC § 139)
5. States that it is unlawful for a licensing board to require any examination or establish any other qualification for licensing that has an adverse impact on any class by virtue of its race, creed, color, national origin or ancestry, sex, gender, gender identity, gender expression, age, medical condition, genetic information, physical disability, mental disability, or sexual orientation, unless the practice can be demonstrated to be job related. If an examination or other qualification for licensing is determined to be unlawful, that determination shall not void, limit, repeal, or otherwise affect any right, privilege, status, or responsibility previously conferred upon any person by the examination or by a license issued in reliance on the examination or qualification. (Government Code § 12944)

This bill:

1. Establishes an alternative clinical and written examination for dental licensure applicants developed by the American Board of Dental Examiners, Inc (ADEX).
2. Strikes the ability for the WREB to determine the passing score for its exam.
3. Authorizes the DBC to determine the testing format, as relates to patients, for the exam developed by ADEX.
4. Requires a review of the exam developed by the ADEX by OPES prior to its implementation to ensure compliance with current law and deliver this review to the DBC.
5. Prohibits implementation of the exam if the DCA determines that the examination process fails to meet specified standards, does not deliver the review to the DBC, or if ADEX fails to pay costs and expenses, as specified.
6. Requires the ADEX’s examination process to be regularly reviewed by the DCA and comply with statutory requirements.
7. Requires the ADEX to pay all reasonable costs and expenses the DBC incurs for the purposes of reviewing the exam.
8. States that the ADEX examination may only be accepted for licensure by a candidate after it is determined that the examination has met the requirements of current law, and any examinations taken prior to that date may not be used for licensure.
9. Authorizes the Department of Finance to accept funds for the purposes of reviewing and analyzing the examination developed by ADEX.

Background

California requires dental applicants to take either a portfolio examination of the applicant’s competence to practice dentistry, which is offered only by California schools, or a clinical and written examination administered by WREB. This bill will allow ADEX to provide funding to the state to have its test validated and, if determined sufficient, offered as an alternative clinical and written examination.

ADEX is a nonprofit corporation of the State Boards of Dentistry focused on the development of a “state of the art, high quality uniform National dental and dental hygiene clinical licensure examination for the sole use by States Board of Dentistry.” In a letter to the DBC last year, ADEX wrote, “Dentistry is the only health profession that does not have a uniform national licensure examination. ADEX believes that the acceptance of the ADEX by California will set the cornerstone that will bring to fruition the goal of a Uniform National Dental Licensure examination.”

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Senate Appropriations Committee:

• Initial costs of about $20,000 for an occupational and psychometric evaluation of the new examination to ensure that it complies with the occupational requirements for dentists and state law regarding non-discrimination (State Dentistry Fund). DBC will incur a similar cost every seven years to validate the continuing appropriateness of the examination. The costs to validate the examination will be reimbursed by ADEX.
• One-time costs of $90,000 and ongoing costs of $82,000 per year to develop regulations and to process additional licensure applications by DBC (State Dentistry Fund). By providing an additional examination for licensure, the Board anticipates some growth in the number applicants for licensure who trained at out-of-state dental schools.

SUPPORT: (Verified 8/22/16)

American Board of Dental Examiners (source)

California Dental Association

OPPOSITION: (Verified 8/22/16)

None received

ARGUMENTS IN SUPPORT: ADEX writes, “AB 2331 will allow the DBC to recognize the ADEX PC-CIF exam so that students outside of California can choose this exam for admission to the state. This provides these students with an exam option that complies with the patient-centered guidelines established by industry leaders.”

ASSEMBLY FLOOR: 79-0, 6/1/16

AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon

NO VOTE RECORDED: Gordon

Prepared by:

8/22/16 23:02:25

**** END ****

 THIRD READING  

Bill No: AB 2331

Author:

:

Vote:

SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 6/27/16

AYES: Hill, Bates, Block, Gaines, Galgiani, Hernandez, Jackson, Mendoza, Wieckowski

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/1/16

AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen

ASSEMBLY FLOOR: 79-0, 6/1/16 - See last page for vote

SUBJECT:

SOURCE: American Board of Dental Examiners

DIGEST: This bill establishes an alternative clinical and written examination for dental licensure applicants, requires a review of this exam by the Office of Professional Examination Services (OPES).

