06 LC 33
1557S
The
House Committee on Health and Human Services offers the following
substitute
to SB 423:
A
BILL TO BE ENTITLED
AN ACT
AN ACT
To
amend Chapter 44 of Title 31 of the Official Code of Georgia Annotated, relating
to renal disease facilities, so as to provide a short title; to revise a
definition for purposes of conformity; to revise certain provisions relating to
the adoption of rules relative to end stage renal disease facilities and
personnel thereof; to revise certain provisions relating to minimum standards
for curricula, instructors, and training dialysis and reuse technicians; to
amend Title 43 of the Official Code of Georgia Annotated, relating to regulation
of professions and businesses, so as to add a new Chapter 30A regulating
dialysis technicians; to provide for definitions; to provide for certification
requirements for dialysis technicians; to provide for the renewal and
reinstatement of certificates; to provide for powers of the Georgia Board of
Nursing relating to the regulation of dialysis technicians; to provide for
authorized activities of dialysis technicians; to provide for delegation of
dialysis care by a registered professional nurse to a dialysis technician; to
provide for the use of titles and other indications of certification; to provide
for applications under oath; to provide for the creation, composition, and
duties of the Dialysis Technician Advisory Council; to provide for disciplinary
actions; to provide for violations; to provide for actions to enjoin; to provide
for administrative procedures; to revise certain provisions relating to the
nonapplicability of Code Section 43-34-177 for purposes of conformity; to
provide for related matters; to provide an effective date; to repeal conflicting
laws; and for other purposes.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION
1.
This
Act shall be known and may be cited as the "Ray Biddy and Gene Mullis
Act."
SECTION
2.
Chapter
44 of Title 31 of the Official Code of Georgia Annotated, relating to renal
disease facilities, is amended in Code Section 31-44-1, relating to definitions,
by striking paragraph (2) and inserting in its place the following:
"(2)
'Dialysis technician' means an individual
certificated
as a dialysis technician pursuant to Chapter 30A of Title
43
who is not
a registered nurse or physician and who
provides
dialysis
care under the supervision of a registered nurse or
physician."
SECTION
3.
Such
chapter is further amended in Code Section 31-44-3, relating to adoption of
rules, council established, and terms of councilmembers, by striking subsection
(a) and inserting in its place the following:
"(a)
The board shall adopt rules to implement this chapter, including but not limited
to requirements for the issuance, renewal, denial, suspension, and revocation of
a license to operate an end stage renal disease facility. The rules adopted by
the board pursuant to this Code section shall not conflict with
the provisions
of Chapter 30A of Title 43 or any federal
law or regulation applicable to end stage renal disease facilities or personnel
thereof and shall set forth minimum standards for the health, safety, and
protection of the patient being
served."
SECTION
4.
Such
chapter is further amended by striking Code Section 31-44-9, relating to minimum
standards for curricula, instructors, and training dialysis and reuse
technicians, and inserting in its place the following:
"31-44-9.
The
rules adopted by the board under Code Section 31-44-3 shall
establish:
(1)
Minimum standards for the curricula and instructors used to train individuals to
act as
dialysis
or reuse technicians;
(2)
Minimum standards for the
initial and
annual determination of the competency of
individuals who have been trained as dialysis or reuse technicians
to perform
delegated tasks in a licensed facility so long as such standards do not conflict
with the provisions of Chapter 30A of Title
43;
(3)
Minimum requirements for documentation that an individual has been trained and
determined to be competent as a
dialysis
or reuse technician and the acceptance of
that documentation by another end stage renal disease facility that may later
employ the individual; and
(4)
The acts and practices that are allowed or prohibited for dialysis or reuse
technicians so
long as such provisions do not conflict with the provisions of Chapter 30A of
Title 43 and are not construed to expand or limit the scope of practice of
dialysis technicians authorized pursuant to such
chapter."
SECTION
5.
Title
43 of the Official Code of Georgia Annotated, relating to regulation of
professions and businesses, is amended by adding a new Chapter 30A to read as
follows:
"CHAPTER
30A
43-30A-1.
As
used in this chapter, the term:
(1)
'Applicant' means any person seeking a certificate under this
chapter.
(2)
'Approved dialysis technician training curriculum' means a board approved
curriculum used to train dialysis technicians including, but not limited to, a
board approved dialysis company or facility-sponsored training curriculum or
another state approved curriculum.
(3)
'Board' means the Georgia Board of Nursing established pursuant to Code Section
43-26-4.
