BILL NUMBER: SB 112 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 3, 2009
AMENDED IN SENATE APRIL 1, 2009
AMENDED IN SENATE MARCH 4, 2009
INTRODUCED BY Senator Oropeza
(Coauthor: Senator Wyland)
JANUARY 29, 2009
An act to amend Sections 1247.2, 1247.4, 1247.6, 1247.63, 1247.64,
and 1247.8 of, to add Section 1247.61 to, and to add and repeal
Section 1247.62 of, the Business and Professions Code, relating to
healing arts, and declaring the urgency thereof, to take effect
immediately.
LEGISLATIVE COUNSEL'S DIGEST
SB 112, as amended, Oropeza. Hemodialysis technicians.
Existing federal law sets forth certain requirements that dialysis
facilities must meet in order to be certified under the Medicare
Program, including a requirement that patient care dialysis
technicians at those facilities complete a specified training
program, have a high school diploma or equivalency, be certified
under a state or national certification program, and meet all
applicable state requirements, as specified.
Existing law provides for the licensure and regulation of various
clinical laboratory personnel and makes a violation of those
provisions a crime. Within that law, the Hemodialysis Technician
Training Act prohibits a person from providing services as a
hemodialysis technician without being certified by the State
Department of Public Health as meeting certain requirements, as
specified.
This bill would revise those requirements and prohibit a person
from providing services as a hemodialysis technician without being
certified by the department as having a high school diploma or
equivalency or 4 years of specified work experience, successfully
completing a training program meeting specified requirements, and
passing a board-approved standardized test ,
certified by faculty of the University of California, as specified,
or passing an examination offered by a certification program
approved by the Centers for Medicare and Medicaid Services, as
specified. The bill would require technicians certified by the
department as of the bill's operative date to meet those requirements
by April 15, 2010, as specified. The bill would make other
conforming and technical, nonsubstantive changes.
By changing the definition of a crime, this bill would impose a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
This bill would also declare that it is to take effect immediately
as an urgency statute.
Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. The Legislature hereby finds and declares all of the
following:
(a) In April 2008, the Centers for Medicare and Medicaid Services
(CMS) issued final regulations, the Conditions for Coverage of
End-Stage Renal Disease Facilities (Conditions for Coverage), at Part
494 of Title 42 of the Code of Federal Regulations, establishing
conditions that dialysis facilities must meet to be certified under
the Medicare Program.
(b) The Conditions for Coverage require hemodialysis technicians
providing services at dialysis facilities to be certified under a
state certification program or a national commercially available
certification program by a specified date.
(c) The Conditions for Coverage further require hemodialysis
technicians providing services at dialysis facilities to, among other
things, have a high school diploma or equivalency and have completed
a specified training program.
(d) More than 5,000 persons provide services as state-certified
hemodialysis technicians in California.
(e) Only three national commercially available certification
programs have been approved by CMS.
(f) Therefore, it is the intent of the Legislature to revise the
Hemodialysis Technician Training Act to ensure that hemodialysis
technicians meet the requirements of the Conditions for Coverage so
that dialysis facilities in this state may continue to employ those
technicians.
(g) It is the further intent of the Legislature that the revisions
to the Hemodialysis Technician Training Act by this act shall be
implemented without the adoption of additional regulations by the
department.
SEC. 2. Section 1247.2 of the Business and Professions Code is
amended to read:
1247.2. For the purpose of this article, the following terms have
the following meaning:
(a) "Immediate supervision" means supervision of dialysis
treatment in the same room in which the dialysis treatment is being
performed.
(b) "Department" means the State Department of Public Health.
(c) "Hemodialysis technician" means an unlicensed health care
provider who is employed by a hemodialysis clinic or unit for the
purpose of participating in the direct treatment of patients
undergoing hemodialysis.
(d) "Standardized test" means an examination certified by faculty
of the University of California to validly and reliably measure the
knowledge required to demonstrate competency in the areas being
tested.
SEC. 3. Section 1247.4 of the Business and Professions Code is
amended to read:
1247.4. The department shall adopt regulations it deems necessary
to implement this article.
SEC. 4. Section 1247.6 of the Business and Professions Code is
amended to read:
1247.6. (a) Except during training under immediate supervision,
and except as provided in Section 1247.62, no person shall provide
services as a hemodialysis technician without being certified by the
department as a Certified Hemodialysis Technician (CHT).
(b) This article does not apply to home dialysis patients, or
patient helpers not employed by the licensed facility, who have
undergone a home dialysis training program operated by a licensed
clinic or hospital as defined in Sections 1204 and 1250 of the Health
and Safety Code and have been certified by the medical director of
the facility as being competent to perform home dialysis treatment.
