Amended IN Assembly March 18, 2024 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 2526Introduced by Assembly Member GipsonFebruary 13, 2024An act to amend Section 1646 Sections 1646, 1646.1, 1646.2, 1646.3, 1646.7, 1646.10, and 1646.11 of the Business and Professions Code, relating to healing arts. LEGISLATIVE COUNSEL'S DIGESTAB 2526, as amended, Gipson. Dentistry: deep sedation and general anesthesia. anesthesia: dedicated permitted anesthesia provider.Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. Under existing law, a dentist is required to possess certain permits, as prescribed, to administer or order the administration of deep sedation or general anesthesia, as those terms are defined, on an outpatient basis for dental patients. Existing law requires a dentist who desires to administer or order the administration of deep sedation or general anesthesia to apply to the board on an application form prescribed by the board. As part of their application, existing law requires a dentist to submit an application fee and produce evidence showing that they have successfully completed specified requirements.This bill would revise existing permit requirements to require a dentist to possess, among other things, a general anesthesia administration or ordering permit issued by the board for the purpose of administering or ordering the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, as defined. For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, the bill would require a dentist to apply to the board on the appropriate application form prescribed by the board, submit an application fee, and include documentation that required equipment and drugs are on the premises. The bill would, in addition to any other requirement imposed by law, provide that a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age, provide proof of specified information.Existing law requires any dentist that holds a general anesthesia permit to maintain specified information, including medical history and general anesthesia records as required by board regulations.This bill would provide, in addition to any dentist that holds a general anesthesia permit, that any dentist whose office administers deep sedation or general anesthesia is also required to maintain the specified information.Existing law makes a violation of specified provisions grounds for suspension or revocation of a physician and surgeons permit issued as specified. Existing law requires the board to refer a violation by a physician and surgeon to the Medical Board of California, as specified.This bill would delete the provision that requires the board to refer a violation by a physician and surgeon to the Medical Board of California, make a violation of specified provisions by a dentist grounds for suspension or revocation of the dentists permit issued by the board, and authorize the board to investigate and consider the violation as unprofessional conduct. The bill would authorize the Medical Board of California and the Board of Registered Nursing to investigate violations of specified provisions by a physician and surgeon or a certified nurse anesthetist, respectively, and to consider the violation as unprofessional conduct.Existing law requires a general anesthesia permit to expire on a prescribed date that next occurs after the permits issuance, unless the permit is renewed as specified. Existing law authorizes a general anesthesia permitholder who has a permit that was issued before January 1, 2022, to follow the terms of that existing permit until it expires. Existing law requires any permit issued or renewed, as specified, on or after January 1, 2022, to require the permitholder to follow new requirements.This bill would revise the expiration provision to provide that a general anesthesia administration or ordering permit is required to expire on a prescribed date, as specified. The bill would provide that a physician and surgeon who has a permit to administer general anesthesia in the office of a dentist before January 1, 2025, may follow the terms of that existing permit until it expires. The bill would require the board to adopt emergency regulations to implement these provisions.The Dental Practice Act provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. The act, among other things, prescribes requirements for dentists who administer or order the administration of deep sedation or general anesthesia, as those terms are defined.This bill would make a nonsubstantive change to the provision that defines those terms.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 1646 of the Business and Professions Code is amended to read:1646. As used in this article, the following definitions apply:(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.(c) Dedicated permitted anesthesia provider means any of the following:(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.SEC. 2. Section 1646.1 of the Business and Professions Code is amended to read:1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.(d) For patients under 13 years of age, all of the following shall apply:(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.SEC. 3. Section 1646.2 of the Business and Professions Code is amended to read:1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises. (c)(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.(d)(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.(2) Current certification in ACLS and PALS.SEC. 4. Section 1646.3 of the Business and Professions Code is amended to read:1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.SEC. 5. Section 1646.7 of the Business and Professions Code is amended to read:1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.SEC. 6. Section 1646.10 of the Business and Professions Code is amended to read:1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.SEC. 7. Section 1646.11 of the Business and Professions Code is amended to read:1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code. SECTION 1.Section 1646 of the Business and Professions Code is amended to read:1646.As used in this article, the following definitions shall apply:(a)Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b)General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
