Under the Dental Practice Act, the Dental Board of California is responsible for the licensure and regulation of dentists. Existing law establishes the Dental Corps Loan Repayment Program of 2002 to assist dentists who practice in an underserved area with loan repayment pursuant to an agreement between the board and the dentist, as specified. Existing law governs eligibility, application, selection, placement, and repayment for the program, and authorizes the board to adopt standards to implement the program relating to eligibility, placement, and termination. Existing law creates the Dentally Underserved Account within the State Dentistry Fund and moneys in the account are continuously appropriated for purposes of the program.

This bill would require that the program be known as the California Dental Corps Loan Repayment Program and would revise program provisions regarding eligibility, application, selection, and placement. The bill would require the board to develop a process for repayment of loans or grants disbursed if the participant is terminated from the program or is not able to complete the required service obligation, as provided.

This bill would declare that it is to take effect immediately as an urgency statute.

Under the Dental Practice Act, the Dental Board of California is responsible for the licensure and regulation of dentists. Existing law establishes the Dental Corps Loan Repayment Program of 2002 to assist dentists who practice in an underserved area with loan repayment pursuant to an agreement between the board and the dentist, as specified. Existing law governs eligibility, application, selection, placement, and repayment for the program, and authorizes the board to adopt standards to implement the program relating to eligibility, placement, and termination. Existing law creates the Dentally Underserved Account within the State Dentistry Fund and moneys in the account are continuously appropriated for purposes of the program.

This bill would require that the program be known as the California Dental Corps Loan Repayment Program and would revise program provisions regarding eligibility, application, selection, and placement. The bill would require the board to develop a process for repayment of loans or grants disbursed if the participant is terminated from the program or is not able to complete the required service obligation, as provided.

This bill would declare that it is to take effect immediately as an urgency statute.

Under the Dental Practice Act, the Dental Board of California is responsible for the licensure and regulation of dentists. Existing law establishes the Dental Corps Loan Repayment Program of 2002 to assist dentists who practice in an underserved area with loan repayment pursuant to an agreement between the board and the dentist, as specified. Existing law governs eligibility, application, selection, placement, and repayment for the program, and authorizes the board to adopt standards to implement the program relating to eligibility, placement, and termination. Existing law creates the Dentally Underserved Account within the State Dentistry Fund and moneys in the account are continuously appropriated for purposes of the program.

This bill would require that the program be known as the California Dental Corps Loan Repayment Program and would revise program provisions regarding eligibility, application, selection, placement, and repayment. The bill would establish specific grounds for termination and would authorize the board to require the repayment of loans or grants in the case of termination. Among other new program requirements, applicants would be required to sign the agreement with the board under penalty of perjury and to provide annual progress reports, signed under penalty of perjury by both the applicant and employer, thereby imposing a state-mandated local program by creating new crimes. and placement. The bill would require the board to develop a process for repayment of loans or grants disbursed if the participant is terminated from the program or is not able to complete the required service obligation, as provided.

Existing law establishes the Dental Corps Loan Repayment Program of 2002 within the Dental Board of California. Existing law creates the Dentally Underserved Account within the State Dentistry Fund. The program assists dentists who practice in an underserved area with loan repayment pursuant to an agreement between the board and the dentist, as specified.

This bill would repeal those provisions and instead transfer the authority to implement the program to the Health Professions Education Foundation within the Office of Statewide Health Planning and Development and would rename the account the Dental Corps Loan Repayment Account. The bill would make funds in the account available, upon appropriation by the Legislature, for purposes of the program. The bill would require the foundation to submit a report to the Dental Board of California and the Legislature by January 1, 2019. July 1, 2018. The bill would make related findings and declarations.

Existing law establishes the Dental Corps Loan Repayment Program of 2002 within the Dental Board of California. Existing law creates the Dentally Underserved Account within the State Dentistry Fund. The program assists dentists who practice in an underserved area with loan repayment pursuant to an agreement between the board and the dentist, as specified.

This bill would repeal those provisions and instead transfer the authority to implement the program to the Health Professions Education Foundation within the Office of Statewide Health Planning and Development and would rename the account the Dental Corps Loan Repayment Account. The bill would make funds in the account available, upon appropriation by the Legislature, for purposes of the program. The bill would require the foundation to submit a report to the Legislature by an unspecified date. January 1, 2019. The bill would make related findings and declarations.

Existing law establishes the Dental Corps Loan Repayment Program of 2002 within the Dental Board of California. Existing law creates the Dentally Underserved Account within the State Dentistry Fund. The program assists dentists who practice in an underserved area with loan repayment pursuant to an agreement between the board and the dentist, as specified.

This bill would repeal those provisions and instead transfer the authority to implement the program to the Health Professions Education Foundation within the Office of Statewide Health Planning and Development and would rename the account the Dental Corps Loan Repayment Account. The bill would make funds in the account available, upon appropriation by the Legislature, for purposes of the program. The bill would require the foundation to submit a report to the Legislature by an unspecified date. The bill would make related findings and declarations.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 2485

Author:(Santiago)

As Amended Ver:August 15, 2016

2/3 vote. Urgency.

Original Committee Reference: B. & P.

SUMMARY: Streamlines the California Dental Corps Loan Repayment Program (DCLRP), under the jurisdiction of the Dental Board of California (DBC), within the Department of Consumer Affairs (DCA), expands eligibility of applicants to the program, and reschedules the timeline that loan repayments may be disbursed. Specifically, this bill:

1. Reestablishes the DCLRP, under the jurisdiction of the DBC, within the DCA, and authorizes the DBC to implement the DCLRP.
2. Defines and reorders several terms for the purpose of administering the DCLRP.
3. Provides that a program applicant must possess a current valid license to practice dentistry in this state issued by the DBC within the last five years, or be eligible for graduation from an approved pre or post-doctoral dental education program, as specified, and meet all criteria for licensure, subject to successful completion of applicable requirements.
4. Requires a program applicant to submit a completed application, which includes documentation detailing current loan obligations, the current balance owing, and monthly installment plan, as applicable.
5. Requires an application to disclose any and all obligations for which the applicant has defaulted or has been subjected to a lien within the last 10 years.
6. Requires the applicant to sign an agreement with the DBC to maintain qualified employment, as specified, and provide an annual progress report, as specified.
7. Specifies that the DBC give priority consideration to applicants that are best suited to meet the cultural and linguistic needs and demands of dentally underserved populations and who also speak a Medi-Cal language; come from an economically disadvantaged background; have received significant training in cultural and linguistically appropriate service delivery; have worked in a health field in an underserved area or with an underserved population; and, have recently received a license to practice dentistry, or has received an offer of unemployment in an underserved area.
8. Specifies that practice setting must be located in a dentally underserved area or ensures that the program participant serves a patient population that consists of at least 50% dentally underserved populations.
9. Requires a program applicant to be working in, or have a signed agreement with, an eligible practice setting and be employed on a full-time basis, as specified, unless the DBC determines on a case-by-case basis that a participant should be exempted from the minimum requirements.
10. Provides that a program participant is required to commit to a minimum of three years of service in a qualified practice setting, but may be eligible for leave of absence as determined by the DBC; provides that loan repayment will be deferred until the dentist is employed on a full-time basis.
11. Requires the DBC to develop a process for a program participant's repayment of loans or grants disbursed in the event that the participant is terminated prior to completion of, or is otherwise unable to complete, his or her three years of service obligation.
12. Specifies that "cause for termination" includes, but is not limited to a) a recipient's termination of full-time, qualified employment; b) a recipient's failure to maintain his or her professional license in good standing; and c) a recipient's failure to comply with any other term or condition of this article.
13. Permits the DBC to adopt any other standards of eligibility, placement, and termination appropriate to achieve the aim of providing competent dental services in these approved practice settings.
14. Provides that the DBC may coordinate with local and statewide trade and professional dental organizations, as well as educational institutions, for outreach to potentially eligible applicants.
15. Provides that funds paid out for loan repayment may have a funding match from foundations or other private sources.
16. Provides that after a participant has completed six months of service, the DBC may award up to $35,000 for repayment; upon completion of a 18 months of service, a participant is eligible for up to an additional $35,000; and upon completion of 30 months of service, would earn an additional $35,000 in loan repayment; and, specifies that loan repayments may not exceed $105,000 or the total amount of the loan, whichever is lesser.
17. Codifies existing regulations for the selection and placement of applicants and the timeline for the disbursement of funds to a recipient.
18. Requires the DBC to submit a report to the Legislature during its sunset review period detailing the experience of the program, an evaluation of its effectiveness in improving access to dental care for underserved populations, and recommendations for maintaining or expanding its operation, as specified.
19. Makes other technical, non-substantive changes.

The Senate amendments:

1. Delete declaration of the Legislature's intent to streamline the administration of the DCLRP such that the DBC does not need to promulgate regulations to implement changes to the DCLRP.
2. Delete the requirement for applicants to sign the loan repayment agreement under penalty of perjury.
3. Add an urgency clause to ensure that low-income communities immediately receive the dental care they desperately lack as soon as possible by removing barriers to available and unused special funds for dentists who seek to serve designated underserved populations.

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

1. Minor costs for revising existing regulations and administering the Program by the Dental Board of California (Dentally Underserved Account).
2. Additional expenditure of loan repayment funds, up to $1.6 million (Dentally Underserved Account). The Program has existed for over 10 years with limited participation, particularly in recent years. The intention of the bill is to broaden the participation in the program to make use of existing funds. To the extent that the bill is successful, additional expenditures are likely.

COMMENTS:

Purpose. This bill is sponsored by the California Dental Association (CDA). The bill would streamline the California DCLRP under the jurisdiction of the DCA, within the DCA, and remove some of the statutory requirements, which have been identified as deterrents to potential applicants.

According to the author, "The [DCLRP] was created to be a first step in a long-term effort to improve access to dental care by increasing the number of providers in underserved communities in California, yet it never realized its full potential due to administrative and statutory limits on its effectiveness. The funding is still available for this program, and many Californians still face barriers accessing dental care. The [L]egislature should act to remove the deterrents that keep away potential applicants to the [DCLRP] and encourage participation so that the state can better serve those individuals with the most critical oral health needs."

Background. The Legislature passed the DCLRP in 2002 with an initial investment of $3 million from the State Dentistry fund, to be disbursed to eligible candidates over the course of three years. Fourteen years later, a little more than half of those funds are still sitting in the grant program account, yet to be awarded. The lack of program participants stems from extensive and burdensome qualification requirements, and a general lack of awareness of the program's existence. There is approximately $1.6 million left in the account with very few or no applicants to the DCLRP in almost 10 years.

When the DBC was reviewed in 2015, as part of the joint Senate Business, Professions and Economic Development Committee and the Assembly Business and Professions Committee (Committees) Sunset Review process, the DBC stated that it had promoted the program on its website, included information about the program in its presentation to senior students in California dental schools, and distributed information through their stakeholder and professional association publications. At the time, DBC staff and its Access to Care Committee was researching other loan repayment programs offered by the California Dental Association, the Medical Board of California, and the Office of Statewide Health Planning and Development (OSHPD). During the 2015 Sunset Review hearings, the Committees recommended that the DBC consider transferring the DCLRP to Health Professions Education Foundation, housed within the OSHPD in order to increase participation in the program and more effectively administer the funds.

Instead, this bill will codify existing regulations for the implementation of the program; expand the pool of applicants eligible for the DCLRP; revise the timeline for loan disbursements; remove deterrents that keep away potential applicants; and, require the DBC to report on the effectiveness of the DCLRP at the time of its sunset review.

Analysis Prepared by: Gabby Nepomuceno / B. & P. / (916) 319-3301 FN: 0004750

 THIRD READING  

Bill No: AB 2485

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, 8/11/16

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

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

SUBJECT:

SOURCE: California Dental Association

DIGEST: This bill revises terms of qualification and disbursement for the Dental Board of California’s Dental Corps Loan Repayment Program.

ANALYSIS:

Existing law:

1. Establishes the Dental Board of California (Board) within the Department of Consumer Affairs to license and regulate the practice of dentistry. (Business and Professions Code (BPC) §§ 1601.1, 1611)
2. Establishes the Dental Corps Loan Repayment Program of 2002 (Program) in the Board. (BPC § 1970)
3. Requires a Program applicant to have a current, valid license to practice dentistry. (BPC § 1972 (a))
4. Establishes loan repayment as follows: (BPC § 1975)
   1. After a Program participant has completed one year of providing services as a dentist in a dentally underserved area, the Board shall provide up to twenty-five thousand dollars ($25,000) for loan repayment.
   2. After a Program participant has completed two consecutive years of providing services as a dentist in a dentally underserved area, the Board shall provide up to an additional thirty-five thousand dollars ($35,000) of loan repayment, for a total loan repayment of up to sixty thousand dollars ($60,000).
   3. After a Program participant has completed three consecutive years of providing services as a dentist in a dentally underserved area, the Board shall provide up to a maximum of an additional forty-five thousand dollars ($45,000) of loan repayment, for a total loan repayment of up to one hundred five thousand dollars ($105,000).