(4)
'Certificate' means a valid and current certificate of registration issued by
the board pursuant to this chapter permitting a person to provide dialysis care
as a dialysis technician.
(5)
'Dialysis care' means performing and monitoring dialysis procedures, including
initiating and discontinuing dialysis, drawing blood, and administering
medications in accordance with this chapter and with board rules.
(6)
'Dialysis facility' means an end stage renal disease facility licensed pursuant
to Chapter 44 of Title 31.
(7)
'Dialysis technician' means a person who provides dialysis care.
(8)
'Dialysis technician trainee' means a person enrolled in an approved dialysis
technician training curriculum.
(9)
'Direct supervision' means initial and ongoing direction, procedural guidance,
and observation and evaluation by a registered professional nurse or physician;
and when a patient is being dialyzed, the nurse or physician is in the immediate
clinical care area.
(10)
'National certification' means certification as a dialysis technician issued by
a nationally recognized accrediting organization such as, but not limited
to:
(A)
Certified Clinical Hemodialysis Technician (CCHT) through the Nephrology Nursing
Certification Commission (NNCC);
(B)
Certified Hemodialysis Technician (CHT) through the Board of Nephrology
Examiners Nursing and Technology (BONENT); or
(C)
Certified Clinical Nephrology Technician (CCNT) or Certified Biomedical
Nephrology Technician (CBNT) through the National Nephrology Certification
Organization (NNCO).
(11)
'Person' means a natural person only.
(12)
'Physician' means an individual who is licensed to practice medicine under
Article 2 of Chapter 34 of this title.
(13)
'Registered professional nurse' means an individual who is licensed to practice
nursing under Article 1 of Chapter 26 of this title.
43-30A-2.
(a)
On and after March 1, 2007, no person may provide dialysis care as a dialysis
technician in this state who is not licensed pursuant to this chapter. All
applicants for a certificate to practice as a dialysis technician shall make
application to the board in the form and manner established by the board. Such
applicants shall submit to the board a designated fee and written evidence
demonstrating that the applicant:
(1)
Is of good moral character;
(2)
Has attained a high school diploma or a general educational development (GED)
diploma or the equivalent thereof;
(3)
Has successfully completed an approved dialysis technician training
curriculum;
(4)
Has achieved national certification as a dialysis technician; and
(5)
Has met such other qualifications as required by the board.
(b)
An individual who was working on or before March 1, 2007, as a dialysis
technician in a dialysis facility and whose administrative registered
professional nurse in charge acknowledges that he or she is competent to perform
the delegated duties and practices in accordance with the laws regulating the
provision of dialysis care, the rules of the board, and any other applicable
federal and state laws and regulations shall be considered as having met the
requirements of paragraphs (3) and (4) of subsection (a) of this Code section
for the purposes of being certified by the board as a dialysis
technician.
(c)
An individual who has successfully completed an approved dialysis technician
training curriculum on or before March 1, 2007, who was working on or before
March 1, 2007, as a dialysis technician trainee in a dialysis facility and whose
administrative registered professional nurse in charge acknowledges that he or
she is competent to perform the delegated duties and practices in accordance
with the laws regulating the provision of dialysis care, the rules of the board,
and any other applicable federal and state laws and regulations shall be
considered as having met the requirements of paragraph (4) of subsection (a) of
this Code section for the purposes of being certified by the board as a dialysis
technician.
(d)
The board may, upon receipt of a completed application and fee, issue a
temporary permit to practice as a dialysis technician to an applicant who has
completed an approved dialysis technician training curriculum and who meets the
qualifications established by the board. A temporary permit shall not be
renewable, and shall be effective 90 days from the date of issuance, unless the
board revokes the temporary permit prior to its expiration.
(e)
The board may, upon receipt of a completed application and fee, issue a
temporary endorsement to practice as a patient care dialysis technician to an
applicant who has been certified as a dialysis technician under the laws of
another state, territory, or foreign country and who meets the qualifications
established by the board. A temporary endorsement shall not be renewable and
shall be effective for 90 days unless the board revokes the temporary
endorsement prior to its expiration.
(f)
Application for a certificate under this Code section shall constitute consent
for performance of a criminal background check. Each applicant who submits an
application to the board for certification agrees to provide the board with any
and all information necessary to run a criminal background check, including but
not limited to classifiable sets of fingerprints. The applicant shall be
responsible for all fees associated with the performance of a background check.
