Section § 1247

Explanation

This law is called the Hemodialysis Technician Training Act, which sets rules and requirements for training technicians who operate dialysis machines.

This article shall be known and may be cited as the Hemodialysis Technician Training Act.

Section § 1247.2

Explanation

This section defines key terms used in the context of dialysis treatment and supervision in California. It clarifies that "immediate supervision" requires overseeing dialysis treatment in the same room. The "Department" refers to the State Department of Public Health. A "Hemodialysis technician" is an unlicensed worker involved in direct patient care during dialysis, and those certified by the state are known as Certified Hemodialysis Technicians. Lastly, a "Standardized test" is an exam endorsed by the University of California to measure required knowledge effectively.

For the purpose of this article, the following terms have the following meaning:
(a)CA Business & Professions Code § 1247.2(a) “Immediate supervision” means supervision of dialysis treatment in the same room in which the dialysis treatment is being performed.
(b)CA Business & Professions Code § 1247.2(b) “Department” means the State Department of Public Health.
(c)CA Business & Professions Code § 1247.2(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)CA Business & Professions Code § 1247.2(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.

Section § 1247.3

Explanation

This law explains what a hemodialysis technician can do when treating patients. They can insert needles into veins or arteries to start dialysis and give certain medicines like local anesthetics, heparin, and saline. These activities must follow rules set by the medical director and be directly supervised by a doctor or nurse. The painkillers can only be given just under the skin or on it directly. Technicians certified to work at patients' homes don't need direct supervision, but only until a past date of January 1, 1991.

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.

Section § 1247.4

Explanation

This law allows a department to create rules to make sure this article is followed properly.

The department may adopt regulations it deems necessary to implement this article.

Section § 1247.5

Explanation

This law allows a hemodialysis clinic within a licensed medical facility to run training and testing programs for hemodialysis technicians. These programs need approval from the relevant department and must follow specific rules. The training has to cover local anesthetics, heparin, and sodium chloride solution administration.

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.

Section § 1247.6

Explanation

This law says that, with a couple of exceptions, you can't work as a hemodialysis technician without a special certification from the state. The exceptions include situations where you're training directly under someone else's supervision or cases covered by another specific section. Additionally, if you're a dialysis patient or helper who's been trained and certified to do dialysis at home, and you're not employed by a licensed facility, this rule doesn't apply to you.

(a)CA Business & Professions Code § 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)CA Business & Professions Code § 1247.6(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.

Section § 1247.7

Explanation

If someone is training to become a hemodialysis technician, they must be called a 'trainee' and be directly supervised by either a licensed doctor or nurse while working with patients.

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.

Section § 1247.8

Explanation

The law requires every hemodialysis unit or clinic to keep accessible records proving that their hemodialysis technicians fulfill certain qualifications, as described in another section. These records must be ready for inspection by department survey teams.

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.

Section § 1247.9

Explanation

This law states that only licensed chronic dialysis clinics or general acute care hospitals are allowed to offer dialysis services to patients. This means that any person or entity not properly licensed under these specific health code sections cannot legally provide chronic dialysis.

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.

Section § 1247.61

Explanation

To become a Certified Hemodialysis Technician (CHT) in California, you need a high school diploma or equivalent, or experience in dialysis. You must complete a training program approved by a hemodialysis clinic and overseen by a registered nurse. This program covers everything from operating dialysis machines to patient care and safety. If you've worked as a technician for over two years before a certain date in 2008 without formal training, you can meet the requirement by passing both a written exam and a skills checklist. You'll also need to pass a specific test on the training subjects. Starting in 2019, applicants must provide a taxpayer or social security number for certification, but their citizenship or immigration status won't affect their application.

