AMENDED IN SENIOR SENATE OCTOBER 16, 2006

SENIOR SENATE PROPOSAL NO. 18

INTRODUCED BY SENIOR SENATOR WRIGHT

(COAUTHOR: SENIOR ASSEMBLY MEMBER JOHNSTONE)

LEGISLATIVE COUNSEL’S DIGEST

SP 18: ORAL HEALTH IN NURSING HOMES.

UNDER EXISTING LAW, INDIVIDUALS ENTERING NURSING HOMES ARE PROVIDED AN ASSESSMENT THROUGH A MINIMUM DATA SET (MDS) OF VARIOUS ASPECTS OF THEIR HEALTH STATUS, INCLUDING THEIR ORAL AND DENTAL STATUS, AND THESE ASSESSMENTS ARE MADE AVAILABLE TO THE STATE DEPARTMENT OF HEALTH SERVICES FOR REVIEW.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD REQUIRE THE DIRECTOR OF NURSING TO REVIEW THIS COMPONENT OF THE MDS ON A QUARTERLY BASIS, AND ASCERTAIN THAT THE ORAL HEALTH COMPONENT OF THE MDS FORM HAS BEEN PROPERLY COMPLETED AND THAT APPROPRIATE REFERRALS TO DENTAL HEALTH PROFESSIONALS ARE MADE.

VOTE: MAJORITY.

SP 18: RELATING TO ORAL HEALTH IN NURSING HOMES

WHEREAS, TOOTH LOSS IS NOT AN INEVITABLE PROCESS OF AGING, BUT RATHER CAN BE THE RESULT OF ECONOMIC FACTORS SUCH AS THE LOSS OF DENTAL INSURANCE AT AGE 65 YEARS OR DELAYED OR ELIMINATED PREVENTIVE REGIMENS OF EXAMINATIONS AND CLEANING, OR AN INDIVIDUAL’S SYSTEMIC PROBLEMS, CERTAIN MEDICATIONS, NUTRITION DEFICIENCIES, OR DEHYDRATION; AND

WHEREAS, INFECTIONS DUE TO DECAYED TEETH CAN ALSO CAUSE CARDIOVASCULAR PROBLEMS; AND

WHEREAS, NINETY PERCENT OF ALL ORAL CANCERS OCCUR IN INDIVIDUALS AGED 45 YEARS AND OLDER, THE AVERAGE BEING IN THEIR 60S, SO THAT AN ACCURATE DENTAL EXAMINATION WOULD DETECT THE PROBLEM AND TREATMENT CAN BE STARTED, WHILE IF THE CANCER IS NOT DETECTED TN TIME, IT CAN MEAN PREMATURE DEATH; AND

WHEREAS, AN ORAL DISORDER CAN UNDERMINE SELF-IMAGE AND SELF-ESTEEM, DISCOURAGE NORMAL INTERACTION, AND IN THE CASE OF AN INDIVIDUAL ENTERING A NURSING HOME, CAN LEAD TO A POOR AND DIFFICULT ADJUSTMENT TO THE NURSING HOME COMPOUNDED BY CLINICAL DEPRESSION; AND

WHEREAS, AT THE TIME AN INDIVIDUAL ENTERS A NURSING HOME, A MINIMUM DATA SET (MDS), VERSION 2.0 IS COMPLETED, WHICH IS A NURSING HOME RESIDENT ASSESSMENT AND CARE SCREENING, BASIC ASSESSMENT TRACKING FORM; AND

WHEREAS, SECTION L OF THIS TRACKING FORM PERTAINS TO THE INDIVIDUAL’S “ORAL/DENTAL STATUS,” WHICH LISTS VARIOUS POSSIBLE CONDITIONS OF THE INDIVIDUAL’S MOUTH; AND

WHEREAS, THE FORM COMPLETED BY THE NURSING HOME STAFF DOES NOT ALWAYS REFLECT THE CONDITION OF THE PERSON’S MOUTH; AND

WHEREAS, DEPRIVATION OF OR FAILURE TO PROVIDE GOODS OR SERVICES NECESSARY TO AVOID PHYSICAL HARM BY A CARE CUSTODIAN CONSTITUTES ELDER ABUSE UNDER STATE LAW; 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 2006 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT THE DIRECTOR OF NURSING SHALL CONSIDER A PATIENT’S ORAL EXAMINATION AS IMPORTANT AS THE PHYSICAL EXAMINATION WHEN REVIEWING A NURSING HOME’S MDS, AND EXAMINE ORAL HEALTH COMPONENTS OF THE MDS ON A QUARTERLY BASIS, INCLUDING REVIEWS OF PREVIOUS ACTIONS CHECKED AGAINST A PATIENT’S CHART WHEN NECESSARY; AND BE IT FURTHER

RESOLVED, THAT THE LICENSING AND CERTIFICATION SURVEYORS ASCERTAIN THAT THE ORAL HEALTH COMPONENT OF THE MDS FORM HAS BEEN PROPERLY COMPLETED, AND THAT A REFERRAL TO A REGISTERED DENTAL HYGIENIST OR DENTIST HAS BEEN MADE WHEN APPROPRIATE, AND IF A PROPER REFERRAL HAS NOT BEEN MADE, REPORT THE FAILURE AS AN INCIDENT OF ELDER ABUSE, TO BE DOCUMENTED IN THE PATIENT’S CHART; 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 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.

RN20061897507

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