Morgan Ransdell

KRS 314.137 requires the board to promulgate administrative regulations to regulate dialysis technicians. This administrative regulation establishes the requirements for credentialing dialysis technicians, initially, by renewal, and by reinstatement.

This regulation is necessary pursuant to KRS 314.137.

This regulation conforms to the content of KRS 314.137 by establishing requirements for credentialing dialysis technicians, initially, by renewal, and by reinstatement.

This regulation will assist in the effective administration of KRS 314.021, as amended effective June 30, 2021, and KRS 314.137, by establishing requirements for credentialing dialysis technicians, initially, by renewal, and by reinstatement.

This regulation will change the DT renewal cycle from two years to one year. In light of this change, the fee required in conjunction with a renewal application has been halved, resulting in no net renewal fee change. This regulation, in conjunction with 201 KAR 20:472, eliminates the DT Trainee role designation, and replaces it with an 18-month period of provisional licensure. During this period, all provisionally licensed DTs will be required to obtain certification from the Board of Nephrology Examiners Nursing Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), or the National Association of Nephrology Technicians/Technologists (NANT). The application for DT initial licensure and reinstatement has been edited and reformatted, as has the application for DT renewal.

The regulation is necessary for the oversight and credentialing of dialysis technicians, as required by KRS 314.021 (amendment effective June 30, 2021), and KRS 314.137.

The regulation conforms to the content of the authorizing statutes, KRS 314.131(1) and KRS 314.137, by establishing appropriate standards for DT credentialing, in order to protect and safeguard the health and safety of the citizens of the Commonwealth of Kentucky.

The regulation will assist in the effective administration of KRS 314.021 and KRS 314.137, by establishing standards for DT credentialing.

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 approved 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 20:476.

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, 201 KAR 20:474, and 201 KAR 20:476. DT training is on-the-job training, and employers are necessarily involved in administering training program requirements and overseeing the progression of the trainees from the DT Trainee role designation through provisional licensure, full initial licensure, and renewal of licensure. Employers of DTs will move to validating the credentials of their DT employees on an annual basis in late October and early November of each year, which will simplify oversight of DT renewal, as compared to the oversight required when the renewal cycle was a two-year period, and when DTs renewed their licenses throughout the calendar year, rather than during a fixed renewal period.

The regulation adds a requirement that all DTs obtain certification from the Board of Nephrology Examiners Nursing Technology (BONENT), the Nephrology Nursing Certification Commission (NNCC), or the National Association of Nephrology Technicians/Technologists (NANT), and any resultant cost will be borne by the provisionally licensed DT or their employer.

Compliance with 201 KAR 20:476 allows DT trainees to obtain full credential status and to lawfully maintain employment in the DT role.

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, with no additional costs specifically related to the implementation of 201 KAR 20:476.

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. No ongoing costs are anticipated specifically with regard to implementation of 201 KAR 20:476.

Fees paid by DTs and DT training programs are the primary source of funding for implementation of 201 KAR 20:476.

The regulation halves the fee required of renewing DTs, in light of the reduction of the renewal cycle from two years to one year, resulting in no net fee increase for renewing DTs. No DT fee increases are anticipated in the foreseeable future.

Reinstating DTs will notice a minor indirect fee increase, as the credential issued upon reinstatement will be valid for one year rather than two. This adjustment is warranted in light of increased personnel costs, as the reinstatement fee has only risen by ten dollars since the 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.

Tiering was not applied to 201 KAR 20:476, as the regulation treats all DT applicants similarly.

KRS 314.131 and KRS 314.137.

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, with no additional costs specifically related to the implementation of 201 KAR 20:476.

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. No ongoing costs are anticipated specifically with regard to implementation of 201 KAR 20:476.

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.

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.

No significant changes in agency revenues or expenditures are anticipated specifically with regard to the promulgation and implementation of 201 KAR 20:476.