Texas · Verified November 2026
Best Sterile Processing Technician Programs in Texas
What Are the Best Sterile Processing Technician Programs in Texas?
Temple College in Temple ranks first among 15 schools offering sterile processing technician programs in Texas, with a score of 61 of 100. 17 sterile processing technician programs in Texas run at 15 schools, with the most in Houston, San Antonio and Austin. 15 include clinical hours, and 1 states the 400 hands-on hours that HSPA's CRCST, the central service technician certification, requires. The lowest published price is $900 at Del Mar College. Medical equipment preparers in Texas earn a median of $46,970 a year (BLS, May 2025).
- schools in Texas
- 15
- programs
- 17
- include clinical hours
- 15
- median published cost
- $1,960
- median pay (BLS May 2025)
- $46,970
Top Picks in Texas
| Pick | Program | Score |
|---|---|---|
| Best overall | Temple College courseTemple · 22 weeks · $2,234 · 80 clinical hours | 61 |
| Best for the CRCST's 400 hours | Lone Star College-Tomball courseTomball · 400 clinical hours | 58 |
| Lowest published cost | Del Mar College courseCorpus Christi · $900 | 60 |
| Fastest | Kilgore College courseKilgore · 8 weeks · $900 | 54 |
| Best online or hybrid | Austin Community College courseAustin · 13 weeks · $1,140 | 59 |
The 15 Best Sterile Processing Technician Programs in Texas, Ranked
How this list is ranked: highest score first. The score (out of 100) adds hands-on training (35), certification prep (25), published cost (25) and the school's federal track record in sterile processing (15), each from the school's own pages or IPEDS; a part a program has no figure for is left out and the rest are rescaled. One program per school; programs not admitting students are left out.
Temple College: Sterile Processing and Distribution TechnicianSterile Processing and Distribution Technician
61score of 100Best for having the certification exam paid for near Temple
Temple College (Temple, TX, public) runs this on campus non-credit course (5 months). The school publishes a price of $2,234 for the program (2026-27). Clinical: SRGT 1060 Clinical, 80 contact hours; students may be eligible for an optional 80-hour off-site externship Monday to Friday. Evening classes are offered.
- Weeks
- 225 months
- Hours
- 160instruction
- Clinical
- 80hours
- Cost
- $2,234published total, 2026-27
Includes- Clinicals
- Exam voucher
- Textbook
Prepares forDel Mar College: Sterile Processing TechnicianSterile Processing Technician
60score of 100Best for hybrid study near Corpus Christi
Del Mar College (Corpus Christi, TX, public) runs this hybrid non-credit course. The school publishes a price of $900 for the program. Clinical: Clinical rotations at local hospital sites.
- Hours
- 80instruction
- Clinical
- Yesincluded
- Cost
- $900published total
Includes- Clinicals
Prepares forAustin Community College: Sterile Processing (Certified Sterile Processing Technician)Sterile Processing (Certified Sterile Processing Technician)
59score of 100Best for hybrid study near Austin
Austin Community College (Austin, TX) runs this hybrid non-credit course (3 months, about 9 hours per week). The school publishes a price of $1,140 for the program (2026-27). Clinical: SRGT-1060 Sterile Processing Clinical at a local hospital.
- Weeks
- 133 months, about 9 hours per week
- Clinical
- Yesincluded
- Cost
- $1,140published total, 2026-27
Includes- Clinicals
Prepares forLone Star College-Tomball: Sterile Processing Technician Practicum TrackSterile Processing Technician Practicum Track
58score of 100Best for covering the CRCST's 400 hands-on hours near Tomball
Lone Star College-Tomball (Tomball, TX) runs this non-credit course. Clinical: 400-hour Sterile Processing Practicum, open after completing the Non-Practicum Certificate.
- Clinical
- 400hours, meets 400
Includes- Clinicals
Kilgore College: Sterile ProcessingSterile Processing
54score of 100Best for having the certification exam paid for near Kilgore
Kilgore College (Kilgore, TX, public) runs this on campus non-credit course. The school publishes a price of $900 for the program (2026-27). Clinical: Clinical training on Tuesdays and Wednesdays from week 4 at assigned facilities.
