Section 25-1.5-108 - Regulation of dialysis treatment clinics - training for hemodialysis technicians - state board of health rules - definitions - repeal(1) As used in this section, unless the context otherwise requires:(a) "Dialysis treatment clinic" means a health facility or a department or unit of a licensed hospital that is planned, organized, operated, and maintained to provide outpatient hemodialysis treatment or hemodialysis training for home use of hemodialysis equipment.(b) "End-stage renal disease" means the stage of renal impairment that appears irreversible and permanent and that requires a regular course of dialysis or a kidney transplant to maintain life.(c) "Hemodialysis technician" means a person who is not a physician or a licensed professional nurse and who provides dialysis care.(d) "National credentialing program" means any national program for credentialing or determining the competency of hemodialysis technicians that is recognized by the national association of nephrology technicians/technologists (NANT), or a successor association.(2) The state board of health shall adopt rules to establish a process to verify that persons performing the duties and functions of a hemodialysis technician at or for a dialysis treatment clinic have been credentialed by a national credentialing program. The verification process shall be part of the department's licensing of dialysis treatment clinics and part of each routine survey of licensed dialysis clinics conducted by the department. As part of the rules adopted pursuant to this section, the state board shall establish fees consistent with section 25-3-105 to be assessed by the department against dialysis treatment clinics to cover the department's administrative costs in implementing this section.(3)(a) A person shall not act as, or perform the duties and functions of, a hemodialysis technician unless the person has been credentialed by a national credentialing program and is under the supervision of a licensed physician or licensed professional nurse experienced or trained in dialysis treatment.(b) A dialysis treatment clinic licensed by the department shall not allow a person to perform the duties and functions of a hemodialysis technician at or for the dialysis treatment clinic if the person has not been credentialed by a national credentialing program.(c) Nothing in this subsection (3) prohibits: (I) A person from providing dialysis care to himself or herself or in-home, gratuitous dialysis care provided to a person by a friend or family member who does not represent himself or herself to be a hemodialysis technician;(II) A person participating in a hemodialysis technician training program from performing the duties and functions of a hemodialysis technician if: (A) The person is under the direct supervision of a physician, or a licensed professional nurse experienced or trained in dialysis treatment, who is on the premises and available for prompt consultation or treatment; and(B) The person receives his or her credentials from a national credentialing program within eighteen months after the date the person enrolled in the training program.(4) In connection with its regulation of dialysis treatment clinics pursuant to section 25-1.5-103(1)(a)(I) and 25-3-101(1) and rules adopted by the state board of health pursuant to subsection (2) of this section, on and after January 1, 2009, the department shall verify that a dialysis treatment clinic only employs hemodialysis technicians who have been credentialed by a national credentialing program. Compliance by a dialysis treatment clinic with this section shall be a condition of licensure by the department.(5) Each dialysis treatment clinic licensed by the department and operating in this state shall post a clear and unambiguous notice in a public location in the clinic specifying that the clinic is licensed, regulated, and subject to inspection by the Colorado department of public health and environment. The dialysis treatment clinic shall also inform consumers, either in the public notice required by this subsection (5) or in written materials provided to consumers, about the ability to provide feedback to the clinic and to the department, including the method by which consumers can provide feedback. The state board may adopt rules, as necessary, to specify the contents of the notice or written materials required by this subsection (5).(5.5) A dialysis treatment clinic shall not provide outpatient hemodialysis treatment to a non-end-stage renal disease patient without a referral for treatment from a board-certified or board-eligible nephrologist licensed as a physician in Colorado. When making the referral, the nephrologist and other licensed physicians who cared for the patient in the hospital shall use their professional judgment to determine when the patient no longer requires hospitalization and may receive outpatient dialysis.(6) This section is repealed, effective September 1, 2026. Before the repeal, this section is scheduled for review in accordance with section 24-34-104.Amended by 2019 Ch. 218,§ 2, eff. 8/2/2019.Amended by 2013 Ch. 53,§ 1, eff. 3/22/2013.L. 2007: Entire section added with relocations, p. 1623, § 1, effective July 1. L. 2012: (2), (3)(a), and (6) amended, (HB 12-1204), ch. 348, p. 348, § 1, effective July 1. L. 2013: (1)(a) amended and (5.5) added, (SB 13-046), ch. 178, p. 178, § 1, effective March 22. L. 2019: (1)(c), (2), (3)(a), (3)(b), IP(3)(c), (3)(c)(II)(A), and (6) amended, (SB 19-145), ch. 2241, p. 2241, § 2, effective August 2.