Title 201 | Chapter 020 | Regulation 472


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BOARDS AND COMMISSIONS
Board of Nursing
(Amended After Comments)

201 KAR 20:472.Initial approval for dialysis technician training programs.

Section 1.

(1)

A training program that prepares an individual to become a credentialed dialysis technician shall be approved by the board of nursing.

(2)

(a)

A dialysis technician training program that seeks to be approved by the board shall file an Application for Dialysis Technician Training Program Approval and pay a fee of $2,000; and

(b)

The dialysis technician training program shall include with its application:

1.

A copy of the approval of certification for the dialysis technician training program's governing organization to operate a renal dialysis center from the Centers for Medicare and Medicaid Services (CMS); and

2.

The most recent site visit or survey report a statement of deficiencies and plan of correction, if applicable.

Section 2.

A training program that prepares an individual to become a dialysis technician which is located in this state shall meet the standards established by this administrative regulation. A training program that is located out of state shall not be subject to the approval process specified in this administrative regulation. However, an applicant who has completed an out of state training program may apply for a dialysis technician credential pursuant to 201 KAR 20:476, Section 1(1)(b).

Section 3.

Renal Dialysis Organization.

(1)

(a)

An organization which is licensed to operate a renal dialysis center pursuant to 902 KAR 20:018 shall assume full legal responsibility for the overall conduct of the dialysis technician training program.

(b)

The organization shall appoint a program administrator who shall be administratively responsible for the oversight of the dialysis technician training program on a twelve (12) month basis.

(c)

The organization shall submit to the board in writing the name of the registered nurse who has been designated to assume the administrative duties for the program, the date the person will assume the duties of program administrator, and a copy of his or her curriculum vitae.

(d)

The board shall be notified in writing of a change, vacancy, or pending vacancy, in the position of the program administrator within thirty (30) days of the dialysis technician training program's awareness of the change, vacancy, or pending vacancy.

(2)

The organization shall develop and implement a plan of organization and administration that clearly establishes the lines of authority, accountability, and responsibility for each dialysis technician training program location.

(3)

A system of official records and reports essential to the operation of the dialysis technician training program shall be maintained according to institutional policy. Provisions shall be made for the security and protection of records against loss and unauthorized distribution or use. The system of records shall include:

(a)

A policy that all records shall be maintained for at least five (5) years;

(b)

Provider name, dates of program offerings and sites of the training program;

(c)

Admission materials, grades received, and clinical performance records;

(d)

Trainee roster that includes name, date of birth, social security number, and program completion date;

(e)

Faculty records including:

1.

Validation of current licensures or credentials; and

2.

Performance evaluation for faculty employed more than one (1) year.

(f)

Systematic plan of evaluation;

(g)

Graduates of the dialysis technician training program; and

(h)

Administrative records and reports from accrediting agencies.

Section 4.

Program Administrator and Assistant Program Administrator.

(1)

The program administrator shall have the following qualifications:

(a)

1.

A minimum of a master's degree from an accredited college or university;

2.

A program administrator who currently does not hold a master's degree from an accredited college or university shall be required to obtain the degree within five (5) years of the effective date of this administrative regulation. The program administrator shall provide documentation that shows active and steady progression towards the degree;

3.

The board may waive this requirement upon a showing that the proposed program administrator is otherwise qualified.

(b)

A minimum of the equivalent of one (1) year of full time teaching experience;

(c)

At least two (2) years of experience in the care of a patient with end stage renal disease or who receives dialysis care;

(d)

Demonstrated experience or preparation in education that includes teaching adults, adult learning theory teaching methods, curriculum development, and curriculum evaluation. A program administrator without previous program administrator experience shall have a mentor assigned by the renal dialysis center and an educational development plan implemented. The assigned mentor shall have documented experience in program administration;

(e)

An active and unencumbered Kentucky registered nurse license, temporary work permit or multistate privilege; and

(f)

Current knowledge of requirements pertaining to the dialysis technician training program and credential as established in 201 KAR 20:472, 474, 476, and 478.

