AMENDED IN ASSEMBLY OCTOBER 20, 2004
AMENDED IN SENATE OCTOBER 19, 2004
SENIOR SENATE PROPOSAL NO. 5
INTRODUCED BY SENIOR SENATOR WRIGHT
(COAUTHORS: SENATORS BLUME AND DENNISON)
(COAUTHOR: ASSEMBLY MEMBER JOHNSTONE)
LEGISLATIVE COUNSEL'S DIGEST
SP 5: SKILLED 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 PRESCREENING REPORT, CONDUCTED BY A LICENSED DENTIST, REGISTERED DENTAL HYGIENIST, 3RD OR 4TH YEAR DENTAL STUDENT BEING SUPERVISED BY A LICENSED DENTIST, OR A DENTAL HYGIENIST IN TRAINING SUPERVISED BY A LICENSED DENTIST OR REGISTERED DENTAL HYGIENIST, BE INCLUDED AS PART OF THE REPORTS FOR THE INTERDISCIPLINARY TEAM TO BE USED TO FORMULATE A PERSONALIZED TREATMENT PLAN FOR PROSPECTIVE RESIDENTS IN SKILLED NURSING FACILITIES.
VOTE: MAJORITY.
SP 5: RELATING TO SKILLED 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 LACK OF DENTAL INSURANCE COVERAGE AFTER OR AGE 65 YEARS, DELAYED OR ELIMINATED EXAMINATIONS ; 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, SENIORS AND INDIVIDUALS WITH DISABILITIES DUE TO CHRONIC ILLNESS ARE VERY FRAIL AND CANNOT EASILY BE TRANSPORTED TO DENTAL OFFICES FOR THE TREATMENT OP DENTAL PROBLEMS PRIOR TO THEIR ENTRY INTO SKILLED NURSING FACILITIES; AND
WHEREAS, AN INFECTION IN THE MOUTH CAN CAUSE CARDIAC PROBLEMS AND PREMATURE DEATH; 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, MALNUTRITION AND THE SIDE EFFECTS OF CERTAIN MEDICATIONS 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, IN-SERVICES BY CERTIFIED NURSE ASSISTANTS ARE REQUIRED,BY LICENSING LAWS AND CERTAIN IN-SERVICES COULD BE CONDUCTED BY REGISTERED DENTAL HYGIENISTS; 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; AND
WHEREAS, THIS PRESCREENING IS BOTH PREVENTIVE AND CONSIDERABLY LESS COSTLY THAN A TRIP TO THE EMERGENCY ROOM DUE TO AN EMERGENCY DENTAL PROBLEM. AT NORTHERN INYO HOSPITAL, BISHOP, THE COST WOULD BE $190 FOR BED AND DOCTOR PLUS ADDITIONAL COSTS FOR LAB WORK, CT SCAN, X-RAYS, AND POSSIBLY A REQUEST FOR AN ORAL SURGEON CONSULTATION. THESE COSTS FAR EXCEED THE INITIAL COST BY A DENTAL HYGIENIST OR A TRAINED ORAL HEALTH CARE PERSON; NOW, THEREFORE, BE IT
RESOLVED, BY THE SENIOR SENATE AND THE SENIOR ASSEMBLY, JOINTLY, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA AT ITS 2004 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT THE STATE DEPARTMENT OF HEALTH SERVICES REQUIRE THAT A DENTAL PRESCREENING REPORT, CONDUCTED BY A LICENSED DENTIST, REGISTERED DENTAL HYGIENIST, 3RD OR 4TH YEAR DENTAL STUDENT BEING SUPERVISED BY A LICENSED DENTIST, OR A DENTAL HYGIENIST IN TRAINING, SUPERVISED BY A LICENSED DENTIST OR REGISTERED DENTAL HYGIENIST, BE INCLUDED AS PART OF THE REPORTS FOR THE RESIDENT INTERDISCIPLINARY TEAM WHEN THE TEAM REVIEWS REPORTS AND FORMULATES PERSONALIZED TREATMENT PLANS FOR PROSPECTIVE RESIDENTS IN SKILLED NURSING FACILITIES THAT WILL INCLUDE ENSURING THAT THE RESIDENTS 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 OF THE STATE OF CALIFORNIA TO ENACT APPROPRIATE LEGISLATION WHICH 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.
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