Bill Text: CA SB652 | 2021-2022 | Regular Session | Amended
Bill Title: Dentistry: use of sedation: training.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2022-05-05 - Referred to Com. on B. & P. [SB652 Detail]
Download: California-2021-SB652-Amended.html
|
Amended
IN
Senate
May 11, 2021 |
|
Amended
IN
Senate
April 12, 2021 |
| Introduced by Senator Bates |
February 19, 2021 |
LEGISLATIVE COUNSEL'S DIGEST
Existing law, commencing on January 1, 2022, authorizes a dentist to administer or order the administration of moderate sedation on an outpatient basis for a dental patient if specified conditions are met. Existing law specifies additional requirements if the patient is under 13 years of age, including that there be at least 2 support personnel in addition to the operating dentist present at all times during the procedure and that the
operating dentist and one personnel member maintain current certification in PALS and airway management or other board-approved training.
This bill would also require, if the patient is 13 years of age or older, that there be at least 2 support personnel in addition to the operating dentist present at all times during the procedure and that the operating dentist and one personnel member maintain current certification in ACLS and airway management.
Existing law, commencing on January 1, 2022, requires a dentist who desires to administer or to order the administration of moderate sedation to apply to the board for a permit and produce evidence showing that they have successfully completed
training in moderate sedation that meets specified requirements.
This bill would require a permitholder to maintain current and continuous certification in ACLS and airway management.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
(a)A dentist shall possess either a current license in good standing and a general anesthesia permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia on an outpatient basis for dental patients.
(b)A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.
(c)A dentist shall be physically within the dental office at the time
of ordering, and during the administration of, general anesthesia or deep sedation.
(d)The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.
(e)If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:
(1)The operating dentist and at least one of the additional personnel shall maintain certification in one of the following:
(A)If the patient is under 13 years of age, certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted
pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.
(B)If the patient is 13 years of age or older, certification in Advanced Cardiac Life Support (ACLS). The additional personnel who is certified in ACLS and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor,
blood pressure, pulse, capnograph, and respiration monitoring devices.
(2)The operating dentist shall be responsible for initiating and administering any necessary emergency response.
(f)If a dedicated permitted anesthesia provider is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:
(1)The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in one of the following:
(A)If the patient is under 13 years of age, Pediatric Advanced Life Support (PALS) and airway management or other board-approved
training in pediatric life support and airway management, adopted pursuant to Section 1601.8.
(B)If the patient is 13 years of age or older, Advanced Cardiac Life Support
(ACLS).
(2)The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.
(g)This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.
(a)A dentist may administer or order the administration of moderate sedation on an outpatient basis for a dental patient if one of the following conditions is met:
(1)The dentist possesses a current license in good standing and either holds a valid general anesthesia permit or obtains a moderate sedation permit.
(2)The dentist possesses a current permit under Section 1638 or 1640 and either holds a valid general anesthesia permit or obtains a moderate sedation permit.
(b)A dentist shall obtain a pediatric endorsement on the moderate sedation permit prior to
administering moderate sedation to a patient under 13 years of age.
(c)(1)A dentist who orders the administration of moderate sedation shall be physically present in the treatment facility while the patient is sedated.
(2)There shall be at least two support personnel in addition to the operating dentist present at all times during the procedure involving moderate sedation.
(3) For patients under 13 years of age, the operating dentist and one personnel member shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The personnel
member with current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be dedicated to monitoring the patient during the procedure involving moderate sedation and may assist with interruptible patient-related tasks of short duration, such as holding an instrument.
(4)For patients 13 years of age or older, the operating dentist and one personnel member shall maintain current certification in Advanced Cardiac Life Support (ACLS). The personnel member with current certification in ACLS and
airway management shall be dedicated to monitoring the patient during the procedure involving moderate sedation and may assist with interruptible patient-related tasks of short duration, such as holding an instrument.
(d)A dentist with a moderate sedation permit or a moderate sedation permit with a pediatric endorsement shall possess the training, equipment, and supplies to rescue a patient from an unintended deeper level of sedation.
(e)This article shall not apply to the administration of local anesthesia, minimal sedation, deep sedation, or general anesthesia.
(a)A dentist who desires to administer or to order the administration of moderate sedation shall apply to the board on an application form prescribed by the board. The dentist shall submit an application fee and produce evidence showing that they have successfully completed training in moderate sedation that meets the requirements of subdivision (c).
(b)The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.
(c)Training in the administration of moderate sedation shall be acceptable if it meets all of the following as approved by the board:
(1)Consists of at least 60 hours of instruction.
(2)Requires satisfactory completion of at least 20 cases of administration of moderate sedation for a variety of dental procedures.
(3)Complies with the requirements of the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students of the American Dental Association, including, but not limited to, certification of competence in rescuing patients from a deeper level of sedation than intended, and managing the airway, intravascular or intraosseous access, and reversal medications.
(d)A dentist may apply for a pediatric endorsement for a moderate sedation permit by confirming all of the
following:
(1)Successful completion of residency in pediatric dentistry accredited by the Commission on Dental Accreditation (CODA) or the equivalent training in pediatric moderate sedation, as determined by the board.
(2)Successful completion of at least 20 cases of moderate sedation to patients under 13 years of age to establish competency in pediatric moderate sedation, both at the time of the initial application and at renewal. The applicant or permitholder shall maintain and shall provide proof of these cases upon request by the board for up to three permit renewal periods.
(3)In order to provide moderate sedation to children under seven years of age, a dentist shall establish and maintain current competency
for this pediatric population by completing 20 cases of moderate sedation for children under seven years of age in the 24-month period immediately preceding application for the pediatric endorsement and for each permit renewal period.
(4)Current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.
(e)A permitholder shall maintain current and continuous certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8, for the duration of the permit.
(f)A permitholder shall maintain current and continuous certification in Advanced Cardiac Life Support (ACLS) and airway management for the duration of the permit.
(g)Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of moderate sedation to patients under 13 years of age may administer moderate sedation to patients under 13 years of age under the direct supervision of a general anesthesia or moderate sedation permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 required in order to qualify for the applicant’s pediatric endorsement.
(h)Moderate sedation permit holders with a pediatric endorsement seeking to provide moderate sedation to children under seven years of age, but who lack sufficient cases of moderate sedation to patients under seven years of age pursuant to paragraph (3) of subdivision (d), may administer moderate sedation to patients under seven years of age under the direct supervision of a permitholder who meets those qualifications.
