Dialysis Technician Training Schools

“The dialysis field is the most rewarding and emotionally challenging field I have ever worked in in my 27 years in healthcare. You get so attached to your patients that they become like family. Every day you treat them, you are improving their quality of life. You build bonds with them and their family as they go through something we may never truly understand.”

Ryan White, Southwest Regional VP of National Association of Nephrology Technicians/Technologists (NANT)

Of all the reasons to pursue a career in healthcare, the most noble is wanting to help others live a happier, healthier life. Dialysis technicians, also referred to as hemodialysis technicians or dialysis techs, make a difference in the lives of those with chronic kidney failure and end-stage renal disease. Patients experiencing kidney failure have two options: organ transplant or kidney dialysis.

To stay alive, the National Kidney Foundation states that kidney dialysis patients must undergo regular clinical dialysis treatments to remove waste, balance chemicals, and control blood pressure. Risk factors for kidney disease include advanced age and the incidence of type 2 diabetes, which are on the rise in the United States.

To start strong in this career, finding a reputable dialysis tech school that prepares graduates for entry-level careers is necessary. Dialysis training programs may offer classroom instruction or online courses. Clinical practicums allow students to work directly with patients under supervision to prepare for their new careers. Dialysis tech programs prepare graduates to take national or state-approved certification exams to be ready to work in a hospital, home care setting, or dialysis center. Because dialysis training can take as little as a semester, it is easy to choose a program and start working and earning quickly.

Careers in dialysis technician training have a long history of professional support from the Board of Nephrology Examiners Nursing Technology or BONENT. For the past 45 years, BONENT’s mission has been to “promote excellence in nursing and technology globally through credentialing exams that enhance the care of patients with kidney disease.” More than 7,500 nurses and dialysis technicians are certified by BONET worldwide, and members of this organization must recertify every four years by earning continuing education credits.

Keep reading to learn more about the growing career opportunities for dialysis technicians.

Ask the Experts

Shelba Jones

Shelba Jones, Preceptor III, Fresenius Kidney Care
Northeast Regional VP of National Association of Nephrology Technicians/Technologists (NANT)

Medical Technology Schools: What is something you wish the public understood about the dialysis technician role?

Jones: Dialysis is a very robust field and learning to navigate patients affected by kidney disease is important. Let us take a mini educational moment: dialysis is a type of treatment that helps the body remove extra fluids and waste products from your blood when the kidneys are not working.

From my perspective, it’s about having the passion and drive to motivate patients to determine the modality of choice that they prefer, whether in-center or home dialysis, which in turn prepares them for a kidney transplant.

Medical Technology Schools: What advice would you give to those considering a career as a dialysis technician?

Jones: The sky is the limit when you consider becoming a dialysis technician. The option of learning and collaborating with other technicians is so amazing. Dialysis is a craft when you master it, and there is a joy that comes along with it. Once you know your craft, you’re able to work with colleagues and patients on an amazing journey.

I have been a dialysis technician for the past 39 years and this has elevated my skills and critical thinking to another level. I am entrusted with the role of a preceptor lll, and in this role that I have gained with my years of dialysis, I can calmly educate other staff and patients with confidence.

Medical Technology Schools: What does the future of the field look like to you?

Jones: The future in dialysis is bright for patients and for dialysis technicians. The patient, for example, can dialyze themselves in the comfort of their homes, and with professional training as well as support, their mental health is more stable. Dialysis technicians are changing in the sense that they are more able to grow in their career and climb up the ladder.

I have become the northeast vice president of NANT, and this position provides education opportunities for myself and other technicians as well as the patients. Currently, I am on the North/South Division PCT Council, which helps keep technicians aware of policies and procedures. This council has allowed me to have a direct voice in senior leadership.

Ryan White

Ryan White, Preceptor III, Fresenius Kidney Care
Southwest Regional VP of National Association of Nephrology Technicians/Technologists (NANT)

Medical Technology Schools: What is something you wish the public understood about the dialysis technician role?

White: The dialysis field is the most rewarding and emotionally challenging field I have ever worked in in my 27 years in healthcare. You get so attached to your patients that they become like family. Every day you treat them, you are improving their quality of life. You build bonds with them and their family as they go through something we may never truly understand.