(2)

A dialysis technician training program may have an assistant program administrator at each location. An assistant program administrator shall have the following qualifications:

(a)

1.

A minimum of a baccalaureate degree in nursing;

2.

An assistant program administrator who currently does not hold a baccalaureate degree in nursing from an accredited college or university shall be required to obtain the degree within five (5) years of the effective date of this administrative regulation. The assistant program administrator shall provide documentation that shows active and steady progression towards the degree;

3.

The board may waive this requirement upon a showing that the proposed assistant program administrator is otherwise qualified.

(b)

A minimum of the equivalent of one (1) year of full time teaching experience;

(c)

At least two (2) years of experience in the care of a patient with end stage renal disease or who receives dialysis care;

(d)

Demonstrated experience or preparation in education that includes teaching adults, adult learning theory teaching methods, curriculum development, and curriculum evaluation. A program administrator without previous program administrator experience shall have a mentor assigned by the renal dialysis center and an educational development plan implemented. The assigned mentor shall have documented experience in program administration;

(e)

An active and unencumbered Kentucky registered nurse license, temporary work permit or multistate privilege; and

(f)

Current knowledge of requirements pertaining to the dialysis technician training program and credential as established in 201 KAR 20:472, 474, 476, and 478.

Section 5.

Faculty.

(1)

The faculty shall be adequate in number to implement the curriculum as determined by program outcomes, course objectives, the level of the student, and the educational technology utilized.

(2)

The faculty shall be approved by the program administrator and shall include didactic and clinical faculty.

(3)

The name, title and credential identifying the education and professional qualifications of each didactic and clinical faculty shall be provided to the board within thirty (30) days of hire. With each change in faculty, whether a new hire or a termination or retirement, an updated list of current faculty shall be provided to the board.

(4)

Didactic faculty.

(a)

Didactic faculty shall have a minimum of a baccalaureate degree from an accredited college or university.

1.

A faculty member who currently does not hold a baccalaureate degree from an accredited college or university shall be required to obtain the degree within five (5) years of the effective date of this administrative regulation. The program administrator shall provide documentation that shows active and steady progression towards the degree.

2.

The board may waive this requirement upon a showing that the faculty member is otherwise qualified.

(b)

Didactic faculty shall consist of multidisciplinary members with expertise in the subject matter.

(c)

Didactic faculty who hold a credential other than as a registered nurse shall document a minimum of two (2) years full time or equivalent experience in their profession or discipline.

(d)

Didactic faculty shall document preparation in educational activities in the area of teaching and learning principles for adult education, including curriculum development and implementation. The preparation shall be acquired through planned faculty in-service learning activities, continuing education offerings, or academic courses.

(e)

Didactic faculty hired without prior teaching experience shall have a mentor assigned and an educational development plan implemented.

(5)

Clinical faculty and preceptors.

(a)

Clinical faculty or a preceptor shall hold a current, unencumbered Kentucky nursing license, temporary work permit, or multistate privilege or a current, unencumbered Kentucky dialysis technician credential.

(b)

Clinical faculty or a preceptor shall have evidence of clinical competencies in end stage renal disease and dialysis care.

(c)

A preceptor who is a dialysis technician shall hold certification by one of the following dialysis technician certification organizations: the Board of Nephrology Examiners Nursing Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), or the National Association of Nephrology Technicians/Technologists (NANT).

(6)

There shall be documentation that the clinical faculty have been oriented to the course, program outcomes, student learning objectives, evaluation methods used by the faculty, and documented role expectations.

Section 6.

Standards for Training.

(1)

Philosophy, mission, and outcomes.

(a)

The philosophy, mission, and outcomes of the training program shall be clearly defined in writing by the faculty and shall be consistent with those of the Renal Dialysis Center.

(b)

The program outcomes shall be consistent with those required by the Centers for Medicare and Medicaid Services and the dialysis technician certification organizations listed in paragraph (2)(b) of this section.

