Thank some Legislators!

The Colorado State bill for the certification of Hemodialysis Technicians - that so many of us fought so hard for back in 2007 - is in danger of being wiped out. The Sunset Review of the bill which reviews bills years after they have been passed occurred this last January 24th. We were very surprised when some committee members of the house Health and Environment committee objected to the bill. We strongly feel their objections didn’t have enough merit to kill the bill. We are happy to report the bill passed review by a 6-5 vote. However this bill that has worked so well, is now going to have to be voted on again by the legislature - we are very worried it could be a tough fight. Right now we are in the process of finding backers of the bill at the dialysis companies, Colorado Hospital Association, etc… We don’t even have a number for the bill yet. But we are encouraging you to write or call the Reps who are sponsoring and co-sponsoring this bill and express your support! It is hard to fight for something when you feel alone.

Sponsor: Representative Beth McCann, email:, ph. 303-866-2959

Co-sponsor: Representative John Kefalas, email:, ph. 303-866-4569
(Rep. Kefalas was also a sponsor of the 2007 bill)

Co-sponsor: Representative Dave Young, email, ph. 303-866-2929


  1. This state bill ties in tech certification with a dialysis clinic’s license. Tech certification is checked at the start of a clinic, during the annual license renewal, and during state inspections - other states don’t do this! California for example only checks every 3 years! We believe this may allow clinics to be less tempted to hire less qualified individuals.
  2. This bill is a backup – think of it as insurance – if the feds weaken or abolish current regulations.
  3. Abolishing this bill might encourage those who favor a less-qualified labor force to bring in a watered-down tech certification such as California’s CDC program
  4. Little fiscal impact: ($1,818 in 2010)
  5. DORA now recommends it (change from 2007):


  1. Duplicates the federal regulations. Answer: see above
  2. If home dialysis caregivers don’t require certification, why do techs? Answer: A caregiver specializes in one patient, a tech is required to help a group of people with different reasons for kidney disease - who have other illnesses many times. Also home dialysis patients are usually healthier than the general dialysis population.

And give a special thanks to the Chair of the Health and Environment committee, Representative Ken Summers, for going against the grain and siding with us! Representative Ken Summers,, ph. 303-866-2927

From Rep. McCann: “The bill has now been officially set for Feb. 21st at 1:30 in the Health committee which meets in the Legal Services Building on 14th between Sherman and Grant - south side of the Capitol.”

And another item, the number of the bill is HB1204

I hope this helps to ease your mind. I suspect CO legislators believe that the state law is not needed because in 2008 the federal Conditions for Coverage (dialysis regulation) was published and requires dialysis technicians (anyone who is unlicensed that provides direct care to patients) to meet certain education qualifications, have training that covers certain topics, and to pass a certification exam within 18 months of their hire date. The federal government is unlikely to loosen that regulation. It was included in the regulation because patients and staff advocated for this on the federal level to protect patients in all states, not just those that had passed state legislation. It took 30+ years for the regulation to be revised and published in 2008 and there is no effort at this time to revise them. Also, since Donald Berwick’s tenure at the Centers for Medicare & Medicaid Services there has been a strong movement to strengthen patient protections, not weaken them.

I hope the feds keep strengthening patient protections, but there is no guarantee.

Also we check tech certification annually when the license is renewed. Out in California, for example, I understand they are supposed to check every three years - a lot of times not even that with their budget problems! Speaking of California, I understand they have a watered-down tech certification test; instead of classes to help their techs pass, they made things easier. Many of us have seen the results of less stringent staff qualifications.

For the price, we get insurance against an easier test, and more incentive not to use less-qualified staff with more checking- looks like a good deal to me!

And I hope you would agree with this field of medicine’s history a little paranoia might be warranted. And thank you for your reply. If you have any other concerns, I sure would like to hear them before the hearing!

