Maine Board Of Dental Practice An Overview of

Maine Board Of Dental Practice An Overview of Board Rule, Chapter 14 “Rules for Use of Sedation and General Anesthesia“ Presented by Penny Vaillancourt, Executive Director September 15, 2017 www. maine. gov/dental

Today’s Presentation I. Overview of the New Rule II. Highlighted Changes III. New Applications and Forms IV. Transition Plan for current Permit Holders V. Links and Resources

I. Overview of the New Rule A. What’s New? What’s Different? What’s the Same? B. Method of Obtaining Permits C. 14 Day Notification Process D. Certification Form; Anesthesia Committee

A. What’s New? q What’s New: q De-regulation of site permits; site permit applications are no longer required to be filed with the Board to utilize the services of another provider q Itinerant Permits – Itinerant Permits are issued to qualifying dentists who wish only to provide sedation/anesthesia services in agreement with an operating dentist q Elimination of required board inspections for initial permits and renewal of permits q Duration of Permits – permits are issued for a fixed, two year biennium to align with the dentists license expiration date (December 31 st of odd years) q Application Forms, Certification Form, 14 Day Notification Form q Capnography required by July 1, 2018; and electrocardiograph for Moderate Sedation Level II Permit Holders when providing services to certain patients

A. What’s Different…What’s the Same? q What’s Different: q Operating dentists are not required to obtain a Site Permit when utilizing the services of another sedation/general anesthesia provider. Rather, operating dentists are required to file a 14 Day Notification Form q Licensees seeking initial or renewal of permits will be required to meet the requirements outlined in Board Rule, Chapter 14 by attesting on forms provided by the Board q Elimination of temporary permits; elimination of the Anesthesia Committee duties/functions q What’s the Same: q Sedation and/or general anesthesia permits are still issued and renewed to qualifying dentists q Education/Training qualifications are the same for each permit type q Practice standards are still consistent with the 2007 ADA Guidelines and the 2006 AAP/AAPD Guidelines q Board still retains the authority to inspect

B. Method of Obtaining Permits q Permitting Process q Initial application: Dentists applying for Moderate Level I, Moderate Level II and Deep Sedation/General Anesthesia Permits must complete the application form, including the Certification Form and submit to the Board for review/approval q Renewal: Dentists applying for renewal of an existing permit will be required to complete a renewal form, and attest to meeting the requirements as outlined in Board Rule, Chapter 14 q Initial application: Dentists applying for an Itinerant Permit must complete the application form, including the Certification Form, and the 14 Day Notification Form prior to providing services q Renewal: Same as above

C. 14 Day Notification Process q Operating Dentists – are required to file 14 Day Notification Form when utilizing the services of another sedation/anesthesia provider pursuant to Section XIII of the Rule q Itinerant Permit holders – are required to file a 14 Day Notification Form when providing services to an operating dentist pursuant to Section IX(A)(4) of the Rule q A signed, written agreement between the parties is required as part of the 14 Day Notification Form. The written agreement identifies the division of responsibilities between the operating dentist and the provider q A separate form must be submitted for each, individual agreement between the operating dentist and the provider

D. Certification Form; Anesthesia Committee q Certification Forms – mirrors the former inspection process using the ADA’s 2007 guidelines and the AAP/AAPD 2006 Guidelines q The form which is included in the initial application for permit identifies the requirements to ensure licensees are adhering to the requirements related to Emergency Equipment, Drug Inventory, Anesthesia Gas Delivery Systems, Patient Documentation, Patient Monitoring, and Miscellaneous/Personnel requirements outlined in the Rule q Anesthesia Committee q The new rule eliminates the committee; however, the Board will continue to utilize the committee in an advisory capacity as needed

II. Highlighted Changes q Highlights of the new rule include: q The Rule lists the required elements to safely deliver sedation/anesthesia services such as emergency equipment, drug inventory, anesthesia gas delivery systems, patient documentation, patient monitoring, and miscellaneous/personnel requirements q Eliminates board inspections, but requires applicants/licensees to attest to adhering to the requirements q Eliminates issuing temporary permits and site permits q Identifies a new permit type – Itinerant Provider q 14 Day Notification Requirements – dentists are responsible for submitting notifications for review and approval by the Board prior to either utilizing the services of another provider, or as an Itinerant Permit holder provider services in agreement with an operating dentist q Aligns the duration of the permit to the dentist licensure cycle

III. New Applications and Forms q q Moderate Level I (Enteral) Permit application Moderate Level II (Parenteral) Permit application Deep Sedation / General Anesthesia Permit application Itinerant Permit application q 14 Day Notification Form q Certification Form website link: http: //www. maine. gov/dental/licensure/forms. html

IV. Transition Plan q Current permit holders waiting for an inspection q Licensees waiting for an inspection will be mailed instructions to complete a Certification Form. The Board will not be conducting inspections as part of the permitting process under the old rule. q Licensees with a pending permit renewal application will be mailed instructions to complete a Certification Form. The Board will not be conducting inspections as part of the permitting process under the old rule. q Current site permit holders q Licensees with an active site permit are not required to file a renewal application. Rather, licensees using another provider will be required to file a 14 Day Notification Form for each, individual provider prior to the date of the site permit expiration date.

V. Links and Resources FOR MORE INFORMATION: ü ADA and AAP/AAPD Guidelines: http: //www. maine. gov/dental/boardinformation/resources. html ü Board Rule, Chapter 14: http: //www. maine. gov/dental/statutesrules/statutes-rules. html ü Applications and Forms: http: //www. maine. gov/dental/licensure/forms. html ü Contact Board Staff: http: //www. maine. gov/dental/boardinformation/contact. html