SEC. 5. Section 1247.61 is added to the Business and Professions
Code, to read:
1247.61. To be certified by the department as a Certified
Hemodialysis Technician (CHT), a person shall meet all of the
following requirements:
(a) Have a high school diploma or equivalency, or have greater
than four years of work experience in dialysis as of October 14,
2008.
(b) Have successfully completed a training program that is
approved by the medical director and governing body of a hemodialysis
clinic or unit, under the direction of a registered nurse, focused
on the operation of kidney dialysis equipment and machines, providing
direct patient care, and communication and interpersonal skills,
including patient sensitivity training and care of difficult
patients. For purposes of this subdivision, a person "successfully
completes a training program" if he or she completes all didactic
portions of the program and demonstrates competency in the knowledge
and skills provided by the program.
(1) The training program shall include all of the following
subjects:
(A) Principles of dialysis.
(B) Care of patients with kidney failure, including interpersonal
skills.
(C) Dialysis procedures and documentation, including initiation,
proper cannulation techniques, monitoring, and termination of
dialysis.
(D) Possible complications of dialysis.
(E) Water treatment and dialysate preparation.
(F) Infection control.
(G) Safety.
(H) Dialyzer reprocessing, if applicable.
(2) A community or corporate-based training program, or a training
program offered by an educational institution, is acceptable if the
program meets the requirements of this subdivision.
(3) A person employed as a hemodialysis technician by a
hemodialysis clinic or unit for more than two years as of October 14,
2008, who does not have documentation of having successfully
completed a training program meeting the requirements of this
subdivision, shall be deemed to be in compliance with this
subdivision by doing both of the following:
(A) Passing a written exam, offered by a hemodialysis clinic or
unit, covering the subjects listed in paragraph (1).
(B) Passing a skills checklist through observation by a registered
nurse of the technician's skills.
(c) Successfully accomplish either of the following:
(1) Pass a standardized test that is approved by the department
and that covers, at a minimum, the subjects listed in paragraph (1)
of subdivision (b). This test shall be administered in a proctored
environment by an independent examiner. For purposes of this
subdivision, independent examiners may include representatives
appointed by End-Stage Renal Disease Network 17, End-Stage Renal
Disease Network 18, the California Dialysis Council, or any private
testing organization approved by the department for that purpose.
(2) Successfully pass an examination offered by a national,
commercially available certification program for hemodialysis
technicians which is approved for this purpose by the Centers for
Medicare and Medicaid Services.
SEC. 6. Section 1247.62 is added to the Business and Professions
Code, to read:
1247.62. (a) Except as provided in subdivision (b), Section
1247.6 shall not apply to a person certified by the department as a
hemodialysis technician as of the operative date of this section.
(b) Notwithstanding Section 1247.63, the certification of a person
described in subdivision (a) shall be valid until April 15, 2010.
That person shall, on or before that date, obtain a new certification
under Section 1247.61 in a manner prescribed by the department.
(c) This section shall become inoperative on July 1, 2010, and, as
of January 1, 2011, is repealed, unless a later enacted statute,
that becomes operative on or before January 1, 2011, deletes or
extends the dates on which it becomes inoperative and is repealed.
SEC. 7. Section 1247.63 of the Business and Professions Code is
amended to read:
1247.63. (a) Certification of a hemodialysis technician issued by
the department pursuant to subdivision (a) of Section 1247.6 shall
be valid for four years.
(b) A certified hemodialysis technician applying for renewal of
his or her certification shall submit proof that he or she has
obtained 30 hours of in-service training or continuing education in
dialysis care or general health care as a requirement for the renewal
of his or her certification.
(c) An expired certification may be renewed at any time within two
years after its expiration on the filing of an application for
renewal and documentation of the required in-service education.
SEC. 8. Section 1247.64 of the Business and Professions Code is
amended to read:
1247.64. A hemodialysis technician may obtain the in-service
training or continuing education required by subdivision (b) of
Section 1247.63 from one or more of the following sources:
(a) Health-related courses offered by accredited postsecondary
institutions.
(b) Health-related courses offered by continuing education
providers approved by the California Board of Registered Nursing.
(c) Health-related courses offered by recognized health
associations if the department determines the courses to be
acceptable.
(d) Health-related, employer-sponsored in-service training or
continuing education programs.
SEC. 9. Section 1247.8 of the Business and Professions Code is
amended to read:
1247.8. Each hemodialysis unit or clinic shall have information
available for inspection by the department survey teams which
verifies that the hemodialysis technicians employed at the unit or
clinic meet the requirements of Section 1247.61.
SEC. 10. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
SEC. 11. This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:
To avoid a critical shortage of hemodialysis technicians meeting
the requirements of the Medicare Program Conditions for Coverage of
End-Stage Renal Disease Facilities, it is necessary that this act
take effect immediately.