When we come to work and make them feel comfortable during treatment and let them know they are not going to have to do this alone, you may just be the reason they keep coming back to treatment. But the one thing you can never prepare for is the loss of a patient—that is the hardest part of this job.

Medical Technology Schools: What advice would you give to those considering a career as a dialysis technician?

White: Do it! You will not regret it. It is a physical job that challenges you daily, but at the end of the day, you can honestly say that you saved lives. We provide life-sustaining treatment to our patients every time they come into treatment.

Do not focus on speed. That will come with time. One of the most discouraging things I hear when training someone is that they are not as fast as the other staff, not realizing that the “other staff” have been doing this for over 20 years! It is more important to be accurate than fast.

I would also suggest coming into a clinic and shadowing someone for a couple of hours during turnover, which is our busiest time. This will help you determine if this is something that you are really interested in.

I have been in this field for over 19 years and it has changed my life. I have become very active on advisory councils. I am the current southwest VP of NANT. I am a co-editor of the Preceptor Pulse, which is a quarterly newsletter that goes out to all of our preceptors and is available to everyone.

There are so many opportunities to grow and give input to help change not only your co-workers’ lives but your patients’ lives as well. I started an initiative in my clinic where we have a movie and popcorn day, and have also started bingo in our clinic. You just need to have the drive. This career is absolutely what you make of it.

Medical Technology Schools: What does the future of the field look like to you?

White: The future of dialysis, to me, looks very advanced. We are already using ultrasounds to help cannulate Endo AVFs, and the MDs are listening more to us technicians as we spend the most time with patients. I have seen lots of growth with the home departments and how they are training. We have come a long way. Home patients used to need to have a partner, and now they can do it on their own.

There is no limit to how much more advanced this career can get. I remember reading an article not too long ago about an external wearable kidney that they were trying to develop. The sky is the limit, and I am so excited to see what the future holds.

Dialysis Technician Fast Facts
Projected Jobs Created16,800
Projected Job Growth5 percent
Average Salary$59,130
Low Salary$35,220
High Salary$84,670
Entry-Level EDU Certificate, associate’s, or bachelor’s degree
Sourced from BLS 2024

Dialysis Technician Degree & Certification Programs

To apply for proper certification as a dialysis technician, either through the Board of Nephrology Examiners Nursing and Technology (BONENT) or the Nephrology Nursing Certification Commission (NNCC), students must either have the requisite experience or complete an approved training program. Dialysis technician programs typically have very few admissions prerequisites. It is common to find a school that requires only a high school diploma or GED to enroll.

An approved program may take as little as one semester to complete. BONENT has approved the following dialysis technician schools to prepare students for work as dialysis technicians. A complete list of BONENT-approved dialysis tech schools is available on their website.

Read on to learn more about on-campus, on-the-job, and hybrid and online dialysis tech programs.

On-Campus Dialysis Technician Training Programs

American College Health & Sciences (ACHS)

At ACHS, students can earn a hemodialysis technician diploma which prepares them for entry-level positions in kidney dialysis healthcare facilities. Upon completing this program, students are ready to sit for national certification exams and work as integral parts of renal healthcare teams.

This program can be completed in 3.5 months and covers courses such as Principles of Hemodialysis; Basic Clinical Procedures; Diseases of the Human Body; Dialysis Delivery Systems; Fundamentals of Renal Nutrition; Dialysis Treatment of Renal Disease; and Dialysis Quality and Safety Procedures, among others. The program also includes an externship.

After earning this diploma, students must pass the BONET certified hemodialysis technician (CHT) exam to be eligible for employment.

  • Location: Margate, FL
  • Accreditation: Board of Nephrology Examiners Nursing and Technology (BONENT)-approved
  • Expected Time to Completion: 3.5 to seven months

Central Georgia Technical College (CGTC)

At CGTC, students interested in pursuing a career as a dialysis technician can enroll in the hemodialysis patient care specialist technical certificate, hemodialysis reuse/reprocessing technical certificate, or the hemodialysis technology diploma program.

Each program was explicitly designed with local dialysis centers to train students to enter the workforce. The diploma program requires 37 total credits, including general education courses, while the technical certificate programs require 16 or 17 credits, depending on which one is chosen.

Courses include structure and function of the human body; introduction to healthcare; introduction to computer literacy; hemodialysis patient care; a hemodialysis practicum; and a hemodialysis reuse/reprocess practicum.

