This training guides staff through the state and HIPAA requirements for providing access. Instructions on staff presentation are included.

Considerations when leasing office space. Contracts will include both assets and liabilities that will govern your tenancy, poorly negotiated leases could have negative financial impact on a practice.

Overview of requirement and related CDC recommendations. Cal/OSHA requires employers to offer certain employees the hepatitis B vaccination series and post-vaccination testing.

Best practices for working with outside vendors for your business. Dentists should analyze contracts closely during the negotiation process to make sure they know exactly what they are committing to.

The State of California requires in rooms where X-ray equipment is used posting a sign (that may include the radiation symbol) stating: CAUTION X-RAYS. This sample sign may be used.

These instructions should be provided to employees and must be available when a dental practice is inspected by the Department of Public Health Radiologic Health Branch.

A form to document employee’s voluntary declaration of pregnancy and that employee has been informed of facts on occupational radiation exposure and other information.

A log and a form to assist the dental practice in gathering information on employee radiation exposure at other employers.

Dental practices using traditional film radiography must meet regulatory standards for quality assurance. This regulation summary includes a sample office policy and a template for a corrective actions log.

A list of best practices and information resources on managing amalgam waste.

Dental practices must provide a copy of the Dental Board-approved Dental Materials Fact Sheet to a patient or guardian at least once prior to performing a restorative procedure on that patient.

Document prescriber’s discussion with a minor and guardian on opioid risks prior to prescribing the medication in non-emergency circumstances.

Guidance for dentists looking to hire or become an associate. Hiring an associate will affect practice staff, the well-being of the business and the welfare of the patients. Take the time and research strategies prior to making any hiring decisions.

Before bringing an associate into the practice, take the time to carefully examine the basis for this decision and evaluate the possible limitations of adding another dentist.

Provides extensive questions and considerations to guide you through the interview and associate agreement process.

Dental facilities without amalgam separators on June 14, 2017, with exceptions, must install an amalgam separator by this date and comply with documentation requirements. Separators must be compliant with either the American National Standards Institute (ANSI) American National Standard/American Dental Association (ADA) Specification 108 for Amalgam Separators (2009) With Technical Addendum (2011) or the International Organization for Standardization (ISO) 11143 Standard (2008) or subsequent versions so long as that version requires amalgam separators to achieve at least a 95 percent removal efficiency.

Dentists who order or provide Medicare-covered items and services (clinical laboratory services, imaging services or durable medical equipment, prosthetics, orthotics and supplies) will need to either enroll in Medicare using form CMS-855-I (PDF) or the shorter enrollment form CMS-855-O (PDF) or formally opt out of Medicare by Jan. 1, 2019. To assure one's status with Medicare and that patients' Medicare benefits do not lapse, dentists should allow sufficient time for processing whichever form is submitted. Learn more about enrollment requirements by visiting the ADA’s Facts and FAQ on Medicare.

See the IRS’s press release. For business expense reimbursement, the 2019 rate is $0.58 per mile. That’s up $0.035 from last year. California employers need to reimburse such common expenses as work-related travel, dining expenses and mileage when an employee uses a personal car for work-related business. However, employees who can prove they spend more than $0.58 per mile to operate their personal vehicles for business use may be entitled to reimbursement of the actual expense. It’s up to the employees to prove their expenses, however.

The new law amends the Labor Code to specify that an employer may now ask for an applicant’s salary expectations for the position being applied for, only external applicants (not current employees) and are entitled to request a pay scale for the position they are applying for, but only after completing an initial interview. The pay scale provided only needs to include salary and hourly wage ranges. AB 2282

Section 1031 of the Labor Code has now been updated to specify that employers should provide a location other than a bathroom. Employers must make reasonable efforts to provide the employee the use of a room, other than a bathroom, in close proximity to the employees work area to express milk in private. Employers should update their employee policy to reflect the new
lactation accommodation requirements. Sample Employee Manual (Doc)

The minimum wage for a large employer with 26 or more employees in California will increase from $11 per hour to $12 per hour, and employers with 25 or fewer employees will increase from $10.50 per hour to $11 per hour on Jan. 1, 2019. Some cities and counties have their own ordinances beyond what is required by state law, with more expected to follow. CDA provides a guide to minimum wage ordinances by city and county and employers are advised to check with their local jurisdictions to ensure they are in compliance.

When performing procedures on exposed dental pulp, water or other methods used for irrigation must be “sterile or contain recognized disinfecting or antibacterial properties.”

As of Jan. 1, 2019, a prescriber must offer a patient a prescription for naloxone hydrochloride or other FDA-approved drugs for the complete or partial reversal of opioid depression when one or more of the following conditions are present:

1. The prescription dosage for the patient is 90 or more morphine milligrams equivalent of an opioid medication per day. (See this CDC document on how to calculate MME.)
2. Opioid medication is prescribed concurrently with a prescription for benzodiazepine.
3. The patient presents with an increased risk for overdose, including a patient with a history of overdose, a patient with a history of substance use disorder or a patient at risk for returning to a high dose of opioid medication to which the patient is no longer tolerant.

Additionally, a prescriber must provide education to a patient, or the patient’s guardian if the patient is a minor, receiving a prescription per the above circumstance on overdose prevention and the use of naloxone hydrochloride or other FDA-approved drugs for the complete or partial reversal of opioid depression. AB 2760

Beginning Jan. 1, 2019, a prescriber is required to discuss the following with a minor or the minor’s parent or guardian before issuing the first opioid prescription in a single course of treatment:

1. The risks of addiction and overdose associated with the use of opioids.
2. The increased risk of addiction to an opioid to an individual suffering from both mental and substance-abuse disorders.
3. The danger of taking an opioid with benzodiazepine, alcohol or another central nervous system depressant.

A new informed consent form, Consent to Prescribe Opioid to a Minor, (Spanish version) has been developed and is available on the TDIC and CDA Practice Support websites.

SB 1109  requires a warning notice be prominently displayed on the label or container of an opioid dispensed to a patient for outpatient use. The notice must state: "Caution. Opioid. Risk of overdose and addiction." The law requires the notice be displayed "by means of a flag or other notification mechanism attached to the container."

As announced by the Department of Justice in April 2018, California’s Controlled Substance Utilization Review and Evaluation System (CURES 2.0) is ready for statewide consultation by prescribers. As of Oct. 2, 2018, prescribers must check a patient’s prescription history in CURES 2.0 before prescribing a Schedule II-IV substance, with some specific exceptions. Refer to CDA’s article on mandatory checks for information on the exception applicable to some dentists. Prescribers who have issues accessing CURES can email the DOJ or call 916.210.3187.