This bill:

1. Renames the California Dental Corps Loan Repayment Program of 2002 as the Program.
2. Defines a “practice setting” to mean either of the following:
   1. A community clinic, as specified; a clinic owned or operated by a public hospital and health system; or a clinic owned and operated by a hospital that maintains the primary contract with a county government to fulfill the county’s role, as specified, that is located in a dentally underserved area or at least 50 percent of whose patients are from a dentally underserved population.
   2. A dental practice or dental corporation located in a dentally underserved area, or at least 50 percent of whose patients are from a dentally underserved population.
3. Requires an applicant, if selected, to sign an agreement with the Board to maintain qualified employment for 36 months continuously, and that the qualified employment meets or, once commenced, will meet the minimum requirements of the Program regarding practice setting, and clinical hours worked. Requires an applicant to agree to provide an annual progress report signed by both the applicant and employer or employer’s designee. A progress report shall verify the practice setting’s qualified status, clinical hours worked by the applicant, number of patients treated, specific treatment rendered and its value, and patient’s payer source.
4. Requires the Board, in selecting a participant for the Program, to give priority consideration to an applicant who is best suited to meet the cultural and linguistic needs and demands of dentally underserved populations by demonstrating experience in one or more of the following areas:
   1. Speaks one or more Medi-Cal threshold languages.
   2. Comes from an economically disadvantaged background with economic, social, or other circumstances.
   3. Has worked in a health field in an underserved area or with an underserved population.
   4. Is a dentist specialist recognized by the American Dental Association or has met all eligibility requirements to graduate from a dental specialty residency Program approved by the Commission on Dental Accreditation.
   5. Has completed an extramural Program or rotation during dental school or postgraduate education in which the applicant provided services to a population that speaks any Medi-Cal threshold language.
5. Requires the practice setting to be located in a dentally underserved area and to ensure that the Program participant serves a patient population that consists of at least 50 percent dentally underserved populations.
6. Requires a Program participant to commit to a minimum of three years of service in one or more eligible practice settings. Loan repayment or grant disbursement shall be deferred until the dentist is employed on a full-time basis.
7. Requires the Board to develop a process for a program participant’s repayment of loans or grants disbursed in the event that the participant is terminated prior to completion of, or is otherwise unable to complete, his or her three years of service obligation. Cause for termination shall include, but is not limited to, the following:
   1. Recipient’s termination of full-time, qualified employment.
   2. Recipient’s failure to maintain his or her professional license in good standing.
   3. Recipient’s failure to comply with any other term or condition of this article.
8. Requires the Board to report to the Legislature on the Program during its sunset review period.
9. Declares this act an urgency statute necessary for the immediate preservation of the public peace, health, or safety in order to ensure that low-income communities immediately receive the dental care they desperately lack as soon as possible by removing barriers to available and unused special funds for dentists who seek to serve designated underserved populations.

Background

According to the author’s office, this bill is necessary to “codify existing regulations for the implementation of the Program; expand pool of applicants eligible for the Dental Corps Loan Repayment Program; revise the timeline for loan distribution; remove deterrents that keep away potential applicants; and, require the DBC to report on the effectiveness of the Program at the time of its sunset review.”

The Program. AB 982 (Firebaugh, Chapter 1131, Statutes of 2002) established the original California Dental Corps Loan Repayment Program. The Program, administered by the Board, is designed to assist dentists who practice in dentally underserved areas by repaying dental school loans up to $105,000. A total of $3 million was initially authorized to expend from the State Dentistry Fund for this Program. SB 540 (Price, Chapter 385, Statutes of 2011) then extended the Program until all the money is expended. However, the Board has awarded funds to only 19 participants in five years. Approximately $1.63 million is left in the account.

The Board indicates that it promotes the Program through the Board’s Web site and presents information to California dental students, as well as partners with stakeholders and professional associations to increase awareness.

Concerns about the unspent funds were raised in the Board’s 2014 Sunset Review. The Board reported that its Access to Care Committee was in the process of exploring why applications have dropped off and whether the Board’s requirements are more restrictive than those of other organizations having success with similar loan repayment programs.

This bill keeps largely the same parameters as those required in the prior Program, as well as integrates some existing regulations. The major changes allow individuals who are still in school to apply, changes language requiring certain criteria to instead “give priority” to those individuals who meet them, and change the structure of the repayment program.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Senate Appropriations Committee, this bill will result in minor costs for revising existing regulations and administering the Program and the additional expenditure of loan repayment funds of up to $1.6 million.

SUPPORT: (Verified 8/16/16)

California Dental Association (source)

OPPOSITION: (Verified 8/16/16)

None received

ARGUMENTS IN SUPPORT: The California Dental Association (CDA) writes, “The legislature recognized the importance of growing the dental workforce in 2002 when it passed Assembly Bill 982… and those populations have only grown since then, and it is still a challenge to find dental providers to serve them. Despite this, the state still has over a million and a half dollars left in the loan repayment grant fund with no recent applicants to receive it.” According to CDA, the lack of program participants stems from extensive and burdensome qualification requirements, and a general lack of awareness of the program’s existence. The organization notes that this bill “will …remove some unnecessary and burdensome provisions of the program that have been serving as a deterrent to qualified and willing potential applicants.”

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, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, 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: Cooper

Prepared by:

8/16/16 10:28:44

**** END ****

SENATE COMMITTEE ON

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

AB 2485 (Santiago) - Dental Corps Loan Repayment Program

*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********

The following information is revised to reflect amendments

adopted by the committee on August 11, 2016

Bill Summary:

AB 2485 would revise the terms and qualifications required for participation in the Dental Board of California’s Dental Corps Loan Repayment Program.

Fiscal Impact:

• Minor costs for revising existing regulations and administering the Program by the Dental Board of California (Dentally Underserved Account).
• Additional expenditure of loan repayment funds, up to $1.6 million (Dentally Underserved Account). The Program has existed for over ten years with limited participation, particularly in recent years. The intention of the bill is to broaden the participation in the program to make use of existing funds. To the extent that the bill is successful, additional expenditures are likely.

Author Amendments:

Make minor changes to the eligibility requirements, add an urgency clause, and make technical corrections.

-- END --

SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

AB 2485 (Santiago) - Dental Corps Loan Repayment Program

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

AB 2485 would revise the terms and qualifications required for participation in the Dental Board of California’s Dental Corps Loan Repayment Program.

Fiscal Impact:

• Minor costs for revising existing regulations and administering the Program by the Dental Board of California (Dentally Underserved Account).
• Additional expenditure of loan repayment funds, up to $1.6 (Dentally Underserved Account). The Program has existed for over ten years with limited participation, particularly in recent years. The intention of the bill is to broaden the participation in the program to make use of existing funds. To the extent that the bill is successful, additional expenditures are likely.

Background:

Under current law, the Dental Board of California manages the Dental Corps Loan Repayment Program of 2002 (the Program). The Program provides for up to $105,000 in loan repayments over three years for dentists practicing in dentally underserved areas. The Program was established with an initial appropriation of $3 million. Since the Program’s inception, there has been limited demand for its funds. In the last five years there have been only been five applications approved. There is a remaining balance of $1.6 million from the original appropriation.

Proposed Law:

AB 2485 would revise the terms and qualifications required for participation in the Dental Board of California’s Dental Corps Loan Repayment Program.

