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New Mexico Regulation and Licensing Department BOARDS AND COMMISSIONS DIVISION New Mexico Board of Dental Health Care and New Mexico Dental Hygienist Committee Toney Anaya Building ▪ P.O. Box 25101 ▪ Santa Fe, New Mexico 87505 (505) 476-4680▪ Fax (505) 476-4545 ▪ www.rld.state.nm.us
New Mexico Dental Health Care REGULAR BOARD MEETING July 17, 2015 Albuquerque, NM
MEETING MINUTES
1. CALL TO ORDER
At 11:53 a.m. the Board Chair, Dr. Charles Schumacher, DDS, called the New Mexico Board of Dental Health Care July 17, 2015 meeting to order.
2. ROLL CALL
MEMBERS PRESENT: Charles Schumacher, DDS Burrell Tucker, DDS David Warren III, DMD Leo Paul Balderamos, DDS Jolynn Galvin, DDS Ermelinda Baca, RDH Melissa Barbara, RDH Richard Hatch, Public Member
MEMBERS ABSENT: Robert Blewer, Public Member
OTHERS PRESENT: Jennifer Salazar, Assistant Attorney General
STAFF PRESENT: Roberta Perea, Board Administrator Brian McBain, Compliance Liaison Roll Call was taken by Roberta Perea and a quorum was determined present.
3. APPROVAL OF AGENDA
Ms. Ermelinda Baca, RDH made a MOTION to approve the agenda as amended. Dr. Paul Balderamos, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
4. APPROVAL OF MEETING MINUTES
April 24, 2015 Regular Meeting Ms. Ermelinda Baca, RDH made a MOTION to approve the minutes of the April 24, 2015 Regular Meeting as written. Dr. Jolynn Galvin, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL. Dr. David Warren, III abstained.
5. REPORTS Revision date: 10/2013 A. Introduction of New Board Member – Dr. David Warren, III B. Chair’s Report – Dr. Charles Schumacher, DDS Verbal Report C. Secretary’s Report – Dr. Burrell Tucker, DDS Dr. Burrell Tucker, DDS reported to the board that from April 10, 2015 through June 25, 2015 the following licenses were issued: 24 Dental licenses issued by Examination 3 Dental licenses issued by Credentials 75 Dental Assistant Certificates 0 Expanded Function Dental Auxiliary Certificates 0 Community Dental Health Coordinator Certificates 3 Non-Dentist Owner Ms. Ermelinda Baca, RDH made a MOTION to enter the Boards Secretaries report into record and to ratify the licenses and certifications. Dr. Paul Balderamos, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
D. Dental Hygienist Committee Report – Ms. Ermelinda Baca, RDH Dr. Burrell Tucker, DDS made a MOTION to ratify the recommendations of the Dental Hygienist Committee and ratify licenses and retirements/inactive status. Dr. Jolynn Galvin, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL. Licenses Issued for Period 04/10/15 thru 06/25/2015 22 Dental Hygienists by Examination 6 Dental Hygienists by Credentials
E. Anesthesia Committee Report – Dr. John Mitchell, DDS Written Report (Attachment A) Dr. John Mitchell, DDS reported to the board that from April 10, 2015 thru June 25, 2015 the following permits were issued: 8 Nitrous Oxide Permits, 1 0onscious Sedation I permit, 1 Conscious Sedation II permits 0 Deep Sedation/General Anesthesia permits Dr. Burrell Tucker, DDS made a MOTION to enter the Anesthesia Committee report into record and to ratify the licenses. Dr. Paul Balderamos, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
F. Administrator’s Report – Ms. Roberta Perea Written Report (Attachment B) G. Compliance Liaison Report – Mr. Brian McBain Verbal Report H. CODA Report. Charles Schumacher, DDS No Report I. NMDHA Report – Ms. Kathy Sovereign RDH Written Report (Attachment C) New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 2 of 28 Revision date: 10/2013 J. NMDA Report – No Report K. NM Department of Health Report – Ms. Carol Hanson, RDH Written Report (Attachment D) L. NM Health Services Medicaid Report – Dr. Devi Gajapathi No Report M. PIMA Report – Ms. Melissa McDougal-Plese No Report N. AADB – Ms. Ermelinda Baca, RDH Written Report O. WREB Report – Ms. Ermelinda Baca, RDH Written Report P. CRDTS Report –Ms. Ermelinda Baca, RDH Written Report (Attachment E) Q. CDCA Report – Dr. Charles Schumacher, DDS Verbal Report R. SRTA Report – No Report S. ADEX Report – Dr. Robert Gherardi, DMD Verbal Report T. CITA Report – No Report U. Prescription Drug Misuse and Overdose Prevention and Pain Management Advisory Council Report – Dr. Paul Balderamos, DDS Verbal Report V. Rules Committee – Dr. Charles Schumacher, DDS No Report W. Statutes Committee – Dr. Charles Schumacher, DDS No Report X. Ad Hoc Committees No Report
6.OLD BUSINESS A. Confirm Future Meeting Dates and Locations October Board Meeting – October 16, 2015 – Santa Fe January Board Meeting – January 29, 2015 – Santa Fe April Board Meeting – April , 2015, Albuquerque July Board Meeting – July , 2015 – Ruidoso
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 3 of 28 Revision date: 10/2013 7. NEW BUSINESS
A. Proposed Rule Changes
Mr. Richard Hatch made a MOTION to move forward to a rule hearing in October with the discussed changes for further modifications by the rules committee. Dr. Burrell Tucker, DDS SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.
