BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           112 (Oropeza)
          
          Hearing Date:  4/20/2009        Amended: 4/1/2009
          Consultant: Katie Johnson       Policy Vote: Health 10-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:   SB 112, an urgency measure, would revise  
          existing requirements for the certification of hemodialysis  
          technicians by the Department of Public Health (DPH) in response  
          to final regulations, the Conditions for Coverage of End-Stage  
          Renal Disease Facilities, issued by the Centers for Medicare and  
          Medicaid Services (CMS) in April 2008.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions        2009-10      2010-11       2011-12     Fund
           
          DPH Regulations        $69        $117        $69       Special*
                                                                  
          *State Department of Public Health Licensing and Certification  
          Program Fund
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: 
          
          Existing law establishes the Hemodialysis Technicians Training  
          Act (act) which allows for the certification of hemodialysis  
          technicians by the DPH. The act requires the DPH to certify the  
          following for an applicant to become a certified hemodialysis  
          technician (CHT): 1) the person is certified by the Board of  
          Nephrology Examination for Nurses and Technicians (BONENT), 2)  
          the person completed a DPH-approved training and testing program  
          in a hemodialysis clinic or unit, or 3) the person is a graduate  
          of a local training and testing program operated by a  
          DPH-approved accredited college or university or a private  
          training program. 

          This bill would delete the requirement that the DPH approve  
          training programs run by hemodialysis clinics or units, as well  
          as the requirement that the DPH approve educational institutions  
          or private training programs.











          This bill would require that a CHT's certification would be  
          valid until April 15, 2010. After that date, this bill would  
          require CHTs to, on or before that date, obtain a new  
          certificate from the DPH.

          This bill would provide that an expired certification may be  
          renewed any time within two years after its expiration on the  
          filing of an application for renewal and documentation of the  
          required in-service education. Current law states that a CHT  
          certification is valid for four years and that a CHT must  
          complete 30 hours of in-service training or continuing  
          education. 

          In accordance with new CMS final regulations, this bill would  
          require that, to be certified by the DPH as a CHT, a person  
          must: 1) have a high school diploma or equivalency, or 
          Page 2
          SB 112 (Oropeza)

          have greater than four years of work experience in dialysis as  
          of October 14, 2008, 2) have successfully completed a training  
          program that is approved by the medical director and governing  
          body of a hemodialysis clinic or unit, as specified, or  
          completed a community or corporate based training program or a  
          training program offered by an educational institution, and 3)  
          either successfully pass a DPH-approved standardized test or  
          successfully pass a CMS-approved national, commercially  
          available certification program. If a person has two or more  
          years of experience working in hemodialysis clinic or unit as of  
          October 14, 2008, but does not have documentation of having  
          successfully completed a training program meeting the  
          requirements of this bill, he or she may satisfy the  
          requirements listed above by doing both of the following:  1)  
          passing a written exam offered by a hemodialysis clinic or unit,  
          and 2) passing a skills checklist. 

          A Management Services Technician currently certifies  
          hemodialysis technicians and the DPH anticipates that workload  
          related to this bill in terms of certifying these new  
          technicians would be absorbable. 

          This bill would provide that the DPH shall adopt regulations it  
          deems necessary to implement these provisions. The DPH estimates  
          that it would require one full-time, limited-term Health  
          Facilities Evaluator Nurse for up to two years at a cost of  










          $69,000 in FY 2009-10, $117,000 in FY 2010-2011, and $69,000 in  
          FY 2011-2012 from the State Department of Public Health  
          Licensing and Certification Program Fund to promulgate  
          regulations.