- Weeks
- 8
- Clinical
- Yesincluded
- Cost
- $900published total, 2026-27
Includes- Clinicals
- Exam voucher
Alamo Colleges District (Alamo Technical Institute): Certified Sterile Processing Technician (CSPDT)Certified Sterile Processing Technician (CSPDT)
53score of 100Best for having the certification exam paid for near San Antonio
Alamo Colleges District (Alamo Technical Institute) (San Antonio, TX) runs this hybrid non-credit course (5 months). The school publishes a price of $3,855 for the program. Clinical: 112-hour supervised externship in healthcare settings.
- Weeks
- 225 months
- Hours
- 264instruction
- Clinical
- 112hours
- Cost
- $3,855published total
Includes- Clinicals
- Exam voucher
Prepares forDallas College: Sterile Processing TechnicianSterile Processing Technician
52score of 100Best for hybrid study near Dallas
Dallas College (Dallas, TX, public) runs this hybrid non-credit course (About 4 months). The school publishes a price of $1,960 for the program (2026-27). Clinical: SRGT 1060 Sterile Processing Clinical, 120 hours.
- Weeks
- 17About 4 months
- Hours
- 216instruction
- Clinical
- 120hours
- Cost
- $1,960published total, 2026-27
Includes- Clinicals
Prepares forCollin College: Central Sterile Processing, Level 1 CertificateCentral Sterile Processing, Level 1 Certificate
50score of 100Best for hybrid study near McKinney
Collin College (McKinney, TX, public) runs this hybrid certificate (2 semesters). Clinical: HPRS 1561 on-site clinical capstone in the second (spring) semester.
- Weeks
- 322 semesters
- Credits
- 16
- Clinical
- Yesincluded
Includes- Clinicals
Prepares forConcorde Career College: Sterile Processing Technician DiplomaSterile Processing Technician Diploma
50score of 100Best for hybrid study near San Antonio
Concorde Career College (San Antonio, TX) runs this hybrid diploma. Clinical: 80-hour unpaid, in-person externship toward the 400-hour HSPA requirement; graduates complete the remaining 320 hours on their own.
- Weeks
- 22
- Hours
- 216instruction
- Clinical
- 80hours
Includes- Clinicals
Prepares forSouth Plains College: Certificate in Sterile Processing TechnicianCertificate in Sterile Processing Technician
50score of 100Best for hybrid study near Lubbock
South Plains College (Lubbock, TX) runs this hybrid certificate (2 semesters). Clinical: Experience in a sterile processing and central service setting. Evening classes are offered.
- Weeks
- 322 semesters
- Clinical
- Yesincluded
Includes- Clinicals
Prepares forTarrant County College District: Central Sterile Processing Certificate (Level 1)Central Sterile Processing Certificate (Level 1)
46score of 100Best for hybrid study near Fort Worth
Tarrant County College District (Fort Worth, TX, public) runs this hybrid certificate (2 semesters, full time). The school publishes a price of $1,184 for the program (2026-27). Clinical: Second-semester clinical, tentatively Mondays and Wednesdays 7 a.m; to 3 p.m; 240 total clinic hours arranged by the program director. The school reported 3 sterile processing awards for 2022-23 (IPEDS).
- Weeks
- 322 semesters, full time
- Credits
- 16
- Clinical
- 240hours
- Cost
- $1,184published total, 2026-27
Includes- Clinicals
Tarrant County College District certificate on the school's site
Fortis College: Sterile Processing TechnicianSterile Processing Technician
45score of 100Best for hybrid study near Houston
Fortis College (Houston, TX, private for-profit) runs this hybrid diploma (36 instructional weeks). The school publishes a price of $18,063 for the program (2025-26). Clinical: SPT190 Externship, 180 clock hours, unpaid, scheduled during typical office hours. The school reported 32 sterile processing awards for 2022-23 (IPEDS).
- Hours
- 780instruction
- Clinical
- 180hours
- Cost
- $18,063published total, 2025-26
Includes- Clinicals
- Textbook
Prepares forFortis Institute: Sterile Processing TechnicianSterile Processing Technician
44score of 100Best for hybrid study near Houston
Fortis Institute (Houston, TX, private for-profit) runs this hybrid diploma (36 instructional weeks). The school publishes a price of $18,063 for the program (2025-26). Clinical: Three externship courses: SPT180 (120 clock hours), SPT185 (180 clock hours) and SPT190 (120 clock hours). Evening classes are offered. The school reported 32 sterile processing awards for 2022-23 (IPEDS).