B. Appoint Board Member to attend the AADB Annual Meeting, November 3-4, 2015 Washington, DC
Dr. Paul Balderamos, DDS made a MOTION to approve either Dr. Charles Schumacher or Dr. Burrell Tucker to attend the AADB annual meeting on November 3-4, 2015 in Washington, DC. Dr. David Warren, III SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.
C. Budget Report- Dr. Schumacher Dr. Charles Schumacher appointed an Ad Hoc Committee to review budget. The committee will be Dr. Charles Schumacher, Dr. Paul Balderamos, Dr. Robert Gherardi and Ms. Ermelinda Baca, RDH
D. Anesthesia Appointments – Dr. Schumacher - No Action Taken
E. Anesthesia Forum - Dr. Charles Schumacher will continue to work on a date for the anesthesia forum.
F. Public Comment - None
8. EXECUTIVE SESSION
Chair: I will hear a motion for closure of the meeting to enter into Executive Session.
Board Member Ms. Ermelinda Baca, RDH: I move that the New Mexico Dental Health Care Board close this meeting in order to enter into Executive Session to discuss the items listed in the agenda. Pursuant to Sections 10-15-1.H of the Open Meetings Act authorizing closed sessions for matters related to issuance, suspension, renewal, revocation of a license. Dr. Burrell Tucker, DDS SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.
Chair: Would the Board Administrator take a roll call vote to enter into Executive Session?
Roll Call Vote: Charles Schumacher, DDS Burrell Tucker, DDS David Warren III, DMD Leo Paul Balderamos, DDS Jolynn Galvin, DDS New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 4 of 28 Revision date: 10/2013 Ermelinda Baca, RDH Melissa Barbara, RDH Richard Hatch, Public Member
Chair: The motion is approved by a unanimous approval. Let the record show that at 2:13 p.m. the Board entered into closed session and the recorder has been turned off.
Back in Open Session
Let the record show that the recorder is back on. The New Mexico Board of Dental Health Care is back in open session. The time is 4:35pm Pursuant to 10-15-1 H 1, 3 & 7 of the Open Meetings Act the matters discussed in the closed meeting were limited only to the items listed in the motion.
9. BOARD ACTION ON MATTERS DISCUSSED IN EXECUTIVE SESSION
Requests for Inactive:
Ms. Melissa Barbara, RDH made a MOTION to approve the requests for Inactive Status of all the names listed on the agenda. Dr. Burrell Tucker, DDS SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.
Requests for Retirement Status:
Ms. Melissa Barbara, RDH made a MOTION to approve the requests for Retirement Status. Dr. Burrell Tucker, DDS SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.
APPLICATIONS:
15-51-APP Dr. Burrell Tucker made a MOTION to deem the application incomplete at this time pursuant to 16.5.17.8. Dr. Paul Balderamos SECONDED the motion which was PASSED by UNANIMOUS APPROVAL with Board Member Ms. Melissa Barbara, RDH, recusing.
15-59-APP Ms. Melissa Barbara, RDH made a MOTION to approve reinstatement. Dr. Jolynn Galvin, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
15-61-APP Ms. Melissa Barbara, RDH made a MOTION to approve reinstatement. Dr. Burrell Tucker, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
15-62-APP Ms. Melissa Barbara, RDH made a MOTION to approve reinstatement. Dr. Burrell Tucker, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
15-65-APP New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 5 of 28 Revision date: 10/2013 Ms. Melissa Barbara, RDH made a MOTION to accept the DANBE exam taken in May 17, 2014 until January 1, 2016. Dr. Burrell Tucker, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL with Board Member Dr. Jolynn Galvin, DDS, recusing.
15-73-APP Ms. Melissa Barbara, RDH made a MOTION to a 6 month temporary license. Dr. Burrell Tucker, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
15-76-APP Ms. Melissa Barbara, RDH made a MOTION to submit amended application with the additional CRNA;s and credentials of the CRNA’s. Dr. Burrell Tucker, DDS SECONDED the motion which was PASSED by UNANIMOUS APPROVAL.
COMPLAINTS:
Melissa Barbara, RDH, made a MOTION to dismiss the following case(s): 14-12-COM, 14-71-COM, 15- 22-COM, 15-37-COM, 15-38-COM, 15-41-COM, 15-45-COM, 15-48-COM, 15-50-COM, 15-25-COM and 15-34-COM: Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.
Melissa Barbara, RDH, made a MOTION to dismiss with an Advisory Letter for the following cases:15- 44-COM, 15-29-COM, 15-48-COM, and 15-43-COM: Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.
15-19-MAL and 15-33-MAL: No Action was taken by the Board on these items; these items were placed on the agenda for informational purposes only.
14-72-COM Melissa Barbara, RDH, made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5), 61-5A-21 (A)(13) and Rule 16.5.16.10 (B)(30) with a proposed early resolution (Settlement Agreement) with the following terms: (1) Respondent shall pay a $1,000 fine to the Board within 30 days of settlement. (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of settlement. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Ermelinda Baca, RDH and Dr. Jolynn Galvin, DDS, abstaining.
14-15-COM Melissa Barbara, RDH, made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5) and Rule 16.5.16.10 (B13) for violation of the ADA Code of Ethics Sections 2, 3 and 3F, with a proposed early resolution (Settlement Agreement) with the following terms: (1) Respondent shall pay a $1,000 fine to the Board within 30 days of settlement. (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of settlement. (3) Respondent shall complete 8 hours of CE classes (4 CE’s in Anger Management and 4 CE’s in Pediatric Behavior) which all must come from classroom credit within 90 days of settlement. The Board also requests that this NCA is expedited with the AGO. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 6 of 28 Revision date: 10/2013 15-17-COM Melissa Barbara, RDH, made a MOTION to refer to the AGO for the issuance of an NCA for violation of 61-5A-21 (A)(5), Rule 16.5.16.10 (B)(13) and ADA Code of Ethics Sections 2, 3 and 3F, with a proposed early resolution (Settlement Agreement) with the following terms: (1) Respondent shall pay a $1,000 fine to the Board within 30 days of settlement. (2) Respondent shall take and pass the New Mexico Dental Jurisprudence Exam within 30 days of settlement. (3) Respondent shall complete 8 hours of CE classes (4 CE’s in Anger Management and 4 CE’s in Pediatric Behavior) which all must come from classroom credit within 90 days of settlement. The Board also requests that this NCA is expedited with the AGO. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Ermelinda Baca, RDH, and Dr. Jolynn Galvin, DDS, abstaining.