(c)

The program shall conduct an evaluation to validate that identified program outcomes have been achieved and provide evidence of improvement based on an analysis of those results.

(d)

The training program shall include a minimum of 200 hours of didactic course work and 200 hours of direct patient contact. The didactic course work and direct patient contact shall be at least ten (10) weeks. The training program shall maintain a log of clinical hours for each student. It may also include an internship of at least 160 hours. The internship shall begin after two (2) unsuccessful attempts to pass the final examination. The internship shall be completed prior to a third final examination attempt. The internship shall be under the supervision of a registered nurse and shall include a preceptor.

(2)

The curricula of the program shall minimally include the following topics:

(a)

The legal and ethical aspects of practice including:

1.

The history of dialysis;

2.

The state and federal regulations governing dialysis including 201 KAR 20:478, 902 KAR 20:018, 907 KAR 1:400, and 42 C.F.R. 494.140;

3.

The resources available for pursuing personal and career development;

4.

The principles and legal aspects of documentation, communication and patient rights;

5.

The roles of the dialysis technician and other multidisciplinary team members;

6.

The principles related to patient safety; and

7.

The role of the board of nursing.

(b)

Anatomy and physiology applicable to renal function including:

1.

Renal anatomy;

2.

Organs of the urinary system and components of the nephron; and

3.

Functions of the normal kidney.

(c)

Diseases of the kidney including:

1.

Causes and complications of acute renal failure; and

2.

Causes and complications of chronic renal failure.

(d)

The psychosocial and physical needs of the end stage renal disease (ESRD) patient and family including:

1.

The impact on family and social systems;

2.

Coping mechanisms utilized;

3.

Rehabilitative needs;

4.

Community resources available;

5.

All aspects of renal diet and fluid restrictions; and

6.

Educational needs of patients receiving dialysis including the role of the technician and resources available.

(e)

The principles of pharmacology as related to ESRD including:

1.

Commonly used medications and their side effects;

2.

The principles of medication administration;

3.

The indications, dosage, action, and adverse effects of heparin, local anesthetics, and normal saline; and

4.

The accurate administration of heparin, local anesthetics and normal saline.

(f)

Aseptic techniques and established infection control practices including:

1.

Dialysis precautions as issued by the United States Centers for Disease Control; and

2.

Proper hand washing technique.

(g)

Principles of dialysis and dialysis treatment including:

1.

Definitions and terminology;

2.

Principles of osmosis, diffusion, ultrafiltration and fluid dynamic;

3.

The structure and function of various types of circulatory access sites and devices;

4.

The indications, advantages, disadvantages, and complications of internal arteriovenous (A/V) fistulas and A/V grafts, and central venous access devices;

5.

The various types of dialyzers;

6.

The benefits, risks and precautions associated with dialyzer reuse;

7.

The purpose and concept of water treatment;

8.

Knowledge and ability to manage and operate dialysis equipment;

9.

Knowledge and ability to appropriately monitor and collect data throughout the course of treatment;

10.

The etiology, signs and symptoms, prevention, intervention and treatment, and options for the most common complications;

11.

The knowledge and ability to safely initiate and discontinue treatment; and

12.

Routine laboratory tests, values and collection techniques.

(h)

Other treatment modalities for ESRD including:

1.

Renal transplantation; and

2.

Home dialysis options.

(3)

Implementation of the curriculum.

(a)

There shall be a written plan, including supporting rationale, which describes the organization and development of the curriculum.

(b)

The curriculum plan shall reflect the philosophy, mission, and outcomes of the program and shall prepare the student to meet the qualifications for certification as established by the Board of Nephrology Examiners Nursing Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), or the National Association of Nephrology Technicians/Technologists (NANT).

(c)

The dialysis technician training program shall have written measurable program outcomes that reflect the role of the dialysis technician graduate upon completion of the program.

(d)

The dialysis technician training program shall be logical and sequential, and shall demonstrate an increase in difficulty and complexity as the student progresses through the program.