Amended IN Assembly March 18, 2024 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 2526Introduced by Assembly Member GipsonFebruary 13, 2024An act to amend Section 1646 Sections 1646, 1646.1, 1646.2, 1646.3, 1646.7, 1646.10, and 1646.11 of the Business and Professions Code, relating to healing arts. LEGISLATIVE COUNSEL'S DIGESTAB 2526, as amended, Gipson. Dentistry: deep sedation and general anesthesia. anesthesia: dedicated permitted anesthesia provider.Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. Under existing law, a dentist is required to possess certain permits, as prescribed, to administer or order the administration of deep sedation or general anesthesia, as those terms are defined, on an outpatient basis for dental patients. Existing law requires a dentist who desires to administer or order the administration of deep sedation or general anesthesia to apply to the board on an application form prescribed by the board. As part of their application, existing law requires a dentist to submit an application fee and produce evidence showing that they have successfully completed specified requirements.This bill would revise existing permit requirements to require a dentist to possess, among other things, a general anesthesia administration or ordering permit issued by the board for the purpose of administering or ordering the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, as defined. For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, the bill would require a dentist to apply to the board on the appropriate application form prescribed by the board, submit an application fee, and include documentation that required equipment and drugs are on the premises. The bill would, in addition to any other requirement imposed by law, provide that a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age, provide proof of specified information.Existing law requires any dentist that holds a general anesthesia permit to maintain specified information, including medical history and general anesthesia records as required by board regulations.This bill would provide, in addition to any dentist that holds a general anesthesia permit, that any dentist whose office administers deep sedation or general anesthesia is also required to maintain the specified information.Existing law makes a violation of specified provisions grounds for suspension or revocation of a physician and surgeons permit issued as specified. Existing law requires the board to refer a violation by a physician and surgeon to the Medical Board of California, as specified.This bill would delete the provision that requires the board to refer a violation by a physician and surgeon to the Medical Board of California, make a violation of specified provisions by a dentist grounds for suspension or revocation of the dentists permit issued by the board, and authorize the board to investigate and consider the violation as unprofessional conduct. The bill would authorize the Medical Board of California and the Board of Registered Nursing to investigate violations of specified provisions by a physician and surgeon or a certified nurse anesthetist, respectively, and to consider the violation as unprofessional conduct.Existing law requires a general anesthesia permit to expire on a prescribed date that next occurs after the permits issuance, unless the permit is renewed as specified. Existing law authorizes a general anesthesia permitholder who has a permit that was issued before January 1, 2022, to follow the terms of that existing permit until it expires. Existing law requires any permit issued or renewed, as specified, on or after January 1, 2022, to require the permitholder to follow new requirements.This bill would revise the expiration provision to provide that a general anesthesia administration or ordering permit is required to expire on a prescribed date, as specified. The bill would provide that a physician and surgeon who has a permit to administer general anesthesia in the office of a dentist before January 1, 2025, may follow the terms of that existing permit until it expires. The bill would require the board to adopt emergency regulations to implement these provisions.The Dental Practice Act provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. The act, among other things, prescribes requirements for dentists who administer or order the administration of deep sedation or general anesthesia, as those terms are defined.This bill would make a nonsubstantive change to the provision that defines those terms.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NO
Amended IN Assembly March 18, 2024
Amended IN Assembly March 18, 2024
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 2526
Introduced by Assembly Member GipsonFebruary 13, 2024
Introduced by Assembly Member Gipson
February 13, 2024
An act to amend Section 1646 Sections 1646, 1646.1, 1646.2, 1646.3, 1646.7, 1646.10, and 1646.11 of the Business and Professions Code, relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 2526, as amended, Gipson. Dentistry: deep sedation and general anesthesia. anesthesia: dedicated permitted anesthesia provider.
Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. Under existing law, a dentist is required to possess certain permits, as prescribed, to administer or order the administration of deep sedation or general anesthesia, as those terms are defined, on an outpatient basis for dental patients. Existing law requires a dentist who desires to administer or order the administration of deep sedation or general anesthesia to apply to the board on an application form prescribed by the board. As part of their application, existing law requires a dentist to submit an application fee and produce evidence showing that they have successfully completed specified requirements.This bill would revise existing permit requirements to require a dentist to possess, among other things, a general anesthesia administration or ordering permit issued by the board for the purpose of administering or ordering the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, as defined. For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, the bill would require a dentist to apply to the board on the appropriate application form prescribed by the board, submit an application fee, and include documentation that required equipment and drugs are on the premises. The bill would, in addition to any other requirement imposed by law, provide that a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age, provide proof of specified information.Existing law requires any dentist that holds a general anesthesia permit to maintain specified information, including medical history and general anesthesia records as required by board regulations.This bill would provide, in addition to any dentist that holds a general anesthesia permit, that any dentist whose office administers deep sedation or general anesthesia is also required to maintain the specified information.Existing law makes a violation of specified provisions grounds for suspension or revocation of a physician and surgeons permit issued as specified. Existing law requires the board to refer a violation by a physician and surgeon to the Medical Board of California, as specified.This bill would delete the provision that requires the board to refer a violation by a physician and surgeon to the Medical Board of California, make a violation of specified provisions by a dentist grounds for suspension or revocation of the dentists permit issued by the board, and authorize the board to investigate and consider the violation as unprofessional conduct. The bill would authorize the Medical Board of California and the Board of Registered Nursing to investigate violations of specified provisions by a physician and surgeon or a certified nurse anesthetist, respectively, and to consider the violation as unprofessional conduct.Existing law requires a general anesthesia permit to expire on a prescribed date that next occurs after the permits issuance, unless the permit is renewed as specified. Existing law authorizes a general anesthesia permitholder who has a permit that was issued before January 1, 2022, to follow the terms of that existing permit until it expires. Existing law requires any permit issued or renewed, as specified, on or after January 1, 2022, to require the permitholder to follow new requirements.This bill would revise the expiration provision to provide that a general anesthesia administration or ordering permit is required to expire on a prescribed date, as specified. The bill would provide that a physician and surgeon who has a permit to administer general anesthesia in the office of a dentist before January 1, 2025, may follow the terms of that existing permit until it expires. The bill would require the board to adopt emergency regulations to implement these provisions.The Dental Practice Act provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. The act, among other things, prescribes requirements for dentists who administer or order the administration of deep sedation or general anesthesia, as those terms are defined.This bill would make a nonsubstantive change to the provision that defines those terms.
Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. Under existing law, a dentist is required to possess certain permits, as prescribed, to administer or order the administration of deep sedation or general anesthesia, as those terms are defined, on an outpatient basis for dental patients. Existing law requires a dentist who desires to administer or order the administration of deep sedation or general anesthesia to apply to the board on an application form prescribed by the board. As part of their application, existing law requires a dentist to submit an application fee and produce evidence showing that they have successfully completed specified requirements.
This bill would revise existing permit requirements to require a dentist to possess, among other things, a general anesthesia administration or ordering permit issued by the board for the purpose of administering or ordering the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, as defined. For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, the bill would require a dentist to apply to the board on the appropriate application form prescribed by the board, submit an application fee, and include documentation that required equipment and drugs are on the premises. The bill would, in addition to any other requirement imposed by law, provide that a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age, provide proof of specified information.
Existing law requires any dentist that holds a general anesthesia permit to maintain specified information, including medical history and general anesthesia records as required by board regulations.
This bill would provide, in addition to any dentist that holds a general anesthesia permit, that any dentist whose office administers deep sedation or general anesthesia is also required to maintain the specified information.
Existing law makes a violation of specified provisions grounds for suspension or revocation of a physician and surgeons permit issued as specified. Existing law requires the board to refer a violation by a physician and surgeon to the Medical Board of California, as specified.
This bill would delete the provision that requires the board to refer a violation by a physician and surgeon to the Medical Board of California, make a violation of specified provisions by a dentist grounds for suspension or revocation of the dentists permit issued by the board, and authorize the board to investigate and consider the violation as unprofessional conduct. The bill would authorize the Medical Board of California and the Board of Registered Nursing to investigate violations of specified provisions by a physician and surgeon or a certified nurse anesthetist, respectively, and to consider the violation as unprofessional conduct.
