Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities, including intellectual disabilities and other conditions, and their families. Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. Existing law defines services and supports for persons with developmental disabilities to mean specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability, or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. Under existing law, specialized medical and dental care are included within that definition.

This bill, subject to an appropriation by the Legislature, would require the department, no later than July 1, 2027, to contract with a public or private California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. The bill would require the department to prioritize contracting with a public California dental school or college to administer the program. The bill would authorize the contracted California dental school or college to partner with a public or private dental school or college, and would require the schools to meet certain criteria relating to location, accreditation, and a demonstrated record of working with regional centers. The bill would require the contracted school or partnership, among other responsibilities, to work with the department to engage up to 21 regional centers to participate, provide practical experience, systems development, and expertise in relevant subject areas, to train, monitor, and support regional center and oral health personnel, and to collect and analyze program data with the support of participating regional centers and oral health providers. The bill would require the department to submit an annual report of the collected data to the Legislature, and to provide guidance and establish protocols to support the program, among other things. The bill also would specify regional center duties, including identifying consumers who can benefit from the program, and establishing vendor agreements with interested oral health professionals.

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities, including intellectual disabilities and other conditions, and their families. Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. Existing law defines services and supports for persons with developmental disabilities to mean specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability, or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. Under existing law, specialized medical and dental care are included within that definition.

This bill, subject to an appropriation by the Legislature, would require the department, no later than July 1, 2027, to contract with a public or private California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. The bill would require the department to prioritize contracting with a public California dental school or college to administer the program. The bill would authorize the contracted California dental school or college to partner with a public or private dental school or college, and would require the schools to meet certain criteria relating to location, accreditation, and a demonstrated record of working with regional centers. The bill would require the contracted school or partnership, among other responsibilities, to work with the department to engage up to 21 regional centers to participate, provide practical experience, systems development, and expertise in relevant subject areas, to train, monitor, and support regional center and oral health personnel, and to collect and analyze program data with the support of participating regional centers and oral health providers. The bill would require the department to submit an annual report of the collected data to the Legislature, and to provide guidance and establish protocols to support the program, among other things. The bill also would specify regional center duties, including identifying consumers who can benefit from the program, and establishing vendor agreements with interested oral health professionals.

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities, including intellectual disabilities and other conditions, and their families. Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. Existing law defines services and supports for persons with developmental disabilities to mean specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability, or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. Under existing law, specialized medical and dental care are included within that definition.

This bill bill, subject to an appropriation by the Legislature, would require the department, no later than July 1, 2027, to contract with a public or private California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. The bill would require the department to prioritize contracting with a public California dental school or college to administer the program. The bill would authorize the contracted California dental school or college to partner with a public or private dental school or college, and would require the schools to meet certain criteria relating to location, accreditation, and a demonstrated record of working with regional centers. The bill would require the contracted school or partnership, among other responsibilities, to identify up to 10 work with the department to engage up to 21 regional centers to participate, provide practical experience, systems development, and expertise in relevant subject areas, to train, monitor, and support regional center and oral health personnel, and to collect and analyze program data with the support of participating regional centers and oral health providers. The bill would require the department to submit an annual report of the collected data to the Legislature, and to provide guidance and establish protocols to support the program, among other things. The bill also would specify regional center duties, including identifying consumers who can benefit from the program, and establishing vendor agreements with interested oral health professionals.

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities, including intellectual disabilities and other conditions, and their families. Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. Existing law defines services and supports for persons with developmental disabilities to mean specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability, or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. Under existing law, specialized medical and dental care are included within that definition.

This bill would require the department, no later than July 1, 2027, to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. The bill would authorize the contracted California dental school or college to partner with a public or private dental school or college, and would require the schools to meet certain criteria relating to location, accreditation, and a demonstrated record of working with regional centers. The bill would require the contracted school or partnership, among other responsibilities, to identify up to 10 regional centers to participate, provide practical experience, systems development, and expertise in relevant subject areas, to train, monitor, and support regional center and oral health personnel, and to collect and analyze program data with the support of participating regional centers and oral health providers. The bill would require the department to submit an annual report of the collected data to the Legislature, and to provide guidance and establish protocols to support the program, among other things. The bill also would specify regional center duties, including identifying consumers who can benefit from the program, and establishing vendor agreements with interested oral health professionals.

Existing law, the Lanterman Developmental Disabilities Services Act, requires the State Department of Developmental Services to contract with regional centers to provide services and supports to individuals with developmental disabilities, including intellectual disabilities and other conditions, and their families. Under existing law, the regional centers purchase needed services and supports for individuals with developmental disabilities through approved service providers, or arrange for their provision through other publicly funded agencies. Existing law defines services and supports for persons with developmental disabilities to mean specialized services and supports or special adaptations of generic services and supports directed toward the alleviation of a developmental disability, or toward the social, personal, physical, or economic habilitation or rehabilitation of an individual with a developmental disability, or toward the achievement and maintenance of an independent, productive, and normal life. Under existing law, specialized medical and dental care are included within that definition.

This bill would require the department, no later than July 1, 2027, to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. The bill would authorize the contracted California dental school or college to partner with a public or private dental school or college, and would require the schools to meet certain criteria relating to location, accreditation, and a demonstrated record of working with regional centers. The bill would require the contracted school or partnership, among other responsibilities, to identify up to 10 regional centers to participate, provide practical experience, systems development, and expertise in relevant subject areas, to train, monitor, and support regional center and oral health personnel, and to collect and analyze program data with the support of participating regional centers and oral health providers. The bill would require the department to submit an annual report of the collected data to the Legislature, and to provide guidance and establish protocols to support the program, among other things. The bill also would specify regional center duties, including identifying consumers who can benefit from the program, and establishing vendor agreements with interested oral health professionals.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 341

Author:(Arambula)

As Amended Ver:September 3, 2025

Majority vote

SUMMARY

Requires, subject to an appropriation by the Legislature, the Department of State Department of Developmental Services (DDS) to contract with a public or private California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.

Senate Amendments

Amendments taken in the Senate:

1. Requires the DDS will contract with a public or private California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program, requires DDS to prioritize contracting with a public California dental school or college to administer the program, and requires the contract to expire on June 30, 2032;
2. Specifies that, if the contracted California dental school or college elects to partner with another dental school or college, the contracted California dental school or college will prioritize partnering with a public California dental school or college;
3. Requires all partner public or private schools be located in California, and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association and requires the contracted school, and requires DDS to engage up to 21 regional centers to participate in the program; and,
4. Specifies that the annual reporting will begin one year after the contract, as specified, commences and continue until June 30, 2033.

COMMENTS

Background. The Lanterman Developmental Disabilities Act (Lanterman Act) originally became statute in 1969. The Lanterman Act provides entitlement to services and supports for individuals three years of age and older who have a qualifying developmental disability. Qualifying disabilities include autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a disability that is substantial that began before they attained 18 years of age and is expected to be lifelong. There are no income-related eligibility criteria. Direct responsibility for implementation of the Lanterman Act's service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities, that contract with DDS to carry out many of the state's responsibilities.

As of August 2023, the 21 regional centers served 459,395 consumers, providing services such as: information and referral; assessment and diagnosis; counseling; lifelong individualized planning and service coordination; purchase of necessary services included in the individual program plan (IPP); resource development; outreach; assistance in finding and using community and other resources; advocacy for the protection of legal, civil, and service rights; early intervention services for at risk infants and their families; genetic counseling; family support; planning, placement, and monitoring for 24-hour out-of-home care; training and educational opportunities for individuals and families; and, community education about developmental disabilities. Regional centers services vary at each location. One location might offer one program and the next might offer what they consider an alternative or offer nothing comparable. Geographically, regional centers' spending also varies.

Dental Care for Individuals with Developmental Disorders. Dental services are coordinated through regional centers just like other services. Most regional centers employ a "dental coordinator." Dental coordinators are responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with the Medi-Cal Dental Program (Denti‑Cal) administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive less dental services than the general population which causes more complex dental problems due to neglect of addressing early problems. Dentists and dental hygienists receive limited training in school and through continuing education courses on how to serve individuals with developmental disabilities. This contributes to the lack of access.

According to a dental association, there are only 14 dental schools and surgery centers in California that can handle special needs patients.

According to the Author

According to the author, "people with disabilities should have access to quality and timely dental care to prevent dental disease. Access to preventative dental care is critical for the prevention of chronic illness. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes."

"People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. AB 341 establishes the Oral Health for People with Disabilities Technical Assistance Center to provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood"

Arguments in Support

According to the California Dental Association, "in recent years, California has made significant progress on improving access to oral health care, including investments in Medi-Cal Dental to support provision of care to special needs patients and increased access to sedation. Recently awarded grants approved in the 2022 state budget are a historic investment that will help establish more settings able to provide care for patients with special health care needs. Despite these recent investments, access to care for patients with special health care needs continues to be an unnecessary challenge. Many settings, including dental schools, have exceptionally long wait times, even a year or more, which often require families to travel for hours to clinics just to receive routine care."

"While there needs to be more physical settings with the infrastructure to treat this population, more training and educational material also needs to be available for dental providers to ensure that waiting times can be reduced. Depending on the severity of the disability, daily health care routines can be a challenge to complete and even diagnosing dental conditions may require some level of stabilization or sedation."

Arguments in Opposition

None on file.

FISCAL COMMENTS

According to the Senate Committee on Appropriations:

1. State operations costs of $91,000 ($73,000 General Fund and $18,000 federal funds) in 2026-27 and $176,000 ($141,000 General Fund and $35,000 federal funds) in 2027-28 and annually thereafter for staffing resources;
2. State operations costs of $1.7 million (General Fund) on an ongoing basis to contract with a dental school or university beginning in 2027-28. Costs would depend on the scope and duration of the contract;
3. Regional center costs of approximately $139,000 ($97,000 General Fund and $42,000 federal funds) per regional center annually, which could total $1.4 million for 10 participating regional centers; and,
4. General Fund costs pressures, potentially millions of dollars annually, due to increased utilization of regional center services.

