1247. This article shall be known and may be cited as the
Hemodialysis Technician Training Act.
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. A hemodialysis technician certified by the
state as a person meeting the requirements of Section 1247.61 shall
be referred to as a Certified Hemodialysis Technician (CHT).
(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.
1247.3. The treatment of patients by a hemodialysis technician
includes performing venipuncture and arterial puncture for the
purpose of providing dialysis treatment for a patient. The treatment
of patients includes the administration of local anesthetics,
heparin, and sodium chloride solutions. The administration of these
medications shall be pursuant to protocol established by the medical
director of the hemodialysis clinic or unit and shall be under the
immediate supervision of a licensed physician and surgeon or a
licensed registered nurse. The administration of local anesthetics
shall be limited to intradermal, subcutaneous, or topical
administration. Hemodialysis technicians who treat patients in the
home and are certified by the Board of Nephrology Examination for
Nurses and Technicians are exempted from the requirements of
immediate supervision until January 1, 1991.
1247.4. The department may adopt regulations it deems necessary to
implement this article.
1247.5. A hemodialysis clinic or unit within a licensed clinic or
hospital, as defined respectively in Sections 1204 and 1250 of the
Health and Safety Code, may operate a hemodialysis training and
testing program. A hemodialysis technician training program and
competency test, provided under this section, or provided by an
accredited college, an accredited university, or a private training
program, shall be approved by the department, shall comply with the
regulations adopted pursuant to Section 1247.4, and shall include
training and testing in the administration of local anesthetics,
heparin, and sodium chloride solutions.
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.
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. Following
approval by the medical director and governing body, the training
program shall be submitted to the department for approval. The
training program shall be approved by the department prior to
implementation. The training program shall focus 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, at a minimum:
(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, or a community or corporate-based training program that meets
the requirements of this chapter, covering the subjects listed in
paragraph (1).
(B) Passing a skills checklist through observation by a registered
nurse of the skills listed in paragraph (1).
(c) Successfully accomplish either of the following:
(1) Pass a standardized test that is approved by the department
and that covers the subjects listed in paragraph (1) of subdivision
(b) and in Section 1247.5. 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.
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.
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.
1247.66. (a) The department may deny, suspend, or revoke the
certification of a hemodialysis technician if it finds that the
hemodialysis technician is not in compliance with this article, or
any regulations adopted by the department to administer this article.
(b) The department may deny, suspend, or revoke the certification
of a hemodialysis technician for any of the following causes:
(1) Unprofessional conduct, which includes incompetence or gross
negligence in carrying out his or her usual functions.
(2) Procuring a certificate by fraud, misrepresentation, or
mistake.
(3) Making or giving any false statement or information in
conjunction with the application for issuance or renewal of a
certificate.
(4) Conviction of a crime substantially related to the
qualifications, functions, and duties of a hemodialysis technician in
which event the record of the conviction shall be conclusive
evidence thereof.
(c) In addition to other acts constituting unprofessional conduct
within the meaning of this article, all of the following constitute
unprofessional conduct:
(1) Conviction for, or use of, any narcotic drug, as defined in
Division 10 (commencing with Section 11000) of the Health and Safety
Code, or any dangerous drug, as defined in Article 7 (commencing with
Section 4211) of Chapter 9, or alcoholic beverages, to an extent or
in a manner dangerous or injurious to the hemodialysis technician or
any other person, or the public, to the extent that this use impairs
the ability to conduct, with safety to the public, the practice of a
hemodialysis technician.
(2) Abuse, whether verbal, physical, or mental, of a patient in
any setting where health care is being rendered.
(d) Proceedings to deny, suspend, or revoke a certification under
this article shall be conducted in accordance with Section 100171 of
the Health and Safety Code.
1247.7. An employee in training shall be classified as a
hemodialysis technician trainee and shall be under the immediate
supervision of a licensed physician and surgeon or licensed
registered nurse whenever involved in the treatment of a patient, as
described in Section 1247.3.
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.
1247.9. No person or entity shall provide chronic dialysis services
to patients in this state unless the services are provided under the
direction of a chronic dialysis clinic, licensed pursuant to Section
1204 of the Health and Safety Code, or a general acute care
hospital, licensed pursuant to Section 1250 of the Health and Safety
Code.