Existing law requires a general anesthesia permit to expire on a prescribed date that next occurs after the permits issuance, unless the permit is renewed as specified. Existing law authorizes a general anesthesia permitholder who has a permit that was issued before January 1, 2022, to follow the terms of that existing permit until it expires. Existing law requires any permit issued or renewed, as specified, on or after January 1, 2022, to require the permitholder to follow new requirements.
This bill would revise the expiration provision to provide that a general anesthesia administration or ordering permit is required to expire on a prescribed date, as specified. The bill would provide that a physician and surgeon who has a permit to administer general anesthesia in the office of a dentist before January 1, 2025, may follow the terms of that existing permit until it expires. The bill would require the board to adopt emergency regulations to implement these provisions.
The Dental Practice Act provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. The act, among other things, prescribes requirements for dentists who administer or order the administration of deep sedation or general anesthesia, as those terms are defined.
This bill would make a nonsubstantive change to the provision that defines those terms.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 1646 of the Business and Professions Code is amended to read:1646. As used in this article, the following definitions apply:(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.(c) Dedicated permitted anesthesia provider means any of the following:(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.SEC. 2. Section 1646.1 of the Business and Professions Code is amended to read:1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.(d) For patients under 13 years of age, all of the following shall apply:(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.SEC. 3. Section 1646.2 of the Business and Professions Code is amended to read:1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises. (c)(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.(d)(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.(2) Current certification in ACLS and PALS.SEC. 4. Section 1646.3 of the Business and Professions Code is amended to read:1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.SEC. 5. Section 1646.7 of the Business and Professions Code is amended to read:1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.SEC. 6. Section 1646.10 of the Business and Professions Code is amended to read:1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.SEC. 7. Section 1646.11 of the Business and Professions Code is amended to read:1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code. SECTION 1.Section 1646 of the Business and Professions Code is amended to read:1646.As used in this article, the following definitions shall apply:(a)Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b)General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 1646 of the Business and Professions Code is amended to read:1646. As used in this article, the following definitions apply:(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.(c) Dedicated permitted anesthesia provider means any of the following:(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.
SECTION 1. Section 1646 of the Business and Professions Code is amended to read:
### SECTION 1.
1646. As used in this article, the following definitions apply:(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.(c) Dedicated permitted anesthesia provider means any of the following:(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.
1646. As used in this article, the following definitions apply:(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.(c) Dedicated permitted anesthesia provider means any of the following:(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.
1646. As used in this article, the following definitions apply:(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.(c) Dedicated permitted anesthesia provider means any of the following:(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.
1646. As used in this article, the following definitions apply:
(a) Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
(b) General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
(c) Dedicated permitted anesthesia provider means any of the following:
(1) A physician and surgeon who has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the Accreditation Council on Graduate Medical Education pursuant to Section 2079.
(2) A certified nurse anesthetist licensed under Article 2 (commencing with Section 2725) or Article 7 (commencing with Section 2825) of Chapter 6.
(3) A dentist licensed under this chapter who possesses a general anesthesia administration permit from the board pursuant to this article.
SEC. 2. Section 1646.1 of the Business and Professions Code is amended to read:1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.(d) For patients under 13 years of age, all of the following shall apply:(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.
SEC. 2. Section 1646.1 of the Business and Professions Code is amended to read:
### SEC. 2.
1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.(d) For patients under 13 years of age, all of the following shall apply:(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.
1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.(d) For patients under 13 years of age, all of the following shall apply:(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.
1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.(d) For patients under 13 years of age, all of the following shall apply:(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.
1646.1. (a) A dentist shall possess either a current license in good standing and a general anesthesia administration or ordering permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia administration or ordering permit issued by the board in order to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider on an outpatient basis for dental patients.
(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.
(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation.
(d) For patients under 13 years of age, all of the following shall apply:
(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.
(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:
(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.
(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.
(3) If a dedicated permitted anesthesia provider other than the operating dentist is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:
(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.
(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.
(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.
SEC. 3. Section 1646.2 of the Business and Professions Code is amended to read:1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises. (c)(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.(d)(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.(2) Current certification in ACLS and PALS.
