BILL ANALYSIS
SB 112
Page 1
SENATE THIRD READING
SB 112 (Oropeza)
As Amended August 27, 2009
2/3 vote. Urgency
SENATE VOTE : 37-0
BUSINESS & PROFESSIONS 10-0 APPROPRIATIONS 15-0
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|Ayes:|Hayashi, Emmerson, |Ayes:|De Leon, Nielsen, |
| |Conway, Eng, | |Ammiano, |
| |Hernandez, Nava, Niello, | |Charles Calderon, Coto, |
| |John A. Perez, Ruskin, | |Davis, Duvall, Fuentes, |
| |Smyth | |Hall, Harkey, Miller, |
| | | |John A. Perez, Skinner, |
| | | |Audra Strickland, |
| | | |Torlakson |
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SUMMARY : Revises the training requirements for certified
hemodialysis technicians (CHT). Specifically, this bill :
1)Prohibits an individual from providing services as a
hemodialysis technician without being certified by the
Department of Public Health (DPH) as a CHT, as specified.
2)Requires an individual to meet the following requirements to
become a CHT:
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 under the
direction of a registered nurse that is approved by the
medical director and governing body of a hemodialysis
clinic or unit, and DPH. 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; and,
c) Successfully accomplish either of the following:
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i) Pass a standardized test approved by the DPH and
covers specified subjects; or,
ii) 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.
3)Requires a training program to include 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; and,
h) Dialyzer reprocessing, if applicable.
4)States that a community or corporate-based training program,
or a training program offered by an educational institution,
is acceptable if the program meets the applicable
requirements.
5)Permits an individual 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 showing
successful completion of a qualified training program to be
deemed to be in compliance by:
a) Passing a written exam offered by a hemodialysis clinic
or unit, or qualified community or corporate-based training
program, covering the subjects listed above; and,
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b) Passing a skills checklist through observation by a
registered nurse of the technician's skills, as specified.
6)Permits the DPH to adopt regulations to implement this bill.
7)Permits current hemodialysis technicians to retain their
certifications until April 15, 2010.
8)Is an urgency statute, and becomes inoperative on July 1,
2010, and, as of January 1, 2011, is repealed, unless a later
enacted statute deletes or extends the dates on which it
becomes inoperative and is repealed.
9)Permits an expired certification to 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.
10)Requires each hemodialysis unit or clinic to have information
available for inspection by the department survey teams which
verifies that the hemodialysis technicians employed at the
unit or clinic meet the certification requirements.
11)Defines "standardized test" as 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.
12)Defines "Hemodialysis technician" as 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
this bill shall be referred to as a CHT.
13)Makes legislative findings and declarations.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, absorbable workload to DPH to continue oversight of
CHT training and educational requirements.
COMMENTS : According to the author's office, "SB 112 will bring
California's hemodialysis technician certification program into
compliance with the [Centers for Medicare and Medicaid Services'
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(CMS)] Conditions for Coverage (CfC) [of End-Stage Renal Disease
facilities] so that our program can be granted approval by CMS,
thus allowing an alternative pathway to certification for
California's CHTs."
On April 15, 2008, CMS established new CfCs for dialysis
facilities. CfCs are the minimum health and safety standards
that providers and suppliers must meet in order to be Medicare
and Medicaid certified. According to the U.S. Department of
Health and Human Services, the new conditions update CMS
standards for delivering safe, high-quality care to dialysis
patients. The revised regulations are patient-centered; reflect
improvements in clinical standards of care, the use of more
advanced technology, and, most notably, a framework to
incorporate performance measures viewed by the scientific and
medical community to be related to the quality of care provided
to dialysis patients. The conditions also established specific
standards which include the certification of "Patient Care
Technicians," known in California as Certified Hemodialysis
Technicians.
According to the author's office, there are over 5,000 CHTs
currently in California, and all must be recertified to be in
compliance with the new CfC prior to April 15, 2010. CMS has
only approved three private certification programs, so this bill
modifies California's state certification program as an
alternative pathway.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301
FN: 0002515