These additional costs are highly uncertain. The physician designs the dialysis treatment plan, including specific aspects such as frequency, duration, and associated medicines. SEIU-UHW West was the primary sponsor and contributed over $7.97 million to the support committee. To register to vote in California, you must be a resident of the state. In contrast, group and individual health insurers negotiate with clinic owners and operators to set rates. If CDPH approves the exception, the clinic can meet the requirement through telehealth. Government regulations largely decide what these rates are. You can find a full list of the opponents on noprop29.com. The clinic may request a hearing if it disagrees with the penalty. If federal data is insufficiently timely or complete, health advocates purposes would seem better served by working with the CDC to improve that data rather than imposing a second collection system in just one state un Prop. When a patient has kidney failure, the patients physician develops a plan of care, which could include a referral for dialysis. You can read more about the boards mission and its members at About The Times Editorial Board. This California farm kingdom holds a key, Six people, including mother and baby, killed in Tulare County; drug cartel suspected, These are the 101 best restaurants in Los Angeles, New Bay Area maps show hidden flood risk from sea level rise and groundwater, Editorial: 2022 brought more heat and pollution. It would also establish other state requirements on clinics including requiring them to disclose all physicians that have clinic ownership interests of 5% or more to their patients and requiring clinics to report infection data to the state. Improved transparency and accessibility of information can help patients make informed decisions for their care. 29 will help ensure they receive safe treatment in dialysis clinics under the care of a doctor or another highly trained clinician in case of emergencies, without risk of infection, and without discrimination. Some people qualify for both Medicare and Medi-Cal. We don't need another major government program or bureaucracy in California," he said. 29 is the third attempt in four years by labor organization Service Employees International Union-United Healthcare Workers West (SEIU-UHW West) to regulate dialysis clinics. Federal law requires a group insurer to be the main payer for dialysis treatment for the first 30 months of treatment. Even the labor-friendly Legislature has refusedto pass similar legislation. In recent years, the majority of clinics revenues exceed costs, while a smaller share of clinics operate at a loss. Requires physician, nurse practitioner, or physician assistant on site during treatment. SAN FRANCISCO (KGO) -- For the third time in three straight elections, California voters rejected a ballot measure that would have mandated major changes to the operations of dialysis clinics that provide life-saving care to 80,000 people with kidney failure. Supporters also say that greater financial disclosure is required so that researchers and the public can better assess the impact of physician ownership of clinics. Dialysis patients who are in kidney failure typically require several hours of dialysis three times a week. Stop yet another dangerous dialysis proposition. Federal courts | Help expand Ballotpedia's elections coverage - volunteer with us. Con: Opponents of Proposition 29 argue that it would shut down dialysis clinics and threaten the lives of 80,000 California patients who need dialysis to survive. Requires dialysis clinics to enact extra procedures and restrictions that increase patient oversight, including on-site medical practitioners, data reporting and financial transparency. This November is no different. July 26, 2022 . Proposition 29 requires a clinic to give patients a list of all physicians who own at least 5percent of the clinic. A clinic may ask CDPH to grant an exception from this requirement if there are not enough physicians, nurse practitioners, or physician assistants in the clinics area. It gives duties to CDPH to implement and administer the proposition, including adopting regulations within one year after the law takes effect. "[16], Jim Miller, a columnist for The Sacramento Bee, and Melanie Mason, a state politics journalist for the Los Angeles Times, both stated that the ballot initiative would also provide the SEIU-UHW West with leverage over legislation to enact new regulations on dialysis clinics in the California State Legislature. The committee reported nearly $86.4 million in contributions from DaVita Inc. and Fresenius Medical Care. Plus, kidney dialysis clinics, arts and music education in public schools and the flavored tobacco ban. July 26, 2022 mirrormmg. [2], In 2018, SEIU-UHW also sponsored Proposition 8, which was defeated with 59.9% of voters rejecting it. No program or agency should be specifically funded by fines and fees revenue. | Opponents, however, say this is just another effort by labor organizers to get the industry to unionize its workers. California has implemented an online voter registration system. 