ANALYSIS:

Existing law:

1. Establishes the Dental Board of California (DBC) within the Department of Consumer Affairs (DCA) to license and regulate the practice of dentistry. (Business and Professions Code (BPC) §§ 1601.1, 1611)
2. Requires the examination of applicants for a license to practice dentistry to be sufficiently thorough to test the fitness of the applicant to practice dentistry, and that both questions and answers are written in the English language.
   (BPC § 1630)
3. Requires the DBC to require each dental licensure applicant to: (BPC § 1632)
   1. Successfully complete the Part I and Part II written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations.
   2. Successfully complete an examination in California law and ethics developed and administered by the DBC.
   3. Have taken and received a passing score on one of the following:
      1. A portfolio examination of the applicant’s competence to enter the practice of dentistry, conducted while the applicant is enrolled in a dental school program at a DBC-approved school in California.
      2. A clinical and written examination administered by the Western Regional Examining Board (WREB).
4. Requires all DCA boards and bureaus to ensure that every licensing examination administered by or pursuant to contract with the board is subject to periodic evaluation. The evaluation shall include (a) a description of the occupational analysis serving as the basis for the examination; (b) sufficient item analysis data to permit a psychometric evaluation of the items; (c) an assessment of the appropriateness of prerequisites for admittance to the examination; and (d) an estimate of the costs and personnel required to perform these functions. The evaluation shall be revised and a new evaluation submitted to the Director whenever, in the judgment of the board, program, or bureau, there is a substantial change in the examination or the prerequisites for admittance to the examination. (BPC § 139)
5. States that it is unlawful for a licensing board to require any examination or establish any other qualification for licensing that has an adverse impact on any class by virtue of its race, creed, color, national origin or ancestry, sex, gender, gender identity, gender expression, age, medical condition, genetic information, physical disability, mental disability, or sexual orientation, unless the practice can be demonstrated to be job related. If an examination or other qualification for licensing is determined to be unlawful, that determination shall not void, limit, repeal, or otherwise affect any right, privilege, status, or responsibility previously conferred upon any person by the examination or by a license issued in reliance on the examination or qualification. (Government Code § 12944)

This bill:

1. Establishes an alternative clinical and written examination for dental licensure applicants developed by the American Board of Dental Examiners, Inc (ADEX).
2. Strikes the ability for the WREB to determine the passing score for its exam.
3. Authorizes the DBC to determine the testing format, as relates to patients, for the exam developed by ADEX.
4. Requires a review of the exam developed by the ADEX by OPES prior to its implementation to ensure compliance with current law and deliver this review to the DBC.
5. Prohibits implementation of the exam if the DCA determines that the examination process fails to meet specified standards, does not deliver the review to the DBC, or if ADEX fails to pay costs and expenses, as specified.
6. Requires the ADEX’s examination process to be regularly reviewed by the DCA and comply with statutory requirements.
7. Requires the ADEX to pay all reasonable costs and expenses the DBC incurs for the purposes of reviewing the exam.
8. States that the ADEX examination may only be accepted for licensure by a candidate after it is determined that the examination has met the requirements of current law, and any examinations taken prior to that date may not be used for licensure.
9. Authorizes the Department of Finance to accept funds for the purposes of reviewing and analyzing the examination developed by ADEX.

Background

California requires dental applicants to take either a portfolio examination of the applicant’s competence to practice dentistry, which is offered only by California schools, or a clinical and written examination administered by WREB. This bill will allow ADEX to provide funding to the state to have its test validated and, if determined sufficient, offered as an alternative clinical and written examination.

ADEX is a nonprofit corporation of the State Boards of Dentistry focused on the development of a “state of the art, high quality uniform National dental and dental hygiene clinical licensure examination for the sole use by States Board of Dentistry.” In a letter to the DBC last year, ADEX wrote, “Dentistry is the only health profession that does not have a uniform national licensure examination. ADEX believes that the acceptance of the ADEX by California will set the cornerstone that will bring to fruition the goal of a Uniform National Dental Licensure examination.”

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Senate Appropriations Committee:

• Initial costs of about $20,000 for an occupational and psychometric evaluation of the new examination to ensure that it complies with the occupational requirements for dentists and state law regarding non-discrimination (State Dentistry Fund). DBC will incur a similar cost every seven years to validate the continuing appropriateness of the examination. The costs to validate the examination will be reimbursed by ADEX.
• One-time costs of $90,000 and ongoing costs of $82,000 per year to develop regulations and to process additional licensure applications by DBC (State Dentistry Fund). By providing an additional examination for licensure, the Board anticipates some growth in the number applicants for licensure who trained at out-of-state dental schools.