(e)

A course syllabus shall be developed to include outcomes, planned instruction, learning activities, and method of evaluation.

(f)

The teaching methods and activities of both instructor and learner shall be specified. The activities shall be congruent with stated objectives and content shall reflect adult learning principles.

(g)

A copy of the course syllabus shall be on file in the dialysis technician training program office and shall be available to the board upon request.

(h)

Any proposed substantive changes to the dialysis technician training program syllabus shall be submitted to the board in writing at least two (2) months prior to implementation and shall not be implemented without approval from the board. A substantive change is any change in the philosophy, mission, or outcomes that results in a reorganization or reconceptualization of the entire curriculum.

(i)

Training may be offered through distance learning technologies. Training offered through the use of distance learning technologies shall be comparable to the training offered in a campus based program.

(4)

The curriculum shall require that the student hold a current Basic Life Support (BLS) certificate.

Section 7.

Students in Dialysis Technician Training Programs.

(1)

Preadmission requirements shall be stated and published in all publications utilized by the dialysis technician training program including recruitment materials.

(a)

Program information communicated by the program shall be accurate, complete, consistent, and publicly available.

(b)

Participation shall be made available for students in the development, implementation, and evaluation of the program.

(2)

Written dialysis technician training program student policies shall be accurate, clear, and consistently applied.

(3)

Upon admission to the training program, each student shall be advised in electronic or written format of policies pertaining to:

(a)

Prerequisites for admission, readmission or dismissal;

(b)

Evaluation methods that include the grading system;

(c)

Any fees or expenses associated with the training program and refund policies;

(d)

Health requirements and other standards as required by the renal dialysis center;

(e)

Student responsibilities;

(f)

A plan for emergency care while in the clinical setting; and

(g)

Program completion requirements.

(4)

A student enrolled in a training program is exempt from the credentialing requirement while enrolled. The student shall use the title dialysis technician (DT) trainee.

Section 8.

Program Completion Requirements.

(1)

Requirements for successful completion of the dialysis technician training program shall be clearly specified.

(2)

The requirements shall provide evidence of clinical competency through the use of evaluation methods and tools that measure the progression of the student's cognitive, affective, and psychomotor achievement of clinical outcomes based on published rubrics and sound rationale;

(3)

Students shall have sufficient opportunities in simulated or clinical settings to develop psychomotor skills essential for safe, effective practice.

(4)

A final examination shall be administered only during the final forty (40) hours of the first 400 hours of the training program.

(a)

The final examination shall be mapped to program outcomes and blueprinted to the examination content of one (1) of the certification organizations as listed in Section 6 (2)(b) of this administrative regulation.

(b)

Following successful completion of the final examination, the student may begin the internship.

(5)

The individual who successfully completes the training program, including the internship, shall receive a certificate of completion that documents the following:

(a)

Name of individual;

(b)

Title of training program, date of completion, and location;

(c)

Provider's name;

(d)

The program code number issued by the board: and

(e)

Name and signature of the program administrator or the assistant program administrator.

(6)

The program shall submit the List of Dialysis Technician Training Program Graduates within three (3) working days of the program completion date.

Section 9.

Incorporation by Reference.

(1)

The following materials are incorporated by reference:

(a)

"Application for Dialysis Technician Training Program Approval", 4/2021; and

(b)

"List of Dialysis Technician Training Program Graduates", 4/2021.

(2)

This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222-5172, Monday through Friday, 8 a.m. to 4:30 p.m. This material is also available on the board's Web site at https://kbn.ky.gov/legalopinions/Pages/laws.aspx.

