BILL NUMBER: AB 552 CHAPTERED 07/26/99 CHAPTER 177 FILED WITH SECRETARY OF STATE JULY 26, 1999 APPROVED BY GOVERNOR JULY 26, 1999 PASSED THE SENATE JULY 15, 1999 PASSED THE ASSEMBLY MAY 10, 1999 INTRODUCED BY Assembly Member Thompson (Principal coauthor: Senator Speier) FEBRUARY 18, 1999 An act to amend Sections 1646.7, 1646.9, 2079, and 2245 of the Business and Professions Code, relating to outpatient care, and making an appropriation therefor. LEGISLATIVE COUNSEL'S DIGEST AB 552, Thompson. Outpatient settings: general anesthesia. Existing law, until January 1, 2000, permits a physician and surgeon to administer general anesthesia in the office of a licensed dentist, for dental patients, whether or not the dentist has been certified to perform general anesthesia, if the licensed physician and surgeon holds a valid general anesthesia permit issued by the Board of Dental Examiners of California. It also requires payment of a fee for issuance of the permit, requires onsite inspection and evaluation, and requires automatic suspension of the permit for a physician and surgeon who has failed an onsite inspection and evaluation, except as prescribed. Existing law, until January 1, 2000, requires the Medical Board of California to inform the Board of Dental Examiners of California whether the applicant is a licensed physician and surgeon and to verify and inform the Board of Dental Examiners of California whether the applicant has successfully completed a postgraduate residency training program in anesthesiology recognized by the American Council on Graduate Medicine. Existing law declares that a violation by the dentist of related provisions constitutes unprofessional conduct and authorizes the Board of Dental Examiners of California to take prescribed actions. Existing law, until January 1, 2000, provides that a violation of those provisions and of provisions relating to general anesthesia by a physician and surgeon may constitute unprofessional conduct under the Medical Practice Act, and is grounds for suspension or revocation of the general anesthesia permit issued by the Board of Dental Examiners of California. It also requires the Board of Dental Examiners of California to refer the matter to the Medical Board of California for its consideration as unprofessional conduct and for further action under the Medical Practice Act. It also provides that a suspension or revocation of a physician and surgeon's permit by the Board of Dental Examiners shall not constitute a disciplinary proceeding or action except to permit the initiation of an investigation or disciplinary action by the Medical Board of California. The bill would extend the repeal date of the provisions that are repealed on January 1, 2000, until January 1, 2002. By extending the period increased moneys will be deposited in a continuously appropriated fund, this bill would make an appropriation. Appropriation: yes. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. Section 1646.7 of the Business and Professions Code, as amended by Section 1 of Chapter 505 of the Statutes of 1998, is amended to read: 1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentist's permit, license, or both, or the dentist may be reprimanded or placed on probation. (b) A violation of any provision of this article or Section 1682 is grounds for suspension or revocation of the physician and surgeon' s permit issued pursuant to this article by the Board of Dental Examiners of California. The exclusive enforcement authority against a physician and surgeon by the Board of Dental Examiners of California shall be to suspend or revoke the permit issued pursuant to this article. The Board of Dental Examiners of California shall refer a violation of this article by a physician and surgeon to the Medical Board of California for its consideration as unprofessional conduct and further action, if deemed necessary by the Medical Board of California, pursuant to Chapter 5 (commencing with Section 2000). A suspension or revocation of a physician and surgeon's permit by the Board of Dental Examiners pursuant to this article shall not constitute a disciplinary proceeding or action for any purpose except to permit the initiation of an investigation or disciplinary action by the Medical Board of California as authorized by Section 2220.5. (c) The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the Board of Dental Examiners of California shall have all the powers granted therein. (d) This section shall remain in effect only until January 1, 2002, and as of that date is repealed, unless a later enacted statute, which is enacted on or before January 1, 2002, deletes or extends that date. SEC. 2. Section 1646.7 of the Business and Professions Code, as added by Section 2 of Chapter 505 of the Statutes of 1998, is amended to read: 1646.7. (a) A violation of this article constitutes unprofessional conduct and is grounds for the revocation or suspension of the dentist's permit, license, or both, or the dentist may be reprimanded or placed on probation. The proceedings