BILL ANALYSIS

Senate Research Center	S.B. 1692
	By: Miles
	Health & Human Services
	4/12/2021
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Currently, certified dialysis patient care technicians are permitted to perform dialysis in a licensed end stage renal disease facility (ESRD) or dialysis centers so long as a registered nurse (RN) is providing direct supervision. However, Texas law does not allow certified dialysis technicians to work in nursing homes or skilled nursing facilities. This causes labor costs to be higher due to the need for registered nurses to perform the dialysis. These types of facilities may have multiple residents requiring hemodialysis at any given time, and allowing technicians to participate in their care, consistent with current RN and technician scope of practice and supervision rules, would make "at-home" dialysis treatment more available to them, rather than sending them outside their facility for dialysis.  

S.B. 1692 would address this inconsistency in law, by applying the existing ESRD rules regarding the use of dialysis technicians to the nursing home dialysis setting.  The bill would allow dialysis patient care technicians to work under direct supervision of a registered nurse, similar to the outpatient dialysis clinic setting.

As proposed, S.B. 1692 amends current law relating to the provision of home dialysis care by a dialysis technician.

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 2 of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Subchapter C, Chapter 251, Health and Safety Code, by adding Section 251.033, as follows:

Sec. 251.033.  PROVISION OF HOME DIALYSIS CARE. (a) Authorizes a dialysis technician to provide home dialysis care, including hemodialysis, only if:

(1) the care is provided under the direct supervision of a registered nurse who is employed by the same entity that employs the dialysis technician; and

(2)  the dialysis technician has complied with all rules of the executive commissioner of the Health and Human Services Commission (executive commissioner) on training and competency for dialysis technicians, and successfully completed orientation and skills education requirements equivalent to the requirements for a registered or licensed vocational nurse who provides home dialysis care.

(b) Defines "direct supervision."

SECTION 2. Requires the executive commissioner, as soon as practicable after the effective date of this Act, to adopt rules necessary to implement Section 251.033, Health and Safety Code, as added by this Act.

SECTION 3. Effective date: September 1, 2021.