VOTES:

ASM HIGHER EDUCATION: 10-0-0

YES: Fong, DeMaio, Boerner, Jeff Gonzalez, Jackson, Muratsuchi, Patel, Celeste Rodriguez, Sharp-Collins, Tangipa

ASM HUMAN SERVICES: 7-0-0

YES: Lee, Castillo, Calderon, Elhawary, Jackson, Celeste Rodriguez, Tangipa

ASM APPROPRIATIONS: 14-0-1

YES: Wicks, Arambula, Calderon, Caloza, Dixon, Elhawary, Fong, Mark González, Hart, Pacheco, Pellerin, Solache, Ta, Tangipa

ABS, ABST OR NV: Sanchez

ASSEMBLY FLOOR: 79-0-0

YES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

SENATE FLOOR: 39-0-1

YES: Allen, Alvarado-Gil, Archuleta, Arreguín, Ashby, Becker, Blakespear, Cabaldon, Caballero, Cervantes, Choi, Cortese, Dahle, Durazo, Gonzalez, Grayson, Grove, Hurtado, Jones, Laird, Limón, McGuire, McNerney, Menjivar, Niello, Ochoa Bogh, Padilla, Pérez, Reyes, Richardson, Rubio, Seyarto, Smallwood-Cuevas, Strickland, Umberg, Valladares, Wahab, Weber Pierson, Wiener

ABS, ABST OR NV: Stern

UPDATED

VERSION: September 3, 2025

CONSULTANT: Kevin J. Powers / HIGHER ED. / (916) 319-3960 FN: 0001881

 THIRD READING  

Bill No: AB 341

Author: Arambula (D)

Amended: 9/3/25 in Senate

Vote: 21

SENATE HUMAN SERVICES COMMITTEE: 5-0, 6/30/25

AYES: Arreguín, Ochoa Bogh, Becker, Limón, Pérez

SENATE EDUCATION COMMITTEE: 7-0, 7/9/25

AYES: Pérez, Ochoa Bogh, Cabaldon, Choi, Cortese, Gonzalez, Laird

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/29/25

AYES: Caballero, Seyarto, Cabaldon, Dahle, Grayson, Richardson, Wahab

ASSEMBLY FLOOR: 79-0, 6/3/25 - See last page for vote

SUBJECT: Oral Health for People with Disabilities Technical Assistance Center Program

SOURCE: The Arc of California

DIGEST:

Requires the Department of Developmental Services (DDS) to contract with a public California dental school to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.

Senate floor amendments of 9/3/25 incorporate technical assistance from department of developmental services. Amendment to add private dental schools back in was agreed to by AHUM Chair.

ANALYSIS:

Existing Law:

1. Establishes the Lanterman Developmental Disabilities Services Act (Lanterman Act), which states that California is responsible for providing a range of services and supports sufficiently complete to meet the needs and choices of each person with developmental disabilities, regardless of age or degree of disability, and at each stage of life, and to support their integration into the mainstream life of the community. (Welfare and Institutions Code (WIC) 4500 et seq.)
2. Establishes a system of nonprofit regional centers, overseen by DDS, to provide fixed points of contact in the community for all persons with developmental disabilities and their families, to coordinate services and supports best suited to them throughout their lifetime. (WIC 4620)
3. Defines “developmental disability” to mean a disability that originates before an individual attains 18 years of age, continues, or can be expected to continue, indefinitely, and constitutes a substantial disability for that individual. As defined by the Director of DDS, in consultation with the Superintendent of Public Instruction, provides that this term shall include intellectual disability, cerebral palsy, epilepsy, and autism. Provides that this term shall also include disabling conditions found to be closely related to intellectual disability or to require treatment similar to that required for individuals with an intellectual disability, but shall not include other handicapping conditions that are solely physical in nature. (WIC 4512(a))

This bill

1. Makes Legislative findings and declarations regarding the historic use of sedatives and general anesthesia during dental treatment for people with intellectual and developmental disabilities, which has caused lack of access to dental care; however, new developments in dental treatment have created alternatives to the use of sedation and general anesthesia, which can reduce risk, wait times, and cost, and improve patient outcomes.
2. Requires DDS, no later than July 1, 2027, to contract with a public or private California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program. Requires DDS to prioritize contracting with a public California dental school or college to administer the program. States the purpose of the program is to improve dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. Provides that the contract shall expire on June 30, 2032.
3. Authorizes the contracted California dental school or college to partner with a public or private dental school or college. Specifies, if the contracted California dental school or college elects to partner with another dental school or college, the contracted California dental school or college shall prioritize partnering with a public California dental school or college. Requires the contracted school or resulting partnership to collectively meet both of the following qualifications:
   1. All partner public or private schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings.
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia.
      3. Demonstrated improved oral health in community settings as the result of meeting these achievements.
4. Requires the contracted school or partnership to do all of the following:
   1. Work with DDS to engage up to 21 regional centers to participate in the program.
   2. Provide practical experience, systems development, and expertise in relevant subject areas.
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center.
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel.
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel.
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel.
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center.
   8. Organize and direct a statewide advisory committee and learning community.
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
5. Requires DDS to submit to the Legislature an annual report on program data beginning one year after the contract commences and until June 30, 2033.
6. Authorizes DDS to enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Provides that contracts entered into or amended shall be exempt from Chapter 6 of Part 5.5 of Division 3 of Title 2 of the Government Code, Part 2 of Division 2 of the Public Contract Code, and the review or approval of the Department of General Services.
7. Requires participating regional centers to do all of the following:
   1. Designate a lead person at each regional center with responsibility for duties related to the Oral Health for People with Disabilities Technical Assistance Center Program.
   2. Establish vendor agreements with interested oral health professionals.
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future.
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional.
   5. Facilitate referrals to participating oral health professionals.
   6. Monitor program and individual patient activity and progress.
8. Requires DDS to do all of the following:
   1. Establish procedures for regional center directors, or their designees, to participate in the program.
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments.
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments.
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
   5. Allow regional centers to aggregate and publish anonymized results data.
9. Provides that DDS may consult and share information with other state entities as necessary to implement this bill. Provides that DDS may adopt other rules and regulations necessary to implement this bill.
10. Provides that implementation of this bill is subject to an appropriation by the Legislature for this purpose.

Background

Purpose of this bill. According to the author, “People with disabilities should have access to quality and timely dental care to prevent dental disease. People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. AB 341 would provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood.”

Lanterman Act. In 1969, the Lanterman Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy. As there are no income-related eligibility criteria, Lanterman Act services are considered an entitlement program. The Department of Finance estimates that approximately 465,165 individuals will receive developmental services in 2024–25, increasing to 504,905 in 2025–26.

Regional Centers. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities that contract with DDS to carry out many of the state’s responsibilities. Regional center services may include diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, and physical, occupational, and speech therapy. Additional services include, but are not limited to: mental health services, recreation, counseling for the individual served and their family, assistance locating a home, behavior training and modification programs, emergency and crisis intervention, respite for family caregivers, short-term out-of-home care, social skills training, specialized medical and dental care, telehealth services and supports, training for parents of children with developmental disabilities, and transportation services.

Dental Care for Individuals with Intellectual and Developmental Disabilities. As with other developmental services, regional centers coordinate dental services for consumers. Many regional centers employ a dental coordinator responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive fewer dental services than the general population, which can cause more complex dental problems due to neglect of addressing problems early. According to a 2018 report by the Legislative Analyst’s Office (LAO), the oral health of individuals with developmental disabilities is worse on average than that of the general population; they have higher rates and increased severity of periodontal (gum) disease, higher rates of untreated cavities, and more missing and decaying teeth. The LAO report stated that some oral health problems stem directly from the disability, for example, mouth breathing among individuals with Down syndrome can lead to a dry mouth, which can result in increased risk of gum disease.

According to the LAO, some DDS and regional center staff estimate between one-fifth and one-third of consumers require general anesthesia or intravenous sedation to undergo dental treatment. Furthermore, the report found that wait times for appropriate operating or surgical facilities can take as long as three years, and dentists less experienced in working with patients with developmental disabilities may resort to using general anesthesia rather than providing behavioral supports.

Dentists and dental hygienists receive limited training on how to serve individuals with developmental disabilities. This contributes to a lack of access and a lack of understanding this population’s unique needs. According to the California Dental Association, there are only 14 dental schools and surgery centers in California that can handle special needs patients. Health coverage is another barrier. While a majority of people with disabilities rely on Medi-Cal for their health care, in 2021, only about 36% of active licensed dentists accepted Medi-Cal. The 2018 LAO report found that only about 22% of consumers enrolled in Medi-Cal received a dental services each year in 2014, 2015, and 2016.

Dental Clinics at Alta California Regional Center. Beginning in November 2024, Alta California Regional Center (Alta) has partnered with On My Own Independent Living Services to host a series of dental clinics for consumers. These dental clinics aim to provide preventative dental care in an accessible environment. Registered Dental Hygienists in Alternative Practice, dental hygienists who can work in a variety of community settings outside of a traditional dental office, performed fluoride treatments, X-rays, cleanings, and provided resources for follow-up treatment and personalized instructions on proper oral hygiene. According to the Alta dental coordinator, most patients who attended the February 2025 dental clinic had not had their teeth checked in several years, with some not seeing a dentist for five to 10 years.

Related/Prior Legislation

AB 2510 (Arambula, 2024) was substantially similar to this bill. AB 2510 was held on the Assembly Appropriations Committee suspense file.

AB 649 (Wilson, 2023) would have permitted regional centers to purchase services that would otherwise be available from other specified means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 was held on the Assembly Appropriations Committee suspense file.

AB 1957 (Wilson, Chapter 314, Statutes of 2022) added additional data points to the set of data that DDS and regional centers must report. These additional data mostly relate to services that were cut during the COVID-19 pandemic and recently restored, including social recreation, camping, educational services, and nonmedical therapies such as art, dance, and music. AB 1957 also added untimely translations of an individual program plan in a threshold language to be included in the set of data.

AB 1-X2 (Thurmond, Chapter 3, Statutes of 2016) authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.

Comments

This bill seeks to provide early prevention and intervention dental care for individuals with intellectual and developmental disabilities by establishing a dental school program to reduce reliance on anesthesia and sedation for this population. Reports have found that individuals with intellectual and developmental disabilities receive fewer dental services than the general population, which can cause more complex and long-term dental problems. These dental problems can look like tooth decay and loss, soreness or pain, gum recession, and can increase the risk for other health conditions. This bill would establish a dental program with the goal of reducing or eliminating the need for dental treatment using sedation and general anesthesia. This program is similar to a recommendation made by the 2018 LAO report, to authorize a pilot program to educate and train Medi-Cal providers on how to serve DDS consumers.

