The Board proposes this rule amendment to relocate the provision on dentists treating patients who have been administered anesthesia by a physician anesthesiologist in the dental outpatient facility.

 

DEPARTMENT OF HEALTH
Board of Dentistry

RULE NO.:RULE TITLE:
64B5-14.0032Use of Physician Anesthesiologist
PURPOSE AND EFFECT: The Board proposes this rule amendment to relocate the provision on dentists treating patients who have been administered anesthesia by a physician anesthesiologist in the dental outpatient facility.
SUMMARY: The proposed rule amendment is necessary to address the requirements of dentists treating patients who have been administered anesthesia by a physician anesthesiologist in dental outpatient facilities.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:
The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the agency.
The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board, based upon the expertise and experience of its members, determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
RULEMAKING AUTHORITY: 466.004(4), 466.017(3) FS.
LAW IMPLEMENTED: 466.017(3) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Susan Foster, Executive Director, Board of Dentistry, 4052 Bald Cypress Way, Bin #C08, Tallahassee, Florida 32399-3258

THE FULL TEXT OF THE PROPOSED RULE IS:

(Substantial rewording of Rule 64B5-14.0032 follows. See Florida Administrative Code for present text.)

 

64B5-14.0032 Itinerate/Mobile Anesthesia- Physician Anesthesiologist.

The provisions of this rule control the treatment of dental patients in an outpatient dental office setting where a physician anesthesiologist has performed the sedation services. This rule shall control notwithstanding any rule provision in this Chapter that prohibits such conduct.   The level of sedation is not restricted to the level of the permit held by the treating dentist.  The level of sedation may be any level necessary for the safe and effective treatment of the patient. 

(1)General Anesthesia Permit Holders.

A dentist who holds a general anesthesia permit may treat their adult, pediatric, or special needs patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply: 

(a) The physician anesthesiologist performs the administration of the anesthesia and the physician anesthesiologist is responsible for the anesthesia procedure;

(b)The dental treatment takes place in the general anesthesia permit holder’s board-inspected and board-registered dental office.

(2)Pediatric Conscious Sedation Permit Holders.

A pediatric dentist, as recognized by the American Dental Association, who holds a pediatric conscious sedation permit may treat their pediatric or special needs dental patients when a physician anesthesiologist performs the sedation services. The following conditions shall apply:

(a)The physician anesthesiologist performs the administration of the anesthesia, and the physician anesthesiologist is responsible for the anesthesia procedure;

(b)The treatment takes place in the permit holder’s board-inspected and board-registered dental office;

(c)The dental office meets the supply, equipment, and facility requirements as mandated in Rule 64B5-14.008;

(d)A board-approved inspector performs an inspection of the dental office and the inspector reports the office to be in full compliance with the minimum supply, equipment, and facility requirements.

A pediatric dentist who holds an active conscious sedation permit and not a pediatric conscious sedation permit shall meet the sedation permit requirement of this rule until the next biennial license renewal cycle that follows the effective date of this rule.  At the next biennial license renewal cycle that follows the effective date of this rule, a pediatric dentist who hold a conscious sedation permit may transfer the permit to a pediatric conscious sedation permit without any additional cost besides the renewal fee.  

(3)Conscious Sedation Permit Holders:

A dentist who holds a conscious sedation permit may treat their adult or adult special needs dental patients when a physician anesthesiologist performs the sedation services.  The following conditions shall apply:

(a)The physician anesthesiologist performs the administration of the anesthesia, and the physician anesthesiologist is responsible for the anesthesia procedure;

(b)The treatment takes place in the permit holder’s properly board-inspected and board-registered dental office;

(c)The dental office meets the supply, equipment, and facility requirements as mandated in Rule 64B5-14.008, F.A.C.;

(d)A board-approved inspector performs an inspection of the dental office and the inspector reports the office to be in full compliance with the minimum supply, equipment, and facility requirements.

(4)Non-Sedation Permit Holders:

All provisions of this Chapter relating to the administration of any type of anesthesia or sedation and treatment to sedated patients shall remain in full force and effect. Nothing in this section supersedes, alters, or creates a variance to any prohibitions and mandates applicable to non-sedation permit holding dentists.

(5)Staff or Assistants:  A dentist treating a patient pursuant to this rule must have at least three (3) properly credentialed individuals present as mandated in Rule 64B5-14.003, F.A.C. To fulfill the mandatory minimum required personnel requirements of Rule 64B5-14.003, a physician anesthesiologist assistant or a certified registered nurse anesthetist in addition to, or in lieu of a dental assistant or dental hygienist may be utilized.  However, the dentist must have a dedicated member of the team to assist in the dental procedure or during dental emergencies.

(6)Equipment:

A dentist may comply with the electrocardiograph and end tidal carbon dioxide monitor equipment standards set by Rule 64B5-14.008, by utilizing mobile or non-fixed equipment if the dentist meets the following conditions:

(a)During the required board inspection, the equipment is available for inspection, and the dentist supplies an inspection of the equipment, which a licensed health care risk manager performed. A licensed health care risk manager inspection is valid for a period of twelve months; and 

(b). The dentist shall make the inspected equipment available during all required inspections and the equipment must be immediately available for an adverse incident inspection.

(7)Records:

The treating dentist shall maintain a complete copy of the anesthesia records in the patient’s dental chart. The dentist shall make certain that name and license numbers identify the treating dentist, the physician anesthesiologist, and all personnel utilized during the procedure.

Rulemaking Authority 466.004(4), 466.017(3) FS. Law Implemented 466.017(3) FS. History–New 8-20-12, Amended 11-19-12, ___________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Anesthesia Committee
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Dentistry
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: November 16, 2012
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: August 31, 2012