HOUSE BILL REPORT

                  HB 2293

             As Reported By House Committee On:

                         Health Care

Title:  An act relating to the credentialing of hemodialysis technicians.

Brief Description:  Certifying hemodialysis technicians.

Revised for 1st Substitute: Establishing training standards for hemodialysis technicians.

Sponsors:  Representatives Cody and Van Luven.

Brief History:

  Committee Activity:

Health Care:  1/21/00, 1/27/00 [DPS].

           Brief Summary of Substitute Bill

$Renal dialysis facilities are required to certify their hemodialysis technicians as trained for performing dialysis functions, and are required to registered them with the Department of Health under the law regulating health care assistants.

$The department must establish training requirements for hemodialysis technicians, and is authorized to establish a task force to assist in the development of training standards.

HOUSE COMMITTEE ON HEALTH CARE

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  Signed by 10 members:  Representatives Cody, Democratic Co-Chair; Parlette, Republican Co-Chair; Pflug, Republican Vice Chair; Schual-Berke, Democratic Vice Chair; Alexander; Campbell; Conway; Edmonds; Edwards and Mulliken.

Staff:  John Welsh (786-7133).

Background:

Hemodialysis technicians are currently exempt from regulation as health care assistants.

Hemodialysis is a form of dialysis that uses an artificial kidney machine to remove fluids and waste products from the bloodstream.  The blood must be passed through a dialyzer and returned to the body by means of surgically implanted devices.  A hemodialysis technician works under the supervision of a trained dialysis nurse, and are trained on site by the facility as there are no academic institutions in this state that provide a curriculum for hemodialysis patient care technicians.

There are approximately 325 hemodialysis technicians in the state, and approximately 2,700 renal care patients.  It is estimated that the number of patients will double in the next few years because people are living longer; people on dialysis live longer; and the number of people with high blood pressure and diabetes are increasing, accounting for some 30 percent of dialysis patients.

A report by the Department of Health under the Sunrise Review Act found that improper dialysis techniques present risks of serious harm to patients.

Summary of Substitute Bill:

There is an expression of legislative intent that acknowledges concerns about the quality of care dialysis patients are receiving due to the lack of uniform training standards for hemodialysis technicians working in renal dialysis facilities.  There is a legislative finding that the regulation of these technicians will provide increased quality assurance for patients, health providers, third-party payers, and the public.

Hemodialysis technicians are regulated as a category of health care assistants.  Renal dialysis facilities are required to certify that their technicians are capable of performing the functions authorized for hemodialysis, and must register them with the Department of Health.  The department must establish educational, occupational, and training qualifications of hemodialysis technicians.  However, persons trained in federally approved facilities performing in-home dialysis are exempt from certification.

The functions authorized for hemodialysis technicians are expanded to include the process of connecting vascular catheters.

An advisory task force is established to assist the Secretary of Health in developing core competencies and minimum training standards for hemodialysis technicians.  The members of the task force include nephrologists, dialysis nurses, patient care hemodialysis technicians, dialysis patients and other persons with recognized expertise.

Substitute Bill Compared to Original Bill:  Hemodialysis technicians are certified and registered by renal dialysis facilities as health care assistants under an existing chapter of the code. The original bill established a separate regulatory program for certifying hemodialysis technicians as a distinct health profession.  The department is authorized to establish an advisory task force to assist in the development of the required training standards.  However, persons trained in federally approved facilities performing in-home dialysis are exempted from regulation. Hemodialysis technicians may connect vascular catheters in the dialysis process.

Appropriation:  None.

Fiscal Note:  Requested on January 23, 2000.

Effective Date of Substitute Bill:  Ninety days after adjournment of session in which bill is passed except for section 2 which takes effect March 1, 2001.

Testimony For:  There are concerns expressed about the quality of care kidney dialysis patients are receiving due to a lack of required and uniform training standards for hemodialysis technicians. The Sunrise Report of the department found that improper dialysis techniques present risks of serious harm to patients.  Recent national studies cite health and safety problems due to the lack of trained technicians who are systematically displacing professionally trained nurses working in these facilities.

Testimony Against:  None.

Testified:  (In support) Representative Van Luven, prime sponsor; and Michael Matson, National Kidney Foundation of Oregon and Washington.

(Support with changes) Dr. Christopher Blagg and Connie Anderson, Northwest Kidney Center; and Jean Stevens, Sacred Heart Medical Center.

(Information) Steve Boruchowitz, Department of Health.