SUPPORT: (Verified 8/3/16)

American Board of Dental Examiners (source)

California Dental Association

OPPOSITION: (Verified 8/3/16)

None received

ARGUMENTS IN SUPPORT: ADEX writes, “AB 2331 will allow the DBC to recognize the ADEX PC-CIF exam so that students outside of California can choose this exam for admission to the state. This provides these students with an exam option that complies with the patient-centered guidelines established by industry leaders.”

ASSEMBLY FLOOR: 79-0, 6/1/16

AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon

NO VOTE RECORDED: Gordon

Prepared by:

8/3/16 19:31:31

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

AB 2331 (Dababneh) - Dentistry: applicants to practice

This bill does not meet the criteria for referral to the Suspense File.

Bill Summary:

AB 2331 would authorize the Dental Board of California to accept an additional clinical and written examination for dental licensure applicants.

Fiscal Impact:

• Initial costs of about $20,000 for an occupational and psychometric evaluation of the new examination to ensure that it complies with the occupational requirements for dentists and state law regarding non-discrimination (State Dentistry Fund). The Dental Board will incur a similar cost every seven years to validate the continuing appropriateness of the examination. The costs to validate the examination will be reimbursed by the American Board of Dental Examiners.
• One-time costs of $90,000 and ongoing costs of $82,000 per year to develop regulations and to process additional licensure applications by the Dental Board (State Dentistry Fund). By providing an additional examination for licensure, the Board anticipates some growth in the number applicants for licensure who trained at out-of-state dental schools.

Background:

Under current law, the Dental Board of California licenses dentists and regulates the practice of dentistry. In order to be licensed by the Dental Board, an applicant must successfully complete a specific written examination on the practice of dentistry, successfully complete an examination on California law and ethics, and pass either a portfolio examination (including a clinical portion) offered at a California dental school or a clinical and written examination administered by the Western Regional Examining Board.

Under current law, any licensing examination used by a licensing board or bureau within the Department of Consumer Affairs must be evaluated to ensure that the examination meets certain requirements (for example that it appropriately reflects the scope of practice for the license and that it does not result in gender, ethnic or other forms of discrimination).

Proposed Law:

AB 2331 would authorize the Dental Board of California to accept an additional clinical and written examination for dental licensure applicants.

Specific provisions of the bill would:

• Authorize the Dental Board to accept a clinical and written examination developed by the American Board of Dental Examiners;
• Authorize the Dental Board to determine the testing format for that examination;
• Require the Office of Professional Examination Services (within the Department of Consumer Affairs) to review the examination developed by the American Board of Dental Examiners to ensure that the examination meets current requirements;
• Prohibit the examination from being accepted by the Dental Board if the examination does not meet existing standards or if the American Board of Dental Examiners does not pay for the costs incurred by the Dental Board;
• Require the American Board of Dental Examiners to pay all reasonable costs for the Dental Board to implement the bill;
• Specify that the examination shall only be accepted for licensure once the conditions in the bill have been satisfied and that examinations taken prior to that time are not valid for licensure.

-- END --

SENATE COMMITTEE ON

BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT

Senator Jerry Hill, Chair

2015 - 2016 Regular

Bill No: AB 2331 Hearing Date: June 27, 2016

Subject: Dentistry: applicants to practice

SUMMARY:

Establishes an alternative clinical and written examination for dental licensure applicants, requires a review of this exam by the Office of Professional Examination Services (OPES).

Existing law:

