WSR 10-16-118

PROPOSED RULES

DEPARTMENT OF HEALTH


(Dental Quality Assurance Commission)

[ Filed August 2, 2010, 5:12 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 09-15-115.

Title of Rule and Other Identifying Information: WAC 246-817-701 Administration of anesthetics agents for dental procedures and 246-817-722 Defibrillator.

Hearing Location(s): Department of Health, 310 Israel Road S.E., Room 152/153, Tumwater, WA 98501, on September 17, 2010, at 8:00 a.m.

Date of Intended Adoption: September 17, 2010.

Submit Written Comments to: Jennifer Santiago, P.O. Box 47852, Olympia, WA 98504, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2901, by September 10, 2010.

Assistance for Persons with Disabilities: Contact Jennifer Santiago by September 10, 2010, TTY (800) 833-6388 or 711.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rules remove the twenty-four hour on-call availability requirement following procedures using local anesthetic and the automated external defibrillator (AED) requirement for dental offices only performing local anesthetic (not sedation). The proposed rule also modifies the current AED requirement for dental offices performing sedation by allowing an office to share access to an AED or defibrillator with another business if it is available and in reach within sixty seconds.

Reasons Supporting Proposal: Proposed rule amendments are based on input from stakeholders, specifically dentists. Rules adopted in January 2009 increased the requirements regarding on-call availability and the placement of AED or defibrillators in dental offices. Dentists demonstrated there was insufficient data to support the requirement for on-call availability and AED's following procedures that used only local anesthetic. Based on professional experience and judgment, the commission approved the proposal for official public comment.

Statutory Authority for Adoption: RCW 18.32.640 and 18.32.0365.

Statute Being Implemented: RCW 18.32.640.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Washington state dental quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Jennifer Santiago, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4893.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry. A copy of the statement may be obtained by contacting Jennifer Santiago, 310 Israel Road S.E., Tumwater, WA 98501, phone (360) 236-4893, fax (360) 236-2901, e-mail jennifer.santiago@doh.wa.gov.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Jennifer Santiago, P.O. Box 47852, Olympia, WA 98504, phone (360) 236-4893, fax (360) 236-2901, e-mail jennifer.santiago@doh.wa.gov.

July 30, 2010

Andrew A. Vorono, D.D.S.

Chair

OTS-2861.2


AMENDATORY SECTION(Amending WSR 09-04-042, filed 1/30/09, effective 3/2/09)

WAC 246-817-701   Administration of anesthetic agents for dental procedures.   The purpose of WAC 246-817-701 through 246-817-790 is to govern the administration of sedation and general anesthesia by dentists licensed in the state of Washington in settings other than hospitals as defined in WAC 246-320-010 and ambulatory surgical facilities as defined in WAC 246-310-010, pursuant to the DQAC authority in RCW 18.32.640.

(1) The DQAC has determined that anesthesia permitting should be based on the "level" of anesthesia because anesthesia/sedation is a continuum, and the route of administration and drug combinations are both capable of producing a deeper level of sedation/anesthesia than is initially intended. Practitioners intending to produce a given level of sedation should be able to rescue patients who enter a state deeper than initially intended.

(2) All anesthesia providers must provide twenty-four hour, on-call availability following an anesthesia procedure, excluding those procedures using only local anesthetic.

(3) The dental assistant and expanded function dental auxiliary may not administer any general or local anesthetic, including intravenous sedation.

[Statutory Authority: RCW 18.32.640 and 18.32.0365. 09-04-042, 246-817-701, filed 1/30/09, effective 3/2/09. Statutory Authority: RCW 18.32.035. 95-21-041, 246-817-701, filed 10/10/95, effective 11/10/95.]


AMENDATORY SECTION(Amending WSR 09-04-042, filed 1/30/09, effective 3/2/09)

WAC 246-817-722   Defibrillator.   (1) Every dental office in the state of Washington that administers ((anesthetic)) minimal, moderate, or deep sedation, or general anesthesia, as defined in WAC 246-817-710, must have an ((automatic)) automated external defibrillator (AED) or defibrillator.

(2) The dentist and staff must ((be prepared)) have access to ((use this equipment)) the AED or defibrillator in an emergency, and it must be available and in reach within sixty seconds.

(3) A dental office may share a single AED or defibrillator with adjacent businesses if it meets the requirements in this section.

[Statutory Authority: RCW 18.32.640 and 18.32.0365. 09-04-042, 246-817-722, filed 1/30/09, effective 3/2/09.]

Washington State Code Reviser's Office