  • Location: Warner Robins, GA
  • Accreditation: Southern Association of Colleges and Schools Commission on Colleges (SACSCOC); Board of Nephrology Examiners Nursing and Technology (BONENT)-approved
  • Expected Time to Completion: Five semesters

Bismarck State College

Bismarck State College offers a dialysis technician certificate providing students with the skills and knowledge needed to perform the required tasks and duties of dialysis technicians. Graduates will learn procedures for operating kidney dialysis machines, reprocessing and delivery systems, preparation of the dialyzer, patient monitoring, and equipment maintenance.

Interested students for this program must be certified nursing assistants and must have patience, manual dexterity, and a strong sense of responsibility. Applicants must submit proof of high school diploma or high school equivalency, proof of CPR certification, proof of nursing assistant certification, proof of immunizations dependent on clinical placement, and proof of English proficiency.

This 16-credit certificate includes courses such as nurse assistant training; medical terminology for allied health professionals; hemodialysis; and first aid and CPR.

  • Location: Bismarck, ND
  • Accreditation: Higher Learning Commission (HLC)
  • Expected Time to Completion: Less than a year

Midwestern Career College

Midwestern Career College offers a dialysis technician training program preparing students with the clinical knowledge and skills necessary to become dialysis technicians. During classroom and clinical training, students will learn about operating dialysis technology, providing effective and safe care to patients, identifying renal system failure complications, thinking critically, reporting on treatments and outcomes, and educating patients on their health.

This dialysis technician program allows for a 220-hour clinical externship at an MCC-affiliated site.

Topics covered in this program include anatomy of the kidney; principles of dialysis; dialysis procedures; drawing blood; basic chemistry of body fluids; and infection control.

  • Location: Chicago, IL
  • Accreditation: Commission of the Council on Occupational Education (COE); Board of Nephrology Examiners Nursing and Technology (BONENT)-approved
  • Expected Time to Completion: 40 weeks

On-the-Job Dialysis Technician Training Programs

In addition to formal classroom training, there are also dialysis centers that offer prospective dialysis technicians the opportunity to learn on the job. These types of programs may hire someone with little or no dialysis experience and allow them to earn hours working as a dialysis technician to qualify for the certification exam. Here are two examples of on-the-job dialysis technician training programs.

DaVita Healthcare Partners

DaVita is a national brand of dialysis centers dedicated to treating patients with chronic kidney failure and end-stage renal disease. DaVita offers incoming employees the opportunity to train as dialysis technicians while working in the dialysis setting, which can be an affordable solution for many prospective technicians. DaVita is an international company with several dialysis centers located throughout the United States.

  • Location: Locations throughout the U.S.
  • Accreditation: N/A
  • Expected Time to Completion: Varies

Fresenius Medical Care North America

With clinics located throughout the U.S., Fresenius Medical Care trains dialysis clinic patient care technicians on the job. Professionals in these positions learn essential dialysis tech skills while earning salaries and benefits such as healthcare, paid time off, and continuing education. The main responsibilities of dialysis techs in this program are to learn how to care for patients in the clinic and basic procedures and policies under the supervision of dialysis RNs.

  • Location: Locations throughout the US
  • Accreditation: N/A
  • Expected Time to Completion: Varies

SELECT * FROM `mts_online_offline_data` WHERE `page_url` = '/dialysis-technician' AND ( `table_type` = 'Offline' OR `table_type` = 'BOTH (Online + Offline)' ) ORDER BY `grads` DESC

