PRINTER'S NO. 287
No. 286 Session of 2001
INTRODUCED BY BLAUM, GORDNER, DeWEESE, M. COHEN, BELARDI,
YOUNGBLOOD, HALUSKA, CRUZ, TIGUE, FREEMAN, DAILEY, SURRA,
STABACK, HORSEY, MUNDY, PRESTON, DeLUCA, McCALL AND SHANER,
JANUARY 30, 2001
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE,
JANUARY 30, 2001
AN ACT
1 Amending the act of May 1, 1933 (P.L.216, No.76), entitled "An
2 act relating to dentistry; defining and providing for the
3 licensing and registration of dentists and dental hygienists,
4 and for the revocation and suspension of such licenses and
5 registrations, subject to appeal, and for their
6 reinstatement; defining the powers and duties of the State
7 Dental Council and Examining Board and the Department of
8 Public Instruction; providing penalties; and repealing
9 existing laws," providing for functions of the Commissioner
10 of Professional and Occupational Affairs; and further
11 providing for anesthesia.
12 The General Assembly of the Commonwealth of Pennsylvania
13 hereby enacts as follows:
14 Section 1. The act of May 1, 1933 (P.L.216, No.76), known as
15 The Dental Law, is amended by adding a section to read:
16 Section 3.2. Commissioner of Professional and Occupational
17 Affairs.--Thirty (30) days after the effective date of this
18 section and every thirty (30) days thereafter, the Commissioner
19 of Professional and Occupational Affairs shall submit a written
20 report on the status of regulations required under section 11.2
21 to the Consumer Protection and Professional Licensure Committee
1 of the Senate and to the Professional Licensure Committee of the
2 House of Representatives.
3 Section 2. Section 11.2 of the act, added December 20, 1985
4 (P.L.513, No.118), is amended to read:
5 Section 11.2. Anesthesia.--(a) [Prior to January 1, 1987,
6 the] The board shall promulgate regulations which:
7 (1) Establish minimal training and education or
8 certification for the issuance of permits to dentists to
9 administer general anesthesia on an outpatient basis. Such
10 regulations shall include a requirement of a minimum of one year
11 in an approved program of advanced training in anesthesiology
12 and related academic subjects, beyond the undergraduate dental
13 school level.
14 (2) Establish further requirements relating to the use of
15 general anesthesia, including, but not limited to, the
16 collection of permit fees, temporary permit fees, biennial [the
17 collection of biennial license and license] renewal fees, office
18 inspection fees, clinical evaluation fees, equipment standards
19 and the conducting of workplace inspections.
20 (3) Establish minimal training and education for the
21 issuance of permits to dentists to administer conscious sedation
22 on an outpatient basis. Such regulations shall include a minimum
23 period of time of didactic instruction and clinical experience
24 in an accredited educational institution or program.
25 (4) Establish further requirements relating to the use of
26 conscious sedation, including, but not limited to, the
27 collection of permit fees, temporary permit fees, biennial [the
28 collection of biennial license and license] renewal fees, office
29 inspection fees, clinical evaluation fees, equipment standards
30 and the [conduct] conducting of workplace inspections.
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1 (5) Establish minimal training and education for the
2 issuance of permits to dentists to administer nitrous
3 oxide/oxygen analgesia on an outpatient basis. Such regulations
4 shall include a minimum period of time of didactic instruction
5 or clinical experience in an accredited educational institution
6 or program.
7 (6) Establish further requirements relating to the use of
8 nitrous oxide/oxygen analgesia, including, but not limited to,
9 the collection of permit fees, [the collection of biennial
10 licenses and license] temporary permit fees, biennial renewal
11 fees, equipment standards and the conduct of workplace
12 inspections.
13 [(7) Establish fees for temporary permits which permits may
14 be issued by the board for one year to a person whose
15 application indicates that he possesses the necessary
16 qualifications pending a complete processing of the
17 application.]
18 (b) [The board may issue the appropriate permits in
19 accordance with this section to a dentist who has been
20 administering general anesthesia, conscious sedation agents or
21 nitrous oxide or oxygen analgesia if the dentist submits
22 evidence satisfactory to the board that he has been
23 administering these agents for a period of at least five years
24 prior to the effective date of this section and that the dentist
25 has applied within one year of the effective date of the
26 regulations.]
