TITLE 22. EXAMINING BOARDS

PART 5. STATE BOARD OF DENTAL EXAMINERS

CHAPTER 100. GENERAL PROVISIONS

22 TAC §100.12

The State Board of Dental Examiners (Board) proposes repeal of §100.12, concerning the Advisory Committee on Dental Anesthesia. The proposed repeal removes all references to the Blue Ribbon Panel, which was disbanded following the completion of its duties in January 2017.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed repeal is in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Kelly Parker has also determined that for the first five-year period the proposed repeal is in effect, the public benefit anticipated as a result of repealing the rule will be accuracy and clarity. Ms. Parker has determined that for the first five-year period the proposed repeal is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rules are enforced or administered.

Comments on the proposed repeal may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 475-0977, rulecomments@tsbde.texas.gov.

The repeal is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by these proposed repeal.

§100.12.Advisory Committee - Blue Ribbon Panel on Dental Sedation/Anesthesia Safety.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on July 28, 2017.

TRD-201702821

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: September 10, 2017

For further information, please call: (512) 475-0977


22 TAC §100.12

The State Board of Dental Examiners (Board) proposes new rule §100.12, concerning the Advisory Committee on Dental Anesthesia. The new rule establishes the Advisory Committee on Dental Anesthesia and specifies its duties and the appointment of its members.

Kelly Parker, Executive Director, has determined that for the first five-year period the proposed rules are in effect, there will not be any fiscal implications for state or local government as a result of enforcing or administering the rule.

Kelly Parker has also determined that for the first five-year period the proposed rule is in effect, the public benefit anticipated as a result of establishing the committee will be to increase our understanding of anesthesia related incidents in dentistry. Ms. Parker has determined that for the first five-year period the proposed rule is in effect, costs to persons or small businesses will be minimal. There is no foreseeable impact on employment in any regional area where the rules are enforced or administered.

Comments on the proposed new rule may be submitted to Tyler Vance, General Counsel, 333 Guadalupe, Suite 3-800, Austin, Texas 78732, Fax (512) 475-0977, rulecomments@tsbde.texas.gov.

The new rule is proposed under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety.

No statutes are affected by the proposal.

§100.12.Advisory Committee on Dental Anesthesia.

(a) Pursuant to §258.202 of the Texas Occupations Code, the board establishes an advisory committee: the Advisory Committee on Dental Anesthesia.

(b) Purpose. The purpose of the advisory committee is to analyze and report on de-identified data and associated trends concerning anesthesia-related deaths or incidents. The data and information provided by the agency to the advisory committee is confidential. The recommendations and findings reported by the advisory committee to the board are public information and published on the board's Internet website.

(c) Compilation of Information by Agency. The agency shall identify investigations and provide confidential, de-identified information regarding the investigations to the advisory committee as described below:

(1) By September 30 of each year, the agency shall identify official investigations in which the preliminary investigation was initiated after September 1, 2016, and the official investigation was resolved by the board in the preceding fiscal year, which involve anesthesia-related deaths or incidents. A death shall be considered anesthesia-related if the dental treatment involved the administration of an anesthetic or sedative agent in the dental office, including local anesthesia, and a death occurred. An incident shall be considered anesthesia-related if the dental treatment involved the administration of an anesthetic or sedative agent in a dental office, including local anesthesia, and the Dental Review Panel identified a complication associated with the administration of the anesthetic or sedative agent.

(2) By November 30 of each year, the agency shall compile confidential, de-identified information on each investigation identified under paragraph (1) of this subsection, including, but not limited to, the following information:

(A) Information about respondent:

(i) Whether respondent is a Medicaid provider;

(ii) Respondent's highest sedation/anesthesia permit level;

(iii) Whether respondent reported providing anesthesia services in more than one location on the licensee's application or latest renewal;

(iv) Respondent's self-reported practice area; and

(v) Whether the investigation was initiated as the result of a complaint submitted by a patient or member of the public, as a self-report to the agency required by Board Rule 108.6, or both.

(B) Information about patient:

(i) Patient ASA, as identified in respondent's dental records and/or determined by Dental Review Panel;

(ii) Patient age -- under the age of 13, 13 and over but under 18, 18 and over but under 75, and 75 and over;

(iii) Location of the treatment investigated by the agency -- dental office, hospital, ASC, office of other practitioner;

(iv) Level of sedation/anesthesia administered -- Local, Nitrous, I, II, III, IV (determined by Dental Review Panel);

(v) Sedation/anesthesia administrator -- respondent, other dentist, MD, CRNA (determined by Dental Review Panel); and

(vi) Whether treatment investigated by the agency was paid by Medicaid; and

(C) The Dental Review Panel report designated as the final report by the Dental Review Panel.

(3) By November 30 of each year, the agency shall provide the information identified under paragraph (2) of this subsection to the members of the advisory committee.

(4) On request of the advisory committee, the agency may provide confidential, de-identified investigative files to the advisory committee in addition to the information provided under paragraph (2) of this subsection. Pursuant to §258.505 of the Texas Occupations Code, the advisory committee may conduct a closed meeting to review confidential investigative files provided to the advisory committee under this paragraph.

(d) Analysis of Information by Advisory Committee. The advisory committee shall analyze the information compiled under subsection (c)(2) to identify any trends and submit a report to the board as described below:

(1) By June 30 of each year, the advisory committee shall submit a written report to the board of the advisory committee's findings and any recommendations for changes to the board rules or the Dental Practice Act.

(2) The advisory committee's annual report shall be posted on the Board's Internet website.

