Nurse anesthetists: general anesthesia or deep sedation.

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. Existing law authorizes a licensed physician and surgeon to administer deep sedation or general anesthesia in the office of a licensed dentist for dental patients if specified conditions are met, including that they hold a valid general anesthesia permit issued by the board as prescribed. Existing law, the Nurse Anesthetists Act, provides for the certification and regulation of nurse anesthetists by the Board of Registered Nursing within the Department of Consumer Affairs. Existing law requires the utilization of a nurse anesthetist to provide anesthesia services in an acute care facility to be approved by the acute care facility administration and the appropriate committee, and at the discretion of the physician, dentist, or podiatrist. This bill would authorize a certified registered nurse anesthetist to administer general anesthesia or deep sedation in the office of a licensed dentist for dental patients if specified conditions are met, including that they hold a valid general anesthesia permit issued by the board as prescribed. To obtain that permit, the bill would require a nurse anesthetist to apply to the board on an application form prescribed by the board and to submit, among other things, payment of an application fee. Prior to issuance or renewal of a permit pursuant to these provisions, the bill authorizes the board to require an onsite inspection and evaluation of the facility, equipment, and personnel, as specified. If a nurse anesthetist fails an onsite inspection and evaluation, the bill would require their permit be automatically suspended for 30 days, as specified. The bill would authorize a nurse anesthetist who additionally meets certain requirements to apply to the board for a pediatric endorsement to provide general anesthesia or deep sedation to a child under 7 years of age. The bill would require the administration of general anesthesia or deep sedation in a dental office by a nurse anesthetist at the request of a dentist to be in accordance with prescribed requirements, including, among other things, registering with the federal Drug Enforcement Administration and ensuring that the facilities, equipment, personnel, and procedures utilized meet the Dental Board of California's onsite inspection requirements, as specified. The bill would provide that failure of an onsite inspection constitutes unprofessional conduct and is grounds for disciplinary action by the Board of Registered Nursing. By expanding the scope of existing crimes under the Nurse Anesthetists Act and the Dental Practice 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.