1247. This article shall be known and may be cited as the
Hemodialysis Technician Training Act.
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. A hemodialysis technician certified by the
state as a person meeting the requirements of Section 1247.61 shall
be referred to as a Certified Hemodialysis Technician (CHT).
(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.
1247.3. The treatment of patients by a hemodialysis technician
includes performing venipuncture and arterial puncture for the
purpose of providing dialysis treatment for a patient. The treatment
of patients includes the administration of local anesthetics,
heparin, and sodium chloride solutions. The administration of these
medications shall be pursuant to protocol established by the medical
director of the hemodialysis clinic or unit and shall be under the
immediate supervision of a licensed physician and surgeon or a
licensed registered nurse. The administration of local anesthetics
shall be limited to intradermal, subcutaneous, or topical
administration. Hemodialysis technicians who treat patients in the
home and are certified by the Board of Nephrology Examination for
Nurses and Technicians are exempted from the requirements of
immediate supervision until January 1, 1991.
1247.4. The department may adopt regulations it deems necessary to
implement this article.
1247.5. A hemodialysis clinic or unit within a licensed clinic or
hospital, as defined respectively in Sections 1204 and 1250 of the
Health and Safety Code, may operate a hemodialysis training and
testing program. A hemodialysis technician training program and
competency test, provided under this section, or provided by an
accredited college, an accredited university, or a private training
program, shall be approved by the department, shall comply with the
regulations adopted pursuant to Section 1247.4, and shall include
training and testing in the administration of local anesthetics,
heparin, and sodium chloride solutions.
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.
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. Following
approval by the medical director and governing body, the training
program shall be submitted to the department for approval. The
training program shall be approved by the department prior to
implementation. The training program shall focus 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, at a minimum:
(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, or a community or corporate-based training program that meets
the requirements of this chapter, covering the subjects listed in
paragraph (1).
(B) Passing a skills checklist through observation by a registered
nurse of the skills listed in paragraph (1).
(c) Successfully accomplish either of the following:
(1) Pass a standardized test that is approved by the department
and that covers the subjects listed in paragraph (1) of subdivision
(b) and in Section 1247.5. 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.
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.
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.
1247.66. (a) The department may deny, suspend, or revoke the
certification of a hemodialysis technician if it finds that the
hemodialysis technician is not in compliance with this article, or
any regulations adopted by the department to administer this article.
(b) The department may deny, suspend, or revoke the certification
of a hemodialysis technician for any of the following causes:
(1) Unprofessional conduct, which includes incompetence or gross
negligence in carrying out his or her usual functions.
(2) Procuring a certificate by fraud, misrepresentation, or
mistake.
(3) Making or giving any false statement or information in
conjunction with the application for issuance or renewal of a
certificate.
(4) Conviction of a crime substantially related to the
qualifications, functions, and duties of a hemodialysis technician in
which event the record of the conviction shall be conclusive
evidence thereof.
(c) In addition to other acts constituting unprofessional conduct
within the meaning of this article, all of the following constitute
unprofessional conduct:
(1) Conviction for, or use of, any narcotic drug, as defined in
Division 10 (commencing with Section 11000) of the Health and Safety
Code, or any dangerous drug, as defined in Article 7 (commencing with
Section 4211) of Chapter 9, or alcoholic beverages, to an extent or
in a manner dangerous or injurious to the hemodialysis technician or
any other person, or the public, to the extent that this use impairs
the ability to conduct, with safety to the public, the practice of a
hemodialysis technician.
(2) Abuse, whether verbal, physical, or mental, of a patient in
any setting where health care is being rendered.
(d) Proceedings to deny, suspend, or revoke a certification under
this article shall be conducted in accordance with Section 100171 of
the Health and Safety Code.
1247.7. An employee in training shall be classified as a
hemodialysis technician trainee and shall be under the immediate
supervision of a licensed physician and surgeon or licensed
registered nurse whenever involved in the treatment of a patient, as
described in Section 1247.3.
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.
1247.9. No person or entity shall provide chronic dialysis services
to patients in this state unless the services are provided under the
direction of a chronic dialysis clinic, licensed pursuant to Section
1204 of the Health and Safety Code, or a general acute care
hospital, licensed pursuant to Section 1250 of the Health and Safety
Code.