JESSICA WILSON, President
APPROVED BY AGENCY: September 24, 2021
FILED WITH LRC: October 12, 2021 at 11:45 a.m.
CONTACT PERSON: Morgan Ransdell, Kentucky Board of Nursing, 312 Whittington Parkway, Suite 300, Louisville, Kentucky 40222, phone (502) 429-3339, email Morgan.Ransdell@ky.gov.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Morgan Ransdell
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the requirements for dialysis technician (“DT”) training programs.
(b) The necessity of this administrative regulation:
This regulation is necessary pursuant to KRS 314.137(2).
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This regulation conforms to the content of KRS 314.137(2) by establishing standards for DT training programs.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This regulation will assist in the effective administration of KRS 314.021, as amended effective June 30, 2021, and KRS 314.137(2), by establishing standards for DT training programs.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
The fee increases set forth in this amendment are addressed below. This regulation: heightens the qualification requirements for a DT training program administrator and for faculty; creates an assistant program director and preceptor roles, and sets minimum qualifications for the roles; assigns responsibility for the overall conduct of a DT training program to a renal dialysis organization licensed pursuant to 902 KAR 20:018; requires the submission to the Board of Centers for Medicaid Services (CMS) reports, surveys and correction plans; specifies an “in state” requirement as a prerequisite for approval, but clarifies that graduates of out-of-state DT training programs may obtain the credential in Kentucky pursuant to 201 KAR 20:476 Section 1(1)(b); specifies that the two hundred hour clinical component last a minimum of ten weeks and involve direct patient contact; sets new DT training program curriculum requirements including principles of dialysis, psychosocial and physical needs of end stage renal disease patients, related principles of pharmacology, and infection control; requires Board approval for substantive syllabus and curriculum changes; allows for didactic education to be accomplished via distance learning technologies; requires publication of pre-admission requirements; requires students to be certified in basic life support; defines the internship phase of DT training, which replaces the “DT applicant” phase and designation; modifies program completion requirements; and modifies the format of the material incorporated by reference within the regulation (DT training program application and list of DT training program graduates).
(b) The necessity of the amendment to this administrative regulation:
The regulation is necessary for the oversight of the practices and training of dialysis technicians, as required by KRS 314.021 (amendment effective June 30, 2021), and KRS 314.137(2).
(c) How the amendment conforms to the content of the authorizing statutes:
The regulation conforms to the content of the authorizing statutes, KRS 314.131(1) and KRS 314.137(2), by establishing appropriate standards for DT training programs in order to protect and safeguard the health and safety of the citizens of the Commonwealth of Kentucky.
(d) How the amendment will assist in the effective administration of the statutes:
The regulation will assist in the effective administration of KRS 314.021, KRS 314.131(1) and KRS 314.137(2), by establishing standards for DT training programs.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
As of April 8, 2021, there were 712 dialysis technicians with a current and active Kentucky DT credential. There are currently seven DT training programs that are located and licensed in Kentucky. The Kentucky Board of Nursing, the seven Kentucky DT training programs in the Commonwealth, and all renal dialysis organizations that provide dialysis services within the Commonwealth will all be affected by the repeal of 201 KAR 20:470 and the promulgation of 201 KAR 20:472. The two largest renal dialysis organizations in Kentucky are Davita, Inc., and Fresenius Medical Care North America. Students who are not currently certified in basic life support will be required to undergo training, and certain program administrators, faculty and preceptors who do not satisfy new minimum qualification requirements will have five years in which to meet the new requirements. Board staff is unaware of the number or identity of new renal dialysis organizations that will seek initial approval status following the effective date of 201 KAR 20:472.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Each existing DT training program and renal dialysis organization in Kentucky will need to evaluate their programmatic requirements and standards in light of 201 KAR 20:472, as the standards for program approval are also relevant to the evaluation of existing programs pursuant to 201 KAR 20:472 Section 2 and 201 KAR 20:474 Section 2(1). Any new DT training programs and renal dialysis organizations that seek to open in the Commonwealth will be guided by 201 KAR 20:472, and must meet the requirements set forth in the regulation. DT students who are not currently certified in basic life support will need to obtain such certification. Individual program administrators, faculty, and preceptors will require additional education within five years of the effective date of the regulation, if they do not currently satisfy new minimum qualification requirements.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
New DT training programs seeking approval status will have a $2000 application fee, which is an increase from the current $950 fee. The existing fee is not adequate to cover the staff cost associated with the provision of staff guidance to the DT training program, and the review of the program’s application and associated submissions, which requires approximately 30 hours of work, on average. The hourly salary inclusive of all benefits of the KBN employee who conducts program review is $69.98.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Compliance with 201 KAR 20:472 allows DT training programs to operate lawfully and avoid closure. Compliance with educational requirements allows DT program administrators, faculty and preceptors to perform those roles. Compliance with the basic life support certification requirement will allows students to remain enrolled in DT training programs.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
Implementation of 201 KAR 20:472 will result in a larger commitment of staff work hours in the review of materials submitted by renal dialysis organizations who seek to open a new program, and in collaboration with existing programs that seek guidance with regard to 201 KAR 20:472; however, it is impossible to calculate the precise cost of the additional demands upon staff that are anticipated. Agency costs associated with implementation of 201 KAR 20:472 are further addressed below in Section 3(c) of the Fiscal Note on State or Local Government.
(b) On a continuing basis:
Following implementation of 201 KAR 20:472 by all existing DT training programs in the Commonwealth, additional agency cost associated with 201 KAR 20:472 will be attributable entirely to the work hours associated with coordination with new renal dialysis organizations, and associated document review. Agency costs associated with the continued enforcement 201 KAR 20:472 of are further addressed below in Section 3(d) of the Fiscal Note on State or Local Government.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
Fees paid by DTs and DT training programs are the primary source of funding for implementation of 201 KAR 20:472.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
The increase in the initial application fee, from $950 to $2,000, is implemented to address an existing inequity, as the review of a renal dialysis organization application pursuant to 201 KAR 20:472, and associated submissions, requires approximately 30 hours of work, on average. The hourly salary, inclusive of all benefits, of the KBN employee who conducts program review is $69.98. The existing fee of $950 for new DT training programs was determined immediately following passage of HB 184 in 2001, which is when the Kentucky Board of Nursing was first assigned regulatory authority over DTs and DT training programs. In the twenty years since, the fee has remained static, while personnel costs have increased.
(8) State whether or not this administrative regulation established any fees or directly or indirectly increased any fees:
New DT training programs seeking approval status will have an application fee of $2,000, which is an increase from the current $950 fee.
(9) TIERING: Is tiering applied?
Tiering was not applied to 201 KAR 20:472, as the regulation treats all renal dialysis organizations similarly.