15-12-COM
Tabled
15-23-COM
Tabled
Pending Licensee Matters:
12-93-COM FYI Only, No Action Taken.
13-55-MAL
Melissa Barbara, RDH, made a MOTION to accept the Proposed Settlement Agreement. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Member Ermelinda Baca, RDH, abstaining.
13-80-COM
Melissa Barbara, RDH, made a MOTION to dismiss this case. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Member Ermelinda Baca, RDH, abstaining.
14-87-COM FYI Only, No Action Taken.
15-02-APP Melissa Barbara, RDH, made a MOTION to accept the withdrawal of this application and dismiss the NCA. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL.
13-62-MAL
Melissa Barbara, RDH, made a MOTION to dismiss the NCA and vacate the hearing. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL. New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 7 of 28 Revision date: 10/2013 13-68-COM
This case was not discussed, the Board took No Action.
Pending Litigation
D-202-CV-2014-03969-William C. Gardner, DDS- No Action taken.
Default Orders
13-37-COM
Melissa Barbara, RDH, made a MOTION to revoke license by Default Order. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Member Ermelinda Baca, RDH, abstaining.
13-52-COM
Melissa Barbara, RDH, made a MOTION to issue a Default Order with a $1,000 fine. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Member Ermelinda Baca, RDH, abstaining.
13-66-COM
Melissa Barbara, RDH, made a MOTION to revoke license by Default Order. Dr. Burrell Tucker, DDS, SECONDED the motion. Motion PASSED by UNANIMOUS APPROVAL with Board Members Dr. Paul Balderamos, DDS, and Dr. Jolynn Galvin, DDS, recusing and Ms. Ermelinda Baca, RDH abstaining.
REPORTS
New Mexico Monitored Treatment Quarterly Report – FYI Only
XI. ADJOURNMENT
There being no other business to come before the Dental Board, Dr. Charles Schumacher, DDS, made a MOTION to adjourn the meeting at 4:52pm. Ms. Ermelinda Baca, RDH, SECONDED the motion. All in Favor. All Opposed. All Abstained. Motion PASSED by UNANIMOUS APPROVAL.
Submitted by: ______Roberta Perea, Board Administrator Date Approved by: ______Charles Schumacher, DDS, Chair Date
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 8 of 28 Revision date: 10/2013 (Attachment A)
2 July 2015
The New Mexico State Board of Dental Health Care Anesthesia Committee Report for 02 July 2015:
1. The meeting of the Anesthesia Committee of the New Mexico Board of Dental Health Care was held at the office of John C. Mitchell DDS on 07 April 2015 from 1730 until 2000.
2. The minutes of the last meeting were read and discussed.
a. Members present:
i. John Mitchell Chairman
ii. Ray Lyons
iii. Gary Cutrell
iv. Wai Pong Ng
v. Jason Flores
b. Members present by Phone in:
i. Aaron Rasmussen
ii. L. Paul Balderamos
iii. Joy Trigo
c. Members Absent: none
3. A discussion regarding examinations performed and/or permits approved since the last meeting.
a. See following documentation.
4. Assignments were made for members of the Anesthesia Committee to complete of Office Anesthesia Evaluations which are pending.
5. The recommendation made by Dr. Flores about the possibility of amending the requirements for facilities and types of agents to be used for anesthesia providers. (see addendum#1 from Dr. Flores)
a. Extensive discussion of these recommended changes led to unanimous agreement that these changes to the regulations governing sedation providers be enacted by the Board of dental Health Care as soon as is practical.
b. Special emphasis was given to the recommendation that the restriction of recognized general anesthetic agents should be restricted to the use by holders of DS/GA permits. New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 9 of 28 Revision date: 10/2013 c. There was once again majority agreement that the Board should no longer accept ACLS courses taken on line as meeting the criteria for certification or re-certification at the CSII or DS/GA level.
d. Once again, all agreed that CSII and DS/GA permit holder who sedate pediatric patients (under the age of 12 years) be PALS certified as well as ACLS certified.
e. The committee was greatly looking forward to input from the Boards legal counsel on several issue of a legal nature. Unfortunately such representation was not available since Jennifer Salazar (Board Attorney) was not able to make the meeting or was not aware that she was expected to be present at this meeting. As such, all members agreed that until we can get further legal advice, especially regarding the use of CRNA’s by dental providers, in the dental setting, that the current pending applications for CSII and DS/GA facility permits for said facilities be “put on hold” until such legal guidance can be rendered to the committee. All felt that it is imperative that a discussion be had with all committee member and such legal representative as to the patient safety issues created in these settings.
f.
