06 LC 28
2691
Senate
Bill 423
By:
Senators Unterman of the 45th, Mullis of the 53rd and Thomas of the 54th
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 patient
care dialysis technicians; to provide for definitions; to provide for licensing
requirements for patient care dialysis technicians; to provide for the renewal
and reinstatement of licenses; to provide for powers of the Georgia Board of
Nursing relating to the regulation of patient care dialysis technicians; to
provide for authorized activities of patient care dialysis technicians; to
provide for delegation of dialysis care by a registered professional nurse to a
patient care dialysis technician; to provide for the use of titles and other
indications of licensure; to provide for applications under oath; to provide for
the creation, composition, and duties of the Patient Care 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 Biddie 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
licensed as a
patient care 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 in
accordance with the provisions of such
chapter.∀
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 determination of the competency of individuals who
have been trained as
dialysis
or reuse technicians;
(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.∀
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 license under this chapter.
(2)
'Approved dialysis technician training program' means a board approved program
used to train patient care dialysis technicians including, but not limited to, a
board approved dialysis facility-sponsored training program or another state
approved program.
(3)
'Board' means the Georgia Board of Nursing established pursuant to Code Section
43-26-4.
(4)
'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.
(5)
'Dialysis facility' means an end stage renal disease facility licensed pursuant
to Chapter 44 of Title 31.
(6)
'Direct supervision' means initial and ongoing direction, procedural guidance,
observation and evaluation, and on-site presence of a registered professional
nurse or physician.
(7)
'License' 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
patient care dialysis technician.
(8)
'Licensee' means any person holding a license.
(9)
'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).
(10)
'Patient care dialysis technician' means a person who provides dialysis
care.
(11)
'Patient care dialysis technician trainee' means a person enrolled in an
approved dialysis technician training program.
(12)
'Person' means a natural person only.
(13)
'Physician' means an individual who is licensed to practice medicine under
Article 2 of Chapter 34 of this title.
(14)
'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)
No person may provide dialysis care as a patient care dialysis technician in
this state who is not licensed pursuant to this chapter. All applicants for a
license to practice as a patient care 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)
equivalency diploma or the equivalent thereof;
(3)
Has successfully completed an approved dialysis technician training
program;
(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 July 1, 2006, 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 will 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 patient care dialysis
technician.
(c)
An individual who has successfully completed an approved dialysis technician
training program on or before July 1, 2007, who was working on or before July 1,
2006, 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 will 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 patient
care dialysis technician.
(d)
The board may, upon receipt of a completed application and fee, issue a
temporary permit to practice as a patient care dialysis technician to an
applicant who has completed an approved dialysis technician training program and
who meets the qualifications established by the board. A temporary permit shall
not be renewable, and shall be effective for two years 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 patient care 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 ninety days unless the board revokes the
temporary endorsement prior to its expiration.
(f)
Application for a license under this Code section shall constitute consent for
performance of a criminal background check. Each applicant who submits an
application to the board for licensure 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.
43-30A-3.
(a)
Licenses issued under this chapter shall be renewed biennially prior to the
expiration of the license according to schedules and fees decided by the
board.
(b)
A license shall be renewed for any patient care 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 license to
complete board approved continuing education.
(c)
The voluntary surrender of a license or the failure to renew a license by the
end of an established renewal period shall have the same effect as revocation of
said license, subject to reinstatement at the discretion of the board. The
board may restore and reissue a license, 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 license that is not renewed by the end of the renewal period may not
thereafter be renewed, and the licensee must apply for reinstatement.
Applicants for reinstatement who have not been engaged in the active practice of
dialysis care as a patient care 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 licensing
examination. Upon completion of the program, an application may be made for
licensure 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 licensure
as patient care dialysis technicians in this state;
(2)
Establish minimum standards for the determination of the competency of
individuals who have been trained as patient care dialysis technicians;
(3)
Establish standards for approving and withdrawing approval of dialysis
technician training programs;
(4)
Establish minimum standards for the curricula and instructors used to train
individuals to act as patient care dialysis technicians in approved dialysis
technician training programs;
(5)
Issue, renew, refuse to renew, deny, suspend, and revoke licenses of patient
care dialysis technicians in this state or otherwise discipline patient care
dialysis technicians;
(6)
Determine the acts and practices that are allowed or prohibited for patient care
dialysis technicians, in accordance with the provisions of this
chapter;
(7)
Establish continuing education requirements for patient care dialysis
technicians;
(8)
Conduct investigations for the purpose of discovering violations of this chapter
or grounds for disciplining persons licensed 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 patient care dialysis technician may provide dialysis care when delegated to
him or her by a registered professional nurse if:
(1)
The patient care dialysis technician has a valid license issued pursuant to this
chapter;
(2)
The registered professional nurse considers the patient care dialysis technician
to be competent; and
(3)
The patient care 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 patient care 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 program.
43-30A-6.
A
patient care 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; 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 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 patient care dialysis technician
pursuant to the provisions of this chapter shall be known as a patient care
dialysis technician or dialysis technician and may use the initials 'P.C.D.T.'
or 'D.T.' after his or her name. On and after July 1, 2006, 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 patient care dialysis technician in this
state.
(b)
An individual enrolled in an approved dialysis technician training program shall
be known as a patient care dialysis technician trainee. A patient care dialysis
technician trainee shall adhere to the rules and regulations of the board for
patient care 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 Patient Care Dialysis Technician Advisory Council, which
shall advise the board on issues relating to the qualifications, standards for
training, competency determination of patient care dialysis technicians, and all
other matters relating to patient care dialysis technicians.
(b)
The council shall be appointed by the board and shall consist of six members as
follows:
(1)
One member of the board, who shall serve as chairperson of the
council;
(2)
Two patient care dialysis technicians;
(3)
Two registered professional nurses who regularly provide dialysis care and care
for patients who receive dialysis; and
(4)
One physician who regularly treats patients receiving dialysis
care.
(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 a dialysis technician training program
or aid or abet therein;
(2)
Perform services as a patient care 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 patient care 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 licensed 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 unlicensed person may, on behalf of
the public, bring an action to restrain and enjoin such unlicensed practice in
the superior court of the county where such unlicensed 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
patient care
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.