1. Establishes the Dental Board of California (DBC) within the Department of Consumer Affairs (DCA) to license and regulate the practice of dentistry. (Business and Professions Code (Business and Professions Code (BPC) §§ 1601.1, 1611)
2. Requires the examination of applicants for a license to practice dentistry to be sufficiently thorough to test the fitness of the applicant to practice dentistry, and that both questions and answers are written in the English language. (BPC § 1630)
3. Requires the DBC to require each dental licensure applicant to: (BPC § 1632)
   1. Successfully complete the Part I and Part II written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations.
   2. Successfully complete an examination in California law and ethics developed and administered by the DBC.
   3. Have taken and received a passing score on one of the following:
      1. A portfolio examination of the applicant’s competence to enter the practice of dentistry, conducted while the applicant is enrolled in a dental school program at a DBC-approved school in California.
      2. A clinical and written examination administered by the Western Regional Examining Board (WREB).
4. Requires all DCA boards and bureaus to ensure that every licensing examination administered by or pursuant to contract with the board is subject to periodic evaluation. The evaluation shall include (1) a description of the occupational analysis serving as the basis for the examination; (2) sufficient item analysis data to permit a psychometric evaluation of the items; (3) an assessment of the appropriateness of prerequisites for admittance to the examination; and (4) an estimate of the costs and personnel required to perform these functions. The evaluation shall be revised and a new evaluation submitted to the Director whenever, in the judgment of the board, program, or bureau, there is a substantial change in the examination or the prerequisites for admittance to the examination. (BPC § 139)
5. States that it is unlawful for a licensing board to require any examination or establish any other qualification for licensing that has an adverse impact on any class by virtue of its race, creed, color, national origin or ancestry, sex, gender, gender identity, gender expression, age, medical condition, genetic information, physical disability, mental disability, or sexual orientation, unless the practice can be demonstrated to be job related. If an examination or other qualification for licensing is determined to be unlawful, that determination shall not void, limit, repeal, or otherwise affect any right, privilege, status, or responsibility previously conferred upon any person by the examination or by a license issued in reliance on the examination or qualification. (Government Code § 12944)

This bill:

1. Establishes an alternative clinical and written examination for dental licensure applicants developed by the American Board of Dental Examiners, Inc.
2. Strikes the ability for the WREB to determine the passing score for its exam.
3. Authorizes the DBC to determine the testing format, as relates to patients, for the exam developed by the American Board of Dental Examiners, Inc.
4. Requires a review of the exam developed by the American Board of Dental Examiners, Inc. by OPES prior to its implementation to ensure compliance with current law and deliver this review to the DBC.
5. Prohibits implementation of the exam if the DCA determines that the examination process fails to meet specified standards, does not deliver the review to the DBC, or if the American Board of Dental Examiners, Inc. fails to pay costs and expenses, as specified.
6. Requires the American Board of Dental Examiners, Inc.’s examination process to be regularly reviewed by the DCA and comply with statutory requirements.
7. Requires the American Board of Dental Examiners, Inc. to pay all reasonable costs and expenses the DBC incurs for the purposes of reviewing the exam.
8. States that the American Board of Dental Examiners, Inc. examination may only be accepted for licensure by a candidate after it is determined that the examination has met the requirements of current law, and any examinations taken prior to that date may not be used for licensure.
9. Authorizes the Department of Finance to accept funds for the purposes of reviewing and analyzing the examination developed by the American Board of Dental Examiners, Inc.

FISCAL EFFECT:

This bill is keyed “fiscal” by the Legislative Counsel. According to the Assembly Appropriations analysis dated April 20, 2016, this bill has one-time costs to the DBC and to the OPES of $200,000 to perform reviews and issue regulations (State Dentistry Fund). These costs could be reimbursed by private donations as the bill authorizes; however, the requirement to perform the review is not contingent on such donation. Ongoing costs will depend upon volume of additional applications.

COMMENTS:

1. Purpose. This bill is sponsored by The American Board of Dental Examiners (ADEX). According to the Author’s office, “Once a dental student has completed dental school they are required to pass an exam approved by the DBC prior to licensure. This exam is either administered by the WREB or completed through a recently approved DBC sponsored, Portfolio Exam process. The Portfolio Exam is only offered in California, however. At this time, graduates from out-of-state dental programs, including California residents, can only take the WREB exam in particular locations where the exam is offered.

“Over the last few years, the DBC has been examining how patients are involved in dental exams. For each dental exam, candidates must demonstrate their clinical knowledge by practicing on live patients. The American Dental Association (ADA), as well as the California Dental Association, have adopted ethical guidelines for the inclusion of patients in licensure exams. These guidelines require structured patient involvement, informed consent, and patient follow-up. Patients who are involved in these exams are “patients of record” and receive ongoing, appropriate care. The DBC has developed the Portfolio exam to address these issues. The Portfolio exam is currently being offered to students at some California dental schools.