[See the Senate Human Services Committee and Senate Education Committee analyses for additional background on this bill.]

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee, “DDS estimates the following:

• “State operations costs of $91,000 ($73,000 General Fund and $18,000 federal funds) in 2026-27 and $176,000 ($141,000 General Fund and $35,000 federal funds) in 2027-28 and annually thereafter for staffing resources.
• “State operations costs of $1.7 million (General Fund) on an ongoing basis to contract with a dental school or university beginning in 2027-28. Costs would depend on the scope and duration of the contract.
• “Regional center costs of approximately $139,000 ($97,000 General Fund and $42,000 federal funds) per regional center annually, which could total $1.4 million for 10 participating regional centers.
• “General Fund costs pressures, potentially millions of dollars annually, due to increased utilization of regional center services.”

SUPPORT: (Verified 9/3/25)

The Arc California (Sponsor)

Association of Regional Center Agencies

California Academy of General Dentistry

California Association of Orthodontists

California Dental Association

California Dental Hygienists' Association

California Disability Services Association

Children's Choice Dental Care

Cleanearth4kids.org

Easterseals Northern California

OPPOSITION: (Verified 9/3/25)

None received

ASSEMBLY FLOOR: 79-0, 6/3/25

AYES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

Prepared by: Diana Dominguez / HUMAN S. / (916) 651-1524

9/6/25 10:24:26

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 THIRD READING  

Bill No: AB 341

Author: Arambula (D)

Amended: 5/1/25 in Assembly

Vote: 21

SENATE HUMAN SERVICES COMMITTEE: 5-0, 6/30/25

AYES: Arreguín, Ochoa Bogh, Becker, Limón, Pérez

SENATE EDUCATION COMMITTEE: 7-0, 7/9/25

AYES: Pérez, Ochoa Bogh, Cabaldon, Choi, Cortese, Gonzalez, Laird

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/29/25

AYES: Caballero, Seyarto, Cabaldon, Dahle, Grayson, Richardson, Wahab

ASSEMBLY FLOOR: 79-0, 6/3/25 - See last page for vote

SUBJECT: Oral Health for People with Disabilities Technical Assistance Center Program

SOURCE: The Arc of California

DIGEST:

This bill requires the Department of Developmental Services (DDS) to contract with a public California dental school to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.

ANALYSIS:

Existing Law:

1. Establishes the Lanterman Developmental Disabilities Services Act (Lanterman Act), which states that California is responsible for providing a range of services and supports sufficiently complete to meet the needs and choices of each person with developmental disabilities, regardless of age or degree of disability, and at each stage of life, and to support their integration into the mainstream life of the community. (Welfare and Institutions Code (WIC) § 4500 et seq.)
2. Establishes a system of nonprofit regional centers, overseen by DDS, to provide fixed points of contact in the community for all persons with developmental disabilities and their families, to coordinate services and supports best suited to them throughout their lifetime. (WIC § 4620)
3. Defines “developmental disability” to mean a disability that originates before an individual attains 18 years of age, continues, or can be expected to continue, indefinitely, and constitutes a substantial disability for that individual. As defined by the Director of DDS, in consultation with the Superintendent of Public Instruction, provides that this term shall include intellectual disability, cerebral palsy, epilepsy, and autism. Provides that this term shall also include disabling conditions found to be closely related to intellectual disability or to require treatment similar to that required for individuals with an intellectual disability, but shall not include other handicapping conditions that are solely physical in nature. (WIC § 4512(a))

This bill:

1. Makes Legislative findings and declarations regarding the historic use of sedatives and general anesthesia during dental treatment for people with intellectual and developmental disabilities, which has caused lack of access to dental care; however, new developments in dental treatment have created alternatives to the use of sedation and general anesthesia, which can reduce risk, wait times, and cost, and improve patient outcomes.
2. Requires DDS, no later than July 1, 2027, to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program. States the purpose of the program is to improve dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
3. Authorizes the contracted California dental school or college to partner with a public dental school or college. Requires the contracted school or resulting partnership to collectively meet both of the following qualifications:
   1. All partner public schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings.
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia.
      3. Demonstrated improved oral health in community settings as the result of meeting these achievements.
4. Requires the contracted school or partnership to do all of the following:
   1. Identify up to 10 regional centers to participate in the program.
   2. Provide practical experience, systems development, and expertise in relevant subject areas.
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center.
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel.
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel.
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel.
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center.
   8. Organize and direct a statewide advisory committee and learning community.
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
5. Requires DDS to submit to the Legislature an annual report on program data.
6. Authorizes DDS to enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Provides that contracts entered into or amended shall be exempt from Chapter 6 of Part 5.5 of Division 3 of Title 2 of the Government Code, Part 2 of Division 2 of the Public Contract Code, and the review or approval of the Department of General Services.
7. Requires participating regional centers to do all of the following:
   1. Designate a lead person at each regional center with responsibility for duties related to the Oral Health for People with Disabilities Technical Assistance Center Program.
   2. Establish vendor agreements with interested oral health professionals.
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future.
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional.
   5. Facilitate referrals to participating oral health professionals.
   6. Monitor program and individual patient activity and progress.
8. Requires DDS to do all of the following:
   1. Establish procedures for regional center directors, or their designees, to participate in the program.
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments.
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments.
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
   5. Allow regional centers to aggregate and publish anonymized results data.
9. Provides that DDS may consult and share information with other state entities as necessary to implement this bill. Provides that DDS may adopt other rules and regulations necessary to implement this bill.

Background

Purpose of this Bill. According to the author, “People with disabilities should have access to quality and timely dental care to prevent dental disease. People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. AB 341 would provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood.”

Lanterman Act. In 1969, the Lanterman Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy. As there are no income-related eligibility criteria, Lanterman Act services are considered an entitlement program. The Department of Finance estimates that approximately 465,165 individuals will receive developmental services in 2024–25, increasing to 504,905 in 2025–26.

Regional Centers. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities that contract with DDS to carry out many of the state’s responsibilities. Regional center services may include diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, and physical, occupational, and speech therapy. Additional services include, but are not limited to: mental health services, recreation, counseling for the individual served and their family, assistance locating a home, behavior training and modification programs, emergency and crisis intervention, respite for family caregivers, short-term out-of-home care, social skills training, specialized medical and dental care, telehealth services and supports, training for parents of children with developmental disabilities, and transportation services.

Dental Care for Individuals with Intellectual and Developmental Disabilities. As with other developmental services, regional centers coordinate dental services for consumers. Many regional centers employ a dental coordinator responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive fewer dental services than the general population, which can cause more complex dental problems due to neglect of addressing problems early. According to a 2018 report by the Legislative Analyst’s Office (LAO), the oral health of individuals with developmental disabilities is worse on average than that of the general population; they have higher rates and increased severity of periodontal (gum) disease, higher rates of untreated cavities, and more missing and decaying teeth. The LAO report stated that some oral health problems stem directly from the disability, for example, mouth breathing among individuals with Down syndrome can lead to a dry mouth, which can result in increased risk of gum disease.

According to the LAO, some DDS and regional center staff estimate between one-fifth and one-third of consumers require general anesthesia or intravenous sedation to undergo dental treatment. Furthermore, the report found that wait times for appropriate operating or surgical facilities can take as long as three years, and dentists less experienced in working with patients with developmental disabilities may resort to using general anesthesia rather than providing behavioral supports.

Dentists and dental hygienists receive limited training on how to serve individuals with developmental disabilities. This contributes to a lack of access and a lack of understanding this population’s unique needs. According to the California Dental Association, there are only 14 dental schools and surgery centers in California that can handle special needs patients. Health coverage is another barrier. While a majority of people with disabilities rely on Medi-Cal for their health care, in 2021, only about 36% of active licensed dentists accepted Medi-Cal. The 2018 LAO report found that only about 22% of consumers enrolled in Medi-Cal received a dental services each year in 2014, 2015, and 2016.

Dental Clinics at Alta California Regional Center. Beginning in November 2024, Alta California Regional Center (Alta) has partnered with On My Own Independent Living Services to host a series of dental clinics for consumers. These dental clinics aim to provide preventative dental care in an accessible environment. Registered Dental Hygienists in Alternative Practice, dental hygienists who can work in a variety of community settings outside of a traditional dental office, performed fluoride treatments, X-rays, cleanings, and provided resources for follow-up treatment and personalized instructions on proper oral hygiene. According to the Alta dental coordinator, most patients who attended the February 2025 dental clinic had not had their teeth checked in several years, with some not seeing a dentist for five to 10 years.

Related/Prior Legislation

AB 2510 (Arambula, 2024) was substantially similar to this bill. AB 2510 was held on the Assembly Appropriations Committee suspense file.

AB 649 (Wilson, 2023) would have permitted regional centers to purchase services that would otherwise be available from other specified means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 was held on the Assembly Appropriations Committee suspense file.

AB 1957 (Wilson, Chapter 314, Statutes of 2022) added additional data points to the set of data that DDS and regional centers must report. These additional data mostly relate to services that were cut during the COVID-19 pandemic and recently restored, including social recreation, camping, educational services, and nonmedical therapies such as art, dance, and music. AB 1957 also added untimely translations of an individual program plan in a threshold language to be included in the set of data.

AB 1-X2 (Thurmond, Chapter 3, Statutes of 2016) authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.

Comments

This bill seeks to provide early prevention and intervention dental care for individuals with intellectual and developmental disabilities by establishing a dental school program to reduce reliance on anesthesia and sedation for this population. Reports have found that individuals with intellectual and developmental disabilities receive fewer dental services than the general population, which can cause more complex and long-term dental problems. These dental problems can look like tooth decay and loss, soreness or pain, gum recession, and can increase the risk for other health conditions. This bill would establish a dental program with the goal of reducing or eliminating the need for dental treatment using sedation and general anesthesia. This program is similar to a recommendation made by the 2018 LAO report, to authorize a pilot program to educate and train Medi-Cal providers on how to serve DDS consumers.

[See the Senate Human Services Committee and Senate Education Committee analyses for additional background on this bill.]

