SENATE AMENDED
PRIOR PRINTER'S NOS. 287, 1068 PRINTER'S NO. 4468
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, SHANER,
WASHINGTON, HARHAI, THOMAS, JAMES, WATERS, SCHULER AND BEBKO-
JONES, JANUARY 30, 2001
AS AMENDED ON THIRD CONSIDERATION, IN SENATE, OCTOBER 9, 2002
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. Section 11.2 of the act of May 1, 1933 (P.L.216,
15 No.76), known as The Dental Law, added December 20, 1985
16 (P.L.513, No.118), is amended to read:
17 Section 11.2. Anesthesia.--(a) [Prior to January 1, 1987,
18 the] The board shall [promulgate regulations which:] DO ALL OF <--
19 THE FOLLOWING:
20 (1) Establish minimal training and education or
1 certification for the issuance of permits to dentists to
2 administer general anesthesia on an outpatient basis. [Such <--
3 regulations] THE BOARD shall [include a requirement of] REQUIRE <--
4 a minimum of one year in an approved program of advanced
5 training in anesthesiology and related academic subjects, beyond
6 the undergraduate dental school level.
7 (2) Establish further requirements relating to the use of
8 general anesthesia, including, but not limited to, the
9 collection of permit fees, temporary permit fees, biennial [the
10 collection of biennial license and license] renewal fees, office
11 inspection fees, clinical evaluation fees, equipment standards
12 and the conducting of workplace inspections.
13 (3) Establish minimal training and education for the
14 issuance of permits to dentists to administer conscious sedation
15 on an outpatient basis. Such regulations shall include a minimum
16 period of time of didactic instruction and clinical experience
17 in an accredited educational institution or program.
18 (4) Establish further requirements relating to the use of
19 conscious sedation, including, but not limited to, the
20 collection of permit fees, temporary permit fees, biennial [the
21 collection of biennial license and license] renewal fees, office
22 inspection fees, clinical evaluation fees, equipment standards
23 and the [conduct] conducting of workplace inspections.
24 (5) Establish minimal training and education for the
25 issuance of permits to dentists to administer nitrous
26 oxide/oxygen analgesia on an outpatient basis. [Such regulations <--
27 shall include] THE BOARD SHALL REQUIRE a minimum period of time <--
28 of didactic instruction or clinical experience in an accredited
29 educational institution or program.
30 (6) Establish further requirements relating to the use of
20010H0286B4468 - 2 -
1 nitrous oxide/oxygen analgesia, including, but not limited to,
2 the collection of permit fees, [the collection of biennial
3 licenses and license] temporary permit fees, biennial renewal
4 fees, equipment standards and the conduct of workplace
5 inspections.
6 [(7) Establish fees for temporary permits which permits may
7 be issued by the board for one year to a person whose
8 application indicates that he possesses the necessary
9 qualifications pending a complete processing of the
10 application.]
11 (b) [The board may issue the appropriate permits in
12 accordance with this section to a dentist who has been
13 administering general anesthesia, conscious sedation agents or
14 nitrous oxide or oxygen analgesia if the dentist submits
15 evidence satisfactory to the board that he has been
16 administering these agents for a period of at least five years
17 prior to the effective date of this section and that the dentist
18 has applied within one year of the effective date of the
19 regulations.]
20 (1) Beginning April 1, 2004, prior to issuing initial
21 permits to administer general anesthesia, DEEP SEDATION or <--
22 conscious sedation, the board shall require permit applicants to
23 satisfactorily undergo clinical evaluations and office
24 inspections. The board may contract with dental SCHOOLS, <--
25 organizations or individuals expert HAVING EXPERTISE in dental <--
26 outpatient anesthesia to perform such THE office inspections and <--
27 clinical evaluations. A written report of the results of all
28 inspections and evaluations shall be provided to the board in a
29 timely manner. If the results of the evaluation or inspection
30 are deemed unsatisfactory, subsequent evaluations or inspections
20010H0286B4468 - 3 -
1 may be conducted, within a reasonable time, upon written request
2 of the applicant. No permit shall be issued until the applicant
3 satisfactorily completes a clinical evaluation and office
4 inspection.
5 (2) Beginning April 1, 2004, prior to issuing initial
6 permits to administer nitrous oxide/oxygen analgesia, the board
7 shall require permit applicants to provide the make, model and
8 serial number of any nitrous oxide/oxygen analgesia equipment
9 utilized by the applicant, and certification that the equipment
10 is in proper working order. Thereafter, such permit holders
11 shall provide evidence to the board that their equipment is
12 properly calibrated, at least once every six years.
13 (3) The board shall adopt by regulation those guidelines, <--
14 ESTABLISH standards and procedures necessary to perform clinical <--
15 evaluations and office inspections. Such guidelines, standards <--
16 and procedures WHICH shall include, but not be limited to, the <--
17 requirement that equipment be maintained in good working order
18 and in accordance with the manufacturer's specifications. The
19 standards for equipment shall be updated periodically. All staff
20 assisting in the administration of anesthesia shall, AT A <--
21 MINIMUM, maintain a current certification to administer
22 cardiopulmonary resuscitation (CPR).