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT
(1) What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 314.131 and KRS 314.137.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
In FY2020, KBN revenues from receipts associated with the DT program were $15,106. For FY2021, revenues from receipts associated with the program are $7,973 to date. The precise amount of anticipated FY2022 DT program receipts is not known, but is expected to be approximately $15,000. The bulk of DT program receipts are attributable to DT renewal fees. These receipts are not consistent year to year, in light of the two-year DT renewal cycle. The fee increase for renal dialysis organizations seeking initial program approval will not have a significant impact on agency receipts, as there are only seven DT training programs in Kentucky currently, and the Board does not anticipate a significant number of new program applications.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
As the agency is not anticipating a significant number of new DT training program applications, the fee increase specified in 201 KAR 20:472 will not have a substantial impact on revenues.
(c) How much will it cost to administer this program for the first year?
The agency expended $26,446.02 for the DT program in FY2020. The FY2021 budget for the DT program is $26,600, and $25,331.69 has been expended associated with the DT program to date in the current fiscal year. Board staff anticipates a similar level of expenditure in FY2022.
(d) How much will it cost to administer this program for subsequent years?
Board staff anticipates that DT program expenditures will rise from a baseline cost of $26,600 in future years, as personnel costs rise; however, the precise impact of possible personnel cost increases have not been determined.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
In light of the small number of new DT training program applications that are anticipated in future years, there being only seven active programs in the state at this time, the anticipated fiscal impact of the fee increase specified in 201 KAR 20:472 is small, amounting to $1,050 for each such application.

7-Year Expiration: 6/21/2030

Last Updated: 12/8/2023


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