Assigned to COM AS PASSED BY COW
ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
AMENDED
FACT SHEET FOR S.B. 1602
dental anesthesia; requirements
Purpose
Allows a qualified anesthesia provider to administer general anesthesia and sedation in
dental offices and clinics. Outlines requirements for administering general anesthesia and sedation
in dental offices and clinics.
Background
The Arizona State Board of Dental Examiners (BODEX) is established to promote the safe
and professional practice of dentistry. The mission of BODEX is to provide professional, courteous
service and information to the dental profession and the general public through: 1) the examination
and licensure process; 2) the complaint adjudication and enforcement processes; and 3) the
protection of oral health, safety and welfare of Arizona citizens through a fair and impartial system.
BODEX is charged with the investigation of complaints regarding dental professionals and
related business entities, which are resolved through: 1) the issuing of a letter of concern; 2) the
issuing of decrees of censure; 3) fixing periods and terms of probation; 4) suspending or revoking
licenses, certificates and restricted permits; and 5) reinstating licenses, certificates and restricted
permits in proper cases.
Statute also directs BODEX by rule to: 1) require that a dental licensee obtain a permit for
applying general anesthesia, semiconscious sedation or conscious sedation; 2) establish and collect
a fee of not more than $300 to cover administrative costs connected with issuing the permit; and
3) conduct inspections to ensure compliance (A.R.S. § 32-1207).
There is no anticipated fiscal impact to the state General Fund associated with this
legislation.
Provisions
Qualified Anesthesia Providers
1. Allows a BODEX licensee who has obtained a permit for applying general anesthesia or
sedation to perform dental procedures on a patient who receives anesthesia or sedation
administered by a qualified anesthesia provider who is exclusively responsible for the
preoperative, intraoperative and postoperative anesthetic management of the patient.
2. Allows the Arizona Medical Board (AMB) to issue registrations to administer general
anesthesia and sedation in dental offices and clinics to doctor of medicine who have completed
residency training in anesthesiology. FACT SHEET – Amended
S.B. 1602
Page 2
3. Allows the Arizona Board of Osteopathic Examiners in Medicine and Surgery (ABOE) to issue
registrations to administer general anesthesia and sedation in dental offices and clinics to
physicians who have completed residency training in anesthesiology.
4. Allows the Arizona Board of Nursing (AZBN) to issue registrations to administer general
anesthesia and sedation in dental offices and clinics to certified registered nurse anesthetists
who have certification in anesthesiology.
5. Requires a dental office or clinic at which general anesthesia or sedation is administered to:
a) contain properly operating equipment and supplies as prescribed by BODEX in rule; and
b) have proper emergency response protocols in place, including advanced cardiac life
support and airway management.
6. Requires a qualified anesthesia provider to confirm that the dentist who owns the dental office
or clinic where general anesthesia or sedation is being administered holds the required permit
issued by BODEX.
7. Requires a dental office or clinic that uses a qualified anesthesia provider to confirm that the
qualified anesthesia provider:
a) holds a valid, current license in good standing with no restrictions; and
b) holds a permit or is registered to administer general anesthesia or sedation in that setting.
8. Asserts that a qualified anesthesia provider who is licensed by BODEX that fails to comply
with dental anesthesia requirements commits an act that constitutes a danger to the health,
welfare or safety of the public.
Duty to Report
9. Requires BODEX to promptly report a qualified anesthesia provider to the regulatory board
that licenses the provider if the provider who is not licensed by BODEX fails to comply with
the dental anesthesia requirements.
10. Requires BODEX to promptly report an adverse anesthesia outcome to the regulatory board
that licenses the qualified anesthesia provider, if the adverse outcome involves a provider who
is not licensed by BODEX.
11. Requires the treating dentist, if a death or incident requiring emergency medical response
occurs, to submit a complete report of the incident to BODEX within three business days after
the occurrence.
12. Requires BODEX, if the incident involves a qualified anesthesia provider who is not licensed
by BODEX, to immediately forward a copy of the incident report to the applicable regulatory
board that licenses the qualified anesthesia provider.
13. Requires a doctor of medicine, doctor of osteopathic medicine or certified registered nurse
Anesthetist, if a death or an incident requiring emergency medical response occurs in a dental
office or clinic, to report the death or incident to the licensee's regulatory board within three
business days after the occurrence. FACT SHEET – Amended
S.B. 1602
Page 3
14. Allows any other person, if a death or an incident requiring emergency medical response occurs
in a dental office or clinic, to report the death or incident to a licensee's applicable regulatory
board within three business days after the occurrence.
BODEX's Anesthesia and Sedation Committee
15. Requires BODEX's Anesthesia and Sedation Committee, by September 1, 2023, to submit to
BODEX its final recommendations to improve the general anesthesia and sedation permit
requirements as provided in BODEX's existing administrative rules.
16. Stipulates that the final recommendations are for the purpose of increasing patient safety when
general anesthesia or sedation is being administered by an anesthesia provider within:
a) a dental practice; or
b) a similar setting that is under the jurisdiction of BODEX.