List of Dialysis Technician Training Schools

Filter by state :
School City State Website grads
Central Georgia Technical College Warner Robins Georgia https://www.centralgatech.edu 31
National Polytechnic College Lakewood California https://npcollege.edu 29
Atlantic Technical College Coconut Creek Florida https://www.atlantictechnicalcollege.edu 25
Florida Panhandle Technical College Chipley Florida https://www.fptc.edu 16
Clover Park Technical College Lakewood Washington https://www.cptc.edu 16
Dorsey College-Wayne Wayne Michigan https://www.dorsey.edu 14
Midwestern Career College Chicago Illinois https://mccollege.edu 13
Community College of Rhode Island Warwick Rhode Island https://www.ccri.edu 11
Chemeketa Community College Salem Oregon https://www.chemeketa.edu 11
Delgado Community College New Orleans Louisiana https://www.dcc.edu 10
Dorsey College Madison Heights Michigan https://www.dorsey.edu 9
Orange Technical College-Winter Park Campus Winter Park Florida https://www.orangetechcollege.net/campuses/east_campus 9
Atlanta Technical College Atlanta Georgia https://atlantatech.edu 8
Blue Cliff College-Gulfport Gulfport Mississippi https://www.bluecliffcollege.edu 7
Richmond Community College Hamlet North Carolina https://richmondcc.edu 4
Southern University at Shreveport Shreveport Louisiana https://www.susla.edu 3
Southern Crescent Technical College Griffin Georgia https://www.sctech.edu 2
Healthcare Training Institute Kenner Louisiana http://healthcaretraininginstitutenola.net 1
Palm Beach Academy of Health & Beauty Lake Park Florida https://pbacademy.net 1
School Data from IPEDS (Sourced in September, 2023)

Hybrid & Online Dialysis Technician Training Programs

There are many courses required for a dialysis certification that can be feasibly transferred to an online format. For this reason, many schools have begun to introduce online training programs as a precursor to practical clinical experiences.

The following dialysis tech schools offer courses that can be completed entirely online.

Career Step, LLC

CareerStep is part of Carrus, one of the nation’s most trusted online healthcare training providers. It offers an online hemodialysis technician training program preparing students to take their choice of three industry-recognized certification exams. Upon completion, graduates will have the skills and knowledge needed to prepare, operate, and clean hemodialysis machines and monitor patients during appointments.

Students in this program will get an overview of renal anatomy, medical terminology, blood draw procedures, and more. They will develop a thorough knowledge of dialysis machines, their functions, and the proper procedures for use. Graduates will also be prepared for the midterm and final course exams, which will prepare them for the Certified Hemodialysis Technician (CHT) and Certified Clinical Hemodialysis Technician (CCHT) exams.

This program is divided into nine online training courses and a clinical externship experience providing students with the skills-based knowledge they need for becoming successful hemodialysis technicians. Topics include hemodialysis professional development; dialysis initiation and components; introduction to dialysis; and fundamentals of HIPAA, among others.

  • Location: Lehi, UT
  • Accreditation: Board of Nephrology Examiners Nursing and Technology (BONENT)-approved
  • Expected Time to Completion: 12 months

North Shore Community College

Located in Danvers, Massachusetts, North Shore Community College offers a dialysis technician certificate of completion. This non-credit program is available online and prepares graduates for entry-level dialysis tech positions. Skills taught include monitoring vital signs, administering local anesthetics, and CPR, and training patients for at-home dialysis treatment. Applicants must take a reading comprehension and mathematics assessment to qualify for admission.

  • Location: Danvers, MA
  • Accreditation: New England Commission of Higher Education (NECHE)
  • Expected Time to Completion: Six months or less

Tyler Junior College

The Dialysis Technician Online Certification Program offered by Tyler Junior College (TJC) is an innovative program that aims to create skilled healthcare professionals in the field of dialysis. The curriculum includes interactive learning modules, comprehensive exercises, labs, and 24/7 mentoring support, providing students with a well-rounded education experience.

The program extensively covers essential procedures such as the operation of kidney dialysis machines, preparation of dialyzer and delivery systems, equipment maintenance, vital signs monitoring, and administration of local anesthetics and drugs. It also provides training on dealing with complications, preparing patients for at-home dialysis treatment, and offering emotional support for self-care.

This program, which requires a high school diploma or GED, is designed to cover the key objectives of leading dialysis technician certification exams, ensuring that graduates are well-prepared for their careers.

Course topics covered include diabetes and hemodialysis; kidney transplantation; acute renal failure and dialysis; dietary regulation and medication problems relating to dialysis; routine aspects of hemodialysis; handling of hazardous materials; anticoagulation and heparin administration; composition of dialysate solution; and pediatric hemodialysis.

  • Location: Tyler, TX
  • Accreditation: Southern Association of Colleges and Schools Commission on Colleges (SACSCOC)
  • Expected Time to Completion: 12 months

Utopia Health Career Center

Based in Kissimmee, Florida, Utopia Health Career Center offers BONET-approved hemodialysis courses online: certified hemodialysis technologist/technician (CHT), certified hemodialysis nurse (CHN), and a hemodialysis online course for reinforcement or knowledge. The theory portion in the certified hemodialysis technician certificate program and the certified hemodialysis nurse certificate program are offered online during the first 15 weeks, while the clinical practice portion is offered in person.