“ADEX has also developed such an exam that includes all the guidelines outlined by the dental associations. The ADEX Patient Centered Curriculum Integrated Dental Examination Format (PC-CIF) is designed to specifically addresses each of the concerns listed above. It is currently provided in 6 states, with a growing number of additional dental schools adding this option for their graduating students. The exam tests the same high criteria as the ADEX exam recognized in 43 states, but it is offered in the patient-centered format. This format also meets the ADA standard for patient centered exams. The recent amendments will allow the DBC to require this testing format as the required test for ADEX.

“AB 2331 will allow the California Board of Dentistry to recognize the ADEX PC-CIF exam so that students outside of California can choose this exam for admission to the state. This provides these students with an exam option that complies with the patient-centered guidelines established by the industry leaders.”

1. Background. California requires dental applicants to take either a portfolio examination of the applicant’s competence to practice dentistry, which is offered only by California schools, or a clinical and written examination administered by WREB. This bill will allow ADEX to provide funding to the state to have its test validated and, if determined sufficient, offered as an alternative clinical and written examination.

ADEX is a nonprofit corporation of the State Boards of Dentistry focused on the development of a “state of the art, high quality uniform National dental and dental hygiene clinical licensure examination for the sole use by States Board of Dentistry.” In a letter to the DBC last year, ADEX wrote, “Dentistry is the only health profession that does not have a uniform national licensure examination. ADEX believes that the acceptance of the ADEX by California will set the cornerstone that will bring to fruition the goal of a Uniform National Dental Licensure examination.”

1. Previous Legislation. AB 1524 (Hayashi, Chapter 446, Statutes of 2010) repealed the clinical and written examination administered by the DBC and replaced it with a portfolio examination of an applicant’s competence to practice dentistry to be administered while the applicant is enrolled in a dental school program.

SB 1865 (Aanestad, Chapter 670, Statutes of 2004) provided that an applicant for a license to practice dentistry may either successfully complete the current clinical and written examination developed and administered by the DBC, or a clinical and written examination administered by the WREB.

1. Arguments in Support. The American Board of Dental Examiners write, “AB 2331 will allow the DBC to recognize the ADEX PC-CIF exam so that students outside of California can choose this exam for admission to the state. This provides these students with an exam option that complies with the patient-centered guidelines established by industry leaders.”

SUPPORT AND OPPOSITION:

Support:

American Board of Dental Examiners (Sponsor)

California Dental Association

Opposition:

None on file as of June 21, 2016.

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2331

Author:(Dababneh)

As Amended Ver:May 27, 2016

Majority vote

SUMMARY: Allows an applicant to satisfy the licensure examination requirement for a dental license by receiving a passing score on an examination developed by the American Board of Dental Examiners, Inc. Patient Centered Curriculum Integrated Dental Examination Format, subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided. This bill would also authorize the Director of Finance to accept funds for the purposes of implementing the dental examination developed by the American Board of Dental Examiners, Inc. Specifically, this bill:

1. Provides that a passing score on an examination developed by the American Board of Dental Examiners, Inc., Patient Centered Curriculum Integrated Dental Examination Format, fulfills part of the examination requirements for the Dental Board of California (DBC).
2. Specifies that the DBC shall determine the passing score for the examination.
3. Indicates that the Department of Consumer Affair's Office of Professional Examination Services shall review the American Board of Dental Examiners, Inc. examination to ensure compliance with the requirements of Section 139 and to certify that the examination process meets those standards, prior to implementation of the examination.
4. Specifies that if the department determines that the examination process fails to meet those standards, or if the American Board of Dental Examiners, Inc. fails to pay the costs and expenses the DBC incurs, it shall not be implemented. The review of the American Board of Dental Examiners, Inc. examination shall be conducted during or after DBC's occupational analysis.
5. Requires the American Board of Dental Examiners, Inc. to pay all reasonable costs and expenses the DBC incurs, as specified.
6. Permits the Department of Finance to accept funds for the purposes of reviewing and implementing the examination developed by the American Board of Dental Examiners, Inc.

FISCAL EFFECT: According to Assembly Appropriations Committee, one-time costs to the Dental Board and to the OPES of $200,000 to perform reviews and issue regulations (State Dentistry Fund, reimbursed by private funds).

COMMENTS:

Purpose. This bill is sponsored by the American Board of Dental Examiners, Inc. According to the author, "AB 2331 will facilitate the recognition of the ADEX Patient Centered Curriculum Integrated Dental Examination Format (PC-CIF) as an option for initial licensure in California. This additional exam option will allow out-of-state dental students seeking to practice in California, including California residents choosing to return to their home state, the opportunity to take the ADEX PC-CIF test in other states where it is administered. This exam format meets the American Dental Association and California Dental Associations guidelines for the ethical use of patients during a licensure exam."