- Hours
- 900instruction
- Clinical
- Yesincluded
- Cost
- $18,063published total, 2025-26
Includes- Clinicals
- Textbook
Prepares forCollege of the Mainland: Sterile Processing Technician CertificateSterile Processing Technician Certificate
25score of 100Best for hands-on training near Texas City
College of the Mainland (Texas City, TX, public) runs this on campus non-credit course (2 to 4 months). Clinical: Clinicals and lab practice; all assigned clinical hours must be completed.
- Weeks
- 172 to 4 months
- Clinical
- Yesincluded
Includes- Clinicals
Houston Community College: Sterile Processing, C1Sterile Processing, C1
25score of 100Best for hybrid study near Houston
Houston Community College (Houston, TX, public) runs this on campus and hybrid certificate (2 semesters, full time). Clinical: Clinical rotations at partner healthcare institutions.
- Weeks
- 322 semesters, full time
- Credits
- 16
- Clinical
- Yesincluded
Includes- Clinicals
Admission details for the Houston Community College certificate
Sterile Processing Schools in Texas, Compared
| School | Best score | Credentials | Clinical | Lowest published cost | Awards, 2022-23 |
|---|---|---|---|---|---|
| Temple College: official siteTemple · Public | 61 | Non-credit course | 80 hr | $2,234 | |
| Del Mar College: official siteCorpus Christi · Public | 60 | Non-credit course | Included | $900 | |
| Austin Community College: official siteAustin | 59 | Non-credit course | Included | $1,140 | |
| Lone Star College-Tomball: official siteTomball | 58 | Non-credit course | 400 hr | ||
| Kilgore College: official siteKilgore · Public | 54 | Non-credit course | Included | $900 | |
| Alamo Colleges District (Alamo Technical Institute): official siteSan Antonio | 53 | Non-credit course | 112 hr | $3,855 | |
| Dallas College: official siteDallas · Public | 52 | Non-credit course | 120 hr | $1,960 | |
| Collin College: official siteMcKinney · Public | 50 | Certificate | Included | ||
| Concorde Career College: official siteSan Antonio | 50 | Diploma | 80 hr | ||
| South Plains College: official siteLubbock | 50 | Certificate | Included | ||
| Tarrant County College District: official siteFort Worth · Public | 46 | Certificate | 240 hr | $1,184 | 3 |
| Fortis College: official siteHouston · Private for-profit | 45 | Diploma | 180 hr | $18,063 | 32 |
| Fortis Institute: official siteHouston · Private for-profit | 44 | Diploma | Included | $18,063 | 32 |
| College of the Mainland: official siteTexas City · Public | 25 | Non-credit course | Included | ||
| Houston Community College: official siteHouston · Public | 25 | Certificate | Included |
From each school's own pages, reviewed November 2026. Best score: the school's highest-scoring program. Awards from IPEDS 2022-23 (CIP 51.1012) count credit certificates conferred, not graduates; non-credit courses aren't counted. Blank cells: the school's pages don't give that figure.
