Californians to vote again on tougher dialysis clinic rules
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For the second time in 2 years, Californians will be asked in November to decide whether new regulations are needed for dialysis companies operating in the state.
Proposition 29, known as the Dialysis Clinic Requirement Initiative, is sponsored by the United Healthcare Workers West (UHW) union – the same organization that launched a similar ballot in the state in 2020, along with one in 2018 that called for limiting dialysis profits to 15% more than the cost of providing dialysis services.
Both measures were defeated by voters.
Ballot proposition
This year’s ballot proposition would require outpatient dialysis providers operating in California to do the following:
Have an on-site licensed medical professional, such as a nurse practitioner, physician assistant or nephrologist, supervise all outpatient dialysis treatments. The supervisor would need 6 months of relevant experience in kidney care. Telehealth would be allowed if there is a staffing shortage;
- Provide a list of physicians who have ownership interest of 5% or more at the facility where patients are receiving treatment;
- Report dialysis-related infections to the California Department of Public Health;
- Seek state approval in writing before closing or substantially reducing services at a dialysis facility; and
- Accept all patients to a facility regardless of the source of payment.
Proposition 29 differs slightly from the failed 2020 ballot initiative by allowing dialysis facilities to use a nurse practitioner or physician assistant with relevant experience, as well as a nephrologist, to be on-site during patient treatments.
Large providers
The ballot propositions from the UHW have been aimed at DaVita Kidney Care and Fresenius Kidney Care, which treat about 75% of the 80,000 patients who receive dialysis in California. UHW, which has unionized hospital workers in California, has said that it is interested in unionizing dialysis center workers in the state.
“There’s just so much improvement that can be made, and there’s plenty of resources in the industry to make those improvements,” David Miller, research director of SEIU-UHW, said in a statement about Proposition 29.
Dialysis providers are opposed to the measure and are spending millions of dollars to defeat it. An organization called “No on Prop 29: Stop Yet Another Dangerous Dialysis Proposition,” funded by Fresenius, DaVita and U.S. Renal Care, said in a press release that the ballot measure “will jeopardize access to care, worsen our health care provider shortage and increase health care costs for all Californians.
“Voters have rejected the two previous kidney dialysis ballot measures with good reason. They should do so again by voting no on Prop. 29,” according to the release.
DaVita has contributed close to $25 million toward organized opposition of Proposition 29 and Fresenius has donated close to $12 million. The measure is opposed by the California Medical Association and the American Nurses Association\California.
DaVita and Fresenius also spent $96.6 million to oppose Proposition 23, the failed 2020 ballot initiative, and close to $100 million to defeat Proposition 8 in 2018.
UHW gathered 1,018,730 signatures to get Proposition 29 approved for the November ballot. The California secretary of state approved 725,890 of those signatures, meeting the requirements for getting the initiative on the ballot.
References:
In Case You Missed It: San Jose Mercury News & East Bay Times Say Prop 29 “would make it harder for patients to receive critical care.” https://noprop29.com/2022/08/04/in-case-you-missed-it-san-jose-mercury-east-bay-times/. Published Aug. 4, 2022. Accessed Aug. 9, 2022.
https://ballotpedia.org/California_Proposition_29,_Dialysis_Clinic_Requirements_Initiative_(2022). Accessed Aug. 9, 2022.
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