The bill recasts the existing code sections authorizing the program, but much of the new statutory language retains existing law or regulation governing the program.

Key changes in the bill to the existing program would:

• Allow individuals still in dental school to apply to the Program (with loan repayments to begin once the applicant begins working);
• Require certain Program criteria to be given priority, rather than be required (for example, the Program currently requires an applicant to speak a Medi-Cal threshold language, whereas the bill only requires such ability to be prioritized);
• Authorize loan repayments of $35,000 per year over three years.

Staff Comments:

The bill includes legislative intent language that regulations do not need to be promulgated by the Dental Board of California to implement the bill. However, the Dental Board indicates that existing regulations will need to be amended to conform to the statutory changes in the bill.

The only costs that may be incurred by a local agency relate to crimes and infractions. Under the California Constitution, such costs are not reimbursable by the state.

-- END --

SENATE COMMITTEE ON

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

AB 2485 (Santiago) - Dental Corps Loan Repayment Program

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

AB 2485 would revise the terms and qualifications required for participation in the Dental Board of California’s Dental Corps Loan Repayment Program.

Fiscal Impact:

• Minor costs for revising existing regulations and administering the Program by the Dental Board of California (Dentally Underserved Account).
• Additional expenditure of loan repayment funds, up to $1.6 million (Dentally Underserved Account). The Program has existed for over ten years with limited participation, particularly in recent years. The intention of the bill is to broaden the participation in the program to make use of existing funds. To the extent that the bill is successful, additional expenditures are likely.

Background:

Under current law, the Dental Board of California manages the Dental Corps Loan Repayment Program of 2002 (the Program). The Program provides for up to $105,000 in loan repayments over three years for dentists practicing in dentally underserved areas. The Program was established with an initial appropriation of $3 million. Since the Program’s inception, there has been limited demand for its funds. In the last five years there have been only been five applications approved. There is a remaining balance of $1.6 million from the original appropriation.

Proposed Law:

AB 2485 would revise the terms and qualifications required for participation in the Dental Board of California’s Dental Corps Loan Repayment Program.

The bill recasts the existing code sections authorizing the program, but much of the new statutory language retains existing law or regulation governing the program.

Key changes in the bill to the existing program would:

• Allow individuals still in dental school to apply to the Program (with loan repayments to begin once the applicant begins working);
• Require certain Program criteria to be given priority, rather than be required (for example, the Program currently requires an applicant to speak a Medi-Cal threshold language, whereas the bill only requires such ability to be prioritized);
• Authorize loan repayments of $35,000 per year over three years.

Staff Comments:

The bill includes legislative intent language that regulations do not need to be promulgated by the Dental Board of California to implement the bill. However, the Dental Board indicates that existing regulations will need to be amended to conform to the statutory changes in the bill.

The only costs that may be incurred by a local agency relate to crimes and infractions. Under the California Constitution, such costs are not reimbursable by the state.

-- END --

SENATE COMMITTEE ON

BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT

Senator Jerry Hill, Chair

2015 - 2016 Regular

Bill No: AB 2485 Hearing Date: June 27, 2016

Subject: Dental Corps Loan Repayment Program

SUMMARY:

Revises terms of qualification and disbursement for the Dental Board of California’s (Board) Dental Corps Loan Repayment Program (Program).

Existing law:

1. Establishes the Board within the Department of Consumer Affairs (DCA) to license and regulate the practice of dentistry. (Business and Professions Code (BPC) §§ 1601.1, 1611)
2. Establishes the Dental Corps Loan Repayment Program of 2002 (Program) in the Board. (BPC § 1970)
3. Requires a Program applicant to have a current, valid license to practice dentistry. (BPC § 1972 (a))
4. Establishes loan repayment as follows: (BPC § 1975)
   1. After a Program participant has completed one year of providing services as a dentist in a dentally underserved area, the Board shall provide up to twenty-five thousand dollars ($25,000) for loan repayment.
   2. After a Program participant has completed two consecutive years of providing services as a dentist in a dentally underserved area, the Board shall provide up to an additional thirty-five thousand dollars ($35,000) of loan repayment, for a total loan repayment of up to sixty thousand dollars ($60,000).
   3. After a Program participant has completed three consecutive years of providing services as a dentist in a dentally underserved area, the Board shall provide up to a maximum of an additional forty-five thousand dollars ($45,000) of loan repayment, for a total loan repayment of up to one hundred five thousand dollars ($105,000).

This bill:

1. States Legislative intent that the changes made by this bill are comprehensive, and that regulations do not need to be promulgated by the Dental Board of California to implement the changes made by this act.
2. Renames the California Dental Corps Loan Repayment Program of 2002 the California Dental Corps Loan Repayment Program.
3. Requires a Program applicant to possess a current, valid license to practice dentistry in California within the five years immediately prior to application for the Program, or be currently eligible for graduation from a predoctoral or postdoctoral dental education Program approved by the Commission on Dental Accreditation or the Board and meet all criteria for licensure, subject to successful completion of applicable education and examination requirements.
4. Requires an applicant to submit documentation detailing current loan obligations from any government or commercial lender obtained for purposes of financing tuition or fees at a dental school approved by the Commission on Dental Accreditation or the Board. Documentation shall contain the applicant’s account number and the lender’s contact information, as well as current balance owing and monthly installment plan details, if applicable.
5. Requires an applicant to disclose any and all obligations for which the applicant has defaulted or been subject to a judgment lien within the last ten years, and explanations for each default or judgment lien disclosed.
6. Requires an applicant, if selected, to sign an agreement with the Board, under penalty of perjury, to maintain qualified employment for 36 months continuously, and that the qualified employment meets or will meet the minimum requirements of the Program regarding practice setting, clinical hours worked, and population served.
7. Requires an applicant to agree to provide an annual progress report, signed under penalty of perjury by both the applicant and employer or employer’s designee. A progress report shall verify the practice setting’s qualified status, clinical hours worked by the applicant, number of patients treated, specific treatment rendered and its value, and patient’s payer source.
8. Requires the Board, in selecting a participant for the Program, to give priority consideration to an applicant who is best suited to meet the cultural and linguistic needs and demands of dentally underserved populations by demonstrating experience in one or more of the following areas:
   1. Speaks one or more Medi-Cal threshold languages.
   2. Comes from an economically disadvantaged background with economic, social, or other circumstances.
   3. Has worked in a health field in an underserved area or with an underserved population.
   4. Is a dentist specialist recognized by the American Dental Association or has met all eligibility requirements to graduate from a dental specialty residency Program approved by the Commission on Dental Accreditation.
   5. Has completed an extramural Program or rotation during dental school or postgraduate education in which the applicant provided services to a population that speaks any Medi-Cal threshold language.
9. Requires the practice setting to meet one or both of the following criteria:
   1. The practice setting shall be located in a dentally underserved area.
   2. The practice setting shall ensure that the Program participant serves a patient population that consists of at least 50 percent dentally underserved populations.
10. Requires a Program applicant to be working in, or have a signed agreement for future employment with, an eligible practice setting. The Program participant shall be employed on a full-time basis. “Full-time basis” means 30 hours of clinical hands-on care per week, for no less than 45 weeks per year, except as provided for during customary holidays, personal or family illness, and vacation time as described in a separate employment agreement between the recipient and the practice setting. Upon 30-day notice to the Board, the Board shall grant an extended leave of absence period for serious illness, pregnancy, or other natural cause. The Board may establish other exemptions to the minimum time requirements of this subdivision on a case-by-case basis.
11. Requires a Program participant to commit to a minimum of three years of service in one or more eligible practice settings. Loan repayment shall be deferred until the dentist is employed on a full-time basis.
12. Authorizes the Board to coordinate with local and statewide trade and professional dental organizations, as well as educational institutions, for outreach to potentially eligible applicants.
13. Authorizes the Board to terminate the applicant’s participation in the Program for cause. Cause for termination shall include the following:
    1. Recipient’s termination of full-time, qualified employment.
    2. Recipient’s failure to maintain his or her professional license in good standing.
    3. Recipient’s failure to comply with any other term or condition of this article.
14. States that, if the Board terminates a recipient’s participation for cause at any time during the 36-month period of the Program, the Board may require the recipient to repay the total amount of loans or grants disbursed in their name plus ten percent interest within maximum period of seven years.
15. Adjusts the timing of loan repayment to allow an initial disbursement of funds to be made within 30 days from execution of a Program agreement between the Board and the recipient directly from the Board to the qualified lender selected by the recipient, to be credited to the recipient’s account. States that subsequent disbursements in sums equal to the initial disbursement, but not equaling more than the total amount owed by the recipient, shall be made within 30 days of months 13 and 25 of the recipient’s participation in the Program.
16. Requires the Board to report to the Legislature on the Program during its sunset review period.
17. Makes technical amendments.