Background. Examination Requirements. The DBC requires that applicants for licensure as a dentist meet a number of examination requirements including: 1) passing Parts I and II of the written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations, and 2) obtaining a passing score on either the Western Region Examining Board examination written or clinical examination, or a portfolio examination. Applicants must also complete a California law and ethics examination.

History of the DBC Portfolio Examination. In 2008, the DBC commissioned Comira Psychometric Services to conduct a study of competencies in dental education programs. The Board had concerns about existing clinical examinations, especially in terms of validity of the content tested and the reliability of judgments made on examinee performance. Comira identified four alternatives to initial licensure based on interviews, observations, and documentation; those alternatives were: 1) Curriculum Integrated Format (CIF), 2) Objective Standardized Clinical Examination (OSCE), 3) traditional portfolio, and 4) a hybrid portfolio examination. The hybrid portfolio examination was an alternative based upon the synthesis of the traditional portfolio and test cases (or competency cases) used in the dental schools for competency evaluations.

In February 2009, Comira prepared a report for the DBC entitled, Alternative Pathways for Initial Licensure for General Dentists, Final Report, February 9, 2009, which provided findings and evidence to support the feasibility of an additional examination for the DBC to add as a pathway to initial licensure. The report supported the conclusion that the hybrid portfolio examination model satisfied the criteria identified by the DBC and the psychometric consultants. Subsequently, Comira prepared an additional report for the DBC entitled Portfolio Examination to Qualify for California Dental Licensure, December 1, 2009 which defined the competencies to be tested in the portfolio examination and provided background research for the examination's implementation process.

Using the findings of these two reports, the DBC sponsored legislation, AB 1524 (Hayashi), Chapter 446, Statutes of 2010. AB 1524 eliminated the clinical and written examination administered by the DBC and replaced it with a portfolio examination of an applicant's competence to enter the practice of dentistry, to be conducted while the applicant is enrolled in a DBC-approved dental school located in California.

The DBC implemented the Portfolio Examination process in 2014. The Portfolio Exam is currently offered at four of the six dental schools in California including: 1) University of California, Los Angeles, 2) University of California, San Francisco, 3) University of the Pacific, and 4) University of Southern California

Portfolio Examination Application Process. The portfolio examination is to be conducted while the applicant is still enrolled in a DBC-approved dental school located in California. The portfolio examination is required to utilize uniform standards of clinical experiences and competencies approved by the DBC. An applicant is required to pass a final assessment of the submitted portfolio at the end of his or her dental school program. Before the portfolio may be submitted to the DBC, the applicant must pay the Board a $350 application fee and provide a letter of good standing signed by the dean of the dental school, or his or her delegate, stating that the applicant has graduated or will graduate with no pending ethical issues.

The ADEX Examination. The ADEX examination has been recognized in 43 states. The new PC-CIF, which the author compares to the DBC s Portfolio Exam, is only recognized in New York. The PC-CIF includes structured patient involvement, informed consent, and patient follow-up.

The author purports that graduates from out-of-state dental programs, including California residents, have to pass the Western Regional Examining Board examination which requires out-of-state students to travel to California to take the examination. The author believes that by adding the ADEX's PC-CIF as an option, students will be able to take this examination in the state they are located in

Occupational Analysis. An occupational analysis generally employs survey methodology to gather job information. That information may be used to help establish recruitment and selection criteria for entry into the occupation, and identify training standards for evaluating training efficacy and efficiency. Prior to the DBC accepting the ADEX PC-CIF, an occupational analysis must be completed. In addition, this measure allows the DBC to accept funding from entities to cover the costs associated with conducting the occupational analysis of the ADEX examination to ensure it meets California's standards.

Analysis Prepared by: Le Ondra Clark Harvey Ph.D. / B. & P. / (916) 319-3301 FN: 0003347

Date of Hearing: April 20, 2016

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 2331

Author:(Dababneh) – As Amended Ver:April 12, 2016

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill adds an additional examination option for meeting the requirements for licensure as a dentist. Specifically, this bill:

1. Adds the Patient Centered Curriculum Integrated Dental Examination Format developed by the American Board of Dental Examiners, Inc. (ADEX exam) as a qualifying examination for dental licensure applicants.
2. Requires, prior to acceptance of the ADEX exam, the Department of Consumer Affairs (DCA) Office of Professional Examination Services (OPES) to perform a review and certify that the examination process meets certain standards. Specifies if the review is not performed or the exam does not meet the standards, that the Board shall not accept the exam.
3. Authorizes the Department of Finance to accept funds, pursuant to existing law, for the purposes of implementing the ADEX exam review and acceptance.