27 (1) Beginning April 1, 2004, prior to issuing initial
28 permits to administer general anesthesia or conscious sedation,
29 the board shall require permit applicants to satisfactorily
30 undergo clinical evaluations and office inspections. The board
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1 may contract with dental organizations or individuals expert in
2 dental outpatient anesthesia to perform such office inspections
3 and clinical evaluations. A written report of the results of all
4 inspections and evaluations shall be provided to the board in a
5 timely manner. If the results of the evaluation or inspection
6 are deemed unsatisfactory, subsequent evaluations or inspections
7 may be conducted, within a reasonable time, upon written request
8 of the applicant. No permit shall be issued until the applicant
9 satisfactorily completes a clinical evaluation and office
10 inspection.
11 (2) Beginning April 1, 2004, prior to issuing initial
12 permits to administer nitrous oxide/oxygen analgesia, the board
13 shall require permit applicants to provide the make, model and
14 serial number of any nitrous oxide/oxygen analgesia equipment
15 utilized by the applicant, and certification that the equipment
16 is in proper working order. Thereafter, such permit holders
17 shall provide evidence to the board that their equipment is
18 properly calibrated, at least once every six years.
19 (3) The board shall adopt by regulation those guidelines,
20 standards and procedures necessary to perform clinical
21 evaluations and office inspections. Such guidelines, standards
22 and procedures shall include, but not be limited to, the
23 requirement that equipment be maintained in good working order
24 and in accordance with the manufacturer's specifications. The
25 standards for equipment shall be updated periodically. All staff
26 assisting in the administration of anesthesia shall maintain a
27 current certification to administer cardiopulmonary
28 resuscitation (CPR).
29 (4) Permit holders who travel to office locations other than
30 their own to administer anesthesia shall ensure that the office
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1 location has the equipment required by board regulation, and
2 that the staff is properly trained to handle anesthesia-related
3 emergencies.
4 (5) A licensee who does not possess a permit issued pursuant
5 to this section shall not allow general anesthesia, conscious
6 sedation or nitrous oxide/oxygen analgesia to be administered on
7 an outpatient basis in his or her dental office unless the
8 office is in compliance with board regulations, including those
9 regulations pertaining to equipment requirements and staffed
10 with a supervised team of auxiliary personnel capable of
11 appropriately managing procedures and emergencies incident to
12 the administration of anesthesia.
13 (6) As a condition of permit renewal for the biennial
14 renewal period beginning April 1, 2004, permit holders for the
15 administration of general anesthesia and conscious sedation
16 shall have satisfactorily undergone a clinical evaluation and
17 office inspection pursuant to this section. The board may waive
18 this requirement for permit holders who can demonstrate to the
19 board's satisfaction that he or she has satisfactorily undergone
20 a clinical evaluation, administered by a dental organization
21 acceptable to the board, within the six years immediately
22 preceding the effective date of this clause. Thereafter, permit
23 holders shall satisfactorily undergo clinical evaluations and
24 office inspections at least once every six years.
25 (c) Beginning on April 1, 2004, the board may issue
26 temporary permits to administer general anesthesia, conscious
27 sedation or nitrous oxide/oxygen analgesia, which shall be valid
28 for one year, to individuals whose application indicates that he
29 or she possesses the necessary qualifications pending a complete
30 processing of the application. Temporary permits shall not be
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1 subject to renewal.
2 (d) As a condition of permit renewal for the biennial
3 renewal period beginning April 1, 2004, and all renewal periods
4 thereafter, general anesthesia permit holders shall have
5 completed fifteen hours of board-approved courses of study
6 related to general anesthesia and conscious sedation permit
7 holders shall have completed fifteen hours of board-approved
8 courses of study related to conscious sedation. Licensees who
9 are not permit holders, but who maintain offices in which
10 general anesthesia or conscious sedation is administered, shall
11 have completed five hours of board-approved courses of study
12 related to anesthesia. Continuing anesthesia education shall be
13 credited toward a permit holder's or licensee's continuing
14 education requirement under section 3(j.2) of this act.
15 (e) Permit holders shall conduct a physical evaluation and
16 take a medical history of a patient prior to the administration
17 of general anesthesia, conscious sedation or nitrous
18 oxide/oxygen analgesia, and maintain records of the physical
19 evaluation, medical history and anesthesia procedures utilized.
20 (f) Permit holders shall obtain the written informed consent
21 of a patient prior to the administration of general anesthesia,
22 conscious sedation or nitrous oxide/oxygen analgesia. The
23 consent shall include, but not be limited to, a description of
24 the procedure, its risks and possible alternative treatments. In
25 the case of a minor patient, the consent shall be obtained from
26 the minor's parent or guardian.
27 (g) Noncompliance with any of the provisions of this section
28 shall be considered a violation of this act.
29 (h) The board shall promulgate the regulations required by
30 this section within one year of the effective date of this
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1 subsection.
2 Section 3. This act shall take effect in 30 days.
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