(e) Membership and Term Length. The advisory committee consists of six members appointed by the board to serve two-year terms beginning on December 1 of each odd-numbered year. Members, including the advisory committee chair, may serve no more than three consecutive terms as members of the advisory committee. An advisory committee chair may serve no more than four consecutive one-year terms as advisory committee chair. The advisory committee must include a licensed Texas physician anesthesiologist and five licensed Texas dentists. The five licensed Texas dentists must include at least one dentist who holds a level 1 sedation/anesthesia permit and no higher permit, at least one dentist who holds a level 2 sedation/anesthesia permit and no higher permit, at least one dentist who holds a level 3 sedation/anesthesia permit and no higher permit, and at least one dentist who holds a level 4 sedation/anesthesia permit. In addition, the five dentist members of the advisory committee shall include one general dentist. The remaining four dentist members shall be dentists who are university-trained in their respective practice areas, with applicants' education and experience verified during the application process. These four dentist members shall include one university-trained dentist to represent each of the following practice areas:

(1) dental anesthesiology;

(2) oral and maxillofacial surgery;

(3) pediatric dentistry; and

(4) periodontics.

(f) Qualification for Membership. A person cannot be appointed as a member unless he or she holds a Texas dental or medical license that he or she has maintained in good standing for at least the five years preceding application for membership on the advisory committee. A license is in good standing if it is not expired, currently subject to a probated suspension, or currently subject to an enforced suspension.

(g) Board Member Membership on Advisory Committee. In accordance with §258.202(c) of the Texas Occupations Code, a currently serving board member cannot be appointed to the advisory committee. A former board member cannot be appointed to the advisory committee prior to the second anniversary of the expiration or termination of the board member's service on the board.

(h) Application, Nomination, and Confirmation Process. Pursuant to §258.203 of the Texas Occupations Code, the board establishes the following process for the application, nomination, and confirmation of members of the advisory committee.

(1) Application for Membership. By October 1 of each odd-numbered year, the agency shall publish an application for advisory committee membership on the board's Internet website. The application period shall close on October 15 of each odd-numbered year.

(2) Nomination of Advisory Committee Members. By November 1 of each odd-numbered year, the presiding officer of the board shall review all applications and nominate six applicants for membership on the advisory committee. The applicants nominated by the presiding officer shall represent the membership described by subsection (e) of this section.

(3) Confirmation of Advisory Committee Members. By December 1 of each odd-numbered year, the board shall vote by ballot in a public meeting to confirm or reject each of the presiding officer's nominees for membership on the advisory committee. Confirmation of a nominee requires the affirmative vote of an absolute majority of the entire membership of the board if the board is comprised of more than six, but fewer than eleven members, or if the board is comprised of more than eleven members. Confirmation of a nominee requires the affirmative vote of at least seven members of the board if the board is comprised of eleven members.

(4) Rejection of Nomination by Board. If one of the presiding officer's nominations for membership on the advisory committee is rejected by the board, the presiding officer shall nominate another applicant to membership on the advisory committee, subject to confirmation by the board, as described in paragraph (3) of this subsection. The subsequent nominee shall represent the same self-reported practice area as the original nominee.

(5) Appointment of Advisory Committee Members. The appointment of an advisory committee member commences on the date the board confirms the presiding officer's appointment of the advisory committee member.

(i) Designation of Advisory Committee Chair. Each year the presiding officer of the board shall designate one of the advisory committee members appointed by the board to serve a one-year term as chair of the advisory committee.

(1) This paragraph applies if the board is comprised of more than six, but fewer than eleven members, or if the board is comprised of more than eleven members. The board shall confirm the presiding officer's designation by affirmative vote of an absolute majority of the entire membership of the board. If the presiding officer's designation is unconfirmed by such an affirmative vote, the presiding officer shall designate another member of the advisory committee as the chair of the advisory committee, subject to an affirmative vote of an absolute majority of the entire membership of the board.

(2) This paragraph applies if the board is comprised of eleven members. The board shall confirm the presiding officer's designation by affirmative vote of at least seven members of the board. If the presiding officer's designation is unconfirmed by such an affirmative vote, the presiding officer shall designate another member of the advisory committee as the chair of the advisory committee, subject to an affirmative vote of at least seven members of the board.

(j) Resignation, Removal, and Replacement of Advisory Committee Members. If an advisory committee member resigns or is removed from the advisory committee prior to the expiration of his or her term, the advisory committee member shall be replaced with another member that represents the self-reported practice area of the former advisory committee member. The application period shall re-open for a period of no more than 30 days. The agency shall publish the application for advisory committee membership on the board's Internet website, specifying the self-reported practice area to be replaced by a new member of the advisory committee. The presiding officer shall nominate the replacement member of the advisory committee at the next public meeting of the board, and the board shall confirm or reject the nomination as described in subsection (h) of this section.

(k) Confidential Information. The members of the advisory committee shall execute confidentiality agreements related to their membership on the advisory committee. Violation of the confidentiality agreement is grounds for immediate removal from the advisory committee and may subject the member of the advisory committee to investigation and disciplinary proceedings for dishonorable conduct pursuant to Board Rule 108.9.

(l) Communication with Other Parties. Members of the advisory committee shall not engage in private communications with non-advisory committee members about the subject matter of the advisory committee or its work, except that members of the advisory committee may communicate with agency staff to facilitate the completion of tasks required by this rule.

(m) Reimbursement. The advisory committee may be reimbursed for expenses in accordance with §2110.004 of the Texas Government Code.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on July 28, 2017.

TRD-201702822

Kelly Parker

Executive Director

State Board of Dental Examiners

Earliest possible date of adoption: September 10, 2017

For further information, please call: (512) 475-0977