| 1 | 1 | | 88R6172 BEE-F |
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| 2 | 2 | | By: Clardy H.B. No. 1930 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the administration of anesthesia by a certified |
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| 8 | 8 | | registered nurse anesthetist on the order of a dentist. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 258.001, Occupations Code, is amended to |
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| 11 | 11 | | read as follows: |
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| 12 | 12 | | Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not |
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| 13 | 13 | | delegate: |
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| 14 | 14 | | (1) an act to an individual who, by board order, is |
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| 15 | 15 | | prohibited from performing the act; |
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| 16 | 16 | | (2) any of the following acts to a person not licensed |
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| 17 | 17 | | as a dentist or dental hygienist: |
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| 18 | 18 | | (A) the removal of calculus, deposits, or |
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| 19 | 19 | | accretions from the natural and restored surfaces of exposed human |
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| 20 | 20 | | teeth and restorations in the human mouth; |
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| 21 | 21 | | (B) root planing or the smoothing and polishing |
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| 22 | 22 | | of roughened root surfaces or exposed human teeth; or |
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| 23 | 23 | | (C) any other act the delegation of which is |
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| 24 | 24 | | prohibited by board rule; |
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| 25 | 25 | | (3) any of the following acts to a person not licensed |
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| 26 | 26 | | as a dentist: |
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| 27 | 27 | | (A) comprehensive examination or diagnosis and |
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| 28 | 28 | | treatment planning; |
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| 29 | 29 | | (B) a surgical or cutting procedure on hard or |
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| 30 | 30 | | soft tissue; |
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| 31 | 31 | | (C) the prescription of a drug, medication, or |
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| 32 | 32 | | work authorization; |
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| 33 | 33 | | (D) the taking of an impression for a final |
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| 34 | 34 | | restoration, appliance, or prosthesis; |
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| 35 | 35 | | (E) the making of an intraoral occlusal |
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| 36 | 36 | | adjustment; |
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| 37 | 37 | | (F) direct pulp capping, pulpotomy, or any other |
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| 38 | 38 | | endodontic procedure; |
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| 39 | 39 | | (G) the final placement and intraoral adjustment |
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| 40 | 40 | | of a fixed or removable appliance; or |
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| 41 | 41 | | (H) the placement of any final restoration; or |
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| 42 | 42 | | (4) the authority to an individual to administer a |
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| 43 | 43 | | local anesthetic agent, inhalation sedative agent, parenteral |
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| 44 | 44 | | sedative agent, or general anesthetic agent, including as a |
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| 45 | 45 | | teledentistry dental service as that term is defined by Section |
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| 46 | 46 | | 111.001, if the individual is not licensed as: |
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| 47 | 47 | | (A) a dentist with a permit issued by the board |
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| 48 | 48 | | for the procedure being performed, if a permit is required; |
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| 49 | 49 | | (B) a certified registered nurse anesthetist |
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| 50 | 50 | | licensed by the Texas Board of Nursing[, only if the delegating |
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| 51 | 51 | | dentist holds a permit issued by the board for the procedure being |
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| 52 | 52 | | performed, if a permit is required]; or |
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| 53 | 53 | | (C) a physician anesthesiologist licensed by the |
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| 54 | 54 | | Texas Medical Board. |
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| 55 | 55 | | SECTION 2. Subchapter D, Chapter 258, Occupations Code, is |
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| 56 | 56 | | amended by adding Section 258.158 to read as follows: |
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| 57 | 57 | | Sec. 258.158. ADMINISTRATION OF ANESTHESIA BY NURSE |
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| 58 | 58 | | ANESTHETIST. (a) The board and the Texas Board of Nursing shall |
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| 59 | 59 | | jointly adopt rules governing the administration of anesthesia by a |
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| 60 | 60 | | certified registered nurse anesthetist on the order of a dentist. |
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| 61 | 61 | | The rules must: |
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| 62 | 62 | | (1) for each category under Section 258.155(a), |
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| 63 | 63 | | establish standards and requirements for the administration of |
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| 64 | 64 | | anesthesia by a certified registered nurse anesthetist on the order |
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| 65 | 65 | | of a dentist who does not hold a permit in that category; and |
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| 66 | 66 | | (2) authorize a dentist to order, and a certified |
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| 67 | 67 | | registered nurse anesthetist to administer, anesthesia in |
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| 68 | 68 | | accordance with the standards and requirements described by |
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| 69 | 69 | | Subdivision (1). |
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| 70 | 70 | | (b) Rules adopted under Subsection (a) do not apply to the |
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| 71 | 71 | | administration of anesthesia: |
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| 72 | 72 | | (1) in a licensed hospital or licensed ambulatory |
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| 73 | 73 | | surgical center; or |
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| 74 | 74 | | (2) by a certified registered nurse anesthetist acting |
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| 75 | 75 | | under the delegated authority of a dentist who holds a permit to |
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| 76 | 76 | | administer the anesthesia. |
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| 77 | 77 | | SECTION 3. Not later than January 1, 2024, the State Board |
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| 78 | 78 | | of Dental Examiners and the Texas Board of Nursing shall jointly |
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| 79 | 79 | | adopt rules under Section 258.158, Occupations Code, as added by |
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| 80 | 80 | | this Act. |
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| 81 | 81 | | SECTION 4. This Act takes effect September 1, 2023. |
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