SEC. 3. Section 1646.2 of the Business and Professions Code is amended to read:
### SEC. 3.
1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises. (c)(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.(d)(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.(2) Current certification in ACLS and PALS.
1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises. (c)(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.(d)(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.(2) Current certification in ACLS and PALS.
1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises. (c)(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.(d)(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.(2) Current certification in ACLS and PALS.
1646.2. (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider shall apply to the board on an the appropriate administration or ordering permit application form prescribed by the board. The dentist must submit an application fee and produce evidence showing that he or she has successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.
(b) (1) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises. For a permit to administer deep sedation or general anesthesia, a dentist shall submit an application fee and produce evidence showing that they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.
(2) If the deep sedation or general anesthesia is to be administered in the dentists office, the application shall also include documentation that equipment and drugs required by the board are on the premises.
(c) For a permit to order the administration of deep sedation or general anesthesia by a dedicated permitted anesthesia provider, a dentist shall submit an application fee and include documentation that equipment and drugs required by the board are on the premises.
(c)
(d) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:
(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.
(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods.
(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.
(d)
(e) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicants pediatric endorsement.
(f) In addition to any other requirement imposed by law, a dedicated permitted anesthesia provider, other than the operating dentist, who administers deep sedation or general anesthesia to dental patients under seven years of age shall provide proof of all of the following:
(1) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the prior 24-month time period.
(2) Current certification in ACLS and PALS.
SEC. 4. Section 1646.3 of the Business and Professions Code is amended to read:1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.
SEC. 4. Section 1646.3 of the Business and Professions Code is amended to read:
### SEC. 4.
1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.
1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.
1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.
1646.3. (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.
(b) Any dentist holding a permit and in whose office the deep sedation or general anesthesia is administered shall maintain medical history, physical evaluation, deep sedation, and general anesthesia records as required by board regulations.
SEC. 5. Section 1646.7 of the Business and Professions Code is amended to read:1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
SEC. 5. Section 1646.7 of the Business and Professions Code is amended to read:
### SEC. 5.
1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentists permit or license, or both. The board shall issue probationary terms only for violations that do not result in bodily harm.
(b) (1) A violation of any provision of this article or Section 1682 by a dentist is grounds for suspension or revocation of the physician and surgeons dentists permit issued pursuant to this article and may be investigated and considered as unprofessional conduct by the board. The exclusive enforcement authority against a physician and surgeon by the board shall be to suspend or revoke the permit issued pursuant to this article. The board shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeons permit by the board pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California, as authorized by Section 2220.5.
(2) A violation of any provision of this article by a physician and surgeon or a certified nurse anesthetist may be investigated and considered as unprofessional conduct by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000) or the Board of Registered Nursing, pursuant to Chapter 6 (commencing with Section 2700), as appropriate.
(c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
SEC. 6. Section 1646.10 of the Business and Professions Code is amended to read:1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.
SEC. 6. Section 1646.10 of the Business and Professions Code is amended to read:
### SEC. 6.
1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.
1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.
1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.
1646.10. A general anesthesia administration or ordering permit issued by the board under this article shall expire on the date provided in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.
SEC. 7. Section 1646.11 of the Business and Professions Code is amended to read:1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.
SEC. 7. Section 1646.11 of the Business and Professions Code is amended to read:
### SEC. 7.
1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.
1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.
1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.
1646.11. (a) A general anesthesia permitholder who has a permit that was issued before January 1, 2022, may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, 2025, shall require the permitholder to follow the new requirements of this article.
(b) A physician and surgeon who has a permit to administer general anesthesia in the office of a dentist, pursuant to Section 2079, before January 1, 2025, may follow the terms of that existing permit until it expires and shall not be required to obtain a new permit until the expiration of the existing permit. Any permit issued or renewed pursuant to this article on or after January 1, 2025, shall require the permitholder to follow the new requirements of this article.
(c) The board shall revise its current regulations and adopt new regulations to implement this article. The adoption, amendment, repeal, or readoption of a regulation authorized by this section is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.
As used in this article, the following definitions shall apply:
(a)Deep sedation means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
(b)General anesthesia means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.