Every Sterile Processing Technician Program in Texas
- Non-credit course
Sterile Processing and Distribution Technician at Temple College: Length, Clinicals and Exam Prep
Temple College school profile and campuses · Temple
- Weeks
- 225 months
- Hours
- 160instruction
- Clinical
- 80hours
- Cost
- $2,234published total, 2026-27
- Clinicals
- Exam voucher
- Textbook
- Non-credit courseCRCST prep
Sterile Processing Technician at Del Mar College: Length, Clinicals and Exam Prep
Del Mar College school profile and campuses · Corpus Christi
- Hours
- 80instruction
- Clinical
- Yesincluded
- Cost
- $900published total
- Clinicals
- Non-credit course
Sterile Processing (Certified Sterile Processing Technician) at Austin Community College: Cost, Length and Clinical Hours
Austin Community College sterile processing profile · Austin
- Weeks
- 133 months, about 9 hours per week
- Clinical
- Yesincluded
- Cost
- $1,140published total, 2026-27
- Clinicals
- Non-credit course
- Non-credit course
Sterile Processing Technician Practicum Track at Lone Star College-Tomball: Schedule, Cost and What It Includes
Lone Star College-Tomball school facts and programs · Tomball
- Clinical
- 400hours, meets 400
- Clinicals
- Non-credit course
Sterile Processing at Kilgore College: Schedule, Cost and What It Includes
Kilgore College school profile and campuses · Kilgore
- Weeks
- 8
- Clinical
- Yesincluded
- Cost
- $900published total, 2026-27
- Clinicals
- Exam voucher
- Non-credit course
Certified Sterile Processing Technician (CSPDT) at Alamo Colleges District: Length, Clinicals and Exam Prep
Alamo Colleges District (Alamo Technical Institute) school profile and campuses · San Antonio
- Weeks
- 225 months
- Hours
- 264instruction
- Clinical
- 112hours
- Cost
- $3,855published total
- Clinicals
- Exam voucher
- Non-credit course
Sterile Processing Technician at Dallas College: Schedule, Cost and What It Includes
Dallas College school profile and campuses · Dallas
- Weeks
- 17About 4 months
- Hours
- 216instruction
- Clinical
- 120hours
- Cost
- $1,960published total, 2026-27
- Clinicals
- CertificateCRCST prep
Central Sterile Processing, Level 1 Certificate at Collin College: Cost, Length and Clinical Hours
Collin College school facts and programs · McKinney
- Weeks
- 322 semesters
- Credits
- 16
- Clinical
- Yesincluded
- Clinicals
- DiplomaCRCST prep
Sterile Processing Technician Diploma at Concorde Career College: Admission, Cost and Length
Concorde Career College programs at this school · San Antonio
- Weeks
- 22
- Hours
- 216instruction
- Clinical
- 80hours
- Clinicals
- CertificateCRCST prep
Certificate in Sterile Processing Technician at South Plains College: Schedule, Cost and What It Includes
South Plains College school profile and campuses · Lubbock
- Weeks
- 322 semesters
- Clinical
- Yesincluded
- Clinicals
- Certificate
Central Sterile Processing Certificate (Level 1) at Tarrant County College District: Cost, Length and Clinical Hours
Tarrant County College District school facts and programs · Fort Worth
- Weeks
- 322 semesters, full time
- Credits
- 16
- Clinical
- 240hours
- Cost
- $1,184published total, 2026-27
- Clinicals
- DiplomaCRCST prep
Sterile Processing Technician at Fortis College: Admission, Cost and Length
Fortis College school facts and programs · Houston
- Hours
- 780instruction
- Clinical
- 180hours
- Cost
- $18,063published total, 2025-26
- Clinicals
- Textbook
- DiplomaCRCST prep
Sterile Processing Technician at Fortis Institute: Admission, Cost and Length
Fortis Institute school facts and programs · Houston
- Hours
- 900instruction
- Clinical
- Yesincluded
- Cost
- $18,063published total, 2025-26
- Clinicals
- Textbook
- Non-credit course
Sterile Processing Technician Certificate at College of the Mainland: Admission, Cost and Length
College of the Mainland school profile and campuses · Texas City
- Weeks
- 172 to 4 months
- Clinical
- Yesincluded
- Clinicals
- Certificate
Sterile Processing, C1 at Houston Community College: Cost, Length and Clinical Hours
Houston Community College school facts and programs · Houston
- Weeks
- 322 semesters, full time
- Credits
- 16
- Clinical
- Yesincluded
- Clinicals
- CertificateCRCST prep
Sterile Processing Technician, O.S.A. at Houston Community College: Tuition, Hours and Certification
Houston Community College school facts and programs · Houston
- Weeks
- 322 semesters, full time
- Credits
- 13
Online and Hybrid Options for Texas Residents
Online coursework still leads to hands-on hours in a real department: the CRCST requires 400 of them. Hybrid programs here hold labs or clinicals in Texas.
