AMENDED IN ASSEMBLY OCTOBER 21, 2003

SENIOR ASSEMBLY PROPOSAL NO.7

INTRODUCED BY SENIOR ASSEMBLY MEMBER WRIGHT

(COAUTHOR:  SENIOR ASSEMBLY MEMBER JOHNSTONE)

(COAUTHOR:  SENIOR SENATOR OWEN)

LEGISLATIVE COUNSEL'S DIGEST

AP 7: NURSING FACILITIES: DENTAL HYGIENE.

UNDER EXISTING LAW, THE STATE DEPARTMENT OF HEALTH SERVICES REGULATES THE LICENSURE AND OPERATION OF HEALTH FACILITIES INCLUDING SKILLED NURSING FACILITIES.  EXISTING REGULATIONS SPECIFY THE SERVICES REQUIRED TO BE PROVIDED TO PATIENTS IN SKILLED NURSING FACILITIES, INCLUDING REQUIRING ARRANGEMENTS TO BE MADE FOR AN ADVISORY DENTIST TO PARTICIPATE AT LEAST ANNUALLY IN THE FACILITY'S STAFF DEVELOPMENT PROGRAM FOR PATIENT CARE PERSONNEL AND TO APPROVE ORAL HYGIENE POLICIES AND PRACTICES FOR THE CARE OF PATIENTS.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD REQUIRE THE STATE DEPARTMENT OF HEALTH SERVICES TO REQUIRE THAT A DENTAL HYGIENIST PRESCREENING REPORT BE INCLUDED AS PART OF THE REPORTS FOR THE INTERDISCIPLINARY TEAM TO BE USED TO FORMULATE A PERSONALIZED TREATMENT PLAN FOR PROSPECTIVE RESIDENTS.

VOTE: MAJORITY.

AP 7: RELATING TO NURSING FACILITIES; DENTAL HYGIENE EXAMINATIONS

WHEREAS, TOOTH LOSS IS NOT AN INEVITABLE PROCESS OF AGING BUT RATHER THE RESULT OF ECONOMIC FACTORS SUCH AS THE LOSS OF DENTAL INSURANCE AT AGE 65 YEARS, DELAYED OR ELIMINATED EXAMINATIONS AND CLEANING, SIDE EFFECTS OF CERTAIN MEDICATIONS, OR NUTRITION DEFICIENCIES OR MALNUTRITION; AND

WHEREAS, 90 PERCENT OF ALL ORAL CANCERS OCCUR IN INDIVIDUALS 45 YEARS OF AGE AND OLDER, THE AVERAGE AGE OF THOSE INDIVIDUALS BEING IN THEIR 60'S; AND

WHEREAS, A DENTAL EXAMINATION WOULD DETECT THE PROBLEMS ASSOCIATED WITH ORAL CANCER; AND

WHEREAS, IT IS IMPORTANT THAT MUCOSA BE MAINTAINED INTACT AND FREE FROM CHRONIC IRRITATION; AND

WHEREAS, THESE SENIORS AND INDIVIDUALS WITH DISABILITIES DUE TO CHRONIC ILLNESS ARE VERY FRAIL AND CANNOT EASILY BE TRANSPORTED TO DENTAL OFFICES FOR THE TREATMENT OF DENTAL PROBLEMS PRIOR TO THEIR ENTRY INTO SKILLED NURSING FACILITIES; AND

WHEREAS, AN ORAL DISORDER MAY UNDERMINE SELF-IMAGE AND SELF-ESTEEM, DISCOURAGE NORMAL SOCIAL INTERACTION, AND LEAD TO A DIFFICULT TRANSITION INTO THE NURSING FACILITY; AND

WHEREAS, THE RESULT OF MALNUTRITION AND MEDICATION MAY PLACE THE ELDERLY AND INDIVIDUALS WITH DISABILITIES AT RISK FOR ADDITIONAL COMPLICATIONS SUCH AS PERIODONTAL DISEASE, PHYSICAL WEAKNESS, TOOTHACHES, INFECTIONS, AND THE INABILITY TO MASTICATE PROPERLY, AND THUS, THEY WILL CHOOSE SOFT FOODS OFTEN HIGH IN SUGAR AND CARBOHYDRATES; AND

WHEREAS, IF AN INITIAL MOUTH SCREENING IS DONE BY A TRAINED DENTAL HYGIENIST, AND REFERRED TO A DENTIST TO CORRECT THE PROBLEM DETECTED BY THE EVALUATION, THE RESIDENT'S LIFE WILL BE GREATLY IMPROVED; NOW, THEREFORE, BE IT

RESOLVED, BY THE SENIOR ASSEMBLY AND THE SENIOR SENATE, JOINTLY, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA AT ITS 2003 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT THE STATE DEPARTMENT OF HEALTH SERVICES REQUIRE A DENTAL HYGIENIST PRESCREENING REPORT BE INCLUDED AS PART OF THE REPORTS FOR THE RESIDENT INTERDISCIPLINARY TEAM WHEN THE TEAM REVIEWS REPORTS AND FORMULATES A PERSONALIZED TREATMENT PLAN FOR PROSPECTIVE RESIDENTS IN THE SKILLED NURSING FACILITIES AND TO ENSURE THAT THE RESIDENT WILL RECEIVE QUALITY ORAL HYGIENE; AND BE IT FURTHER

RESOLVED, THAT THE CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY, THE CALIFORNIA DEPARTMENT OF AGING, THE AMERICAN DENTAL HYGIENIST ASSOCIATION, THE DENTAL HYGIENIST REVIEW BOARD, AND OTHER DENTAL HYGIENIST ORGANIZATIONS ASSIST THE STATE DEPARTMENT OF HEALTH SERVICES IN DETERMINING THE REQUIREMENTS AND ACTION NECESSARY FOR THIS PROJECT; AND BE IT FURTHER

RESOLVED, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA RESPECTFULLY MEMORIALIZES THE LEGISLATURE AND THE GOVERNOR TO ENACT APPROPRIATE LEGISLATION THAT WOULD ADDRESS THE CONCERNS SET FORTH IN THIS MEASURE; AND BE IT FURTHER

RESOLVED, THAT A COPY OF THIS MEASURE BE TRANSMITTED TO THE SPEAKER OF THE ASSEMBLY, THE PRESIDENT PRO TEMPORE OF THE SENATE, AND THE GOVERNOR OF THE STATE OF CALIFORNIA.

RN0316386

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