under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein. (b) This section shall become operative January 1, 2002. SEC. 3. Section 1646.9 of the Business and Professions Code is amended to read: 1646.9. (a) Notwithstanding any other provision of law, including, but not limited to, Section 1646.1, a physician and surgeon licensed pursuant to Chapter 5 (commencing with Section 2000) may administer general anesthesia in the office of a licensed dentist for 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 physician and surgeon possesses a current license in good standing to practice medicine in this state. (2) The physician and surgeon holds a valid general anesthesia permit issued by the Board of Dental Examiners of California pursuant to subdivision (b). (b) (1) A physician and surgeon who desires to administer general anesthesia as set forth in subdivision (a) shall apply to the Board of Dental Examiners of California on an application form prescribed by the board and shall submit all of the following: (A) The payment of an application fee prescribed by this article. (B) Evidence satisfactory to the Medical Board of California showing that the applicant has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the American Council on Graduate Medical Education, as set forth in Section 2079. (C) Documentation demonstrating that all equipment and drugs required by the Board of Dental Examiners of California are possessed by the applicant and shall be available for use in any dental office in which he or she administers general anesthesia. (D) Information relative to the current membership of the applicant on hospital medical staffs. (2) Prior to issuance or renewal of a permit pursuant to this section, the Board of Dental Examiners of California may, at its discretion, require an onsite inspection and evaluation of the facility, equipment, personnel, including, but not limited to, the physician and surgeon, and procedures utilized. At least one of the persons evaluating the procedures utilized by the physician and surgeon shall be a licensed physician and surgeon expert in outpatient general anesthesia who has been authorized or retained under contract by the Board of Dental Examiners of California for this purpose. (3) The permit of any physician and surgeon who has failed an onsite inspection and evaluation shall be automatically suspended 30 days after the date on which the board notifies the physician and surgeon of the failure unless within that time period the physician and surgeon has retaken and passed an onsite inspection and evaluation. Every physician and surgeon issued a permit under this article shall have an onsite inspection and evaluation at least once every six years. Refusal to submit to an inspection shall result in automatic denial or revocation of the permit. (c) This section shall remain in effect only until January 1, 2002, and as of that date is repealed, unless a later enacted statute, which is enacted on or before January 1, 2002, deletes or extends that date. SEC. 4. Section 2079 of the Business and Professions Code is amended to read: 2079. (a) A physician and surgeon who desires to administer general anesthesia in the office of a dentist pursuant to Section 1646.9 shall provide the Medical Board of California with a copy of the application submitted to the Board of Dental Examiners of California pursuant to subdivision (b) of Section 1646.9 and a fee established by the board not to exceed the costs of processing the application as provided in this section. (b) The Medical Board of California shall review the information submitted and take action as follows: (1) Inform the Board of Dental Examiners of California whether the physician and surgeon has a current license in good standing to practice medicine in this state. (2) Verify whether the applicant has successfully completed a postgraduate residency training program in anesthesiology and whether the program has been recognized by the American Council on Graduate Medical Education. (3) Inform the Board of Dental Examiners of California whether the Medical Board of California has determined that the applicant has successfully completed the postgraduate residency training program in anesthesiology recognized by the American Council on Graduate Medicine. (c) This section shall remain in effect only until January 1, 2002, and as of that date is repealed, unless a later enacted statute, which is enacted on or before January 1, 2002, deletes or extends that date. SEC. 5. Section 2245 of the Business and Professions Code is amended to read: 2245. (a) A violation of Article 2.7 (commencing with Section 1646) of Chapter 4 of Division 2 or Section 1682 by a physician and surgeon who possesses a permit issued by the Board of Dental Examiners of California to administer general anesthesia in a dental office may constitute unprofessional conduct. (b) This section shall remain in effect only until January 1, 2002, and as of that date is repealed, unless a later enacted statute, which is enacted on or before January 1, 2002, deletes or extends that date.