2, 2005, pages 11521. Kidney Failure. [1] Legislative Analysts Office, Proposition 23, November 3, 2020, https://lao.ca.gov/BallotAnalysis/Proposition?number=23&year=2020. Thats the tension: theres enormous profitability, then you meet folks of enormous need, and you realize that some of that money should be diverted to patient care. What would this ballot initiative have required of dialysis clinics? 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. Abcarian: Did Donald Trump rape, then defame a well known advice columnist? .endorsements-header { Under federal rules, the physician must visit the patient during dialysis treatment at the clinic at least once per month. There are no recent or relevant statistics, surveys or studies that suggest a need for dialysis reform, nor is there substantial support for this proposition from dialysis professionals. margin-bottom: 10px; and the California Dialysis Council. Proposition 29 requires a clinic to give patients a list of all physicians who own at least 5percent of the clinic. The proposition also requires clinics to report to CDPH every three months persons who own at least 5percent of the clinic. For a third straight election, California voters are being asked to decide on a measure to regulate dialysis clinics across the state. It's almost identical to the 2020 measure that failed, but supporters say they did make some changes after receiving feedback from voters in 2020. In 2018, the campaign Californians for Kidney Dialysis Patient Protection supported a ballot initiative to require dialysis clinics to issue refunds to patients or patients' payers for revenue above 115% of the costs of direct patient care and healthcare improvements. Petitions are allowed to circulate for 180 days from the date the attorney general prepares the petition language. Doctors, nurses, and patients urge you to vote NO on Prop 29. Kidneys filter a person's blood, removing wastes, excess water, and surplus chemicals and nutrients. columns: 2; The federal government could consider relaxing the prohibition of cash compensation for live kidney donors included in the National Organ Transplant Act (NOTA). font-weight:bold; The Legislative Analyst Office estimates that Proposition 29 would cost Californias state and local governments taxpayerstens of millions of dollars annually. Dialysis centers would incur additional costs to implement the measure some of which they would be expected to pass along in the form of higher fees and charges to Californias Medi-Cal system and to health care plans for public sector employees and retirees. 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. Initiative Statute. ), First published on May 13, 2012 / 4:53 PM. The committee had raised $105.24 million, with $66.8 million from DaVita, Inc. and $29.8 million from Fresenius Medical Care.[12]. Opponents, however, say this is just another effort by labor organizers to get the industry to unionize its workers. Through October 27, 2022, the campaign had received over $23.2 million, including $9.7 million from R.J. Reynolds Tobacco Co. and $9.5 million from Philip Morris USA. vehicle certificate of ownership issued by a governmental agency. font-size:1.2em; A voter must be at least 18 years of age on Election Day. The Los Angeles Times editorial board determines the positions of The Times as an institution. Some patients requiring treatment in costlier settings like hospitals if some clinics closed in response to the proposition. YES July 26, 2022 . *The 2022 CalMatters Voter Guide is sponsored by the California State Library. Provide the CDPH with a list of physicians who have an ownership interest of 5% or more in the clinic. Jan 29, 2023. Dialysis patients who are in kidney failure typically require several hours of dialysis three times a week. In 2020, Gov. CDPH licenses clinics to operate in California. While our example was specifically drawn from a home in Los Angeles, a similar story is likely to play out in other areas of California. This proposition was placed on the ballot through the collection of signatures, and a simple majority (50% plus one vote) is required for it to pass. } Patient advocates, labor advocates and clinic operators could negotiate these changes through the normal legislative process. Residents can register to vote by visiting this website. And the trained nurses and technicians at dialysis clinics are just as equipped to deliver basic lifesaving care as doctors or nurse practitioners required under the proposition. They argue that California voters have overwhelmingly rejected similar dialysis propositions twice. 