88R6172 BEE-F     By: Clardy H.B. No. 1930       A BILL TO BE ENTITLED   AN ACT   relating to the administration of anesthesia by a certified   registered nurse anesthetist on the order of a dentist.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 258.001, Occupations Code, is amended to   read as follows:          Sec. 258.001.  IMPERMISSIBLE DELEGATIONS. A dentist may not   delegate:                (1)  an act to an individual who, by board order, is   prohibited from performing the act;                (2)  any of the following acts to a person not licensed   as a dentist or dental hygienist:                      (A)  the removal of calculus, deposits, or   accretions from the natural and restored surfaces of exposed human   teeth and restorations in the human mouth;                      (B)  root planing or the smoothing and polishing   of roughened root surfaces or exposed human teeth; or                      (C)  any other act the delegation of which is   prohibited by board rule;                (3)  any of the following acts to a person not licensed   as a dentist:                      (A)  comprehensive examination or diagnosis and   treatment planning;                      (B)  a surgical or cutting procedure on hard or   soft tissue;                      (C)  the prescription of a drug, medication, or   work authorization;                      (D)  the taking of an impression for a final   restoration, appliance, or prosthesis;                      (E)  the making of an intraoral occlusal   adjustment;                      (F)  direct pulp capping, pulpotomy, or any other   endodontic procedure;                      (G)  the final placement and intraoral adjustment   of a fixed or removable appliance; or                      (H)  the placement of any final restoration; or                (4)  the authority to an individual to administer a   local anesthetic agent, inhalation sedative agent, parenteral   sedative agent, or general anesthetic agent, including as a   teledentistry dental service as that term is defined by Section   111.001, if the individual is not licensed as:                      (A)  a dentist with a permit issued by the board   for the procedure being performed, if a permit is required;                      (B)  a certified registered nurse anesthetist   licensed by the Texas Board of Nursing[, only if the delegating   dentist holds a permit issued by the board for the procedure being   performed, if a permit is required]; or                      (C)  a physician anesthesiologist licensed by the   Texas Medical Board.          SECTION 2.  Subchapter D, Chapter 258, Occupations Code, is   amended by adding Section 258.158 to read as follows:          Sec. 258.158.  ADMINISTRATION OF ANESTHESIA BY NURSE   ANESTHETIST. (a)  The board and the Texas Board of Nursing shall   jointly adopt rules governing the administration of anesthesia by a   certified registered nurse anesthetist on the order of a dentist.   The rules must:                (1)  for each category under Section 258.155(a),   establish standards and requirements for the administration of   anesthesia by a certified registered nurse anesthetist on the order   of a dentist who does not hold a permit in that category; and                (2)  authorize a dentist to order, and a certified   registered nurse anesthetist to administer, anesthesia in   accordance with the standards and requirements described by   Subdivision (1).          (b)  Rules adopted under Subsection (a) do not apply to the   administration of anesthesia:                (1)  in a licensed hospital or licensed ambulatory   surgical center; or                (2)  by a certified registered nurse anesthetist acting   under the delegated authority of a dentist who holds a permit to   administer the anesthesia.          SECTION 3.  Not later than January 1, 2024, the State Board   of Dental Examiners and the Texas Board of Nursing shall jointly   adopt rules under Section 258.158, Occupations Code, as added by   this Act.          SECTION 4.  This Act takes effect September 1, 2023.