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee, “DDS estimates the following:

• “State operations costs of $91,000 ($73,000 General Fund and $18,000 federal funds) in 2026-27 and $176,000 ($141,000 General Fund and $35,000 federal funds) in 2027-28 and annually thereafter for staffing resources.
• “State operations costs of $1.7 million (General Fund) on an ongoing basis to contract with a dental school or university beginning in 2027-28. Costs would depend on the scope and duration of the contract.
• “Regional center costs of approximately $139,000 ($97,000 General Fund and $42,000 federal funds) per regional center annually, which could total $1.4 million for 10 participating regional centers.
• “General Fund costs pressures, potentially millions of dollars annually, due to increased utilization of regional center services.”

SUPPORT: (Verified 8/29/25)

The Arc California (Sponsor)

Association of Regional Center Agencies

California Academy of General Dentistry

California Association of Orthodontists

California Dental Association

California Dental Hygienists’ Association

California Disability Services Association

Children's Choice Dental Care

Cleanearth4kids.org

Easterseals Northern California

OPPOSITION: (Verified 8/29/25)

None received

ASSEMBLY FLOOR: 79-0, 6/3/25

AYES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

Prepared by: Diana Dominguez / HUMAN S. / (916) 651-1524

8/29/25 20:33:25

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anna Caballero, Chair

2025 - 2026 Regular Session

AB 341 (Arambula) - Oral Health for People with Disabilities Technical Assistance Center Program

Bill Summary:

AB 341 would require the Department of Developmental Services (DDS) to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program.

Fiscal Impact:

The DDS estimates the following:

• State operations costs of $91,000 ($73,000 General Fund and $18,000 federal funds) in 2026-27 and $176,000 ($141,000 General Fund and $35,000 federal funds) in 2027-28 and annually thereafter for staffing resources.
• State operations costs of $1.7 million (General Fund) on an ongoing basis to contract with a dental school or university beginning in 2027-28. Costs would depend on the scope and duration of the contract.
• Regional center costs of approximately $139,000 ($97,000 General Fund and $42,000 federal funds) per regional center annually, which could total $1.4 million for 10 participating regional centers.
• General Fund costs pressures, potentially millions of dollars annually, due to increased utilization of regional center services.

Background:

California’s Lanterman Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy.

Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities that contract with DDS to carry out many of the state’s responsibilities. The primary purpose of regional centers is to connect individuals with services in the community. Current law requires the DDS and the regional centers to annually collaborate to compile and report data in a uniform manner relating to purchase of service authorization, utilization, and expenditure by each regional center, as specified.

As with other developmental services, regional centers coordinate dental services for consumers. Many regional centers employ a dental coordinator responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Proposed Law:

Specific provisions of the bill would:

• Require, no later than July 1, 2027, the DDS to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program; and specify that the purpose of the program is to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
• Authorize the contracted California dental school or college to partner with a public dental school or college.
• Require the contracted school or resulting partnership to collectively meet both of the following qualifications:
• All partner public schools must be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
• Lead faculty at one or more schools must demonstrate having developed and implemented at regional centers, community-based dental care programs as specified.
• Impose requirements on the contracted school or partnership, as specified.
• Impose requirements on participating regional centers, as specified.
• Require DDS to do all of the following:
• Establish procedures for regional center directors, or their designees, to participate in the program.
• Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments.
• Provide guidance for regional centers regarding the use of specialized therapeutic services payments.
• Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
• Allow regional centers to aggregate and publish anonymized results data.
• Submit to the Legislature an annual report of data, as specified.

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Sasha Renée Pérez, Chair

2025 - 2026 Regular

Bill No: Hearing Date: July 9, 2025

Subject: .

SUMMARY

This bill requires the Department of Developmental Services (DDS) to contract with a public dental school in California, by July 1, 2027, to administer the Oral Health for People with Disabilities Technical Assistance Center Program for the purpose of improving dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.

BACKGROUND

Existing law:

1. Establishes a system of non-profit regional centers, under contract with the state and overseen by DDS, to provide fixed points of contact in the community for all persons with developmental disabilities and their families, to coordinate services and supports best suited to them throughout their lifetime. (Welfare and Institutions Code § 4620)
   
2. Grants to the University of California (UC) the exclusive jurisdiction in public higher education over instruction in the profession of law and over graduate instruction in the professions of medicine, dentistry, and veterinary medicine. It has the sole authority in public higher education to award the doctoral degree in all fields of learning, except that it may agree with the California State University to award joint doctoral degrees in selected fields. The UC shall be the primary state-supported academic agency for research. (Education Code § 66010.4)

ANALYSIS

This bill:

1. Requires DDS to contract with a public dental school or college in California, by July 1, 2027, to administer the Oral Health for People with Disabilities Technical Assistance Center Program.
   
2. Provides that the purpose of the program is to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
   
3. Authorizes the contracted public dental school or college in California to partner with a public dental school or college (not located in California).
   
4. Requires the contracted school or resulting partnership to collectively meet both of the following qualifications:
   
   1. All partner public schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
      
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings.
         
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia.
         
      3. Demonstrated improved oral health in community settings as the result of meeting the achievements described in (i) and (ii) above.
         
5. Requires the contracted school or partnership to do all of the following:
   
   1. Identify up to 10 regional centers to participate in the program.
      
   2. Provide practical experience, systems development, and expertise in relevant subject areas.
      
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center.
      
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel.
      
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel.
      
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel.
      
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center.
      
   8. Organize and direct a statewide advisory committee and learning community.
      
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
      
6. Requires participating regional centers to do all of the following:
   
   1. Designate a lead person at each regional center with responsibility for duties related to this bill.
      
   2. Establish vendor agreements with interested oral health professionals.
      
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future.
      
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional.
      
   5. Facilitate referrals to participating oral health professionals.
      
   6. Monitor program and individual patient activity and progress.
      
7. Requires DDS to do all of the following:
   
   1. Establish procedures for regional center directors, or their designees, to participate in the program.
      
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments.
      
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments.
      
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
      
   5. Allow regional centers to aggregate and publish anonymized results data.
      
8. Authorizes DDS to consult and share information with other state entities, and adopt other rules and regulations, as necessary to implement this bill.
   
9. Requires DDS to submit an annual report to the Legislature on the program data the contracted school or partnership has collected and analyzed.
   
10. Authorizes DDS to enter into exclusive or non-exclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this bill shall be exempt from the California State Contracts Register, the State Contract Act, and the review or approval of the Department of General Services.
    
11. States legislative findings and declarations relative to the need for alternatives to the use of sedation and general anesthesia for people with intellectual and developmental disabilities, and the lack of trained practitioners, policy barriers, and systemic deficiencies in payment and other support systems for practitioners who otherwise might provide care to this vulnerable population.

STAFF COMMENTS

1. Need for the bill. According to the author, “People with disabilities should have access to quality and timely dental care to prevent dental disease. Access to preventative dental care is critical for the prevention of chronic illness. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes.
   
   “People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care.
   
   “AB 341 establishes the Oral Health for People with Disabilities Technical Assistance Center to provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood.”
   
2. CA public dental schools. This bill requires DDS to contract with “a public California dental school or college,” and allows the school with the contract to partner with “a public dental school or college.” The bill further requires that all partner public schools be located in California. There are only two public schools of dentistry in California – the UCLA School of Dentistry, and the UCSF School of Dentistry. This bill would result in one of the UC schools of dentistry being under contract with DDS, and then potentially partnering with the other UC school of dentistry.
   
3. Regional centers. DDS oversees the coordination and delivery of services for people with developmental disabilities through a statewide network of 21 community-based, non-profit agencies known as regional centers. Regional centers provide assessments, determine eligibility for services, and offer case management services. Regional centers also develop, purchase, and coordinate the services in each person’s Individual Program Plan.
   
   Among many other things, regional centers coordinate dental services for consumers. According to prior committee analyses of this bill, many regional centers employ a dental coordinator responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, and training consumers and residential care providers on oral hygiene, and coordinating desensitization (helping to make consumers more comfortable with dental procedures, such as experiencing bright lights and new sounds).
   
   According to a 2018 report by the Legislative Analyst’s Office (LAO), the oral health of individuals with developmental disabilities is worse on average than that of the general population; they have higher rates and increased severity of periodontal (gum) disease, higher rates of untreated cavities, and more missing and decaying teeth. According to the LAO, some DDS and regional center staff estimate between one-fifth and one-third of consumers require general anesthesia or intravenous sedation to undergo dental treatment. Furthermore, the report found the following related to general anesthesia and sedation:
   
   “General anesthesia often requires the use of an operating room in a hospital or surgical center, yet the wait time for such facilities can be lengthy—sometimes as long as three years. […] Because many patients with developmental disabilities suffer distinct oral health problems, cannot easily comply with home care guidelines, and often lack adequate preventive care, they can end up requiring more extensive treatments (such as a higher than average number of fillings) and/or intensive treatments (such as extractions or scaling and root planing) than they would have otherwise. To avoid extensive treatment, dentists will sometimes resort to extracting all the teeth and providing a full set of dentures. Some dentists, especially those who are less experienced in working with patients with developmental disabilities, will resort to using general anesthesia, rather than providing behavioral supports.”
   
   This bill establishes a dental program with the goal of reducing or eliminating the need for dental treatment using sedation and general anesthesia. This program is similar to a recommendation made by the 2018 LAO report, which was to authorize a pilot program to educate and train Medi-Cal providers on how to serve DDS consumers.
   
   As noted in the Senate Human Services Committee’s analysis, the author may wish to consider adding a requirement that the contracted school or partnership consider diversity of geography when identifying regional centers to participate in the program. The author may additionally wish to consider specifying the makeup of the statewide advisory committee and learning community, to include people with lived experience, local regional center staff, and advocates.
4. Dental Clinics at Alta California Regional Center. The Alta California Regional Center has partnered with On My Own Independent Living Services since November 2024, to host a series of dental clinics for consumers. These dental clinics provide preventative dental care in an accessible environment. According to the Bridges Newsleter on DDS’s website, Alta California Regional Center’s Dental Coordinator noted that most patients who attended the February 2025 dental clinic had not had their teeth checked in several years, with some not seeing a dentist for five to 10 years.
   
5. Prior legislation.
   
   AB 2510 (Arambula, 2024) was substantially similar to this bill. AB 2510 was held on the Assembly Appropriations Committee’s suspense file.

SUPPORT

The ARC California (sponsor)
Association of Regional Center Agencies
California Association of Orthodontists
California Dental Association
Children’s Choice Dental Care
Easterseals Northern California

OPPOSITION

None received

-- END --

SENATE COMMITTEE ON HUMAN SERVICES

Senator Arreguín, Chair

2025 - 2026 Regular

Subject: Oral Health for People with Disabilities Technical Assistance Center Program

SUMMARY

This bill would require the Department of Developmental Services (DDS), no later than July 1, 2027, to contract with a public California dental school to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.