And I’ll mention I’ve been using Ghandhi’s Salt March as an example because he was being told there were bigger issues out there, that the issue of the British controlling salt was inconsequential. Some might feel what is happening in Colorado is inconsequential for the rest of the nation. But we are seeing the scenario where if this bill is knocked down, those who believe in a less-educated labor force just might be
bold enough to water-down tech certification here - then elsewhere. It has already happened in California with their CDC certification. I say we fight now, so we don’t have to fight later.

Inserted a new item 3 into the "Why"s in the top post

Here is a link to the bill, it doesn’t look like there is anything worriesome:

I should mention there are two other legislators who should be thanked for their yes vote at the sunset review meeting:

Representative Rhonda Fields, email:, ph. 303-866-3911

Representative Sue Schafer, email:, ph. 303-866-5522

And if anybody was curious about how the overall vote went, here is the link, then follow instructions below:

Click “Summaries by Committee”, then “House Health and Environment”, then “01/24/2012”

Amended directions:
The bill has now been officially set for Feb. 21st at 1:30 in the Health committee which meets in the Legal Services Building on 14th between Sherman and Grant – south side of the Capitol. (Hearing Room A)

It is the place at 225 E. 14th Street, NOT the place on Grant which google comes up with if you type in Legislative Services.

!!!we passed out of committee 12-0!!!

!!!we passed out of committee 12-0!!!

I’m hearing the Colorado house floor vote could be as soon as Monday!

So I wrote my new State Rep:

Representative DelGrosso,

I’m the father of a daughter with kidney disease (transplant now). I recently moved into your district, but have been involved in issues concerning kidney disease and kidney dialysis for about 12 years now. I was part of a group that got a Colorado state bill passed back in 2007 for the certification of hemodialysis technicians. It is up for a Sunset Review, and this last Tuesday the bill passed out of the Health and Environment committee by a 12-0 vote! The concerns at the earlier review have been answered and I will be very happy if the bill gains your vote.

Some of the reasons to vote for the bill are the following:

  1. Checks tech certification every year with the renewal of the license vs. other states like California which check every 3 years (if that). We are hearing clinic managers are less likely to try and use less-qualified staff.
  2. Infections like sepsis, a potentially lethal infection of the blood, took a significant dip in 2008-2009 when the state tech program was starting to be implemented - California continued to climb, their tech certification hadn’t been implemented yet.
  3. Stopping this bill could lead to a watered-down version of tech certification which California has with their CDC program - good only in California. I should note California appears to have higher rates of infections (sepsis was very notable!)
  4. A retired dialysis nurse testified about the case of someone who couldn’t pass the company test, but was allowed on the floor anyway jeopardizing the safety of patients. Had there been state or federal certification, she felt there was less of chance of this person getting out on the floor - or even being hired.
  5. A lady who had been on dialysis eleven years testified she met a tech who was allowed on the floor after two weeks! Would you trust a mechanic working on your brakes if they had just picked up a wrench two weeks ago?
  6. A current dialysis patient testified how he had seen staff short-handed. Would you want that already short-handed staff to be also poorly-trained?
  7. Low fiscal impact
  8. Clinic managers report less turn-over with certification.

In the years since the bill has been implemented I haven’t heard staff or patients complain about certification. I hope you will find enough reasons to support this bill!

Chris Schwab

Any Coloradoans out there might consider shooting off a quick email to their state reps!

We passed the Colorado state House 54-9!!! State Senate committee here we come!

Here is the audio of the state House hearing:

I am sure it has to do with cheapness with the you know who’s.

Unfortunately using less-qualified staff (then overworking them) and shortening treatments has been good for next quarter’s earnings in the past. I would like to see where the money went, since from the rising costs you would have thought care would be just great! But at least there are some signs things are getting better.

While we are waiting for a state Senate committee date, thought I would post the graphs we gave to the Colorado state legislators. Particularly we asked them to pay attention to the sepsis graph - a worrisome uptrend for an infection that can be fatal, but from 2008-2009 there was a significant dip for Colorado. Could it be because here in Colorado we were implementing our tech certification program?

We compared Colorado to California after reading about their 56% tech pass rate, compared to Colorado’s 80-93% pass rate.