23 (4) Permit THE BOARD SHALL REQUIRE PERMIT holders who travel <--
24 to office locations other than their own to administer
25 anesthesia shall TO ensure that the office location has the <--
26 equipment required by board regulation, THE BOARD and that the <--
27 staff is properly trained to handle anesthesia-related
28 emergencies.
29 (5) A THE BOARD SHALL PROHIBIT A licensee who does not <--
30 possess a permit issued pursuant to this section shall not allow <--
20010H0286B4468 - 4 -
1 FROM ALLOWING general anesthesia, DEEP SEDATION, conscious <--
2 sedation or nitrous oxide/oxygen analgesia to be administered on
3 an outpatient basis in his or her dental office unless the
4 office is in compliance with board regulations, including those <--
5 regulations pertaining to equipment requirements and staffed
6 with a supervised team of auxiliary personnel capable of
7 appropriately managing procedures and emergencies incident to
8 the administration of anesthesia. THIS SECTION, INCLUDING THE <--
9 REQUIREMENTS PERTAINING TO EQUIPMENT AND STAFFING.
10 (6) As a condition of permit renewal for the biennial
11 renewal period beginning April 1, 2005, THE BOARD SHALL REQUIRE <--
12 permit holders for the administration of general anesthesia, <--
13 DEEP SEDATION and conscious sedation shall TO have <--
14 satisfactorily undergone a clinical evaluation and office
15 inspection pursuant to this section. The board may waive this
16 requirement for permit holders who can demonstrate to the
17 board's satisfaction that he or she has satisfactorily undergone
18 a clinical evaluation, administered by a dental AN organization <--
19 acceptable to the board, within the six years immediately
20 preceding the effective date of this clause. Thereafter, permit
21 holders shall satisfactorily undergo clinical evaluations and
22 office inspections at least once every six years.
23 (c) Beginning on April 1, 2004, the board may issue
24 temporary permits to administer general anesthesia, DEEP <--
25 SEDATION, conscious sedation or nitrous oxide/oxygen analgesia,
26 which shall be valid for one year, to individuals whose
27 application indicates that he or she possesses the necessary
28 qualifications pending a complete processing of the application.
29 Temporary permits shall not be subject to renewal.
30 (d) As a condition of permit renewal for the biennial
20010H0286B4468 - 5 -
1 renewal period beginning April 1, 2005, and all renewal periods
2 thereafter, THE BOARD SHALL REQUIRE general anesthesia AND DEEP <--
3 SEDATION permit holders shall TO have completed fifteen hours of <--
4 board-approved courses of study related to general anesthesia
5 and DEEP SEDATION, AND REQUIRE conscious sedation permit holders <--
6 shall TO have completed fifteen hours of board-approved courses <--
7 of study related to conscious sedation. Licensees who are not
8 permit holders, but who maintain offices in which general
9 anesthesia, DEEP SEDATION or conscious sedation is administered, <--
10 shall have completed five hours of board-approved courses of
11 study related to anesthesia. Continuing anesthesia education
12 shall be credited toward a permit holder's or licensee's
13 continuing education requirement under section 3(j.2) of this
14 act.
15 (e) Permit holders shall THE BOARD SHALL REQUIRE PERMIT <--
16 HOLDERS TO conduct a physical evaluation and take a medical
17 history of a patient prior to the administration of general
18 anesthesia, DEEP SEDATION, conscious sedation or nitrous <--
19 oxide/oxygen analgesia, and maintain records of the physical
20 evaluation, medical history and anesthesia procedures utilized.
21 (f) Permit holders shall THE BOARD SHALL REQUIRE PERMIT <--
22 HOLDERS TO obtain the written informed consent of a patient
23 prior to the administration of general anesthesia, DEEP <--
24 SEDATION, conscious sedation or nitrous oxide/oxygen analgesia.
25 The consent shall include, but not be limited to, a description
26 of the procedure, its risks and possible alternative treatments.
27 In the case of a minor patient, the consent shall be obtained
28 from the minor's parent or guardian.
29 (g) Noncompliance with any of the provisions of this section <--
30 shall be considered a violation of this act.
20010H0286B4468 - 6 -
1 (h) The board shall promulgate the regulations required by
2 this section within one year of the effective date of this
3 subsection. Thirty (30) days after the effective date of this
4 subsection and every thirty (30) days thereafter, the
5 Commissioner of Professional and Occupational Affairs shall
6 submit a written report on the status of regulations required
7 under this subsection to the Consumer Protection and
8 Professional Licensure Committee of the Senate and to the
9 Professional Licensure Committee of the House of
10 Representatives.
11 Section 2. This act shall take effect in 30 days.
12 SECTION 2. THE STATE DENTAL COUNCIL AND EXAMINATION BOARD <--
13 SHALL PROMULGATE REGULATIONS NECESSARY TO ADMINISTER THIS ACT
14 WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS SECTION.
15 SECTION 3. THIS ACT SHALL TAKE EFFECT IN 30 DAYS.
L21L63DMS/20010H0286B4468 - 7 -