ABSTRACT

Existing Law:

1. Establishes the Lanterman Developmental Disabilities Services Act (Lanterman Act), which states that California is responsible for providing a range of services and supports sufficiently complete to meet the needs and choices of each person with developmental disabilities, regardless of age or degree of disability, and at each stage of life, and to support their integration into the mainstream life of the community. (Welfare and Institutions Code (WIC) 4500 et seq.)
2. Establishes a system of nonprofit regional centers, overseen by DDS, to provide fixed points of contact in the community for all persons with developmental disabilities and their families, to coordinate services and supports best suited to them throughout their lifetime. (WIC 4620)
3. Defines “developmental disability” to mean a disability that originates before an individual attains 18 years of age, continues, or can be expected to continue, indefinitely, and constitutes a substantial disability for that individual. As defined by the Director of DDS, in consultation with the Superintendent of Public Instruction, provides that this term shall include intellectual disability, cerebral palsy, epilepsy, and autism. Provides that this term shall also include disabling conditions found to be closely related to intellectual disability or to require treatment similar to that required for individuals with an intellectual disability, but shall not include other handicapping conditions that are solely physical in nature. (WIC 4512(a))

This Bill:

1. Makes Legislative findings and declarations regarding the historic use of sedatives and general anesthesia during dental treatment for people with intellectual and developmental disabilities, which has caused lack of access to dental care; however, new developments in dental treatment have created alternatives to the use of sedation and general anesthesia, which can reduce risk, wait times, and cost, and improve patient outcomes.
2. Requires DDS, no later than July 1, 2027, to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program. States the purpose of the program is to improve dental care services for people with intellectual and developmental disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
3. Authorizes the contracted California dental school or college to partner with a public dental school or college. Requires the contracted school or resulting partnership to collectively meet both of the following qualifications:
   1. All partner public schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings.
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia.
      3. Demonstrated improved oral health in community settings as the result of meeting these achievements.
4. Requires the contracted school or partnership to do all of the following:
   1. Identify up to 10 regional centers to participate in the program.
   2. Provide practical experience, systems development, and expertise in relevant subject areas.
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center.
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel.
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel.
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel.
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center.
   8. Organize and direct a statewide advisory committee and learning community.
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
5. Requires DDS to submit to the Legislature an annual report of the program data.
6. Authorizes DDS to enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Provides that contracts entered into or amended shall be exempt from Chapter 6 of Part 5.5 of Division 3 of Title 2 of the Government Code, Part 2 of Division 2 of the Public Contract Code, and the review or approval of the Department of General Services.
7. Requires participating regional centers to do all of the following:
   1. Designate a lead person at each regional center with responsibility for duties related to the Oral Health for People with Disabilities Technical Assistance Center Program.
   2. Establish vendor agreements with interested oral health professionals.
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future.
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional.
   5. Facilitate referrals to participating oral health professionals.
   6. Monitor program and individual patient activity and progress.
8. Requires DDS to do all of the following:
   1. Establish procedures for regional center directors, or their designees, to participate in the program.
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments.
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments.
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
   5. Allow regional centers to aggregate and publish anonymized results data.
9. Provides that DDS may consult and share information with other state entities as necessary to implement this bill. Provides that DDS may adopt other rules and regulations necessary to implement this bill.

FISCAL IMPACT

According to the Assembly Appropriations Committee, “DDS estimates total General Fund (GF) costs of approximately $566,000 in fiscal year (FY) 2026-27 and $2.8 million in FY 2027-28 and annually thereafter, as follows:

1. Regional center staffing costs of $708,000 ($494,000 GF) in FY 2026-27, and $1.4 million ($1.0 million GF) in FY 2027-28 for each of 10 regional centers to hire a full-time staff member to coordinate and carry out the dental-related activities and responsibilities set forth in the bill. DDS assumes a cost of approximately $142,000 ($99,000 GF) per regional center annually.
2. DDS staffing costs of approximately $90,000 ($72,000 GF) in FY 2026-27 and $172,000 ($138,000 GF) in FY 2027-28 and annually thereafter for one position at DDS to research and establish guidelines and regulations by July 1, 2027, and provide technical assistance to regional centers.
3. Contract costs of $1.7 million GF annually beginning in FY 2027-28 to contract with dental schools or universities.”

BACKGROUND AND DISCUSSION

Purpose of the Bill:

According to the author, “People with disabilities should have access to quality and timely dental care to prevent dental disease. Access to preventative dental care is critical for the prevention of chronic illness. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes. People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. AB 341 establishes the Oral Health for People with Disabilities Technical Assistance Center to provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood.”

Lanterman Act

In 1969, the Lanterman Act established that individuals with developmental disabilities and their families have a right to receive the necessary supports and services required to live independently in the community. The Lanterman Act enumerates the rights of individuals with developmental disabilities, as well as the rights of their families, what services and supports are available to these individuals, and how regional centers and service providers work together to provide these supports and services. The term “developmental disability” is defined as a disability that originates before a person reaches 18 years of age, is expected to continue indefinitely, and is a significant disability for the individual; such disabilities include, among others: epilepsy, autism spectrum disorder, intellectual disability, and cerebral palsy. As there are no income-related eligibility criteria, Lanterman Act services are considered an entitlement program. The Department of Finance estimates that approximately 465,165 individuals will receive developmental services in 2024–25, increasing to 504,905 in 2025–26.^[1]

Regional Centers

Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities that contract with DDS to carry out many of the state’s responsibilities. Regional center services may include diagnosis, evaluation, treatment, and care coordination of services such as personal care, day care, special living arrangements, and physical, occupational, and speech therapy. Additional services include, but are not limited to: mental health services, recreation, counseling for the individual served and their family, assistance locating a home, behavior training and modification programs, emergency and crisis intervention, respite for family caregivers, short-term out-of-home care, social skills training, specialized medical and dental care, telehealth services and supports, training for parents of children with developmental disabilities, and transportation services.

Dental Care for Individuals with Intellectual and Developmental Disabilities

As with other developmental services, regional centers coordinate dental services for consumers. Many regional centers employ a dental coordinator responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive fewer dental services than the general population, which can cause more complex dental problems due to neglect of addressing problems early. According to a 2018 report^[2] by the Legislative Analyst’s Office (LAO), the oral health of individuals with developmental disabilities is worse on average than that of the general population; they have higher rates and increased severity of periodontal (gum) disease, higher rates of untreated cavities, and more missing and decaying teeth. The LAO report stated that some oral health problems stem directly from the disability, for example, mouth breathing among individuals with Down syndrome can lead to a dry mouth, which can result in increased risk of gum disease.

According to the LAO, some DDS and regional center staff estimate between one-fifth and one-third of consumers require general anesthesia or intravenous sedation to undergo dental treatment. Furthermore, the report found the following related to general anesthesia and sedation:

“General anesthesia often requires the use of an operating room in a hospital or surgical center, yet the wait time for such facilities can be lengthy—sometimes as long as three years. […] Because many patients with developmental disabilities suffer distinct oral health problems, cannot easily comply with home care guidelines, and often lack adequate preventive care, they can end up requiring more extensive treatments (such as a higher than average number of fillings) and/or intensive treatments (such as extractions or scaling and root planing) than they would have otherwise. To avoid extensive treatment, dentists will sometimes resort to extracting all the teeth and providing a full set of dentures. Some dentists, especially those who are less experienced in working with patients with developmental disabilities, will resort to using general anesthesia, rather than providing behavioral supports.”

Dentists and dental hygienists receive limited training on how to serve individuals with developmental disabilities. This contributes to a lack of access and a lack of understanding this population’s unique needs. According to the California Dental Association^[3], there are only 14 dental schools and surgery centers in California that can handle special needs patients. Health coverage is another barrier. While a majority of people with disabilities rely on Medi-Cal for their health care, in 2021, only about 36% of active licensed dentists accepted Medi-Cal^[4]. The 2018 LAO report found that only about 22% of consumers enrolled in Medi-Cal received a dental services each year in 2014, 2015, and 2016.

Dental Clinics at Alta California Regional Center

Beginning in November 2024, Alta California Regional Center (Alta) has partnered with On My Own Independent Living Services to host a series of dental clinics for consumers. These dental clinics aim to provide preventative dental care in an accessible environment. Registered Dental Hygienists in Alternative Practice, dental hygienists who can work in a variety of community settings outside of a traditional dental office, performed fluoride treatments, X-rays, cleanings, and provided resources for follow-up treatment and personalized instructions on proper oral hygiene. According to the Alta dental coordinator^[5], most patients who attended the February 2025 dental clinic had not had their teeth checked in several years, with some not seeing a dentist for five to 10 years.

Related/Prior Legislation:

AB 2510 (Arambula, 2024) was substantially similar to this bill. AB 2510 was held on the Assembly Appropriations Committee suspense file.

AB 649 (Wilson, 2023) would have permitted regional centers to purchase services that would otherwise be available from other specified means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 was held on the Assembly Appropriations Committee suspense file.

AB 1957 (Wilson, Chapter 314, Statutes of 2022) added additional data points to the set of data that DDS and regional centers must report. These additional data mostly relate to services that were cut during the COVID-19 pandemic and recently restored, including social recreation, camping, educational services, and nonmedical therapies such as art, dance, and music. AB 1957 also added untimely translations of an individual program plan in a threshold language to be included in the set of data.

AB 1-X2 (Thurmond, Chapter 3, Statutes of 2016) authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.

COMMENTS

This bill seeks to provide early prevention and intervention dental care for individuals with intellectual and developmental disabilities by establishing a dental school program to reduce reliance on anesthesia and sedation for this population. Reports have found that individuals with intellectual and developmental disabilities receive fewer dental services than the general population, which can cause more complex and long-term dental problems. These dental problems can look like tooth decay and loss, soreness or pain, gum recession, and can increase the risk for other health conditions. This bill would establish a dental program with the goal of reducing or eliminating the need for dental treatment using sedation and general anesthesia. This program is similar to a recommendation made by the 2018 LAO report, to authorize a pilot program to educate and train Medi-Cal providers on how to serve DDS consumers.