29 argue that patients have a higher chance of infection or death when a nurse practitioner, physician, or practitioner is not present and that requiring those medical professionals to be on staff would reduce the likelihood of death or infection. [19][20] Wherley said the union was taking a two-pronged approach, wanting to make "sure we have as many options available as possible. Government shouldnt be setting pay willy-nilly just for some workers in some facilities without at least considering or debating the repercussions. Firearms A NO vote on this measure means: Chronic dialysis clinics would not be required to have a physician, nurse practitioner, or physician assistant on-site during all patient treatment hours. } Dialysis Mimics What a Normal Kidney Does. Dialysis companies are so profitable that they can easily afford to make the proposed changes while still covering their operating costs. The PAC raised over $7.9 million from the SEIU-UHW West. Higher costs could result in clinics being forced to close, which would reduce access to dialysis care or cause higher costs to be passed along to patients. That amounts to more than $700 per UHW member that theyve wasted on these failed and reckless efforts. Voters will be asked to consider seven thorny policy proposals, from abortion to zero emission vehicles. [12],

CDPH must post each clinics infection information on the CDPH website, including the name of the clinics owner or operator. Proposition 29 requires clinics to report dialysis-related infection information to CDPH every three months. vehicle certificate of ownership issued by a governmental agency. 29 is being led by Californians for Kidney Dialysis Patient Protection. Most people with kidney failure receive dialysis at chronic dialysis clinics (clinics), although some may receive dialysis at hospitals or in their own homes. 8 in 2018 and Prop. Most of these other owners and operators have multiple clinics in California, while a small number own or operate a single clinic. The federal government could consider relaxing the prohibition of cash compensation for live kidney donors included in the National Organ Transplant Act (NOTA). Prop. Conflict between labor and dialysis businesses, recently scheduled reports processed by Ballotpedia, Californians for Kidney Dialysis Patient Protection, Stop Yet Another Dangerous Dialysis Proposition, Campaign finance requirements for California ballot measures, California Proposition 8, Limits on Dialysis Clinics' Revenue and Required Refunds Initiative (2018), California Proposition 23, Dialysis Clinic Requirements Initiative (2020), Laws governing the initiative process in California, Laws permitting noncitizens to vote in the United States, Click here for the California Secretary of State page to ensure you have the most current information, Petition drive deadlines and requirements, Changes in 2022 to laws governing the initiative process, https://ballotpedia.org/wiki/index.php?title=California_Proposition_29,_Dialysis_Clinic_Requirements_Initiative_(2022)&oldid=9009613, California 2022 ballot measures, certified, Initiated statute certified for the 2022 ballot, Conflicts in school board elections, 2021-2022, Special Congressional elections (2023-2024), 2022 Congressional Competitiveness Report, State Executive Competitiveness Report, 2022, State Legislative Competitiveness Report, 2022, Partisanship in 2022 United States local elections, Californians for Kidney Dialysis Patient Protection - Yes on 29, No on 29: Stop Yet Another Dangerous Dialysis Proposition. If a clinic or its owner or operator does not report required information or reports inaccurate information, CDPH may issue a penalty of up to $100,000 against the clinic. Click here for the California Secretary of State page to ensure you have the most current information. MORE | What's the difference between Prop 26 and Prop 27? 5737 Mesmer Ave. State approval of clinic closures would protect rural communities from losing access to needed dialysis services. This measure isnt really about patient care. [1], In 2020, 63.4% of voters rejected Proposition 23, which was also sponsored by SEIU-UHW. Ballotpedia lists the positions of and excerpts from editorials supporting or opposing ballot measures from the editorial boards of certain media outlets. A total of $13,374,336.75 was spent to collect the 623,212 valid signatures required to put this measure before voters, resulting in a total cost per required signature (CPRS) of $21.46. If they miss a treatment because of reduced hours or access, it could be fatal. margin-bottom: 5px !important; *The 2022 CalMatters Voter Guide is sponsored by the California State Library. Further, tying up physicians and other highly trained medical personnel at dialysis centers would worsen the shortage of healthcare workers across the state and increase waiting times at emergency rooms. Continue Current Operations, but With Lower Profits. Owners and operators might respond to Proposition 29 in one or more of the following ways: Negotiate Increased Rates With Payers. CDPH must specify which information clinics should report, and how and when to report the information. The California Democratic Party is in favor of the measure. [1] Legislative Analysts Office, Proposition 23, November 3, 2020, https://lao.ca.gov/BallotAnalysis/Proposition?number=23&year=2020. Fiscal Impact: Increased state and local government costs likely in the tens of millions of dollars annually. Voters correctly rejected the last two propositions, and they should do so a third time. } 23 in 2020 included similar requirements for dialysis clinics, and both failed when taken to voters. 