6. Re-discussed how to get Office Anesthesia Evaluations for doctors and facilities in far Southeast and far Southwest New Mexico. See addendum #2:
a. No agreement could be reached as to how to make these examinations happen given the geography and difficulties brought about by distances and travel times, etc. However:
b. A recommendation was made that the Board very strongly consider having applicants sign an affidavit (see addendum #2) upon application and upon permit renewal. This is a direction taken by other states (e. g. Colorado and Texas) with geographic difficulties similar to New Mexico. The follow-on recommendation is for this to take the place of Office Anesthesia Evaluations prior to issuing permits and that random, announced and unannounced Office Anesthesia Evaluations would be conducted (possibly by the contracted examiners mentioned in addendum #2)
c. Any failure of said evaluations would constitute perjury on the part of the permit holder and should result in permanent revocation of sedation privileges.
d. Obviously, the applications for CSI, CSII and DS/GA permits would continue to receive close scrutiny.
e. The Oral and Maxillofacial Surgeons would still undergo Office Anesthesia Evaluations as mandated by the American Association of Oral and Maxillofacial Surgeons for all members of that organization.
7. The Meeting was adjourned:
Permits recommended for approval since last committee meeting:
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 10 of 28 Revision date: 10/2013 A. Nitrous Oxide/ Oxygen
a. Anne McLean Santa Fe
b. Brita Loepke Farmington
c. Matthew Loepke Bloomington
d. Richard Baldwin Albuquerque
e. Rohini Bansal Las Cruces
f. Stephen Tropp Arvada, CO
g. William Burnett Albuquerque
B. CSI:
a. Christina Chung
i. Los Lunas Permanent (Initial)
ii. Golf Course Rd, ABQ Permanent (Initial)
b. Laurie Gormley Las Cruces Permanent (Renewal)
c. Peter Roukema Albuquerque Permanent (Renewal)
d. Spencer Tasker
i. 111 Coors Blvd NW Albuquerque Permanent (Initial)
ii. 210 San Pedro SW Albuquerque Permanent (Initial)
iii. 3510 Coors Blvd SW Albuquerque Permanent (initial)
C. CSII
a. Aaron Rasmussen Farmington Temporary (Renewal)
b. Adam S. Bunker Clovis Pending- Additional CRNA’s
c. Anne Scott 3900 Eubank, ABQ Temporary (New facility)
d. Craig Cardon Portales Pending-CRNA-?DS/GA
e. Hailey Ritchie Santa Fe Pending Temporary
f. Jacob Rogers Paradise Blvd ABQ Temporary (New Facility)
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 11 of 28 Revision date: 10/2013 g. Kennedy Merritt Clovis Pending-CRNA-?DS/GA
h. Ronald Ulike Los Lunas Temporary (Renewal)
D. DS/GA
a. Ben Smith Roswell Temporary (Renewal)
b. Christopher Buttner Albuquerque Temporary (Renewal)
c. Stephen Christiansen Albuquerque Temporary (Renewal)
Office Anesthesia Evaluations Completed:
None of which I am Aware at time of creating this document.
Office Anesthesia Evaluations Pending:
A. CSII
a. Logan Behrman Alamagordo Initial (Aug ‘15)
b. Venkata Nalla Hobbs Initial (Jun ’15)
c. Kendra Velasquez Rio Rancho Initial (Jun ’15)
d. Christian Anderson Bloomfield Renewal (Aug ’15)
e. Cody Coleman Kirtland Renewal (Aug ’15)
f. Adam Bunker Clovis Initial (Aug ’15)
g. Aaron Rasmussen Farmington Renewal (Oct. ‘15)
h. Anne Scott 3900 Eubank ABQ New Facility (Sep. ’15)
i. Hailey Ritchie Santa Fe Re-exam (No Temp)
j. Jacob Rogers Paradise Blvd ABQ New Facility (Oct. ’15)
k. Justin Porter Silver City Renewal (Dec. ’15)
l. Ronald Ulike Los Lunas Renewal (Dec. ’15)
m. Craig Cardon Portales Facility Only (CRNA)
n. Kennedy Merritt Clovis Facility Only (CRNA)
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 12 of 28 Revision date: 10/2013 B. DS/GA
a. Sean Healy
i. Taos Initial-Facility only
ii. Los Alamos Initial-Facility only
b. Nathan Gunning Portales Initial-Facility only (Sep. ’15)
c. Jon Wagner Albuquerque Initial (April ’15)
Have not been able to get Dr. Wagner to schedule an evaluation after multiple, multiple attempts to schedule an evaluation
d. David Eric Tuggle Albuquerque Renewal (Sep ’15)
e. Ben Smith Roswell Renewal (Dec. ’15)
f. Chris Buttner Albuquerque Renewal (Dec. ’15)
g. Stephen Christiansen Albuquerque Renewal (Dec. ’15)
h. Terry Carlberg Albuquerque Renewal and new facility (Dec ’15)
Addendum #1 (Revised)
16.5.15.11 ADMINISTRATION OF CONSCIOUS AND DEEP SEDATION: The following three categories of anesthesia shall not be administered in a dental facility unless the licensed dentist has obtained a permit from the board. The conscious sedation II and deep sedation/general anesthesia permits are issued to the dentist for a specific practice location, unless the anesthesia provider holds an anesthesia permit at large. Administration without a permit is grounds for disciplinary action against the licensee.
A. Conscious sedation I permit allows a licensed dentist to use only oral or rectal medications or
combined inhalation-enteral conscious sedation to obtain conscious sedation on an outpatient basis
for dental patients.
B. Conscious sedation II permit allows a licensed dentist to use parenteral injection with administration of one parenteral sedation agent/drug class only to obtain conscious sedation on an outpatient basis for dental patients.