The author may wish to consider adding a requirement that the contracted school or partnership consider diversity of geography when identifying regional centers to participate in the program. The author may additionally wish to consider specifying the makeup of the statewide advisory committee and learning community, to include people with lived experience, local regional center staff, and advocates.

Double Referral: This bill has been double referred. Should this bill pass out of this Committee, it will be referred to the Senate Committee on Education.

PRIOR VOTES

POSITIONS

Support:

The Arc California (Sponsor)

Association of Regional Center Agencies
California Academy of General Dentistry

California Association of Orthodontists
California Dental Association
California Dental Hygienists' Association
California Disability Services Association
Children's Choice Dental Care

Oppose:

None received

-- END --

1. https://www.dds.ca.gov/wp-content/uploads/2025/01/GovernorsBudgetHighlights_20250110.pdf ↑

2. https://lao.ca.gov/reports/2018/3884/dental-for-developmentally-disabled-092718.pdf ↑

3. https://calmatters.org/health/2022/05/special-needs-dental-patients/ ↑

4. Ibid. ↑

5. https://www.dds.ca.gov/newsletter/expanding-access-to-dental-care-for-alta-california-regional-center-clients/ ↑

ASSEMBLY THIRD READING

ATR Bill Id:AB 341

Author:(Arambula)

As Amended Ver:May 1, 2025

Majority vote

SUMMARY

Requires the Department of Developmental Services (DDS) to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program (Program) to improve dental care services for people with developmental and intellectual disabilities.

Major Provisions

1. Specifies that, by July 1, 2027, DDS must contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program (Program). The purpose of the Program is to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
2. Specifies that the contracted California dental school or college may partner with a public dental school or college. The contracted school or resulting partnership must collectively meet both of the following qualifications:
   1. All partner public schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association; and,
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings;
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia; and,
      3. Demonstrated improved oral health in community settings as the result of meeting the achievements, as described in i) and ii) above.
3. Requires that, in administering the Program, the contracted school or partnership must do all of the following:
   1. Identify up to 10 regional centers to participate in the program;
   2. Provide practical experience, systems development, and expertise in relevant subject areas;
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center;
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel;
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel;
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel;
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center;
   8. Organize and direct a statewide advisory committee and learning community; and,
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
4. Specifies that DDS must submit to the Legislature an annual report of the data in 3) i) above.
5. Declares that, to implement this section, DDS may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to these provisions are exempt from specified provisions in existing law related to the California State Contracts Register, contracting by state agencies, and the review or approval of the Department of General Services.
6. Requires participating regional centers to have the following program responsibilities:
   1. Designate a lead person at each regional center with responsibility for duties related to the program;
   2. Establish vendor agreements with interested oral health professionals;
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future;
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional;
   5. Facilitate referrals to participating oral health professionals; and,
   6. Monitor program and individual patient activity and progress.
7. Requires DDS to do all of the following:
   1. Establish procedures for regional center directors, or their designees, to participate in the program;
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments;
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments; and,
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
8. Authorizes DDS to consult and share information with other state entities, as necessary.
9. Authorizes DDS to adopt regulations as necessary to implement this bill.

COMMENTS

Background: Lanterman Developmental Disabilities Act originally became statute in 1969. The Lanterman Act provides entitlement to services and supports for individuals three years of age and older who have a qualifying developmental disability. Qualifying disabilities include autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a disability that is substantial that began before they attained 18 years of age and is expected to be lifelong. There are no income‑related eligibility criteria. Direct responsibility for implementation of the Lanterman Act's service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities, that contract with DDS to carry out many of the state's responsibilities.

As of August 2023, the 21 regional centers served 459,395 consumers, providing services such as: information and referral; assessment and diagnosis; counseling; lifelong individualized planning and service coordination; purchase of necessary services included in the individual program plan (IPP); resource development; outreach; assistance in finding and using community and other resources; advocacy for the protection of legal, civil, and service rights; early intervention services for at risk infants and their families; genetic counseling; family support; planning, placement, and monitoring for 24-hour out-of-home care; training and educational opportunities for individuals and families; and, community education about developmental disabilities. Regional centers services vary at each location. One location might offer one program and the next might offer what they consider an alternative or offer nothing comparable. Geographically, regional centers' spending also varies.

Dental Care for Individuals with Developmental Disorders. Dental services are coordinated through regional centers just like other services. Most regional centers employ a "dental coordinator." Dental coordinators are responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with the Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive less dental services than the general population which causes more complex dental problems due to neglect of addressing early problems. According to the Legislative Analyst's Office on Improving Access to Dental Services for Individuals with Developmental Disabilities,

"The oral health of individuals with developmental disabilities is worse on average than the oral health of the general population on several key factors. For example, they have higher rates and increased severity of periodontal disease, much higher rates of untreated cavities, and more missing and decaying teeth. (One study in Massachusetts found that patients with developmental disabilities average 6.7 missing teeth, whereas the Centers for Disease Control and Prevention estimate the general population averages 3.6 missing teeth.) Compared to the general population, patients with developmental disabilities are more likely to have missing teeth than to have teeth with fillings. This could be due, for example, to situations where their decaying teeth are more likely to be extracted than restored with fillings. Some oral health problems stem directly from the particular disability itself. For example, mouth breathing among individuals with Down syndrome can lead to a dry mouth, which makes it more difficult to wash away bacteria and can result in increased risk of gum disease."

Dentists and dental hygienists receive limited training in school and through continuing education courses on how to serve individuals with developmental disabilities. This contributes to the lack of access. According to a dental association, there are only 14 dental schools and surgery centers in California that can handle special needs patients.

A 2022 CalMatters article, "'Like Torture': For Californians with Special Needs, Getting to See a Dentist Can Take Years" by Kristen Hwang found that, "One of the primary reasons it's so difficult to find a dentist is that most don't accept Medi-Cal, the state health plan for its poorest residents, which a majority of people with disabilities rely on. In 2021, about 36% of active licensed dentists in the state accepted Medi-Cal."

According to the Author

"People with disabilities should have access to quality and timely dental care to prevent dental disease. Access to preventative dental care is critical for the prevention of chronic illness. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes. People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. [This bill] establishes the Oral Health for People with Disabilities Technical Assistance Center to provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood."

Arguments in Support

Supporters say, "It is part of a long history of changes, refinements, and reforms that have both directly and indirectly impacted our service system. This legislation will improve the lives of people with developmental disabilities and, by benefiting them, will also strengthen our overall service system."

Arguments in Opposition

None on file.

FISCAL COMMENTS

According to the Assembly Appropriations Committee on May 14, 2025:

DDS estimates total General Fund (GF) costs of approximately $566,000 in fiscal year (FY) 2026-27 and $2.8 million in FY 2027-28 and annually thereafter, as follows:

1. Regional center staffing costs of $708,000 ($494,000 GF) in FY 2026-27, and $1.4 million ($1.0 million GF) in FY 2027-28 for each of 10 regional centers to hire a full-time staff member to coordinate and carry out the dental-related activities and responsibilities set forth in the bill. DDS assumes a cost of approximately $142,000 ($99,000 GF) per regional center annually.
2. DDS staffing costs of approximately $90,000 ($72,000 GF) in FY 2026-27 and $172,000 ($138,000 GF) in FY 2027-28 and annually thereafter for one position at DDS to research and establish guidelines and regulations by July 1, 2027, and provide technical assistance to regional centers.
3. Contract costs of $1.7 million GF annually beginning in FY 2027-28 to contract with dental schools or universities.

VOTES

ASM HIGHER EDUCATION: 10-0-0

YES: Fong, DeMaio, Boerner, Jeff Gonzalez, Jackson, Muratsuchi, Patel, Celeste Rodriguez, Sharp-Collins, Tangipa

ASM HUMAN SERVICES: 7-0-0

YES: Lee, Castillo, Calderon, Elhawary, Jackson, Celeste Rodriguez, Tangipa

ASM APPROPRIATIONS: 14-0-1

YES: Wicks, Arambula, Calderon, Caloza, Dixon, Elhawary, Fong, Mark González, Hart, Pacheco, Pellerin, Solache, Ta, Tangipa

ABS, ABST OR NV: Sanchez

UPDATED

VERSION: May 1, 2025

CONSULTANT: Alexandria Smith / HUM. S. / (916) 319-2089 FN: 0000808

Date of Hearing: May 14, 2025

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

ABPCA Bill Id:AB 341

Author:(Arambula) – As Amended Ver:May 1, 2025

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

SUMMARY:

This bill requires the Department of Developmental Services (DDS) to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program (Program) to improve dental care services for people with developmental and intellectual disabilities.

Among its provisions, this bill:

1. Requires DDS, by July 1, 2027, to contract with a California dental school or college to administer the Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
2. Specifies the contracted California dental school or college may partner with a public dental school or college. The contracted school or resulting partnership must collectively meet the following:
3. Be located in the state and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.
4. Have lead faculty with a demonstrated record of working with multiple regional centers in the state in programs that have successfully developed and implemented community-based dental care programs, as specified.
5. In administering the Program, requires the contract school or partnership to identify up to 10 regional centers to participate in the Program, provide practical experience and expertise, provide initial and ongoing training and support for participating regional center personnel, and collect and analyze program data, among other duties.
6. Requires DDS to submit to the Legislature an annual report of the data described in item 3, above.
7. Requires a participating regional center to designate a lead person with responsibility for duties related to the Program, establish vendor agreements with interested oral health professionals, identify regional center consumers who can benefit from the Program, collect and store information necessary for a referral to a participating oral health professional, provide referrals, and monitor patient activity and progress, as specified.
8. Requires DDS to provide guidance and technical assistance to regional centers on payment processes and the vendorization process for dental professionals, among other items.

FISCAL EFFECT:

DDS estimates total General Fund (GF) costs of approximately $566,000 in fiscal year (FY) 2026-27 and $2.8 million in FY 2027-28 and annually thereafter, as follows:

1. Regional center staffing costs of $708,000 ($494,000 GF) in FY 2026-27, and $1.4 million ($1.0 million GF) in FY 2027-28 for each of 10 regional centers to hire a full-time staff member to coordinate and carry out the dental-related activities and responsibilities set forth in the bill. DDS assumes a cost of approximately $142,000 ($99,000 GF) per regional center annually.
2. DDS staffing costs of approximately $90,000 ($72,000 GF) in FY 2026-27 and $172,000 ($138,000 GF) in FY 2027-28 and annually thereafter for one position at DDS to research and establish guidelines and regulations by July 1, 2027, and provide technical assistance to regional centers.
3. Contract costs of $1.7 million GF annually beginning in FY 2027-28 to contract with dental schools or universities.