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. Proposition 29 requires each clinic to have, at its expense, at least one physician, nurse practitioner, or physician assistant on-site during all the hours patients receive treatments at that clinic. Requires Dialysis Clinics to Report Infection-Related Information to CDPH. Have at least one of the following on site during patient treatments: Legislative Analysts Office, Proposition 23, November 3, 2020. Public File for KBCW-TV / KBCW 44 Cable 12. Specifically, because dialysis is a dangerous procedure, it is essential that a trained clinician be nearby to react if something goes wrong. Ballotpedia includes editorials from newspapers and outlets based on: To submit a media editorial for inclusion, email editor@ballotpedia.org. The attorney general wrote the ballot language for this measure. .ballot-measure-endorsements ul { Life is stressful. California Proposition 29, the Dialysis Clinic Requirements Initiative, was on the ballot in California as an initiated state statute on November 8, 2022. Federal guidelines, however, consider the position to reflect about one-quarter of a full-time position. A variety of nonprofit organizations and for-profit companies own or operate the other clinics. The PAC raised over $7.9 million from the SEIU-UHW West. Prop. Read more endorsements at: latimes.com/endorsements. 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. Educational. Who supported and opposed Proposition 29? 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. "[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. 29 would require all clinics throughout the state to have an on-site physician during all hours of operation. The measure has a number of needless provisions, such as requiring infections to be reported to the state, though these data are being reported to the federal government now, and prohibiting dialysis centers from discriminating due to payer source, which even the proponents say is not a problem now. The labor union SEIU is a major supporter of this measure and supported the previous two measures. [1], In 2020, 63.4% of voters rejected Proposition 23, which was also sponsored by SEIU-UHW. State and local courts | California Proposition 29, Dialysis Clinic Requirements Initiative (2022) California Proposition 29, the Dialysis Clinic Requirements Initiative, was on the ballot in California as an initiated state statute on November 8, 2022. Here's what you need to know about the measure: App users: For a better experience, click here to view the full map in a new window. Improved transparency and accessibility of information can help patients make informed decisions for their care. See CA Ballot Propositions by CalMatters which provides 1-minute video summaries and other key information about the propositions. 8 is on the ballot is because they have a terrible business model and theyre gouging patients and insurers. width: 50%; Report dialysis-related infections to the California Department of Public Health (CDPH). Some people qualify for both Medicare and Medi-Cal. California voters will decide the fate of seven statewide propositions on Nov. 8. Its shameful that this union would continue to use vulnerable patients as pawns to advance their political agenda. [7], The fiscal impact statement was as follows:[6], Increased state and local government costs likely in the low tens of millions of dollars annually. The requirements to get initiated state statutes certified for the 2022 ballot: Signatures are first filed with local election officials, who determine the total number of signatures submitted. A "no" vote opposed this ballot initiative to require dialysis clinics to have at least one physician, nurse practitioner, or physician assistant while patients are being treated; report data on dialysis-related infections; and not discriminate against patients based on the source of payment for care. Currently, California relies primarily on federal regulations as the basis for its licensing program. Ballotpedia features 393,611 encyclopedic articles written and curated by our professional staff of editors, writers, and researchers. (State and local governments currently spend more than $65billion on Medi-Cal and employee and retiree health coverage.) Proposition 29 Could Increase Health Care Costs for State and Local Governments. The following list of accepted ID was current as of November 2022. CalMatters reporter Ana Ibarra explains Prop. 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. 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. This November is no different. If a clinic plans to close or substantially reduce its services, Proposition 29 requires the clinic or its owner or operator to notify CDPH in writing and obtain CDPHs written consent. To receive payments from Medicare, clinics must report specific dialysis-related infection information to the National Healthcare Safety Network at the federal Centers for Disease Control and Prevention. Dialysis copies what healthy kidneys do. On average, group and individual health insurers pay multiple times what government programs pay for a dialysis treatment. | [6] Prop. Clinics carry out the treatment. The ballot measure was defeated . In contrast, group and individual health insurers negotiate with clinic owners and operators to set rates. } Here's a breakdown of each proposition and what it entails. 