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A BILL TO BE ENTITLED
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AN ACT
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relating to the administration of anesthesia by a certified |
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registered nurse anesthetist on the order of a dentist. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 258.001, Occupations Code, is amended to |
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read as follows: |
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Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not |
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delegate: |
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(1) an act to an individual who, by board order, is |
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prohibited from performing the act; |
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(2) any of the following acts to a person not licensed |
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as a dentist or dental hygienist: |
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(A) the removal of calculus, deposits, or |
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accretions from the natural and restored surfaces of exposed human |
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teeth and restorations in the human mouth; |
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(B) root planing or the smoothing and polishing |
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of roughened root surfaces or exposed human teeth; or |
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(C) any other act the delegation of which is |
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prohibited by board rule; |
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(3) any of the following acts to a person not licensed |
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as a dentist: |
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(A) comprehensive examination or diagnosis and |
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treatment planning; |
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(B) a surgical or cutting procedure on hard or |
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soft tissue; |
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(C) the prescription of a drug, medication, or |
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work authorization; |
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(D) the taking of an impression for a final |
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restoration, appliance, or prosthesis; |
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(E) the making of an intraoral occlusal |
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adjustment; |
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(F) direct pulp capping, pulpotomy, or any other |
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endodontic procedure; |
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(G) the final placement and intraoral adjustment |
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of a fixed or removable appliance; or |
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(H) the placement of any final restoration; or |
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(4) the authority to an individual to administer a |
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local anesthetic agent, inhalation sedative agent, parenteral |
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sedative agent, or general anesthetic agent, including as a |
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teledentistry dental service as that term is defined by Section |
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111.001, if the individual is not licensed as: |
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(A) a dentist with a permit issued by the board |
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for the procedure being performed, if a permit is required; |
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(B) a certified registered nurse anesthetist |
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licensed by the Texas Board of Nursing[, only if the delegating |
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dentist holds a permit issued by the board for the procedure being |
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performed, if a permit is required]; or |
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(C) a physician anesthesiologist licensed by the |
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Texas Medical Board. |
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SECTION 2. Subchapter D, Chapter 258, Occupations Code, is |
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amended by adding Section 258.158 to read as follows: |
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Sec. 258.158. ADMINISTRATION OF ANESTHESIA BY NURSE |
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ANESTHETIST. (a) The board and the Texas Board of Nursing shall |
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jointly adopt rules governing the administration of anesthesia by a |
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certified registered nurse anesthetist on the order of a dentist. |
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The rules must: |
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(1) for each category under Section 258.155(a), |
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establish standards and requirements for the administration of |
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anesthesia by a certified registered nurse anesthetist on the order |
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of a dentist who does not hold a permit in that category; and |
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(2) authorize a dentist to order, and a certified |
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registered nurse anesthetist to administer, anesthesia in |
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accordance with the standards and requirements described by |
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Subdivision (1). |
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(b) Rules adopted under Subsection (a) do not apply to the |
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administration of anesthesia: |
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(1) in a licensed hospital or licensed ambulatory |
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surgical center; or |
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(2) by a certified registered nurse anesthetist acting |
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under the delegated authority of a dentist who holds a permit to |
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administer the anesthesia. |
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SECTION 3. Not later than January 1, 2024, the State Board |
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of Dental Examiners and the Texas Board of Nursing shall jointly |
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adopt rules under Section 258.158, Occupations Code, as added by |
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this Act. |
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SECTION 4. This Act takes effect September 1, 2023. |