C. Deep sedation/general anesthesia permit allows a licensed dentist to use deep sedation or general
anesthesia on an outpatient basis for dental patients.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 13 of 28 Revision date: 10/2013 (1) A dentist without a deep sedation/general anesthesia permit shall not administer or employ
any agent(s) which has a narrow margin for maintaining consciousness, or is federally classified
as a general anesthetic including, but not limited to,
(a) Ultra short acting barbiturates including, but not limited to, sodium methohexital,
thiopental, thiamylal;
(b) Alkylphenols — propofol (Diprivan) including precursors or derivatives;
(c) Neuroleptic agents;
(d) Dissociative agents — i.e. ketamine;
(e) Etomidate; and similarly acting drugs
(f) Rapidly acting steroid or anti-histamine IV preparations; or and
(g) Volatile inhalational agents.
(h) Or quantity of agent(s), or technique(s), or any combination, thereof, that would possibly
render a patient deeply sedated or generally anesthetized
These drugs/techniques are conclusively presumed to produce general anesthesia and may only be used by a licensee holding a valid deep sedation/general anesthesia permit issued by the board.
(2) A licensee that does not hold a deep sedation/general anesthesia permit may not, for the
purpose of anxiolysis or sedation, administer benzodiazepines or narcotics in children under 12
years of age via parenteral routes.
D. Permit levels: The level of permits in order of increasing complexity are conscious sedation I, conscious sedation II, and deep sedation/general anesthesia. When a permit is issued for one a higher level, all levels of lesser complexity are considered within the scope of that permit.
…
16.5.15.12 PERMIT REQUIREMENTS:
…
16.5.15.11 ADMINISTRATION OF CONSCIOUS AND DEEP SEDATION: The following three categories of anesthesia shall not be administered in a dental facility unless the licensed dentist has obtained a permit from the board. The conscious sedation II and deep sedation/general anesthesia permits are issued to the dentist for a specific practice location, unless the anesthesia provider holds an anesthesia permit at large. Administration without a permit is grounds for disciplinary action against the licensee. New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 14 of 28 Revision date: 10/2013 A. Conscious sedation I permit allows a licensed dentist to use only oral or rectal medications or combined inhalation-enteral conscious sedation to obtain conscious sedation on an outpatient basis for dental patients. B. Conscious sedation II permit allows a licensed dentist to use parenteral injection with administration of one parenteral sedation agent/drug class only to obtain conscious sedation on an outpatient basis for dental patients. C. Deep sedation/general anesthesia permit allows a licensed dentist to use deep sedation or general anesthesia on an outpatient basis for dental patients. (1) A dentist without a deep sedation/general anesthesia permit shall not administer or employ any agent(s) which has a narrow margin for maintaining consciousness, or is federally classified as a general anesthetic including, but not limited to, (a) Ultra short acting barbiturates including, but not limited to, sodium methohexital, thiopental, thiamylal; (b) Alkylphenols — propofol (Diprivan) including precursors or derivatives; (c) Neuroleptic agents; (d) Dissociative agents — i.e. ketamine; (e) Etomidate; and similarly acting drugs (f) Rapidly acting steroid or anti-histamine IV preparations; or and (g) Volatile inhalational agents. (h) Or quantity of agent(s), or technique(s), or any combination, thereof, that would possibly render a patient deeply sedated or generally anesthetized These drugs/techniques are conclusively presumed to produce general anesthesia and may only be used by a licensee holding a valid deep sedation/general anesthesia permit issued by the board. (2) A licensee that does not hold a deep sedation/general anesthesia permit may not, for the purpose of anxiolysis or sedation, administer benzodiazepines or narcotics in children under 12 years of age via parenteral routes. D. Permit levels: The level of permits in order of increasing complexity are conscious sedation I, conscious sedation II, and deep sedation/general anesthesia. When a permit is issued for one a higher level, all levels of lesser complexity are considered within the scope of that permit. … 16.5.15.12 PERMIT REQUIREMENTS: … C. Deep sedation/general anesthesia: (1) To administer deep sedation/general anesthesia, the dentist must satisfy one of the following criteria: (a) completion of an advanced training program in anesthesia and related subjects beyond the undergraduate dental curriculum that satisfies the requirements described in part II of the current ADA guidelines for teaching and comprehensive control of anxiety and pain in dentistry; (b) completion of an ADA accredited post-doctoral training program (e.g. oral and maxillofacial surgery, dental anesthesiology), which affords comprehensive and appropriate training necessary to administer and manage deep sedation/general anesthesia, commensurate with these rules (c) current permit holders would be grandfathered by New Mexico laws in effect at the time of original issue of their permit.
(c) verify appropriate training for the level of anesthesia being provided (formal documentation from the anesthesia training program verifying at least 50 DS/GA cases in the patient age population served) (d) verify appropriate case documentation for pediatric (age 12 and under) cases if anesthesia is to be provided to children (formal documentation from the anesthesia training program
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 15 of 28 Revision date: 10/2013 verifying at least 50 DS/GA pediatric cases and 1 month rotation dedicated to pediatric anesthesia) (e) Anesthesia for children (age 12 and under) must be provided in a facility that is large enough to accommodate the patient in an operating chair/table, permit easy movement of the anesthesia and surgical team, and allow for easy access of emergency wheeled equipment (In compliance with current AAOMS Office Anesthesia Evaluation Manual recommended operatory standards)
(2) For any anesthesia provider, dentist, physician, nurse anesthetist, anesthesia assistant providing deep sedation/general anesthesia in a dental office, the operatory in which anesthesia will be administered must: a. have a site certification issued by the NM Board of Dental Health Care b. be large enough to accommodate the patient in an operating chair/table, permit easy movement of the anesthesia and surgical team, and allow for easy access of emergency wheeled equipment (In compliance with current AAOMS Office Anesthesia Evaluation Manual recommended operatory standards) A dentist who does not hold a deep sedation/general anesthesia permit may not allow any persons to administer anesthesia to his/her patients unless the treatment is rendered in a facility that meets the above size requirement. (3) The office is staffed with supervised clinical auxiliary personnel capable of handling procedures, problems and emergencies incident thereto. (4) The dentist and auxiliary clinical personnel have current basic life support certification. (5) The patient's record shall reflect that the pre-operative patient evaluation, pre-operative preparation, monitoring recovery, discharge and documentation was performed in accordance with the current ADA guidelines for the use of conscious sedation, deep sedation and general anesthesia for dentists. (6) The dentist passes the examination and receives approval after facility inspection by the anesthesia committee or designated examiner. (7) The following rules shall apply to the administration of deep sedation/general anesthesia in the dental office.