The board may accept the results of criminal background checks conducted by an
applicant́s
employer if they were conducted within an acceptable period of time and if they
include the minimum required checks.
43-30A-3.
(a)
Certificates issued under this chapter shall be renewed biennially prior to the
expiration of the certificate according to schedules and fees decided by the
board.
(b)
A certificate shall be renewed for any dialysis technician who remits the
required fee and complies with the requirements established by the board. The
board shall be authorized to require persons seeking renewal of a certificate to
complete board approved continuing education.
(c)
The voluntary surrender of a certificate or the failure to renew a certificate
by the end of an established renewal period shall have the same effect as
revocation of said certificate, subject to reinstatement at the discretion of
the board. The board may restore and reissue a certificate, and, as a condition
thereof, may impose any disciplinary sanction provided by Code Section 43-1-19
upon such grounds as specified in such Code section.
(d)
Any certificate that is not renewed by the end of the renewal period may not
thereafter be renewed, and the certificate holder must apply for reinstatement.
Applicants for reinstatement who have not been engaged in the active practice of
dialysis care as a dialysis technician for a period which exceeds five years
shall be required to obtain such additional education and training as provided
in the rules and regulations of the board, which may include but not be limited
to returning to school for full training and taking the certification
examination. Upon completion of the curriculum, an application may be made for
certification as a new applicant.
(e)
Other criteria for reinstatement may be determined by the rules of the board,
including but not limited to the following: additional coursework, a refresher
course, supervised clinical practice, or examination by the board.
43-30A-4.
(a)
The board shall have the power to:
(1)
Examine and determine the qualifications and fitness of applicants for
certification as dialysis technicians in this state;
(2)
Establish minimum standards for the determination of the competency of
individuals who have been trained as dialysis technicians;
(3)
Establish standards for approving and withdrawing approval of dialysis
technician training curricula;
(4)
Establish minimum standards for the curricula and instructors used to train
individuals to act as dialysis technicians in approved dialysis technician
training curricula;
(5)
Issue, renew, refuse to renew, deny, suspend, reinstate, and revoke certificates
of dialysis technicians in this state or otherwise discipline dialysis
technicians;
(6)
Determine the acts and practices that are allowed or prohibited for dialysis
technicians, in accordance with the provisions of this chapter;
(7)
Establish continuing education requirements for dialysis technicians which may
include any continuing education requirements for national
certification;
(8)
Conduct investigations for the purpose of discovering violations of this chapter
or grounds for disciplining persons certificated under this
chapter;
(9)
Hold hearings on all matters pertaining to this chapter properly brought before
the board and, in conjunction therewith, to administer oaths, receive evidence,
make the necessary determinations, and enter orders consistent with the
findings. The board may designate one or more of its members as its hearing
officer;
(10)
Adopt rules and regulations consistent with this chapter necessary to enable it
to carry into effect the provisions of this chapter, including disciplinary
rules;
(11)
Establish fees pertaining to this chapter; and
(12)
Bring proceedings to the courts for the enforcement of this chapter or any rules
and regulations promulgated pursuant to this chapter.
(b)
In addition to the enumerated powers in subsection (a) of this Code section, the
board has the authority to conduct its business pursuant to the provisions of
Code Section 43-1-19 which is incorporated herein and made a part of this
chapter by specific reference.
43-30A-5.
(a)
A dialysis technician may provide dialysis care when delegated to him or her by
a registered professional nurse if:
(1)
The dialysis technician has a valid certificate issued pursuant to this
chapter;
(2)
The registered professional nurse considers the dialysis technician to be
competent; and
(3)
The dialysis technician provides the care under the direct supervision of the
registered professional nurse.
(b)
Nothing in this chapter may be construed to prohibit a dialysis technician
trainee from performing dialysis care as a part of and within the scope of the
clinical skills instruction segment of an approved dialysis technician training
curriculum.
43-30A-6.
A
dialysis technician is authorized to perform the following activities, under the
direct supervision of a registered professional nurse or a
physician:
(1)
Preparing and initiating dialysis access sites;
(2)
Initiating, delivering, or discontinuing dialysis care;
(3)
Administering only the following medications:
(A)
Heparin to prime the pump, initiate treatment, or for administration through
treatment in an amount prescribed by a physician or other authorized
practitioner; this may be done intravenously, peripherally via a fistula needle,
or in another clinically acceptable manner;
(B)
Normal saline via the dialysis extra corporeal circuit as needed through the
dialysis procedure; this may be done intravenously, peripherally via a fistula
needle, or in another clinically acceptable manner; and
(C)
Intradermal anesthetic in an amount prescribed by a physician or other
authorized practitioner;
(4)
Obtaining a blood specimen via the dialysis extra corporeal circuit or a
peripheral access site;
(5)
Reporting changes that arise in conjunction with dialysis care to the registered
professional nurse or physician; and
(6)
Engaging in other acts as permitted by board rules and as delegated by the
registered professional nurse or physician in order to provide dialysis
care.
