By Carona S.B. No. 539
77R5501 JRD-F
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, or sublingually.
1-13 Sec. 258.152. APPLICABILITY. Rules adopted by the board
1-14 under this subchapter do not apply to:
1-15 (1) the administration of a topical anesthetic that is
1-16 not designed to be absorbed through the oral mucosa;
1-17 (2) the regional injection of an anesthetic to reduce
1-18 or eliminate sensation, especially pain, in one part of the body;
1-19 or
1-20 (3) the administration of anxiolytics and analgesics
1-21 in doses that do not have the probability of placing the dental
1-22 patient at risk for loss of the dental patient's life-preserving
1-23 protective reflexes.
1-24 Sec. 258.153. RULES. (a) The board shall establish by rule
2-1 the minimum standards for the enteral administration of anesthesia
2-2 by a dentist.
2-3 (b) The rules must be designed to protect the health,
2-4 safety, and welfare of the public and must include requirements
2-5 relating to:
2-6 (1) the methods used to enterally administer an
2-7 anesthetic and the anesthetic agents that may be used;
2-8 (2) dental patient evaluation, diagnosis, counseling,
2-9 and preparation;
2-10 (3) dental patient monitoring to be performed and
2-11 equipment to be used during a procedure and during post-procedure
2-12 monitoring;
2-13 (4) emergency procedures, drugs, and equipment,
2-14 including education, training, and certification of personnel, as
2-15 appropriate, and including protocols for transfers to a hospital;
2-16 (5) the documentation necessary to demonstrate
2-17 compliance with this subchapter; and
2-18 (6) the period in which protocols or procedures
2-19 covered by rules of the board shall be reviewed, updated, or
2-20 amended.
2-21 Sec. 258.154. COMPLIANCE WITH ANESTHESIA RULES. (a) On and
2-22 after August 31, 2002, a dentist who practices dentistry in this
2-23 state and who enterally administers anesthesia or performs a
2-24 procedure for which anesthesia is enterally administered shall
2-25 comply with the rules adopted under this subchapter.
2-26 (b) The board may require a dentist to submit and comply
2-27 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) Beginning September 1,
3-4 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
3-27 on-site inspection of a dentist's office.
4-1 Sec. 258.157. REQUESTS FOR INSPECTION AND ADVISORY OPINION.
4-2 (a) The board may consider a request by a dentist for an on-site
4-3 inspection. The board may, in its discretion and on payment of a
4-4 fee in an amount established by the board, conduct the inspection
4-5 and issue an advisory opinion.
4-6 (b) An advisory opinion issued by the board under this
4-7 section is not binding on the board, and the board, except as
4-8 provided by Subsection (c), may take any action under this subtitle
4-9 in relation to the situation addressed by the advisory opinion that
4-10 the board considers appropriate.
4-11 (c) A dentist who requests and relies on an advisory opinion
4-12 of the board may use the opinion as mitigating evidence in an
4-13 action or proceeding to impose an administrative or civil penalty
4-14 under this subtitle. The board or court, as appropriate, shall
4-15 take proof of reliance on an advisory opinion into consideration
4-16 and mitigate the imposition of administrative or civil penalties
4-17 accordingly.
4-18 SECTION 2. The State Board of Dental Examiners may allow the
4-19 permitting requirements imposed under Subchapter D, Chapter 258,
4-20 Occupations Code, as added by this Act, to be staggered and phased
4-21 in so that not later than September 1, 2004, all dentists required
4-22 to obtain a permit under the law will be in compliance.
4-23 SECTION 3. (a) The rules required under Subchapter D,
4-24 Chapter 258, Occupations Code, as added by this Act, must be
4-25 adopted by the State Board of Dental Examiners not later than
4-26 January 8, 2002.
4-27 (b) The board shall report to the speaker of the house of
5-1 representatives and the lieutenant governor on the implementation
5-2 and enforcement of those rules and of the law added by this Act not
5-3 later than January 1, 2003. The report must include any suggested
5-4 amendments or changes to the law added by this Act to make the law
5-5 more effective or efficient.
5-6 SECTION 4. This Act takes effect September 1, 2001.