FISCAL EFFECT:

Unknown. This bill is keyed “fiscal” by the Legislative Counsel. The Assembly Appropriations Committee analyzed this bill in a different form.

COMMENTS:

1. Purpose. This bill is sponsored by the California Dental Association. According to the Author’s office, this bill is necessary to “codify existing regulations for the implementation of the Program; expand pool of applicants eligible for the Dental Corps Loan Repayment Program; revise the timeline for loan distribution; remove deterrents that keep away potential applicants; and, require the DBC to report on the effectiveness of the Program at the time of its sunset review.”
2. The Program. AB 982 (Firebaugh, Chapter 1131, Statutes of 2002) established the original California Dental Corps Loan Repayment Program. The Program, administered by the Board, is designed to assist dentists who practice in dentally underserved areas by repaying dental school loans up to $105,000. A total of three million dollars was initially authorized to expend from the State Dentistry Fund for this Program.

SB 540 (Price, Chapter 385, Statutes of 2011) extended the Program until all the money is expended. However, the Board has awarded funds to only 19 participants in five years. Approximately $1.63 million is left in the account.

The Board indicates that it promotes the Program through the Board’s website and presents information to California dental students, as well as partners with stakeholders and professional associations to increase awareness.

Concerns about the unspent funds were raised in the Board’s 2014 Sunset Review.

The Board reported that its Access to Care Committee was in the process of exploring why applications have dropped off and whether the Board’s requirements are more restrictive than those of other organizations having success with similar loan repayment programs.

This bill keeps largely the same parameters as those required in the prior Program, as well as integrates some existing regulations. The major changes allow individuals who are still in school to apply, changes language requiring certain criteria to instead “give priority” to those individuals who meet them, and change the repayment program.

1. Previous Legislation. SB 540 (Price, Chapter 385, Statutes of 201)1 extended the Program until all monies are expended.

SB 599 (Negrete-McLeod, Chapter 642, Statutes of 2009) extended the sunset date of the Program to 2012.

AB 982 (Firebaugh, Chapter 1131, Statutes of 2002) created the Program to be administered by the DBC.

1. Arguments in Support. The California Dental Association (CDA) writes, “The legislature recognized the importance of growing the dental workforce in 2002 when it passed Assembly Bill 982 by Assemblymember Marco Firebaugh and allocated funds to student loan debt repayment for dentists who would commit to providing at least three years of service to the state’s most needy and most vulnerable populations. Those populations have only grown since then, and it is still a challenge to find dental providers to serve them. Despite this, the state still has over a million and a half dollars left in the loan repayment grant fund with no recent applicants to receive it.

“The lack of program participants stems from extensive and burdensome qualification requirements, and a general lack of awareness of the program’s existence. AB 2485 will …remove some unnecessary and burdensome provisions of the program that have been serving as a deterrent to qualified and willing potential applicants.

“CDA believes these revisions to the program will enable qualified and willing dentists to serve the state’s most vulnerable populations and most effectively utilize the funds dedicated by the legislature so many years ago.”

SUPPORT AND OPPOSITION:

Support:

California Dental Association (Sponsor)

Opposition:

None on file as of June 21, 2016.

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2485

Author:(Santiago)

As Amended Ver:

Majority vote

SUMMARY: Streamlines the California Dental Corps Loan Repayment Program (DCLRP), under the jurisdiction of the Dental Board of California (DBC), within the Department of Consumer Affairs (DCA), expands eligibility of applicants to the program, and reschedules the timeline that loan repayments may be disbursed. Specifically, this bill:

1. Declares the Legislature's intent to streamline the administration of the DCLRP such that the DBC does not need to promulgate regulations to implement changes to the DCLRP.
2. Establishes the DCLRP, under the jurisdiction of the DBC, within the DCA, and authorizes the DBC to implement the DCLRP.
3. Defines and reorders several terms for the purpose of administering the DCLRP.
4. Provides that a program applicant must possess a current valid license to practice dentistry in this state issued by the DBC within the last five years, or be eligible for graduation from an approved pre or post-doctoral dental education program, as specified, and meet all criteria for licensure, subject to successful completion of applicable requirements.
5. Requires a program applicant to submit documentation detailing current loan obligations, the current balance owing, and monthly installment plan, as applicable.
6. Requires an application to disclose any and all obligations for which the applicant has defaulted or has been subjected to a lien within the last 10 years.
7. Requires the applicant to sign, under penalty of perjury, an agreement with the DBC to maintain qualified employment, as specified, and provide an annual progress report, as specified.
8. Specifies that the DBC give priority consideration to applicants that are best suited to meet the cultural and linguistic needs and demands of dentally underserved populations and who also speak a Medi-Cal language; come from an economically disadvantaged background; have received significant training in cultural and linguistically appropriate service delivery; have worked in a health field in an underserved area or with an underserved population; and, have recently received a license to practice dentistry, or has received an offer of unemployment in an underserved area.
9. Specifies that practice setting must be located in a dentally underserved area or ensures that the program participant serves a patient population that consists of at least 50% dentally underserved populations.
10. Requires a program applicant to be working in, or have a signed agreement with, an eligible practice setting and be employed on a full-time basis, as specified, unless the DBC determines on a case-by-case basis that a participant should be exempted from the minimum requirements.
11. Provides that a program participant is required to commit to a minimum of three years of service in a qualified practice setting, but may be eligible for leave of absence as determined by the DBC; provides that loan repayment will be deferred until the dentist is employed on a full-time basis.
12. Provides that the DBC may terminate an applicant's participation in the program for cause, as specified, and require a recipient to repay the total amount of loans or grants disbursed plus 10% interest within no more than seven years.
13. Provides that the DBC may coordinate with local and statewide trade and professional dental organizations, as well as educational institutions, for outreach to potentially eligible applicants.
14. Provides that funds paid out for loan repayment may have a funding match from foundations or other private sources.
15. Provides that after a participant has completed six months of service, the DBC may award up to $35,000 for repayment; upon completion of a 18 months of service, a participant is eligible for up to an additional $35,000; and upon completion of 30 months of service, would earn an additional $35,000 in loan repayment; and, specifies that loan repayments may not exceed $105,000 or the total amount of the loan, whichever is lesser.
16. Codifies existing regulations for the selection and placement of applicants and the timeline for the disbursement of funds to a recipient.
17. Requires the DBC to submit a report to the Legislature during its sunset review period detailing the experience of the program, an evaluation of its effectiveness in improving access to dental care for underserved populations, and recommendations for maintaining or expanding its operation, as specified.
18. Makes other technical, non-substantive changes.

FISCAL EFFECT: According to the Assembly Appropriations Committee, this bill will result in minor and absorbable costs to the DBC.

COMMENTS:

Purpose. This bill is sponsored by the California Dental Association (CDA). The bill would streamline the California DCLRP under the jurisdiction of the DCA, within the DCA, and remove some of the statutory requirements, which have been identified as deterrents to potential applicants.

According to the author, "“The [DCLRP] was created to be a first step in a long-term effort to improve access to dental care by increasing the number of providers in underserved communities in California, yet it never realized its full potential due to administrative and statutory limits on its effectiveness. The funding is still available for this program, and many Californians still face barriers accessing dental care. The [L]egislature should act to remove the deterrents that keep away potential applicants to the [DCLRP] and encourage participation so that the state can better serve those individuals with the most critical oral health needs."

Background. The Legislature passed the DCLRP in 2002 with an initial investment of $3 million from the State Dentistry fund, to be disbursed to eligible candidates over the course of three years. Fourteen years later, a little more than half of those funds are still sitting in the grant program account, yet to be awarded. The lack of program participants stems from extensive and burdensome qualification requirements, and a general lack of awareness of the program's existence. There is approximately $1.6 million left in the account with very few or no applicants to the DCLRP in almost 10 years.

When the DBC was reviewed in 2015, as part of the joint Senate Committee on Business, Professions and Economic Development and the Assembly Committee on Business and Professions (Committees) Sunset Review process, the DBC stated that it had promoted the program on its website, included information about the program in its presentation to senior students in California dental schools, and distributed information through their stakeholder and professional association publications. At the time, DBC staff and its Access to Care Committee was researching other loan repayment programs offered by the California Dental Association, the Medical Board of California, and the Office of Statewide Health Planning and Development (OSHPD). During the 2015 Sunset Review hearings, the Committees recommended that the DBC consider transferring the DCLRP to Health Professions Education Foundation, housed within the OSHPD in order to increase participation in the program and more effectively administer the funds.

Instead, this bill will codify existing regulations for the implementation of the program; expand the pool of applicants eligible for the DCLRP; revise the timeline for loan disbursements; remove deterrents that keep away potential applicants; and, require the DBC to report on the effectiveness of the DCLRP at the time of its sunset review.

Prior Related Legislation. AB 982 (Firebaugh), Chapter 1131, Statutes of 2002, created the DCLRP to be administered by the DBC.

SB 599 (Negrete-McLeod), Chapter 642, Statutes of 2009, extended the sunset date of the DCLRP to 2012.

SB 540 (Price), Chapter 385, Statutes of 2011, extended the DCLRP until all monies are expended.

Analysis Prepared by: Gabby Nepomuceno / B. & P. / (916) 319-3301 FN: 0003331

Date of Hearing: April 20, 2016

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 2485

Author:(Santiago) – As Amended Ver:April 11, 2016

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

SUMMARY:

This bill transfers the California Dental Corps Loan Repayment Program (loan repayment program) from the Dental Board of California (Board) to the Health Professions Education Foundation within the Office of Statewide Health Planning and Development (OSHPD), extends the program indefinitely, and makes minor changes to the program.

FISCAL EFFECT:

1. One-time administrative costs to OSHPD of $160,000 for the first year of operation, and ongoing costs of $100,000 to administer the program (Health Data and Planning Fund). Funding for the loan repayment awards will come from the remaining $1.5 million in the Dentally Underserved Account, which this bill renames the Dental Corps Loan Repayment Account.
2. Unknown, potentially significant cost pressure (private, GF, or other funds) in future years to maintain the program after currently available funds are expended. Existing law extends the program only until all the remaining funds are expended. This bill removes that language.

COMMENTS:

1. Purpose. This bill would move the loan repayment program and remove some of the statutory requirements that the sponsor, the California Dental Association, indicates have been identified as deterrents to potential applicants.
2. Background. The loan repayment program was created in 2002 and was funded with an initial amount of $3 million over three years (State Dentistry Fund). A 2014 Board sunset review report and related 2015 hearing examined the loan repayment program and noted its underutilization—half the funds still remain after a decade. At that time, legislative committees recommended the Board consider transferring the loan repayment program to OSHPD, as this bill proposes, in order to increase participation and more effectively administer the funds.
3. Staff Comments. Transfer to OSHPD is consistent with prior recommendations and with OSHPD's expertise and existing workload. This change would likely improve administrative efficiency and effectiveness. However, the author should consider moving the Dental Corps Loan Repayment Account into a fund administered by OSHPD.

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 2485

Author:(Santiago) – As Amended Ver:March 30, 2016

SUBJECT: Dental Corps Loan Repayment Program.

SUMMARY: Transfers the California Dental Corps Loan Repayment Program of 2002 (DCLRP) under the jurisdiction of the Health Professions Education Foundation (HPEF), housed within the Office of Statewide Health Planning and Development (OSHPD), expands eligibility of applicants to the program, and reschedules the timeline that loan repayments may be disbursed.