| Program | Format | Length | Clinical | Cost |
|---|---|---|---|---|
| Kishwaukee College course: online program pageMalta, IL | Online | 16 weeks | $1,300published total, 2026-27 | |
| Herzing University-Madison diploma: online program pageMadison, WI | Online | 43 weeks | Included | $530per credit, 2026-27 |
| Lehman College course: online program pageBronx, NY | Online | 80 hours | Included | |
| Alamo Colleges District course: hybrid program pageSan Antonio, TX | Hybrid | 22 weeks | 112 hours | $3,855published total |
| Austin Community College course: hybrid program pageAustin, TX | Hybrid | 13 weeks | Included | $1,140published total, 2026-27 |
| Collin College certificate: hybrid program pageMcKinney, TX | Hybrid | 32 weeks | Included | |
| Concorde Career College diploma: hybrid program pageSan Antonio, TX | Hybrid | 22 weeks | 80 hours | |
| Dallas College course: hybrid program pageDallas, TX | Hybrid | 17 weeks | 120 hours | $1,960published total, 2026-27 |
| Del Mar College course: hybrid program pageCorpus Christi, TX | Hybrid | 80 hours | Included | $900published total |
| Fortis College diploma: hybrid program pageHouston, TX | Hybrid | 780 hours | 180 hours | $18,063published total, 2025-26 |
| Fortis Institute diploma: hybrid program pageHouston, TX | Hybrid | 900 hours | Included | $18,063published total, 2025-26 |
| Houston Community College certificate: hybrid program pageHouston, TX | Hybrid | 32 weeks | Included | |
| Houston Community College certificate: hybrid program pageHouston, TX | Hybrid | 32 weeks | ||
| South Plains College certificate: hybrid program pageLubbock, TX | Hybrid | 32 weeks | Included | |
| Tarrant County College District certificate: hybrid program pageFort Worth, TX | Hybrid | 32 weeks | 240 hours | $1,184published total, 2026-27 |
How We Rank Sterile Processing Programs in Texas
Every Texas program is scored out of 100 from figures on the school's own pages and federal data. A part a program has no figure for is left out and the others are rescaled, so a missing fact never counts against it.
| Part | Weight | What it measures |
|---|---|---|
| Hands-on training | 35 | Clinical hours the program states, measured against the 400 hands-on hours HSPA's CRCST requires. A program at 400 hours or more scores full marks; clinical time without stated hours scores 15 of 35. |
| Certification prep | 25 | 15 points when the program's page names the CRCST or CSPDT exam, and 10 more when the exam fee or a voucher is included. |
| Cost | 25 | The whole-program price the school publishes, ranked against every priced program. Per-credit rates are never multiplied out. |
| Track record | 15 | Sterile processing awards the school reported to the U.S. Department of Education for 2022-23 (IPEDS, CIP 51.1012), on a log scale that reaches full marks at 50. |
Sterile Processing Technician Certification in Texas
No Texas law in force requires sterile processing certification, so the requirement comes from employers. Many hospitals hire for, or ask new technicians to earn, HSPA's CRCST (the central service technician credential) or CBSPD's CSPDT. Full CRCST certification needs 400 hands-on hours in a sterile processing department; you can test first and hold provisional status while you log them.
How the CRCST and its 400 hours work · States that require certification by law
Sterile Processing Technician Salary in Texas
- bottom tenth
- $35,390
- median
- $46,970
- top tenth
- $69,950
- employed
- 4,520
Texas's median of $46,970 is below the national median of $47,700. Figures are annual wages for medical equipment preparers (SOC 31-9093), the BLS occupation for sterile processing technicians, OEWS May 2025.
