2005 California Business and Professions Code Sections 1247-1247.9 Article 3.5. Hemodialysis Training

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 Health Services.
   (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.
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 shall adopt rules and regulations, by July
1, 2001, prescribing minimum training standards for hemodialysis
technicians who are certified pursuant to paragraphs (2), (3), and
(4) of subdivision (a) of Section 1247.6.
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, no
person shall provide services as a hemodialysis technician without
meeting one or more of the following requirements:
   (1) Certification by the department as having been certified by
the Board of Nephrology Examination for Nurses and Technicians
(BONENT).
   (2) Certification by the department as having completed a
department-approved training and testing program in a hemodialysis
clinic or unit.
   (3) Certification by the department as being a graduate of a local
training and testing program operated by an accredited college or
accredited university approved by the department, or a graduate of a
private training program approved by the department.  As used in this
article, accredited has the same meaning as defined by Section 94711
of the Education Code.
   (4) Certification by the department as hemodialysis technicians on
or before the effective date of regulations adopted pursuant to
Section 1247.4.
   (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.
   (c) A hemodialysis technician training program and competency
test, that is approved by the department before January 1, 1998,
shall not be required to be reapproved pursuant to this section or
Section 1247.5 unless the department determines reapproval to be
necessary to protect patient safety.
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) Those hemodialysis technicians certified by the department or
the Board of Nephrology Examination for Nurses and Technicians
(BONENT) before January 1, 1995, shall, before January 1, 1996, apply
to renew their certification, or in the case of those technicians
certified by the Board of Nephrology Examination for Nurses and
Technicians (BONENT) obtain department certification, by submitting
the fee required by subdivision (n) of Section 1300 and proof of
previous certification.  The department shall automatically renew the
certification of those hemodialysis technicians who were certified
before January 1, 1995, and who apply for renewal pursuant to this
subdivision.
   (c) For renewals occurring on or after January 1, 1996, a
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.
1247.64.  A hemodialysis technician may obtain the in-service
training or continuing education required by subdivision (c) 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 shows
the local training program and competency test and the names of all
hemodialysis technicians and hemodialysis technician trainees
employed in the unit or clinic.  Where a hemodialysis unit or clinic
does not adopt a local training program and test, it shall provide
proof that the hemodialysis technicians employed meet the
requirements of subdivision (a) of Section 1247.6.
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, a home dialysis agency licensed
pursuant to Chapter 11 (commencing with Section 1794.01) of Division
2 of the Health and Safety Code, or a general acute care hospital,
licensed pursuant to Section 1250 of the Health and Safety Code.