California ballot measure would put stricter regulations on kidney dialysis clinics


Soraya Marashi


A proposal to impose more stringent regulations on kidney dialysis clinics will be placed on the November ballot this year for California voters. 


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Proposition 29 would task the California Department of Public Health (CDPH) with imposing requirements on each state dialysis center to have a physician, nurse practitioner, or physician assistant on-site during all times that dialysis patients are being treated at the center. This individual must have at least 6 months of experience providing care to dialysis patients and is responsible for ensuring patient safety and the provision of quality medical care. 

The proposition requires dialysis clinics to report infection-related data to CDPH and requires dialysis clinics to give patients a list of all owners of the clinic, as well as penalizes clinics that do not report required information. The proposition also requires dialysis clinics to notify and get consent from CDPH before closing down or reducing services. 

The proposition also prohibits dialysis clinics from refusing to treat a patient based on the payer of the treatment. The proposition stipulates that the payer can be the patient, a private entity, the patient’s health insurer, Medi-Cal, or Medicare.

This proposition is being brought forth after 2 previous unsuccessful attempts by the Service Employees International Union-United Healthcare Workers West labor union. 

According to supporters of the measure, this proposition will put important protections in place for dialysis patients.

“Because the lives of these fellow Californians are so dependent on dialysis done both safely and effectively, we must give our absolute support to the Protect the Lives of Dialysis Patients Act on the Nov. 8 ballot,” a group of the measure’s supporters stated on the California voter guide. “This initiative makes common-sense improvements to dialysis treatment to protect some of the most medically vulnerable Californians.”

Opponents of the measure argue that the proposition would put patients at risk by forcing clinics that do not meet each requirement to close down, as well as overcrowd emergency rooms. They say dialysis clinics are already subject to strict regulations, and that the unnecessary requirement for medical professionals to supervise these clinics would cost hundreds of millions every year, forcing clinics throughout the state to reduce services or shut down, making it harder for patients to access their treatments. 

“Proposition 29 would take thousands of doctors, physician assistants, and nurse practitioners away from hospitals and clinics—where they’re needed—and place them into administrative jobs at dialysis clinics where they aren’t,” said Marketa Houskova, Executive Director of the American Nurses Association California.

Some stakeholders have also argued that there hasn’t been a demonstrated need for increased staffing in dialysis centers and that the proposition isn’t merited.