Vital Times 2017 - 24

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Oppose efforts to repeal or undermine the
Affordable Care Act.
Oppose Senate Bill 562 or any other health care
proposal that destabilizes California's health
care system by calling for unrealistic revenue
increases that could destabilize our state
budget.
Commit to improving and expanding care
for all Californians through an approach that
builds upon California's existing health care
delivery system.

Bottom line: CSA will be coordinating with our
House of Medicine peers to effectively advocate on this
high-profile issue moving forward. Brace yourself for
more rhetoric on single-payer universal healthcare in
the coming year. In fact, be prepared for some form of
legislation to actually pass the Senate and Assembly. And
as is often the case in politics, logic and common sense
need not apply!

Update on Pediatric Dental Legislation
During the past two years, CSA has been intimately
involved with the Dental Board of California (DBC)
and the State Legislature regarding two bills seeking to
improve patient safety for children receiving sedation
and anesthesia services in the office-based dental setting.
AB 224 (Thurmond) was sponsored by the AAP
(American Academy of Pediatrics) and supported by the
California Academy of Dentist Anesthesiologists. The
CSA supported the bill and served as the subject matter
experts on sedation and anesthesia throughout the
process. Due in large part to CSA input and testimony,
the DBC recommended a number of "enhancements"
to current State regulations to provide a greater level of
public protection.
As commendable and somewhat surprising the DBC
was in its recommendations, we did not feel they were
enough. AB 224 started out as a well-intentioned patient
safety initiative which underwent various permutations

24 | CSA Vital Times

- some weaker, some stronger - as it made its way to the
Senate Business and Professions Committee this past
July.
CSA was pushing for amendments to the bill that would
only allow a CMS-recognized provider to function as the
"dedicated monitor "for children under age 7 receiving
deep sedation and general anesthesia. These negotiations
broke down and the bill author, Tony Thurmond
(D-Richmond), decided to hold the bill after a one-hour
debate on that issue. This means AB 224 is now a twoyear bill and can be acted upon this year.
The somewhat contentious committee hearing was
attended by a television crew from Dateline NBC. CSA
President Karen Sibert, MD, FASA, was interviewed
by NBC in a piece aired on Sunday Night with Megyn
Kelley in July of 2017.
Coincidentally, the Senate Business and Professions
Committee passed SB 501 (Glazer) this past July. Due to
amendments accepted by the Assembly Appropriations
Committee, SB 501 is a two-year bill and will most likely
get reconsidered by the committee this year.
This bill was a companion measure to its Assembly
counterpart (AB 224) and sponsored by the California
Dental Association (CDA) and the California
Association of Oral and Maxillofacial Surgeons
(CALAOMS). This bill incorporated most of the DBC
recommendations with one important exception: it did
not allow for a dedicated anesthesia provider for children
under the age of 7 receiving deep sedation and general
anesthesia.
Current practice allows an OMFS to oversee a dental
assistant and/or dental assistant to be a "dedicated
monitor" and administer drugs. CSA believes they are
ill-equipped to rescue a child with an airway problem or
even perform the basic medical tasks required by PALS
training. The coauthor of the AAP-AAPD Guidelines,
Dr. Charles Cote, made this point during his statements

Table of Contents for the Digital Edition of Vital Times 2017