EXISTING LAW:

1. Establishes the Dental Board of California (DBC) within the Department of Consumer Affairs (DCA) for the purpose of licensing and regulating the practice of dentistry and requires these activities to be funded from fees imposed upon licensees. (Business and Professions Code (BPC) Section 1600 et seq.)
2. Provides that the DCLRP is to be administered by the DBC; provides loan repayments for dental practitioners who serve in underserved areas; establishes the Dentally Underserved Account in the State Dentistry Fund, and transfers $3 million from the Dentistry Fund to the Dental Account over three years, starting July 1, 2003. (BPC Section 1973)
3. Specifies that after a Dental Corps participant has completed one year of service, the DBC shall provide up to $25,000 for loan repayment; a participant who serves a second consecutive year shall receive up to an additional $35,000; and, a third consecutive year would earn an additional $45,000 in loan repayment from the Dental Account, but may not exceed $105,000. (BPC Section 1975)
4. Establishes a nonprofit public benefit corporation within the OSHPD to be known as the HPEF that is governed by a board consisting of 11 members, as specified. (Health and Safety Code (HSC) Section 128335)
5. Authorizes the HPEF to solicit and receive funds from private or public sources for the purpose of providing financial assistance in the form of scholarships or loans to students from underrepresented groups. (HSC Section 128345(a))
6. Provides that the HPEF may recommend the disbursement of moneys deposited in the Health Professions Education Fund to students from underrepresented groups accepted to or enrolled in schools of dentistry or other health professions, as specified, in the form of loans or scholarships. (HSC Section 128345(b))
7. Provides that the HPEF develop criteria for selecting applicants including, but not limited to, the likelihood of remaining in the designated service area to practice his or her profession; develop an application form; and, encourage private sector institutions to identify and provide educational experiences. (HSC Section 128345(c)-(f))
8. Authorizes the HPEF to implement the Steven M. Thompson Physician Corps Loan Repayment Program and the Volunteer Physician Program. (HSC Section 128345(i))

THIS BILL:

1. Repeals provisions for the DCLRP to be administered by the DBC.
2. Renames the Dental Account to be called the Dental Corps Loan Repayment Account.
3. Makes funds in the Dental Corps Loan Repayment Account available upon appropriation by the Legislature, which are to be used to repay the loans per agreements made with dentists.
4. Establishes the DCLRP within the HPEF within the OSHPD so the ongoing program can be administered and managed by the HPEF.
5. Defines for purposes of establishing the HPEF within the OSHPD:
   1. “Account” to be the Dentally Underserved Account, which is contained within the fund.
   2. “Board” to be the DBC.
   3. “Dentally underserved area” to be a geographic area eligible to be designated as having a shortage of dental professionals, as specified.
   4. “Dentally underserved population” to be persons without dental insurance and persons eligible for Denti-Cal who are population groups, as specified.
   5. “Fund” to be the State Dentistry Fund.
   6. “Medi-Cal threshold languages” to be primary languages spoken by limited-English-proficient population groups, as specified.
   7. “Office” to be the OSHPD.
   8. “Program” to be the California DCLRP.
   9. “Practice Setting” to be either:
      1. A community clinic, as specified, or a clinic owned and operated by a hospital that maintains the primary contract with a county government, as specified; or,
      2. A dental practice or dental corporation, as specified, which is located in a dentally underserved area.
6. Provides that a program applicant must possess a current valid license to practice dentistry in this state issued by the DBC, or be eligible for graduation from an approved pre or post-doctoral dental education program, as specified, and meet all criteria for licensure, subject to successful completion of applicable requirements.
7. Provides that the foundation shall develop the guidelines for selection and placement of applicants and guidelines for the DCLRP must:
   1. Provide priority consideration to applicants who are best suited to meet the cultural and linguistic needs and demands of dentally underserved populations and who also speak a Medi-Cal language; come from an economically disadvantaged background; have received significant training in cultural and linguistically appropriate service delivery; have worked in a health field in an underserved area or with an underserved population; recently received a license to practice dentistry, or has received an offer of unemployment in an underserved area; and,
   2. Include a process for determining the needs for dental services identified by the practice setting; provides that the practice setting must be located in a dentally underserved area and seeks to place the most qualified applicants in areas with the greatest need.
8. Requires a program applicant to be working in, or have a signed agreement with, an eligible practice setting and be employed on a full-time basis, which is to be defined by the HPEF.
9. Provides that a program participant is required to commit to a minimum of three years of service in a qualified practice setting, but may be eligible for leave of absence as determined by the HPEF; that the HPEF develop a process to use if a dentist is not able to complete his or her three-year obligation; that the HPEF may adopt any other standards of eligibility, placement, and termination.
10. Defers loan repayment until the dentist is employed on a full-time basis.
11. Provides that funds paid out for loan repayment may have a funding match from foundations or other private sources.
12. Limits loan repayments to a total of one hundred five thousand dollars ($105,000) per individual licensed dentist.
13. Provides that after a participant has completed six months of service, the HPEF may award up to $35,000 for repayment from the Dental Account; upon completion of a 18 months of service, a participant is eligible for up to an additional $35,000; and upon completion of 30 months of service, would earn an additional $35,000 in loan repayment; and specifies that loan repayments from the Dental Account may not exceed $105,000.
14. Requires the HPEF to submit a report to the Legislature by January 1, 2019 regarding the experience of the program, an evaluation of its effectiveness in improving access to dental care for underserved populations, and recommendations for maintaining or expanding its operation, as specified.
15. Declares that an adequate supply of dentists to all communities in the state is imperative to the well-being of California residents.
16. Describes the initiation of the California DCLRP and the HPEF and the intention of those programs to provide access to healthcare in underserved areas.
17. Declares the intent of the Legislature to transfer the DCLRP from the DBC to the HPEF.

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

COMMENTS:

Purpose. This bill is sponsored by the California Dental Association (CDA). The bill would move the California DCLRP under the jurisdiction of the HPEF, housed within the OSHPD, and remove some of the statutory requirements, which have been identified as deterrents to potential applicants.

According to the author, “The [DCLRP] was created to be a first step in a long-term effort to improve access to dental care by increasing the number of providers in underserved communities in California, yet it never realized its full potential due to administrative and statutory limits on its effectiveness. The funding is still available for this program, and many Californians still face barriers accessing dental care. The [L]egislature should act to remove the deterrents that keep away potential applicants to the [DCLRP] and encourage participation so that the state can better serve those individuals with the most critical oral health needs.”

Background. The Legislature passed the DCLRP in 2002 with an initial investment of $3 million from the State Dentistry fund, to be disbursed to eligible candidates over the course of three years. Fourteen years later, a little more than half of those funds are still sitting in the grant program account, yet to be awarded.