Schools in States Near Texas
- Baton Rouge Community CollegeBaton Rouge, LA · certificate
- Delgado Community CollegeNew Orleans, LA · certificate
- Fletcher Technical Community CollegeSchriever, LA · certificate
- Southern University at ShreveportShreveport, LA · certificate
- Central New Mexico Community CollegeAlbuquerque, NM · certificate
Programs Near Texas Cities
- AlamoClosest programs and online options
- Allen3 programs within 50 miles
- AmarilloClosest programs and online options
- Arlington3 programs within 50 miles
- Austin1 program within 50 miles
- Baytown7 programs within 50 miles
- BeaumontClosest programs and online options
- Bedford3 programs within 50 miles
- BrownsvilleClosest programs and online options
- Carrollton3 programs within 50 miles
- Cedar Hill3 programs within 50 miles
- Cibolo2 programs within 50 miles
- Conroe6 programs within 50 miles
- Coppell3 programs within 50 miles
- Corpus Christi1 program within 50 miles
- Dallas3 programs within 50 miles
- Deer Park7 programs within 50 miles
- Denton3 programs within 50 miles
- El PasoClosest programs and online options
- Fairview3 programs within 50 miles
- Fort Worth3 programs within 50 miles
- Frisco3 programs within 50 miles
- Fulshear6 programs within 50 miles
- Grand Prairie3 programs within 50 miles
- HarlingenClosest programs and online options
- Horizon CityClosest programs and online options
- Houston7 programs within 50 miles
- Humble7 programs within 50 miles
- Irving3 programs within 50 miles
- Katy6 programs within 50 miles
- Kilgore1 program within 50 miles
- Killeen1 program within 50 miles
- Kyle1 program within 50 miles
- Lake Jackson4 programs within 50 miles
- Lavon2 programs within 50 miles
- League City5 programs within 50 miles
- Leon Valley2 programs within 50 miles
- Little Elm3 programs within 50 miles
- Lubbock1 program within 50 miles
- LufkinClosest programs and online options
- Manor1 program within 50 miles
- McAllenClosest programs and online options
- McKinney3 programs within 50 miles
- Melissa2 programs within 50 miles
- Mesquite3 programs within 50 miles
- MidlandClosest programs and online options
- Midlothian2 programs within 50 miles
- New Braunfels3 programs within 50 miles
- North Richland Hills3 programs within 50 miles
- OdessaClosest programs and online options
- ParisClosest programs and online options
- Pasadena7 programs within 50 miles
- Pearland7 programs within 50 miles
- Plano3 programs within 50 miles
- Port Arthur1 program within 50 miles
- Randolph AFB2 programs within 50 miles
- Richmond7 programs within 50 miles
- Rosenberg6 programs within 50 miles
- Round Rock2 programs within 50 miles
- San Antonio2 programs within 50 miles
- Sugar Land7 programs within 50 miles
- The Woodlands6 programs within 50 miles
- VictoriaClosest programs and online options
- Waco1 program within 50 miles
- Waxahachie2 programs within 50 miles
- Weatherford1 program within 50 miles
- Webster7 programs within 50 miles
- Wharton1 program within 50 miles
- Wichita FallsClosest programs and online options
- Wylie2 programs within 50 miles
Questions About Sterile Processing Technician Programs in Texas
What Is the Best Sterile Processing Technician Program in Texas?
Sterile Processing and Distribution Technician at Temple College ranks first with a score of 61 of 100, ahead of Del Mar College (60) and Austin Community College (59). The score weighs hands-on hours, certification prep, published cost and the school's federal track record. How the score works.
How Many Training Programs Does Texas Have?
17 at 15 schools, verified on each school's own site in November 2026. Houston (3), San Antonio (2), Austin (1) and Texas City (1) have the most.
Which Texas Programs Include Clinical Hours?
Alamo Colleges District, Austin Community College, College of the Mainland, Collin College, Concorde Career College and Dallas College and others include clinical or practicum time. HSPA's CRCST requires 400 hands-on hours for full certification. How the 400-hour requirement works.
How Much Does Training Cost in Texas?
Among the 9 Texas programs that publish a price for the whole program, cost runs from $900 to $18,063, with a median of $1,960.
How Much Do Sterile Processing Technicians Make in Texas?
The median for medical equipment preparers in Texas is $46,970 a year, with the bottom tenth earning $35,390 and the top tenth $69,950, across 4,520 jobs (BLS OEWS, May 2025). The national median is $47,700. Pay in every state.
Can Texas Residents Train Online?
Partly. 3 programs put all coursework online, and 12 Texas programs are hybrid, but the CRCST's 400 hands-on hours happen in a real sterile processing department. Online program rankings.
More Sterile Processing Rankings
- Best Programs NationwideEvery verified program, scored on hands-on hours, certification prep, cost and track record
- Online and Hybrid RankingsOnline and hybrid programs, and how each one gets you hands-on hours
- Most Affordable RankingsPrograms ranked by the whole-program price each school publishes
- With Externships RankingsPrograms with clinical hours in a hospital sterile processing department
- CRCST CertificationThe 400-hour requirement and the exam
- Certification Requirements by StateWhich states require it by law
- Best Programs in Louisiana5 schools
- Best Programs in New Mexico1 school
- Rankings by StateEvery state's ranking
Sources
- Official program pages of the 15 Texas schools listed, reviewed November 2026
- U.S. Department of Education, IPEDS completions 2022-23, CIP 51.1012
- U.S. Bureau of Labor Statistics, OEWS May 2025: Medical Equipment Preparers, state estimates