Addendum #2:
APPLICANT NAME ______
AFFIDAVIT OF APPLICANT APPLICATION
CONSCIOUS SEDATION 1, CONSCIOUS SEDATION 2,
DEEP SEDATION/GENERAL ANESTHESIA PERMITS
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 16 of 28 Revision date: 10/2013 I, the below named applicant, hereby declare under penalty of perjury that I am the person described and identified in this application and that my answers and all statements made by me on this application and accompanying attachments are true and correct. Should I furnish any false information, or have substantial omission, I hereby agree that such an act shall constitute cause for denial, suspension, or revocation of my license or personal/ facility permit to provide Conscious Sedation 1, Conscious Sedation 2, or Deep Sedation/General Anesthesia permanently and without recourse for reapplication. I also declare that if I did not personally complete the foregoing application that I have fully read and confirmed that I have fully read and confirmed each question and accompanying answer, and take full responsibility for all answers contained in this application.
I understand that I have no legal authority to administer Conscious Sedation 1, Conscious Sedation 2, or Deep Sedation/General Anesthesia until a permit has been granted.
I certify that I am trained and capable of administering Basic Life Support and certify that I am trained and capable of administering Advanced Cardiac Life Support if I provide sedation exclusively for adult patients and certify that I am trained and capable of administering Pediatric Advanced Life Support if I provide sedation for children under twelve (12) years of age or younger.
I certify that I employ qualified auxiliary personnel that are trained in and are capable of monitoring vital signs, assisting in emergency procedures, and administering basic life support.
I understand that if a patient enters a deeper level of sedation than what I am qualified to provide, I must stop the dental procedure until the patient returns to the intended level of sedation. I understand that I am responsible for the sedative management, adequacy of the facility and staff, diagnosis and treatment of emergencies and providing the equipment and protocols for patient rescue. I understand that I must be able to rescue patients who enter a deeper state of sedation than intended and must be prepared to treat emergencies that may arise.
I understand that if I perform a procedure for which Conscious Sedation 1, Conscious Sedation 2, is being employed I shall not administer the pharmacologic agents prohibited in TITLE 16. OCCUPATIONAL AND PROFESSIONAL LICENSING, CHAPTER 5. DENTISTRY. PART 15. DENTISTS, ANESTHESIA ADMINISTRATION and shall not administer pharmacologic agents or monitor the patient without the presence and assistance of at least one additional person trained in Basic Life Support for Healthcare Providers.
I understand that if I perform a procedure for which Deep Sedation/General Anesthesia is being employed that I shall not administer the pharmacologic agents and monitor the patient without the presence and assistance of two additional individuals who have current certification in Basic Life Support for Healthcare Providers.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 17 of 28 Revision date: 10/2013 I am aware that in signing this form, I declare that the appropriate (defined by current standards of care set by the AAOMS, Office Anesthesia Evaluation Manual, current edition) equipment, emergency supplies, and conditions are met for each facility in which anesthesia is performed, including but not limited to:
- Appropriate history and pre-sedation preparation of each patient
- Appropriate vital monitors for each patient with direct writing capability
- Appropriate agents used, including non-expired drugs and Controlled Substance logs in compliance with
TITLE 16. OCCUPATIONAL AND PROFESSIONAL LICENSING, CHAPTER 19.
- Appropriate infection control techniques
- Appropriate monitoring for patient recovery and transport
- Adequate knowledge of emergencies related to anesthesia administration and associated age/size
appropriate rescue equipment and reserve oxygen in working order and easily accessible
- Appropriate logs kept of regular equipment checks
- Appropriate safety and fire rescue equipment per Code of Federal Regulations, OSHA Standards, OSHA 3187-
09R, Title 29.
- Appropriate compressed gases safety per OSHA Safety Regulations, 29CFR, Part 1910, Subpart: H, Hazardous
Materials, 1910.101, Compressed gases
- Appropriate office emergency protocols, including Emergency Procedure Record form and emergency phone
numbers
I understand that all aspects of the facility and provider that pertain to the use of anesthesia, including previous sedation records, are subject to inspection, scheduled or unannounced.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 18 of 28 Revision date: 10/2013 I am aware that pursuant to TITLE 16. OCCUPATIONAL AND PROFESSIONAL LICENSING, CHAPTER 5. DENTISTRY. PART 15. DENTISTS, ANESTHESIA ADMINISTRATION 16.5.15.13 REPORTING ADVERSE INCIDENTS, I must report any adverse occurrences related to the use of sedation.
I hereby authorize the release of any and all information and records the Board shall deem pertinent to the evaluation of this application, and shall supply to the Board such records and information as requested for evaluation of my qualifications for a permit to administer Conscious Sedation 1, Conscious Sedation 2, Deep Sedation/General Anesthesia in the State of New Mexico.
I understand that based on evaluation of credentials, facilities, equipment, personnel, and procedures, the Board may place restrictions on the permit, or revoke the personal/facility permit entirely.
