Section 447.02 (2) (b), Stats. The examining board shall promulgate rules specifying the “…standards, conditions and any educational requirements that are in addition to the requirements specified in s. 447.04 (1), Stats., that must be met by a dentist to be permitted to induce general anesthesia or conscious sedation in connection with the practice of dentistry."

Section 447.01 (8) (d), Stats.

The intent of the rule is to allow the Dentistry Examining Board discretion in approving sedation permits for licensees who have received discipline action against their permit(s) or are currently under investigation regarding their permit(s). Therefore, the granting of permits shall be permissive. In addition, the definitions of classes of sedation permits are added as no such reference occurs in the rule or the rule series, chs. DE 1 to 13.

SECTION 1 provides a definition of sedation permit classes which correspond to the permit application process.

SECTIONS 2 to 4 modify the current text making the approval of permits permissive and update the permit classes as now defined in s. DE 11.02 (9m).

No existing or proposed rules or laws were found in an Internet-based search of the U.S. Code or the Code of Federal Register (CFR) regarding classes of sedation, sedation permits for licensed dentists or how discipline may affect dentists applying for or maintaining such permits.

Illinois: The State of Illinois has an application process for dental sedation permits, which includes conscious sedation - Permit A and deep sedation and general anesthesia — Permit B. A permit application includes a request for information on fines, reprimands, probations, censures, revocations, suspensions, license surrenders, restrictions or limitations, but does not specifically list a prohibition of permit approval as a consequence of any discipline. [Title 68, subch. VIIb, sec. 1220.510]

Iowa: Iowa rules, IAC 650—Chapter 29, much like Illinois, have permits for sedation and their application forms request the following information: “…have your clinical activities ever been limited, suspended, revoked, not renewed, voluntarily relinquished, or subject to other disciplinary or probationary conditions?" In order to obtain a permit for deep sedation/general anesthesia, a dentist must hold current certification in Advanced Cardiac Life Support (ACLS) 650 IAC 29.3(4) — procedures by a dentist with a permit for deep sedation/general anesthesia can only be done with the assistance of at least two auxiliary personnel that have current basic life support certification [IAC 29.3(5)]. In this search, no rule or law was found to specifically prohibit applying for or maintaining such a permit while a licensee has been disciplined.

Michigan: In a search of ch. 33 Michigan health code, no provisions for application for sedation classes or permits were found.

Minnesota: In Minnesota, dentists must obtain a certificate from the Board to administer general anesthesia or conscious sedation per Ch. 3100.3600 Subp 9. Requirements for both general anesthesia and conscious sedation stipulate for the dentist to have current ACLS certification (Subp 2, 3).

Dentists, dental hygienists and registered dental assistants may administer nitrous oxide inhalation analgesia with current CPR certification (Subp 4D). The required continuing education includes both advanced cardiac life support (ACLS) and pediatric advanced life support (PALS). There is no mention of the ability to apply for or termination of such certification based on discipline or a licensee.

No factual data and analytical methodologies were used to draft these rules.

The information comparing the states listed in this analysis was obtained directly from an Internet-based search and a review of the applicable regulations and rules, when found.

The Fiscal Estimate and Economic Impact Analysis is attached.

These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department's Regulatory Review Coordinator may be contacted by email at Greg.Gasper@wisconsin.gov, or by calling (608) 266-8608.

This rule change will not have an effect on small business.

N/A

Jean MacCubbin, Program Manager, Department of Safety and Professional Services, Division of Policy Development, 1400 East Washington Avenue, Room 151, P.O. Box 8935, Madison, Wisconsin 53708; telephone 608-266-0955 or telecommunications relay services via 711; email at Jean.MacCubbin@wisconsin.gov.

STATE OF WISCONSIN DEPARTMENT OF ADMINISTRATION DOA-2049 (R03/2012)	Division of Executive Budget and Finance 101 East Wilson Street, 10th Floor P.O. Box 7864 Madison, WI 53707-7864 FAX: (608) 267-0372
ADMINISTRATIVE RULES Fiscal Estimate & Economic Impact Analysis

1. Type of Estimate and Analysis
X Original   ⍽ Updated   ⍽ Corrected
2. Administrative Rule Chapter, Title and Number
Ch. DE 11 Anesthesia
3. Subject
Sedation Permits
4. Fund Sources Affected			5. Chapter 20, Stats. Appropriations Affected
⍽ GPR   ⍽ FED   X PRO   ⍽ PRS   ⍽ SEG   ⍽ SEG-S			20.165 (1) (g)
6. Fiscal Effect of Implementing the Rule
X No Fiscal Effect ⍽ Indeterminate	⍽ Increase Existing Revenues ⍽ Decrease Existing Revenues		⍽ Increase Costs ⍽ Could Absorb Within Agency's Budget ⍽ Decrease Cost
7. The Rule Will Impact the Following (Check All That Apply)
⍽ State's Economy ⍽ Local Government Units		⍽ Specific Businesses/Sectors ⍽ Public Utility Rate Payers ⍽ Small Businesses (if checked, complete Attachment A)
8. Would Implementation and Compliance Costs Be Greater Than $20 million? ⍽ Yes   X No
9. Policy Problem Addressed by the Rule
The objective of the proposed rule is to allow the Board to use discretion in granting sedation permits to a dentist who is currently being investigated or has had disciplinary action relating to general anesthesia or conscious sedation.
10. Summary of the businesses, business sectors, associations representing business, local governmental units, and individuals that may be affected by the proposed rule that were contacted for comments.
Licensees
11. Identify the local governmental units that participated in the development of this EIA.
None
12. Summary of Rule's Economic and Fiscal Impact on Specific Businesses, Business Sectors, Public Utility Rate Payers, Local Governmental Units and the State's Economy as a Whole (Include Implementation and Compliance Costs Expected to be Incurred)
None.
13. Benefits of Implementing the Rule and Alternative(s) to Implementing the Rule
Providing the Board to use discretion in granting sedation permits based on investigation or disciplinary actions of licensees.
14. Long Range Implications of Implementing the Rule
None known.
15. Compare With Approaches Being Used by Federal Government
None found.
16. Compare With Approaches Being Used by Neighboring States (Illinois, Iowa, Michigan and Minnesota)
Illinois and Iowa request information pertaining to arrests, convictions, etc. Neither Minnesota or Michigan appears to request such information at time of permit application.
17. Contact Name				18. Contact Phone Number
Jean MacCubbin				608.266.0955