FISCAL EFFECT:

One-time costs to the Dental Board and to the OPES of $200,000 to perform reviews and issue regulations (State Dentistry Fund). These costs could be reimbursed by private donations as the bill authorizes; however, the requirement to perform the review is not contingent on such donation. Ongoing costs will depend upon volume of additional applications.

COMMENTS:

1. Purpose. The intent of this bill is to provide an additional exam option that will allow out-of-state dental students seeking to practice in California, including California residents choosing to return to their home state, the opportunity to take the exam in other states where it is administered. The sponsors of this bill, ADEX, Inc., indicate the exam is similar to the portfolio exam, a clinical exam option recently adopted by the Board.
2. Background. Prior to accepting an exam as a qualification for licensure, a Board must ensure an exam is valid, which requires occupational analysis and psychometric testing. OPES employs test validation and development specialists who are trained to develop and analyze occupational licensing examinations. Existing clinical exam options are only available in California.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing:

ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS

Rudy Salas, Chair

ABPCA Bill Id:AB 2331

Author:(Dababneh) – As Amended Ver:March 28, 2016

SUBJECT: Dentistry: applicants to practice.

SUMMARY: Allows an applicant to satisfy the licensure examination requirement for a dental license by receiving a passing score on an examination developed by the American Board of Dental Examiners, Inc. Patient Centered Curriculum Integrated Dental Examination Format, subject to prior review and approval of the examination by the Office of Professional Examination Services, as provided. The bill would also authorize the Director of Finance to accept funds for the purposes of implementing the dental examination developed by the American Board of Dental Examiners, Inc.

EXISTING LAW:

1. Allows for the licensure and regulation of dentists, dental assistants, and dental hygienists by the Dental Board of California (DBC). (Business and Professions Code (BPC § 1600 et seq.)
2. Requires applicants for licensure as a dentist to complete Part I and Part II written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations. (BPC § 1632 (a))
3. Requires applicants to complete an examination in California law and ethics developed and administered by the DBC. (BPC § 1632(b))
4. Requires a passing score on either:
   1. a portfolio examination of the applicant’s competence to enter the practice of dentistry, or
   2. a clinical and written examination administered by the Western Regional Examining Board, which the board shall determine the passing score for that examination. (BPC § 1632.(C))

THIS BILL:

1. Provides that a passing score on an examination developed by the American Board of Dental Examiners, Inc., Patient Centered Curriculum Integrated Dental Examination Format, fulfils part of the examination requirements for the DBC.
2. Specifies that the DBC shall determine the passing score for the examination.
3. Indicates that the Department of Consumer Affair’s Office of Professional Examination Services shall review the American Board of Dental Examiners, Inc. examination to ensure compliance with the requirements of Section 139 and to certify that the examination process meets those standards, prior to implementation of the examination.
4. Specifies that if the department determines that the examination process fails to meet those standards, it shall not be implemented. The review of the American Board of Dental Examiners, Inc. examination shall be conducted during or after DBC’s occupational analysis.
5. Permits the Department of Finance to accept funds for the purposes of implementing the examination developed by the American Board of Dental Examiners, Inc.

FISCAL EFFECT: Unknown. This bill has been keyed fiscal by the Legislative Counsel.

COMMENTS:

Purpose. This bill is sponsored by the American Board of Dental Examiners, Inc. According to the author, “AB 2331 will facilitate the recognition of the ADEX Patient Centered Curriculum Integrated Dental Examination Format (PC-CIF) as an option for initial licensure in California. This additional exam option will allow out-of-state dental students seeking to practice in California, including California residents choosing to return to their home state, the opportunity to take the ADEX PC-CIF test in other states where it is administered. This exam format meets the American Dental Association and California Dental Associations guidelines for the ethical use of patients during a licensure exam.”

