Legislative Affairs

One of the core principles of BONENT is that “better trained and educated practitioners leads to improved quality of care for dialysis patients.” Therefore, it is the position of BONENT to encourage the certification of all nephrology professionals.

The BONENT Legislative Committee works with various government organizations to require certification of those who provide dialysis care in all states by working:

  • With the legislative branch of state governments to pass laws that make certification essential to the practice of nephrology care; and,
  • To assist the executive branch of state governments in the implementation of the law through rule writing.

The Legislative Committee also mentors “grassroots” efforts to encourage elected officials to begin the process that leads to enacting new laws. The committee assists these groups in how to:

  • Contact and approach their elected officials;
  • Prepare to testify before appropriate committees; and,
  • Continue to press for reform.

The membership of BONENT (currently certified individuals) and its Regional Representatives are critical components in keeping BONENT legislative efforts up-to-date, so that the BONENT position on pending laws is expressed in a timely manner.

Representatives of BONENT are available to present — or to advise others on — presentation before federal or state legislative committees currently involved in the development of laws or the rules that may eventually be put into practice.

If, as a member, you hear of a change — or even rumors of a change — in your state, we ask that you contact the BONENT Legislative Committee Chair (Lyle Smith, BSN, CNN, CPDN; E-Mail: Lyle_BONENT@msn.com). Please, do not assume that BONENT has heard of all new efforts in your state legislature. It is through you that BONENT can be its most effective in promoting certification and licensure.

ESRD Federal Regulations

The ESRD Rules & Regulations approved by the Centers for Medicare & Medicaid Services (CMS) were submitted to the Office of the Federal Register for publication and published with comments in the Federal Register (4-15-08). It is currently a 116-page document (see CMS ESRD Final Rules). The rules that apply to certification start on page 20425.

Policy & Timeline

Here is the exact wording related to the timeline for Dialysis Technicians to have certification:

Patient care dialysis technicians (must) be certified under a state certification program or a national commercially available certification program as follows:

  • For newly-employed patient care technicians(certified) within 18 months of being hired as a dialysis patient care technician.If a newly hired PCT stops working before they have 18 months of experience, they can start working at another facility but the experience from their first job will be added to their new job. For example: A PCT works in Facility “A” for 7 months. Then, he/she has to move to another state. Once Facility “B” hires this person, he/she will have 11 months to become certified.
    • NOTE: If you are a patient care technician currently employed in dialysis and have a current BONENT certification, you will NOT need to re-take the exam. But, BONENT will not be able to verify your certification to employers or state boards unless your annual certification fees are up-to-date.

State Mandates for Certification

In several states, BONENT certification or state certification is required for technicians who perform certain patient care procedures. It is incumbent upon certification applicants to familiarize themselves with any state licensure requirements for the state in which they intend to be certified.


The BONENT certification is approved in California based on the California State Senate Bill No.112, SEC. 5, Section1247.61, #3c2, which states, “Successfully pass 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.”

State Board Contact Information.