The certified hemodialysis technician certificate program provides students with a solid education in the areas of dialysis and kidney failure and covers topics such as manifestation of renal failure; principles of hemodialysis; complications of renal failure; vascular accesses; chemistry as it pertains to dialysis patients; complications of dialysis; and dialyzer reprocessing.

The certified hemodialysis nurse certificate program covers topics such as vaccines for dialysis patients; dialysis medications; nursing interventions in dialysis; and the nursing process and patient assessments, among others.

The continuing education certificate in hemodialysis is offered entirely online.

  • Location: Kissimmee, FL
  • Accreditation: Board of Nephrology Examiners Nursing and Technology (BONENT)-approved
  • Expected Time to Completion: 12 months

Dialysis Technician Training - Core & Elective Courses

Although the fundamentals of dialysis technician training are the same, the curriculum for any single program will depend primarily on whether the program leads to a degree or a non-credit certificate. At a minimum, dialysis technician programs cover the basics of kidney function and the progression of kidney disease and end-stage renal failure. More in-depth programs may take the time to cover overall anatomy as well.

In addition, dialysis technicians must learn how to operate dialysis equipment and keep that equipment well-maintained. Basic hemodialysis technician curricula also include phlebotomy since accessing a vein to use the dialysis equipment is a necessary part of the job. Of course, as with any healthcare profession, dialysis technicians need to be sensitive to the needs of their patients. While a proper bedside manner can not always be taught, most curricula include some semblance of adequate patient care and communication.

In programs that lead to a degree, students may be required to take core educational classes in communications, composition, and mathematics. These programs are also where electives may come into play. Dialysis technician students can choose to take electives in the allied health field to further their expertise, but that is not a requirement for most electives.

Dialysis Technician Training Accreditation

Although many dialysis technician schools or programs are not accredited, it can be essential to look at institutional accreditation that addresses the school as a whole. Community colleges may be accredited by their local higher learning accreditation agency. For instance, schools located in midwestern states might have earned accreditation from the Higher Learning Commission.

Institutional Accreditation

The Council for Higher Education Accreditation (CHEA), an organization affiliated with the U.S. Department of Education, is the organization that oversees regional accrediting organizations. Although each institution’s accreditation process may vary, most rely on a self-study from the school and a site visit from an accreditation board member. This process usually covers faculty, facilities, and general practices of the school, ensuring that specific standards are met so that students have a practical learning experience.

Programmatic Accreditation

Dialysis programs may also have healthcare-specific accreditation, known as programmatic accreditation, from a source such as the Commission on Accreditation of Allied Health Education Programs (CAAHEP). Because the members of this accreditation agency have expertise in healthcare, they can better accredit specific programs, rather than entire schools. Prospective students may visit the CAAHEP website for more information on that organization's exact accreditation process and find accredited schools and programs.

Additionally, the Board of Nephrology Examiners Nursing Technology (BONENT) has approved several dialysis technician programs. The programs approved by BONENT may not necessarily meet the requirements of official CAAHEP accreditation since not all of them are offered by institutions of higher learning.

Still, the BONENT seal of approval does mean that these programs are designed to prepare students for the CHT exam upon graduation. A list of approved training programs is available on the BONENT website.

Career Outlook

Because the Bureau of Labor Statistics (BLS) does not track numbers that are unique to dialysis technicians, data sourced from that organization does not necessarily offer a complete picture of the career. Instead, the numbers available from the BLS track all clinical laboratory technologists and technicians as one group, which includes dialysis technicians and a wide range of other medical occupations.

The career outlook for all medical and clinical laboratory technicians is quite good, with a growth rate of 5 percent expected through 2032 (BLS 2023). There are many reasons for this faster-than-average growth, chief among them being the aging U.S. population, who will continue to need more medical attention as time goes on. For dialysis technicians specifically, the rising rate of type 2 diabetes is expected to contribute to increased demand since that disease is a significant risk factor for kidney disease, according to the National Kidney Foundation.