29 are already in place. Revenues go toward K-12 schools, California Community Colleges, and healthcare. The word count for the ballot title is 17. This field is for validation purposes and should be left unchanged. margin-bottom: 10px; [13] On the ballot as Proposition 8, 59.9% of voters rejected the proposal. On November 3, 2020, 58.63% of voters in California voted in favor of Prop 22 and the law went into effect in mid-December of 2020. . }, The following is the argument in support of Proposition 29 found in the Official Voter Information Guide:[9], Stop Yet Another Dangerous Dialysis Proposition led the campaign in opposition to Proposition 29. These revenues consist of payments for dialysis from a few main sources, or payers: Medicare. [36], On October 10, 2015, California Governor Jerry Brown (D) signed into law Assembly Bill No. Requires Dialysis Clinics to Report Infection-Related Information to CDPH. For some owners and operators, the higher costs would reduce their profits, but they still could operate at current levels without closing clinics. Petitions are allowed to circulate for 180 days from the date the attorney general prepares the petition language. [2] Camryn Park, California Voters Will Weigh in on Dialysis Clinics for the Third Time in Four Years, San Francisco Chronicle, July 6, 2022. Clinics are already required to have a physician on staff overseeing patients care, and each patient has a kidney specialist directing their individual treatment. Counties will begin mailing vote-by-mail ballots. } Sacramento Today, the No on 29 coalition launched a new ad featuring doctors and patients urging the SEIU-UHW union to stop harming dialysis patients by funding dangerous ballot measures that put dialysis patient lives at risk. [3], Californians for Kidney Dialysis Patient Protection led the Kidney Patients Deserve Better campaign in support of Proposition 29. Instead, this measure would increase the cost of care to the detriment of patients. It operates separately from the newsroom. Should dialysis clinics be forced to close as a result of increased operating costs, vulnerable patients could lose access to life-saving treatments, sending them to emergency rooms to receive necessary procedures. The opponents say Proposition 29 would probably hurt patients more than help. California voters have seven propositions to vote on in the Nov. 8 general election. Californians for Kidney Dialysis Patient Protection led the Kidney Patients Deserve Better campaign in support of Proposition 29. State legislature | Proposition 29 Could Increase Health Care Costs for State and Local Governments. Peritoneal dialysis: Surgeons insert a catheter into the lining of a person's abdomen. The measure would have required a doctor, nurse practitioner or physicians' assistant to be present during treatment at the state's 600 outpatient dialysis facilities. Proposition 29 Increases Costs for Dialysis Clinics. The Los Angeles Times editorial board determines the positions of The Times as an institution. requiring clinics to obtain the CDPH's written consent before closing or substantially reducing services to patients. For people enrolled only in Medi-Cal, the Medi-Cal program alone pays for dialysis. Kidney disease happens when a persons kidneys do not work properly. NO Group and Individual Health Insurers Typically Pay Higher Rates for Dialysis Than Government Programs. Code of Federal Regulations Title 42, Chapter IV, Subchapter G, Part 494: Conditions for Coverage for End-Stage Renal Disease Facilities, last modified July 11, 2022. Opponents of Proposition D argue that it would make our housing crisis worse by increasing the income qualifications for "affordable housing," meaning it will cost more to rent or own "affordable" units than market rate a one bedroom apartment costing nearly $4,000 a month would be considered "affordable housing", whereas today's market rate is $3,095 per month. Some patients requiring treatment in costlier settings like hospitals if some clinics closed in response to the proposition. PRO Pro- $4 billion to $9 billion for schools and health care. On November 7, 2018, Californians for Kidney Dialysis Patient Protection announced that a similar ballot initiative would be filed for 2020. margin-bottom: 0 !important; [2] At the election on November 3, 2020, 63.4% of voters rejected the ballot initiative. Federal guidelines, however, consider the position to reflect about one-quarter of a full-time position. Californians will vote on propositions ranging from abortion to sports betting in the November general election. Cross Lunch Off Your List, Lunch Bunch delivers nutritious, creative and fun to eat meals for kids aged 3-10. . [8], .ballot-measure-endorsements p { The payer could be the patient, a private entity, the patients health insurer, Medi-Cal, or Medicare. U.S. Congress | Prop. Proposition 8 would have required dialysis clinics to issue refunds to patients or patients' payers for revenue above 115% of the costs of direct patient care and healthcare improvements. Another potential issue for Prop. Two private for-profit companiesDaVita, Inc. and Fresenius Medical Careown or operate nearly 75percent of licensed clinics in California. If Proposition 26 passes this November, another form of gambling would be permitted at horse racing tracks and tribal casinos in California: Sports betting. 