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. Copyright 2023 KABC Television, LLC. 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. The proposition requires CDPH to adjust the annual licensing fee paid by clinics to cover these costs. An individual who is in line at the time polls close must be allowed to vote. As the verification process can take multiple months, the secretary of state provides suggested deadlines for ballot initiatives. If the random sample estimates that more than 110 percent of the required number of signatures are valid, the initiative is eligible for the ballot. The payer could be the patient, a private entity, the patients health insurer, Medi-Cal, or Medicare. Tobacco, What's on my ballot? The initiative was also opposed by the Republican Party of California, California Chamber of Commerce, and California Medical Association. 29 Dialysis Clinics: no. [12], The following were the top donors to the committee. 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. Los Angeles, CA 90230 Pros & Cons Unbiased explanation with arguments for and against . .footer-nav .dropIcon { display: none !important;} .footer-nav .sub-menu {display: none !important;}Paid for by No on 29: Stop Yet Another Dangerous Dialysis Proposition, sponsored by patients, doctors, nurses and dialysis providers. [3], Californians for Kidney Dialysis Patient Protection led the Kidney Patients Deserve Better campaign in support of Proposition 29. A YES vote on this measure means: Chronic dialysis clinics would be required to have a physician, nurse practitioner, or physician assistant on-site during all patient treatment hours. [12], The following table includes contribution and expenditure totals for the committee in opposition to the initiative.[12]. If less than 95 percent are estimated to be valid, the initiative does not make the ballot. Most Dialysis Patients Receive Treatment in Clinics. Firearms SEIU-UHW West was the primary sponsor and contributed over $7.97 million to the support committee. SUMMARY Put on the Ballot by Petition Signatures Requires physician, nurse practitioner, or physician assistant on site during treatment. It would also require increased disclosure of clinic ownership and dialysis-related infections. [1] Most of these private clinics are owned and operated by two companies, DaVita and Fresenius Medical Care. Federal Regulations Require a Medical Director at Each Dialysis Clinic. As noted earlier, an owner or operator might be able to support these clinics with its higher-earning clinics. Dialysis care is a highly complex issue and should not be left up to voters to decide. Federal regulations do not require medical directors to spend a set amount of time at the clinic. Instead, this measure would increase the cost of care to the detriment of patients. Overall, we assume that clinic owners and operators generally would: (1)be able to negotiate with some payers to receive higher payment rates to cover some of the new costs imposed by the proposition, particularly if many clinics were to close otherwise; (2)continue to operate some clinics with reduced income; and (3)close some clinics, with the consent of CDPH. Counties | This material may not be published, broadcast, rewritten, or redistributed. Opponents, organized as Patients and Caregivers to Protect Dialysis Patients, raised $111.48 million, with DaVita and Fresenius Medical Care North America providing 90% of the campaign's funds. 5737 Mesmer Ave. font-size:1.0em; Prop. Education and Health Care Tax, Prop 55 12-year extension to the 2012 tax income tax increases on those making $250,000 or more a year. Other people purchase health insurance individually. 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. . margin-top: 0 !important; Run/Walk for WeSPARK 5k/10k . This dangerous dialysis proposition would shut down dialysis clinics across California, putting 80,000 patients' lives at risk. Its an assertion they cant back up with evidence. Counties will begin mailing vote-by-mail ballots. Prop. 2012 CBS Broadcasting Inc. All Rights Reserved. Californias initiative system was created more than a hundred years ago to give citizens the power to make new laws when their elected leaders failed to do so. "We can prove absolutely through statistics, that when you increase the price of cigarettes, there's an immediate drop in the number of kids who will start smoking as a result.". You can hear KCBS In Depth, a weekly half-hour news interview, Saturdays at 5:30a.m. In the less likely event that a relatively large number of clinics would close due to this proposition, having obtained consent from CDPH, state and local governments could have additional costs in the short run. State executives | California voters are being asked to weigh new regulations for dialysis clinics for a third straight election. https://healthpolicy.usc.edu/article/dialysis-costs-the-healthcare-syst, specialized physician, such as a nephrologist, physician assistant with at least six months of experience with end-stage renal disease. Sean Fleming and Jonathan Everhart filed the ballot initiative on August 24, 2021. 