I further state that I have read the rules related to the use of anesthesia and sedation, as described in TITLE 16, CHAPTER 5, of the New Mexico Occupational and Professional Licensing Code. I hereby agree to abide by the laws and rules pertaining to the practice of dentistry and anesthesia and sedation in the State of New Mexico.
MUST BE SIGNED
IN THE PRESENCE
OF A NOTARY PUBLIC
SIGNATURE OF APPLICANT: ______
SUBSCRIBED AND SWORN BEFORE ME, THIS
______DAY OF ______,
YEAR ______.
(NOTARY SEAL)
NOTARY PUBLIC SIGNATURE:______
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 19 of 28 Revision date: 10/2013 NOTARY PUBLIC NAME
(TYPED OR PRINTED):______
MY COMMISSION EXPIRES:______
Respectfully submitted,
John C. Mitchell DDS
Chairman of Anesthesia Committee
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 20 of 28 Revision date: 10/2013 (ATTACHMENT B)
BOARD STATUS SHEET BOARD OF DENTAL HEALTH CARE 7/17/2015
BOARD MEMBERSHIP Member Name Start Date Expiration Term Date # Professional Member, Board Chair Charles Schumacher, DDS 9/6/2013 7/1/2018 1 Professional Member, Vice Chair Leo Paul Balderamos, DDS 12/10/2013 7/1/2017 1 Professional Member, Secretary Burrell Tucker, DDS 7/1/2016 2 Professional Member David Warren III, DDS 7/1/2015 7/1/2020 1 Professional Member Jolynn Galvin, DDS 11/7/2013 7/1/2014 1 Dental Hygiene Committee Ermelinda Baca, RDH 12/17/2012 7/1/2016 1 Representative Chair of the Hygiene Committee Sits on Hygiene Committee & Board Dental Hygiene Committee Melissa Barbara, RDH 6/6/2013 7/1/2014 1 Representative Vice Chair of Hygiene Committee Sits on Hygiene Committee & Board Professional Member of Dental Hygiene Denise Teague-Myrick, RDH 11/28/2012 7/1/2015 1 Committee Professional Member of Dental Hygiene Sarah Kay Thiel, RDH 4/15/2014 7/1/2017 1 Committee Professional Member of Dental Hygiene Paula Jenkins, RDH 9/3/2014 7/1/2018 1 Committee Public Robert Blewer 7/2/2013 7/1/2018 1 Public Richard Hatch 7/2/2013 7/1/2018 1
ISSUES PENDING WITH OR TOPICS THAT COULD AFFECT THE BOARD:
None at this time
STATUTE/RULE CHANGES WANTED BY THE BOARD:
16.5.1 – GENERAL PROVISIONS
16.5.7 DENTISTS, TEMPORARY OR PUBLIC SERVICE LICENSURE
16.5.9 – NON-DENTIST OWNERS
16.5.15 – DENTIST, ANESTHESIA ADMINISTRATION
16.5.16 – SUSPENSION FOR DISCIPLINARY ACTIONS
16.5.17 -DENTISTS AND DENTAL HYGIENISTS, LOCAL ANESTHESIA CERTIFICATION New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 21 of 28 Revision date: 10/2013 16.5.28 –DENTAL HYGIENISTS, LOCAL ANESTHESIA CERTIFICATION
15.5.29 – DENTAL HYGIENISTS, PRACTICE
15.5.30 – DENTAL HYGIENISTS, DISCIPLINARY PROCEEDINGS, LICENSE REVOCATION OR SUSPENSION FOR DISCIPLINARY ACTION
16.5.42 – EXPANDED FUNCTION DENTAL AUXILLARY, REQUIREMENTS FOR CERTIFICATION
THE NUMBERS
NUMBER OF CURRENT LICENSES
DD’S = 1,568
DA’S = 2,684
DH’S = 1,367
CDHC = 1
EFDA’s =3
NON-DENTIST OWNER = 22
Total Number of Complaints Received in 2015: 71
Status of collaborative hygienists registering:
Received 5
Total of 54 collaborative hygienists
ACCOMPLISHMENTS/UPDATES
DD & DH newsletters are posted on the website
Board short one staff members (compliance officer )
New team leader (Martha Gallegos)
.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 22 of 28 Revision date: 10/2013 (Attachment C)
July 15, 2015
TO: Rules Committee, NM Board of Dental Health Care
FROM: NM Dental Hygienists’ Association
RE: proposed Rule 16.5.1
Thank-you for the opportunity to give early input into the rule writing process.
In studying proposed rule 16.5.1.7.J, the definition of Dental Mobile Unit includes “portable” and “equipment.” This would appear to apply to providers that deliver dental services in schools, long term care facilities, private homes, or anywhere outside a traditional dental office or clinic.
With this definition in place, the association believes that the reporting requirements stated in proposed rule 16.5.1.28 Dental Mobile Unit for such providers to be onerous. While the frequency of reports is not stated, it requires that the dates and location where care WILL BE provided be reported to the board, indicating it is to be done before care is delivered.
Schedules can change week to week and are often in flux given the circumstances. Providing reports ahead of time would make them tentative at best.
What is the purpose of collecting this data? Who will receive and review the reports?