Indeed, according to the Centers for Disease Control (CDC), more than 38 million Americans have diabetes, approximately 98 million Americans have prediabetes, and more than 80 percent are unaware that they have it (CDC 2023).

As with other healthcare professions, the demand for hemodialysis technicians does not decrease or fluctuate with the economy, making it an attractive choice for those who do not want to take that type of career risk.

Career Facts Dialysis Technician
Related CareersClinical Laboratory Technologists and Technicians
Common Job TitlesDialysis Technician, Certified Hemodialysis Technologist, Certified Clinical Hemodialysis Technician (CCHT), Certified Hemodialysis Technician
Technology & EquipmentDialysis Machines, Computers, Medical and Productivity Software
Sourced from BLS 2024

How Much Do Dialysis Techs Make?

Salaries for dialysis techs vary based on education, experience, and cost of living. According to the BLS (May 2022), clinical laboratory technologists and technicians earned average annual salaries of $59,130 with the following percentiles:

  • 10th percentile: $35,220
  • 25th percentile: $40,440
  • 50th percentile (median): $57,380
  • 75th percentile: $74,920
  • 90th percentile: $84,670

As for the cost of living, the Missouri Economic Research and Information Center (MERIC) provides a cost of living index that reveals the least and most expensive states in the nation to live in. This data is critical to consider when weighing job offers in different locations. To this point, the top-paying states in the list above for clinical laboratory technologists and technicians are also in MERIC’s top ten most expensive places to live.

Licensing & Certification for Dialysis Technicians

Hemodialysis technicians must be licensed in order to work unsupervised. Even those programs that accept trainees without prior experience generally require those individuals to obtain certification as soon as they are qualified. There are two nationally recognized certification agencies as well as state licensing procedures in some states.

The Nephrology Nursing Certification Commission (NNCC) offers exams for a Certification for Clinical Hemodialysis Technician (CCHT) and for Certified Clinical Hemodialysis Technician Advanced (CCHT-A). The NNCC recommends that applicants have at least six months of work as a dialysis technician before sitting for the CCHT exam, and five years of clinical experience for the CCHT-A exam.

BONENT offers an exam for Certified Hemodialysis Technologist/Technician (CHT), which requires either 12 months of clinical experience or the satisfactory completion of an approved educational program before sitting for the exam. BONENT offers three certifications for technicians which can be taken in paper and pencil or computer-based formats.

The National Association of Nephrology Technicians/Technologists (NANT) is “dedicated to the education of dialysis professionals”. NANT offers continuing education resources needed to maintain credentials with BONENT and NNCC. NANT refers to dialysis techs by two titles: nephrology clinical technicians (NCT) for professionals who work directly with patients and nephrology biomedical technologists (NBT) for those who operate dialysis equipment.

Keep in mind that certifications are not necessarily required at a state level. For instance, in California, a dialysis technician must have earned his or her certification from either a national exam such as those mentioned above or from the California Dialysis Council exam. In addition, all technicians must be certified by the California Department of Public Health. Keep in mind this is only for the state of California.

Any prospective dialysis technician should be sure to check with their local department of health, board of nursing, or other certifying agency to determine the licensing requirements in their state.

Rachel Drummond, MEd
Rachel Drummond, MEd Writer

Rachel Drummond has contributed insightful articles to MedicalTechnologySchools.com since 2019, where she offers valuable advice and guidance for those pursuing careers in the healthcare field, combining her passion for education with her understanding of the critical role that healthcare professionals play in promoting physical and mental well-being.

Rachel is a writer, educator, and coach from Oregon. She has a master’s degree in education (MEd) and has over 15 years of experience teaching English, public speaking, and mindfulness to international audiences in the United States, Japan, and Spain. She writes about the mind-body benefits of contemplative movement practices like yoga on her blog, inviting people to prioritize their unique version of well-being and empowering everyone to live healthier and more balanced lives.

Matt Zbrog
Matt Zbrog Writer

Matt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about emerging topics in medical technology, particularly the modernization of the medical laboratory and the network effects of both health data management and health IT. In consultation with professors, practitioners, and professional associations, his writing and research are focused on learning from those who know the subject best. For MedicalTechnologySchools.com, he’s interviewed leaders and subject matter experts at the American Health Information Management Association (AHIMA), the American Society of Clinical Pathology (ASCP), and the Department of Health and Human Services (HHS).