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. Take a look at the latest stories and videos about the 2022 Midterm Elections here. Washington, DC 20009 How to run for office | Obtain the CDPHs written consent before closing or substantially reducing services to patients. Healthy kidneys remove waste and extra fluid from a persons blood. 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. For some owners and operators, the higher costs would reduce their profits, but they still could operate at current levels without closing clinics. KCBS Interviews Ray Durazo and Tom Del Beccaro: Ray Durazo is the former American Heart Association Western States Affiliate Board President and currently serves as California Advocacy Task Force Chair. Nor is there evidence that the current arrangement has harmed patients. The physician designs the dialysis treatment plan, including specific aspects such as frequency, duration, and associated medicines. How often a person needs hemodialysis treatment can vary. Business regulation If Proposition 26 passes this November, another form of gambling would be permitted at horse racing tracks and tribal casinos in California: Sports betting. California does not require voters to present photo identification. Prop 28 is supported by numerous famous California musicians, actors, and media industry executives. .sbtotaltotal { Gambling California's current cigarette tax is 87 cents per pack. The exception lasts for one year. The previous two efforts to regulate dialysis clinics failed, so what is different this time around? You can read more about the boards mission and its members at About The Times Editorial Board. Sacramento TheSanta Rosa Press Democratand the 11 papers that make up theSouthern California News Grouptold voters to reject Proposition 29 in recent editorials. }, .arguments-bm-widget { All Rights Reserved. Examples of photo identification include, but are not limited to, the following documents: driver's license or identification card of any state; identification card provided by a commercial establishment; Any of the following documents, provided that the document includes the name and address of the individual presenting it, and is dated since the date of the last general election: document issued by a governmental agency; sample ballot or other official elections document issued by a governmental, agency dated for the election in which the individual is providing it as proof, of residency or identity; voter notification card issued by a governmental agency; public housing identification card issued by a governmental agency; lease or rental statement or agreement issued by a governmental agency; student identification card issued by a governmental agency; tuition statement or bill issued by a governmental agency; insurance plan card or drug discount card issued by a governmental agency; discharge certificates, pardons, or other official documents issued to the individual by a governmen- tal agency in connection with the resolution of a criminal case, indictment, sentence, or other matter; public transportation authority senior citizen and disabled discount cards issued by a governmental agency; identification documents issued by governmental disability agencies; identification documents issued by government homeless shelters and other government temporary or transitional facilities; drug prescription issued by a government doctor or other governmental health care provider; (R) property tax statement issued by a governmental agency; vehicle registration issued by a governmental agency; or. Any penalties collected would be used by CDPH to implement and enforce laws concerning clinics. Proponents reported collecting 25% of the required signatures (155,803) on January 24, 2022. This is the third ballot measure since 2018 sponsored by UHW targeting dialysis providers. [2], Prop. The Stop the Dangerous & Costly Dialysis Proposition PAC was registered to oppose the ballot initiative. 