Thank-you for your consideration.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 23 of 28 Revision date: 10/2013 (Attachment D)
To: New Mexico Board of Dental Health Care and the Dental Hygiene Committee
From: Carol Hanson, RDH, BSDH, MPH NM Dental Support Center (NMDSC) Coordinator New Mexico DOH/PHD/HSB/OPCRH 300 San Mateo NE, Suite 900 Albuquerque, NM 87108 505-222-8685 [email protected]
Date: June 19, 2015 In partnership with the New Mexico Primary Care Association (NMPCA): developed and disseminated April and May 2015 Oral Health e-News to network dental providers, dental educators, and other interested parties; participated in the April 17, 2015 NMPCA/NMDSC Provider Meeting—a total of 28 people attended. Maintained and updated the NMDSC network provider and dental educator databases and distribution lists. Provided technical assistance for network dental providers and Las Cruces area Head Start programs. Disseminated information on continuing education opportunities and other pertinent information to network dental providers and educators. Disseminated April, May, and June Brush Up on Oral Health Newsletters to NM Head Start/Early Head Start Directors and Health Coordinators.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 24 of 28 Revision date: 10/2013 Assessed students at Carlos Rey Elementary School in Albuquerque for 3rd grade Office of Oral Health surveillance project on April 10, 2015. Co-presented “The Tooth of the Matter: Assessing a Student’s Oral Health” at the Head to Toe Conference in Albuquerque on April 16, 2015. Attended the National Oral Health Conference in Kansas City, Missouri April 25-29, 2015. Participated in the UNM Dental Hygiene Advisory Committee meeting on May 1, 2015. Participated in the DentaQuest West Regional Convening in Seattle, Washington, May 6-May 8, 2015. Chaired the Association of State and Territorial Dental Directors Healthy Aging Committee conference call meeting on May 14, 2015. Participated in the Youth Development, Inc. (YDI) Head Start Health Services Advisory Committee meetings on April 8 and May 27, 2015. Assisted YDI Head Start Health Manager to update the organization’s “Child Health & Developmental Services Plan”. Participated in the Office of Oral Health CPR refresher, OSHA annual, and staff meeting on May 29, 2015. Operated an exhibit booth at the NM Pediatric Society Wylder Lectures on May 30, 2015 and promoted the use of fluoride varnish at pediatric well- checks. Participated in the NM Healthy Aging Collaborative conference call on June 10, 2015. Provided scholarships for 13 dentists and 10 dental hygienists to attend the NM Health Resources (NMHR), Inc. Provider Retreat June 12-13, 2015. Attended the NMHR Retreat June 12-13, 2015. Attended the NM Oral Health Coalition meeting on June 12, and facilitated the NMPCA Dental Provider Breakfast meeting on June 13. Participated in the NM Department of Health TeleHealth Summit on June 16, 2015. Attended the Project ECHO (Extension for Community Healthcare Outcomes) Orientation on June 17, 2015. Attended the NMPCA Conference on June 18, 2015.
Respectfully Submitted, Carol Hanson
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 25 of 28 Revision date: 10/2013 (Attachment E)
AADB REPORT Ermelinda Baca, RDH June 29, 2015
I represented the Board and Dental Hygienists Committee at the AADB Midyear meeting in Chicago, April 26-27, 2015. The program focused on issues of professional impairment. However, with many Board attorney's present who have been involved with the North Carolina vs. FTC case, in addition to NC Board Members, there was a very informative panel discussion about the recent supreme Court decision and its potential impact on State Board of Dentistry. Some of the cogent points that struck me are:
a. The Supreme Court ruling is confusing and no one is quite sure what its implications might be, including many attorneys.
b. No one knows how far the FTC may continue to push its boundaries; however Board Members should be legally indemnified by their state law.
c. Recommendation to Boards: Any Board member living in the area of a respondent, should automatically recuse him/herself from a case to prevent the appearance of anti-competitiveness.
Points on Professional Impairment:
a. ADA has an Addiction CE course available. (Webinar). Recommended to be used with monitored treatment program.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 26 of 28 Revision date: 10/2013 b. ADA has A Conference on Dentist Health and Well Being every other year. It will be held this year on Sept, 18, 19, 2015. Also recommended to be used along with monitored treatment program.
c. Recommended that states push for mandated use of PMPs.
Addiction Symptoms:
a. Promise to cut back b. Mood swings c. Memory problems d. Blaming others for behavior e. Changes with patients f. Deterioration of appearance and hygiene g. Super DDS or Pharmacist attitude h. Poor record keeping i. Mistakes and errors j. Absenteeism or tardiness k. Pattern of frequent job changes. l. Frequent trips to the bathroom m. Paranoia
Why do Professional ask for help: a. Liver b. Lover c. Livelihood d. Law
AADB Assessment Services available by AADB
a. ERA-expert review service (Independent review or witness in a disciplinary case)
b. D-Prep: Evaluates the practitioner (respondent) and will let the state know if the problem can be fixed.
c. Remediation: Customized hour based remediation. Different than CE's. An outcomes assessment will be completed at the end of the remediation process.
d. All fees are paid by the respondent. Application-$1000.00 Evaluation - $3000.00 Remediation- $10,000
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 27 of 28 Revision date: 10/2013 CRDTS STEERING COMMITTEE REPORT
SUBMITTED BY: ERMELINDA BACA, RDH
JUNE 29, 2015
Dr. Thomas Haladyna, Professor Emeritus of Arizona State University and a widely published author has completed Technical Reports of the 2014 testing cycled for both CRDTS' dental and dental hygiene exams. Dr. Haladyna's reports cite all the measurement principles from the NEW STANDARDS FOR EDUCATIONAL AND PSYCOLOGICAL TESTING. The Standards were released early in 2015, just as the 2014 CRDTS database was completed and ready for analysis. These reports show very strong validity evidence for CRDTS' exams and testing protocols. This provides solid documentation of CRDTS as viable testing agency, operating ethically and transparently in compliance with established measurement principles to assist State Board of Dentistry in their testing responsibilities for the protection of the public. All participating Sate Boards, examiners , regional schools and test sites are encouraged to read the 2014 Technical Reports that are available on the CRDTS web site.
New Mexico Regulation and Licensing Department BOARDS AND COMMISSION DIVISION Page 28 of 28 Revision date: 10/2013