1247. This article shall be known and may be cited as the
Hemodialysis Technician Training Act.
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. A hemodialysis technician certified by the
state as a person meeting the requirements of Section 1247.61 shall
be referred to as a Certified Hemodialysis Technician (CHT).
(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.
1247.3. The treatment of patients by a hemodialysis technician
includes performing venipuncture and arterial puncture for the
purpose of providing dialysis treatment for a patient. The treatment
of patients includes the administration of local anesthetics,
heparin, and sodium chloride solutions. The administration of these
medications shall be pursuant to protocol established by the medical
director of the hemodialysis clinic or unit and shall be under the
immediate supervision of a licensed physician and surgeon or a
licensed registered nurse. The administration of local anesthetics
shall be limited to intradermal, subcutaneous, or topical
administration. Hemodialysis technicians who treat patients in the
home and are certified by the Board of Nephrology Examination for
Nurses and Technicians are exempted from the requirements of
immediate supervision until January 1, 1991.
1247.4. The department may adopt regulations it deems necessary to
implement this article.
1247.5. A hemodialysis clinic or unit within a licensed clinic or
hospital, as defined respectively in Sections 1204 and 1250 of the
Health and Safety Code, may operate a hemodialysis training and
testing program. A hemodialysis technician training program and
competency test, provided under this section, or provided by an
accredited college, an accredited university, or a private training
program, shall be approved by the department, shall comply with the
regulations adopted pursuant to Section 1247.4, and shall include
training and testing in the administration of local anesthetics,
heparin, and sodium chloride solutions.
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.
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. Following
approval by the medical director and governing body, the training
program shall be submitted to the department for approval. The
training program shall be approved by the department prior to
implementation. The training program shall focus 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, at a minimum:
(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, or a community or corporate-based training program that meets
the requirements of this chapter, covering the subjects listed in
paragraph (1).
(B) Passing a skills checklist through observation by a registered
nurse of the skills listed in paragraph (1).
(c) Successfully accomplish either of the following:
(1) Pass a standardized test that is approved by the department
and that covers the subjects listed in paragraph (1) of subdivision
(b) and in Section 1247.5. 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.
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.
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.
1247.66. (a) The department may deny, suspend, or revoke the
certification of a hemodialysis technician if it finds that the
hemodialysis technician is not in compliance with this article, or
any regulations adopted by the department to administer this article.
(b) The department may deny, suspend, or revoke the certification
of a hemodialysis technician for any of the following causes:
(1) Unprofessional conduct, which includes incompetence or gross
negligence in carrying out his or her usual functions.
(2) Procuring a certificate by fraud, misrepresentation, or
mistake.
(3) Making or giving any false statement or information in
conjunction with the application for issuance or renewal of a
certificate.
(4) Conviction of a crime substantially related to the
qualifications, functions, and duties of a hemodialysis technician in
which event the record of the conviction shall be conclusive
evidence thereof.
(c) In addition to other acts constituting unprofessional conduct
within the meaning of this article, all of the following constitute
unprofessional conduct:
(1) Conviction for, or use of, any narcotic drug, as defined in
Division 10 (commencing with Section 11000) of the Health and Safety
Code, or any dangerous drug, as defined in Article 7 (commencing with
Section 4211) of Chapter 9, or alcoholic beverages, to an extent or
in a manner dangerous or injurious to the hemodialysis technician or
any other person, or the public, to the extent that this use impairs
the ability to conduct, with safety to the public, the practice of a
hemodialysis technician.
(2) Abuse, whether verbal, physical, or mental, of a patient in
any setting where health care is being rendered.
(d) Proceedings to deny, suspend, or revoke a certification under
this article shall be conducted in accordance with Section 100171 of
the Health and Safety Code.
1247.7. An employee in training shall be classified as a
hemodialysis technician trainee and shall be under the immediate
supervision of a licensed physician and surgeon or licensed
registered nurse whenever involved in the treatment of a patient, as
described in Section 1247.3.
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.
1247.9. No person or entity shall provide chronic dialysis services
to patients in this state unless the services are provided under the
direction of a chronic dialysis clinic, licensed pursuant to Section
1204 of the Health and Safety Code, or a general acute care
hospital, licensed pursuant to Section 1250 of the Health and Safety
Code.