COMMENTS:

1. Purpose. According to the author:

People with disabilities should have access to quality and timely dental care to prevent dental disease. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes. People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care.

1. Background. The Lanterman Developmental Disabilities Act provides entitlement to services and supports for individuals three years of age and older who have a qualifying developmental disability, including autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a substantial disability that began before they reached 18 years of age and is expected to be lifelong. There are no income-related eligibility criteria. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities, that contract with DDS to carry out many of the state’s responsibilities. As of August 2023, the 21 regional centers serve 459,395 consumers.

Dental services are coordinated through regional centers similar to other services. Most regional centers employ a dental coordinator who is responsible for expanding the network of dental providers willing to serve DDS consumers, assisting providers with the Medi-Cal Dental Program administration, conducting consumer case reviews, assisting individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

1. Arguments in Support. The California Dental Association, writes in support:

Access to care for patients with special health care needs continues to be an unnecessary challenge, as only a few settings can provide care for this patient population. Many settings, including dental schools, have exceptionally long wait times, even a year or more, which often require families to travel for hours to clinics just to receive routine care. While there needs to be more physical settings with the infrastructure to treat this population, more training and educational material also needs to be available for dental providers to ensure that wait times can be reduced. Depending on the severity of the disability, daily health care routines can be a challenge to complete and even diagnosing dental conditions may require some level of stabilization or sedation.

1. Prior Legislation. AB 2510 (Arambula), of the 2023-24 Legislative Session, was substantially similar to this bill, but contained a five-year sunset date. AB 2510 was held on this committee’s suspense file.

Analysis Prepared by: Jennifer Swenson / APPR. / (916) 319-2081

Date of Hearing: April 29, 2025

ASSEMBLY COMMITTEE ON HUMAN SERVICES

Alex Lee, Chair

ABPCA Bill Id:AB 341 (

Author:Arambula) – As Introduced Ver:January 28, 2025

SUBJECT: Oral Health for People with Disabilities Technical Assistance Center Program

SUMMARY: Requires the Department of Developmental Services (DDS) to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program (Program) to improve dental care services for people with developmental and intellectual disabilities. Specifically, this bill:

1. Specifies that, by July 1, 2027, DDS must contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program. The purpose of the Program is to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
2. Specifies that the contracted California dental school or college may partner with a public or private dental school or college. The contracted school or resulting partnership must collectively meet both of the following qualifications:
   1. All partner public or private schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association; and,
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings;
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia; and,
      3. Demonstrated improved oral health in community settings as the result of meeting the achievements, as described in i) and ii) above.
3. Requires that, in administering the Program, the contracted school or partnership must do all of the following:
   1. Identify up to 10 regional centers to participate in the program;
   2. Provide practical experience, systems development, and expertise in relevant subject areas;
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center;
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel;
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel;
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel;
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center;
   8. Organize and direct a statewide advisory committee and learning community; and,
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
4. Specifies that DDS must submit to the Legislature an annual report of the data in 3) i) above.
5. Declares that, to implement this section, DDS may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to these provisions are exempt from specified provisions in existing law related to the California State Contracts Register, contracting by state agencies, and the review or approval of the Department of General Services.
6. Requires participating regional centers to have the following program responsibilities:
   1. Designate a lead person at each regional center with responsibility for duties related to the program;
   2. Establish vendor agreements with interested oral health professionals;
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future;
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional;
   5. Facilitate referrals to participating oral health professionals; and,
   6. Monitor program and individual patient activity and progress.
      
7. Requires DDS to do all of the following:
   1. Establish procedures for regional center directors, or their designees, to participate in the program;
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments;
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments; and,
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals.
8. Authorizes DDS to consult and share information with other state entities, as necessary.
9. Authorizes DDS to adopt regulations as necessary to implement this bill.

EXISTING LAW:

1. Establishes an entitlement to services for individuals with developmental disabilities under the Lanterman Developmental Disabilities Services Act (Lanterman Act). (Welfare and Institutions Code [WIC] § 4500 et seq.)
2. Grants all individuals with developmental disabilities, among all other rights and responsibilities established for any individual by the United States Constitution and laws and the California Constitution and laws, the right to treatment and habilitation services and supports in the least restrictive environment. (WIC § 4502)
3. Establishes a system of nonprofit regional centers throughout the state to identify needs and coordinate services for eligible individuals with developmental disabilities and requires DDS to contract with regional centers to provide case management services and arrange for or purchase services that meet the needs of individuals with developmental disabilities, as defined. (WIC § 4620 et seq.)

FISCAL EFFECT: Unknown, this bill has not been analyzed by a fiscal committee.

COMMENTS:

Background: Lanterman Developmental Disabilities Act originally became statute in 1969. The Lanterman Act provides entitlement to services and supports for individuals three years of age and older who have a qualifying developmental disability. Qualifying disabilities include autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a disability that is substantial that began before they attained 18 years of age and is expected to be lifelong. There are no income‑related eligibility criteria. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities, that contract with DDS to carry out many of the state’s responsibilities.

As of August 2023, the 21 regional centers served 459,395 consumers, providing services such as: information and referral; assessment and diagnosis; counseling; lifelong individualized planning and service coordination; purchase of necessary services included in the individual program plan (IPP); resource development; outreach; assistance in finding and using community and other resources; advocacy for the protection of legal, civil, and service rights; early intervention services for at risk infants and their families; genetic counseling; family support; planning, placement, and monitoring for 24-hour out-of-home care; training and educational opportunities for individuals and families; and, community education about developmental disabilities. Regional centers services vary at each location. One location might offer one program and the next might offer what they consider an alternative or offer nothing comparable. Geographically, regional centers’ spending also varies.

Dental Care for Individuals with Developmental Disorders. Dental services are coordinated through regional centers just like other services. Most regional centers employ a “dental coordinator.” Dental coordinators are responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with the Medi-Cal Dental Program administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive less dental services than the general population which causes more complex dental problems due to neglect of addressing early problems. According to the Legislative Analyst’s Office on Improving Access to Dental Services for Individuals with Developmental Disabilities,

“The oral health of individuals with developmental disabilities is worse on average than the oral health of the general population on several key factors. For example, they have higher rates and increased severity of periodontal disease, much higher rates of untreated cavities, and more missing and decaying teeth. (One study in Massachusetts found that patients with developmental disabilities average 6.7 missing teeth, whereas the Centers for Disease Control and Prevention estimate the general population averages 3.6 missing teeth.) Compared to the general population, patients with developmental disabilities are more likely to have missing teeth than to have teeth with fillings. This could be due, for example, to situations where their decaying teeth are more likely to be extracted than restored with fillings. Some oral health problems stem directly from the particular disability itself. For example, mouth breathing among individuals with Down syndrome can lead to a dry mouth, which makes it more difficult to wash away bacteria and can result in increased risk of gum disease.”

Dentists and dental hygienists receive limited training in school and through continuing education courses on how to serve individuals with developmental disabilities. This contributes to the lack of access. According to a dental association, there are only 14 dental schools and surgery centers in California that can handle special needs patients.

A 2022 CalMatters article, “‘Like Torture’: For Californians with Special Needs, Getting to See a Dentist Can Take Years” by Kristen Hwang found that, “One of the primary reasons it’s so difficult to find a dentist is that most don’t accept Medi-Cal, the state health plan for its poorest residents, which a majority of people with disabilities rely on. In 2021, about 36% of active licensed dentists in the state accepted Medi-Cal.”

Author’s Statement: According to the Author, “People with disabilities should have access to quality and timely dental care to prevent dental disease. Access to preventative dental care is critical for the prevention of chronic illness. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes. People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. [This bill] establishes the Oral Health for People with Disabilities Technical Assistance Center to provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood.”

Double referral: For timing purposes, this bill was previously heard in the Assembly Committee on Higher Education on April 8, 2025, and was approved on a 10-0 vote.

Equity Implications: Dental health and oral hygiene are important at all stages of life since they support human functions like breathing, speaking, and eating. Poor dental health can lead to infections in the bloodstream and heart disease. This bill is attempting to create equity by considering the special needs of someone with a developmental disability.

Amendments: The Author has agreed to take the following amendments:

(b) The contracted California dental school or college may partner with a public or private dental school or college. The contracted school or resulting partnership shall collectively meet both of the following qualifications:

(1) All partner public or private schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association.

RELATED AND PRIOR LEGISLATION:

AB 2510 (Arambula) of 2024, was substantially similar to this bill. AB 2510 was held on the Assembly Committee on Appropriations suspense file.

AB 649 (Wilson) of 2023, would have permitted regional centers to purchase services that would otherwise be available from other specified means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 was held on the Assembly Committee on Appropriations suspense file.

AB 1957 (Wilson), Chapter 314, Statutes of 2022, added additional data points to the set of data that DDS and regional centers must report. These additional data mostly relate to services that were cut during the pandemic and recently restored, including social recreation, camping, educational services, and nonmedical therapies such as art, dance, and music. AB 1957 also added untimely translations of an IPP in a threshold language to be included in the set of data.

AB 1 X2 (Thurmond), Chapter 3, Statutes of 2016, second extraordinary session, authorized the Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.

REGISTERED SUPPORT / OPPOSITION:

Support

The Arc and United Cerebral Palsy California Collaboration (Sponsor)

Association of Regional Center Agencies

California Association of Orthodontists

California Dental Association

California Dental Hygienists' Association

California Disability Services Association

Children's Choice Dental Care

Pediatric Day Health Care Coalition

Opposition

None on file.

Analysis Prepared by: Alexandria Smith / HUM. S. / (916) 319-2089

Date of Hearing: April 8, 2025

ASSEMBLY COMMITTEE ON HIGHER EDUCATION

Mike Fong, Chair

ABPCA Bill Id:AB 341 (

Author:Arambula) – As Introduced Ver:January 28, 2025

[Note: This bill is double-referred to the Assembly Committee on Human Services and will be heard by that Committee as it relates to issues under its jurisdiction.]