The lack of program participants stems from extensive and burdensome qualification requirements, and a general lack of awareness of the program’s existence. There is approximately $1.6 million left in the account with very few or no applicants to the DCLRP in almost 10 years. When the DBC was reviewed in 2015, as part of the joint Senate Committee on Business, Professions and Economic Development and the Assembly Committee on Business and Professions (Committees) Sunset Review process, the DBC stated that it had promoted the program on its website, included information about the program in its presentation to senior students in California dental schools, and distributed information through their stakeholder and professional association publications. At the time, DBC staff and its Access to Care Committee was researching other loan repayment programs offered by the California Dental Association, the Medical Board of California (MBC), and the OSHPD. During the 2015 Sunset Review hearings, the Committees recommended that the DBC consider transferring the DCLRP to HPEF in order to increase participation in the program and more effectively administer the funds. This bill would move the loan repayment grant program out of the DBC’s management and oversight and place it under the HPEF.

HPEF Scholarship Programs. There are currently a number of scholarship programs administered and managed by the HPEF including: the Allied Healthcare Scholarship Program (AHSP), Advanced Practice Healthcare Scholarship Program (APHSP) (Formerly Health Professions Education Scholarship Program) (HPSP), Associate Degree Nursing Scholarship Program (ADN), Bachelor of Science Nursing Scholarship Program (BSN), Licensed Vocational Nurse to Associate Degree Nursing Scholarship Program (LVN to ADN), and the Vocational Nurse Scholarship Program (VNSP).

HPEF Loan Repayment Programs. There are currently a number of loan repayment programs administered and managed by the HPEF including: the Allied Healthcare Loan Repayment Program (AHLRP), Advanced Practice Healthcare Loan Repayment Program (APHLRP) (Formerly Health Professions Loan Repayment Program) (HPLRP), Bachelor of Science Nursing Loan Repayment Program (BSNLRP), Licensed Mental Health Services Provider Education Program (LMHSPEP), Licensed Vocational Nurse Loan Repayment Program (LVNLRP), Mental Health Loan Assumption Program (MHLAP), and the Steven M. Thompson Physician Corp Loan Repayment Program (STLRP).

The National Health Service Corp (NHSC) Repayment Program. According to the NHSC, “the NHSC Loan Repayment Program (LRP) is administered by the Bureau of Health Workforce (BHW) in the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). The purpose of the NHSC LRP is to recruit and retain medical, nursing, dental, and behavioral/mental health clinicians in eligible communities of need designated as health professional shortage areas.to provide culturally competent, interdisciplinary primary health care services to underserved populations located in selected Health Professional Shortage Areas (HPSAs) identified by the Secretary of the HHS. HPSAs can be found in rural and urban communities across the nation. In return, the NHSC LRP assists clinicians in their repayment of outstanding qualifying educational loans. The NHSC Loan Repayment funds are exempt from Federal income and employment taxes. These funds are not included as wages when determining benefits under the Social Security Act.”

California’s State Loan Repayment Program (SLRP). According to the OSHPD, “SLRP is federally funded through a grant from the Health Resources and Services Administration (HRSA), Bureau of Health Professions (BHPR), National Health Service Corps (NHSC) and is administered by the State of California’s Office of Statewide Health Planning and Development (OSHPD). SLRP increases the number of medical, nursing, dental, and behavioral/mental health providers practicing in federally designated California Health Professional Shortage Areas (HPSAs). SLRP authorizes repayment of qualified educational loans for eligible primary health care professionals, who must commit to an initial 2-year, full-time or 4-year, half-time service agreement to provide direct patient care in a primary, dental, or mental health HPSA. SLRP requires the providers site to: match the award, on a dollar-for-dollar basis, with non-federal contributions (directly or through donations from public or private entities), in addition to the providers prevailing salary and must located on the SLRP Certified Eligible Site List.”

Prior Related Legislation. AB 982 (Firebaugh), Chapter 1131, Statutes of 2002 created both the DCLRP to be administered by the DBC; and the Steven M. Thompson California Physician Corps Loan Repayment Program, to be administered by the Medical Board of California (MBC).

SB 599 (Negrete-McLeod), Chapter 642, Statutes of 2009 extended the sunset date of the DCLRP to 2012.

SB 540 (Price), Chapter 385, Statutes of 2011 extended the DCLRP until all monies are expended.

AB 920 (Aghazarian), Chapter 317, Statutes of 2005 transferred administration of the Steven M. Thompson Physician Corps Loan Repayment Program from the MBC to the HPEF under the OSHPD.

ARGUMENTS IN SUPPORT:

The California Dental Association (CDA) writes in support, “The lack of program participants stems from extensive and burdensome qualification requirements, and a general lack of awareness of the program’s existence. CDA believes these revisions to the program will enable qualified and willing dentists to serve the state’s most vulnerable populations and most effectively use the funds dedicated by the [L]egislature so many years ago.”

POLICY ISSUES FOR CONSIDERATION:

1. In moving the DCLRP to HPEF within the OSPHD, it is unclear whether the additional administration and management would overburden the current HPEF resources. The DCLRP, as it exists under the DBC, allotted $135,000 in the first three years to address administrative costs associated with implementing this program. If any of this specific fund to cover administrative costs is still unused, the author may wish to consider specifying a portion of the funds to be used for implementing this program under the HPEF.
2. The Committees recommended, during the 2015 Sunset Review process, that the DBC advise the Committees on whether the DCLRP should be administered by HPEF; as such, this issue will be discussed when the DBC is reviewed again in 2019. This bill requires the HPEF to report to the Legislature on the efficacy of the DCLRP under the administration and management of the HPEF. The author may wish to require the HPEF to also submit the report to the DBC, or to require HPEF to submit the report in consultation with the DBC, so that both entities benefit from the information gathered.

IMPLEMENTATION ISSUES:

1. The boards and bureaus under the DCA that will be reviewed in a given year are required to submit a Background Report to the Committees in November of the preceding year. For example, the DBC will be reviewed in 2019; therefore its Sunset Review Report will be due to the Committees in November 2018. In order for the DBC to adequately address the Committees’ recommendation to transfer the DCLRP to the HPEF, the author may wish to adjust the deadline for the HPEF report to be submitted to the Legislature before the DBC’s background paper is submitted to the Committees.

AMENDMENT:

1. To address the policy and implementation concerns regarding the deadline for the HPEF to report to the Legislature, and the DBC’s involvement in the report, the following amendment will require the HPEF to submit its report to the DBC before the DBC Sunset Review Report is submitted to the Committees:

On page 7, line 34-35, strike “January 1, 2019, the foundation shall submit a report to the Legislature” and insert “July 1, 2018, the foundation shall submit a report to the Dental Board of California and the Legislature.”

1. The author should make the following technical amendment:

On page 6, line19, strike both references to the “board” and after both “the” insert “foundation”

REGISTERED SUPPORT:

California Dental Association (sponsor)

REGISTERED OPPOSITION:

None on File.

Analysis Prepared by: Gabby Nepomuceno / B. & P. / (916) 319-3301