29 would also prohibit clinics from refusing patient care based on the patients form of payment, whether the patient is an individual payer or whether the patients health insurer is Medi-Cal or Medicare. Ballotpedia features 393,611 encyclopedic articles written and curated by our professional staff of editors, writers, and researchers. Given how often patients need dialysis and how long treatments last, clinics often offer treatments six days per week and often are open outside of typical business operating hours. California voters are being asked to weigh new regulations for dialysis clinics for a third straight election. [6] Stephanie Hedt, Dialysis Costs the Healthcare System Three Times More in the Individual Market, USC Leonard D. Schaeffer Center for Health Policy & Economics, March 23, 2021. https://healthpolicy.usc.edu/article/dialysis-costs-the-healthcare-syst. School districts | Federal regulations do not require medical directors to spend a set amount of time at the clinic. The attorney general wrote the ballot language for this measure. The SEIU-UHW West sponsored Californians for Kidney Dialysis Patient Protection, which raised $18.94 million. The California Republican Party is against the measure. INITIATIVE STATUTE. Federal law generally makes people with kidney failure eligible for Medicare coverage regardless of age or disability status. This dangerous dialysis proposition would shut down dialysis clinics across California, putting 80,000 patients' lives at risk. na si. California Department of Public Health (CDPH) Licenses and Certifies Dialysis Clinics. But the most consequential provision is the requirement that a physician, nurse practitioner or physicians assistant with experience be on-site at all times at the roughly 650 dialysis centers in the state. California automatically registers eligible individuals to vote when they complete a driver's license, identification (ID) card, or change of address transaction through the Department of Motor Vehicles. Get browser notifications for breaking news, live events, and exclusive reporting. If there is a shortage of licensed healthcare workers available to monitor. Opponents view the measure as a further attempt to politically and financially weaken DaVita and Fresenius Medical Care and to unionize dialysis workers, and assert that the shortage of nephrologists in the state would leave clinics unable to meet the requirements of Prop. California does not require proof of citizenship for voter registration, although individuals who become U.S. citizens less than 15 days before an election must bring proof of citizenship to their county elections office to register to vote in that election.[39]. Its an assertion they cant back up with evidence. How to run for office | The PAC raised over $86.4 million in contributions. Since many dialysis patients are highly vulnerable, the requirement that a licensed medical professional is on-site during procedures appears to make sense. Washington, DC 20009 fx vd. nurse practitioner or physician assistant be on site during treatment. CDPH must specify which information clinics should report, and how and when to report the information. Its true that clinics often have to call for help if a kidney patient has an emergency, but that wont change even with extra staff because they are not emergency medical facilities. By Vittorio Nastasi November 22, 2022, Reason Foundation Copyright 2023 KGO-TV. The ballot measure was defeated . Further options, short of creating a market for kidney donations, could include offering tax credits for donors. Sean Fleming and Jonathan Everhart filed the ballot initiative on August 24, 2021. "Government can only take so much of a bite out of the economy.". [32], The initiative campaign submitted 1,018,730 raw signatures. In 2020, Gov. On the other hand, opponents question whether an on-site medical practitioner could effectively respond to a medical emergency given the lack of equipment at most dialysis centers. Read more. How to vote | Proposition 29 on the November ballot would set new requirements for all of the states dialysis centers, including forcing the clinics to hire unnecessary medical staff. This means the kidneys no longer work well enough for the person to live without a kidney transplant or ongoing treatment called dialysis. The SEUI-UHW says the 9-1-1 service calls from dialysis centers suggest the need for more staff, though they offer no data that the volume is higher than might be expected given that dialysis patients often have other serious health conditions. Gambling In California, about 80,000 patients receive dialysis treatments each month, most of which happen at one of the roughly 600 private clinics across the state. Read more endorsements at: latimes.com/endorsements. Certification allows clinics to receive payment from Medicare and Medi-Cal. Thats because the added cost of hiring unnecessary staff, which is estimated at several hundreds of thousands of dollars per year for each clinic, could force some centers to close or reduce hours.