To be certified by the department as a Certified Hemodialysis Technician (CHT), a person shall meet all of the following requirements:
(a)CA Business & Professions Code § 1247.61(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)CA Business & Professions Code § 1247.61(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)CA Business & Professions Code § 1247.61(b)(1) The training program shall include all of the following subjects, at a minimum:
(A)CA Business & Professions Code § 1247.61(b)(1)(A) Principles of dialysis.
(B)CA Business & Professions Code § 1247.61(b)(1)(B) Care of patients with kidney failure, including interpersonal skills.
(C)CA Business & Professions Code § 1247.61(b)(1)(C) Dialysis procedures and documentation, including initiation, proper cannulation techniques, monitoring, and termination of dialysis.
(D)CA Business & Professions Code § 1247.61(b)(1)(D) Possible complications of dialysis.
(E)CA Business & Professions Code § 1247.61(b)(1)(E) Water treatment and dialysate preparation.
(F)CA Business & Professions Code § 1247.61(b)(1)(F) Infection control.
(G)CA Business & Professions Code § 1247.61(b)(1)(G) Safety.
(H)CA Business & Professions Code § 1247.61(b)(1)(H) Dialyzer reprocessing, if applicable.
(2)CA Business & Professions Code § 1247.61(b)(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)CA Business & Professions Code § 1247.61(b)(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)CA Business & Professions Code § 1247.61(b)(3)(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)CA Business & Professions Code § 1247.61(b)(3)(B) Passing a skills checklist through observation by a registered nurse of the skills listed in paragraph (1).
(c)CA Business & Professions Code § 1247.61(c) Successfully accomplish either of the following:
(1)CA Business & Professions Code § 1247.61(c)(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)CA Business & Professions Code § 1247.61(c)(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.
(d)Copy CA Business & Professions Code § 1247.61(d)
(1)Copy CA Business & Professions Code § 1247.61(d)(1) No later than July 1, 2019, the department shall require an applicant to provide either the individual taxpayer identification number or social security number for purposes of applying for or the renewal of a certificate issued under this section or regulations promulgated pursuant thereto.
(2)CA Business & Professions Code § 1247.61(d)(2) If the department utilizes a national examination to issue a certificate, and if a reciprocity agreement or comity exists between the State of California and the state requesting release of the individual taxpayer identification number or social security number, any deputy, agent, clerk, officer, or employee of the department may release an individual’s taxpayer identification number or social security number to an examination or certifying entity only for the purpose of verification of certification or examination status.
(3)CA Business & Professions Code § 1247.61(d)(3) The individual taxpayer identification number or the social security number shall serve to establish the identification of persons affected by state tax laws and for purposes of establishing compliance with subsection (a) of Section 666 of Title 42 of the United States Code, Section 60.15 of Title 45 of the Code of Federal Regulations, Section 17520 of the Family Code, and Section 11105 of the Penal Code, and to that end, the information furnished pursuant to this section shall be used exclusively for those purposes.
(4)CA Business & Professions Code § 1247.61(d)(4) The department shall not do either of the following:
(A)CA Business & Professions Code § 1247.61(d)(4)(A) Require an applicant to disclose citizenship status or immigration status for purposes of the application or renewal of a certificate.
(B)CA Business & Professions Code § 1247.61(d)(4)(B) Deny certification to an applicant based solely on his or her citizenship status or immigration status.

Section § 1247.63

Explanation

If you're a certified hemodialysis technician in California, your certification is good for four years. To renew it, you'll need to show proof of completing 30 hours of training or education related to dialysis or general healthcare. If your certification expires, you have two years to renew it by submitting a renewal application and proof of continued education.

(a)CA Business & Professions Code § 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)CA Business & Professions Code § 1247.63(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)CA Business & Professions Code § 1247.63(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.

Section § 1247.64

Explanation

This section outlines where a hemodialysis technician can get the training or education they need. They can choose from courses at accredited colleges, courses through approved nursing education providers, courses from recognized health associations (if deemed acceptable), or employer-sponsored programs.

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)CA Business & Professions Code § 1247.64(a) Health-related courses offered by accredited postsecondary institutions.
(b)CA Business & Professions Code § 1247.64(b) Health-related courses offered by continuing education providers approved by the California Board of Registered Nursing.
(c)CA Business & Professions Code § 1247.64(c) Health-related courses offered by recognized health associations if the department determines the courses to be acceptable.
(d)CA Business & Professions Code § 1247.64(d) Health-related, employer-sponsored in-service training or continuing education programs.

Section § 1247.66

Explanation

The California Department of Public Health can deny, suspend, or revoke a hemodialysis technician's certification if they violate regulations. This includes engaging in unprofessional conduct like incompetence, fraud, or drug abuse. If a technician is convicted of a crime related to their work, or they lie on certification applications, they may also lose their certification. Abuse of patients or unsafe practices involving drugs or alcohol are specific examples of unprofessional conduct. If there's a case to remove a certification, it'll follow a set legal procedure.

(a)CA Business & Professions Code § 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)CA Business & Professions Code § 1247.66(b) The department may deny, suspend, or revoke the certification of a hemodialysis technician for any of the following causes:
(1)CA Business & Professions Code § 1247.66(b)(1) Unprofessional conduct, which includes incompetence or gross negligence in carrying out his or her usual functions.
(2)CA Business & Professions Code § 1247.66(b)(2) Procuring a certificate by fraud, misrepresentation, or mistake.
(3)CA Business & Professions Code § 1247.66(b)(3) Making or giving any false statement or information in conjunction with the application for issuance or renewal of a certificate.
(4)CA Business & Professions Code § 1247.66(b)(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)CA Business & Professions Code § 1247.66(c) In addition to other acts constituting unprofessional conduct within the meaning of this article, all of the following constitute unprofessional conduct:
(1)CA Business & Professions Code § 1247.66(c)(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)CA Business & Professions Code § 1247.66(c)(2) Abuse, whether verbal, physical, or mental, of a patient in any setting where health care is being rendered.
(d)CA Business & Professions Code § 1247.66(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.