Background.  Examination Requirements.  The DBC requires that applicants for licensure as a dentist meet a number of examination requirements including: 1) passing Parts I and II of the written examinations of the National Board Dental Examination of the Joint Commission on National Dental Examinations, and 2) obtaining a passing score on either the Western Region Examining Board examination written or clinical examination, or a portfolio examination.  Applicants must also complete a California law and ethics examination.

History of the DBC Portfolio Examination. In 2008, the DBC commissioned Comira Psychometric Services to conduct a study of competencies in dental education programs.  The Board had concerns about existing clinical examinations, especially in terms of validity of the content tested and the reliability of judgments made on examinee performance.  Comira identified four alternatives to initial licensure based on interviews, observations, and documentation; those alternatives were: 1) Curriculum Integrated Format (CIF), 2) Objective Standardized Clinical Examination (OSCE), 3) traditional portfolio, and 4) a hybrid portfolio examination. The hybrid portfolio examination was an alternative based upon the synthesis of the traditional portfolio and test cases (or competency cases) used in the dental schools for competency evaluations.

In February 2009, Comira prepared a report for the DBC entitled Alternative Pathways for Initial Licensure for General Dentists, Final Report, February 9, 2009 which provided findings and evidence to support the feasibility of an additional examination for the DBC to add as a pathway to initial licensure. The report supported the conclusion that the hybrid portfolio examination model satisfied the criteria identified by the DBC and the psychometric consultants. Subsequently, Comira prepared an additional report for the DBC entitled Portfolio Examination to Qualify for California Dental Licensure, December 1, 2009 which defined the competencies to be tested in the portfolio examination and provided background research for the examination’s implementation process.

Using the findings of these two reports, the DBC sponsored legislation, AB 1524 (Hayashi, Chapter 446, Statutes of 2010). Assembly Bill 1524 eliminated the clinical and written examination administered by the DBC and replaced it with a portfolio examination of an applicant’s competence to enter the practice of dentistry, to be conducted while the applicant is enrolled in a DBC-approved dental school located in California.

The DBC implemented the Portfolio Examination process in 2014.  The Portfolio Exam is currently offered at four of the six dental schools in California including: 1) University of California, Los Angeles, 2) University of California, San Francisco, 3) University of the Pacific, and 4) University of Southern California

Portfolio Examination Application Process. The portfolio examination is to be conducted while the applicant is still enrolled in a DBC-approved dental school located in California. The portfolio examination is required to utilize uniform standards of clinical experiences and competencies approved by the DBC. An applicant is required to pass a final assessment of the submitted portfolio at the end of his or her dental school program. Before the portfolio may be submitted to the DBC, the applicant must pay the Board a $350 application fee and provide a letter of good standing signed by the dean of the dental school, or his or her delegate, stating that the applicant has graduated or will graduate with no pending ethical issues.

The ADEX Examination.  The ADEX examination has been recognized in 43 states.  The new PC-CIF, which the author compares to the DBC’s Portfolio Exam, is only recognized in New York. The PC-CIF includes structured patient involvement, informed consent, and patient follow-up.

The author purports that graduates from out-of-state dental programs, including California residents, have to pass the WREB examination which requires out-of-state students to travel to California to take the examination.  The author believes that by adding the ADEX’s PC-CIF as an option, students will be able to take this examination in the state they are located in

Occupational Analysis.  An occupational analysis generally employs survey methodology to gather job information.  That information may be used to help establish recruitment and selection criteria for entry into the occupation, and identify training standards for evaluating training efficacy and efficiency.  Prior to the DBC accepting the ADEX PC-CIF, an occupational analysis must be completed.  In addition, this measure allows the DBC to accept funding from entities to cover the costs associated with conducting the occupational analysis of the ADEX examination to ensure it meets California’s standards.

ARGUMENTS IN SUPPORT:

The American Board of Dental Examiners, Inc. writes in its letter of support, “AB 2331 will allow the California Board of Dentistry to recognize the ADEX PC-CIF exam so that students outside of California can choose this exam for admission to the state. This provides these students with an exam option that complies with the patient-centered guidelines established by the industry leaders.”

AMENDMENT:

The author should amend the bill to specify that the provisions of the bill will go into effect only after the occupational analysis and psychometric study of the examination are provided to the DBC.

REGISTERED SUPPORT:

American Board of Dental Examiners, Inc. (sponsor)

REGISTERED OPPOSITION:

None on file.

Analysis Prepared by: Le Ondra Clark Harvey, Ph.D. / B. & P. / (916) 319-3301