29infection data is already collected at the federal level by the Centers for Disease Control and Preventions (CDCs) National Healthcare Safety Network (NHSN), so state collection would largely be redundant. Federal courts | Proposition 29 requires clinics to report dialysis-related infection information to CDPH every three months. Medi-Cal. Group and Individual Health Insurance. Requires dialysis clinics to enact extra procedures and restrictions that increase patient oversight, including on-site medical practitioners, data reporting and financial transparency. This amount is less than one-half of 1percent of the states total General Fund spending. } The yes campaign has www.yeson29.com. Over time, a person may develop kidney failure. Letters to the Editor: Rethinking L.A.'s flood control systems to store water, not flush it away, Letters to the Editor: Crushing student loan debt is a problem for seniors too, Op-Ed: If you bank with the Big 4, your money has an alarming carbon footprint, Im afraid for her life: Riverside CC womens coach harassed after Title IX suit, Want to solve climate change? This federally funded program provides health coverage to most people ages 65 and older and certain younger people who have disabilities. The measure would amend the state health code to require dialysis clinics to have a licensed medical professional on-site during treatment or in some cases available virtually during treatments. The California Democratic Party is in favor of the measure. [2], In 2018, SEIU-UHW also sponsored Proposition 8, which was defeated with 59.9% of voters rejecting it. .ballot-measure-endorsements td { width: 35% !important;} Requires clinics to: disclose physicians ownership interests; report infection data. Voters correctly rejected the last two propositions, and they should do so a third time. 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. [3], The committees in support or opposition of Proposition 8 had raised a combined $130.43 million, making the ballot measure the most expensive of 2018. "[18] Wherley, a spokesperson for the SEIU-UHW West, contended that dialysis workers "want these [initiative] reforms regardless of what happens with their union efforts. Close Some Clinics. NoProp29.com, No on 29Yet Another Dangerous Dialysis Proposition. Few Main Sources Pay for Dialysis. In recent years, the majority of clinics revenues exceed costs, while a smaller share of clinics operate at a loss. Ballot measures, Who represents me? Addressing the nephrology workforce shortage via a novel undergraduate pipeline program: the Kidney Disease Screening and Awareness Program (KDSAP) at 10 years, https://lao.ca.gov/BallotAnalysis/Proposition?number=23&year=2020, https://noprop29.com/wp-content/uploads/2022/07/Side-by-side.pdf, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-494. The proposed initiative, if approved by California's voters, would increase the tax on cigarettes in the state by $1 per pack. Prop. 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. No on Prop 31- Californians Against Prohibition is campaigning for the veto referendum to repeal SB 793. This individual must have at least six months of experience providing care to kidney patients and is responsible for patient safety and the provision and quality of medical care. Given the higher costs a clinic would face, some owners and operators may decide to seek consent from CDPH to close some of their clinics that are operating at a loss. Medicare pays for dialysis treatment for the majority of people on dialysis in California. Government shouldnt be setting pay willy-nilly just for some workers in some facilities without at least considering or debating the repercussions. Dialysis is recommended when a person's kidneys lose most of their function. Defining the Future of California Sports Betting: Prop 26 and Prop 27 . Previous SEIU-sponsored measures in 2018 and 2020 were defeated by large margins. Californians will vote on propositions ranging from abortion to sports betting in the November general election. font-weight:bold; Ballotpedia did not identify media editorial boards in support of the ballot measure. When a patient has kidney failure, the patients physician develops a plan of care, which could include a referral for dialysis. (202) 986-0916, Senior Managing Director, Transportation Policy, Photo 193235704 Saengsuriya Kanhajorn | Dreamstime.com, Innovators in Action: James Small, public safety director of Palmyra, Wisconsin, Florida must stop relying on taxation by citation, Properly designed impact fees could help Wakulla County accommodate population growth. Most people on dialysis undergo hemodialysis. California Department of Public Health (CDPH) Licenses and Certifies Dialysis Clinics. 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. NO 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. In presenting Pros and Cons we are nonpartisan, offering supporting and opposing arguments. Original story follows below. [35], To vote in California, an individual must be a U.S. citizen and California resident. [7] Laura C. Plantinga et al., Frequency of PatientPhysician Contact in Chronic Kidney Disease Care and Achievement of Clinical Performance Targets, International Journal for Quality in Health Care 17, no. !function(){"use strict";window.addEventListener("message",(function(e){if(void 0!==e.data["datawrapper-height"]){var t=document.querySelectorAll("iframe");for(var a in e.data["datawrapper-height"])for(var r=0;r Biomes O Plenty Seeds, Articles P