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State of California—Health and Human Services Agency
California Department of Public Health

AFL 09-43
November 24, 2009

Certified Hemodialysis Technicians (CHTs)
End Stage Renal Disease Clinics (ESRDs)
Hemodialysis Training Programs

New CHT Certification Requirements

Senate Bill (SB) 112 (Orpeza) Chapter 559, Statutes of 2009 amended the Business and Professions Code (B&P) Code and established new California certification requirements for hemodialysis technicians.

This All Facilities Letter (AFL) provides a summary of those new requirements.

Current CHT certificate holders must comply with these requirements by April 15, 2010, to ensure continued certification. All current CHTs and any new/initial CHT applicants must complete and submit to the California Department of Public Health (CDPH) the attached application, "Certified Hemodialysis Technician Initial/Renewal Application" (HS 283F), indicating how each of the new requirements were met in order to be certified or to maintain active certification. Additionally, all CHTs whose certification will soon expire, must submit the completed HS 283F along with proof of successful completion of thirty (30) hours of continuing education/in-service in dialysis or general health care.

Effective October 11, 2009, to be certified by the California Department of Public Health (CDPH) as a Certified Hemodialysis Technician (CHT), a person shall meet all three (3) requirements:

  1. Have a high school diploma or equivalency or have greater than four (4) years experience in dialysis as of October 14, 2008; AND,
  2. Have successfully completed a CDPH approved hemodialysis training program. A person "successfully completes a training program" if he or she completes all classroom (didactic) portions of the program and demonstrates competency in the knowledge and skills provided by the program. The training program must include all of the following subjects, at a minimum:
    • Principles of dialysis.
    • Care of patients with kidney failure, including interpersonal skills.
    • Dialysis procedures and documentation, including initiation, proper cannulation techniques, monitoring, and termination of dialysis.
    • Possible complications of dialysis.
    • Water treatment and dialysate preparation.
    • Infection control.
    • Safety.
    • Dialyzer reprocessing, if applicable.

A person employed as a hemodialysis technician by a hemodialysis clinic or unit for more than two (2) years as of October 14, 2008, who does not have documentation of having successfully completed a training program, will be in compliance by doing both of the following:

    • Passing a written exam, offered by a hemodialysis clinic or unit, or a community or corporate-based training program; and
    • Passing a skills checklist through observation by a registered nurse; AND,

       3.  Have successfully accomplished either of the following:

    • Passed a standardized test approved by the CDPH. You may visit our website at for approved standardized test vendors as they
      become available; or
    • Passed an examination offered by a national commercially available certification program for hemodialysis technicians which is approved for this purpose by the Centers for Medicare and Medicaid Services (CMS).

Compliance with Business and Professions Code Sections 1247 through 1247.9 is required for continued certification as a hemodialysis technician in California.

All applications must be post marked by April 15, 2010, and sent to:

Attention: CHT
California Department of Public Health (CDPH)
Aide and Technician Certification Section (ATCS)
Licensing and Certification Program
MS 3301
P.O. Box 997416
Sacramento, CA 95899-7416

Or faxed to (916) 552-8785, Attention: CHT

The information in this AFL provides notification of SB 112's relative new certification requirements for hemodialysis technicians. Facilities, clinics, training programs and hemodialysis technicians should refer to the full text of the statute to ensure compliance with all applicable laws. The CDPH's failure to expressly notify facilities, clinics, training programs and individuals of legislative changes does not relieve these entities or individuals of their responsibility for following all laws and for being aware of all legislative changes.

If you have any questions, please contact Michael Egstad, Chief, CNA/HHA/CHT Certification Unit, at (916) 327-2445 or via email at



Original Signed by Kathleen Billingsley, R.N.

Kathleen Billingsley, R.N.
Deputy Director
Center for Health Care Quality


Attachment: HS 283F: Certified Hemodialysis Technician Initial/Renewal Application

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