By: Carona S.B. No. 539
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to regulating the enteral administration of anesthesia in
1-3 connection with the practice of dentistry.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 258, Occupations Code, is amended by
1-6 adding Subchapter D to read as follows:
1-7 SUBCHAPTER D. ENTERAL ADMINISTRATION OF ANESTHESIA
1-8 Sec. 258.151. DEFINITION. In this subchapter, "enteral"
1-9 means any technique of administering anesthesia in which the
1-10 anesthetic is absorbed through the gastrointestinal tract or oral
1-11 mucosa. Examples of enterally administering anesthesia include
1-12 administering an anesthetic orally, rectally, sublingually, or
1-13 intranasally.
1-14 Sec. 258.152. APPLICABILITY. Rules adopted by the board
1-15 under this subchapter do not apply to:
1-16 (1) the regional injection of an anesthetic to reduce
1-17 or eliminate sensation, especially pain, in one part of the body;
1-18 or
1-19 (2) the administration of anxiolytics and analgesics
1-20 that are not being used in conjunction with the administration of
1-21 nitrous oxide and that are administered in doses that do not have
1-22 the probability of placing the dental patient at risk for loss of
1-23 the dental patient's life-preserving protective reflexes.
1-24 Sec. 258.153. RULES. (a) The board shall establish by rule
1-25 the minimum standards for the enteral administration of anesthesia
2-1 by a dentist.
2-2 (b) The rules must be designed to protect the health,
2-3 safety, and welfare of the public and must include requirements
2-4 relating to:
2-5 (1) the methods used to enterally administer an
2-6 anesthetic and the anesthetic agents that may be used;
2-7 (2) dental patient evaluation, diagnosis, counseling,
2-8 and preparation;
2-9 (3) dental patient monitoring to be performed and
2-10 equipment to be used during a procedure and during postprocedure
2-11 monitoring;
2-12 (4) emergency procedures, drugs, and equipment,
2-13 including education, training, and certification of personnel, as
2-14 appropriate, and including protocols for transfers to a hospital;
2-15 (5) the documentation necessary to demonstrate
2-16 compliance with this subchapter; and
2-17 (6) the period in which protocols or procedures
2-18 covered by rules of the board shall be reviewed, updated, or
2-19 amended.
2-20 Sec. 258.154. COMPLIANCE WITH ANESTHESIA RULES. (a) On and
2-21 after August 31, 2002, a dentist who practices dentistry in this
2-22 state and who enterally administers anesthesia or performs a
2-23 procedure for which anesthesia is enterally administered shall
2-24 comply with the rules adopted under this subchapter.
2-25 (b) The board may require a dentist to submit and comply
2-26 with a corrective action plan to remedy or address any current or
3-1 potential deficiencies with the dentist's enteral administration of
3-2 anesthesia in accordance with this subtitle or rules of the board.
3-3 Sec. 258.155. ANNUAL PERMIT. (a) Not later than September
3-4 1, 2002, the board shall require each dentist who enterally
3-5 administers anesthesia or performs a procedure for which anesthesia
3-6 is enterally administered to annually obtain a permit from the
3-7 board by completing a form prescribed by the board. The board
3-8 shall set and impose a fee for the permit in an amount designed to
3-9 recover the costs of regulating a permit holder under this
3-10 subchapter.
3-11 (b) The board shall coordinate the times at which a permit
3-12 must be renewed with the times at which a dentist's license must be
3-13 renewed under Chapter 257 so that the times of registration,
3-14 payment, notice, and imposition of penalties for late payment are
3-15 similar and provide a minimum of administrative burden to the board
3-16 and to dentists.
3-17 Sec. 258.156. INSPECTIONS. (a) The board may conduct
3-18 inspections to enforce this subchapter, including inspections of an
3-19 office site and of documents of a dentist's practice that relate to
3-20 the enteral administration of anesthesia. The board may contract
3-21 with another state agency or qualified person to conduct these
3-22 inspections.
3-23 (b) Unless it would jeopardize an ongoing investigation, the
3-24 board shall provide at least five business days' notice before
3-25 conducting an on-site inspection under this section.
3-26 (c) This section does not require the board to make an
4-1 on-site inspection of a dentist's office.
4-2 Sec. 258.157. REQUESTS FOR INSPECTION AND ADVISORY OPINION.
4-3 (a) The board may consider a request by a dentist for an on-site
4-4 inspection. The board may, in its discretion and on payment of a
4-5 fee in an amount established by the board, conduct the inspection
4-6 and issue an advisory opinion.
4-7 (b) An advisory opinion issued by the board under this
4-8 section is not binding on the board, and the board, except as
4-9 provided by Subsection (c), may take any action under this subtitle
4-10 in relation to the situation addressed by the advisory opinion that
4-11 the board considers appropriate.
4-12 (c) A dentist who requests and relies on an advisory opinion
4-13 of the board may use the opinion as mitigating evidence in an
4-14 action or proceeding to impose an administrative or civil penalty
4-15 under this subtitle. The board or court, as appropriate, shall
4-16 take proof of reliance on an advisory opinion into consideration
4-17 and mitigate the imposition of administrative or civil penalties
4-18 accordingly.
4-19 SECTION 2. (a) The rules required under Subchapter D,
4-20 Chapter 258, Occupations Code, as added by this Act, must be
4-21 adopted by the State Board of Dental Examiners not later than
4-22 January 8, 2002.
4-23 (b) The State Board of Dental Examiners shall report to the
4-24 speaker of the house of representatives and the lieutenant governor
4-25 on the implementation and enforcement of those rules and of the law
4-26 added by this Act not later than January 1, 2003. The report must
5-1 include any suggested amendments or changes to the law added by
5-2 this Act to make the law more effective or efficient.
5-3 SECTION 3. This Act takes effect September 1, 2001.