SUBJECT: Oral Health for People with Disabilities Technical Assistance Center Program

SUMMARY: Requires the Department of State Department of Developmental Services (DDS) to contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia. Specifically, this bill:

1. Specifies that, by July 1, 2027, DDS must contract with a public California dental school or college to administer the Oral Health for People with Disabilities Technical Assistance Center Program. The purpose of the program is to improve dental care services for people with developmental and intellectual disabilities by reducing or eliminating the need for dental treatment using sedation and general anesthesia.
2. Specifies that the contracted California dental school or college may partner with a public or private dental school or college. The contracted school or resulting partnership must collectively meet both of the following qualifications:
   1. All partner public or private schools shall be located in California and be approved by the Dental Board of California or the Commission on Dental Accreditation of the American Dental Association; and,
   2. Lead faculty at one or more schools shall demonstrate having developed and implemented at regional centers, community-based dental care programs that have achieved all of the following:
      1. Successfully used teledentistry-supported systems to bring dental care to people with developmental disabilities in community settings;
      2. Successfully reduced the number of people needing dental care using sedation or general anesthesia; and,
      3. Demonstrated improved oral health in community settings as the result of meeting the achievements, as described in i) and ii) above.
3. Requires that, in administering the Oral Health for People with Disabilities Technical Assistance Center Program, the contracted school or partnership must do all of the following:
   1. Identify up to 10 regional centers to participate in the program;
   2. Provide practical experience, systems development, and expertise in relevant subject areas;
   3. Enlist dental offices and clinics to participate and establish teams of community-based allied personnel and dentists to work with each participating regional center;
   4. Design, implement, and support customized operational systems in each community in conjunction with the local oral health community and regional center personnel;
   5. Provide initial and ongoing training, monitoring, and support for participating oral health personnel, including, but not limited to, dental offices and clinics, and dentists and allied dental personnel;
   6. Provide initial and ongoing training, monitoring, and support for participating regional center personnel;
   7. Monitor and support the ongoing improvement and sustainability of operational systems at each regional center;
   8. Organize and direct a statewide advisory committee and learning community; and,
   9. Collect and analyze program data with the support of participating regional centers and oral health providers.
4. Specifies that DDS must submit to the Legislature an annual report of the data, as specified.
5. Declares that, to implement this section, DDS may enter into exclusive or nonexclusive contracts, or amend existing contracts, on a bid or negotiated basis. Contracts entered into or amended pursuant to this subdivision are exempt from specified provisions.
6. Requires participating regional centers to have the following program responsibilities:
   1. Designate a lead person at each regional center with responsibility for duties related to this provision;
   2. Establish vendor agreements with interested oral health professionals;
   3. Identify people with intellectual and developmental disabilities who can benefit from the program, especially those who are already experiencing long wait times for dental care using sedation or general anesthesia, or those who are likely to experience long wait times in the future;
   4. Collect and store social, medical, and consent history and information necessary for a referral to a participating oral health professional;
   5. Facilitate referrals to participating oral health professionals; and,
   6. Monitor program and individual patient activity and progress.
7. Requires DDS to do all of the following:
   1. Establish procedures for regional center directors, or their designees, to participate in the program;
   2. Provide guidance and establish protocols to support the program, including detailed clarification of payment for the various components of the program, workflow, and purchase-of-service authorizations and payments;
   3. Provide guidance for regional centers regarding the use of specialized therapeutic services payments;
   4. Provide guidance and technical assistance for regional centers to streamline the vendorization process for dental professionals; and,
8. Authorizes DDS to consult and share information with other state entities, as necessary.
9. Authorizes DDS to adopt regulations as necessary to implement this article.
10. Finds and declares that:
    1. People with intellectual and developmental disabilities are often referred for dental treatment that relies on the use of sedatives and general anesthesia. This leads to longer wait times and increased costs. Because of this, people with intellectual and developmental disabilities are more likely to lack access to dental care and are disproportionately at risk of developing chronic dental illnesses.
    2. Chronic conditions associated with delayed dental care include depression, cardiovascular disease, respiratory infection, and adverse pregnancy outcomes.
    3. New developments in dental materials, dental procedures, and dental treatment delivery systems have created alternatives to the use of sedation and general anesthesia for people with intellectual and developmental disabilities. These improvements can reduce risk, wait times, and cost, which all improve patient outcomes.
    4. Unfortunately, these alternatives are not widely available to those in need because of a lack of trained practitioners, policy barriers, and systemic deficiencies in payment and other support systems for practitioners who otherwise might provide care to this vulnerable population.

EXISTING LAW:

1. Establishes an entitlement to services for individuals with developmental disabilities under the Lanterman Developmental Disabilities Services Act (Lanterman Act). (Welfare and Institutions Code (WIC) Section 4500 et seq.)
2. Grants all individuals with developmental disabilities, among all other rights and responsibilities established for any individual by the United States Constitution and laws and the California Constitution and laws, the right to treatment and habilitation services and supports in the least restrictive environment. (WIC Section 4502)
3. Establishes a system of nonprofit regional centers throughout the state to identify needs and coordinate services for eligible individuals with developmental disabilities and requires DDS to contract with regional centers to provide case management services and arrange for or purchase services that meet the needs of individuals with developmental disabilities, as defined. (WIC Section 4620 et seq.)

FISCAL EFFECT: Unknown

COMMENTS: Purpose. According to the author, “people with disabilities should have access to quality and timely dental care to prevent dental disease. Access to preventative dental care is critical for the prevention of chronic illness. Deferred or avoided oral health treatment is linked not only to tooth decay, but depression, cardiovascular disease, diabetes, respiratory infection, and adverse pregnancy outcomes.”

“People with complex medical, physical, cognitive, or behavioral health challenges are the most vulnerable to delayed dental care. These people often require extra time and attention for routine and preventative care. Unfortunately, there are not enough oral health providers with the expertise to serve these patients effectively. This has led many people with disabilities to be placed on waitlists that are months or years long or to simply go without routine dental care. AB 341 establishes the Oral Health for People with Disabilities Technical Assistance Center to provide training and educational materials to expand the use of alternative methods for providing oral health services for people with disabilities that are not currently widely understood”

Background. The Lanterman Developmental Disabilities Act (Lanterman Act) originally became statute in 1969. The Lanterman Act provides entitlement to services and supports for individuals three years of age and older who have a qualifying developmental disability. Qualifying disabilities include autism, epilepsy, cerebral palsy, intellectual disabilities, and other conditions closely related to intellectual disabilities that require similar treatment. To qualify, an individual must have a disability that is substantial that began before they attained 18 years of age and is expected to be lifelong. There are no income-related eligibility criteria. Direct responsibility for implementation of the Lanterman Act’s service system is shared by DDS and a statewide network of 21 regional centers, which are private, community-based nonprofit entities, that contract with DDS to carry out many of the state’s responsibilities.

As of August 2023, the 21 regional centers served 459,395 consumers, providing services such as: information and referral; assessment and diagnosis; counseling; lifelong individualized planning and service coordination; purchase of necessary services included in the individual program plan (IPP); resource development; outreach; assistance in finding and using community and other resources; advocacy for the protection of legal, civil, and service rights; early intervention services for at risk infants and their families; genetic counseling; family support; planning, placement, and monitoring for 24-hour out-of-home care; training and educational opportunities for individuals and families; and, community education about developmental disabilities. Regional centers services vary at each location. One location might offer one program and the next might offer what they consider an alternative or offer nothing comparable. Geographically, regional centers’ spending also varies.

Dental Care for Individuals with Developmental Disorders. Dental services are coordinated through regional centers just like other services. Most regional centers employ a “dental coordinator.” Dental coordinators are responsible for expanding the network of dental providers willing to serve DDS consumers, helping providers with the Medi-Cal Dental Program (Denti‑Cal) administration, conducting consumer case reviews, helping individual consumers find providers, training consumers and residential care providers on oral hygiene, and coordinating desensitization.

Regional center consumers receive less dental services than the general population which causes more complex dental problems due to neglect of addressing early problems. Dentists and dental hygienists receive limited training in school and through continuing education courses on how to serve individuals with developmental disabilities. This contributes to the lack of access.

According to a dental association, there are only 14 dental schools and surgery centers in California that can handle special needs patients.

Arguments in support. According to the California Dental Association, “in recent years, California has made significant progress on improving access to oral health care, including investments in Medi-Cal Dental to support provision of care to special needs patients and increased access to sedation. Recently awarded grants approved in the 2022 state budget are a historic investment that will help establish more settings able to provide care for patients with special health care needs. Despite these recent investments, access to care for patients with special health care needs continues to be an unnecessary challenge. Many settings, including dental schools, have exceptionally long wait times, even a year or more, which often require families to travel for hours to clinics just to receive routine care.”

“While there needs to be more physical settings with the infrastructure to treat this population, more training and educational material also needs to be available for dental providers to ensure that waiting times can be reduced. Depending on the severity of the disability, daily health care routines can be a challenge to complete and even diagnosing dental conditions may require some level of stabilization or sedation.”

Prior legislation. AB 2510 (Arambula) of 2024, is substantively similar to this measure, and would have required (DDS) to contract with a dental school or college in the state, as specified, to establish a statewide program centered in the state’s regional centers. That legislation was held on suspense in the Assembly Committee on Appropriations.

AB 649 (Wilson) of 2023, would have permitted regional centers to purchase services that would otherwise be available from other specified means when a consumer or a consumer’s representative chooses not to pursue coverage despite eligibility. AB 649 was held on the Assembly Appropriations Committee suspense file.

AB 1957 (Wilson), Chapter 314, Statutes of 2022, added additional data points to the set of data that DDS and regional centers must report. These additional data mostly relate to services that were cut during the pandemic and recently restored, including social recreation, camping, educational services, and nonmedical therapies such as art, dance, and music. AB 1957 also added untimely translations of an IPP in a threshold language to be included in the set of data.

AB 1 X2 (Thurmond), Chapter 3, Statutes of 2016, second extraordinary session, authorized the

Service Access and Equity grant program through which $11 million in ongoing General Fund resources for DDS was provided to assist regional centers in reducing purchase of service disparities.

REGISTERED SUPPORT / OPPOSITION:

Support

Association of Regional Center Agencies

California Association of Orthodontists

California Dental Association

California Dental Hygienists' Association

California Disability Services Association

Children's Choice Dental Care

Pediatric Day Health Care Coalition

The Arc and United Cerebral Palsy California Collaboration

Opposition

None on file.

Analysis Prepared by: Kevin J. Powers / HIGHER ED. / (916) 319-3960