This article shall be known and may be cited as the Hemodialysis Technician Training Act.
(Amended by Stats. 1995, Ch. 302, Sec. 1. Effective January 1, 1996.)
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.
(Amended by Stats. 2009, Ch. 559, Sec. 2. Effective October 11, 2009.)
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.
(Amended by Stats. 1989, Ch. 248, Sec. 2. Effective July 31, 1989.)
The department may adopt regulations it deems necessary to implement this article.
(Amended by Stats. 2009, Ch. 559, Sec. 3. Effective October 11, 2009.)
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.
(Amended by Stats. 1997, Ch. 122, Sec. 1. Effective January 1, 1998.)
(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.
(Amended by Stats. 2009, Ch. 559, Sec. 4. Effective October 11, 2009.)
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.
(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.
(Added by Stats. 2009, Ch. 559, Sec. 5. Effective October 11, 2009.)
(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.
(Amended by Stats. 2009, Ch. 559, Sec. 7. Effective October 11, 2009.)
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.
(Amended by Stats. 2009, Ch. 559, Sec. 8. Effective October 11, 2009.)
(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.
(Amended by Stats. 1999, Ch. 979, Sec. 4. Effective January 1, 2000.)
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.
(Added by Stats. 1987, Ch. 1297, Sec. 4.)
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.
(Amended by Stats. 2009, Ch. 559, Sec. 9. Effective October 11, 2009.)
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.
(Amended by Stats. 2009, Ch. 39, Sec. 2. Effective January 1, 2010.)