CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Senate Bill
No. 889

Introduced by Senator Ochoa Bogh

January 31, 2022

An act to amend Section 2827 of, and to add Section 1646.14 to, the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 889, as introduced, Ochoa Bogh. Nurse anesthetists.
Existing law, the Dental Practice Act, establishes the Dental Board of California in the Department of Consumer Affairs for the licensure and regulation of dentists. The act governs, among other things, the use of general anesthesia and deep sedation, as defined, for adult patients and patients under 13 years of age. The act requires a dentist to possess either a current license in good standing and a general anesthesia permit or a general anesthesia permit together with a maxillofacial surgery permit or a special permit to administer general anesthesia or deep sedation on an outpatient basis for dental patients.
Existing law, the Nurse Anesthetists Act, provides for the certification and regulation of nurse anesthetists by the Board of Registered Nursing, which is within the Department of Consumer Affairs. Under existing law, the utilization of a nurse anesthetist to provide anesthesia services is required to be approved by the acute care facility administration and the appropriate committee, and at the discretion of the physician, dentist, or podiatrist. If a general anesthetic agent is administered in a dental office, existing law requires the dentist to hold a permit authorized by the provisions governing a dentist’s use of deep sedation and general anesthesia.
This bill would allow a nurse anesthetist to administer general anesthesia or deep sedation to dental patients if the nurse anesthetist receives a permit from the Dental Board of California. This bill would require that a nurse anesthetist, in order to administer deep sedation or general anesthesia, apply to the board and provide, among other things, evidence that the nurse anesthetist has met specified educational requirements. This bill would authorize the board to require an onsite inspection and evaluation prior to the issuance or renewal of a permit, and would require that a nurse anesthetist who fails that inspection and evaluation have their permit suspended, as specified. This bill would authorize a nurse anesthetist to apply to the board for an endorsement to perform general anesthesia or deep sedation on a child under 7 years of age.
This bill would also require a nurse anesthetist that is providing general anesthesia or deep sedation in a dental office to do so in accordance with the provisions of the Dental Practice Act that govern the use of general anesthesia or deep sedation in a dental office and in accordance with specified provisions of the Nursing Practice Act. By expanding the scope of existing crimes under the Dental Practice Act and the Nurse Anesthetists Act, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: YES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 2827 of the Business and Professions Code is amended to read:

2827.
 The utilization of a nurse anesthetist to provide anesthesia services in an acute care facility shall be approved by the acute care facility administration and the appropriate committee, and at the discretion of the physician, dentist or podiatrist. If a general anesthetic agent is administered in a dental office, the dentist shall hold a permit authorized by Article 2.7 (commencing with Section 1646) of Chapter 4 or, commencing January 1, 2022, Article 2.75 (commencing with Section 1646) of Chapter 4. General anesthesia or deep sedation administered in a dental office by a nurse anesthetist shall be in accordance with all of the following:
(a) Article 2.7 (commencing with Section 1646) of Chapter 4 or, commencing January 1, 2022, Article 2.75 (commencing with Section 1646) of Chapter 4.
(b) Paragraph (2) of subdivision (b) of Section 2725.

SEC. 2.

 Section 1646.14 is added to the Business and Professions Code, to read:

1646.14.
 (a) Notwithstanding any other law, including, but not limited to, Sections 1646.1 and 1647.2, a certified registered nurse anesthetist licensed pursuant to Article 2 (commencing with Section 2725) of Chapter 6 and certified as a nurse anesthetist pursuant to Article 7 (commencing with Section 2825) of Chapter 6 may administer general anesthesia or deep sedation in the office of a licensed dentist to dental patients without regard to whether the dentist possesses a permit issued pursuant to this article, if all of the following are met:
(1) The nurse anesthetist holds a valid general anesthesia permit issued by the Dental Board of California pursuant to subdivision (b).
(2) The nurse anesthetist meets the requirements of subdivision (d) of Section 1646.1
(b) A nurse anesthetist who desires to administer general anesthesia or deep sedation as set forth in subdivision (a) shall apply to the board on an application form prescribed by the board and shall submit all of the following:
(1) The payment of an application fee prescribed by this article.
(2) Evidence satisfactory to the board and the Board of Registered Nursing showing that the applicant has successfully completed an accredited program pursuant to subdivision (b) of Section 2826.
(3) Documentation demonstrating that all equipment and drugs required by the board are on the premises for use in any dental office in which the nurse anesthetist administers general anesthesia or deep sedation.
(c) Prior to issuance or renewal of a permit pursuant to this section, the board may, at its discretion, require an onsite inspection and evaluation of the facility, equipment, and personnel, including, but not limited to, the certified registered nurse anesthetist and procedures utilized. At least one of the people evaluating the procedures utilized by the nurse anesthetist shall be a certified registered nurse anesthetist expert in outpatient general anesthesia or deep sedation who has been authorized or retained under contract by the board for this purpose.
(d) A nurse anesthetist who has failed an onsite inspection and evaluation shall have their permit suspended automatically for 30 days after the date on which the board notifies the nurse anesthetist of the failure unless within that time period the nurse anesthetist has retaken and passed an onsite inspection and evaluation. A nurse anesthetist who is issued a permit under this article shall be subject to an onsite inspection and evaluation at least once every five years. Refusal to submit to an inspection shall result in automatic denial or revocation of the permit.
(e) A nurse anesthetist who additionally meets the requirements of paragraphs (2) and (3) of subdivision (c) of Section 1646.2 may apply to the board for a pediatric endorsement to provide general anesthesia or deep sedation to a child under seven years of age. A nurse anesthetist without sufficient cases to obtain a pediatric endorsement may qualify for the endorsement pursuant to the requirements of subdivision (d) of Section 1646.2.

SEC. 3.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.