Today's Law As Amended


Bill PDF |Add To My Favorites | print page

AB-2526 Nurse anesthetists: general anesthesia or deep sedation.(2023-2024)



As Amends the Law Today


SECTION 1.

 Section 1646.14 is added to the Business and Professions Code, to read:

1646.14.
 (a) Notwithstanding any other law, including, but not limited to, Sections 1646.1 and 1647.2, a certified registered nurse anesthetist licensed pursuant to Chapter 6 (commencing with Section 2700) and certified as a nurse anesthetist pursuant to Article 7 (commencing with Section 2825) of Chapter 6 may administer general anesthesia or deep sedation in the office of a licensed dentist to dental patients without regard to whether the dentist possesses a permit issued pursuant to this article, if all of the following conditions are met:
(1) The nurse anesthetist meets the requirements of paragraph (2) of subdivision (b) of Section 2827.
(2) The nurse anesthetist holds a valid general anesthesia permit issued by the Dental Board of California pursuant to subdivision (b).
(3) The nurse anesthetist meets the requirements of subdivision (d) of Section 1646.1.
(b) A certified registered nurse anesthetist who desires to administer general anesthesia or deep sedation under subdivision (a) shall apply to the board on an application form prescribed by the board and shall submit all of the following:
(1) Payment of an application fee prescribed by this article.
(2) Evidence satisfactory to the board and the Board of Registered Nursing showing that the applicant has successfully completed an accredited program as defined in subdivision (b) of Section 2826.
(3) Documentation demonstrating that all equipment and drugs required by the board are on the premises for use in any dental office in which the nurse anesthetist administers general anesthesia or deep sedation.
(c) Prior to issuance or renewal of a permit pursuant to this section, the board may at its discretion require an onsite inspection and evaluation of the facility, equipment, and personnel, including, but not limited to, the certified registered nurse anesthetist and procedures utilized. At least one of the people evaluating the procedures utilized by the nurse anesthetist shall be a certified registered nurse anesthetist expert in outpatient general anesthesia or deep sedation who has been authorized or retained under contract by the board for this purpose.
(d) A certified registered nurse anesthetist who has failed an onsite inspection and evaluation shall have their permit automatically suspended for 30 days after the date on which the board notifies the nurse anesthetist of the failure unless within that time period the nurse anesthetist has retaken and passed an onsite inspection and evaluation. A nurse anesthetist who is issued a permit under this article shall be subject to an onsite inspection and evaluation at least once every five years. Refusal to submit to an inspection shall result in automatic denial or revocation of the permit.
(e) A certified registered nurse anesthetist who additionally meets the requirements of paragraphs (2) and (3) of subdivision (c) of Section 1646.2 may apply to the board for a pediatric endorsement to provide general anesthesia or deep sedation to a child under seven years of age. A nurse anesthetist without sufficient cases to obtain a pediatric endorsement may qualify for the endorsement pursuant to the requirements of subdivision (d) of Section 1646.2.

SEC. 2.

 Section 2827 of the Business and Professions Code is amended to read:

2827.
 (a)  The utilization of a nurse anesthetist to provide anesthesia services in an acute care facility shall be approved by the acute care facility administration and the appropriate committee, and at the discretion of the physician, dentist or podiatrist. If a general anesthetic agent is administered in a dental office, the dentist shall hold a permit authorized by Article 2.7 (commencing with Section 1646) of Chapter 4 or, commencing January 1, 2022, Article 2.75 (commencing with Section 1646) of Chapter 4. dentist, or podiatrist. 
(b) General anesthesia or deep sedation administered in a dental office at the request of a dentist by a nurse anesthetist shall be in accordance with the following:
(1) Article 2.75 (commencing with Section 1646) of Chapter 4.
(2) (A) If administering general anesthesia or deep sedation to dental patients in the office of a licensed dentist who does not possess a permit issued pursuant to Article 2.75 (commencing with Section 1646) of Chapter 4, the nurse anesthetist shall do all of the following:
(i) Register with the United States Drug Enforcement Administration.
(ii) Practice within the scope of their clinical and professional education and training.
(iii) Establish a plan for referral of complex cases and emergencies.
(iv) Decline or refer a patient with a preexisting disease or condition that is not optimized and may adversely interact with general anesthesia or deep sedation.
(v) Ensure that the facilities, equipment, personnel, and procedures utilized by the nurse anesthetist meet the Dental Board of California’s onsite inspection requirements under subdivision (c) of Section 1646.14. Failure of an onsite inspection constitutes unprofessional conduct and is grounds for disciplinary action by the board.
(B) This paragraph shall not be construed to require the Dental Board of California to enforce the requirements of this paragraph or verify compliance with this paragraph for purposes of Section 1646.14.
SEC. 3.
 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.