17. Requires that the recommendations:
a) ensure that at least two people are properly trained in advanced cardiac life support and
airway management and pediatric advance life support, as applicable, in any dental office
or clinic at which general anesthesia or sedation is administered; and
b) include a methodology to expedite the review of and response to deaths and incidents
requiring emergency medical response during the administration of or recovery from
general anesthesia or sedation.
18. Requires BODEX, within 60 days after receipt of BODEX's Anesthesia and Sedation
Committee's final recommendations, to approve, modify or reject the recommendations.
19. Exempts BODEX, for the purpose of general anesthesia or sedation requirements, from
statutory rulemaking requirements for one year.
20. Repeals the final recommendations requirements for BODEX's Anesthesia and Sedation
Committee on January 1, 2025.
Miscellaneous
21. Defines qualified anesthesia provider as:
a) a licensee who hold a permit to administer anesthesia and sedation by BODEX;
b) a physician who has completed residency training in anesthesiology and who is licensed
by the AMB or the ABOE and registered to administer anesthesia in dental offices or
clinics; and
c) a certified registered nurse anesthetist who has a national board certification in
anesthesiology and who is licensed by the AZBN and registered to administer anesthesia
in dental offices and clinics.
22. Makes technical and conforming changes.
23. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole FACT SHEET – Amended
S.B. 1602
Page 4
1. Specifies that a licensee who has obtained a permit from BODEX for applying general
anesthesia or sedation may perform dental procedures on a patient who receives anesthesia or
sedation administered by a qualified anesthesia provider.
2. Authorizes the Arizona Medical Board, the Arizona Board of Osteopathic Examiners in
Medicine and Surgery and the Arizona Nursing Board to issue registrations, rather than
permits, to administer anesthesia or sedation in dental offices and clinics.
3. Requires a qualified anesthesia provider to confirm that the dentist who owns the dental office
or clinic where general anesthesia or sedation is being administered holds the required permit
issued by BODEX.
4. Requires a dental office or clinic that uses a qualified anesthesia provider to confirm that the
provider holds a valid, current license in good standing with no restrictions and a permit or is
registered to administer general anesthesia or sedation in that setting.
5. Clarifies that a dental office or clinic at which general anesthesia or sedation is administered
must:
a) contain properly operating equipment and supplies as prescribed by BODEX in rule; and
b) have proper emergency response protocols in place, including advance cardiac life support
and airway management.
6. Eliminates provisions that specify the requirements for proper equipment and emergency
procedure in a dental office or clinic at which general anesthesia or sedation is being
administered.
7. Requires the treating dentist, if a death or incident requiring emergency medical response
occurs, to submit a complete report of the incident to BODEX within three business days after
the occurrence.
8. Requires BODEX, if the incident involves a qualified anesthesia provider who is not licensed
by BODEX, to immediately forward a copy of the incident report to the applicable regulatory
board that licenses the qualified anesthesia provider.
9. Requires a doctor of medicine, doctor of osteopathic medicine or certified registered nurse
anesthetist, if a death or an incident requiring emergency medical response occurs in a dental
office or clinic, to report to the death or incident to the licensee's regulatory board within three
business days after the occurrence.
10. Allows any other person, if a death or an incident requiring emergency medical response occurs
in a dental office or clinic, to report to the death or incident to licensee's applicable regulatory
board within three business days after the occurrence.
11. Eliminates the requirement for the applicable regulatory board to suspend a qualified
anesthesia provider's permit until after an investigation into an adverse anesthesia outcome that
results in death of a patient. FACT SHEET – Amended
S.B. 1602
Page 5
12. Requires the BODEX's Anesthesia and Sedation Committee, by September 1, 2023, to submit
to BODEX its final recommendations to improve the general anesthesia and sedation permit
requirements as provided in BODEX's existing administrative rules.
13. Stipulates that the final recommendations are for the purpose of increasing patient safety when
general anesthesia or sedation is being administered by an anesthesia provider within:
a) a dental practice; or
b) a similar setting that is under the jurisdiction of BODEX.
14. Requires that the recommendations:
a) ensure that at least two people are properly trained in advanced cardiac life support and
airway management and pediatric advance life support, as applicable, in any dental office
or clinic at which general anesthesia or sedation is administered; and
b) include a methodology to expedite the review of and response to deaths and incidents
requiring emergency medical response during the administration of or recovery from
general anesthesia or sedation.
15. Requires BODEX, within 60 days after receipt of BODEX's Anesthesia and Sedation
Committee's final recommendations, to approve, modify or reject the recommendations.
16. Exempts BODEX, for the purpose of general anesthesia or sedation requirements, from
statutory rulemaking requirements for one year.
17. Repeals the final recommendations requirements for BODEX's Anesthesia and Sedation
Committee on January 1, 2025.
18. Makes technical and conforming changes.
Senate Action
COM 2/15/23 DP 4-3-0
Prepared by Senate Research
March 13, 2023
JT/sr