Clinic facilities

California rejects measure to change rules for dialysis clinics

For the third time in three straight elections, California voters rejected an election measure that would have forced major changes to the operations of dialysis clinics that provide lifesaving care to 80,000 people with kidney failure.

Proposition 29 failed after nearly 70% of Californians voted “no” on Tuesday night.

The measure would have required the presence of a doctor, nurse practitioner or medical assistant during treatment at the state’s 600 outpatient dialysis centers.

Dialysis clinic companies said under the mandate between two and three doctors would be needed at each facility, as most are open at least 16 hours a day. This would have created a financial burden that could lead to some clinics closing, making it harder for patients to find treatment, they said.

“Voters chose compassion and voted to protect patients,” said Oakland nephrologist Bryan Wong with the No on 29 campaign.

Proponents of Proposition 29 have insisted that dialysis patients need more in-depth care during their regular visits.

It was the third consecutive general election where Californians were asked to vote on dialysis regulations. And it was one of the most expensive ballot questions in state history. The two sides have collectively spent more than $90 million this year, according to state records.

All three measures have been backed by unions that represent healthcare workers.

Supporters said that despite the loss, they would continue to fight.

“We won’t stop until the dialysis industry is truly reformed – putting patients before profits,” the Yes on Prop campaign said. 29 in a press release.

To stay alive, dialysis patients typically undergo four-hour treatments at least three times a week, during which machines draw blood from the patient’s body, filter out toxins, and then reinfuse the blood, essentially temporarily performing the functions kidneys. but outside the body.

DaVita Inc. and Fresenius Medical Care — two of the nation’s largest for-profit dialysis providers — operate about three-quarters of clinics in California. There are an estimated 80,000 dialysis patients in the state.

Opponents of Proposition 29 said most clinics already provide high-quality care and are regulated by federal and state authorities. They also pointed out that all patients already have a nephrologist — a kidney specialist — who oversees their care, and that nephrologists also run every clinic in California. They said the moves were part of a tactic to pressure dialysis companies into letting workers unionize.

“This unnecessary requirement would cost hundreds of millions statewide, forcing dialysis clinics across California to curtail services or close, making it harder for patients to access their treatments — putting their lives at risk. “said the No on 29 campaign.

supporters says it’s a safety issue.

“Most dialysis patients are medically fragile and often have other health issues,” said a Yes campaign statement on Proposition 29. “Currently, when serious issues arise, most clinics simply call 911 , which puts patients at risk and contributes to emergency room overcrowding.”

In 2018, Proposition 8, backed by unions, sought to cap the profits of dialysis clinics and force them to invest more of their profits in patient care. Voters rejected the measure, but not before it became the costliest initiative of the 2018 ballot, generating more than $130 million in campaign spending — more than $111 million from dialysis companies to kill the initiative and approximately $19 million from the unions that supported it.

Two years later, voters rejected Proposition 23, which would have created terms similar to this year’s measure.