43-30A-7.
(a)
An individual licensed by the board as a dialysis technician pursuant to the
provisions of this chapter shall be known as a dialysis technician and may use
the initials 'D.T.' after his or her name. On and after March 1, 2007, no other
individual may use the title, abbreviation, or any other words, letters,
figures, signs, or devices to indicate that he or she is a dialysis technician
in this state.
(b)
An individual enrolled in an approved dialysis technician training curriculum
shall be known as a dialysis technician trainee. A dialysis technician trainee
shall adhere to the rules and regulations of the board for dialysis technicians
and is subject to disciplinary action by the board as provided by board
rules.
43-30A-8.
The
board may require that all applications be made under oath.
43-30A-9.
(a)
There is created the Dialysis Technician Advisory Council, which shall advise
the board on issues relating to the qualifications, standards for training,
competency determination of dialysis technicians, and all other matters relating
to dialysis technicians.
(b)
The council shall be appointed by the board and shall consist of eight members
as follows:
(1)
One member of the board, who shall serve as chairperson of the
council;
(2)
Two dialysis technicians;
(3)
Two registered professional nurses who regularly provide dialysis care and care
for patients who receive dialysis;
(4)
One physician who regularly treats patients receiving dialysis care;
and
(5)
Two dialysis or kidney transplant patients.
(c)
The board shall specify the length of terms of the members.
(d)
Members of the council shall be reimbursed for expenses and travel as provided
for members of various professional licensing boards in subsection (f) of Code
Section 43-1-2.
43-30A-10.
The
investigatory and disciplinary authority of the board shall be as provided in
Code Section 43-1-19.
43-30A-11.
(a)
It shall be unlawful for any individual, firm, corporation, facility, or
association to:
(1)
Sell or fraudulently obtain or furnish any national certification credential or
documentation of successful completion of an approved dialysis technician
training curriculum or aid or abet therein;
(2)
Perform services as a dialysis technician unless authorized by the provisions of
this chapter;
(3)
Use in connection with his or her name any designation tending to imply that he
or she is a dialysis technician unless authorized by the provisions of this
chapter; or
(4)
Otherwise violate any provision of this chapter.
(b)
Any person who violates this chapter shall be guilty of a misdemeanor and, upon
conviction thereof, shall be punished by a fine not less than $500.00 or more
than $1,000.00.
(c)
Each act of unlawful practice under this Code section shall constitute a
distinct and separate offense.
43-30A-12.
(a)
The practice of dialysis care is declared to be an activity affecting the public
interest and involving the health, safety, and welfare of the public. Such
practice by a person who is not certificated to practice in this state is
declared to be a public nuisance, harmful to the public health, safety, and
welfare.
(b)
Any citizen of this state, the board, or the appropriate prosecuting attorney
where such practice is carried out by such uncertificated person may, on behalf
of the public, bring an action to restrain and enjoin such uncertificated
practice in the superior court of the county where such uncertificated person
resides or works. It shall not be necessary in order to obtain an injunction
under this Code section to allege or prove that there is no adequate remedy at
law or to allege or prove any special injury.
(c)
The remedy provided for in this Code section shall be cumulative to, and not in
lieu of, any other remedy or penalty provided in this chapter or otherwise
provided by law.
43-30A-13.
Proceedings
under this chapter shall be governed by Chapter 13 of Title 50, the 'Georgia
Administrative Procedure
Act.'"
SECTION
6.
Said
title is further amended in Code Section 43-34-178, relating to the
nonapplicability of Code Section 43-34-177, by striking paragraph (6) of
subsection (a) and inserting in its place the following:
"(6)
A person working as a dialysis
care
technician in an end stage renal disease facility licensed pursuant to Chapter
44 of Title 31 or a licensed
hospital."
SECTION
7.
This
Act shall become effective on July 1, 2006.
SECTION
8.
All
laws and parts of laws in conflict with this Act are repealed.