Existing law, the Dental Practice Act, establishes the Dental Board of California in the Department of Consumer Affairs for the licensure and regulation of dentists. The act governs, among other things, the use of general anesthesia and deep sedation, as defined, for adult patients and patients under 13 years of age. The act requires a dentist to possess either a current license in good standing and a general anesthesia permit or a general anesthesia permit together with a maxillofacial surgery permit or a special permit to administer general anesthesia or deep sedation on an outpatient basis for dental patients.

Existing law, the Nurse Anesthetists Act, provides for the certification and regulation of nurse anesthetists by the Board of Registered Nursing, which is within the Department of Consumer Affairs. Under existing law, the utilization of a nurse anesthetist to provide anesthesia services is required to 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, existing law requires the dentist to hold a permit authorized by the provisions governing a dentist’s use of deep sedation and general anesthesia.

This bill would allow a nurse anesthetist to administer general anesthesia or deep sedation to dental patients if the nurse anesthetist receives a permit from the Dental Board of California. This bill would require that a nurse anesthetist, in order to administer deep sedation or general anesthesia, apply to the board and provide, among other things, evidence that the nurse anesthetist has met specified educational requirements. This bill would authorize the board to require an onsite inspection and evaluation prior to the issuance or renewal of a permit, and would require that a nurse anesthetist who fails that inspection and evaluation have their permit suspended, as specified. This bill would authorize a nurse anesthetist to apply to the board for an endorsement to perform general anesthesia or deep sedation on a child under 7 years of age.

This bill would also require a nurse anesthetist that is providing general anesthesia or deep sedation in a dental office to do so in accordance with the provisions of the Dental Practice Act that govern the use of general anesthesia or deep sedation in a dental office and in accordance with specified provisions of the Nursing Practice Act. By expanding the scope of existing crimes under the Dental Practice Act and the Nurse Anesthetists Act, this bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.