House of Representatives

HB 2359

dialysis technicians; standards; quality committee

Sponsors: Representatives Cannell, Huppenthal, Chase, et al

 

DPA

Committee on Health

DPA

Caucus and COW

X

Third Read

 

 

As Passed the House

 

HB 2359 requires dialysis technicians beginning January 1, 2004 to receive minimum training or obtain national certification as a condition of employment.  The bill creates a dialysis quality committee to develop minimum training requirements for dialysis technicians and study dialysis issues as they relate to quality of care.

 

Current Status

The Committee of the Whole adopted the Health Committee amendment that clarifies the duties of the dialysis quality committee, changes the reference to the national certification, allows current employees six months after the implementation date to meet the requirements and changes the repeal date from December 31, 2003 to July 1, 2004.

 

History

End-Stage Renal Disease (ESRD) occurs when a person’s kidney succumbs to an irreversible disease.   ESRD requires that a person either receive a kidney transplant or onging dialysis for treatment. 

 

According to the End-Stage Renal Dialysis Network, a non-profit corporation hired by the federal government to monitor dialysis statistics and quality of care issues, there are approximately 5,000 persons on dialysis in Arizona.  Of those, 91 percent receive dialysis treatment at dialysis centers while the remaining population uses home dialysis.   There are 71 for-profit, 11 non-profit dialysis and seven hospital-based dialysis facilities in Arizona.

 

Dialysis technicians are responsible for assisting, under supervision, in the care of patients undergoing dialysis treatment.   The National Kidney Foundation states that most dialysis technicians undergo a six to twelve week training program as a condition of employment.  The average salary for a dialysis technician may range from $5 – $10 at the entry level and $8 - $16 for experienced technicians. Most dialysis providers in Arizona conduct in-house training for technicians and some require them to become nationally certified.

 

The National Association of Nephrology Technicians/Technologists (NANT) endorses four different types of national certification for dialysis technicians.   To become certified, a technician must meet minimum education and training requirements and pass an examination.  The cost for an examination may range from $125 - $250.  Certification renewal requires the payment of a fee every two or four years.  Two of the certifications also require re-examination as a condition for renewal.

 

According to the Nephrology Nursing Certification Commission, as of October 4, 2001 there are five states that regulate dialysis technicians.  Dialysis technicians are typically regulated by licensure, registration or certification with oversight by a nursing board or state health department.

 

There are currently no requirements for certification and training of dialysis technicians in Arizona.  The Department of Health Services (DHS) licenses dialysis facilities.

 

HB 2359 requires that dialysis providers beginning on January 1, 2004 must use dialysis technicians who are either NANT certified or meet training requirements established in rule by DHS.  A quality committee will develop these minimum training requirements.  The quality committee will also be responsible for studying various dialysis issues as they relate to quality of care.

 

Provisions

·          Requires that a facility must use hemodialysis technicians that are certified by NANT or have completed minimum training requirements recommended by the dialysis quality committee and adopted into DHS rules.

·          Requires DHS to develop rules for dialysis technician trainees.  Stipulates that a trainee may not provide dialysis in any facility if the trainee has not meet the minimum training requirements or passed the national certification.

·          Specifies that dialysis facilities maintain in a technician’s file either verification of certification or a document signed by the technician indicating that they received the minimum training established by rule.

·          Creates a dialysis quality committee consisting of the following members:

Governor Appointed

-         One representative from the End-State Renal Dialysis Network

-         One representative from DHS or designee

-         Two patients that receive dialysis services

-         One representative of a statewide kidney foundation

-         One licensed nephrologist

-         Three providers of dialysis services

-         One dialysis technician

Designated by the Speaker and the President

-         Two members from both the House of Representatives and the Senate

·          Stipulates that the dialysis quality committee shall conduct meetings for the following purpose:

-         Study the issue of vascular access and the use of catheters, dialyzers and other equipment as it relates to quality of care

-         Create a consumer quality perception tracking system to improve the level of quality that patients receive

-         Provide ongoing review and recommendations to the legislature of changes to dialysis certification and training requirements

-         Evaluate the adequacy of reimbursement and other resources available to improve dialysis services

-         Determine what training resources are available for dialysis technicians

·          Requires the committee to recommend minimum training requirements for dialysis technicians and forward the recommendations to DHS to be adopted by rule no later than December 15, 2003.  The committee must comply with the state open meeting laws and provide at least two opportunities for public comment.  The committee must file a report of its findings and recommendations by November 15, 2003.

·          Provides a rule making exemption to DHS to adopt minimum training requirements for dialysis technicians.

·          Repeals the dialysis quality committee on December 31, 2003.

HB 2359 was amended in the Committee of the Whole as follows:

·          Clarifies language regarding the duties of the dialysis quality committee.

·          Changes the certification requirement so that a dialysis technician may obtain certification through a national organization that certifies dialysis technicians, instead of a certification endorsed by the National Association of Nephrology Technicians.

·          Changes the repeal date for the dialysis quality committee from December 31, 2003 to July 1, 2004.

·          Specifies that employed dialysis technicians have six months after the January 1, 2004 implementation date to obtain certification or meet minimum training requirements.

 

 

 

 

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45th Legislature                       

Second Regular Session            3          February 15, 2002

 

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